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HomeMy WebLinkAbout1431 IYANNOUGH ROAD/RTE 132 UNIT BLDG A UNIT 1D - HYANNIS CONDOS ,1431 IYANNOUGH ROAD-Strawberry Hill Hyannis 3 Condominiums Commonwealth of Massachusetts oRLI-Da/ -66�4 6? Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �• 1431 lyannough Rd Units 1-7 Property Address C> Strawberry Hill Condo f,w; Owner Owner's Name ?; information is CenteryXe (,4 /1IS MA` 02632 03-15-2019 ;ate required for every ' • page. city/Town State Zip Code Date of Inspection Inspection results must be submitted on this forma Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information S� on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road Company Address Teaticket Ma. 02536 Cityrrown State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails - 9 spectoes Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <! Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: At the time of the inspection of this 14 Bedroom condo building I did not see any thing that meets a falure condition according to the State and The Barnstable Health Dept. code. + 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts -. Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 i Commonwealth of Massachusetts z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. i ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7. Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static Liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow ❑ ®. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 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 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) 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 CA. 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 ❑ El the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form eb Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for a❑inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? Z ❑ 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .� 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 14 Number of bedrooms (actual): 14 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1540 plus GPD Description: i Number of current residents: apx. 12 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail Water reading attached Sump pump? El Yes ® No Last date of occupancy: occupiedDate t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Last pumped in Dec. 2018 per management Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts �n (t�: Title 5 Official Inspection Form Il h Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code. Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract I ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): " Depth below grade: 48feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain):. Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): water was flowing at the time of the inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . !% 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 36"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: 2000 gallon Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 58" Scum thickness 2" 5" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank is pumped once a year. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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.): I i Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 01. 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.): At the time of the inspection there was no visible signs of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 I Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ............ 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 2 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the liquid level was four plus feet below the invert in one.of the leaching pits. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert i Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form h Subsurface Sewage Disposal System Form- Not for Voluntary Assessments V 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 i Commonwealth of Massachusetts ip Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 5 f(f&L -I—T Grp.1 a t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form y Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20 plus feetfeet 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: I augered a hole at a lower elevation and I shot it with a transit. i Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 i Commonwealth of Massachusetts ,F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 1-7 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included l ��iUy't d�F St� S. 20 C /vo N zv t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Date: 3/14/2019 Meter Reading History Page 1 of 5 Customer# 602583-1 Premise#602583 Service:Water-Regular Metered METER REA !N TRANSACTION INFO 2 2 - �. + Read Date Sequence Meter# Face Sort S Read Code Reading Co um ion Skip Count Tvoe Code Status Bill Period Trans Date 02/26/2019 01 88226380 0 31030290 1 2,190.00 22.00 0 REG A R 201902 02/28/2019 �. 01/28/2019 01 88226380 0 31030290 1 2,168.00 31.00 0 REG A R 201901 01/30/2019 T O` 12/21/2018 1 0I 01 88226380 0 31030290 1 2,137.00 22.00 0 REG A R 201812 12/30/2018 11/26/2018 01 B8226380 0 31030290 1 2,115.00 26.00 0 REG A R 201811 11/28/2018 G ' U 10/30/2018 01 88226380 0 31030290 1 2,089.00 26.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226380 0 31030290 1 2,063.00 39.00 0 REG A R 201809 10/04/2018 08122/2018 01 88226380 0 31030290 1 2,024.00 29.00 0 REG A R 201808 08/27/2018 23 0(i t 07/23/2018 ��, 01 88226380 0 31030290 1 1,995.00 42.00 0 REG A R 201807 07/26/2018 06/13/2018 01 88226380 0 31030290 1 1,953.00 24.00 0 REG A R 201806 06/18/2018 05/16/2018 01 88226380 0 31030290 1 1,929.00 23.00 0 REG A R 201805 05/28/2018 04/17/2018 01 88226380 0 31030290 1 1,906.00 29.00 0 REG A R 201804 04/22/2018 3 ` ' 03/12/2018 01 88226380 0 31030290 1 1,877.00 22.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226380 0 31030290 1 1,855.00 23.00 0 REG A R 201802 02/20/2018 =^ 1 011.15/2018 01 88226380 0 31030290 1 1,832.00 25.00 0 REG A R 201801 01/24/2018 12/11/2017 {r 01 88226380 6 31030290 1 1,807.00 21.00 0 REG A R 201712 12/19/2017 11/14/2017 01 88226380 0 31030290 1 1,786.00 20.00 0 REG A R 201711 11/28/2017 10/18/2017 01 88226380 0 31030290 1 1,766.00 30.00 0 REG A R 201710 10/26/2017 G V 09/12/2017 01 88226380 0 31030290 1 1,736,00 22.00 0 REG A R 201709 09/24/2017 1 ` 08/16/2017 01 88226380 0 31030290 -1 1,714.00 27.00 0 REG A R 261708 08/23/2017 C 1 • 0 G w 07/17/2017 01 88226380 0 31036290 1 1,687.00 29.00 0 REG A R 201707 07/27/2017 9 - U 06/14/2017 (�,� 01 88226380. 0 31030290 1,1.658.00 23.00 0 REG A R 201706 06/26/2017 „ G G 05/17/2017 1 01 88226380 0 31030290 1 1,635.00 18.00 0 REG A R 201705 05/30/2017 l d ° li(!.+ 04/19/2017 r t 01 88226380 0 31030290 '1 1,617.00 21.00 0 REG A R 201704 04/27/2017 03/13/2017 01 88226380 0 31030290 1 1,596.00 17.00 0 REG A R 201703 03/28/2017 c U U 02/14/2017 01 88226380 0 31030290 1 1,579.00 18.00 0 REG A R 201702 02/26/2017 1 01/17/2017 01 88226380 0 31030290 1 1,561.00 23.00 0 REG A _R R 201701 01/29/2017 i✓ U.1 12/12/2016 01 88226380 0 31030290 - 1 1,538.00- 18.00 0 REG A R 201612 12/27/2016 11 fg 11/16/2016 01 88226380 0 31030290 1 1,520.00 19.00 0 REG A R 201611 11/28/2016 is"•.(,I ; 10/17/2016 01 88226380 0 31030290 1 1,501.00 26.00 0 REG A R 201610 10/31/2016 09/09/2016 01 88226380 0 31030290 1'1,475.00 19.00 0 REG A R 201609 09/21/2016 08/17/2016 01 88226380 0 31030290. 1 1,456.00 26.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226380 0 31030290 1 1,430.00 27.00 0 REG A R 201607 07/25/2016 06/13/2016 01 88226380 0 31030290 1 1,403.00 20.00 0 REG A R 201606 06/22/2016 05/16/2016 01 88226380 0 31030290 1 1,383.00. 20.00 0 REG A R 201605 05/26/2016 04/18/2016 01 88226380 0 31030290 1 1,363.00 22.00 0 REG A R 201604 04/27/2016 Date: 3/1 412 0 1 9 Meter Reading History Page 1 of 5 Customer# 602588-1 Premise#602588 Service:Water-Regular Metered METER READING TRANSACTION INFO � Read Date Sequence# Meter# ace Sort# Read Code Reading Consumotion Skip Count Type Code Status Bill Period Trans Date 1 i` ;0,,e. � 02/26/2019 01 88226385 0 31030320 1 2,109.00 20.00 0 REG A R 201902 02/28/2019 ~ 01/28/2019 01 88226385 0 31030320 1 2,089.00 25.00 0 REG A R 201901 01/30/2019 12/21/2018 01 88226385 0 31030320 10 1 ,D 1 2,064.00 18.00 0 REG A R 201812 12/30/2018 U 11/26/2018 01 88226385 0 31030320 Y 1 2,046.00 19.00 0 REG A R 201811 11/28/2018 + 10/30/2018 01 88226385 0 31030320 1 2,027.00 22.00 0 REG A R 201810 10/30/2018 2 3 ° h fU ' 10/01/2018 01 88226385 0 31030320 1 2.005.00 30.00 0 REG A R 201809 10/04/2018 2 1 - C, G + 08/22/2018 01 88226385 0 31030320 1 1,975.00 24.00 0 REG A R 201808 08/27/2018 2-!2 „ ,`i i,i + 07/23/2018 01 88226385 0 31030320 \� 1 1,951.00 32.00 0 REG A R 201807 07/26/2018 S 06/13/2018 01 88226385 0 31030320 1 1,919-00 23.00 0 REG A R 201806 06/18/2018 2 fj o CI i 05/16/2018 01 88226385 0 31030320 tom% \ 1 1,896.00 21.00 0 REG A R 201805 05/28/2018 O 04/17/2018 01 88226385 0 31030320 p 1 1,875.00 22.00 0 REG A R 201804 04/22/2018 03/12/2018 01 88226385 0 31030320 1 1,853.00 18.00 0 REG A R 201803 03/19/2018 r 02/13/2018 01 88226385 0 31030320 1 1,835.00 20.00 0 REG A R 201802 02/20/2018 .01/15/2018 01 88226385 0 31030320._ 1 1,815.00 32.00 0 REG A R 201801 01/24/2018 12/11/2017 01 88226385 0 31030320 1 1,783.00 20.00 0 REG A R 201712 12/19/2017 11/14/2017 01 88226385 0 31030320 1 1,163.00 22.00 0 REG A R 201711 11/28/2017 10/18/2017 01 88226385 0 31030320 1 1,741.00 33.00 0 REG A R 201710 10/26/2017 09/12/2017 01 88226385 0 31030320 1 1,708.00 22.00 0 REG A R 201709 09/24/2017 2 2 tJ t;+ 08/16/2017 01 88226385 0 31030320 1. 1,686.00 22.00 0 REG A R 201708 08123/2017 2 Q ='0. 07/17/2017 01 88226385 0 31030320 t 1,664.00 24.00 0 REG A R. 201707 07/27/2017 2 li G (� 06/14/2017 01 88226385 0 31030320 1 1,640.00 20.00 0 REG A R 201706 06/26/2017 2 G q 0 G. 05/17/2017 01 88226385 0 31030320 �' 1 1.620.00 20.00 0 REG A R 201705 05/30/2017 2 tl ­0!. + �1 04/19/2017 01 88226385 0 31030320 1 1,600.00 25.00 0 REG A R, 201704 04/27/2017 2� � uG+ ! 03/13/2017 01 88226385 0 31030320 1 1,575.00 21.00 0 REG A R 201703 03/28/2017 02/14/2017 01 88226385 0 31030320 1 1,554.00 21.00 0 REG A R 201702 02/26/2017 9- 1 n 10 C.,+ 01/17/2017 01 88226385 0 31030320 1 1,533.00 29.00 0 REG A R 201701 01/29/2017 2 1 OC+ - 12/12/2016 01 88226385 0 31030320 1 1,504.00 20.00 0 REG' A R 201612 12/27/2016 2 =n 11/16/2016 01 88226385 0 31030320 1 1,484.00 24.00 0 REG A R 201611 11/28/2016 10/17/2018 01 88226385 0 31030320 1 1,460.00 28.00 0 REG A R 201610 10/31/2016 09/09/2016 01 88226385 0 31030320 1 1,432.00 18.00 0 REG A R 201609 09/21/2016 08/17/2016 01 88226385 0 31030320 1 1,414.00 26.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226385 0 31030320 1 1,388.00 27.00 0 REG A R 201607 07/25/2018 06/13/2016 01 88226385 0 31030320 1 1,361.00 26.00 0 REG A R. 201606 06/22/2016 05/16/2016 01 88226385 0 31030320 1 1,335.00 29.00 0 REG A R 201605 05/26/2016 04/18/2016 01 88226385 0 31030320 1 1,306.00 33.00 0 REG A R 201604 04/27/2016 Commonwealth of Massachusetts a-7 0,21- 06-4 Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I anou h Road units 1-7 r,r, Property Address Strawberry Hill Condos „ Owner Owners Name information is I ' required for every Hyannis MA 02601 10/23/2015 rt page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in arid, way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return Name of Inspector key. Company Name P.O. Box 49 Company Address Osterville MA 02655 Cityrrown State Zip Code 508-862-9400 S12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Rualuation by the Local Approving Authority 10/28/15 Ins pe is Signature Date The tem inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Vposal �(Sins•3113 Title 5 Official Inspection Form:Subsurface Sewageem•Pa e 1 of 17 9 L Commonwealth of Massachusetts + Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyanough Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is Hyannis required for every Y MA 02601 10/23/2015 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is.imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '' .,a,•y'• 1431 lyanough Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 10/23/2015 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431_lyanough Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owner's Name information is Hyannis MA 02601 10/23/2015 required for every H_Y � page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyanou h Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 page. City/Town State Zip Code Date of bate of 2015 Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOTdue to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 1 00 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Ism Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °°��a,•''V 1431 lyanough Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 10/23/2015 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excludingthe 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 14 14 (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1540 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments C�H e,••''� 1431 lyanough Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 10/23/2015 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: unknown Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 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 '°M a 1431 lyanough Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 10/23/2015 page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: pumped year Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be.obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): l5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth nwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G 9 1431 I ano u h Road -units 1-7 Y 9 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 10/23/2015 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed - unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 3' 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: 2500 gal. Sludge depth: - t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �•a 1431 I anou h Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owner's Name information is required for every Hyannis MA 02601 page. City/Town 10/23/2015 State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle - Scum thickness 6" Distance from top of scum to top of outlet tee or baffle 4 - Distance from'bottom of scum to bottom of outlet tee or baffle - How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The liquid level was up to the outlet pipe-Steel covers are to grade. Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑fiberglass 9 El polyethylene El 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 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M A,•.'" 1431 I anou h Road - units 1-7 Property Address Strawberry Hill Condo's Owner information is Owner's Name required for every Hyannis MA 02601 10/23/2015 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass 9 El polyethylene ❑ other(explain): N/a 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 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyanou h Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owners Name information is required for every Hyannis MA 02601 10/23/2015 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert even 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.): Steel cover was to grade 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.): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 I anou h Road -units 1-7 Property Address - Strawberry Hill Condo's Owner Owner's Name information is required for every Hyannis MA 02601 10/23/2015 page. City/Town State Zi Code P Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2- 100_ 0 gal__ ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The liquid level in the Pits was 4' up from the bottom. There was no sign of failure. Steel covers were to grade. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ® No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I anou h Road-units 1-7 Property Address Strawberr Hill Condo's Owner Owner's Name information is required for every Hyannis MA 02601 10/23/2015 page. CltylTown State -ZIP Code Date of Inspection P D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a,.•'•F 1431 I anou h Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owner's Name information is required for every Hyannis MA 02601 10/23/2015 page. City/Town State -Elp Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately AEI S Tie-I UverS 0 G04 die- i i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I anou h Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owner's Name information is required for every Hyannis MA 02601 10/23/2015 page. CltylTown State Zi Code P Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35'+/- 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: Topo and water contours map ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 1431 I anou h Road -units 1-7 Property Address Strawberry Hill Condo's Owner Owner's Name information is required for every Hyannis MA 02601 10/23/2015 page. Cltyrrown State Zi Code P Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 r f �t COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Strawberry Hill C omin'un 1l- Property Address: 1431 Ivanoujzh R ad units 1-7 Hyannis, MA 026 Owner's Name: Strawberry Hill Condominium Owner's Address: } ram rD Date of Inspection: September 18.'2008 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 p Osterville.MA 02655-0049 Telephone Number: (508)862-9400 rn CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems: I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes N s Further Evaluation by the Local Approving Authority F. ils Inspector's Signature: Date: September 21, 2008 The system inspector shall subm a copy of th's inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the. DEP. The original should be sent to the systein owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments **"This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I 3 r Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Strawberry Hilt'Codo's unit 1-7 1431 IyanoughRoad Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18. :'008 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. Answer yes,no or not determined(Y,N,ND)in the 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 L r Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Strawberry Hill Codo's unit 1-7 1431 lvanough Road Owner's Name: Strawberry Hili Condo's Date of Inspection: September 18, 2008 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 coliforn bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of anvnonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Strawberry Hill Codo's unit 1-7 14311 ay nough Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than i/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped . ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool 'or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have detennined that one or more of the above failure criteria exist as described in 310 CMR 15.2,03,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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area- IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 i Page 5 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B. CHECKLIST Property Address: Strawberry Hill Codo's unit 1-7 14311yanouzh Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping infonnation was provided by the owner,occupant, or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received nonnal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined ?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ _ Were all system components, excluding the SAS, located on site? ✓ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid, depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No ✓ _ Existing infonnation. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)J. 5 I Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Strawberry Hill Codo's unit 1-7 1431 Iyanough Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 14 Number of bedrooms(actual): 14 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1540 Number of current residents: n/a Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No;. Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:pumped yearly for maintenance Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped detennined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: unknown Were sewage odors detected when arriving at the site(yes or no): No t 6 I Page 7 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Strawberry Hill Codo's unit 1-7 14311yanough Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 3' Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 40" Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Commments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tet:or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Commments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Strawberry Hilt Codo's unit 1-7 1431 IyanoughRoad Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 TIGHT or HOLDING TANK: None (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: Rzallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was clean. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber;condition of pumps and appurtenances, etc.): k 8 L Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Strawberry Hill Codo's unit 1-7 1431 Iyanough,Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type _ ✓ leaching pits,number: 2-6x6 Pits 1000 gal. leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Both leach Pits had Y of water on the bottoin. All covers were to grade. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): PRIVY: None (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.): 9 � t Page 10 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Strawberry Hill Codo's unit 1-7 1431 Iyanou h Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pennanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. �,ro,� UYAT# a A ` �4 F1 A 6 1 sa 3 -1 -1 10 r Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Strawberry Hill Codo's unit 1-7 14311yanough Road Owner's Name: Strawberry Hill Condo's Date of Inspection: September 18, 2008 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35 +1- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: Topographic and water contours naps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topo&:aphic and water contours naps, the maps were showing approximately 35'+/-to groundwater at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not , been located and inspected. 11 Commonwealth of Massachusetts l0 Title 5 Official Inspection Form <I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 w Property Address Strawberry Hill Condo a Owner Owner's Name information is required for every Centerv'le A MA 02632 03-15-2019 page. Citylro n State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return key. Company Name 52 Rivers End Road "ICI Company Address Teaticket Ma. 02536 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 03-17-2019 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or.DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 f Commonwealth of Massachusetts �. ... Title 5 Official Inspection Form �I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System.Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: At the time of the inspection of this 14 Bedroom condo building I did not see any thing that meets a falure condition according to the State and The Barnstable Health Dept. code. 2) 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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection. C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �� / 1431 lyannough Rd Units 8-14 V� Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of.Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. CityrFown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool 99 p ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes".or"no for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? P ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? Z ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? Z. ❑ Were all system components,excluding the SAS, located on site? ® ❑ 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? ® 0 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)) t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V 1431 lyannough Rd.Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 14 Number of bedrooms (actual): 14 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1540 plus GPD Description: Number of current residents:. apx. 12 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail Water reading attached Sump pump? ❑ Yes H No Last date-of occupancy: occupiedDate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ............. , 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If,yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/user Date Other(describe below): 3. Pumping Records: Source of information: Last pumped in Dec. 2018 per management Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): Depth below grade: 48"feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): water was flowing at the time of the inspection. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form i; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 I annou h Rd Units 8-14 ." y 9 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 36"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: 2000 gallon Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 58" 2" Scum thickness 5„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16 How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, , liquid levels as related to outlet invert, evidence of leakage, etc.): The tank is pumped once a year. Covers at grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ` 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <lo Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ............ U 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): At the time of the inspection there was no visible signs of leakage. Cover at grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . � 1431 lyannough Rd Units 8-14 Property Address - Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located,explain why: Type: ® leaching pits number: 2 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 i Commonwealth of Massachusetts e Title 5 Official Inspection Form . 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the liquid level was two plus feet below the invert in one of the leaching pits. Cover at grade. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration . Depth—top of liquid to inlet invert layer Depth of solids la P Y Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) I 13. 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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 AN Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u � 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code. Date of Inspection D. System Information (cont.) 14. 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 �L�e v✓tr t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ! Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20 plus feet 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: augered a hole at a lower elevation and I shot it with a transit. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 8-14 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included a T,)e of 5- �1 l L� t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Date:3/14/2019 Meter Reading History Cage 1 of 5 Customer# 602583-1 Premise#602583 Service:Water-Regular Metered METER REA IN TRANSACTION INFO C; Read Date Sequence Meter# Face Sort # Read Code Readin Skip Count fm Code Slotyys ill peog Trans Date r: 02262019 01 88226380 0 31030290 1 2,190.00 22.00 0 REG A R 201902 02/28/2019 f. C i:,- 01282019 01 88226380 0 31030290 1 2,168.00 31.00 0 REG A R 201901 01/302019 12212018 l O= 01 88226380 0 31030290 1 2,137.00 22.00 0 REG A R 201812 12/30/2018 d. 11/26/2018 01 88226380 0 31030290 1 2,115AC 26.00 0 REG A R 201811 11/28/2018 G t' 10/30/2018 01 88226380 0 31030290 1 2,089.00 26.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226380 0 31030290 1 2,063.00 39.00 0 REG A R 201809 10/04/2018 08/22/2018 01 88226380 0 31030290 1 2.024.00 29.00 0 REG A R 201808 0827/2018 2 = C i (: r 07232018 �� 01 88226380 0 31030290 1 1,995.00 42.00 0 REG A R 201807 07262018 06/132018 �n 01 88226380 0 31030290 1 1,953.00 24,00 0 REG A R 201806 06/18/2018 G e0. C 05N62018 01 88226380 0 31030290 1 1,929.00 23.00 0 REG A R 201805 05282098 23 q T 04/172018 01 88226380 0 31030290 1 1,906.00 29.00 0 REG A R 201804 04222018 ° U,�,f u 03/122018 01 88226380 0 31030290 1 1.877.00 22.00 0 REG A R 201803 03/192018 02/132018 01 88226380 0 31030290 1 1,855.00 23.00 0 . REG A R 201802 02202018 01/152018 01 88226380 0 31030290 1 1,832.00 25.00 0 REG A R 201801 01242018 i 12/112017 V{i 01 88226M 0 31030290 1 1,807.00 21.00 0 REG A R 201712 12/19/2017 11/142017 t 01 88228380 0 31030290 1 1,786.00 20.00 0 REG A. R 201711 1128/2017 10/182017 01 88226380 0 31030290 1 1,760.00 30.00 0 REG A R 201710 10/262017 09/122017 01 88226380 0 31,030290 1 1,736,00 22.00 0, REG A R 201709 09242017 08/16/2017 01 88226380 0 31030290 1 1,714.00 27.00 0 REG A R 201708 08232017 c 7 G G. 07/172017 01 88226380 0 31030290 1 1,687.00 29,00 0 REG A R 201707 07272017 i -' 9 ^ C C, 06/142017 01 88226380 0 31030290 1 1,658.00 23.00 0 REG A R . 201706 06262017 � � CL i 051I72017 01 88226380 0 31030290 i 1,635.00. 18.00 0 REG A R 201705 05/302017 b�� + O4/192017 01 88226380 0 31030290 1 1,617.00 21.00 0 REG A R 201704 04272017 . U I' 03/132017 01 88226380 ' 0 31030290. 1 1,596.00 17.00 0 REG A R 261703.03282017 02/142017 01 88226380 0 31030290 1 1,579.00 18.00 0 REG A R 201702 02262017 17 ° G U 01/112017 01 8822638p 0 31030280 1 1,561.00 23.00 0 REG A R 201701 01292017 12/122016 01 88226380 0 31030290' 1 1,538.00 18.00` 0 REG.-_A R _-201812 12272016 r, 11/182016 01 88228380 0 31030290 1 1,526.00 19.00 0 REG A R 201611 1120=16 e Ur, `' t.`t i :^ 10/172016 01 88226380 0 31030290 1 1,501.00 26.00 0 REG A R 201610 10/312016 09/092016 01 88226380 0 31030290 1 1,475.60 19.00 0 REG A R 201609 09212016 08/172016 01 88226380 0 31030290 1 1,456.00 26.00 0 REG A R 201608 08P302016 07/152016 01 88226380 0 31030290 1 1,430.00 27.00 0 REG A R 201607 07252016 06/13/2016 01 88226380 0 31030290 1 1,403.00 20.00 0 REG A R 201606 06222016 05/162016 01 88226380 0 31030290 1 1,383.00 20.00 0 REG A R 201605 051MOIS 04/182016 01 88226380 0 31030290 1 1,363.W 22.00 0 REG A R 201604 04/272016 Date:3/14/2019 Meter Reading HistoEy Page 1 of 5 Customer# 602588-1 Premise#602588 Service:Water-Regular Metered METER READING TRANSACTION INFO Read Date SSe uenpe# Meter# Face Sow Read Code Reading Consumption Skip Count TTwe Code Status Bill Per- Trans Date 02/26@019 01 88226385 0 31030320 1 2,109.00 20.00 0 REG A R 201902 0212WO19 73 ' 01/28/2019 01 88226385 0 31030320 12,089.00 25.00 0 REG A R 201901 01/30/2019 12/21/2018 01 88226385 0 31030320 1 2,064.00 18.00 0 REG A R 201812 12/30/2018 `2 ° 0 fl ' 11/26/2018 01 88226385 0 31030320 v 6 1 2,046.00 19.00 0 REG A R 201811 11/28/2018 Z �' U + 10/30/2018 01 88226385 0 31030320 1 2,027.00 22.00 0 REG A R 201810 10/30/2018 2% 0)11 10/01/2018 01 88226385 0 31030320 1 2,005.00 30.00 0 REG A R 201809 10/04/2018 2 1 - 0 f_: f 08/22/2018 01 88226385 0 31030320 1 1,975.00 24.00 0 REG A R 201808 08/27/2018 -. G _ +U;_i 07/23/2018 01 88226385 0 31030320 1 1,951.00 32.00 0 REG A, R 201807 07/262018 1 �, �, 06/13/2018 01 88226385 0 31030320 \ 1 1,919.00 23.00 0 REG A R 201806 06/18/2018 2 fj a 0 I; 05/16/2018 01 88226385 0 31030320 1 1,896.00 21.00 0 REG A R 201805 W28/2018 04/17/2018 01 88226385 0 31030320 1 1,875.00 22.00 0 REG A R 201804 04/22/2018 ` 1 4 ( r 03/12/2018 01 88226385 0 31030320 1 1,853.00 18.00 0 REG A _R 201803 03/19/2018 02/13/2018 01 88226385 0 31030320 1 1,835.00 20.00 0 REG A R 201802 02/20/2018 01/15/2018 01 88226385 0 31030320 1 1.815.00 32.00 0 REG A R 201801 01/24/2018 r; 12/11/2017 01 SM6386 0 31030320 1 1,783.00 20.00 0 REG A R 201712 12/19/2017 2;, (,1. 11/14/2017 01 88226385 0 31030320 1 1,763.00 22.00 0 REG A R 201711 11/28/2017 10/18/2017 01 88226385 0 31030320 1 1,741.00 33.00 0 REG A R 201710 10126/2017 22 09/12/2017 01 88226385 0 31030320 1 1,708.00 22.00 0 REG A R 201709 09/24/2017 a �� + 08/16/2017 01 88226385 0 31030320 1 11686.00 22.00 0 REG A R 201708 08/23/2017 G ` 'I 0 07/17/201-1 01 88226385 0 31030320 1 1,664.00 24.00 0 REG A R 201707. 07/27/2017 06/14/2017 01 8SM385 0 31030320 (�., 1 1,640.00 20.00 0 REG A R. 201706 06/26/2017 2 C. 0 C ; 05/17/2017 01 8=6385 0 31030320 �' 1 1,620.00 20.00 0 REG A R 201705 05/30/2017 2 u 0 C:+ 04/19/2017 01 88226385 0 31030320 1 1,600.00 25.00 0 REG A R 201704. 04/27/2017 = 0 U+ 03/13/2017 01 88226M 0 31030320 1 1,575.00 21.00 0 REG A R 201703. 03/2802017 C,i 02/14/2017 01 88226385 0 31030320 1 1.554.00 21.00 0 REG A. R 201702 02/26/2017 01/17/2017 _ 01 88226385_ 0 31030320_ _ 1 1,533.00 29.00 0: REG_ A R_ 201701 01/29/2017 12112/2016 01'88226385 0 31030320 1 1,504.00 20.00 0- REG A R 201812. 12/27/2016 11/16/2016 01 88226385 0 31030320 1 1,484.00 24.00 0 REG A R 201611 11/28I2016 10/17/2016 01 88220M 0 31030320 1 1,480.00 28.00 0 REG A R 201810 10/312016 09/09/2016 01 88226385 0 31030320 1 1,432.00 18.00 0 REG A R 201609 09/21/2016 08/17/2016 01 88226385 0 31030320 1 1,414.00 26.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226385 0 31030320 1 1,388.00 27.00 0 REG A R 201607 07/25/2018 06/13/2016 01 88226385 0 31030320 1 1.361.00 26.00 0 REG A R 201606 0&22/2016 05/16/2016 01 88226385 0 31030320 1 1.335.00 29.00 0 REG A R 201605 05/26/2016 04/18/2016 01 88226385 0 31030320 1 1,306.00 33.00 0 REG A R 201604.04/27/2016 Date: 3/14/2019 Meter Reading Histoa Page 1 of 5 Customer# 602587-1 Promise#602587 c=rvice:Water-Regular Metered i ' ' METER READING TRANSACTION INFO _. . C 0= Read Date Sequence# Meter# Face Sort # Reid Code Beading Consumption Sidp Count Taoe Cade Emu Bill Period Trans Date • C30 02/2612019 01 88226368 0 31030310 1 373.00 2.00 0 REG A R 201902 02/28/2019 u a t Ci 01/28/2019 01 88226368 0 31030310 1 371.00 3.00 0 REG A R 201901 01/30/2019 - 0 01 12/21/2018 01 88226368 0 31030310 '1 t1 �p 1 368.00 1.00 0 REG A R 201812 12/30/2018 r G 11/26/2018 01 88226368 0 31030310 r�V b 1 367.00 2.00 0 REG A R 201811 11/28/2018 10/30/2018 01 88226368 0 31030310 1 365.00 2.00 0 REG A R 201810 10/30/2018 ('.T 10/01/2018 01 88226368 0 31030310 1 363.00 4.00 0 REG A R 201809 10/04/2018 { 081=018 01 88226368 0 31030310 1 359.00 7.00 0 REG A R 201808 08/27/2018 0 C;w 07/2=018 01 88226368 0 31030310 1 352.00 5.00 0 REG A R 201807 07/26/2018 0 0 06/13/2018 01 88226368 0 31030310 1 347.00 3.00 0 REG A R 201805 06/18/2018 • (j:1 05/17/2018 01 88226368 0 31030310 1 344.00 2.00 0 REG A R . 201805 05128/2018 1, fj rj 04/17/2018 01 88226368 0 31030310 1 342.00 3.00 0 REG A R 201804 04/22/2018 j 03/12/2018 01 88226368 0 31030310 1 339.00 2.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226368 0 31030310 1 337.00 2.00 0 REG A R 201802 02/20/201 a ;- 01/16/2018 01 88226368 0 31030310 1 335.00 4.00 0 REG A R 201801 01/2412018 • C; 12/11/2017 i 01 88226368 0 310303/0 1 331.00 2.00 0 REG A R 201712 12/19/2017 iy 0.,. 11/14/2017 01 88226368 0 31030310 1 329.00 3.00 0 REG A R 201711 11/28/2017 f 10/18/2017 01 88226368 0 31030310 1 326.00 5.00 0 REG A R 201710 10/26/2017 } 09/12/2017 01 88226368 0 31030310 1 321.00 5.00 0 REG A R 201709 09/24/2017 6 n 0`l + 08/16/2017 01 88226368 0 31030310 1 316.00 6.00 0 REG A R 201708 08/23/2017 07/17/2017 01 88226368 0 31030310 1 310.00 5.00 0 REG A R 201707 07/27/2017 t,. 0 0+ 06/14/2017 01 88228368 0 31030310 1 305.00 4.00 0 REG A R 201706 06/26=17 • G 0 05/17/2017 01 88226368 0 31030310 \ �j 1 301.00 3.00 0 REG A. R 201705 05/30/2017 4 o 0 0+ 04/19/2017 01 98226368 0 31030310 !-\ 1 298.00 4.00 0 REG A R 201704 04/27/2017 3 , ;V+ 03/13/2017 01 88226368 0 3103,0310 1 294.00 3.00 0 REG .A R 201703.03r2&2017 4. • 0 Cl T 02/1412017 01 88228368 0 31030310 1 291.00 4.00 .0 REG. A R 201702 02/26/2017 01/17/2017 01 88226368 0 31030310 1. 287.00 4.00 0 REG A R 201701 01/29/3017 12/12/2016 01 86226368 -0 31030310 1 283.00 3.00 0 REG A R 201612.12/27/2016 C, CI 1 11/16/2016 01 88226368 0 31030310 1 280.00 4.00 0 REG A . R 201611 11/28/2016 10/17/2016 01 88226368 0 31030310 1 276.00 8.00 0 REG A R 201610 10/31/2016 09M9/2016 01 88226368 0 31030310 1 268.00 7.00 0 REG A R 201609 09/21/2016 08/17/2016 01 88226368 0 31030310 1 261.00 8.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226368 0 31030310 1 253.00 9.00 0 REG A R 201607 07/25/2016 06/13/2016 01 88226368 0 31030310 1 244.00 3.00 0 REG A R 201606 06R2/2016 05/16/2016 01 88226368 0 31030310 1 241.00 3.00 0 REG A R 201605 05M=16. 04/18/2016 01 88226368 0 31030310 1 238.00 3.00 0 REG A R 201604 04/27/2016 Date: 3/14/2019 Meter Reading History Page 1 of 5 Customer# 6025864 Premise#602686 Service:Water m Regular Metered METER READING TRANSACTION INFO i % L. ReadDate Seouenoe# Meter# Face Sort # Read Code Reading Consumption Skip Count T�= Code Status Bill eri s Date i 5 + 02/26/2019 01 88226383 0 31030300 - 1 4,372.00 26.00 0 REG A R 201902 02/28/2019 01/28/2019 01 88226383 0 31030300 1 4.346.00 46.00 0 REG A R 201901 01/30/2019 _; v ;_.:+ , 12/21/2018 01 88226383 0 31030300 1 4,300.00 12.00 0 REG A R 201812 12/30/2018 3 0 0 } 11/26/2018 01 88226383 0 31030300 1 4,288.00 15.00 0 REG A R 201811 11/28/2018 5 1 o v 0,� 10/30/2018 01 88226383 0 31030300 1 4,273.00 24.00 0 REG A R 201810 10/30/2018 7 10/01/2018 01 88226383 0 31030300 1 4,249.00 40.00 0 REG A R 201809 14/2018 G c } t 0/0 08/22/2018 01 88226383 0 31030300 1 4.209.00 36.00 0 REG A R 201808 08/27/2018 07/23/2018 01 88226383 0 31030300 1 4,173.00 51.00 0 REG A R 201807 07/28/2018 213 ° 0 C"' 06/13/2018 01 W226383 0 31030300 1 4.122.00 27.00 0 REG A R 201806 06/18MO18 12 1 a G 0 05/17/2018 > 01 88226383 0 31030300 1 4,095.00 24.00 0 REG .A R 201805 05/28/2018 04/17/2018 J 01 88226383 0 31030300 1 4,071.00 28.00 0 REG A R 201804 04/22/2018 03/12/2018 01 8SM383 0 31030300 1 4,043.00 21.00 0 REG A R 201803 03/19/2018. 02/1312018 01 88226383 0 31030300 1 4,022.00 23.00 0 REG A R 201802 02/20/2018 _ " 01/16/2018 01 88226383 0 31030300 1 3,999.00 33.00 0 REG A R 201801 01/24/2018 12/1112017 01 88226383 0 31030300 1 3.966.00 28.00 0 REG A R 201712 12119/2017 11/14/2017 01 88226383 0 31030300 1 3,938.00 49.00 0 REG A R 201711 11/28/2017 C) „ }, .}. 10/18/2017 01 88226383 0 31030300 1 3,889.00 88.00 0 REG A R 201710 10/26/2017 n o 09/122017 01 88226383 0 31030300 1 .3,801.00 63.00 0 REG A R 201709 09/2412017 004- 08/16/2017 %01 88226383 0 31030300 1 3,738.00 71.00 0 REG A. R 201708 OWN2017 07/17/2017 �O 01 88226383 0 31030300 1 3,667.00 53.00 0 REG A R 201707 07/27/2017 7 } ' 06/14/2017 01 88226383 0 31030300 1 3,614A0 31.00 0 REG A R 201706 06/26/2017 ,�05/18/2017 '1\ 01 88228383 0 310303W 1 3,583.00 28.00 0 REG A R 201705 05/30/2017 04/1912017: d 01 88226383 0 31030300 1 3,555.00 32.00 0 REG A R 201704 04/27/2017 ;-� 03/13/2017 01 88226383 0 31030300 1 3,523.00 21.00 0 REG A R. 201703. 0=8=17 + 02114=17 01 88226383 0 31030300 1 3,502.00 23.00 0 REG A R 201702 02/26/2017 2. 1 a f i 0+ i , 01/17/2017 01 88226383 0 31030300 1 3.479.00 26.00 0 REG A R 201701 01129/2017 ,; y i 12/13/2016 01 88226383 0 31030300 1 3,453.00 ry 23.00 0 REG A R 201812 12/27/2018 11/16/2016 01 88226M 0 31630300 1 3,430.00 41.00 0 REG A R 201811 11/28/2016 10117/2016 01 88226383 0 31030300 1 3,389.00 86.00 0 REG A R 201610 10/31/2018 - 09/09/2016 01 88226383 0 31030300 1 3,303.00 68.00 0 REG A R 201609 09121/2016 08I7712016 01 88226383 0 31030300 1 3,245.00 88.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226383 0 31030300 1 3,157.00 78.00 0 REG A R 201607 07/Y5/2016 05/13/2016 01 88226383 0 31030300 1 3,081.00 37.00 0 REG A R 201606 08a2/2018 05/16/2016 01 88226383 0 31M0300 1 3,044.00 25.00 0 REG A R 201605 05/26/2016 04/1.8/2016 01 88226383 0 31030300 1 3,019.00 33.00 0 REG A R 201604 .04a7/2016 Date: 3/14/2019 Meter Reading History Page 1 of 5 Customer# 602587-1 Premise#602587 O?rvice:Water-Regular Metered 1 - C.G. METER READING TRANSACTION INFO • [,!L! + Read Date Sequence# Meter# Face Sort # Read Code Reading Consumption Skip Count Type Code Status Bill Period Trans Date G - 0 0- 02/26/2019 01 88226368 0 31030310 1 373.00 2.00 0 REG A R 201902 02/28/2019 (� 0 C! 01/28/2019 01 88226368 0 31030310 1 371.00 3.00 0 REG A R 201901 01/30/2019 - 00 ;_ 12/21/2018 01 88226368 0 31030310 r� p 1 368.00 1.00 0 REG A R 201812 12/3012018 fi • 0 0 _: 11/26/2018 01 88226368 0 31030310 V b 1 367.00 2.00 0 REG A R 201811 11/28/2018 10/30/2018 01 88226368 0 31030310 1 365.00 2.00 0 REG A R 201810 10/30/2018 • 0T 10/01/2018 01 88226368 0 31030310 1 363.00 4.00 0 REG A R 201809 10/04/2018 • 0 L i 08/22/2018 01 88226368 0 31030310 1 359.00 7.00 0 REG A R 201808 08/27/2018 3 - 0 0+ 07/23/2018 01 88226368 0 31030310 � 1 352.00 5.00 0 REG A R 201807 07/26/2018 2 • Q 4+ 06/13/2018 01 88226368 0 31030310 1 347.00 3.00 0 REG A R 201806 06/18/2018 2 - 0 0+ 05/17/2018 01 88226368 0 31030310 1 344.00 2.00 0 REG A R 201805. 05/28/2018 . 0 0 a. 04/17/2018 01 88226368 0 31030310 1 342.00 3.00 0 REG A R 261804 04/22/2018 3 7 • + 03/12/2018 01 88226368 0 31030310 1 339.00 2.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226368 0 31030310 1 337.00 2.00 0 REG A R 201802 02/20/2018 01/16/2018 01 88226368 0 31030310 1 335.00 4.00 0 REG A R 201801 01/24/2018 3 , 12/i1/2017 01 88226368 0 31030310 1 331.00 2.00 0 REG A R 201712 12/19/2017 11/14/2017 01 88226368 0 31030310 1 329.00 3.00 0 REG A R 201711 11/28/2017 E C. 10/18/2017 01 88226368 0 31030310 1 326.00 5.00 0 REG A R 201710 10/26/2017 09/12/2017 01 88226368 0 31030310 1 321.00 6.00 0 REG A R 201709 09/24/2017 6 • 0 0 + 08/16/2017 01 88226368 0 31030310 1 316.00 6.00 0 REG A R 201708 08/23/2017 07/17/2017 01 88226368 0 31030310 1 310.00 5.00 0 REG A R 201767 07/27/2017 1; C1 t1 i 0611412017 01 88226368 0 31030310 1 305.00 4.00 0 REG A R 201706 06/26/2017 = 0 L+` �. 05/17/2017 01 88226368 0 31030310 -\x� b 1 301.00 3.00 0 REG A R 201705 05/30/2017 0 r+ 04/19/2017 01 88226368 0 31030310 1 \ 1 298.00 4.00 0 REG A R 201704 04/27/2017 0 0+ 03/13/2017 01 88226368 0 3/030310 1' 294.00 3.00 0 REG A R 201703 03/28/2017 0 U + 02/14/2017 01 88226368 0 31030310 t, 291.00 4.00 0 REG A R 201702 02/26/2017 01/17/2017 01 88226368 0 31030310 1, 287.00 4.00 0 REG A R 201701 01/29/2017 �` • G 12/12/2016 01 88226368. -0 31030310 1 283.00 3.00 0 REG A R 201612 12/27/2016 L. C, `-`1' ''' 11/16/2016 01 88226368 0 31030310 1 280.00 4.00 0 REG A - R 201611 11/28/2016 10/17/2016 01 88226368 0 31030310 1 276.00 8.00 0 REG A R 201610 10/31/2016 09/09/2016 01 88226368. 0 31030310 1 26&00 7.00 0 REG A R 201609 09/21/2016 08/1712016 01 88226368 0 31030310 1 261.00 8.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226368 0 31030310 1 253.00 9.00 0 REG A R 201607 07/25/.2016 . 06/13/2016 01 88226368 0 31030310 1 244.00 3.00 0 REG A R 201606 06/22/2016 05/16/2016 01 88226368 0 31030310. 1 241.00 3.00 0 REG A R 201605 05/26/2016 04/18@016 01 88226368 0 31030310 1 238.00 3.00 0 REG A R 201604 04/27/2016 Date: 3/14/2019 Meter Reading History Page 1 of 5 Customer# 602686-1 Premise#602586 Service:Water-Regular Metered METER READING TRANSACTION INFO I 2 C L Read Date Sequence# Meter# Face Sort # Read Code Readin Consumption Skip Count Tye Code Status Bill Period Trans Date 15 02/26/2019 01 88226383 0 31030300 1 4,372.00 26.00 0 REG A R 201902 02/28/2019 01/28/2019 01 88226383 0 310303DO 1 4,346.00 46.00 0 REG A R 201901 01/36)2019 12/21/2018 -- 01 88226383 TO 31030300 .. 1 4,300.00 12.00 0 REG A R 201812 12/3012D18 6 , t`; + 11/26/2018 01 88226383 0 31030300 1 4,288.00 15.00 0 REG A R 201811 11/28/2018 ° U 10/30/2018 01 88226383 0 31030300 1 4,273.00 24.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226383 0 31030300 1 4,249.00 40.00 0 REG A R 201809 10/04/2018 _ r t y 08/22/2018 0 01 88226383 0 3103030D 1 4,209.00 36.00 0 REG A R 201808 08/27/2018 2 L` 07/23/2018 01 88226383 0 31030300 1 4,173.00 51.00 0 REG A R 201807 07/26/2018 * 06/13/2018 01 88226383 0 31030300 1 4.122.00 27.00 0 REG A R 201806 06/18/2018 05/17/2018 N 01 88226383 0 31030300 1 4,095.00 24.00 0 REG A R 201805 05/28/2018 04/17/2018 01 88226383 0 31030300 1 4,071.00 28.00 0 REG A R 201804 04/22/2018 3 `y�` \ 03/12/2018 01 88226383 0 31030300 1 4,043.00 21.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226383 0 31030300 1 4,022.00 23.00 0 REG A R 201802 02/20/2018 01/16/2018 01 88226383 0 31030300 1 3,999.00 33.00 0 REG A R 201801 01/24/2018 12/11/2017 01 88226383 0 31030300 9 3,966.00 28.00 0' REG A R 201712 12/19/2017 11/14/2017 01 88226383 0 31030300 1 3,938.00 49.00 0 REG A R 201711 11/28/2017 + 10/18/2017 01 88226383 0 31030300 1 3.889.00 88.00 0 REG A R 201710 10/26/2017 09/12/2017 01 88226383 0 31030300 1 3,801.00 63.00 0 REG A R 201709 09/24/2017 08/16/2017 01 88226383 0 31030300: 1 3,738.00 71.00 0 REG A R 201708 08/23/2017 07/17/2017 . �O 01 88226383 0 31030300 1 3,667.00 53.00 T REG A R 201707 07/27/2017. 7 1 Ij01 'J � 06/14I2017 /\ 01 88226383 0 31030300 1 3,614.00 31.00 0 REG A R 201706 06/26/2017 � 05/18/2017 (J� 01 88226383 0 31030300. 1 3,583.00 28.00 0 REG A R 201705 05/30/2017 i U,CI r JO 04/19/2017 . 01 88226383 0 31030300 1 3,555.00 32.00 0 REG A R 201704 04/27/2017 ° C'. C + 03/13/2017 01 88226383 0 31030300 f 3,523.00 21.00 0 REG A R 201703 03/28/2017 2 , 10 U. + 02/14/2017 01 88226383 0 31030300 1. 3,502.00 23.00 0 REG A R 201702 02/26/2017 2 1 ° 0 0 k �. 01/17/2017 01 88226383 0 31030300 1 3,479.00 26.00 0 REG A R 201701 01/29/2017 _ ("`12/13/2016 01 88226383 0 31030300 1 3,453.00 - 23.00 0 REG A R 201612 12/27/2016 G C 11/16/2016 01 88226383 0 31030300 1 3,430.00 41.00 0 REG A R 201611 11/28/2016 gib ° 0Uy •� 10/17/2016 01 88226383 0 31030300 1 3,389.00 86.00 0 REG A R 201610 10/31/2016 09/09/2016 01 88226383 0 31030300 1 3,30100 58.00 0 REG A R 201609 09/2l/2016 08/17/2016 01 88226383 0 31030300 1 3,245.00 88.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226383 0 31030300 1 3,157.00 78.00 0 REG A R 201607 07/25/2016 06/13/2016 01 88226383 0 31030300 1 3,081.00 37.00 0 REG A R 261606 O6/22/2016 05/16/2016 01 88226383 0 31030300 1 3,044.00 25.00 0 REG A R 201605 05/26/2016 04/18/2016 01 88226383 0 31030300 1 3,019.00 33.00 0. REG A R 201604 04/27/2016 COMMONWEALTH OF MASSACHUSETTS a _ EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL,INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION StrawbT err Hill Condominiums Property Address: 1431 hanouzli Road,_Units 8-14 Hyannis MA 02601 Owner's Name: Strawbern,Hill Condominiums Owner's Address: Date of Inspection: Atc ust 16 2012 Name of Inspector:(Please Print) J nnes M Ford Company Name: James M..Ford Mailing Address: P.O. Box 49 Osterville,MA 02655-0049 Telephone Number: (508) 862.9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.. I am a DEP approved.system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs Further Evaluation'by.the Local Approving Authority Fails Inspector's Signature: Date: AurTust 17, 2012 The system inspector shall s it a cop rofhis inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing.this inspection. If the system is a shared system or has a design flow of 10,0.00 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority: Notes and Conuiients ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Fonn 6/15/2000 page I / 1z) Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) . Property Address: 1431 hvanough Road, Units 8:14 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: August 16, 2012 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. Answer yes,no or not determined(Y,N,ND)in the 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 tartk will pass inspection if it is structurally sound;not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a_broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed ND explain: . 2 Page 4 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1431 Iyanouzh Road Units 8-14 Hvannis. MA Owner: Strawberrn Hill Condominiums Date of Inspection: Aujzust 16. 2012 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes . No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓' Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or . cesspool ` ✓ Liquid depth in cesspool is less than 6" below invert or available volume is less than%z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓. Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well.: ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water. supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile or compounds indicafes that the well is free from pollution.from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 31.0 CMR I5 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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water.supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA) or a mapped, Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. }` 4 r Page 5 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1431 Iyanouzh Road Units 8-14 Hyannis,MA Owner: _ Strarvberry Hill Condominiums Date of Inspection: August 16, 2012 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? . ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes Hof 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.? stems.. p The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No _ 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(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1431 Ivanough Road Units 8-14 Hvannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: August 16 2012 FLOW CONDITIONS RESIDENTIAL Number of bedroom's (design): n/a Number of bedrooms(actual): 14 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a Number of current residents: n/a . Does residence have a garbage grinder(yes or no): Yes Is laundry on a separate sewage system(yes or no):' Ji/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump (yes or no): ` No Last date of occupancy: Currentiv occuvied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORA'IATION Pumping Records Source of information:_ Punived annually for maintenance-per building manager Was system pumped as part of the inspection(yes or no): No If yes,volume,pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM- ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool. Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Iiuiovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of Information: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no.): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Iyanough Road Units 8-14 Hyannis,MA Owner: _ Strawber•n Hill Condorniniunis Date of Inspection: August 16, 2012 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron _40 PVC other(explain): r Distance from private water supply well or suction line: Comments(on condition of joints,venting,.evidence of leakage ,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: Approx. 3'6" Material of construction: ✓ .concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2500 gal. . Sludge depth:, 6" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness: 6" Distance from top of scum to top of outlet tee or baffle: 4" Distance from bottom of scum to bottom of outlet tee or baffle: 15" How were dimensions determined: MeaStWing stick Continents (on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert, evidence of leakage,etc.): Tees iyere present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage The steel covers were to grade.' GREASE TRAP:. None (locate on site plan) Depth below grade: Material of construction: concrete _Metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffler Distance from bottom of scum to bottom of outlet tee or'baffle: Date of last pumping: Comments(on pumping reconnnendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert, evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Ivanottzh Road Units 8-14 Hyannis,MA Owner: Strawbe7-1y Hill Condoniinituns Date of Inspection: Aurttsl 1.6, 2012 TIGHT or HOLDING TANK: None (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: Qallons/day Alain present(yes or no): Alarm level: Alarm in working order(yes or no): . .'Date of last pumping: Conunents(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: Even Continents(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.): The level in the D-box was normal. Steel covers were to Prade PUMP CHAMBER: 'None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 r Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION.(continued) Property Address: 1431 Ivarlough Road Units 8-14 Hvannis MA Owner: Strai-Obern)Hill Condominiums Date of Inspection: Awtut 16, 2012 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching-pits,number: 1 - 6'x 6' - 1000 gal.• I-4'x 6'stacked on 6'Y 6' leaching chambers,number:. leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow.cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): One pit(#4)was dry. The botton7.to grade was 12.5. The other pit(#5)had avvroeimateh)4'nOigacid on the bottom The bottom to grade was 14'. All steel covers ivere to grade CESSPOOLS: None (cesspoolmust be pumped as part of inspection) (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Continents (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation,etc.): PRIVY: None (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:): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSUR FACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION.(continued) Property Address: 1431 Ivanouph Road Units 8-14 Hyannis MA Owner: Strawberry Hill Condonzinitinis Date of Inspection: August 16 2012 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. AN, 10 GrA& 10 Page 11 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Prop erty.Address: 1431 Iyanough Road Units 8-14 Hyannis,AM Owner: Strawberry,Hill Condominiums Date of Inspection: August 16, 2012 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35 +/- feet Please indicate (check) all methods used to determine the g high round water elevation: g Obtained from system design plans on record If checked, date of design plan reviewed: Observed site.(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic arzd tivater contours maps Checked with local excavators,installers--(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water cotrtours maps the maps were shorvi71g approximately 35'+/ to ground water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a i•varranty or guarantee that the system will . fitl7c6017 properly in the f tt u•e. There have been no i'varranties or guarantees,-either expressed, written or implied, relating to the septic system, the inspection, this report and/or at7ycomponents of the septic system which have not been located and inspected. 11 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM NOT TOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART'A CERTIFICATION Strawberry Hill Con iniunrs--.., Property Address: 1431 lyanoush Roadnits 8-14 J Hyannis, MA 02601 I ��� Owners Name: Strawberry Hill Condominiums Owner's Address: Date of Inspection: December 1, 2008 Name of Inspector: (Please Print): James M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 . Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection, The inspection was,performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Co itionally Passes N s Further Evaluation by the Local Approving Authority F 1 Inspector's Signature: Date: December 2, 2008 The system inspector shall su it a copy of this inspection report to the Approving Authority(Board of.Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions•at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. LOTitle 5 Inspection Form 6/15/20010 page 1 `��0 'l Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 14311yanou-ah Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1. 2008 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. Answer yes,no or not determined(Y,N,ND)in the 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 inuninent: System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain; The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced . obstruction is removed ` ND explain: 2 i Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1431 IyanouQh Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1. 2008 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 detennine distance ' "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 14311 ay nough Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. _ ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface" water supply. _ ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of,a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION.FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1431 Iyanough Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner, occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks ? ✓ _ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been.introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ _ Were all system components,excluding the SAS,located on site? ✓ _ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions, depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with infonnation on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been deternined.based on: Yes No ✓ _ 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(3)(b)]. 5 �L r Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 14311yanouQh Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): 14 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a " Number of current residents: n/a Does residence have a garbage grinder(yes or no): Yes Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): _gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infonnation: Pumped annually for maintenance-per building inanager Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped detennined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy .Shared system(yes or no) (if yes, attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Iyanough Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting, evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: Approx. 3'6" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2000 gal Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness: 8" Distance from top of scum to top of outlet tee,or baffle: 4" Distance from bottom of scum to bottom of outlet tee or baffle: 15" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage;etc.): Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage. The steel covers were to grade. GREASE.TRAP: None (locate on site plan) Depth below grade: Material of construction: concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Iyanough Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Continents(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The level in the D-box was normal. Recommend installingpeed levelers. Steel covers were to grade. PUMP CHAMBER: None- (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 y Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1431 IyanouQh Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6' - 1000 gal.; I -4'x 6'stacked on 6'x 6' leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number, dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding, damp soil,condition of vegetation, etc.): One pit(M was dry. The bottom to grade was 12.5'. The other pit 05)had approximately Y of liquid on the bottom. The bottom to grade was 14'. All steel covers were to grade. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 r Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 14311 ay nough Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pennanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. # fa- 410 g- f 1 dL O O . (3 � as is ti 3 .54 Y S Ito(. Ila- 10 I Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Ivanough Road, Units 8-14 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: December 1, 2008 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to groundwater 35+/- feet Please indicate(check)all methods used to,determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topogrgphic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Usiniz Barnstable topographic and water contours maps, the maps were showing approximately 35'+1-to ground water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 Commonwealth of Massachusetts Title 5 Official Inspection Form �- la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V 1431 lyannough Rd Units 15-22 ; Property Address I Strawberry Hill Condo Owner Owner's Name information is Centerwde �(� is MA 02632 03-15-2019 required for everyh page. Cityrro6n State Zip Code Date of Inspection ` Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information csl 131 a- on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return key. Company Name 52 Rivers End Road 1�-11 Company Address Teaticket Ma 02536 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1.. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate, regional office of the DEP: The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form - (I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !% 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: At the time of the inspection of this 14 Bedroom condo building I did not see any thing that meets a falure condition according to the State and The Barnstable Health Dept. code. 2) 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): t5insp:doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts �� .. Title 5 official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection. C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface.Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded. or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 C.A. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments `............. 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code. Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner.or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out.in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? 0 ® 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)] t5insp.doc•rev_7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �n li� Title 5 Official Inspection Form I; Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 12 Number of bedrooms (actual): 12 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1320 plus GPD Description: Number of current residents: apx. 12 Does.residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes. ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: - Water reading attached Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . . �,L!% 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: . Source of information: Last pumped in Dec. 2018 per management Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): 48" Depth below grade: feet Material of construction: ® cast iron . ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): water was flowing at the time of the inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 36"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: 2000 gallons Sludge depth:. 4" Distance from top of sludge to bottom of outlet tee or baffle 58" Scum thickness 2" 5 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank is pumped once a year. Steel cover at grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts �� .. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0'f - 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.): At the time of the inspection there was no visible signs of leakage. Steel cover at grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V � 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: T I' ype ® leaching pits number: 2 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts 1p Title 5 Official Inspection Form <I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the liquid level was three plus feet below the invert in one of the leaching pits. Steel cover at grade. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town - State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 Sfi�eC- �J✓ eTS wT ��r ,� L15m.p.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope. ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20 plus feetfeet Please indicate all methods used to determine the high ground water elevation: Obtained from El Obtained system design plans on record Y 9 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: I augered a hole at a lower elevation and I shot it with a transit. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 15-22 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/.Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included BjtT3/^'1 U,C J spf Z /110 /We t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Date:3/14/2019 Meter Reading Hey$®@� Page 1 of 5 Customer# 602583-1 Premise#602583 Service:Water-Regular Metered METER READING TRANSACTION INFO Z. „ `;4; + Read pate Seauenoe Meter# Face Sort i� Read Code Reading�Cpjig Skin Count Twe Code tus ill erio Trans Date 6 '; 02/26/2019 01 88226380 0 31030290 1 2,190.00 22.00 0 REG A R 201902 02/28/2019 01/28/2019 01 88226380 0 31030290 1 2,168.00 31.00 0 REG A R 201901 01/30/2019 12/21/2018 , Oi 01 88228380 0 31030290 1 2,137.00 22.00 0 REG A R 201812 12/30/2018 11/26/2018 01 88226380 0 31030290 1 2,115.00 26.00 0 REG A R 201811 11/28/2018 2 ' 10/30/2018 01 88226380 0 31030290 1 2,089.00 26.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226380 0 31030290 1 2,063.00 39.00 0 REG A R 201809 10/04/2018 12 1: ` 0,L` 08/22/2018 01 88226380 0 31030290 1 2,024.00 29.00 6 REG A R 201808 08/27/2018 j ; 0f;; 07l23/2018 �� 01 88226380 0 31030290 1 1,995.00 42.00 0 REG. A R 201807 07/26/2018 06/13/2018 „n,_ 01 88226380 0 31030290 1 1,953.00 24,00 0 REG A R 201806 M18/2018 ., 05/16/2018 01 88226380 0 31030290 1 1,929.00 23.00 0 REG A R 201805 05/28/2018 04/17/2018 01 88226380 0 31030290 1 1,906.00 29.00 0 REG A R 201604 04/22/2018 25b0 ; 03/12/2018 01 88226380 0 31030290 1 1,877.00 22.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226380 0 31030290 1 1,855.00 23.00 0 REG A R 201802 02/20/2018 = r s 01/15/2018 01 8822,6380 0 31030290 1 1,832.00 25.00 0 REG A R 201801 01/24/2018 i 12/11/2017 ({j 01 88226380 0 31030290 1 1,807.00 21.00 0 REG A R 201712 12/19/2017 11/14/2017 1 01 88226380 0 31030290 1 1,786.00 20.00 0 REG A R 201711 11/28/2017 U < C, I; 10/18/2017 01 88226380 0 31030290 1 1,766.00 30.00 0 REG A R 20,1710 10/26/2017 09/12/2017 01 88226380 0 31030290 1 1,736,00 22.00 0 REG A R 201709 09/24/2017 08/16/2017 01 88226380 0 31030290 1 1,714.00 27.00 0 REG A R 201708 08/23/2017 - U U 07/17/2017 01 88226380 0 31030290 1 1.687.00 29.00 0 REG A R 201707 07/27=17 2 9 n C L = 06/14/2017 01 88226380 0 31030290 1 1,658.00 23.00 0. REG A R 201706 06126R017 l' L 05/17/2017 1 01 88226M 0 31030290 1 1,635.00 18.00 0 REG A R 201705 05/30/2017 a 0 f oa192017 t 01 88226380 0 31030290 1 1,617.00 21.00 0 REG A R 201704 04/27/2017 Ci,U 03/13✓2017 01 88226380 0 31MG290 1 1,596.00 17.00 0 REG A R 201703 03/2=017 _ 02/14/2017 01 88226380 0 31030290 1 1,579.00 18.00 0 REG A R 201702 02/26/2017 l / U Y 01/17/2017 01 88226380 0 31030290 1,1,561.0.0 23.00 0 REG A R 201701 01/29/1017 3 ` (--;l' + { 12/12/2016 01 88226380 0 31030290 1 1,538.00- 18.00Y 0 REG A R ''T201812 12/27/2016 2 o A i 11/16/2016 01 88226380 0 31030290 1 1,520.00 19.00 0 REG A R 201611 11/28/2016 6 - P la 10/17/2016 01 88226380 0 31030290 1 1,501.00 26.00 0 REG A R 201610 10/31/2016 09/09/2016 01 88226380 0 31030290 1 1,475.00 19.00 0 REG A R 20.1609 09/21/2016 08/17/2016 01 88226380 0 31030290 1 1,456.00 26.00 0 REG A R 201608 08/30/2016 07/15/2016 01 88226380 0 31030290 1 1,430.00 27.00 0 REG A R 201607 07/25=16 06/13/2016 01 88226380 0 31030290 1 1,403.00 20.00 0 REG A R 201606 06/2Y/2016 05/16/2016 01 88226380 0 31030290 1 1,383.00 20.00 0 REG A R 201605 05/Y6/2016 04/18/2016 . 01 88226380 0 31030290 1 1,363.00 22.00 0 REG A R 201604 04/27/2016 Date:3/14/2019 Meter Reading Hi5t®Iry Page 1 of 5 Customer# 602588.1 Premise#602688 Service:Water-Regular Metered METER READING TRANSACTION INFO 1n Read Date Sequence# Meter# Face Sort Read Code Reading Consumption Skip Count Twe Code Status Bill Per- Trans Date u ; ,r n� 02/262019 01 88226385 0 31030320 1 2,109.00 20.00 0 REG A R 201902 02/28/2019 U - 01/28/2019 01 88226385 0 31030320 1 2,089.00 25.00 0 REG A R 201901 0113012019 r 12/21/2018 01 88226385 0 31030320 10 1 2,064.00 18.00 0 REG A R 201812 12/30/2018 11/26/2018 01 88226385 0 31030320 1 2,046.00 19:00 0 REG A R 201811 11/28/2018 .3.f ` 0 0 + 10/30/2018 01 88226385 0 31030320 1 2,027.00 22.00 0 REG A R 201810 10/30/2018 2 ` 0 f� 10/01/2018 01 88226385 0 31030320 1 2,005.00 30.00 0 REG A R 201809 10/04/2018 2.. E 4 It G + 08/22/2018 01 86226385 0 31030320 1 1,975.00 24.00 0 REG A R 201808 08272018 G D C, + 07/23/2018 01 88226385 0 31030320 1 1,951.00 32.00 0 REG A R 201807 07/26/2018 n 06/13/2018 01 88226385 0 31030320 ` 1 1,919.00 23.00 0 REG A R 201806 06/18/2018 !� 05/1618 01 88226385 0 31030320 1 1,896.00 21.00 0 REG A R 201806 05r 2018 2 01 � C�f� + � O 20 oal172olt; 01 88226385 0 31030320 1 1,875.00 22.00 0 REG A R 201804 04/22,2018 03/12/2018 01 88226385 0 31030320 1 1,853.00 18.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226385 0 31030320 1 1,835.00 20.00 0 REG A R 201802 02/20/201a 01/152018 01 88226385 0 31030320 1 1.815.00 32.00 0 REG A R 201801 01/24/2018 12/11/2017 01 88226385 0 31030320 1 1,783.00 20.00 0 REG A R 201712 12/192017 11/14/2017 01 88226385 0 31030320 1 1,763.00 22.00 0 REG A R 201711 11282017 - 10/18/2017 01 88226385 0 31030320 1 1,741.00 33.00 0 REG A R 201710 10/262017 u[ + 09/12/2017 01 88226385 0 31030320 1 1,708.00 22.00 0 REG A R 201709 09124/2017 u `j¢ 08/16/2017 01 88226385 0 31030320 1 1,686.00 22.00 0 REG A R 201708 08/23/2017 2 r2 [� 07/17/2017 01 88226385 0 31030320 1 1,864.00 24.00 0 REG A R 201707 07272017 2 z -i r+ 06/14/2017 01 88226385 0 31030320 1 1,840.00 20.00 0 REG A R 201706 06/26/2017 2 C. - 0 �: f 05/17/2017 01 88226385 0 31030320 �' 1 1 1,620.00 20.00 0 REG A R 201705 05/30/2017 2 0 - U[.+ � 04/1912017 01 88226385 0 31030320 1 1,600.00 25.00 0 REG A R 201704 04/27/2017 2 = U( + 031132017 01 88226385 0 31030320 1 1,575.00 21.00 0 REG A R 201703, 03282017 02/14/2017 01 88226385 0 31030320 1 1,554.W. . 21.00 0 REG A R 201702 02/26/2017 01117/2017 01 88226385 0 31030320 1 1,533.00_ 29.00 _0. REG A. R 201701 01/29/2017 12/122016 01-88226385' 0 31030320 1 1,504:60 20.00' 0---- REG A R 201612: 12/27/2016 11/162016 01 88226385 0 31030320 1 1,484.00 24.00 0 REG A R 201611 11/28/2016 f 10/172016 01 88226385 0 31030320 1 1,460.00 28.00 0 REG A R 201610 10/31/2018 09/092016 01 88226385 0 31030320 1 1,432.00 18.00 0 REG A R 201609 09212016 08/172016 01 88226385 0 31030320 1 1,414.00 26.00 0 REG A R 201608 08/302016 07/152016 01 88226385 0 31030320 1 1,388.00 27.00 0 REG A R 201607 07252016 06/132016 01 88226385 0 31030320 1 1,361.00 26.00 0 REG A R 2016W 06/222016 05/162016 61 88226385 0 31030320 1 1,335.00 29.00 0 REG A R 201805 05/262016 04/182016 01 88226385 0 31030320 1 1,306.00 33.00 0 REG A R 201804.04272018 Date: 3/14/2019 . Meter Reading History Page 1 of 5 Customer# 602567-1 Promise#602567 1-irvice:Water-Regular Metered �+ METER READING TRANSACTION INFO e ;: + Read Date Sequence# Meter# Face Sort # Read Code Reading ConsumMio Sido Count I= Code Slatus i e•o Trans Date 2 ' ��0. 02/26/2019 01 88226368 0 31030310 1 373.00 2.00 0 REG A R 201902 02/28/2019 U _ 0 01/28/2019 01 88226368 0 31030310 1 371.00 3.00 0 REG A R 201901 01/302019 7 . 0 12/21/2018, 01 88226368 0 31030310 �l r p 1 368.00 1.00 10 REG A R 201812 12/302018 J 1,0 ,y 11/26/2018 01 88226368 0 31030310 1 367.00 2.00 0 REG A R 201811 11/28/2018 10/30/2018 01 88226368 0 31M0310 1 365.00 2.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226368 0 31030310 1 363.00 4.00 0 REG A R 201809 10/04/2018 t { 0812=018 01 88226368 0 31030310 1 359.00 7.00 0 REG A R 201808 08272018 • C?L;+ 07/23/2018 01 88226368 0 31030310 1 352.00 5.00 0 REG A R 201807 0726/2018 06/132018 01 88226368 0 31030310 1 347.00 3.00 0 REG A R 201806 06/182018 2 c EJ 0 05/172018 01 88226368 0 31030310 � � 1 344.00 2.00 0 REG A R 201805 05282018 04/172018 01 88226368 0 31030310 1 342.00 3.00 0 REG A R 201804 04222018 03/122018 01 88226368 0 31030310 1 339.00 2.00 0 REG A R 201803 03/192018 02/132018 01 88226368 0 31030310 1 337.00 2,00 0 REG A R 201802 02202018 • [ u;- 01/162018 01 88226368 .0 31030310 1 335.00 4,00 0 REG A R 201801 0124/2018 ? . y; 12/712017 01 88226368 0 31030310 ( 1 331.00 2.00 0 REG A R 201712 12/19/2017 c. (U 11/142017 01 88226368 0 31030310 `� 1 329.00 3.00 0 REG A R 201711 11282017 c F 10/182017 01 88226368 0 31030310 1 326.00 5.00 0 REG A R 201710, 10/26/2017 1 { 09/122017 01 88226368 0 31030310 1 321.00 5.00 0 REG A R 201709 09/242017 ° ` 08/162017 01 88226368 0 31030310 1 316.00 6.00 0 REG A R 201708 08232017 ' {1 CIS 07/17/2017 01 88228368 0 31030310 1 310.00 5.00 0 REG A R 201707 07272017. 1-' 0 0 06/142017 01 88226368 0 31030310 1 305.00 4.00 0 REG A R 201706 06262017 C C +- 05/172017 01 88226368 0 31030310 ���»i 1 301.00 3.00 0 REG. A R 201705 05/302017 4 ° 0 0-1- 04/19/2017 01 88226368 0 31030310 1 298.00 4.00 0 REG A R 201704 04/272017 G 0 f 03/132017 01 88=368 0 31030310 1 294.00 3.00 0 REG A R 201703,03282017 4 = 0%1 T 02/142017 01 88228368 0 3103031.0 1 291.00 4.00 0 REG A R 201702 02262017 01/172017 01 68226368 0 31030310 1 287.00 4.00 0 REG_ _A_. R 201701 0129/2017 _ 12/122016 01 88226369 0 31030310 1 283.00 3.00 0 REG A R 201612 12/272016 11/16/2016 01 88226368 0 31030310 1 280.00 4.00 0 REG A R 201611 11282016 10/172016 01 88226368 0 31030310 1 276.00 8.00 0 REG A R 201610 10/312016 09/092016 01 88226368 0 31030310 1 268.00 7.00 0 REG A R 201609 09212016 08/172016 01 88226368 0 31030310 1 261.00 8.00 0 REG A R 201608 08/302016 07/152016 01 68226368 0 31030310 1 253.00 9.00 0 REG A R 201607 0725/2016 0&132016 01 88228368 0 31030310 1 244.00 3.00 0 REG A R 2016.06 06222016 05/162016 01 88226368 0 31030310 1 241.00 3.00 0 REG A R 201605 05262016 04/182016 01 88226388 0 31030310 1 238.00 3.00 0 REG A R 201604 04272016 Date: 3/14/2019 deter Reading Hist®ry Page 1 of 5 Customer# 6025864 Premise#602586 Service:Water-Regular Metered METER READING TRANSACTION INFO I ' t Re-W Date Seouence# Meter# Face sort# Read Code Reading Consumption Ski o Count Code Status Bill eri Date I 0 0 '` 02/26/2019 01 88226383 0 31030300 1 4,372.00 26.00 0 REG A R 201902 02/28/2019 01/28/2019 T 01 a 226383 0 31030300 1 4.348.00 46.00 0 REG A R 201901 01/30/2019 L L: 122i2018 01.88226383 0 31030300 1 4,300.00 12.00 0 REG A R 201812 12/30/2018 -, 6 , i_; f 11/26/2018 01 88226383 0 31030300 1 4,288.00 15.00 0 REG A R 201811 11/28/2018 5 1 o J 0, 10/30/2018 01 88226383 0 31030300 1 4,273.00 24.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226383 0 31030300 1 4,249.00 40.00 0 REG A R 201809 10/04/2018 2 r c i t, 08222018 01 88226383 0 31030300 1 4.209.00 36.00 0 REG A R 201808 08/27/2018 29 07/23/2018 01 88226383 0 31030300 1 4.173.00 51.00 0 REG A R 201807 07/28/2018 0�' O6/132018 01.88226383 0 31030300 1 4,122.00 27,00 0 REG A R 201806 06/182018 05/172018 0.1 88226383 0 310303W 1 4,095.00 24.00 0 REG A R 201805 05/28/2018 2 37, • I.:i.= 04/172018 01 88226383 0 31030300 1 4,071.00 28.00 0 REG A R 201804 0422/2018 03/122018 01 88226383 1 0 3 030300 1 4,043.00 21.00 0 REG A R 201803 03/19201 B � > 02/132018 01 88226383 0 31030300 1 4,022.00 23.00 0 REG A R 201802 02202018 01/162018 01 88226383 0 31030300 1 3,999.00 33.00 0 REG A R 201801 01242018 12/11/2017 01 88226383 0 31030300 1 3,966.00 28.00 0 REG A R 201712 12/192017 ':< t 11/142017 01 88226383 0 31030300 1 3.938.00 49.00 0 REG A R 201711 11282017 /, �.• „ r, ,+ .�. 10H82017 01 88226383 0 31030300 1 3,889.00 88.00 0 REG A R 201710 10262017 09/122017 01 88226383 0 31030300 1 3,801.00 63.00 0. REG A R 201709 OG242017 6- `i i; tj + 08/162017 O 01 88226383 0 31030300 1 3,738.00 71.00 0 REG A R 201708 0823/2017 07/172017. /1�0 01 88226383 0 31030300 1 3,667.00 53.00 0 REG A R 201707 0727/2017 I (�L i 06/142017 J 01 88226383 0 31030300 1 3,614.00 31.00 0 REG A R 201706 0626/2017 i 1 .•_ ° �.1. I, , �\� 05/182017 '\ 01 88226383 0 31030300 1 3;583.00 .28.00 0 REG. A R 201705 05/302017 I U C,; 04/192017 d 1 0 88226383 0 31030300 i ,t 1 3,555.00 32.00 0 REG A R 201704 04272017 m f'•t. 03/132017 01 88226383 0 31030300 1 3,523.00 21.00 0 REG A R 201703 03282017 ° f # 02IM017 01 88226383 0.31030300 1-3,502.00 23.00 0 REG A R 201702 0228/2017 2 } {;l ! i 01/172017 01 88226383 0 31030300 1 3,479.00 26.00 0 REG A R 201701 01292017 G � 0 �� 1 12/132016 01188226383 6 31030300 1 3,453t 23.00 0 REG A' R 201612.12/272016 11/162016 01 88226383 0.31030300 1 3,430.00 41.00 0 REG A R 201611 11282016 10/172016 01 88226383 0 31030300 1 3,389.00 86.00 0 REG A R 201610 10/312018 09/092016 01 88226383 0 31030300 1 3,303.00 58.00 0, REG A R 201609 09212016 08/172016 01 88226383 0 31030300 1 3,245.00 88.00 0 REG A R 201608 08/30/2016 07/152016 01 88226383 0 31030300 1 3,157.00 76.00 0 REG A R .201607 07252016 06/132016 01 88226383 0 31030300 1 3,081.00 37.00 0 REG A R 201606.Og/22@016 05/162016 01 88226383 0 31030300 1 3,044.00 25.00 0 REG A R . 201605 0526/2016 04/182016. 01 88226383 0 31030300 1 3,019.00 33.00 0 REG A R 201604 04/272016 Commonwealth of Massachusetts v Title 5 Official Inspection Form m Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ""' ^M v 1431 lyannou h Road Property Address '-0 p..�l Strawberry Hill Condo's units 15-22 � - Owner information is Owners Name t ./ required for every Hyannis Y MA 02601 12/4/2017 page. CltyfFown State ZipCode Date of Inspection n- Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return Name of Ins ector key. P 115 Ford Septic Services, LLC v018 Company Name P.O. Box 49 Company Address Osterville MA CitylTown 02655 State Zip Code 508-862-9400 S 12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 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 uation by the Local Approving Authority 12/8/2017 Insp or's Signature Date The tern inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurfacew Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °�M�,•`''� 1431 lyannou h Road Property Address Strawberry Hill Condo's units 15-22 Owner information is Owner's Name required for every Hyannis MA 02601 12/4/2017 page. City/Town State ZipCode Date of Inspection B. Certification (Cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I annou h Road �M 9 Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 12/4/2017 page. Cltyrrown State ZipCode Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if Pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System'will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 . Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 12/4/2017 page. City/Town State ZipCode Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ E Backup of sewage into facility or system component due to overloaded or , clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 12/4/2017 page. City/Town State Zip Code Date of Inspection B. Certification (Cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area- IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments • 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 12/4/2017 page. City/Town C. Check State ZipCode Date of Inspection list Check if the following have been done. You must indicate "yes"or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of Liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 12 12 . Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 1320 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 page. Cltyrrown 12/4/2017 State Zip Code Date of Inspection D. System Information Description: Number of current residents: n/a Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No t Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑' Yes ❑ No Water meter readings, if available: (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owners Name information is required for every Hyannis MA 02601 Clty/Town 12/4/2017 page. State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: pumped yearly Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 12/4/2017 page. City/Town State ZipCode Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed -unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ❑ 40 PVC ❑ other(explain): Distance from private water Supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 50" feet Material of construction: ® concrete ❑ metal ❑ fiberglass 9 ❑ 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: 2500 H-20 Sludge depth: 6 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis page.. City/Town MA 02601 12/4/2017 State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 10 Distance from top of scum to top of outlet tee or baffle 4 Distance from bottom of scum to bottom of outlet tee or baffle 10 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): There was no sign of leakage. Steel covers were to grade. Grease Trap(locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑fiberglass 9 ❑ 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 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner information is Owner's Name required for every Hyannis MA 02601 12/4/2017 page. City/Town State Zip Code Date of Inspection D. System Information— (co nt.) 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 9 El polyethylene El other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 I annou h Road Property Address Owner StrawberryHill Condo's units 15-22 information is Owner's Name required for every Hyannis 02601 page. City/Town MA State 12/4/2017 D. System Information (cont.) Zip Code Date of Inspection Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert even 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.): The D-box was normal. Steel cover was to grade. 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins t 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 1431 I annou h Road Property Address Owner StrawberryHill Condo's units 15-22 information is Owner's Name required for every Hyannis page. City/Town MA 02601 12/4/2017 State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2- 1000 gal.with 4'stone Elleaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,vegetation, etc.): condition of The pits were taking water. There was no sign of failure. Steel covers were to grade. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 15ins•3/13 . Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ments `M 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 page. City/Town 12/4/2017 D. System Information (cont.) State Zip Code Date of Inspection Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for VoluntaryAssessments nts 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner Owner's Name information is required for every Hyannis MA 02601 12/4/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately A l I COver1 'r0 G(ACL 11 S �01/� t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 I annou h Road Property Address Owner Strawber ry H il I Condo's unit s 15 _ 22 information is Owner's Name required for every Hyannis page. City/Town MA 02601 12/4/2017 State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 35' +/- 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: Topo and water contours map ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above h Before filing this Inspection Report, please see Report Completeness p ss Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 I annou h Road Property Address Strawberry Hill Condo's units 15-22 Owner information is Owner's Name required for every Hyannis MA 02601 12/4/2017 page. City/Town State ZipCode Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, 6, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 17 of 17 COMMONWEALTH OF MASSACHUSETTS a = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS - e DEPARTMENT OF ENVIRONMENTAL PROTECTION a 5 --2 TITLE 5. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSALSYSTEM FORM PART A CERTIFICATION Strawberry Hill Con iniums Property Address: 1431 I anough Rcad•Gnits 15-22 Hyannis,MA 026d1 Owner's Name: Strawberry Hill Condominiums Owner's Address: .,.Building C Date of Inspection: July 15, 2011 Name of Inspector:.(Please Print).James M.Ford - Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400' - CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my. training and experience in the proper function and maintenance of on site sewage disposal systems, .I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.060). The system: y rises 3 ditionally Passes e ds Further Evaluation by the Local Approving Authority ail N In@pcctor's Signature: Date:, July 20, 2011 Th -system inspector shayia of th s inspection report to the Approving Authority(Board of Health or DEPe)within 30 days of cnspection. If the system is a shared system or has a design flow of 10,000 ` gpd'or greater,theinspector and the system owner shall submit the report to the appropriate regional office of the O DEK,The origiral,,should be sent to the system owner and copies sent to the buyer,if applicable,and the approving autho ity. CD c Via, e . t— Not sdand Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under th'e same or different conditions of use. Title 5 Inspection Fonn 6/15/2000 page 1 r Page 2 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A C=15-22 (continued) Property Address: 14311 anou h Ru Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 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. Answer es no or not determined Y N ND in the for the following statements. If"not determined" please yes, ( ) g ,P s 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health):, broken pipe(s)are replaced obstruction is removed distribution.box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1431 Iyanoud Road, Units 15-22 Hyannis,MA Owner: Strawber iT Hill Condominiums Date of Inspection: July 15, 2011 C. Further Evaluation is Required by the Board of Health: Conditions exist which require furtherevaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303 (1)(b)that the system is not functioning in a manner which will protect public health;safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other:> 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1431 Iyanouzh R_,zd, Units 15-22 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or``no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓. Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. _ ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. _ ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory;for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System: To be considered a large system the system'must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No _ the system is within 400 feet of a surface drinking water supply _ the system is within 200 feevof a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 s Page 5 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1431 IyanouQh Road, Units 15-22 Hyannis,MA Owner: Strawbeny Hill Condominiums Date of Inspection: July 15, 2011 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this.inspection? ✓ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS,located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ 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(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1431 Iyanowh Road, Units 15-22 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 T FLOW CONDITIONS RESIDENTIAL Number of bedrooms'(design): 12 Number of bedrooms(actual): 12 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a Number of current residents: n/a Does residence have a garbage grinder(yes or no): N/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] . Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAVINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 sy;em(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unknown Was system pumped as part of the inspection,(yes or no): No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow,cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation app. In 1981 Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 IyanouQh Road, Units 15-22 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): , Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.):- SEPTIC TANK: ✓ (locate on site plan) Depth below grade: Approx. 50" Material of construction: ✓ concrete _metal _fiberglass _polyethylene —other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2500 Qal. Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 4" Distance from bottom of scum to bottom of outlet tee or baffle: 15" How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs ofleakaQe. The steel covers were to grade. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: concrete._:petal _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 baffler Date of last pumping:. Comments(on pumping recommendations,in.le"and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,-etc.): 7 Page 8 of 11 OFFICIAL INSPECTION:FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 IyanouQh Road, Units 15-22 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: Even 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.): The level in the D-box was normal. Steel covers were to Qrade. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 I_ Page 9 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Ivanou-ah Road, Units 15-22 Hyannis, MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 2 - 6'x 6' 1000 Qal. leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): water was flowine to both pits. No sign of failure. All steel covers were to Qrade. CESSPOOLS: None (cesspool must be pumped as part,of inspection)(locate on site plan) } Number and configuration: Depth-top of liquid to inlet.invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 ' OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 IyanouQh Rcad, Units 15-22 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. All cove, 10 ' Page 11 of i 1 I ` OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1431 Ivanou-ah Road, Units 15-22 Hyannis,MA Owner: Strawberry Hill Condominiums Date of Inspection: July 15, 2011 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35 +/- feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked, date of design plan reviewed: Observed site(abutting property/observation hole within.150 feet of SAS) Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Usine Barnstable topographic and water contours maps, the maps were showing approximately 35'+/-to Around water at this site. This report has beers prepared only for the septic system and cornporrews described herein: This septic system has been inspected ail passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the fixture. There have been rzo warranties or guarantees,either expressed, written or implied, relating to the septic system, the inspectiorn, this report and/or any components of the septic system.which have not beeri located arid inspected. 11 Commonwealth of Massachusetts h ,, Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessmentski " !% 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centervll a is MA 02632 03-15-2019 ,. page. Cityrrown/ State Zip Code Date of Inspection. N? Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 6-1*t 3 l S on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road "ICI Company Address Teaticket Ma. 02536 Cityrrown State Zip Code ram, 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property.address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails - 019 Inspector's Signature_ Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: At the time of the inspection of this 12 Bedroom condo building I did not see any thing that meets a falure condition according to the State and The Barnstable Health Dept. code. 2 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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form I, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ............ , 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owners Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Ig Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments l% 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) El 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water, supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well"*. Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate ".Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form . h Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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.] ❑ Z The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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—1WPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface,Sewage Disposal System Form Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system.has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out.in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® -❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® 0 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ............. , 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 12 Number of bedrooms (actual): 12 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1320 plus GPD Description: Number of current residents: apx. 12 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Water reading attached Sump pump? ❑ Yes ® No occupied Last date of occupancy: Date t5insp:doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: . Source of information: Last pumped in Dec. 2018 per management Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts �= l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): 48" Depth below grade: feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage,etc.): water was flowing at the time of the inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ............. !% 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 36"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: 2000 gallon 41 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 58'i , Scum thickness 2' Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? sludge judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank is pumped once a year..Steel cover at grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts IP Title 5 Official Inspection Form <lo Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address - Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code_ Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): 0, 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.): At the time of the inspection there was no visible signs of leakage. Steel cover at grade. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form _ b Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is Centerville MA 02632 03-15-2019 required for every page. CityrTown State Zip Code Date of Inspection D. System Information (cont.) 10. 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.)-. " If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 2 ❑ leaching chambers number: leaching galleries number: El leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary.Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the liquid level was two plus feet below the invert in one of the leaching pits. Steel cover at grade. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer, Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form (I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owners Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owners Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20 plus feet 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: I augered a hole at a lower elevation and I shot it with a transit. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 i Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 lyannough Rd Units 23-30 Property Address Strawberry Hill Condo Owner Owner's Name information is required for every Centerville MA 02632 03-15-2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 2 Iy t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Date:3/14/2019 Meter Reading HIsto!j Page 1 of 5 Customer# 602503-1 Premise#602583 Service:Water Regular Metered METER REA ING TRANSACTION INFO C,`, -; Read Date Seauenoe Meter# Face Sort# Read Code a di kiCount Tvoe Code MAY Bill Endo Trans Date 6 r:`; 02/26/2019 01 88226380 0 31030290 1 2,190.00 22.00 0 REG A R 201902 0228/2019 01/28/2019 01 88226380 0 31030290 1 2,168.00 31.00 0 REG A R 201901 01/30/2019 12212018 1 O 1 g 01 88226380 0 31030290 1 2,137.00 22.00 0 REG A R 201812 12/30/2018 11/26/2018 01 88226380 0 31030290 1 2,115.00 26.00 0 REG A R 201811 11/28/2018 C ` J 10/30/2018 01 88226380 0 31030290 1 2,089.00 26.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226380 0 31030290 1 2,063.00 39.00 0 REG A R 201809 10/04/2018 - 08222018 -01 88226380 0 31030290 1 2,024.00 29.00 0 REG A R 201808 08/27/2018 2 3 = 0 1 + 07/23/2018 �� 01 89226380 0 31030290 1 1,995.00 42.00 0 REG A R 201807 07262018 ,=t; f• (;.r O6/132018 n 01 88226380 0 31030290 1 1,853.00 24.00 0 REG A R 201806 06/18/2018 0 05/18/2018 �� 01 88226380 0 31030290 1 1,929.00 23.00 0 REG A R 201805 05282018 G e. _ 4 T 04/17/2018 01 88226380 . 0 31030290 1 1,906.00 29.00 0 REG A R 201804 04/22/2018 03/12/2018 01 88226380 0 31030290 1 1,877.00 22.00 0 REG A R 201803 03/19/2018 " 02/132018 01 88226380 0 31030290 1 1,855.00 23.00 0 REG A R 201802 02/20/2018 01115,2018 01 88226380 0 31030290 1 1,832.00 25.00 0 REG A R 201801 01/24/2018 1 C 12/11/2017 V{� 01 88228380 0 31030290 1 1.807.00 21.00 0 REG A R 201712 12/19/2017 20 - 6 11/14/2017 1 01 88226380 0 31030290 1 1,786.00 20.00 0 REG A R 201711 11/28/2017 e•� 10/182017 01 88226380 0 31030290 1 1.766.00 30.00 0 REG A R 201710 10/26/2017 C " i`' ` 09/122017 01 88226380 0 31030290 1 1,736,00 22.00 0. REG A R 201709 09/24/2017 2 u C 08/16/2017 01 88226380 0 31030290 1 1,714.00 27.00 0 REG A R 201708 08/23/2017 2 7 Q U 07/17/2017 01 88226380 0 31030290 1 1,687.00 29.00 0 REG A R 201707 07/27/2017 29 - C:(.j= 06/142017 01 88226380 0 31030290 1 1,658.00 23.00 0. REG A R 201706 06/26/2017 CI C, 05/172017 01 88226M 0 31030290 1 1,635.00 18.00 0 REG A R 201705 05/30/2017 1d ^ iii:: i- 04119MO17 01 88226380 0 31030290 1 1,617.00 21.00 0 REG A R 201704 04/272017 L j G U Y 03/13f2017 01 88228380 0 31M0290 1 1,596.00 17.00 0 REG A R . 201703 03/2=017 _ 02/1412017 01 1.88226380 0 31030290 1 1,679.00 18.00 0 REG A R '201702 02/26/2017 f ` U Y 01/17/2017. 01 88226380 0 31030290 1 1,561.00 23.00 0 REG A R 201701 -01292017 f f 12/12/2016 01 88226$80 0 31030290" 1 1;538.00` 18 OOl 0 REG A R -�201612 12r27/2016 n 4 11/16/2016 01 88228380 0 31030290 1 1.520.00 19.00 0 REG A R 201611 11/28/2016 Ij 10/172016 01 88226380 0 31030290 1 1,501.00 26.00 0 REG A R 201610 10/31/2016 09/092016 01 88228380 0 31030290 1 1,475.00 19.00 0 REG A R 20160% 09/212016 08/172016 01 88226380 0 31030290 1 1,456.00 26.00 0 REG A R 201608 08/30/2016 07/152016 01 88226380 0 31030290 1 1,430.00 27.00 0 REG A R 201607 07252016 06/132016 01 88226380 0 31030290 1 1,403.00 20.00 0 REG A R M606 0622/2016 05/182016 01 88226380 0 31030290 1 1,383.00 20.00 0 REG A R 201605 05262016 04/18/2016 .01 88226380 0 31030290 1 1,363.00 22.00 0 REG A R 201604 04272016 Date:3/14/2019 _ Meter Reading HistoEy Page 1 of 5 Customer# 602588-1 Premise#602588 Service:Water-Regular Metered 1 8 a METER READING TRANSACTION INFO 1 Read Date Sequence# Meter# Face Sow Read Code Reading Consumption Skip Count Tyne Code Status Bill Period Trans Date 02/26/2019 01 88226385 0 31030320 1 2,109.00 20.00 0 REG A R 201902 02282019 01/28/2019 01 88226385 0 31030320 1 2,089.00 25.00 0 REG A R 201901 01/30/2019 12/21/2018 01 88226385 0 31030320 11 1 2.064.00 18.00 0 REG A R 201812 12/30/2018 11/26/2018 01 88226385 0 31030320 1 2,046.00 19.00 0 REG A R 261611 11/28/2018 Cl + 10/30/2018 01 88226385 0 31030320 1 2,027.00 22.00 0 REG A R 201810 10/30/2018 2 3 10/012018 01 88226385 0 31030320 1 .2,005.00 30.00 0 REG A R 201809 10/042018 21.1 1 - G G + 08222018 01 88226385 0 31030320 1 1,975.00 24.00 0 REG A R 201808 08272018 2. , `i[i �- � 07/232018 01 88226385 0 31030320 1 1,951.00 32.00 0 REG. A R 201807 07262018 nLi 06/13/2018 01 88226385 0 31030320 \ 1 1,919.00 23.00 0 REG A R 201806 06/182018 20 4 0 t; + iv 05/162018 01 88226385 0 31030320 � � 1 1,896.00 21.00 0 REG A R 201805 05282018 04/172018 01 88226385 0.310.30320 1 1,875.00 22.00 0 REG A R 201804 04222018 03/122018 01.88226385 0 31030320 1 1,853.00 18.00 0 REG A R 201803 03/192018 02/132018 01 88226385 0 31030320 1 1,835.00 20.00 0 REG A R 201802 02202018 01/152018 01 88226385 0 31030320 1 1.815.00 32.00 0 REG A R 201801 01242018 12/112017 01 88226385 0 31030320 1 1,783.00. 20.00 0 REG A R 201712 12/19/2017 2 2 e `,�; 11/142017 01 88226385 0 31030320 1 1,763.00 22.00 0 REG A R 201711 11/282017 10/182017 01 88226385 0 31030320 1 1,741.00 33.00 0 REG A R 201710 10262017 09/122017 01 88226385 0 31030320 . 1 1,708.00 22.00 0 REG .A R 201709 09/242017 2 " 08/16/2017 01 88226385 0.31030320. 1 1,688.00 22.00 0 REG 'A R 201708 08232017 2 2 =i 07,172017 01 88226385 0 31030320 1 1,684.00 24.00 0 REG A R 201707 07272017 2 iYi C; 06/14/2017 01 88226385 0 31ON320 1 1,640.00 20.00 0 REG A R 201706 06262017 2 C 0 C' lO 05/172017 01 88226385 0 31030320 �' a 1 1,620.00 20.00 0 REG A R 201705 .051302017 2 G -,ci„- ii� 04/192017 01 88226385 0 31030320 1 1,600.00 25.00 0 REG A R 201704 041272017 2 5 . CJ 03/132017 01 88226385 0 31030320 1 1,575.00 21.00 0 REG . A R 201703 0328/2017 2 1 ° a C,1 02/142017 01 88226385 0 31030320 1 1.554.00 .21.00 0 . REG A R 201702 02 r2017 01/17/2017 01 88226385 0 31030320_ 1 1,533.00 29.00 2 1 - Q { 201701 ,01/29/2017 12/122016 01'88226385 0 31030320 1 1;504:00 20.0 -� - REG A R REG A R 201612 12272016 29 `(1 11/162016 01 88226385 0 31M0320 1 1,484.00 24.00 0 REG A R 201611 1128/2016 4=' 10/172016 01 88228385 0 31030320 1 1,460.00 28.00 0 REG A R 201610 10/312018 09/092016 01 88226385 0 31030320 1 1,432.W 18.00 0 REG A R 201609 09212016 08/172016 01 88226385 0 31030320 1 1,414.00 .26.00 0 REG A R 201608 08/302016 07/15201/1 01 88226385 0 31030320 1 1,388.00 27.00 0 REG A R 201607 07252016 O6/132016 01 88226385 0 31030320 1 1,361.00 26.00 0 REG A R 201606 06/222016 05/162016 61 88226385 0 31030320 1 1,335.00 29.00 0 REG A R 201605 0526/2016 04/182016 01 88226385 0 31030320 1 1,306.00 33.00 0 REG A R 201604 04272016 Date: 3/14/2019 deter Readina History Page 1 of 5 Customer# 602687-1 Premise#602587 c,§rvice:Water-Regular Metered i L'' METER READING TRANSACTION INFO a L'.i Read Date Sequence# Meter# Face Sort # ReaO Code gg�jpg Consumption Skip Count Tye Code Status Bill Period amens Qgte 2 C?0 02/26/2019 01 88226368 0 31030310 1 373.00 2.00 0 REG A R 201902 02/28/2019 01/28/2019 01 88226368 0 31030310 1 371.00 3.00 0 REG A R 201901 01/30/2019 7 - C 12/21@018 01 88226368 0 31030310 V G 1 368.00 1.00 0 REG A R 201812 12/30/2018 C 01 - 11/26/2018 01 88226368 0 31030310 V b 1 367.00 2.00 0 REG A R 201811 11/28/2018 //'' 10/30/2018 01 88226368 0 31030310 1 365.00 2.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226368 0 31030310 1 363.00 4.00 0 REG A R 201809 10/04/2018 = 0 L i 08/ WO18 01 88226368 0 31030310 1 359.00 7.00 0 REG A R 201808 08/27/2018 0 a 07/23/2018 01 88226368 0 31030310 V 1 352.00 5.00 0 REG A R 201807 07/26/2018 "' O6/13/2018 01 88226368 0 310303, 1 347.00 3.00 0 REG A R 201806 06/18/2018 1 r 0 0+ 05/17/2018 01 88226368 0 31030310 1 344.00 2.00 0 REG A R 201805 05/28/2018 ri Ci 04/17/2018 01 88228368 0 31030310 1 342.00 3.00 0 REG A R 201804 041=018 y 7 - y.U k + 03/12/2018 01 88226368 0 31 D30310 1 339.00 2.00 0 REG A R 201803 03/19/2018 02/13/2018 01 88226368 0 31030310 1 337.00 2,00 0 REG A R 201802 02/20/2018 • In 01/16/2018 01 88226368 0 31030310 1 335.00 4.00 0 REG A R 201801 01/24/2018 12/11/2017 01 88226368 0 31030310 1 331.00 2.00 0 REG A R 201712 12/19/2017 EY` 11/14/2017 01 88226368 0 31030310 1 329.00 3.00 0 REG A R 201711 11/28/2017 ° 10/18/2017 01 88226368 0 31030310 1 326.00 5.00 0 REG A : 0; R 201710 10/28/2017 09/12/2017 01 88226368 0 31030310 1 321.00 6.00 0 REG A R 201709 09/24/2017 ° li 08/16QO17 01 88226368 0 31030310 1 316.00 6.00 0 REG A R 201708 08/23/2017 3 liU•. 07/17/2017 01 88226M 0 31030310 1 310.00 5.00 0 REG A R 201707 07/27/2017 /.. 0 06/14/2017 01 88226368 0 31030310 1 305.00 4.00 0 REG A R 201706 06/26/2017 ° G G,+ 05/17/2017 01 88226368 0 31030310 1 301.00 3.00 0 REG, A R 201705 05/30/2017 4 ° 0 0+ 04/19/2017 01 88226368 0 31030310 1 298A0 4.00 0 REG A R 201704 04/27/2017 3 ° C,U f 03/13/2017 01 88226358 0 31030310 1 294.00 3.00 0 REG A R 201703 03/28/2017 4 - C it T 02/14/2017 01 88226M 0 31030310 1 291.00 4.00 0 REG A R 201702 02/26/2017 01/17/2017 01 88226368 0 31030310 1. 287.00 4.00 __ _0 ." REG_ A R 201701 01/29/2017 12 I2/2016 01 88226368 0 31030316 1 283.00 3.00 0 REG A R 201612 12/27/2016 11/16/2016 01 88226368 0 31030310 1 280.00 4.00 0 REG A R 201611 11/2812016 10/17/2016 01 88226368 0 31030310 1 276.00 8.00 0 REG A R 201610 10131/2016 09/09MO16 01 88226368 0 31030310 1 268.00 7.00 6 REG A R 201609 09/21/2016 08/17/2016 01 BM6368 0 31030310 1 251.00 8.00 . 0 _ REG A R 201608 OM012016 07/15/2016 01 88226368 0 31030310 1 253.00 9.00 0 . REG A R 201607 07/25/2016 06/13/2016 01 88226388 0 31030310 1 244.00 3.00 0 REG A R 201606 OM2/2016 05/16/2016 01 88226368 0 31030310 1 241.00 3.00 0 REG A R 201605 05/26/2016 04/18/2016 .01 88226368 0 31030310 1 238.00 3.00 0 REG A R 201604 04/27/2016 Date: 3/14/2019 deter Reading Hist®trcir Page 1 of 5 Customer# 6025864 Premise#602586 Service;Water-Regular Metered METER READING TRANSACTION INFO a Read Da Seouence#_ Meter# Face Sort # Read Code Reading Consumes Skin Count Tyge Code Status Bill P n e'odTrans Date 02/26/2019 01 88226383 0 31030300 1 4,372.00 26.00 0 REG A R 201902 02128/2019 01/28/2019 01 88226383 0 31030300 1 4,346.00 46.00 0 REG A R 201901 01/30/2019 0( 12/21/2018 01 88226383 0 31030300 1 4,300.00 12.00 0 REG A R 201812 12/30/2018 . (J r 11/26/2018 01 88226383 0 31030300 1 4,288.00 15.00 0 REG A R 201811 11282018 5 1 ° b 0 10/30/2018 01 88226383 0 31030300 1 4,273'.00 24.00 0 REG A R 201810 10/30/2018 10/01/2018 01 88226383 0 31030300 1 4,249.00 40.00 0 REG A R 201809 10/04/2018 G / V 0( � 08/22/2018 01 88226383 0 31030300 1 4.209.00 36.00 0 REG A R 201808 0827/2018 07/23/2018 01 88226383 0 31030300 1 4,173.00 51.00 0 REG A R 201807 07282018 06/13/2018 a 01 88226383 0 31030300 1 4,122.00 27.00 0 REG A R 201806 06/18/2018 r ° 0 0 _ 05/17/2018 0 e 01 88226383 0 31030300 1 4,095.00 24.00 0 REG A R 201805 05/28/2018 2 !;(s �,V 04/17/2018 01 88226383 0 31030300 1 4,071.00 28.00 0 REG A R 201804 04/22/2018 03/12/2018 01 88226383 0 31030300 1 4,043.00 21.00 0 REG A R 201803 031192018 02/13/2018 01 88226383 0 31030300 1 4,022.00 23.00 0 REG A R 201802 02/20/2018 01/18/2018 01 88226383 0 31030300 1 3,999.00 33.00 0 REG A R .201801 01/24/2018 12/112017 61 W226383 0 31030300 1 3,966.00 28.00 0 REG A R 201712 12/19/2017 <. t, 11/142017 01 88226383 0 31030300 1 3,938.00 49.00 0 REG A R 201711 1112VM17 10/182017 01 88226383 0 31030300 1 3,889.00 88.00 0 REG A R 201710 10/26/2017 r 09/122017 01 88226383 0 31030300 1 3,801.00 63.00 0 REG A R 201709 0924/2017 �2-� 08/16/2017 01 88226383 0 31030300 1 3,738.00 71.00 0 REG A R 201708 0823/2017 07/172017 �O 01 88226383 0 31030300 1 3.667.00 53.00 0 REG A R 201707 07/2712017 ,? r (�61 06/14/2017 01 88226M 0 31030300 1 3,614;00 31.00 0 REG A R, 201706 06262017 v; F 05/182017 \ 01 88226M 0 31030300 1 3,583.00 28.00 0 REG A. R 201705 05/302017 ° l.'(! = 04/192017 01 88226383 0 31030300 1 3,555.00 32.00 0 REG A R 201704 04/272017 (' ( 1 03/132017 01 88226383 0 31030300 1 3,523.00 21.00 0 REG A R 2017M 03/282017 2, ° ( OW1412017 01 88226383 0 31030300 1 3,502.00 23.00. 0 REG. A R 201702 02I26/2017 2 1 a {; C3 i 01/17/2017 01 88226383 0 3103030D 1 3,479.00 26.00 0 REG A R 201701 01292017 C }} 12/13/2016 01 86226M 0 31030300 1 3,453,00 EG 23.00 0 R A R " " 201812 12272016 (1 ( i 11/162016 01 882263830 31030300 1 3.430.00 41.00, 0 REG A R 201611 1128/2016 ° "1"} A 10/172016 01 88226383 0 31030300 1 3,389.00 86.00 0 REG A R 201610 10/312018 09/092016 01 88226383 0 31030300 1 3,303.00 58.00 0 REG A R 2016019.0921/2016 0811MON 01 88226383 0 31030300 1 3,245.00 88.00 0 REG A R 201608 08/30/2016 07/152016 01 8=6383 0 31030300 1 3,157.00 76.00 0 REG A R 201607 07252016 06/132016 01 88226383 0 31030300 1 3,081.00 37.00 0 REG A R 201606 08222016 05/162016 01 88226383 0,31030300 1 3,044.00 .25.00 0 REG A R 201606 05262016 04/182016 01 88226383• 0 31030300 1 3,019.00 33.00 0 . REG A' R 201604 04/272016 Ap r' 11. 2012 1 :54PM No, 0270 P. 1 COMMONInlEALTH OF MASSACHUSE17S EXECUTIVE OFFICE OF ENVIRONMENTAL.AFFAIRS DEPARTMENT OF ENVIRONMENTAL FROTEGTION . TITLE s OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Strawberry Hill Condominium Property Address: 1431 IyancuQh. oad Building D . Hyannis.MA 026 Owner's Name: Strawberry Hill Condominium Owner's Address: Units 23-30 Date of Inspection: Novemb r 29. 2011 Name of Inspector:(Please Print) &amg M.Ford - Company-Name: JamesM.F rd Mailing Address: _ P.O.Box 49 teryd1e 11 A 2 33-0049 Telephone Number: 3 8 862-940 CERTIFICATION STATEMENT I certify that I have personally inspected the sewagd disposal system at this address and that the information reported below is true,accurate andcoznplete as of the tine of the inspection. the inspection was performed based on my training and experience in the proper functioq said maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title S(310 CMR 15.000), The system: _✓_ Passes C, ditianally Passes N it Furthar Evaluation:by the Local Approving Authority F ils Inspector's Signature: Date: December 1, 2011 The system inspector shall su t a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP_ The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments "*"This report only describes conditions Ot the time of inspection,and under the conditions of use at that time. This inspection does not address hove the system will perform in the.fature under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page l t Apr, 11. 2012 1 :54PM No. 0270 P. 2 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Strawberry Hill Condos.#:2 _ 1431 hmough Road Owner's flame: _Strawberry Hill Condom. Date of Inspection: November29, 2011 Inspection Summary: Check A,,E,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 Conditianaily 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. Answer yes,no or not determined(Y,N;ND)in the 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 itnmincnt. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: 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 i obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 tunes a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: r Apr' 11, 2012 1 :54PM No. 0270 P. 3 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: &rawbgM Hill Condo's#D 1431 Iyanough Road Owner's Name: St e=Hill Condo's Date of Inspection: _ X ember 29, 2011 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a mariuer 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 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determLtes 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 froth,a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Apr, 11. 2012 1 ;54PM No, 0270 P. 4 + Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Strawb m Hill Condo's#p 1431 Iyanourrh Road Owner's Name: Strawberry Hill Condo's Date of Inspection: November 29, 2011 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No J Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool J Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool T J Liquid depth in cesspool is less than 6" below invert or available volume is less than%a day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_ „�,_ ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. . ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP cerdfled laboratory,for coliform bacteria and volatile organic compounds iuxdlcates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen 1s 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.l No (Yes/No)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 wbat will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located m a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section 1W or failed under Section D shall upgrade the system in accordance with 310 CMR 1,5,304. The system owner should contact the appropriate regional office of the Department. 4 AP r' 11. 2012 1 :55PM No, 0270 P, 5 Page 5 of 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Strawberry Hill Condo's-._#D_ 1431 hanonh Road Owner's Name: Strawberry Hill Condo's Date of Inspection: November 29,2011 Check if the following have been done; You must indicate"yes"or"no"as to each of the following: Yes No ✓ _ Purnpiug information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks ? ✓ _ Has the system received Normal flows in the previous two week period? v1- 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 NIA) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ , T Was the site inspected for signs of break out 7 ✓ _ Were all system components,excluding the SAS,located on site? I ✓ _ Were the septic tank manholes uncovered,opened,and the Wtecior of the tank inspected for the eonditiop 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: Yes No ✓ _ 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(3)(b)]. Apr, 11, 2012 1 : 55PM No, 0270 P. o Page 6 of I I i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAIN C SYSTEM INFORMATION Property Address: Strawberry Hill Condo's#D 1431&anough od Owner's Name: Strawberry Hill Condo's Date of Inspection: November 29, 2011 FLOW CONDITIONS RESLDENTIAL Numberofbedrooms(design): n a Number of,bedrooms(actual): nJa DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): m/a Number of current residents: n/a Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no) .. No Seasonal use(yes or no): No Water meter readings,.if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): Last date of occupancy: Currently occupied . COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgfft etc.): .. _ Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discbarged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records - Source of information:�umped yearly for maintemamee Was system pumped as part of the inspection(yes or no): No If yes,volume pumped:-gallons--How was quantity pumped detemuned? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Innovative/Alternative technology- Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: unknown Were sewage odors detected when arriving at the site(yes or no): No 6 A n i 1, 2012 1 :55FM No, 0270 P. 7 Page 7 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C j SYSTEM INFORMATION(continued) Property Address: Strawberry Hill Condo's #D 14311vanoueh Road Owner's Name: Craw er ill C nd ' Date of Inspection: November 29, 2011 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 3' Material of construction: ✓ concrete —metal _fiberglass polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no):.__ (attach a copy of certificate) Dimensions: 2000 gat. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 40„ Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle: 10„ Distance from bottom of scum to bottom of outlet tee or bade: 10" How were dimensions determined: Measuft stick i Comments(on pumping recommendations,inlet and outlet tee or.baffle condition,structural integrity,liquid levels +, as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even wilb-thq outlet invert. There did not appear to be any signs q leakage. GREASE TRAP; None (locate on site plan) . I Depth below grade: Material of construction: _concrete _metal _fiberglass ___polyethylene _other (explain): Dimensions: Scorn thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or.baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 AP r, 11. 2012 1 :55PM t No. 0270 P, Page 8 of 1] OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SU13SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Strawber ill Condo's # 1431& ou2h Raad • Ownet's Name: _ 54rawbern Hill Condo's Date of Inspeetiou: November 29, 2011 TIGHT or HOLDING TANK: None(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: uallons/day Alarm present(yes or no): Alarm level: _ _ Alarm in working order(yes or no): Date of last pumping: Comments(condition,of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: Evert 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.): The D-box was clean. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber;condition of pumps and appurtenances,etc.): i • 8 Ap r, i 1, 2012 1 :55PM No, 0270 P. 9 Page 9 Of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: a-awberry Hill Condo's #D 14311vanoueh Road Ovrner's Name: StrawbgM Hill Condo's Date of Inspection: &vaher 22,2Q1 j SOIL"SORPTION SYSTEM(SAS); ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 2-6x6 Pits 1000 gal. leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number. hmovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): Both leach Pits had 3.S'ofwamr on the bottom.All covers were to Qrade. I CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number acid configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): ' Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.); PIUV Y: None (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.): g i wp r, I I, LU I L 1 ,77rM No, 02/0 N. 10 Page 10 of I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Strawberry Hill Condo's #D 1431 Jj anough Road Owner's Name: Strawberry Hill Condo's Date of Inspection: November 29.2011 ` SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference Iandmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. t rt t Ad ., over$ we, t, G A� . i . I I 10 I }. . Apf. 11. 10 11 1 ;55FM No, UZ IU F. 11 Page I 1 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Strawberry Hill Condo's #D 14311vanough Road Owner's Name: Strawbgzn Hill Condo's Date of Inspection: __Yovember Z9,1011 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35 +/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting propertylobwrvation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain,: Topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable lowgraphic and water contours traps. the maps were showing apgroximately 35'+/-to groundwc[ter.at thrs sit¢. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty orguarantea that the system will function properly in the f aura_ 711tera have been no werrarities or gun>drrtees,either expressed,written or implied relating to the septic system, the utspectiwt, this report and/or any components of the septic system which have not been located and inspected. 11 i I FAILED INSPECTION COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS. A � DEPARTMENT OF ENVIRONMENTAL PROTECTION Z � F 9 ul A t d h A Y O� In Syey TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE,MA 02632 Owner's Name: PAT O'CONNOR Owner's Address: 180 BISHOPS TERRACE,HYANNIS,.MA.02601 Date of Inspection: 8/27/01 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: _ Passes _ Conditionally Passes _ Needs Furth aluation by the Local Approving Authority X Fails Inspector's Signature: Date: 8/27/01 The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies;sent to the buyer, if applicable,and the approving authority. .' , J Notes and Comments THE SYSTEM FAILS TITLE V INSPECTION.THE LEACH PITS ARE FULL THERE IS NO EFFECTIVE LEACHING LEFT. SYSTEM IS IN HYDRAULIC FAILURE. ****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. Tip-1;• G In. +r•r•li;+n I:.�rri+ /i'1 G�'`(1(111 I Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1431 IYANOUGH ROAD, UNITS 23 TO 30 CENTERVILLE,MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: �i _ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not•evaluated are indicated below. Comments: THE SYSTEM FAILS TITLE V INSPECTION.THE CESSPOOL ARE FULL THERE IS NO EFFECTIVE LEACHING LEFT.SYSTEM IS IN HYDRAULIC FAILURE. 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or'uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a 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): ' 1 _broken pipe(s)are replaced _obstruction is removed ND explain: n/a Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE,MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 6. 3. Other: n/a �. is P, I Z Page 4 of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE,NIA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: Yes No X _ Backup of sewage into,facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow X Required pumping more than 4-times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped nLa. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma X _ (Yes/No)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. i, 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes' in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. i Page 5 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1431 IYANOUG14 ROAD,UNITS 23 TO 30 CENTERVILLE,MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 Check if the following have been done: You must indicate"yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? _ X Have large volumes of water been introduced to the system recently or as part of this inspection '? _ X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site X _ Were the septic tank,mAholes 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 ? X _ 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: Yes no X Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] sit a S Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE, MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 8 Number of bedrooms(actual): 8 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 880 Number of current residents: 5 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1972 Were sewage odors detected when arriving at the site(yes or no): NO Page 7 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE,MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 BUILDING SEWER(locate on site plan) Depth below grade: 54" Materials of construction: Xcast iron _40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 48" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" H 5' 7" W 4' 10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL MAJOR COMPONENTS APPEAR TO BE STRUCTURALLY SOUND. PITS ARE FULL SYSTEM IS IN HYDRAULIC FAILURE. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a tT Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE, MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: OVER PIPE 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.): , y D-BOX WAS INSPECTED AND LEVEL WAS OVER PIPE-SYSTEM WAS PUMPED AND 4 DAYS AFTER PUMPING-LEVEL WAS OVER PIPE AGAIN PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): n/a a r I e r - Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1431 IYANOUGH ROAD, UNITS 23 TO 30 CENTERVILLE, MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 2 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a .innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): THE PITS ARE FULL, THERE IS NO EFFECTIVE LEACHING LEFT.DID NOT EXPOSE. BOTH PITS ARE UNDER ASPHALT. LEVEL OVER PIPE IN DISTRIBUTION BOX CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) t i Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a k. Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a n Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1431 IYANOUGH ROAD,UNITS 23 TO 30 CENTERVILLE, MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. , E E �n r Page 11 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1431 IYANOUGH ROAD, UNITS 23 TO 30 CENTERVILLE,MA 02632 Owner: PAT O'CONNOR Date of Inspection: 8/27/01 SITE EXAM _Slope _Surface water _Check cellar Shallow wells ` Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) YES Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 12+FEET CRS,CBR,GRI Office...................508-775-9119 ext. 1 Home Office...................508-775-1630 Fax .........................................508-775-9497 Email tinacarey20O'*ahoo.com f �✓'��'Q` (J�/ " . F� - g� �� �� Q .��, �� C �,�.� �� Q r ,' F t o Js/os (?�• Box j y 'vn of Barnstable C)2�zr ""r mc,n>aA1aJZ' Board of Health —T'I;e. Main Street,Hyannis MA 02601 �� ry jar cd— Susan G.arils, Q�[G �*t 0 Sumner Kaufman,, MSPH Wayne Miller,M.D. August 29, 2003 161, �4 k Dear Mr. Pesce, This letter is to inform you that you are in violation of the conditional variance which was granted to you last August 2002 on behalf of your client, Strawberry Hill Condominium Trust, which allowed you to construct a soil absorption system to be connected to Building D, at 1431 lyannough Road Centerville. Recall that condition #3 specifically stated "the applicant shall submit a written five (5) year comprehensive plan to replace or upgrade all of the septic systems at this condominium complex with the inclusion of innovative/alternative technology. The plan shall be submitted to the Board of Health within six months of this date, on or before March 1, 2003." To date, the required comprehensive plan has not been received by the Board of Health. Therefore, the variance is null and void. You may request a hearing before the Board of Health if written petition requesting same is received by the Board within ten days. It is suggested that the applicant should submit the required plan along with the request for a hearing to expedite resolution to this matter. Sinc ely yours ayne iller, M.D., Chairman Cc:Paul A.Baron,CCIPM,Box 1144 Osterville,MA PesceViolation CCII'1VI Cape Cod &Islands Property Management "a full service company" P.O. Box 1144 Phone: 508-428-0503 Osterville,MA 02655 Fax: 508-428-1949 September 12, 2003 RECEIVED Wayne Miller,MD., Chairman Town of Barnstable Board of Health S E P 1 5 2003 200 Main Street TOWN OF BARNSTABLE Hyannis,MA 02601 HEALTH DEBT. Dear Dr. Miller, Re: Violation Notice/Strawberry Hill Condominiums We are in receipt of your letter dated August 29, 2003 addressed to Mr. Edward Pesce regarding the above-mentioned notice. Please be advised that on behalf of the Strawberry Hill Condominiums Trustees, we would like to request an extension to the time permitted for the variance due to the pending sewer line connection which we understand is imminent. Both the cost of installing the new systems and the required hook up to the new sewer line, which we understand will commence within the next year or so, would be a tremendous and unnecessary cost to the Association. We wish to inform you that since the last inspection, we have not had any problems nor has this "failed"'system needed to be pumped at any time. We can assure you that we are monitoring this system on a regular basis and it is working fine. For future reference, please direct and address any correspondence to the attention of Strawberry Hill Condominium Association c/o CCIPM,PO Box 1144, Osterville,MA 02655. Thank you for your understanding and consideration in this matter. Sincerely, G Ke cNamara Property Manager i FAX Transmission From: ``�' ' Date- / c4p To: M-w ' !v F< i L FAX#: SX_ .)q 0 Company: H2 Pages (including cover) Message: AiTAclo i�L 1� VOICE: (A)428=0 FAX (508)4 38' Pesce Engineering.&Assoc.. 451 Raymond Road Plymouth, MA 02360 PESCE ENGINEERING AND ASSOCIATES 451 Raymond Road Plymouth, MA 02360 Voice/FAX (508) 743-9206 September 12, 2003 Wayne Miller, M.D. Chairman, Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 SUBJECT: Violation Notice, Strawberry Hill Condominiums, Centerville Dear Dr. Miller, I have received your letter regarding the violation notice for the conditional variance approval for the repair of the septic system serving Building D at the Strawberry Hill Condominiums. For the record I did provide the Condominium Trustees and their property manager, a copy of the Board's approval letter from last August. However, as I told the Board at the August 19, 2003 hearing, the Trustees are pursuing a connection to a new sewer system under design & review by the Town. This effort started with the Barnstable Engineering Dept. shortly after your approval last fall. This process is still apparently underway. Since last fall therefore, I have not been retained on this,matter.by1he Condominium Trustees. The proper contact for this matter, representing the Strawberry Hill Condominium Trustees, is Cape and Islands Property Management, Box 1144, Osterville, MA 02655. Please contact them for all future actions or questions. Thank you, and as always, please call if you have any questions. Sincerely, RECEIVED Edward L. Pesce, P.E. S E P 17 2003 cc: Cape& Islands Property Management TOWN OF BARNSTABLE HEALTH DEPT. . _t `! '' _, . �.,fit],. . _ .+e,•. . G . .- t:, r: •c DATE: • FEE: BA�RNSTABL& REC. BY rE°M,�A Town of Barnstable S CHED. DATE: ]hoard of Health 200 Main Street, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE.REQUEST FORM LOCATION Property Address: 1431 Iyanough Road, Centerville, MA Assessor's Map and Parcel Number: 274/21 Size of Lot: 2.28 Ac Wetlands Within 300 Ft. Yes Business Name: Strawberry Hill Condominiums No X Subdivision Name: APPLICANT'S NAME: Str. Hill Condo. Trustees Phone 508-428-0503 (Pro Mngr. ) Did the owner of the property authorize you to represent him or her? PROPERTY OWNER'S NAME NTACT PERSON Strawberry Hill Condominium Trust Name:c/o Ca & Islands Pro t Mana t Name: Edward L. Pesce, P.E. Address: P.O. Box 1144, Osterville, MA 02 55 AddressP.O. Box 321 , Osterville, MA Qg655 Phone: 508-428-0503 hone: 508-428-3730 VARIANCE FROM REGULATION(List Reg.) REASON FOR VA i more space needed) 310``CMR 15.221 (7) top of - Extreme expense to re plumb & re-set the all system components installed septic tank no more than 36" deep - proposed design includes the use of vents NATURE OF WORK: House Addition 000000 House Renovation ❑ Repair of Failed Septic Systctn �{ Checklist(to be completed by office staff person receiving variance request applicction) Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/hcr for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at apptica,is expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals(same owner(leasec only),and variances to repair;ailed sc;vage disposal systerns (only if no expansion to the building proposed)) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,%i.S.P.H. REASON FOR DISAPPROVAL Wayne A.Nlilicr,ivl.D. Q:\HEALTH\WPFILES\VARIREQ.DOC Town of Barnstable Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.]task,R.S.FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. August 29, 2003 Mr. Edward Pesce, P.-E., R.L.S. P.O. Box 321 Osterville, MA Dear Mr. Pesce, This letter is to inform you that you are in violation of the conditional variance which was granted to you last August 2002 on behalf of your client, Strawberry Hill Condominium Trust, which allowed you to construct a soil absorption system to be connected to Building D, at 1431 lyannough Road Centerville. Recall that condition #3 specifically stated "the applicant shall submit a written five (5) year comprehensive plan to replace or upgrade all of the septic systems at this condominium complex with the inclusion of innovative/alternative technology. The plan shall be submitted to the Board of Health within six months of this date, on or before March 1, 2003." To date, the required comprehensive plan has not been received by the Board of Health. Therefore, the variance is null and void. You may request a hearing before the Board of Health if written petition requesting same is received by the Board within ten days. It is suggested that the applicant should submit the required plan along with the request for a hearing to expedite resolution to this matter. Sinc ely yours ayne Tiller, M.D., Chairman Cc:Paul A.Baron,CCIPM,Box 1144 Osterville,MA PeseeVioMon yw� Town of Barnstable + BARNWABM + q MASS. � r�39• Board of Health i >� 200 Main Street, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. August 29, 2002 Mr. Edward Pesce, P.E., R.L.S. P.O. Box 321 Osterville, MA RE: Strawberry Hill Condominiums, Building D, Assessor's Map 274, parcel 21 Dear Mr. Pesce, You are granted a conditional variance, on behalf of your client, Strawberry Hill Condominium Trust, to construct a soil absorption system to be connected to Building D, at 1431 lyannough Road Centerville. There are four septic systems existing at this property which are connected to four buildings (52 bedrooms) within this condominium complex. The variance granted is as follows: 310 CMR 15.221 M: The top of the system components will be located greater than 36" below grade. The variance is granted with the following conditions: (1) Only the septic system connected to Building "D" may be upgraded at this time. (2) The condition of the existing septic tank shall be inspected for soundness and any signs of ex-filtration by the designing engineer at the time of construction. The inlet and outlet tees shall also be inspected at that time. (3) During a recent inspection, another system at this property was found to be in failure. The applicant shall submit a written five (5) year comprehensive plan to replace or upgrade all of the septic systems at this condominium complex with the inclusion of innovative/alternative technology. The plan shall be submitted to the Board of Health within six months of this date, on or before March 1, 2003. Pesce9 44 'T (4) All septic systems at this property shall be replaced or upgraded with the inclusion of innovative/alternative technology within (5) five years of this date, on or before September 1, 2007. This variance is granted because of the extreme expense which would be incurred by the applicant to re-plumb and reset the existing septic tank if the system were to be elevated. During a recent inspection, another system at this property was found to be in failure. The applicant has agreed to submit a five year comprehensive plan to address wastewater disposal from the entire condominium complex, with the inclusion of innovative/alternative technology. Since r ly your , Wa ne iller, M.D. Chairnifin Pesce9 r PESCE ENGINEERING AND ASSOCIATES P.O. Box 321 Qsterville, MA 02655 Voice/FAX (508) 428-3730 August 13, 2002, Mr. Thomas A. McKean, R.S., C.H.Q. Director, Town of Barnstable- Health Department ; Barnstable Town Hall 367 Main Street Hyannis, MA 02601 SUBJECT: Septic System Inspections, Strawberry Hill Condominiums, Centerville Dear Tom, have completed the septic system-inspections for the remaining units at the Strawberry hill condominiums. l found one other leach pit in failure, serving Building A. So of the total 8 leaching pits that exist).Only ?-were found to be in failure (serving .Buildings A& D) For each of,these 2 systemRiowever, the remaining leach pit was ' found to.be functioning OK and passed inspection;,Attached are a summary table and sketch of the area for our discussions with the Board tonight. Thank you again for your help with this project, and please call if you have any questions. Sincerely, Edward L. esce, P.E. cc: Cape & Islands Property Mangement Attachments 41 \ ST�2Aw �'kR� � � 2 7 GoNmrv�r�ms 9 l3FUIIG # � 9 P� b MA a � 0 C � g �a M � 1 g�� 14 G F r �: t-� a: Strawberry Hill Condominiums—Sept c System/Inspection:Summary Septic System Ouilding Unit # No. of Bedrooms Total Flow(gpd) D-Box Leaching Pits A 1 • 2BR 2 2 BR 3 2 BR 1- PASS 4 ' 2 BR PASS 1-fAIL 5 . 2 BR 6 2'BR 7 2`BR Total 14.BR 1,540 B 8 2 BR 9 2 BR 10; 2 BR 11 2.BR - PASS 2-PASS 12' 2 BR (unbalanced) 13 2 BR 14 2 BR Total 14 BR C 15 2 BR 1.6. 2 BR 17 1 BR 18 1,BR PASS 2-PASS 19 1 BR 20 1 BR 21 2 BR 22 2_BR Total 12 BR 1,320 D 23 2 BR 24 2 BR 25 1.BR 26 1 BR PASS 1- PASS 27 1,BR 1- FAIL 28, .1 BR 29 2 BR 30 2 BR Total 12 BR 1,320 _ TOTAL 5,720 Pesce:Engineering & Associates __ _ - August 13, 2002 I � " CIPM Cape Cod and Islands Property Management P4 Box 1144. Rhone: 508-428-0503 Osterville, MA 02655 Fax.: SOU-428.1949 May 24, 2002 To Whom It May Concern: Re_ Strawberry Hill Condominium, 1431 lyanough Road, Centerville, MA As property managers for the above-mentioned condominiums and on behalf of the trustees, we hereby authorize Mr. Edward Pesce of Pesce Engineering & Associates to assist us with the variance request for the septic system repairs. Please do not hesitate to contact us at 508-420-6284 or 508-428-0503 should you have any questions regarding this matter. S'4Aearo ' au n Propetty Manager tHE Town of Barnstable of Tp� Board of Health snxxsTMBIE, : P.O.Box 534,Hyannis MA 02601 v MASS. $ 163q. ♦0 ArFD MAC A Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance request form Mdn , the Petitioner(s); J regarding the property at e' . the petitioner(s) and the Board of Health agree that the Board of Health has until (insert date)to act upon the Petitioners'completed application for a variance. In executing this Agreement,the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: Signatut Signature: 61AAAD._4 er(s)ore itioner's Representative Chairman Print: A5-saoe Print: Susan G. Rask, R.S. Date: ZALJy 2000 Date: 2000 dress of Petitioner )or Petitioner's Representative -� S s�, Town of Barnstable Board of Health Town Hall Public Health Division Office 367 Main Street, Hyannis, MA 02601 Phone(508)862-4644 Fax(508)790-6304 file q:extend.doc SECOND FLOOR r- - - - - - - - - - - - - - - - - - -� I I I I UNIT 30 I UNIT 28 I UNIT 27 1 UNIT 24 (2 BR) I (I BR) (I BR) 1 (2 BR) I I � I FIRST FLOOR r- - - - I - - - - - - - - - - - - - - -� � I I I UNIT 29 1 UNIT 26 I UNIT 25 I UNIT 23 (2 BR) i (1 BR) (1 BR) 1 (2 BR) I � I TOTAL- 12 BEDROOMS NOTE.• NO BEDROOMS IN BASEMENT LEVEL CONDOMINIUM LA YOUT (ONLY STORAGE & LAUNDRY FACILITIES) SKETCH PLAN FOR UNITS 23-30 MWARED MR STRA WBERRY HILL CONDOMINIUMS 1431 IYANOUCH ROAD PESCE ENGINEERING & A SSOCIA TES CENTER VILLE, MA. P.O. BOX J21 APRIL 13, 2000 OS TER AIL L E, MA. 02655 PH.(508)428-J730 Jf 52968SP fl s6�f1� 3 ROBERT B. OUR CO., INC. Complete Septic Service Water and Sewer Mains Excavation GREAT WESTERN ROAD • P.O. BOX 1539 • NO. HARWICH, MA 02645 TELEPHONE(506)432-0530 319VJZNM:10 NMOL :Ld30 H1lt/31-1 December 7, 1995 966T Z T 090 Town of Barnstable CKPA1333V ATT: Mr.Edward F. Barry 367 Main Street Hyannis,MA 02601 RE:Strawberry Hill Condos Dear Mr. Barry: This letter is to inform you of the work done at Strawberry Hill Condos,Route 132, Centerville, MA. The Robert B. Our Company,Inc.closed off the failed pit for Units 8- 14 so that it will give it some time to recover. The leach pit that was closed off was the one in question on the certified state septic report done by Joseph P. Macomber&Son,Inc. on 11-8-95. On the tank for Units 8-14,the 4"cast iron tees were reamed and cleaned so that they will function property. If you have any questions, or I can be of any assistance to you,please don't hesitate to call. Sin erely, RECEIVE® DEC 1 2 1995 Donald Klimm HEALTH DEK TOWN OF&MMSTABLE CC: Helen M. Baker Chairman- Strawberry Hill Condo Trust DATE: 7/28/95 PROPERTY ADDRESS:—Qtrawberry_ Hillo Condo 's U.nit # 15 AUG 7 I99'5 erviU-e_,.Mgrs 02632 - HEALTHC`PT TOWN OF BARNSTABLE On the above date, i Inspected the septic system at the above address. This system consists of the following: 1-2000 gallon tank. 1-distribution box. 2-1000 gallon leaching pits packed in stone . Based on my Insertion, I certify the following conditions: 1 . This is a title five septic system. ( 78 Code ) 2 . The septic system is in proper working order at the present time . 3 . .The pits do not receive equal flow. r,. SIG NATl9R.. . Name:_JLP,_Macomber Jr .. Company:—L-P .Mzr,o.the_ --&--S-on-Inc : Address: Box 66 ti Centervill,e ,Mass: 02.63'2 ": . (. Phone:---5Q8_775_ THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY s JOSEPH P. MACOMBDRI . .Tanks-Ceupools-, Pumped & ITown Sewer CoP.O. Box 66 Centervil6773-3338 7 7 SEWAGE DISPOSAL SYSTEM Arl'.d7r_as:s: Of Pro.P.e.r-tV Unit 15 Strawberry Hill Condo ' s Owner ' s name Ralph Nardi Date of Inspection 7/24/95 PART A CHECKLIST Chec 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 been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. VAs built plans have been obtained and examined. Note if they are not available with N/A. _Z The facility or dwelling was inspected for signs of sewage back-up. _ZThe site was inspected for signs of breakout., �I/All system components, excluding the SAS, have been located on the site. -,/— The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance -.of SSDS.' SUBS�'::fACE SEWAGE DISPOSAL SYSTEM INSPECTION YoRM PART B SYSTEM INFORMATION FLOW CONDITIONS: If residential number of bedrooms number of current residents garbage grinder, yes or " no . laundry connected to system, yes or no AA1 seasonal use, yes or no If nonresidential , calculated flow: Meter read monthly. Average 3000 cubic feet per month. 22 , 440 :gallon per month = GPD=748=GPD per unit=93. 50 GPD Water meter readings, if available: Last date of occupancy GENERAL INFORMATION Pumping records and, s urc f information: siow- ._ stem S y pumped as part of inspection, yes or no ' if yes, volume:pumped Reason for pumping: Ty a of system Septic tank/distribution box/soil -absorption system Single cesspool Overflow cesspool -�W Privy ' Shared system (yes or no) (if yes, attach previous inspection ) records, if any Other (explain) 1 Approximate age of all components. Date installed, if known. Source of information:. Sewage odors detected when arriving at the site, yes or no Nam: Strawberry Hill Condominiums 775-0184 Customer Code: Address: Route 132 shill Town: Centerville State: Zip: Mailing address: Mrs Boothman Box 344 Centerville MA 02632 Notes- 7181 thru 1112019 5113192 um 4 Ts, 2 LP unit 8 1050.00 617192 110192pump uni 2 &23 rec 420.00 6123192 r 711192 pump unit 22&23 rec 0.00 7114192 719192 um unit 22 240.00 7121192 7116,17&18192 pump unit 21&22 back hoe etc 3591.90 817192 "oared /Ur N ,ve- 9130192 urnp unit 8&9 snake 295.00 1019192 92a�T' 840 Q0 117192 5111193 u Ts 880.00 5121193 122193 unit#8 pump T snake 265.0 719193 1 127128193 u 3 T#1-7 8-14 5-22 24-30 880.0 11116193 q 16114 um all T's 880.00 6 91 44 14194 power snake 3 .00 7129194 6116194 pump LP*8135 6124194 191944 um all T's 920.00 1111194 6122195 pump all T's 920.00 717195 t. 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued . SEPTIC TA1:K: goon gallons (locate on site plan) . depth below grade: .gur.f 2,&Q material of construction: _concrete metal FRP other(explain) dimensions.: H=6 ' =12 ' W=616" 4„ sludge depth -Ui!L distance from top .of sludge to bottom of outlet tee or baffle I" scum thickness 911 distance from top of scum to top of outlet tee or baffle ig, distance from bottom of scum to bottom of .outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffle&, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) Pump septic tank every months . Reason all units have garbage' isposa s . ees are fine water is at operating level . No signs of leakage. No repairs are needed . ( DISTRIBUTION BOX: XXX (locate on site plan) hn depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence 'of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc.) No distribution is not equal ; Noc_ar_ry over of •solids or leakage ; n or out of distribution box . PUMP CHAMBER:,NONR (locate on site plan) { NON ' pumps in working order, . yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) NONE i r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION TORX PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : XX XX -- (locate on site plan, if possible; excavation not required, but `may •be • approximated by non-intrusive- methods) If not determined to be present, explain: Type leaching pits and number 2_61x7 ' leach 'pits leaching chambers and number NONE leaching galleries and number NONE leaching trenches, number, length NONE leaching fields, number, dimensions NONE overflow cesspool,: number NONE Comments: (note condition of soil, signs of hydraulic failure, level of pondirig, condition of vegetation, recommendations for maintenance or repairs,etc. Soil conditions . an o signsondin . No repairs needed . CESSPOOLS (locate on site plan) : number and configuration NONE depth-top of liquid to inlet invert NONE depth of solids layer NONE depth of scum layer NONE dimensions of cesspool materials of construction NONE indication of groundwater inflow (cesspool must be pumped as part of inspection) NONE Comments: (note condition of soil, signs of hydraulic failure, level 'of ponding, condition of vegetation, recommendations for maintenance or repairs,etc.) NONE PRIVY: (locate on site plan) -- ---..---- . . _......_ ..__. ..- . . _ . materials of construction NONE dimensions NONE de th of solids P NONE Comments: (note condition of soil, signs of hydraulic failure, * level of .ponding, condition of vegetation, recommendations for maintenance or repairs,r' Nn_NE-- J • i • • • , 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L=SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 , Town Water 10 1S yS�•6p s o DEPTH TO GROUNDWATER —351+ depth to groundwater method 'of determination or approximation: atra pi ' 12 ' in ground No Water . Sitting on i PVPi pf Route 132, 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe of determination in all instances. If "not determined", explain bwhy snot) Backup of sewage into facility? _4-0 Discharge or ponding of effluent to the surface. of the ground or surface waters? 1V4 Static liquid level in the distribution box above outlet invert? {ors �S Liquid depth in 6e6.speal <6" below invert or available volume< 1/2 day flow? A16 Required pumping 4 times or m re in the last year? number of times pumped ��-d �� . A,O_ Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: _/, below the high groundwater elevation? 16 within 50 feet of a surface water? AIQ_ within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of° a bordering vegetated wetland or salt marsh- (cesspools and .privies only, not the SAS) ? NO within 50 feet of a private water supply well? 1Vd less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable , attach copy of well stater anal for coliform bacteria, volatile o ,a,;ic compounds, ammonia nit rogeni and nitrate nitrogen. .�.�t•.:..T..}LT�1•�L��T:�TCL:-r.+��jy,��J.14S".(.Y�TT TiS31CyT�--CGT.:Ca'ipt:.�D4�¢. Li:S�C:3�C2�C3T.:�.�T�; TOWN OF Barnstable BOARD OF HEALTH i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION I �r.:rscst_-r__rir_srrazsnc•�r-+cz'-ar�:as�a�:r�r�:ntcr�rtr�nsssa�rarsa�s r+�.r:r:a�sr.-a•c�-as-_az.•s te�ssma.�r_rr.:mvr.+ers.•srrnssrrspsr•v-x,•' —TYPE OR PRINT CLEARLY— PROPERTY INSPECTED STREET ADDRUS Uai.t 15 Strawbetxry Hill Condo ' s ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Nardi. PART D - CERTIFICATION NAME OF INSPECTOR J P Macomber Jr COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville Mass . 02632-0066 Street Town or City State ZIP COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposa-1 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 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 16 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which •I have conducted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , acid as specifically noted on PART C - FAILURE CRITERIA of this inspection form . a Inspector Signature Date 1 95 One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . Pk1(-UJ .doo Cc��menweam cr Masscc7.:seT s Executive Or,ice cr tnvircnmenlc, ,4rrc.,S Department of Environmental Protection Water Pollution Control Tecnrncel Asswcnce and Training Secrions WlUI&m F.Weid co. nar Trudy Cox• S•avwy,EOEA . Thomas&Powws Aa"co� 06/12/95 ATTN: Joseph P. Macomber, Jr. Joseph Macomber and Son PO Box 66 Centerville, MA 02632- Dear Joseph P. Macomber, Jr. , I am pleased to inform you that you have attended training, met the experience qualifications, and have passed the Title 5 System Inspector exam, pursuant to 310 CMR. 15 . 340 . The passing grade for the exam was 39/52 or 750. This is an official notification that you are a Certified Department of Environmental Protection System Inspector pursuant to 310 CMR 15 . 340 . You will receive a System Inspector certificate at a later date. If you have any futher questions, please write to me at the following address : Kimball Simpson D.E. P. Training Center 50 Route 20 Millbury, MA 01527 Thank you very much for you:c time and consideration in this matter. Sincerely, Kimball T. Simpson, DEP Training -,ter Director [2405) Routs 20 9 Millbury, MA G'.,:.'",' • FAX 509-755-9253 • Te!rn'u;,• 508-756-72- r r Water , Coris'ervation SAVE Tips . . . ME! , . CHECK FOR LEAKS Water Loss in Gallons Due to Leaks Leak this Loss Per Day . Loss Per Month Size 120 3,600 • 360 10,800 • 693 ' 20,790 • 1,200 36,000 • 1,920 57,600 • 3,096• 92,880 0 4;296 128,980 . 0 6,640 199,200. 6,9.84 '• 200,520 8,424 252,720 9,888 296,640 ® 11,324 339,720 0 12,720 381,600 ® 14,952 448,560 III �7 Al e17 411, ?V; AMR:. 600 Washington St. [] Boston, Mass.,OZ.i l 1 y b lrebruer 4, 12 P Charles N. Uvery* - Orpfl" tE�'d tr < 3 IaR7.iA=_—O di/s�+�4+5� Sewage vAin Street . Disposal tox l 'eposed 12 . aso xas'saclumus Apartmnt Buildings for . o R.I. mKintley socl ates$ - st aviberr*�Hill Road s The DepaxtMeftt, Ot PtIblie HeilW# in response to your requestg, has ha :one. of its engineers oxmine the *tail at the above- toted'site and bas revered a set of Plans it two .shoota, the- `first of vbioh is titled ,: a. M V H. McKMY,ASSOC. i � 8 , Soon irpm=K , i HV NO 712V Soil eiezAnatio ss conducted at the .subject 'Otte in the area"fwgp ed fear sub-. surface disposal I=Ueate that the natural a4 �_�PZlaa�. �s t1 t'� vubsoil., eonslata' i of coarse sand to bey " 1 Bch is cs nsidetod suitable for local.fsubsurfice sewage disposal. vwrposes N The plMs propose to dispose a totax of 14,400 , lane per dq of `seusge .fit the subject project by roam of the. follovinew I. Systems for Suiu 1., #2, and #7 will each,dispose of ${3C# ga.'Ilo is peat. day of sewage by means, of a 1250 gallon precast reia6r ed eaaerete septic tack, i a flve outlet concrete distribution box, end 'me seepage pit° pr d: 41T° square feet Of :avalloble leachiM area. ..j 2. Syotmsifor S41dinp ho #4s • 5t 469 As #10s and #11 wig Bch dispose Of 1200 gallons, per day of aevage by memo of a 2000 gallon precast reinforced • concrete septic tanks, a five cutlet concrete Ustributlon boat, and one se"age pit provid 601 square Peet of leader area or where indicated two seepage t � .-F � • • !.. {,• ' ray f`1 7 ,;'{ ", a.• Y; . ' + ' �.'- y „ t' .iris SYS rM for if+uiiduc "dispose at 4 a - mea et 2WO S41anprey reWcrced 4c nc to septic t �:five nutlet S * spa a pits'providing providin 834'sgMre.feet of eaucrete' e1��tritri�tit�t end. two �€+� _ A. �y " Yy :0.0or $ 3 � �#'8��:re�'0�' , .: y�FW �q �,q f y ter ` d�yl�oy rlibui V ioo x#, WA two a pit* ` ��i+�.� �o";�ee�. vs . i (i) The ;mum dtamet6r of ell pipes in tav Oyatam6,awl be 4 in s: w der . ! ate ztr poisa . s (3) Catob basis a I be 46 Uso t fray apy 40 . (4) Ai- e o 1ta r s of tbe syst et ad areas ebb be -20 e 881&i tiume-areo $ball be°pned v,th 2 ftc ; type . b1tu4S,o - Concrete Qr L t _ 'rEtitei ab .�. be E!t?3' Qi' e�� `l3 Tl the 83�'¢ � and Ce t, ,^ t ' tb Ott.s4v it cde and no, then '� will be � in�'� awoved of this D6partment" t (6) � � t • dird � t date o `meter. } } {7} A Disposal, Vim Ccwtr tau Pe=L.t t be-obtaved frm tbs. Barnstable Board-at Wath :privr to the atart off''at .owstructim. , the s� ..s ad.yeya has boom ca trvcteds, prior to bac�!t n�a Oie a 4ati of tb notified r� a ,e .d not,be c t .e -ftr,the Gem s .e ai, ., cavered,;uat9.i a G+ i .mete;cf -emplian .Issued: by'�b� Bar�tab �csrd of Health. t zw4OSe4 ber"dth are stomped ,aWroved e0pies of Us vlwas a Ovy - t be kept an the site and, be wed.for emstruct on purpose$ Y l 6IJr 4hCii D111��/ri 3 � R,e�g�imai Sanitary Enginqere .. fi h latevi�iie Hmpital y �e l�.eF� SB S+hu �ltte %$46 ; ,� { , ! } t t j .. .} y ". f. St k�"` _l"r • ';tL r' n, "Y` 'l or o , i cc i' $ 1t.�bie Board,Of f • 1 s #� }'�•s c 4 � w y �w_. � ._ .Y'. x¢- . �,;yp�/�,•y�.��.-�4 •. i. �' p•.{y dtr'�r u" �]� . .. a{F %s `'r" T7+F.,Yti,iiFS�4V�4' �1..w♦��• Ali+�rA.44���n�R�!�i WlIG�4 7 •^`" - 't Y ..• .z t.1 Barns Ob a Caur y'Cowct KOuio. e ' . Barnstable,' gaosacxiLik3e�tt ✓i a ..� Sy � _ „ ' If _ .. �'i „ is• , 1., °.ii a - r.{.. Yr rt + }�' ♦. ,SFr.' _�"4: ,r' � .+�',� :a r. �, " Y'� ` p4 Ro• 'r •%'' �.r . - S• �,sw n •' �Y �` * fT R. +-. • _r:Y, E.'. . `' 'F_s Y ; �t_,E.x s;, - a *dr �.` �R 1v✓' - �.z. hK�' Y`f,''S. .}- t'f d�_ F`k _F'� r F•- 1 ll-..�. `'�� ,pr � r•.- i . . "'a tIA 4,..' tc "C r? 4 I-v �• i i f .� *m j .. -,d, w5 e ,•s9. *k a �t.x ,{- A `v 7 `r,,, fr, ^@J � w* r 3 Y .S I�, !� S` .. • 1 n ,�. R �a. ,�. �, W 3. Y .� n � aw :4a -. wr •.L, '_ - .�' � �^ � a�. �� Y �� 1•� ,.�+. "k. '�` rf •.M .f 'i} • J r •�' ' `` tii ` ,4 Y - r R S.'-.-i 4 t pF{Y Ir t ? 1 ' x t a -i.Y, • 2 ..f ,� r ! t f � sir i'C +1 ' Y _ . 1 xx .. d 3 ,•Low1v nF BA.UNs ;.00ATION SEWAGE# VILLAGE ASSESSOR'S MAP&LOT a71/""zl J-��et�ns INSTALLER'S NAME&PHONE NO. i SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: 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 of 1 Ching facility) �' Feet Furnished by �� " ` -40 O t r��1 TQWIN BAR 1STABLE t LOCATION �-I l J +UUWw°` �wWli,) Citi�e'a SEWAGE # *[7t`[-011-0 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. VinTs SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No s r �jp a mom\ \ v 1 t� .. it TOWN OF BARNSTABLE LOCATION / c- 132--J4d 40 EWAGE # l3 S'r. VILLAGE F, , -S ASSESSOR'S MAP & LOT 3-7Y-f/-661V F INSTALLER'S NAME & PHONE NO. A/(d,��,-we SEPTIC TANK CAPACITY LEACHING FACILITY:(type) P/r T (size)�l�-�� NO. OF BEDROOMS PRIVATE WELL OR P�U^BLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No `� d _ � � b� � '� ..z,, ,- , � �� � �6. � ��� � �-� d���` -o it - STrQwbwr7 1.1�i co•►Lo's Qtsl�, rq � �. � uS�OWN OF BARNSTABLE LC,CATION 1 3 ��Z SEWAGE # � 2 "Dal `V LAGE An41S ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. M SEPTIC TANK CAPACITY a C/UD LEACHING FACILITY: (type) 44 X (size) /021) S/J Is• NO.OF BEDROOMS IL 1 � BUILDER OR OWNER -ST�c,��LN"1 11 i I C 0e►zo I PERMUDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table.to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility ( s ex If any wells on site or within 200 feet of leaching facility) Feet i Edge of Wetland and Leaching Facility(If any wetlands exist within 300 fee[of leaching facility) Feet Furnished by 0 tN _ D 0 �� 130 _ / / TOWN OF ARNSpTABI b— '3 b')CATION ! 3/ O�J �C� ((��[�1SEWAGE # VILLAGE 1��(A11111 iJ ASSESSSOR'S MAP & LOT 9)y O I INSTALLER'S NAME&PHONE NO. UINI-f3 t ! SEPTIC TANK CAPACITY, �nCC7D // �i:.' LEACHING FACILITY: (type) Pi^S' ( a (size)6x(0. 6oX 6� NO. OF BEDROOMS BUILDER OR OWNER 5r�L.�1JPl�, I-I, Con�os PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility)` Feet Furnished by •Lns/. tan 3Oi - O O i t 3 S� ya y s3 s� 15L lo( -7 a rt. i LOCATION I SEWAGE PERMIT NO. 31 .o Il/ C.�` , g 7 o� VILLAG ivAl) IL INSTALLIEk'g NAME &ADDRESS OAK C, 14A CH BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -to -�� --. i t 7 `r �� l .J �� J ,srAwlaer.I. N'�ll condos �* TOWN OF BARNSTABLE q LOCATION ��3/ T-46--I000t k �� .3'z SEWAGE # ,VILLAGE ''TdA n I S ASSESSOR'S MAP &LOT o�1y Q INSTALLER'S NAME&PHONE NO. o�7yl SEPTIC TANK CAPACITY LEACHING FACILITY: (type) G (size) NO.OF BEDROOMS r 41 BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: 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 of haching facili ) ® � Feet Furnished by G .a/ 17G/ J ' J J\-p t �J 0 0 N i c J ASSESSORS MAP NO: 27 '_r PARCEL NO: C� No. ._ /FExz...........3 .00 HE COMMONWEALTH OF MASSACHUSETTS OAR® OF HEALTH I� TOWN OF BARNSTABLE Allpfira#iuu for Biliposal Works Tuuitrurtiuu ramit Application is hereby made .for•a Permit-to- Construct ( ,.,)-or Repair,_(X,) an Individual Sewage Disposal System at: Strawberry Hills` Cbnd'b l s' Strawberry Circle Hyannis . ............_........... •-............................................................... -•.......---•----.... -•---.-....s...------------------------............---•--.............. Strawberry Con�'��`Tfi1(`W9s Trust. or Lot No. • .... --------------------------- ..........------------....----•--•----••---•••-- ess.•----•----••-•-----•------...........••--- W J.P.Ma e omb er Jr. Owner Address Installer Address d Type of Building- Size Lot............................Sq. feet U Dwelling No. of Bedrooms.............6............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ............................... .. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity...._.__....gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by...........................................................----••-------- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-.--_---_---____--.- --. 44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water......--.-_._-__-.._--- 9 -•---------•---•-------•.....................••-----•--------•-•.....----------------------•-•-----.......................................................... 0 Description of Soil........................................................................................................................................................................ W ..Sand.. &---Gravel............. W . VNatu; of Repairs or Alterations—Answer when applicable of lines 1eav_ ing, the building and through out system. Possibly will add additional- -pit -or pits . ..------•-----------------------•---------------------------------------------------•-•---------------------••--------------------------------------------------------------------------•--------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian e has be is �y the boa of he h. Signed .. -.... 7/16/92 Date Application Approved By .......--- {``'`' ". ............ Application Disapproved for the following reasons: -- ---- . ..... .................................................................................................. ...... -- -- - -- -- --------------------------------------------------------------------------------------- - - ---- -- -------------------------------------------------------- ---------------------------------------- Da Permit No. e ✓ te 3 ............ -�--'--- -- 3 5- Issued Dare No................_....... THE COMMONWEALTH OF MASSACHUSETTS ^ ) 9"- BOARD OF HEALTH TOWN OF BARNSTABLE Apptiratilau for Dhipaaa1 Works Tom rurtion Vamit Application is hereby made for a Permit to Construct or Repair (X) an Individual Sewage Disposal System at: Strawberry Hills Condo's Strawberry Circle Hyyannis„ -,--_-_ ........................................••-----•------- ....--•-----•-••---•--•-- •--•-------••--------- Strawberry Condominium Trust. or Lot No. ----•................._.---•---•-•--------.............._..---•--------._.........---••-•---•••-- •-••...------------.......-----•----......_._................-----•---......................--•-•- W J.P.Macomber Jr. Owner Address Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling X No. of Bedrooms.............6__.._......____..__......_..Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building .. No. of persons............................ Showers � YP g ----------•------- -------- P ( ) — Cafeteria-(--•->- dOther fixtures .----•------------------------------------------------•••----------------••••------------•-•--•----------••--•-------•-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..........:.......... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date....................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.._-_----_--_.-._.-.... Gz.t Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x 0 Description of Soil............. -•---------- ...... --------------------------------------------------- •--------------- •-------------------------------------•••-- x Sand._&..Gravel+J _ W x •----••----•------------------------------------••---------•---------•--•----•----•---------------•--------•----------------------------•---------------•--------••••---•-•••--••-.....---------•------- U Nature of Repairs or Alterations—Answer when applicable...Replacement Of lines leaving the building and through out system. Possibly will add additionaI__pit-..or pits . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss>ied by the boa ; of hea th. 7/i6/92 Signed ... .. ----------- - ...... ---------------6;le---------------- Application Approved BY ... �". ..... ,..," 7--/G-.72- Date Application Disapproved for the following reasons; ...................... ....................... ............ ....................... ...................................................... ----. .-....------ ...... ------................................. ^� Date Permit No. ............ ---.Z......... -�--5 Issued Date .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (ITIertifirate of C11IImylian.ce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) by-----J.P.Macomber Jr. ------------ -- ------- Installer at ......Strawberry Hill Condominiums Stawberry Circle Hyannis. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------.. -----3:3--S .... dated ............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. .-........... ---- Inspector ...........................>. I...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH qq TOWN OF BARNSTABLE $ 30,00 No...,(.. .:: FEE........................ Permission is hereby granted.......J.P.Ma e omb e r J r. to Construct ( ) or Repair (X) an In ividual Sewage Disposal System at No..._2.Y--&22_.Strawberry Hit-1 Circle Hyannis . Street as shown on the application for Disposal Works Construction Permit No................5__.._ Dated.......................................... - - 7 _ /_ ^9]) Board of Health DATE ............................................................... FORM 36508 H088S 6 WARREN.INC..PUBLISHERS , _ _ ; BARNSTABLE HA TH WAYS c \\ �a A.M. 274129 MH) POND�� O << SMH \ O try OP PA -_- O \\ SMH E�§_�, -TP / A.M. 274121 87/ Q `- _ PROPOSED RISER & MANHOLE COVER OC -_- SHALLOW POND a V� CAnH "� 1 T.O.F.=9L� a� NK EXISTING \ O LEA TO PUMPEp I ° \\ " \ O ` - I --- 1 BOARD OF HEALTH LOCUS MAP AND REMOVED VARIANCES REQUESTED. \ H e9 / II 41\ ° 43'6' 1 1`. 11 - T.0.F=-92.9 `1 1) TITLE 5 310 CMR 15.221 (7) GREATER THAN 36 OF COVER ON SYSTEM COMPONENTS •-_ II o 0 1 1 1 � -_- � _-_- 1 NEH�MANHO /SPHALT II a COVER & D - -__- PARKING I; SEPTIC SYSTEM REP AIR PLAN SNPROPOSED RISER 0BA PREPARED FOR.•& MANHOLE COVER st Q) STRA WBERR Y HILL- ° n", ` — CONDOMINIUMS o lI �1 XISTINC c `I `, 14�31 I YANO UGH ROAD LEACH PLAN REF• 319119, 315166 & sMHIT� 314163 / VENT 1 1TO BE PUMP�p ,� , -- __—_— CENTER VILLE; MA. AND REMO VEd , •_ _ - GWOD. WP e'\� -�-- 12. 11 1 1 r' ___ 9o,�ll 1 ____-- 1 GRAPHIC SCALE MH 1\ 1 1 ---_T.O.F=94.6 20 0 10 20 ao B0 92 ,1> 1 - - - _ _ -_ - LAND SURVEYED BY: \Zy -_ASPHALT III - __ _ -__ 1 1`1 PARKING 11 11 11 ( IN FEET ) YANKEE SURVEY 93 — 1 inch = 20 ft. 1 1 W1 1 CONSULTANTS `II 3MH 11 1 j t-jp of PESCE ENGINEERING & A SSOCIA TES 40 (SUITE 1) / �\ 11\1 R o�' a P. O. BOX 321 E .tc DWARD L. INDUSTRY ROAD PAUL - _________ �` PESCE OSTERVILLE, MA. 02655 MARSTONS MILLS, MA. 02648 ! 11 a; _--_. - - CIV'IL PH. (508)428-3730 No.3'ODo TEL: 428-0055 tft FAX: 420-5553 0111100, S Hol eAsN 11 -__- - e. 12108101, REV 4113102 \ 94\ `n _ -=_-_ SHEET I OF 2 J# 52968 GM 1 719P OF FOUNDATION I EL =91.3(ASSUMED) " — 10' MIN. 2 1a YER OF 4" SCHEDULE 40 PVC. 1/8"-1/2" PROPOSED I EL=90.B MIN. PITCH 1/8 PER FT 3/4" 7v 1-_l/2' WASHED SMNE VENT EL= 89' wASXBD S77vvNE. EL.= B? 3' EXISEL 92. TING I INVERT / • / / / / / 4" CAST IRON PIPE INVERT (OR EQUALj MINIMUM EL.=85.2' vEL EL.=83.8" CLEAN SAND, FILL 9» PI7L^H 1/4 PER FT DIA SCp Z, MIN. FLOW LINE 40 PVC PIPE INVERTG 1!0" 14' 0 0 o p p p p ° om ° p p O omoo°0 EXISTING MIN MUSTINC EXISTING INVERT INVERT INVERT • 24" o p O p O r1 �o p p p m o 4Q — �° m o�°m —81.8 4.0 8.5' 4.O L EL.=86_0 EL.= 85_0 EL. °°°° om NEW (Ty DISTRIBUTION 104.o' n EXISTING 2,500 GAL. BOX 8—500 GAL. DRY WELLS co SEPTIC TANK (H--20) (H--20) OF TEST HOLE ELEV. =_75_4 BOTTOM PROFILE OF ESTIMATED HIGH GROUNDWATER ELEV. = 59'(ASSUMED DATUM) SEWAGE DISPOSAL SYSTEM NOT TO SCALE OBSERVATION HOLE 1 ELEV.= 87 9_ PERCOLATION RATE _2__ MIN./ INCH AT ___40_ INCHES GENERAL NOTES EL= 879 DEPTH ORIZ . TEXTURE COLOR MOTT. OTHER 3��4" 71D 1-1/2' 1 DYER OF EL= 85.73 0-26" TOPSOIL & FILL / / WASHED STONE 1/8" — 1/2 WASHED STONE EL-- 85.57 26"-28» OLD PAVEMENT 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. •• cRA VEL ROAD BASE ,� / EL= 85-07 28 —34 / L TITLE 5 AND THE TOWN OF __ BARNSTABLE__ RULES AND •• MEDIUM SAND ��8a %%%� REGULATIONS FOR THE SUBSURFACE DISPOSAL .OF SEWAGE. EL-- 84.9 34 —36" C1 AND GRAVEL 2.5Y6/6 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO EL= 75.4 36"-150 ' C2 MEDIUM SAND z5ry/3 IOX GRAVEL 4' 4.8, ' 4, WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12 12.8' 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF NO GROUNDWATER ENCOUNTERED DRY WELL WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN PERC TEST PERFORMED 0 48" DEPTH END VIEW 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE BARNSTABLE PERC TEST # N/A USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL 12101101 BE MORTERED IN PLACE. DATE OF SOIL TEST DESIGN CALCULATIONS.'. 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH WITNESSED BY: N/A DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO EDWARD PESCE, P.E. . . . . . . 12 OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. SOIL TEST DONE BY NUMBER OF BEDROOMS . 6 UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR GARBAGE DISPOSAL . NO IS TO CALL "DIG- SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS TOTAL ESTIMATED FLOW 1320 GAL/DAY PRIOR TO COMMENCING WORK ON SITE. ( _110__GAL/BR/DA Y x _12 BR) ` USE EXIST. 2500 CAL SEPTIC TANK 2500 GAL 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO C11c.MMENCING WORK ON SITE. 8) PARCEL IS IN FLOOD ZONE __ INSTALL 8- 500 GAL. DRY WELLS ( WITH CRUSHED STONE) 9) LOT IS SHOWN ON ASSESSORS MAP _274_ AS PARCEL _21 SOIL CLASSIFICATION . . . . . . . . 1 10) ND WATER SUPPLY WELL EXISTS WITHIN 150' OF SAS DESIGN PERCOLATION RATE . . . . . < 2 MIN./IN. ; 11) ENGINEER TO BE NOTIFIED 48 HOURS PRIOR TO EXCA VATION i EFFLUENT LOADING RATE . . . . . . 74 GAL/DA Y/S. ` AND SHALL INSPECT SOIL CONDITIONS PRIOR TO INSTALLATION TOTAL LEACHING CAPACITY 1,330.82 GAL/DA Y 12) THIS DESIGN DOES NOT INCLUDE THE USE OF GARBAGE DISPOSALS sIDEWALL (104' + 12.8) X 2' X 2 SIDES)(74)=345. 73 GAL/DAY ALL EXISTING GARBAGE DISPOSALS MUST BE REMOVED (UNITS 23-30) ' BOTTOM. (104' X 12.8)(.74)=985.09 GAL/DA Y 52968 SHEET 2 OF 2 JOB NUMBER------------- L 3 r m� a .... ...:: _ .. ... ... ... ..... - � 1 � '� _ _ •ems. ..... _ ' l t � a ^ • r : s r 77 b dC i t f x zo Sri rya - p ,, r.: „r..:a r.. ..,-h•-•--,.y. .. s.,. .. ,.,._s S .•s',�k i. �,;,.. 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