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HomeMy WebLinkAbout0048 OAK HILL ROAD - Health 48 OAKHILL RD., HYANNIS Ay= a�8 - og5 i TOWN OF BAFNSTABLE SEWAGE a VILLAGE_ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS Al L BUILDER OR OWNER >C'/lAMD 6-19la 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 leachin f cilit Feet Furnished b L �1 I \ \ a4 i DATE:-7/l/99 ---- PROPERTY ADDRESS:—48 Oak Hill Road ---------------------- Hyannis ,Mass . ------------------------ ------------------------ On the above date, I Inspected the septic system at the above address. This system consists of the following: 1 . 4-6 'x8 ' bloc cesspools . o � s� Based on my inspection, I certify the following conditions: 2 . This is not a title five septic system. 3. This. is a sewage system that is 35-40 years . 4. The sewage system is in proper working order at the present time . 5. A garbage disposal is present . Th@.':_:- maiyn cesspool should be pumped annually . SIGNATURE: f _ _ I Name:_,L_F__ Macomber Jr-__---_ Company: Jose_ph_P. _Macomber—& Son , Inc . Address: Box 66 -------------------- Centerville , Ma . 02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. ^ Tanks-Cesspools-Leachfields Pumped & Installed Town Sewer Connections JUL 1 3 199 P.O. Box 66 Centerville, MA 02632-0066 9 775-3338 775-6412 tOtyiVVOF s gun, • 4* A s COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.5500 TRUDY CO) Sacrew ARGEO PAUL CELLUCCI DAVTD B. STRL'F Governor Co�:_ss:oc SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART A CERTIFICATION PropartyAddreas: 48 Oak Hill Road Name of owner Richard Craig Hyannis ,Mass . Address ofOwnw: oat.e of Irupoctfon: 7/1/9 9 Narr.o of inspector:(Ptaase Print) Joseph P. Macomber Jr. I am a DEP approved system Inspector pursuant to Section 15.340 of Trde 5 (310 CMR 15.000) company Narno: Joseph P. Macomber & Son, Inc. µmg Address: 2632-0066 Telophorse Number: S O 8 .t 3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally Inspected the sewage disposal system at this address and that the Information reported below is true, accurate and complete as of the time of Inspection. The Inspection was performed based on my training and experlence In the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evalulon By the Local Approving Authority _ Fails lnspoctor's Signature: Date: X/V The System Inspector hall submit a copy of this Inspection report to the Approving Authority (Board of Health or DEP)wnnin thirty (30) days of completing this Inspection. If the system Is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system o-ne, shall submit the report to the appropriate regional office of the Department of•Envkonmeruai Protection. The original should be sent to TM system owner and copies sent to tho buyer, If applicable, and the approving authority. NOTES AND COMMENTS revised 9/2/98 Paer i of 11 Vr, Pmaed on R"led Pepe SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (corrtinued) PropertyAddrass: 48 Oak Hill Road Hyannis ,Mass . Owner: Richard Craig Date of inspection: 7/1/9 9 INSPECTION SUMMARY: Check A, B, C, or D. A. SYSTEM PASSES: I have not found any information which Indicates that any of the failure conditions described in 310 CMR 15.303 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. Indicate yes:no, or not determined(Y, N, or NO). Describe basis of determination in all Instances. If 'not determined', explain why not. awe• The septic tank li metal, unless the owner or operator has provided the system Inspector with a copy of a Certificate of Compliance (attached) Indicating that the tank was Installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, Is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is Imminent. The system will pass Inspection If the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. I, Sewage backup or breakout or high static water level observed In the distribution box is due to broken or obstructed pipes or due to a broken, settled or uneven distribution box.wThe system will pass Inspection if(with approval of the Board of Health). broken pips(s)are replaced obstruction Is removed distribution box Is levelled or replaced - The system required pumphig•more than`fourtfines a yeardue to broken or obstructed pipe(s). The system wilt-vess-- inspection if(with approval of the Board of Heaith): - broken p(pe(s) are replaced obstruction Is removed i revised 9/2/98 Page 2of11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (cont:r><red) Ptop«tiyAda.>s: 48 Oak Hill Road Hyannis ,Mass . Owner. Richard Craig osts of V"Pocrdc- 7/1/9 9 C. 4�FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Condldons exist which require further evaluation by the Board of Health In order to determine If the system Is falling to protect the public health, safety and the snvlronment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETDWINES INACCORDANCE WfTH 310 CUR 15.303 (1)(b)THAT THE SYS IS NOT FUNCTIONING W A UANNFR WKC}f..WILLPR02E.CT THE PUBUC UZALTH.AND SAFETY AND THE E?0aBOKVZ4T_ _ Cesspool or privy Is within 60 feetof surface water Cesspool or privy Is within 60 feet of a bordering vegetated watiand or a salt marsh. 2) SYSTEM WU1 FAIL UNLESS THE BOARD OF HEALTH(A 0 PUBUC WATER SUPPLIER, IF MY)DETERULNES THAT THE SYSTE3 FUNCTIONING W A L A11NER THAT PROTECTS THE PUBUC HEALTH AND SAFETY AND THE ENVIRONWENT: The system has a septic tank and soil absorption system(SAS) and the SAS Is wlthln 100 feet of a surface wstar suppy tributary to a surface water supply. AP The system has a septic tank and soU absorption system and the SAS Is wlWn a Zone 1 of a public water supply weu. The system has a septic tank and loll absorption system and the SAS Is within 60 feet of a private water supply weu. The system has a sepdc tank and toll absorption system and the SAS Is less than 100 feat but 60 feet or more from a private water supply well, unless a well water analysis for coUlorm bacteria and voladis organic compounds indicatas tha wall is free from pollution from that facility and the presence of smmonla nitrogen and nitrate nitrogsn is aQuaJ to w Iss, than 6 ppm. Method used to dstsrmins distance _(approximation not valid).• 3) OTHER _ K- y- i revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTiON FORM PART A CERTIFICATION (continued) p, tyAd&au: 48 Oak Hill Road Hyannis ,Mass . Owner: Richard Craig Data of tr.spection: 7/1/9 9 D. SYSTEM FAILS: You m/�ust Indicate either 'Yes' or 'No' to each of the following: I have determined that one or more of the following failure conditions exist as described In 310 CMR 15.303. The basis for this daterminal.ion Is Identified below. The Board of Health should be contacted to determine what will be necessary to correct the failurr Yes N� Backup oFseWage into facility-or�rytem component due sn overloaded orctogg•ed SASorKesspoa. Discharge or ponding of eHluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. NamStatic 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 112 day flow. — Required pumping more than 4 times In the last year NOT due to clogged or obstructed pipe(s). Number of times pumped 0. Any portion of the Soil AbsorptJon System, cesspool or privy Is below the high groundwater elevation. Any portion of a cesspool or privy Is within 100 teat of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy Is-within a Zone I of a public well. Any portion of a cesspool or privy Is within 60 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 60 feel from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, anach copy of well water analysis lot colilorm bacteria, volatile organic-compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either 'Yes' or 'No' to each of the following: The following criteria apply to large systems In addition to the criterla above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to put health and safety and the environment because one or more of the following conditions exist: Yes No _ [/ the system Is within 400 teat of a surface drinking water supply _ _V/ the system•4-wit4in 200 (aetof-a-tributary-toe wrleoo-drinkkay.vater suDWy the system Is located In a nitrogen sensitive area (Interim Wellhead Protection Area IWPA) or a mapped Zone II of a puoh water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.304(2). Please consult the local region office of the Department for further Inlorlrtadon. revised 9/2/98 Pe Ile 4ofII i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Proparty Address: 48 Oak Hill Road Hyannis ,Mass . Owrw: Richard Craig Data of Inspection: 7/1/9 9 Check if the following have been done: You must Indicate either "Yes' or "No" as to each of the following: Yes No Pumping Information was provided by the owner, occupant, or Board of Health. None of the systemcompo"nts.laaua:b"n puaipad+kopatJsast twoweaka an�tbe'system hasbaaaaec"iwg.wa.a! fic rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this Inspection. As built plans have been obtained and examined. Note If they are not available with NIA. _ The facility or dwelling was inspected for signs of sewage back-up. Z/ The system does not receive non-sanitary or Industrial waste flow. The sit@ was Inspected for signs of breakout. All system components, luding the Soil Absorption System, have been located on the site. _�Gsvv_ The septic tank manholes were uncovered, opened, and the interior of the septic tank was Inspected for condition of bat or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System orrthe site has been determined based on: l� Existing Information. For example, Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C Is at issue, approximation of distance is unacceptab — 115.3021311b11 T h a facility owner.(an d.=cupaass,11 difiara= froo"wnw).wara,prnuidad.with ininrmasioaDn tFyn_n�nor rt�n.aa o ^ Subsurface Disposal Systems. revised 9/2/98 Page 5of11 l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Addreu: 48 Oakhill Road Hyannis ,Mass . Owner: Richard Craig Date of kupection: 7/1/9 9 FLOW CONDITIONS RESIN L- Design flow: g.p.d./bedroom. Number of bedrooms Id Number of bedrooms(actual): Total DESIGN flow ��t►!!4 (=('+ Number of current residents: Garbage grinder(yes or no):.ff-47 Laundry(separate system) ( es br o :_ . If yes, separatelaspection.required --. Laundry system Inspected es r no D Seasonal use(yes or no): �'y' Ji Water meter readings,If av •lable (last two year's usage(gpd): *OC7 a rJ/, Sump Pump(yes or no): b Last date of occupancy:t L COMMERCIAL/INDUSTRIAL; Type of establishment: Design flow: d Based on 16.203) Basis of design flow Grease trap present: (yes or no)l,/ Industrial Waste Holding Tank present:(yes or no)ld& Non-sanitary waste discharged to the Title 6 system: s or no) Water meter readings,if avaii�b,�a: Aoq Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING REP RDS and rcp qtinformation: System pumped as part of inspection: (yes or no) If yes,volume pumped: gallons Reason for pumping: (9 TYP SYSTEM Septic tank/distribution box/soil absorption system Single cesspools Overflow cesspool Privy Shared system(yes or no) (if yes, attach previous Inspection records, if any) 1/A Technolog et Attach copy of up to date operation and maintenance contract Tight Tank / Copy of DEP Approval Other APPROXIMATE AGE of all components, date InstaNed{if known)-and source of•information: Sewage odors detected when arriving at the site: (yes or no)_ revised 9/2/98 Page 6orll SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECON FORM TI PART C SYSTEM WFORMATION (con-dnuod) PtW*MAddr.s.a: 48 Oak Hill Road Hyannis ,Mass . 0WTW: Richard Craig. , Data of Mspocdon: y/1/9 9 BULLDWO SEWER: (Locate on site plan) !I Depth below grads:4. c&st M►url+l of cons U I on 40 VC tha lax lain)1� wellorisDistance homp�lwpply /01/70-- Dlameter 17 _ _ Comments:(condition of Joints,venting, evidence of!aa)cage,-etc.) Joints No e;4defl-ee of ±7,a-kage . S77-s t em is surnC TANz: (locals on►Ita plan) Depth below grads:, Materialof constructlon oncretv([�' metal/-' Flbarple3s4&PolyethylonwtAother(sxplain) If tank is (natal, list age M Js.age.confvmed by Certificate of Compliance (Yes/No) Dimensions: Sludge depth: Distance from top of slu go to bottom of outlet tea ortraFfle:� Scum thickness: Distance from top of scum to top of outlet tee or bafile:_�_ Distance from bottom of scum to bosom of o Usl tee or bet le:_,,&& How (timanslons ware detsrmined: Comments: (rscommsndsdon for pumping, condition of Inlet and outlet less or•batfies, depth of liquid level In relstlon to outlet inert, rvucwre::,ut evidence of leakage, etc.) Septic tank is not present _ GREASE TRAP: e (louts on sits plan) Depth below grads:A Matsdal of consuucdon:1LAoncretvtEmetaM Fib orgies so Polysthylen✓4othar(axpiain) AJJO Dimensions: Scum thickness: Distance from top of scum to top of outlet I" or baffle:A Distance from bonom of }cum to bosom of outlet tee or, baHls:Ag— Date of last pumping. �Jf� Comments: (recommsndadon for pumping, condition of Inlet and outlet tees or baMJss, depth of liquid level In relation to outlet Invert. rtruccural inleq evidence of leakage, etc.) rease trap is not =recant revised 9/2/98 Paea7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (corrtirwed) Pro9*MAd&oss: 48 Oak hill Road Hyannis ,Mass . Own,": Richard Craig . Date of Inspection: 7/1/9 9 TIGHT OR HOLDING TANK:_4h�_X(Tank must be pumped prior to, or at time of, Inspection) (locate on slts plan) Depth below 9rade:4 Materiel of construcd :A/dconcreteIRMetalo!YFlberplassAAPolyethyleneAIY�?other(explain) AJA Dimensions: Capacity: gallons Design flow: gallonslday Alum present Alarm level: Alarm Ins�wgorking order: Yes,A NoM Date of previous pumping: _GILL Comments: (condition of Inlet tee, condition of alarm and float switches, etc.) or nOldinR tanks are 4ot prPePnt r — DISTRIBUTION BOX:IAV— (locate on site plan) Depth of liquid level above outlet Invert:— Comments: (note if level and distribution Is equal, evideno-v of solids carryover, evidence of leakage Into or out of box, etc.) — Distribution h0X ; c not present . PUMP CHAMBERA�1 (locate on site plan) Pumps in working order:(Yes or No) !U'J9 Alarms In working order(Yes or No) 'UP Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) _ Pump chamber is not DresPnt _ revised 9/2/98 Peeosof11 SUBSURFACE SEWAGE DIS PART C SYSTEM INSPECTION FORM SYSTEM INFORMATION (continued) Property kddreaa: 48 Ciakhill Road Hyannis ,Mass . 0wnar: Richard Craig—, Dieu ofL-pection:7/1/99 CC99 � �r SOIL ABSORP'T1ON SYSTEM(SAS)*_ by non•intrusive methods! (locate on site plan,it possible; excavation not required,location may be approximated If not located, explain: Type: leaching pits, number: leaching chambers, number:7R leeching galleries,number:,_, leaching trenches,number, length:—Jam---- leaching fields, number, dians ns overflow cesspool,number: Alternative system: r � Name of Technology: Comments: ots condition of loll, signs of hydraulic }allure, level of ponding, damp soil, condition of vegetation.,etc. 'Eoam san o y raujivc fail , ve etn t n n . . CESSPOOLS: 1 (locate on site plan) Number and configuration: Number of liquid to Inlet Invert: Depth of solids Iaye(: Depth of scum layer: Dimensions of cssspool� Materials of construction: ���spec�on) Indication of groundwater: Inflow (cesspool must be pumped as part of In noL PU111111ii11 3 1:: dry . Comments: ic failure, level of ponding,condition of vegetation, etc. (note condition of soil, signs of hydraul PRIVY: (locale on site plan) Dimensions: Materjals of construcdgn: Depth of solids:' Comments: (note condition of soil, signs of hydraulic failure, revel of ponding, condition of vegetation; etc.) Privy is no Psee 9 or I l revised 9/2/98 SUBSURFACE SEWACE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (condn i4 PIT op&MAd&&": 48 .Oak�ill Road Hyannis ,Mass . Owrw: Richard Craig Do. orV"Pocdon: 7/1/99 SKETCH OF SEWACE DISPOSAL SYSTEM: Include tlas to ►t'Isast two psrmansnt reference landmarks or benchmarks locals all wells wlWn 100' (Locals where public water supply comas Into house) >r � s 10�•' r /©h revised 9/2/98 Patilooril SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 48 Oak Hill Road Hyannis ,Mass . Owner: Richard CrAig Date of Inspection: 7/1/9 9 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep _ SITE EXAM Slope Surface water Check Cellar Shallow wells ""99��1 Estimated Depth to Groundwater nv Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record OObbserved.Site (Abutting property, bservation hole, basement sump etc.) 0�Determined from local conditions Checked with local Board of health Checked FEMA Maps __ZChecked pumping records Checked local excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Used water contours map . Gahrety & Miller Model 12/16/94 revised 9/2/98 P2ge11of11 I TOWN OFBARNSTABLE ()UARD OF HEALTH + � �_.Tn-'.•.,'.'-T.t'x_ U[1SU[IFACF 9EW�CF ()( ('USAL�SY�STFM I N�5(�FCTION FORM - PART D^- CERTIFICATION r_1i _• -TYPL OR PR1N1 CI.CARLY- PROPERTY INSPECTED STREET ADDRESS 48 Oak Hill Road Hyannis , Mass . ' ASSESSORS MAP , BLOCK AND PARCEL OWNER' s NAME Richard Cr9aig PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber. Jr. COMPANY NAME Jose h P. Macomber & Son Inc. COMPANY ADDRESS Box 66, Centerville, Ma. 0263.2-0066 Street Town or Clty St". lip COMPANY TELEPHONE (508 )775 -3338 FAX ( 508 )790 -1578 CERTIFICATION STATEMENT " I certify that I have personally inspected the sewage disposal system nt this address and that t)le 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 : Systeui PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public he-alLh or the environment as defined 'in 310 CMR 15 , 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have conducted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this Inspection form . Inspector Signature 1 Date One copy of this certification must be provided to the OWNER, the BUYER ( Where aPplicable ) and the BOARD OF 112ALT11. • If the inspection FAILED, th'e owner or•"operator shall u within one ,Year of the date of the inspection , unless alloweddor-pgre ' the required otherwise as provided in 3.10 Cr1R 16 . 306 . partd . doc