HomeMy WebLinkAbout0091 FALLING LEAF LANE - Health 91 'Falling-Leaf Lane
_ Osterville Ruck
i
A= 144 003617
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i.
Holmes and Mcgrath, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 11/9/2021 JOB No. 217099
falmouth, ma. 02540 ATTENT1oN
508-548-3564 • 800-874-7373 • FAX 508-548-9672 RE: Mr.Arthur Balian
email:Icoel ho0holmesandmcg rath.com
#91 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn: Title 5 Program
1 Winter Street,6t'Floor
Boston, MA 02108
° i
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
1 10/14/2021 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro=Septic, RUCK)
A. Installation
Important:When Mr. Arthur Balian
filling out forms Owner
on the computer, AQ
use only the tab 7' #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return
City Zip
key.
Mailing address of owner, if different:
rab
Same
Street Address/PO Box:
rendn City State Zip
(508)420 -7863 ext.
Telephone Number
B:Authorized Service Provider
Holmes and Mcgrath Inc.
0&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508) 548-3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes 0 No
D. Operating Information
10/14/21 10/20/20
Inspection Date Previous Inspection Date
Blackwater Tank=11" Graywater Tank=8" Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5iaomr.doc• 6-16-06 Page 1 of 3
LL11 Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ® gray ❑ brown ❑ clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH s t0 9 U DO 2 or greatermg/L Turbidity 40 or IesNTU
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
9 9 Y
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
The septic tank was pumped out on April 2020
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. The scum
level is 1" thick inside septic tank.
t5iaomr.doc• 6-16-06 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
H. Certification
certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a tra ing course for this System with the Technology Company and am listed by the
Company a trained ins ector.
November 9, 2021
pe or ignatur Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31s'of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
;,
J
Holmes and Mcgrath, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 1/4/21 JOBNo. 217099
falmouth, ma. 02540 ATTENTION
508-548-3564 9 800-874-7373 • FAX 508-548-9672
email:Icoelho(ftolmesandmcgrath.com Re. Mr.Arthur Balian
#91 Falling Leaf Lane =;
To: DEP Osterville, MA 02655
Attn: Title 5 Program
1 Winter Street, 6t'Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items.-
COPIES DATE N0. DESCRIPTION
1 10/20/2020 DEP Approved Inspection and O&M form.
REMARKS.-
COPY TO:
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
1I
a Massachusetts Department of Environmental Protection
LIBureau of Resource Protection - Title 5
( DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Arthur Balian
filling out forms Owner
on the computer,
use only the tab #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville
use the return 02655
key. City Zip
Mailing address of owner, if different:
rab
Same _
Street Address/PO Box:
ream
City State Zip
(508) 428 - 7863 ext.
Telephone Number
B. Authorized Service Provider
Holmes and Mcgrath Inc.
0&M Firm
205 Worcester Court, Unit A4
Street Address --
Falmouth MA 02540
City State Zip
508) 548 - 3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence— used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/20/20 8/27/19
Inspection Date Previous Inspection Date
Blackwater Tank=6" Graywater Tank=6"
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5iaomr.doc• 6-16-06 Page 1 of 3
r Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
LLA A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ® gray ❑ brown ❑ clear
❑ turbid
❑ Other(specify):
Odor: ® musty El earthy ❑ moldy El offensive ❑ turbid
Effluent Solids: ® no ❑ some
6.5 SU m /LNTU
pH 6 to 9 DO 2 or greater Turbidity 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection & during this inspection:
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. The septic
tank was pumped out April 2020. The scum level is 0"thick.
t5iaomr.doc- 6-16-06 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a training course for this System with the Technology Company and am listed by the
Company a trained in ector.
January 4, 2021
or ignature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use— by January 31st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 301h of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 61h Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
Holmes and Mcgrath, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 9/5/2019 JOB No. 217099
falmouth, ma. 02540 ATTENTION
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:Icoelho(ftolmesandmcgrath.com RE: Mr.Arthur Balian
#91 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn: Title 5 Program
1 Winter Street,6th Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
1 8/27/2019 DEP Approved Inspection and O&M form.
REMARKS:
,COPY.TO:
_ _- _ . -_.
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
Massachusetts Department of Environmental Protection r
Bureau of Resource Protection - Title 5 �u
DEP Approved Inspection and O&M Form for Title 5 I/A
.Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Arthur Balian
filling out forms Owner
on the computer,
use only the tab #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return -- - --
City Zip
key.
r�
Mailing address of owner, if different:
Same _
Street Address/PO Box:
� I
City State Zip
(508) 428 - 7863 ext.
Telephone Number
B. Authorized Service Provider
Holmes and Mcgrath Inc.
O&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth. MA 02540 _
City State Zip
(508) 548 - 3564 ext.
Telephone Number
Luis Coelho _ 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97.894 _ Innovative Ruck Systqms Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
8/27/19 _ - 11/15/18
Inspection Date Previous Inspection Date
Blackwater Tank=14" Graywater Tank=5° Pumping Recommended ® Yes ❑ No
Sludge Depth(to be checked yearly)
t5iaomr.doc- 6-16-06 Page 1 of 3
r Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
L DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal. Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ® gray ❑ brown ❑ clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid .
Effluent Solids: ® no ❑ some
pH 6 to 9 Su
DO 2 or greater Turbidity NTU
40 or less
Should a Remedial or'General-Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling_Information-- not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
- .> Lommercial.systems or systems with a design flow of 200.0 gpd and greater, and General Use
nitrogen reducing systems:
9Pd —
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
6.T G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
None
Notes and Comments:
- All components,inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. The septic
tank could be pumped out...The4wscum level is 1/2" thick. Client could have septic tank pumped out.
t5iaomr.doc- 6-16-06 Page 2 of 3 .
�. Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a trai ing course for this System with the Technology Company and am listed by the
Compan a trained in ector.
September 5, 2019
erator Signatur Date
System owner must submit,this;report technology O&M checklist, and any required sampling results .
to the local board of health and DEP as follows for each inspection performed:
Remedial Use— by January 31s'of each year for the previous calendar year
Piloting Use -within 45 days of inspection date
"Provisional.Use—by March 311hof each year for the previous 12 months
General.Use—by September 301h of each year for the previous.12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6'h Floor
Boston, MA 02108
t5iaomr.doc- 6-16-06 Page 3 of 3
teC.
,
mot'V-
Holmes and Mcgrath, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors s
205 Worcester Court Unit A4 DATE 12/11/18 JOB No. 217099 :�
falmouth, ma. 02540 ATTENTION
508-548-3564 - 800-874-7373 - FAX 508-548-9672 Mr.Arthur Balian
email:Icoelho holmesandmcgrath.com RE:
#91 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program ; g
1 Winter Street,6t'Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
1 11/15/2018 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
I L'Lli DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK) "
A. Installation !MQ
Important:When Mr. Arthur Balian
filling out forms Owner -y
on the computer,
use only the tab #91 Falling Leaf Lane IN7
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return
key. City Zip
Mailing address of owner, if different:
tab
Same
Street Address/PO Box:
lenen
City State Zip
(508)428 -6900 ext.
Telephone Number
B. Authorized Service Provider
Holmes and Mcgrath Inc.
O&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508) 548-3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: E General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
11/15/18 10/18/17
Inspection Date Previous Inspection Date
Blackwater Tank=15" Graywater Tank=4" Pumping Recommended E Yes ❑ No
Sludge Depth(to be checked yearly)
t5iaomr.doc- 6-16-06 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and OW Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ® gray ❑ brown ❑ clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6 to 9 SU DO 2 or greatermg/L Turbidity NTU
40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. Does not
need pumping this year. The scum level is 1/2"thick. Client could have septic tank pumped out.
t5iaomr.doc- 6-16-06 Page 2 of 3
L1Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
1 DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
H. Certification
certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a tr ng course for this System with the Technology Company and am listed by the
Compa a traine spector.
December 11, 2018
erator signs a Date
System owner must submit this report, technology 0&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc- 6-16-06 Page 3 of 3
Innovative Ruck Systems, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 11/7/17 JOBNO- 217099 :Z
falmouth, ma. 02540
508-548-3564 - 800-874-7373 - FAX 508-548-9672 ATTENTION
email:Icoelho(a_holmesandmcgrath.com RE: Mr.Arthur Balian rZ
#91 Falling Leaf Lane ;
To: DEP
Osterville, MA 02655 wv,�
Attn:Title 5 Program �-
wG
1 Winter Street, 6th Floor :;
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
1 10/18/2017 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
l
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Arthur Balian
filling out forms Owner
on the computer,
use only the tab #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville _ 02655
use the return
key. city Zip
Mailing address of owner, if different:
Same
Street Address/PO Box: --
re2on
City State Zip
(508)428-6900 ext.
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems Inc.
O&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508) 548-3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert.#97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/18/17 10/26/16
Inspection Date Previous Inspection Date
Blackwater Tank=11" Graywater Tank=2"
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5iaomr.doc- 6-16-06 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify): —
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6.2 SU DO 0.79 mg/L Turbidity NTU
6 to 9 2 or greater 40 or less
Should a Remedial or General Use fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. Does not
need pumping this year. The scum level is 2"thick.
t5iaomr.doc• 6-16-06 Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
:attended a tr ning course for this System with the Technology Company and am listed by the
mpan s a trained ins tor.
��---- November 7, 2017
ator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use— by January 31 st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
r i
Innovative Ruck Systems, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 11/21/16 JDBND. 214043
falmouth, ma. 02540 ATTENTION
508-548-3564 - 800-874-7373 - FAX 508-548-9672
email:Icoelho(cDholmesandmcgrath.com RE: Mr.Arthur Balian
#91 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street,6th Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
2 10/26/2016 DEP Approved Ins ection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Ll
A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Arthur Balian
filling out forms Owner
on the computer,
use only the tab #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville
use the return 02655
key. city Zip
VQ Mailing address of owner, if different:
Same
Street Address/PO Box:
reran
City State Zip
(508)428 -6900 ext.
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems Inc.
O&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508) 548- 3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/26/16 10/28/15
Inspection Date Previous Inspection Date
Blackwater Tank=7" Graywater Tank=5"
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5iaomr.doc• 6-16-06
Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and OW Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ❑ gray ❑ brown ® clear
❑ turbid
❑ Other(specify):
Odor: ® musty El earthy El moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6.6 SU DO 1.34 mg/L NTU
6 to 9 2 or greater Turbidity 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
slid not notice any evidence of leakage in or out of the tank. Vents in place and working. Does not
need pumping this year. The scum level is 2"thick.
t5iaomr.doc- 6-16-06
Page 2 of 3
=� Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a training course for this System with the Technology Company and am listed by the
Company as a trained inspector.
November21, 2016
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use— by January 31 st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc- 6-16-06
Page 3 of 3
Innovative Ruck Systems, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 11/11/15 JOBND. 214043
falmouth, ma. 02540 ATTENr10N
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr.Arthur Balian
#91 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street,6'h Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
2 10/28!2015 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Arthur Balian
SIGNED: Luis Coelho
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Arthur Balian
filling out forms Owner
on the computer,
use only the tab #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return
key. City Zip
VkA Mailing address of owner, if different:
Same
Street Address/PO Box:
City State Zip
(508) 428-6900 ext.
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems, Inc.
O&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508) 548 - 3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/28/15 12/1/14
Inspection Date Previous Inspection Date
Blackwater Tank=5" Graywater Tank=4"
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5iaomr.doc• 6-16-06 Page 1 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6.5 SU DO 1.29 mg/L Turbidity NTU
6 to 9 2 or greater 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection & during this inspection:
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. Does not
need pumping this year. The scum level is only 1"thick.
t5iaomr.doc• 6-16-06 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a tr ' ing course for this System with the Technology Company and am listed by the
Company a trained beector.
(� 11/11/2015
O for ignature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31 st of each year for the previous calendar year
Piloting Use- within 45 days of inspection date
Provisional Use—by March 31 th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
r
Innovative Ruck SysWms,, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court-Unit A4 DATE 12/5/14 JOB NO. 214043
falmouth, ma. 02540 ATTENTIO.i
508 548-3564 a 800 874-7373 - FAX 508-548-9672
email i�o�i�o(@ii�li���'�ndmc�r�th.com PF: Mr.Arthur Balian
#91 Falling Leaf Lane
To:DEP OsterVille, MA 02655
Attn:Title 5 Program
1 Winter Street,6th Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
2 12/1/2014 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
'B'arnsta`ble Board of Health
Arthur Balian
SIGNED: Luis Coelho
LlMassachusetts Department of-EnVironmental P.rot@ction
Bureau of Resource,Protectlo;n - Title 5
DEP Approved Inspection and O&M Form for Title 5 1/A
Treatment-and Disposal 'Systems (Eijen, Enviro-Septic, RUCK)
A. Installation
Important:when Mr.Arthur Bahian -
filling out forms Owner
on the computer,
use only the tab #91 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return 'City tY Zip
Mailing address of owner, if different:
Same
Street Address/PO Box:
ienun
City State Zip
(508)428-6900 ext.
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems, Inc.
O&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508) 548-3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type- ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
12/1114 9/26/13
Inspection Date Previous Inspection Date
Blackwater Tank=7" Graywater Tank=5"
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5iaomr.doc.- 6=.16-06 Page 1 of 3
LlMassachusetts Department of-Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 UA
Treatment and Disposal .Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
PH 6.2 SU DO 1.07 mg%L Turbidity NTU
6 to 9 2 or greater 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
None
Notes and Comments:
All components inspected and working properly.The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working. Does.not
need pumping this,year.The scum level is only 1/2"thick.
t5iaomr.doc•.6-16-06 Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and OW Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
H. Certification
i certify:J. have inspected,.the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard,Methods,
have completed this report and the attached technology operation and maintenance checklist, and
LI
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a tr ing course for this System with the Technology Company and am listed by the
Compan a trained i gpect
. 12/5/14
Op or Tignatur DateK
System owner must submit this report, technology O&M.checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31 st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31 th of each year for the previous 12 months
General Use—by September 301h of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 6 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaom,r.doc• 6-16-06 Page 3 of 3
''
holmes and mcgrath, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court Unit A4 DATE 10/23/12 T
JOB No. 210011
falmouth, ma. 02540 ArrENTIDN
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:mcgrath holmesandmcgrath.com RE: Mr.Arthur Balian
#91 Falling.Leaf Lane
To: DEP Osterviile, MA 02655
Attn:Title 5 Program
1 Winter Street,6 Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:.
COPIES DATE NO. DESCRIPTION -
1 10/16/2012 1 'DEP Approved Inspection,and O&M form.
REMARKS:
COPY TO;
tBarnstable Board off Healt
C
Arthur Balian
SIGNED: Luis Coelho.
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-septic, RUCK)
A. Installation
Important: Mr. Arthur Balian
When filling out Owner
forms on the
computer,use #91 Falling Leaf Lane
only the tab key Facility Street Address
to move your Osterville 02655
cursor do not
use the return City Zip
key , Mailing address of owner, if different:
Street Address/PO Box:
rem' City State . Zip
(508)428-6900 ext.
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems Inc.
O&M Firm
362 Gifford Street
Street Address
Falmouth . MA . 02540
City State Zip
(508) 548-.3564 ext.
Telephone Number
Luis Coelho 14887 GradeAM
Operator Name Technology.Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK _
DEP.ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ .Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/16/12 10/21/11
Inspection Date Previous Inspection Date
Blackwater Tank=10" Graywater Tank=8" Pumping Recommended ❑ Yes Z No
Sludge Depth(to be checked yearly)
5iaomr.doc 616-06 9_ Pa e 1 of 3
t
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eijen, Enviro-Septic, RUCK)
E. Field Testing - not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
El Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6 to 9 SU DO 2 or greatermg/L Turbidity NTU_
qo or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information -not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 other 2 Other 3
'G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and .
did not notice any evidence of leakage in or out of the tank. Vents in place and working. Scum level
was still thick.
Pa e2of3
t5iaomr.doc• 6-16-06 9
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eijen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required. Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a aining cour for this System with the Technology Company and am listed by the
Comp as a traine inspector.
10/23/12
e for Signatu Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use by January 31 st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
J
holmes and mcgrath, inc. LETTER OF TRANSMITTAL
civil engineers and land surveyors
362 gifford street DATE 10/21/10 7
JOB No. 210011
falmouth, ma. 02540 ATfENnON
508-548-3564 9 800-874-7373 9 FAX 508-548-9672
email:mcgrath@holmesandmcgrath.com Re: Mr.Arthur Balian
#91 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street,e Floor
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
1 10/7/2010 DEP Approved Inspection and O&M form.
REMARKS:
COPY T0; -
E-(Barnstable_Board of Health?- . -
-Arthur Balian
SIGNED: Luis Coelho -
r
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
A. Installation
Important: Mr:Arthur Balian
When filling out Owner
forms on the
computer, use #91 Falling Leaf Lane
only the tab key Facility Street Address
to move your Osterville 02655
cursor-do not
use the return City Zip
key. Mailing address of owner, if different:
VQ
Street Address/PO Box:
ICI City State Zip
(508)428-6900 ext.
Telephone Number
CJ —1
crzi
B. Authorized Service Provider ' o
Innovative Ruck Systems, Inc. w ,
O&M Firm
362 Gifford Street
Street Address
Falmouth MA 02540 CIO
City State Zip ,0 Fii
(508) 548-3564 ext.
Telephone Number
Luis Coelho 14887 Grade 4M
Operator Name Technology Company/Date of Training
C. Facility/System Information
Gen. Use Cert. #97894 Innovative Ruck Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/7/10 9/23/09
Inspection Date Previous Inspection Date
Blackwater Tank=10" Graywater Tank=9" Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5iaomr.doc• 6-16-06 Page 1 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection- Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of Eljen, Enviro-Septic or RUCK
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify):
Odor: E musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6 to 9 SU DO 2 or greatermg/L Turbidity NTU
40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information — not required for standard inspection of Eljen or Eviro-Septic
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
None
Notes and Comments:
All components inspected and working properly. The structural integrity of both tanks were good and
did not notice any evidence of leakage in or out of the tank. Vents in place and working.
t5iaomr.doc- 6-16-06 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems (Ellen, Enviro-Septic, RUCK)
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted any required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I have
attended a ining cours or this System with the Technology Company and am listed by the
Compan s a trained iprinedor.
10/21/10
,Pferato Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 315t of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Pro ram
One Winter Street, 6t Floor
Boston, MA 02108
t5iaomr.doc- 6-16-06 Page 3 of 3
i
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:
When filling out Mr. Arthur Balian
forms on the Owner
computer,use
only the tab key 91 Failing Leaf Lane
to move your Facility Street Address
cursor-do not use the return Osterville MA 02655
key. City State Zip
Mailing address of owner, if different:
Same
Street Address/PO Box:
MA 02421
City State Zip
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems
O&M Firm
362 Gifford Street o
Street Address
Falmouth Ma. 0254')
City State Zip C2 t
(508) 548- 3564 ext. 00
Telephone Number
Luis Coelho 14887 '
Certified Operator Name Certification Number IV
W �
W
C. Facility/System Information
General Use Cert. #: 97894 Innovative RUCK Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑Yes ®No
D. Operating Information
9/23/09 10/14/08
Inspection Date Previous Inspection Date
Septic= 14 inches; Gray = 10 inches Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
Balian Insp. Report Sept08.doc•10/7/09 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent❑ Effluent
Parameters sampled: ❑ pH ❑ BOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
None.
Notes and Comments.
All components inspected and working properly. Vents in place and working:
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massach efts certifle ator in accordance with 257 CMR 2.00.
10/7/09
r or S ig n atU2�1 Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use - General Use—by September
31s'of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environ mental.Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
Balian Insp. Report Sept08.doc•10/7/09 Page 2 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:
When filling out Mr. Arthur Balian
forms on the Owner
computer,use
only the tab key 91'Falli64'Leaf-Lan_ei
to move your Facility Street Address
cursor-do not Osterville MA 02655
use the return
key. City State Zip
Mailing address of owner, if different.
8 Captain Parker Arms, #24
Street Address/PO Box:
' Lexington MA 02421
City State Zip
(781) 861-8928
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems
0&M Firm
362 Gifford Street
Street Address
Falmouth Ma. 02540
City State` Zip
(508) 548-3564 ext.
Telephone Number
Luis Coelho 14887
Certified Operator Name Certification Number
C. Facility/System Information
General Use Cert. #: 97894 Innovative RUCK Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑Yes ®No
D. Operating Information,
10/14/08 6/29/07
Inspection Date Previous Inspection Date
Septic= 12 inches; Gray = 8 inches Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
Balian Insp. Report Oct08.doc•10/21/08 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent❑ Effluent
Parameters sampled: ❑ pH ❑ BOD ❑ TSS❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection & during this inspection:
None.
Notes and Comments:
All components inspected and working properly. Vents in place and working.
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information r ported is true, accurate, and complete as of the time of the inspection. I am a
Massac tts certiiie erator in accordance with 257 CMR 2.00.
10/21/08
Q&erat&Signiture Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use- General Use—by September
315t of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
Balian Insp. Report Oct08.doc•10/21/08 Page 2 of 2
Massachusetts Department of Environmental Protection
'� Bureau of Resource Protection - Title 5
,;__, DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:
When filling out Mr. Arthur Balian
forms on the Owner
computer,use
only the tab key 91 Falling Leaf Lane
to move your Facility Street Address
cursor-do not
use the return Osterville MA 02655
key. City State Zip
Mailing address of owner, if different:
8 Captain Parker Arms, #24
Street Address/PO Box:
Lexington MA 02421
City State Zip
(781) 861-8928
Telephone Number
B. Authorized Service Provider
CD
Innovative Ruck Systems
O&M Firm
362 Gifford Street '
Street Address to
Falmouth Ma. 02540� -a tee.
City State Zip
1(508) 548 - 3564 ext.
Telephone Number - ~
Luis Coelho Ln
Certified Operator Name Certification Number
C. Facility/System Information
General Use Cert. #: 97894 Innovative RUCK Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence-used less than 6 mo./year: ❑Yes ®No
D. Operating Information
6/29/07 10/18/06
Inspection Date Previous Inspection Date "
Septic= 10 inches; Gray= 8 inches Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly) p g
Balian Insp. Report June '07.doc•8/8/07 Page 1 of 2
Z/
. . ... .....
Massachusetts Department of Environmental Protection
\�- Bureau of Resource Protection - Title 5
�, DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ® Influent ® Effluent
Parameters sampled: ❑ pH ❑ BOD ❑ TSS ® TN ❑ Other(list below)
NO2, NO3, NH3, TKN
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
None.
Notes and Comments:
All components inspected and working properly.
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reqortecl is true, accurate, and complete as of the time of the inspection. I am a
Ma7Z(�f! v
s certifie pera in accordance with 257 CMR 2.00.
i 7/2/07
O o Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use- General Use—by September
31st of each year for the within 30 days of inspection 301h of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 61h Floor
Boston. MA 02108
Balian Insp. Report June '07.doc•8/8/07 Page 2 of 2
holmes and mcgrath, inc.
_F civil engineers and land surveyors [LCEUV[En OO
362 gifford street
falmouth, ma 02540
t email: mcgrath@holmesandmcgrath:com DATE
JOB NO.
phone (508) 548-3564 1 800 874-7373
fax 008) 548-9672 ATTENTION
TO RE:
/ 20 5tos); IVA 6)2vO$
WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans 1 ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order
COPIES DATE NO. DESCRIPTION
e
9 e T -
M -or, � ���i � Al-T Zz4
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
❑ FOR BIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
' d
is
Fir)a '-
RE u
co
r.
COPY TO 90J7/
``',o aid" SIGNED:
/S®nn/nc•eamc�dw....a......._<_-e .___se_..__a,-_ -
r _
Massachusetts Department of Environmental Protection
J
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems.
A. Installation
Important:
When filling out Mr. Arthur Balian
forms on the Owner
computer, use
only the tab key 91 Falling Leaf Lane
to move your Facility Street Address
cursor-do not
use the return Osterville MA 02655
key. City State Zip
Mailing address of owner, if different:
reb
8 Captain Parker Arms, #24
Street Address/PO Box:
Lexington MA 02421
city State Zip
(781) 861-8928
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems
O&M Firm
362 Gifford Street
Street Address
Falmouth Ma. 02540
City State Zip
(508) 548 - 3564 ext.
Telephone Number
Luis Coelho
Certified Operator Name Certification Number
C. Facility/System Information
General Use Cert. #: 97894 Innovative RUCK Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: E General ❑ Provisional ❑ Piloting❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑Yes ®No
D. Operating Information
10/18/06 09/21/05
Inspection Date Previous Inspection Date
Septic= 13 inches; Gray = 8 inches Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
Balian Insp. Report '06.doc^10/25/06 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent ❑ Effluent
Parameters sampled: ❑ pH ❑ BOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection & during this inspection:
None.
Notes and Comments:
All components inspected and working properly.
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massac setts certif operator in accordance with 257 CMR 2.00.
10/23/06
perator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use- General Use—by September
31st of each year for the within 30"days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
Balian Insp. Report '06.doc. 10/23/06 Page 2 of 2
Massachusetts Department of Environmental Protection
LiBureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:
When filling out Mr. Arthur Balian
forms on the Owner
computer,use
only the tab key 91 Falling Leaf Lane
to move your Facility Street Address
cursor-do not
use the return Osterville MA 02655
key. City State Zip
Mailing address of owner, if different:
rab
8 Captain Parker Arms, #24
Street Address/PO Box:
Lexington MA 02421
City State Zip
(781)861-8928
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems
O&M Firm
362 Gifford Street
Street Address
Falmouth Ma. 02540
City State Zip
(508) 548-3564 ext.
Telephone Number
Paul C. LaCroix 3340
Certified Operator Name Certification Number
C. Facility/System Information
General Use Cert. #: 97894 Innovative RUCK Systems Residential RUCK
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑Yes ®No
D. Operating Information
6/22/04 5/2/03
Inspection Date Previous Inspection Date
Septic = 6"; Gray=4" Pumping Recommended
Sludge Depth(to be checked yearly) pig ❑ Yes ® No
Balian Insp. Report '04•7/30/04 Page 1 of 1
`rt
Massachusetts Department of Environmental Protection
r� Bureau of Resource Protection - Title 5
Ll DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent❑ Effluent
Parameters sampled: ❑ pH ❑ BOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
None.
Notes and Comments:
All components inspected and working properly.
c
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
M(a� a usetts ce ifi d operator in accordance with 257 CMR 2.00.
gl4y/ay
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use-by January Piloting & Provisional Use - General Use—by September
31 st of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
f
Balian Insp. Report '04.7/30/04 Page 2 of 2
L --
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:
When filling out Mr. Arthur Balian
forms on the Owner
computer,use
only the tab key 91 Falling Leaf Lane
to move your Facility Street Address
cursor-do not use the return Osterville MA . 02655
key. City State Zip
Mailing address of owner, if different:
8 Captain Parker Arms, #24
Street Address/PO Box:
'eta" Lexington MA 02421
City State Zip
(781)861-8928
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems
0&M Firm
362 Gifford Street
Street Address
Falmouth Ma. 02540
City State Zip
(508)548 - 3564 ext.
'telephone Number
Paul C. LaCroix 3340
Certified Operator Name Certification Number
C. Facility/System Information
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑Yes ®No
D. Operating Information
6/22/04 5/2/03
'Inspection Date Previous Inspection Date
Septic= 6"; Gray=4" Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
Balian Insp. '04.5/9/04 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5 r
DEEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent❑ Effluent
Parameters sampled: ❑ pH ❑ BOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
None.
Notes and Comments:
All components inspected and working properly.
F. Certification
certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Mas chusetttsIcified operator in accordance with 257 CMR 2.00.
2 7/910rK
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use- General Use—by September
31 st of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 61h Floor
Boston. MA 02108
Balian Insp. '04.5/9/04 Page 2 of 2
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617-292-5500
JANE SWIFT BOB DURAND
Governor
Secretary
LAUREN A.LISS
Commissioner
December 31,2002
Arthur J.Balian
91 Falling Leaf Lane
Barnstable,MA 02630
Re: 91 Falling Leaf Lane,Barnstable,MA
DEP Facility ID:RUCK53
Operation&Maintenance Requirements
Dear Mr.Balian:
As.you are the owner of an alternative on-site sewage treatment and disposal system regulated under Title 5
of the State Environmental Code, 310 CMR 15.000, I am writing to remind you of your operation and maintenance
obligations.According to the Department of Environmental Protection's records,a RUCK system has'been installed
at the above referenced location. The Department's approval for this system requires that, throughout the system's
life,the system owner must maintain an agreement with a person or firm competent in providing services consistent
with the system's specifications, the operation and maintenance required by the designer and any specified by the
Department. In addition, every time the operator or operators are changed, the owner must notify the Department
and the local Board of Health,in writing,within seven days of such change.
The Department has received information indicating that you are no longer 'under contract with an
operation and maintenance firm in violation of your system approval. Please notify the Department, in writing,
within fourteen days of receipt of this letter,of the name of the new operator for your system and submit a copy of
your current contract.Failure to comply with this request may result in enforcement action by the Department
Please submit the information to:
Department of Environmental Protection
Title 5 Program
Watershed Permitting Program
One Winter Street,6th floor
Boston,MA 02108
If you have any questions concerning your operation and maintenance requirements, please feel free to
contact John L.Ciccotelli at the DEPBoston Office at(617)292-5657.
A
zli.
Sharon M.Pel si,D
Watershed Permitting Program
cc: Barnstable Board of Health
DEP/SERO,B.Dudley
This information is available in alternate format by calling our ADA Coordinator at(617)574-6872.
DEP on the World Wide Web: http://www.staie.ma.us/dep
0 Printed on Recycled Paper
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
k A. Installation
Important: Arthur Balian
When filling out
forms on the Owner
computer,use 91 Falling Leaf Lane.
only the tab key
to move your Facility Street Address
cursor-do not Osterville 02655
use the return City Zip
key.
Mailing address of owher, if different:
reb
5 Viilage Road
Street address/PO Box: -
Lexington MA 02173
City State Zip
( ) - ext.
Telephone Number
B. Authorized Service Provider
Inovative Ruck Systems
O&M Firm .4.,.,
200 Main Street
Street Address
Falmouth Ma. 02540
City . State Zip
(508) 548 -3564 ext.
Telephone Number
Michael B Moreau Jr. 10291
Certified Operator Name Certification Number
C. Facility/System Information
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo:/year: ❑Yes ®No
D. Operating Information
03/04/02
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑Yes ® No
BALIAN •11/20/02 Page 1 of 2
Massachusetts Department of Environmental Protection
' Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
normal
b1 Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent ® Effluent
Parameters sampled: ® pH ® BOD ®TSS ®TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
Notes and Comments:
see results previously submitted
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massa tts rtifi d op r n accordance with 257
OperaiGf Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use- General Use—by September
31 st of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
BALIAN •11/20/02 Page 2 of 2
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: -GW Matrix: Aqueous
Project: 91 fL Sampled: 03-04-02
Client: Holmes&McGrath Received: 03-04-02
H Lab ID: 48911-01 Container: 250 mL Plastic Preservation: Cool
—L f E era«»k ,y"�' z$''``is fiN "� a°" b %er r'�' RepOrting
` ;Ana�lyt�e � ���q � Result ��UYn�ts Analyzed ,� QC Batch � �� Method
t ,:, t• ,.Limit , _ � «
Nitrate(as Nitrogen) 0.12 mg/L 0.02 03-05-02 NI-1360-W EPA 353.2
Nitrite(as Nitrogen) 1.7 mg/L 0.02 03-05-02 NI-1360-W EPA 353.2
'_ab ID: 48911-02 Container: 250 mL Plastic Preservation: H2SO4/Cool
is r T P g tfi �fi :,
Analyt Res lt�� t � �Lim�t ,nalyz w QC Batch } �� AAethod
Ammonia as Nitrogen) 3.0 mg/L 0.2 03-05-02 AM-0898-W EPA 350.1
Nitrogen,Total Kjeldahl (TKN) 7.2 mg/L 0.5 03-11-02 TKN-0817-W EPA 351.2
Method References: Methods for Chemical Analysis of Water and Wastes, US EPA,EPA-600/4-790-020,Revised(1983),and
Methods for the Determination of Inorganic Substances in Environmental Samples,US EPA,
EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater,
APHA,Eighteenth Edition(1992).
Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is the lowest
value that can be reliably quantified under routine laboratory operating conditions.-
Reporting limits are adjusted for sample dilution and sample size.
f
A
t
A
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
S
�f
�j�
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 51/A
Treatment and Disposal Systems
A. Installation
Important:
When filling out Arthur Balian
forms on the Owner
computer,use 91 Falling Leaf Lane.
only the tab key
to move your Facility Street Address
cursor-do not Osterville 02655
use the return City Zip
key.
Mailing address of owner, if different:
5 Viilage Road
Street Address/PO Box:
Lexington MA 02173
City State Zip
( ) - ext.
Telephone Number
B. Authorized Service Provider
Inovative Ruck Systems
O&M Firm
200 Main Street
Street Address
Falmouth Ma. 02540
city State Zip
(508) 548-3564 ext.
Telephone Number
Michael B Moreau Jr. 10291
Certified Operator Name Certification Number
C. Facility/System Information
DEP ID Manufacturer ID Model Number
12/27/99
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑Yes ®No
D. Operating Information
03/04/02 12/07/01
Inspection Date Previous Inspection Date
6"
Sludge Depth(to be checked yearly) Pumping Recommended ❑Yes ® No
BALIAN • 11/20/02 Page 1 of 2
r
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 1/A
Treatment and Disposal Systems
normal
Effluent Description
E. Sampling Information
Samples Taken: ❑ Influent® Effluent
Parameters sampled: ® pH ® BOD ®TSS ®TN ❑ Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
Notes and Comments:
see results previously submitted
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massa tts r�ifsid op r n accordance with 257 M!�22
Operat Signature Date .
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use - General Use—by September
31 st of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 0210&
BALIAN •11/20/02 Page 2 of 2
I
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: GW Matrix: Aqueous
Project: 91 FL Sampled: 03-04-02
Client: Holmes&McGrath Received: 03-04-02
Lab ID: 48911-01 Container: 250 mL Plastic Preservation: Cool
Y ' rgr p s 4^,a . }U
Reportings bf
, �? �Analyte %; �"Result �� Umts LamitAn I;yzedse QCBatch�A Methoii t
Nitrate(as Nitrogen) 0.12 mg/L 0.02 03-05-02 NI-1360-W EPA 353.2
Nitrite(as Nitrogen) 1.7 mg/L 0.02 03-05-02 NI-1360-W EPA 353.2
Lab ID: 48911-02 Container: 250 mL Plastic Preservation: H2SO4/Cool
V� ��W � 3" �.g �. w8
=� Analyte ��� Resu t U is Anal zed C�B'atch Method
E � a rc P- a �1�1
✓ r 't, a �",'�?c,+'.sz .�4kr�i _. ut�,lF;. . x ."`.w' �_ ..F�' �'�.. � 11r111t,�'' � c 3k "" '� " � „�,?".k.-�,
Ammonia(as Nitrogen) 3.0 mg/L 0.2 03-05-02 AM-0898-W EPA 350.1
Nitrogen,Total Kjeldahl (TKN) 7.2 mg/L 0.5 03-11-02 TKN-0817-W EPA 351.2
Method References: Methods for Chemical Analysis of Water and Wastes,US EPA,EPA-600/4-790-020, Revised(1983),and
Methods for the Determination of Inorganic Substances in Environmental Samples, US EPA,
EPA/600/R-93/100, (1993),and Standard Methods for the Examination of Water and Wastewater,
APHA,Eighteenth Edition(1992).
Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is the lowest
value that can be reliably quantified under routine laboratory operating conditions.
Reporting limits are adjusted for sample dilution and sample size.
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
Innovative RUCK Systems, Inc. FZ r NED
A Passive Denitrifying Septic System 0 2002
200 Main Street, Room 201 JAN 3
Falmouth,MA 02S40
1 (800)6S9•RUCK(782S) In MA TOWHEAI TN Der.
1 (SOO) S48.3S64
FAX (S08) S48.9672
January 24 , 2002
Ralph J. King George E. Lloyd, Jr.
24 Falling Leaf Lane 52 Falling Leaf Lane
Osterville, MA 02655 Osterville', MA 02655
Myrna Singer David J. Noreen
72 Falling Leaf, bane 82 Falling Leaf ' Lane
North Grafton, MA 01536 Osterville, MA 02655
Arthur J. Balian _ Suvitya Nopakun
f91 Falling Leaf Lane 81 Falling Leaf Lane
Lexington, MA 02173 Osterville, MA 02655
Vincent G. Legendre George Paton
P.O. Box 1059 39 Falling Leaf Lane
Osterville, MA 02655 Osterville, MA 026.55
DB.P. Berestecky Walter Melnyk
31 Falling Leaf Lane 23 Falling Leaf Lane
Osterville, MA 02655 Barnstable, MA 02655
Ernest P. Mondou
15 Falling Leaf Lane
Osterville, MA 02655
Dear Homeowner:
We have retested the final effluent from your
residential RUCK® system at Falling Leaf Lane i ille,
Barnstable, Massachusetts . The final effluent falls o meet
the discharge limit in the General Certificate. e are
proposing the following solutions :
1 . Meet with the Board of Health and Department of
Environmental Protection (DEP) to discuss
solutions .
2 . Meet with the residents .
3 . Conduct an analysis
4.0 printed on recycled paper
1
2
4 . Revise the systems with the following:
A) Replumb existing plumbing so only laundry
wastewater goes to the greywater tank.
B) Furnish and install- a carbon source to add to
the greywater tank.
C) Furnish and install electrical service from
the house to the carbon source.
5 . Furnish free carbon for a period of three years .
(This carbon cost is about $100 . 00 per year. )
6 . Visit the altered systems quarterly at no cost for
three years .
7 . Prepare a nitrogen loading assessment to
demonstrate that the remediation to the systems
conform to the requirements of the Board of Health.
This method was identified in the original Board of
Health permit .
DAfter we have an agreement with the residents, the Board
of Health and DEP, we will schedule to retrofit� the systems
over the kpext several nnont- r .
Please feel free to contact us to discuss this
individually or as a group.
If you have any questions, please call or write me.
Sincerely,
INNOVATIVE RUCK YST S f
Michael B. McGrath, P.E. , P.L.S.
President
MBM/gd
CC: Stephen Corr, DEP, WPC, Boston
Barnstable Board of Health
c 1 FaIIk'r c� L A
innovative ruck systems, inc. -j y y D 4 3 0 17
200 main street
falmouth,ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATEJan.,9 2002 '
ATTENTION: MARCIA SHERMAN REVISED
1 WINTER STREET
BOSTON MA 02108
DEAR MS.SHERMAN
PLEASE FIND ENCLOSED COPIES OF LAB TEST RESULTS FOR THE RUCK SYSTEM AT THE REFERENCED
LOCATION. BELOW YOU WILL FIND AN ANALYSIS OF THE RESULTS AND A STATEMENT IF THE SYSTEM
CONFORMS TO THE DISCHARGE LIMIT OF THE APPROVED CERTIFICATE.
RESULTS OF RUCK SAMPLING _
TYPE GENERAL CERTIFICATE [LOCATED IN'NITRO ENG SENSITIVE ARE .- YES. .
CLIENT +Arthur Balian
DATE LOCATION Lot 17 Falling Leaf Lane
TOWN Barnstable,Ma
OUTPUT
D-BOX
pH 7.2
BOD 25 mg/I
TSS 160 mg/I
AMMONIA 16 mg/I
TKN 46 mg/I
NO3 9.3 mg/I
TN 55.3 mg/I
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN
LEGEND
BRL BELOW REPORTING RESULTS
TEST RESULTS ARE ATTACHED SIGNEDAlll�v`
MICHAEL MOREAU
innovative ruck systems, inc.
CC:
ARTHUR J. BALIAN_ _
BARNSTABLE BOARD OF HEALTH `
JEFF-000LD-DEP LAKEVILLE—
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: GW Matrix: Aqueous
Project: 91 F/L Sampled: 12-07-01
Client: Holmes&McGrath Received: 12-07-01
Lab ID: 46705-03 Container: I Plastic Preservation: Cool
a
ti9-a"µs h. +Fa -' Reporting ` s.,,
ff �.> Analyte� tZ�esalt, tJntts �� u Analyzed �QC B�atc�h� � Metn'
- re_ - vLIm1t t w.fr,
Biochemical Oxygen Demand 25 mg/L 20 12-07-01 BOD-1029-W EPA 405.1
Solids,Total Suspended 160 mg/L 20 12-10-01 TSS-0627-W EPA 160.2
Lab ID: 46705-01 Container: 250.mL Plastic Preservation: Cool
Analyte a ��Result` UnttsR�° rng Analyied Q'C Batcht r, '`Method h
DWI, sr LIIYIIta4., .r r m z ,
Nitrate(as Nitrogen) 9.3 mg/L 0.1 12-07-01 NI-1287-W EPA 353.2
pH 7.2 pH N/A 12-07-01 PH-1149-W EPA 150.1
Lab ID: 46705-02 Container: 250 mL Plastic Preservation: H2SO4/Cool
"
AN
w Analyte {; ;: Result�t Units " Anatyzel ��QG Batchti� , xMefhbd � ;
�LImIt
Ammonia(as Nitrogen) 16 mg/L 0.2 12-11-01 AM-0841-W EPA 350.1
Nitrogen,Total Kjeldahl (TKN) 46 mg/L 0.5 12-11-01 TKN-0766-W EPA 351.2
Method References: Methods for Chemical Analysis of Water and Wastes, US EPA, EPA-600/4-790-020, Revised(1983),and
Methods for the Determination of Inorganic Substances in Environmental Samples, US EPA,
EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater,
APHA,Eighteenth Edition(1992).
Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is the lowest
value that can be reliably quantified under routine laboratory operating conditions.
Reporting limits are adjusted for sample dilution and sample size.
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
innovative ruck systems, inc.
200 main street
Falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE May 1420®1z
ATTENTION: MARCIA SHERMAN REVISED
1 WINTER STREET
BOSTON MA 02108
DEAR MS. SHERMAN
PLEASE FIND ENCLOSED COPIES OF LAB TEST RESULTS FOR THE RUCK SYSTEM AT THE REFERENCED
LOCATION. BELOW YOU WILL FIND AN ANALYSIS OF THE RESULTS AND A STATEMENT IF THE SYSTEM
CONFORMS TO THE DISCHARGE LIMIT OF THE APPROVED CERTIFICATE.
RESULTS OF RUCK SAMPLING
TYPE GENERAL CERTIFICATELOCATEDIN NITRO,GEN'SENSITIVErAREA YES
CLIENT McShanenStruCtlOn` �A � �
DATE 's04/23%01 LOCATION Lot 17 Falling L�eaflap
TOWN Barnstable'Ma"' �! '
OUTPUT
D-BOX
pH 6 9
BOD250 ``mg/I
TSS 40� � m /I
AMMONIA 7 8 fimg/I
TKN 14 mg/I
N03002 'mg/I
TN 14 02 ' mg/I
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN AYES
LEGEND
BRL BELOW REPORTING RESULTS
TEST RESULTS ARE ATTACHED
SIGNED
TIMOTHY M. SANTOS
innovative ruck systems, inc.
CC:
ARTHUR J. BALIAN
BARNSTABLE BOARD OF HEALTH
JEFF GOULD-DEP LAKEVILLE
I'
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: Lot 17 Matrix: Aqueous
Project: McShane/99170 Sampled: 04-23-01
Client: Holmes&McGrath Received: 04-23-01
Lab ID: 40508-20 Container: 1 L Plastic Preservation: Cool
s
?AT
"'V
Ar ,W Result S 1.
n ' AnalyiedQC ac � MethBiochemical Oxygen Demand 250 mg/L 70 04-23-01 BOD-0902-W EPA 405.1
Solids,Total Suspended 40 mg/L 10 04-24-01 TSS-0536-W EPA 160.2
Lab ID: 40508-04 Container: 250 rnL Plastic Preservation: Cool
t
ev
rut Farm
v-,"AnA Vt6
Nitrate(as Nitrogen) BRIL mg/L 0.02 04-24-01 NI-01083-W EPA 353.2
pH 6.9 pH N/A 04-23-01 PH-01 008-W EPA 150.1
Lab ID: 40508-12 Container: 250 mL Plastic Preservation: H2SO4 Cool
Reporting kle
C C'.Batch
AX
Ammonia(as Nitrogen) 7.8 mg/L 0.2 04-30-01 AM-0693-W EPA 350.1
Nitrogen,Total Kjeldahl (TKN) 14 mg/L 0.5 04-25-01 TKN-0634-W EPA 351.2
Method References: Methods for Chemical Analysis of Water and Wastes, US EPA,EPA-600/4-790-020,Revised(1983),and
Methods for the Determination of Inorganic Substances in Environmental Samples,US EPA,
EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater,
APHA,Eighteenth Edition(1992).
Report Notations: BRL Indicates result,if any,is below reporting limit for analyte. Reporting limit is the lowest
value that can be reliably quantified under routine laboratory operating conditions.
Reporting limits are adjusted for sample dilution and sample size.
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
No. ` Fedvf�c�
TH OMMONWEALTH OF MASSACHUSETTS Entered in computer: A
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Ap plie tion for Woo at *pftem �tCott.5trurtion i3ermit
l 6/' �1Application for a 21-n t toConuct( Repair( )Upgrade( )Abandon( ) 1 Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address an Tel.No.d� 19,
Asses Map/Pazcel � l r�� �b�
;�, 0!r,,d_XL)JLJ_Cf Al.
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building:Dwelling No.of Bedrooms Lot Size la,�11 sq.ft. Garbage Grinder ho
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 57 gallons per day. Calculated daily flow gallons.
a
Plan Date f Number o sheets J Revision Date
Title 05J2201ZLO �<
Size of Septic Tank _ ���," "�7C>��/)Z�CI+J Type ofr .A.S. '/ per 444E? �L���qB-mil
Description of Soil �E' ytt cS� IZ + �� /tS44 :5
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: DESIGNING ENGINEER MUST SUPERVISE
INSTALLATION AND CERTIFY IN WRITING
Agreement: THE SYSTEM WAS INSTALLED IN STRICT
The undersigned agrees to ensure the construction and maintenance`of the afor NcT to sewage disposal system
in accordance with the provisions of Title 5 of th Environmen 1 Code and not t9tlace the system in operation until a Certifi-
cate of Compliance has been issued by this Boar a lth
Signed Date tA/�
Application Approved Date
Application Disapproved for the following reasons
Permit No. Voy Date Issued
sV
No. '� Fe X01111
TH OMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Y S,
Yigtion for i� o ar *pgtem Construction Permit
� ,
Application for Prmit to Construct ' Re atr U rade Abandon Complete System El Com onents
PP ( KCt P ( ) Pg ( )Abandon( ) P Y P
Location Address or Lot No. 1°7 ` Owner's Name,Address and Tel.No.�
Lead c�� --��iv , 10 /l�Jpx(M r1j �e
Assessor's Map/Parcel '` ' 'F
Installer's Name,Address,and Tel.No. \ Designer's Name,Address and Tel.No.
Type of Building: !.J
*� Dwelling it No.of,Bedrooms Lot Size 15,, sq.ft. Garbage Grinder(Kb
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow `J_gallons per day. Calculated daily flow gallons.
Plan Date s —!� Number o sheets Revision Date
Title j!f R r/Q —)74z r ! Q 5 L iLL,�;MX '
i Size of Septic Tank s �G��," _10 .>C/)Z1-1..�1 Type of�S.A.S. �fU�
Descri tion of Soil - �y v/t c$U !L , 94fU44 "
_ .a
t
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: 3
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of th nvironmen 1 Code and not t lace the system in operation until a Certifi-
Cate of Compliance has been issued by this Boar a th
Signed Date P/5-
+Application Approved b Date
!
- Application Disapproved for the following reasons
01
Permit No. .? A' 4* Date Issued ® q
r t
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( )
Abandoned( )by
at !v L �S U- has been constructed in accordance
with the provisions of Title 5 and the for Disposal-System Construction Permit No. 40 dated °" .
Installer �•. '" -r I Designer
The issuance f `'s e� '6 hall not be construed as a guarantee that the to --will function asdesig d. f
Date � `� ` 'inspector �`� �f fit - I✓�k ._.
No. ,� "� --------------------------Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Mi5pogar Opgtem Con!5truction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( )
System located at 2!�>f )7
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions. 1
Provided:Construction must be comp ed within three years of the date of thi'G" a�
Date: �' _ Approved byGl
RUCK 5 Inc
Innovative ysterns. . ; r
A PaSSWO Denitrifying Septic System
200 main Street,Room 201
Falmouth,MA O2540
f low)GS8-RUCK (7828) In MA
.' � (6081 sae-s864 -
ySc
rAX (soel G48•9672
fl. April 25 ; 2000
p.
1..
F�arnat;ahle Board of Health
cr
e Main 5t reet.
•; Nvann MA 0260).
is <
ji;:. (ir'17.t.I11111E=n •.
h�:: L,ot 17
;! i alling Leaf Lane Osterville
��' --' --- - - - ---- .-- -- - - - - _ _ - - - - - 1
Uttr officF witnessed the construction of the RUCK.
ar. the refE:renced lot: . The ' construction of the fZUC.K fi:'.�.c�'r. t'
and a > ».irteriances was gatisfactor_ily constructed in
XF
accordance. with t:he plan•
It you have any questions, please all. r>i• wri.te .
Sincerely, .
INNOVATIVE: RUCK ';YSTSMti,
1A
., Timothy M. Santbs 1.
Project Engineet
cc ....John: McShane
I ,
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lo
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STONYBROOK FOUNDATION PLAN
VENTED
ASPWALT SHINGLES RIME CAP
SIMULATED CATHEDRAL 2X10 RAFTERS
• N' O.C. AT BUILDERS OPTION
- I 2X10 RAFTERS W/2X8 CEIL'G JOISTS �3
• IL' O.C. W/ HANGERS/COLLAR TIES
WHITE CEDAR SHINGLES OR AS' IREOUIRED
CLAPBOARD 5101Nr, OVER VJMO INFILTRATION BARRIER - REF. 12 ;
ELEVS. FOR LOCATION INSULATION VENT
ATTIC. s CLNGS AS REQ SLOPED
VENTED 1
DRIP EDGE
PLATE / CONT. ITTPJ
_ 11LL ALUM. GUTTER t
I/2' GWB OR SKIT1 COAT R-30 BATT DOWNSPOUT 70 3 j
BLUEBOARO • BUILDER'S I INSUL. CEILINGS (TYP.) SPLASHBLOCK (TYP) �
OPTION.
IX6 FASCIA
2X4 STUDS 112 5/e' H) SOFFIT b
W/I/2' COX PLYWOOD GREAT ROOM
FRIEZE Aga
(TYP.)
CONT. BLOCKING OR R-11 OR R-13 BATT
S/J! PLYWOOD FLOOR 0 BRIDGING • MID-SPAN ITYF' INSUL. EXT. WALLS
UN ERL FINISH FLOOR OR REF. ENERGY CALC
UINISH SCHEDULE
E U - REF. R-11 OR R-30
FIRST FLOOR FINISH SCHEDULE
BATT INSUL.
REF. ENERGY CALC
ANCI4Q R
240014, O.C. BOLTS •
FLOOR JOISTSlTYP.) 1;'-0' O.C..
-2X10 GIRT (TYP.) PROVIDE SPLASH
'^ I�'-O' BLOCKS • ALL
UTS Olt
3-1/2' LALLY COL. P PENUNDERGROUND
REF, FNON FOR LOC. TO ORYWELLtTYP)
11
31/2' CONC. SLAB I!' CONCRETE
(REINF. • BLDRS FNDN WALL
6SMT OPTION) 2 95 REINF ROOS !
V
PADXITYPI (ALLY.COL. TOP i BOTTOM
OF WALL i 2 ss A�>�
REINF ROOS IN
FOOTINGS 0
T f'ICAL BUILDING SECTION BLDRS OPTION =j
THRU GREAT ROOM W/FLUSH FLOOR4 CATHEDRAL CEILING
Q
i SCALE 1/4- 1 -O•
BALIAN 8/2199
WINDOW SCHEDULE - -- TWINDOW- IFRAM, - -- COMMENTS -
A DH 2452-3 BS T-S 1/2 X 5'-5 1/4" I NARROW MULLED MITI'-SEE NOTE
B �DH 2446 BS 2'-6 1/8"X 4'-9 1/4" g _ _ _
C :DH 2446-2 BS 4'-11 13/16"X 4'-9 1/4" _ _- 2
D i DH 2O46 BS 2'-2 1(8"X 4'-9 1'4" - 2
E ICSMTC135 BS 2'-0 SB"X Y-5 3/8" 2
F CSMT CW 13 _-- 2'4 7/8"X T-O 1/2" ! 1 OVER GARAGE -
G DH 1832 BS l'-10 1/8"X 3'-5 1/4" 1
H VELUX FS606 44 314"X 47" 2 4 fFDG✓D W/VE NT FLAP
i
J 1BSMT 2817 2'-8 5/8"X 1'-7 1/4" i
K DH 2432 BS 2'-6 1/8"X T-5 1/4" 2 1N BASEMENT --
L HALF ROUND CTN3.4 T-6 1/8"X F-11 3/4" ! 1 JOVER"A"UNIT
M DH 2042 BS 2'-2 1/8"X 4'-5 I'4"
N __HALF ROUND CTCW1 _ 2'4 7/8"X 1'-5" MOVER"F"UNIT
- --
NOTE: VERIFY WIND LOAD SUPPORT REQUIREMENTS WITH WINDOW MANUFACTURER '
BALIAN 8/2/99
DOOR SCHEDULE - - -
-- -
ISIZE 'MAT. JFTN. UAT. -FTN. I -
I FOYER ENTRY - 3'-0" X 6'-8°° INSUL. . 'W/(2) 12"SIDELIGHTS,SCREEN&STORM
2 FOYER COAT CLO.
3 BASEMENT 2'-8"
4 FOYER CLOSET (2)2'-0"X64" 'DOUBLE
S BEDROOM#2 2'-6"
6 BEDRM#2 CLOSET 4'-0" X 6+-8" BI-FOLD
7 BATH 92 2'-4"
8.BATH#2 L[N1✓Tl
9 BEDROOM 03 .2'-6"
10 BEDRM#3 CLOSET_ �Y-0"X 6'-8"- -- - '---- !.
:BI-FOLD _
it GREAT ROOM `6-0"X 6'-8" - - - --- ;SLIDING GLASS PS6L - - -
12.13REAtCFAST :6'-0"X 6'-8" 'SL[D[NG GLASS PS6L
-- - - -+----- i _.. _
13PANTRY :2'-2•' ,
14;BROOMCLOSET -0" - -..,..._._.. �..- -
IS LAUNDRY ;6'-0"X 6'-8" BI-FOLD-F- ------
16^MASTER BEDROOM _ 2'-6
17•MBR CLOSET 331_0" - BIFOLD "
--
l8MBR CLOSET 3'-0" BI-FOLD
--
191:MASTER BATH '2'-6"
20�L[NEN
21-HALL CLOSET 2,_6.
22GAR/1i0USE ENTRY .2'-8" 'INSUL. - -
- � FIRE CODE
23'GARAGE - '2'-8" INSUL. 9 LITE
24•GARAGE 4-0" X 7'-0" OVERHEAD
25
GARAGE :9°.0"}(7'.0" _ OVERHEAD
26 BASEMENT :9 LITE
MAScheck COMPLIANCE REPORT
Maseachusetts' Energy Code Per it #
MAScheck Software Version 2 . 01 Release 2
Check by Date
CITY: Barnstable
STATE: Massachusetts
HDD: 6137
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 8-2-1999
DATE OF PLANS: 8/2/99
TITLE: New Residence
PROJECT INFORMATION:
Mr. & Mrs. Arthur Balian
Lot 17 Schooner Village '
Osterville, MA
COMPANY INFORMATION:
McShane Construction Company
P.O. Box 429
Osterville, MA 02655
NOTES :
Stonybrook
COMPLIANCE:. PASSES
Required UA = 499
Your Home = 495
Area .or Cavity Cont. G1 ing/Door
Perimeter R-Value R-Value U alue UA
----------------------------------
CEILINGS 1454 30. 0 0 . 0 51
CEILINGS 622 30 . 0 0 . 0 22
WALLS: Wood Frame, 16" O. C. 2233 11 . 0 0. 0 199.
GLAZING: Windows or Doors 82 . 290 24
GLAZING: Windows or Doors 4 .280 1
GLAZING: Windows or Doors 205 4 .480 :98
GLAZING: Windows or Doors 14 .450 6
GLAZING: Skylights 30 . 300 9
DOORS 18 . 190 3
DOORS - 35 .480 17
FLOORS: Over Unconditioned Space 1948 30 . 0 0 . 0 �64
FLOORS: ' Over Outside Air 16 30 .0 0 ..0 1
HVAC EQUIPMENT: Boiler, 84 . 0 AFUE
COMPLIANCE STATEMENT: The proposed building design described he is
consistent with the building plans, specifications, and other ca ulations
. submitted with the permit application. The proposed building ha been
designed to meet the requirements of the Massachusetts Energy .Co
The heating load for this building, and the cooling load if appr riate,
r
J
has been determined using the applicable Standard Design Conditio s found
in the Code. The HVAC equipment selected to heat or cool the bui ding
shall be no greater than 125V of the design load as specified in
Sections 780CMR 1310 and J4 .4 .
Builder/Designer Date
}
as
}
Innovative RUCK Systems, Inc. dC44CG3 OCR hJ�Crui]�44Lad
A Passive Denitrifying Septic System
200 Main Street, Rm. 201 Falmouth, MA 02540 ,
DATE JOB NO. "
(800) 659-RUCK (7825) In MA `-2X-_,CA0
(508) 548-3564 FAX (508) 548-9672 ATTENTION
TO RE:
WE ARE SENDING YOU Attached ❑ Under separate cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans - ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑
COPIES DATE NO. DESCRIPTION
t
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval
X For your use ❑ Approved as noted ❑ Submit copies for distribution
;k As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO
SIGNED:
If enclosures are not as rioted,kindly notify us at once.
onimovative RUCK Systems, Onto
d Passive Denitrifying Septic System
200 Main Street, Room 201
Falmouth,MA 02540
1 (.800)659-RUCK(7825) In MA
1 (508)548.3564
FAX (508) 548.9672
April 25, 2000
Barnstable Board of Health
Main Street
Hyannis, MA 02601
Gentlemen
RE : L-ot�-17-7
Falling Leaf Lane, Osterville
------------------------------------
Our office witnessed the construction of the RUCK filter
at the referenced lot . The construction of 'the RUCK filter
and appurtenances was satisfactorily constructed in
accordance with the plan.
If you have any questions, please call or write .
Sincerely,
INNOVATIVE RUCK SYSTEMS, INC.
Timothy M. Santos
Project Engineer
cc :John McShane
y41 printed on recycled paper
innovative ruck systems, inc.
200 main street
falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE NOV21:, 2000
ATTENTION: MARCIA SHERMAN REVISED
1 WINTER STREET
BOSTON MA 02108
DEAR MS. SHERMAN
PLEASE FIND ENCLOSED COPIES OF LAB TEST RESULTS FOR THE RUCK SYSTEM AT THE REFERENC
LOCATION. BELOW YOU WILL FIND AN ANALYSIS OF THE RESULTS AND A STATEMENT IF THE SYSTEM
CONFORMS TO THE DISCHARGE LIMIT OF THE APPROVED CERTIFICATE.
RESULTS OF RUCK SAMPLING
TYPE GENERAL CERTIFICATE LO MATED INNITROGEN SENSITIVE AREYES
CLIENT McShane Construction
DATE 11/21J0 LOCATION Lo," ally Leaf Lanes,
TOWN13a nr stable, Ma ` .`
OUTPUT
D-BOX
pH Y 67
BOD 36mg/I
TSS 26 . mg/I
AMMONIA ' 7 xI'mg/I
TKN 5i /I
NO3 y1��4q ,. m 9
1BRL.';-'�';..` mg/I
TN 5 4. mg/I
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN YE
LEGEND
BRL BELOW REPORTING RESULTS
TEST RESULTS ARE ATTACHED
SIGNED
TIMOTHY M. SANTOS
innovative ruck systems, inc.
CC:
McSHANE CONSTRUCTION CO.
BARNSTABLE BOARD OF HEALTH
R. LAAK
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: L� 1.7 D_Bo Matrix: Aqueous
Project: McShane/99170 Sampled: 11-03-00
Client: Holmes&McGrath Received: 11-03-00
Lab ID: 37150-09 Container: I Plastic Preservation: Cool
c eport�ngh x r
Anal a Result Units ���. AnalyzedQCBatch ethod
tr -
Biochemical Oxygen Demand 36 mg/L 20 11-03-00 BOD-0815-W EPA 405.1
Solids,Total Suspended 26 mg/L 10 11-09-00 TSS-0481-W EPA 160.2
Lab ID: 37150-03 Container: 250 mL Plastic Preservation: Cool
+�
1, Analyte Result Units Anal zed C Batch n Method y� .
� �' �Limrt � bra "� '� �.._: ._,,.��;
Nitrate(as Nitrogen) BRL mg/L 0.02 11-03-00 NI-0953-W EPA 353.2
pH 6.7 pH 2.0 .11-03-00 PH-0919-W EPA 150.1
Lab ID: 37150-06 Container: 250 mL Plastic Preservation: H2SO4/Cool
0�: #tR -.Mn
, Analyte � + Results Un1tsLmit gAnalyzed QCBatch Meth#o�d
Ammonia(as Nitrogen) 1.7 mg/L 0.2 11-06-00 AM-0589-W EPA 350.1
Nitrogen,Total Kjeldahl (TKN) 5.4 mg/L 0.5 11-13-00 TKN-0562-W EPA 351.2
Method References: Methods for Chemical Analysis of Water and Wastes, US EPA,EPA-600/4-790-020,Revised(1983),and
Methods for the Determination of Inorganic Substances in Environmental Samples, US EPA,
EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater,
APHA,Eighteenth Edition(1992).
Report Notations: BRL Indicates result,if any,is below reporting limit for analyte. Reporting limit is the lowest
value that can be reliably quantified under routine laboratory operating conditions.
Reporting limits are adjusted for sample dilution and sample size.
T1V x 5y
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
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I 11, I Ruci( I I I I I Side area proposed: . 157 sq. ft.
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r . I A I- . I A 11 . t __J . 10" min. �. . . i . ., . � 11
I . � I I I i I I I I I , I r L . .. I 14 min. w. .. I THE EXCLUSWE pRopERTy O,n r I
�rl r . I E � r / \ - � 6 = r . L . . I �
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I I I I I I r I I _1- - - - - -:+- - - - I I L.' . o- 10 � INNOVATWE RUCK SYSTFt,4S,INC.: I r I
I VENT PIPE DETAIL r 0. r a
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r. r - r . � I - ; I I I . I I
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I I I L I I / 0 BE 3' ABOVE r : r (A)no person or persons,including arT r I .
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. 41, , I 1 -20 L
r� ,,,r "I ''. . r � � I . � I r . PLAN - L I . L FINISH GRADE 1 4" TEE I . I ! � TYPICAL 1 000 GALLON SEPTIC TANK A OADIN L municipal Or other pubfic officids,rmy re�, 1, L ! I IL.I
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L I I I r � . . � I Innovative RUCIK Systt,,M Im.
I �. I r I , r 'TO THE FACILITY AND UP THROUGH ROOF TO I I r I I I i L L L I I L � I I
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I �, . - LUMBING VENTr . ' ' L I I ,. I I r . I THE SIDES OF THE FILTER MAY BE SLOPED. �THE REQUIRED AREA OF THE I I . � . L I r I r � ,; I
I I �,� I I I . I I L SL P F_ L L I rr FILTER SHALL BE THE MIDDLE LAYER OF THE: INDRAINS. I I � I L I .I .1 I
I I,;,r I I I I I I I I I FILTER CLOTH- TYPAR 3401 L I I I 4L THE CONTAINMENT LINER SHALL BE CAPABLE OF WITHSTANDING A PH OF 3.0 1 1 "I
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I I I I . - 0 -�L�.��.�I..1.I....,1�,11 , " , , -. = 6' STONE 111,11-1111111 I I
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