HomeMy WebLinkAbout0102 FALLING LEAF LANE - Health 102 Falling Leaf Lane DsTERVILLE
Osterville
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Holmes and Mcgrath, Inc LETTER OF TRANSMITTAL
`civil engineers and land surveyors
205 Worcester Court, Unit A4 DATE 11/9/21 JOB No. 216306
falmouth, ma. 02540 ATTENTION
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street,6t' Floor
Boston, MA 02108
WE ARE SENDINGYOU ®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 TC:.
Barnstable Board of Health
Lawrence Morency
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. Lawrence Morency
filling out forms Owner
on the computer,
use only the tab #102 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:
qQ 82 Fox Meadow Lane
Street Address/PO Box:
Dedham MA 02026
City State Zip
(617) 818-5361 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
8/20//98
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/14/21 10/20/20
Inspection Date Previous Inspection Date
Blackwater Tank=10" Graywater Tank=7" Pumping Recommended ❑ 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 O&M Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
r
Ll
E. Field Testing — not required for standard inspection of EIjen, 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 6 to 9 U DO 2 or greatermg/L Turbidity NTU
qo or less
i
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 �
F. Sampling Information — not required for standard inspection of EIjen or Eviro-Septic
i
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 scum
layer in the septic tank was 2" inch 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 51/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 train g course for this System with the Technology Company and am listed by the
Company as tra�iinstor.
November 9, 2021
Ope Sig a ure 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
Holmes and Mcgrath, Inc LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court, Unit A4 DATE 12/15/20 JOBNo. 216306
falmouth, ma. 02540 AnENnON
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655 r
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
1 10/20/2020 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Lawrence Morency
SIGNED: Luis Coelho
i
r. 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)
A. Installation
Important:When Mr. Lawrence Morenc
Y
filling out forms Owner
on the computer,
use only the tab #102 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return
ke City Zip
Y�
Mailing address of owner, if different:
r� 82 Fox Meadow Lane
Street Address/PO Box:
Dedham _ MA 02026
City State Zip
(617) 818 - 5361 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
8/20//98
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=12" Graywater Tank=8" Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5iaomr.doc• 6-16-06 Page 1 of 3
f
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 6.6 6 to g U DO 2 or greater Turbidity NTU
y 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 scum
layer in the septic tank was 1" inch thick.
t5iaomr.doc• 6-16-06 Page 2 of 3
f .
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 a trained in ector.
December 15, 2020
pe or 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 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 Program
One Winter Street, 6th Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
r ,
Holmes and Mcgrath, Inc LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court, Unit A4 DATE 9/10/19 JOBNO. 216306
falmouth, ma. 02540 ATTUMON
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street, 61h 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
Lawrence Morency
SIGNED: Luis Coelho
i
Massachusetts 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 (Eljen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Lawrence More
filling out forms Owner
on the computer,
use only the tab #102 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:
same
Street Address/PO Box:
rcmm
City State Zip
(617) 818 - 5361 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
8/20//98 _
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional [I 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=9" Graywater Tank=8"
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 ®&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
Ll
Field Inspection:
Color: ® gray ❑ brown ❑ clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6 to 9 U DO 2 or grea eg/L Turbidity 40 or iPSNTU
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 In#orrn:at�on =;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
s 'did,not.notice any.evidence:"of.leakage in or out of the tank. Vents in place and working. The scum
layer in the septic tank was 1" inch thick.
t5iaomr.doc• 6-16-06 Page 2 of 3
Massachusetts Department of Environmental Protection
L7 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
Compan a trained i ector.
September 10, 2019
rator 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 follovas 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 311h 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, 6th Floor
Boston, MA 02108
t5iaomr.doc• 6-16-06 Page 3 of 3
f
i
Holmes and Mcgrath, Inc LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court, Unit A4 DATE 12/11/18 JOB No. `;: 16306
falmouth, ma. 02540 ATTENTION
508-548-3564 - 800-874-7373 - FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency ;C)
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655 �q
Attn: Title 5 Program
Iti;=
1 Winter Street, 61h Floor n
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
Lawrence Morency
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:When Mr. Lawrence Morency
filling out forms Owner
on the computer,
use only the tab #102 Falling Leaf Lane .
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return
key. City Zip
r�
Mailing address of owner, if different:
same
Street Address/PO Box:
ream
City State Zip
(617) 818 - 5361 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
8/20//98
Installation Date Start of Operation
Approval Type: ® 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=7" Graywater Tank=4" 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 OW Form for Title 5 I/A
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
E. Field Testing — not required for standard inspection of EIjen, 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 s SU DO 2 or greatermg/L Turbidity NTU
y ao 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 EIjen 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 scum
layer in the septic tank was 1" inch 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 (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 train* g course for this System with the Technology Company and am listed by the
Company as rained inspe r.
December 11, 2018
0,RWor 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
w
Innovative Ruck Systems, Inc LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court, Unit A4 DATE 11/13/17 JOBNO. 216366:
falmouth, ma. 02540 ATTENTION
508-548-3564 - 800-874-7373 - FAX 508-548-9672 I"
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency ;
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655 X.
ErWu
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 10/18/2017 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Lawrence Morency
SIGNED: Luis Coelho
n
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)
A. Installation
Ll
Important:When Mr. Lawrence Morency
filling out forms Owner
on the computer,
use only the tab #102 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:
remm
City State Zip
(617)818-5361 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
8/20//98
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 10/25/16
Inspection Date Previous Inspection Date
Blackwater Tank=6" Graywater Tank=4"
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5iaomr.doc• 6-16-06 Page 1 of 3
i
Massachusetts Department of Environmental Protection
\ Bureau of Resource Protection - Title 5
r �\
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
f Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive El turbid
Effluent Solids: ® no ❑ some,
pH 7.2 SU DO 1.13 m / NTU
Turbidity 6 to 9 2 or greater y 40 or less
Should a Remedial or General Us syste it the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
i
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. Ins Inspection p 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 scum
layer in the septic tank was 0" inch 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 train'
i course for this System with the Technology Company and am listed by the
Company as rained inspe r.
November 13, 2017
Opepal r Si nature 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 311h 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 11/15/16 JOBNO. 213266
falmouth, ma. 02540 ATTENTION
508-548-3564 - 800-874-7373 - FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street, 61h Floor M2
Boston, MA 02108
WE ARE SENDING YOU ®Attached ❑ Under separate cover via the following items:
COPIES DATE NO. DESCRIPTION
2 10/25/2016 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Lawrence Morency
SIGNED: Luis Coelho
AMassachusetts 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. Lawrence Morency
filling out forms Owner
on the computer,
use only the tab "#102.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:
rab
same
Street Address/PO Box:
reran
City State Zip
(617) 818- 5361 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
8/20//98
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
10/25/16 10/28/15
Inspection Date Previous Inspection Date
Blackwater Tank=6" Graywater Tank=3" pumping Recommended ❑ 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 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)Ll
Odor: __ ® musty_ ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
7.4 SU �'72 mg/L NTU
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
I
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 scum
layer in the septic tank was only 1" inch 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 (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 trainip course for thi System with the Technology Company and am listed by the
Company as rained inspec
November 15, 2016
O r 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 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
I
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 JOSNO. 213266
falmouth, ma. 02540 ATTENTION
508-548-3564 - 800-874-7373 - FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com RE: Mr. Lawrence Morency
#102 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 10/28/2015 DEP Approved Inspection and O&M form.
REMARKS:
COPY TO:
Barnstable Board of Health
Lawrence Morency
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
Treatment and Disposal Systems (Eljen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr. Lawrence Morency
filling out forms Owner
on the computer,
use only the tab #102 Falling Leaf Lane
key to move your Facility Street Address
cursor-do not Osterville 02655
use the return
key. City Zip
�1 Mailing address of owner, if different:
VA
same
Street Address/PO Box:
moan
City State Zip
(617) 818 -5361 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
8/20//98
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=3"
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 1/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 6.0 SU DO 1.15 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:
9pd
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 scum
layer in the septic tank was only 0 inch 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 1/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 trainin course for this System with the Technology Company and am listed by the
Company a fined inspec . .
11/11/2015
O or Signature X Date
i
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 s'of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 311h 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
Innovative Ruck:Sy$Wms, Inc LETTER OF TRANSMITTAL
civil engineers and land surveyors
205 Worcester Court, Unit A4 DATE 12/8/14 .1DBND. 213266
falmouth, ma. 02540 ATTENTION
508-548-3564 • 800-874-7373 • FAX 508-548-9672
email:Icoelho@holmesandmcgrath.com Re. Mr. Lawrence Morency
#102 Falling Leaf Lane
To: DEP Osterville, MA 02655
Attn:Title 5 Program
1 Winter Street,6th Floor
Boston, MA 02108
WE ARE SENDINGYOU ®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:
T _
Barnstablel6oar�d_of Health,
Lawrence Morency--
sa
SIGNED: Luis Coelho L?
r� Massachusetts.Department.of Environmental Protection
Ll
Bureau of Resource'Protection - Title 5
DEP A roved Ins action and O&M forr>n f
pp p or Title 5 I/A
Treatment and Disposal Systems (E jen, Enviro-Septic, RUCK)
A. Installation
Important:When Mr:Lawrence Morenci
filing out forms Owner
on.the computer,
use only the tab #102 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:
tab
same
Street Address/PO Box:
Haan
City State Zip
(617)818-5361 ext.
Telephone Number
B. Authorized Service Provider
Innovative Ruck Systems, Inc.
0&M Firm
205 Worcester Court, Unit A4
Street Address
Falmouth MA 02540
City State Zip
(508)5.48-3564 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
8/20808
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence.—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
12/1/14
Inspection Date Previous Inspection Date
Blackwater Tank=6" Graywater Tank=4"
Sludge Depth(to be checked.yearly) Pumping Recommended El Yes ® No
t5iaomr.doc• 6-16-06 Page 1 of
Massachtisetts Department of Environmental Protection
Bureau of.Resource Protection. Titl e.5.
DEP Approved Inspection and O&M, Form for Title 5 'l/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
❑ Other(specify):
Odor: 0 musty El earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: E no ❑ some
5.8.SU 1.49 mg/L NTU
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
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection R 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 scum
layer in.the septic tank was only 1 inch thick.
t5iaomr.doc• 6-16-06 Page 2 of 3
Massachusetts Department;of Environmental Protection
Bure of Resource Protection. Title 5
DEau P Approved Inspection and O.&M Form for Title 5 #/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 -spa trained inspector.
12/8/2014
erator igna 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
I
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is Osterville MA 02655 September 29, 2013
required for every p
page. City/Town State Zip Code Date of Inspection x
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. General Information
on the computer,
use only the tab 1. Inspector: r
key to move your
cursor-do not David D. Coughanowr, IRS
use the return Name of Inspector
key.
Eco-Tech Environmental
Company Name
43 Triangle Circle
Company Address
Sandwich MA 02563
City/Town State Zip Code
508 364-0894 1328
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the ,
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
® Passes ❑ Conditionally Passes. ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
SSeptember 29, 2013
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system,is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
0N/!,3
l5ins•3/13 Title 5 Official InspectiojForm:Su rf Sewage Disposal System•Page 1 of 17
T '
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
a 9 p Y ►Y
GM 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is required for every Osterville MA 02655 September 29, 2013
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
Inspector's Note==> The septic system described herein is deemed to pass this Real Estate Transfer
Inspection if it does not meet any of the failure criteria enumerated in Section D on pages 4-5. The
scope of this inspection is limited to health and environmental compliance and the septic system has
been evaluated according to the conditions observed on the day it was inspected. No estimate or
guarantee of system longevity is made or implied by a passing determination.
A renewed O & M contract is attached. Holmes & McGrath to submit test results from next sampling.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M ,•'V 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is required for every Ostery p
ille MA 02655 September 29, 2013
page. Cityrrown State . Zip Code Date of Inspection_
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ .ND (Explain below):
❑ obstruction is removed ' ❑.. Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
1
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is required for every Osterville MA 02655 September 29, 2013
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
0 ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/2 day flow
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection 'Form .
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 102 Falling Leaf Lane
Property Address
Raymond F. Schneider `
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29 2013
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a'cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis,performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ - the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29 2013
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® ❑ Existing information.For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. Cityrrown State Zip Code Date of Inspection
D. System Information '
Description:
Number of current residents: 1
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
r
Water meter readings, if available last 2 ears usage d 255 gpd
9 ( Y 9 (gpd)):
Detail:
2011-2012
Sump pump? ❑ Yes ® No
Last date of occupancy: current
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged'to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
{
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.
M ,•'`v 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.) ,
Last date of occupancy/use: Date
Other(describe below):
/. General Information
Pumping Records:
Source of information: occupant
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
® Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29 2013
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components,date installed (if known) and source of information:
15 years. Site plan by Baxter and Nye in Building Department file dated 4/13/98.
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2-3
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Sewer lines appear structurally sound with no evidence of leakage or backup into dwelling.
Septic Tank(locate on site plan):
Depth below grade: 1 ft(black) 6 ft(gray)
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
Flow for this dwelling is separated into a black water tank for toilet waste and a gray water tank for
wastewater from other sources. Flow leaving the black water tank goes through the Ruck nitrogen
reomval system, and then is piped into the grey water tank before being distributed and dispersed.
If tank is metal, list age:
. years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
8.5 x 5 x 6-1000 gallon (both)
. Sludge depth:
2 in (black) 1 in (gray)
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 102 Failing Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 32 in (black) 33 in (gray)
Scum thickness none (both)
Distance from top of scum to top of outlet tee or baffle 10 in (both)
Distance from bottom of scum to bottom of outlet tee or baffle 14 in (both)
How were dimensions determined? Design plan of Holmes & McGrath
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Pumping is not required at this time. Maintenance pumping is recommended every 2-4 years. Tanks
and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was
observed.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form i
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29 2013
page. CityrFown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons -
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert at outlet invert
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D-Box appears structurally sound and functioning as intended. No evidence of leakage in or out was
observed.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
I
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 102 Falling Leaf Lane
Property Address i
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
I
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries - number:
❑ leaching trenches number, length:
® leaching fields number, dimensions:
1 (40 ft x 12 ft)
❑ overflow cesspool number:
® innovative/alternative system
Type/name of technology: Ruck system
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Soils above leaching pit appear unsaturated. No evidence of surface ponding,-breakout, lush
vegetation, or other evidence of hydraulic failure was observed. Camera inspection showed pipes to
be clean and dry. Ruck system was located - no adverse conditions were observed.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer,
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes . ❑ No
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°r 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.
M 102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is Osterville. MA 02655 September 29, 2013
required for every P
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal.System: Provide a view of the sewage disposal system, including ties to.
at least two permanent reference landmarks or benchmarks._ Locate all wells within 100 feet.,Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area.below
❑ drawing attached separately
- i
40ftx12ft
- D—BOX I LEACHING
5 _
FIELD
i
4
INNOVATIVE
GRAY r�r—�—
rq
WATER JI_JL 2
TANK
BLACK
3 WATER
TANK
RUCK SYSTEM '
A 8. .
I
VQ C
L O CA TIONS
EXQSTING DISTANCES IN DECIMAL FEET.
i
3 BEDROOM f A B 8
WELLING 1 -- 36.5 20
2 --- 38.5 25.5
3 22.5 .17 ---
4 27 22.5 ---
102
5 . 35.5 . . .31.5 ---
2
3
hffQLL§NICE . LEAF L ANE.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
102 Falling Leaf Lane
Property Address
Raymond F. Schneider
Owner Owner's Name
information is p
required for every Osterville MA 02655 September 29, 2013
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: 15
feet
Please indicate all methods used to determine the high ground water elevation:
z Obtained from system design plans on record
If checked, date of design plan reviewed: Baxter& Nye plan dated 4/13/1998
Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
z Accessed USGS database-explain:
Town of Barnstable GIS Department records
You must describe how you established the high ground water elevation:
Approved design plan on file with the Board of Health shows bottom of leaching field to be 6 feet
above the bottom of a witnessed test spit in which no water or groundwater mottling was noted. Town
of Barnstable GIS Department records indicate that the property is over 15 feet above groundwater
table.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
102 Falling Leaf Lane
Property Address
Raymond F. Schneider ,
Owner Owner's Name
information is P
required for every Osterville MA 02655 September 29 2013
page. Cityrrown State Zip Code. Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information= Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate-file
Z
Q
/Z�
V
BOTTOM OF o
LEACHING FIELD LEACHING
PER DESIGN p
In "- PLAN
o a
W
GROUNDWATER ELEVATION PER GIS MAPS
}
t5ins•3/13 * Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
Innovative RUCK Systems, Inc COPY
A Denitrifying Septic System
205 worcester court, unit A4
falmouth,ma 02540
508-548-3564.800-874-7373•fax 508-548.9672
email:tsantos@holmesandmcgrath.com
Chip Schneider
102 Falling Leaf Lane
Osterville, MA 02655
Re: #102 falling LeafLane, Osterville,MA
Dear Mr. Schneider:
The Department' of Enviionmental Protection requires that every
innovative alternative sewage disposal system be maintained and under a
service contract. The RUCK® system serving your house is an innovative
alternative sewage disposal system. Below you will find the required
service contract. Please. review 'this, sign it and return it to us. We
will perform the required inspections and 'monitoring and bill you for
the service. .
RUCK® System Three Year Maintenance Agreement
Innovative RUCK® Systems Inc. agrees to• perform, on an annual
basis, the following services to the RUCK® system located at the address
above. RUCK® systems are served by a series of septic tanks. The RUCK
system also has a RUCK filter .and a soil absorption system. The fee for
the operation and maintenance and issuance of the DEP report. will be
$150.00 per inspection, plus expenses. The Barnstable County Health
Department applies a $50/year charge per system that will be billed to
you as an annual expense. The services are described below:
The services are described below:
A) Inspect Septic Tanks for Required Pumping under the Following
Criteria:
1. Inspect the condition of the tanks.
2. Measure the distance between bottom of scum/grease layer and
bottom of the outlet baffle.
3. Measure the distance between top,of scum layer and top of outlet tee.
4. Measure the thickness of the scum/grease layer.
5. Measure the sludge layer and distance from sludge to outlet tee.
6. Inspect the condition of the inlet and outlet tees.
7. Report any evidence of leakage into or out of the tank.
8. Report any evidence of any backup of effluent.
B) Inspect the Vents for Evidence of Blockage:
9,. Inspect vent tee and insure insect screen is in place and that no
bird or insect nest is blocking the vent.
S
y
C) Monitoring:
10. Your system was approved under the General Use Certificate. The DEP
and Barnstable Board of Health require monitoring of the system. The
applicable procedures set forth in the most recent "General Use
Certificate Approval - Pursuant to Title 5, 310 CMR 15.000" (See
"Conditions Applicable to the System Owner" attached) shall be strictly
adhered to. The laboratory tests will be billed to you as an expense.
After 12 months of monitoring, if the System is approved as acceptable
by the DEP and Board of Health, in - accordance with 310 CMR 15.285,
General Certificate Approval, and at the written request of the System.
owner, the DEP and local Board of Health may reduce the monitoring
requirements.
D) System Failure:
11. Within twenty-four (24) hours of, a system failure or alarm event,
this office will notify the 'Massachusetts D.E.P. and the local Board of
Health by both telephone and letter of this fact along with whatever
corrective measures are to be taken immediately. Also as part of this
service & maintenance agreement please find a detailed contingency plan
(attached) to be implemented immediately upon first learning of a system
failure. A failure is defined by a final effluent TN concentration
exceeding 19 mg/L. In addition, Innovative RUCK Systems, Inc. , hereby
agrees to comply with all criteria outlined in the "Conditions Applicable
to the System Owner" section outlined in the most recent version of
Massachusetts D.E.P.' s General Use Certificate Approval Pursuant to
Title 5, 310 CMR 15.000, Section IV (See Attached) .
TERMS: Statements will be rendered at the completion of the work,
or monthly, and are due upon presentation. A FINANCE CHARGE of 1- 1/2%
per month (18% per year) on all sums under five hundred ($500.00)
dollars, and 1 1/2% per month (18% per year) on all sums over five
hundred ($500.00) dollars will be added to the then unpaid balance after
thirty (30) days from the date of the billing. Innovative RUCK Systems,
Inc. reserves the right to terminate work in progress in the event
payment is not received in accordance with the payment provisions.
COLLECTIONS: The Client agrees to pay all costs of collection, including
reasonable attorney's fees.
This Agreement is null and void unless executed by the Client and
returned to Innovative RUCK Systems, Inc. within thirty (30) days.
COORDINATING INSTRUCTIONS: The inspector will need to uncover the septic
tank covers, inspection ports and pump chamber hatches. Obviously, there
will be holes dug in lawns or landscaped areas. We will endeavor to
protect lawns and landscaping but the covers have to be exposed. Please
call our office and discuss the particulars with Luis Coelho or Timothy
Santos.
Issued By: Date: July 24, 2013
Accepted By. J Date:
Telephone 1-978-340-8987
Billing Address:
l -
1
innovative ruck systems, Inc.
200 main street
,falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION; DATE _ NQU 21,2000'
ATTENTION: MARCIA SHERMAN REVISED
1 WINTER STREET
BOSTON MA 0210$
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 LOC-TEDINIITROGtN SIlSITI'VE4AEEES
CLIENT Q8.--h1a ie;Cb rstRactlorr°� S "
DATE 1fi721J0.0: LOGATlONo1n8aEl�n Leif Lne K
TOWN l3arnstable,'.Ma
OUTPUT
D-BOX
pH
SOD 32 mg/i ,
TSS 1' mgll _
AMMONIA wf :. :... mg/f
TKN ;5, .. :.:. mg/f
NO3 0 �12 mg/l
TN ;962 :' mgll
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS,FOR,`TN
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 , -
R
Non-Compliant Innovative/Alternative Of
Septic System Referral Summary o$ s
•Barnstable County Department of Health and Environment ass
acHvs
P.O. Box 427, Barnstable, MA 02630
Raymond Schnieder
102 Falling Leaf Lane
Barnstable, MA 02655
Referral Summary
Letter and'certified letter sent.
No contact made by owner.
Contact Chronology
07/19/2013- Letter sent via certified mail#70023150000492087789.
06/27/2013- Letter sent via standard mail.
Documentation
The attached documents are copies of the correspondence sent to the owner. The originals are available if needed.
F
•
l '
���F gA�ls 13ARNSTABLE COUNTY
DEPARTMENT OF HEALTH AND ENVIRONMENT
BARNSTABLE COUNTY COMPLEX
� 1
3195 MAIN STREET/ PO BOX 427 Phone: (508) 375-6613
�fss�CHUS�S`j' BARNSTABLE, MASSACHUSETTS 02630 FAX
� (508) 362-2603
TDD (508) 362-5885
Judy 19th, 2013
Raymond Schnieder
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System.installed at 102 Falling Leaf
Lane in the town of Barnstable.
Dear Raymond Schnieder,
Our records indicate that the operation and maintenance contract with Unknown for your innovative/alternative
wastewater treatment system may have expired or cancelled as of July 19th, 2013. To date we have not received evidence
that you have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental,Protection (MA DEP)and the Town of
Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system.
•Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees I/A septic system mana ement and
9 compliance efforts for the Board of Health in your town.We
are authorized by your Board of Health to contact you to inform you of the above requirement and to request your
compliance, Accordingly, please forward a copy of a signed contract via mail,fax or e-mail within fifteen (15) days of
receipt of this letter.
For your convenience, I am enclosing a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you do'not respond within fifteen (15) days of your receipt of this letter by forwarding a
copy of a signed contract, I may refer you to the Barnstable Board of Health for further enforcement action.You may
be required to appear before the Barnstable Board of Health to show cause as to why you have not maintained the
required contract.
I can be reached at (508)375-6901; my Fax number is (508)362-2603. I can also be reached via email at
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter.
. Sincerely
Lindsey Wright
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
ertified Mail Number: 70023150000492087789
y
of Bs BARNSTABLE COUNTY
DEPARTMENT OF HEALTH AND ENVIRONMENT
r
BARNSTABLE COUNTY COMPLEX
* 3195 MAIN STREET/ PO BOX 427
• 9s j �`�� BARNSTABLE MASSACH Phone: (508) 375-6613
USETTS 02630 FAX (508) 362-2603
TDD (508) 362-5885
June 27th, 2013
Raymond Schnieder
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 102 Falling Leaf
Lane in the town of Barnstable.
Dear Raymond Schnieder,
Our records indicate that the operation and maintenance contract with Unknown for your innovative/alternative
wastewater treatment system may have expired or cancelled as of 12/31/69. To date we have not received evidence that you
have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and the Town of
Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system.
Information about these requirements may be found at http://www.,barhstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees VA septic system management and compliance efforts for the Board of Health in your town.We
are authorized by your Board of Health to contact you to inform you of the above requirement and to request your
compliance.Accordingly, please forward a copy of a signed contract via mail;fax or e-mail within fifteen (15)days of
receipt of this letter.
For your convenience, I am enclosing a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you do not respond within fifteen (15)-days-of your receipt ofth.is Letter by forwarding a copy of
a signed contract, I may refer you to the Barnstable Board of Health for further enforcement action. You may be required to
appear before the Barnstable Board of Health to show cause as to why you have not maintained the required contract.
I can be reached at (508)375-6901; my Fax number is (508)362-2603. 1 can also 'be reached via email at
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter.
:Sincerely
Lindsey Wright
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
•
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°F B BARNSTABLE COUNTY
DEPARTMENTOF HEALTH AND ENVIRONMENT
BARNSTABLE COUNTY COMPLEX
3195 MAIN STREET/ PO BOX 427 Phone: (508) 375-6613
BARNSTABLE, MASSACHUSETTS 02630. FAX (508) 362-2603
TDD (508) 362-5885
July 19th, 2013
Raymond Schnieder
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 102 Falling Leaf..
Lane isn the town of Barnstable.
• � r
Dear Raymond Schnieder,
Our records indicate that the operation and maintenance contr,1ct. with Unknown for your innovative/alternative
wastewater treatment system may have expired or cancelled as of July.19th, 2013, To date we have not received evidence
that you have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and.the Town of
Barnstable require you to keep an. operation and maintenance (O&M) contract in effect at all times for your system:
Information about these requirements may be found at htfp://www.barnstablecountyhealth.brg/ia-systems/ia-owners-guide.
My department oversees I/A septic system management and compliance efforts for the Board of Health in your town We
are authorized by your Board of Health to contact you to inform you of the above requirement and to request your
compliance. Accordingly, please forward a copy of a signed contract via mail,fax or e-mail within fifteen (15)days of
receipt of this letter.
For your convenience; I am enclosing a list of wastewater operators.we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you do not respond within fifteen (15) days of your receipt of this letter by forwarding a
copy of a signed contract, I may refer you to the Barnstable Board of Health for further enforcement action,,You may
be required to appear before the Barnstable Board of Health to show cause as to why you hmWijot mainf§Died
required contract. y
l can be reached at (508)375-6901; my Fax number is (508)362-2603. I can also be reached via«email a
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter. `-
` Si"ncerely i
r'n
Lindsey Wright.
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
Certified Mail Number: 70023150000492087789
v
;54 of B`1 . BARNSTABLE COUNTY
�\ DEPARTMENT OF HEALTH AND ENVIRONMENT
O
BARNSTABLE COUNTY COMPLEX
3195 MAIN STREET/.PO BOX 427 Phone: (508) 375-6613
9ssACs�S BARNSTABLE, MASSACHUSETTS 02630 FAX (508) 362-2603
TDD (508) 362-5885
July 19th, 2013
Raymond Schnieder
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at{102 Falling Leaf,
.Lane inthe town of Barnstable.
dSf
Dear Raymond Schnieder,
Our records indicate that the operation and maintenance contract with Unknown for your innovative/alternative
wastewater treatment system may have expired or cancelled as,of July 19th, 2013. To date we have not received evidence
that you have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and the Town of.
Barnstable require youAo .keep_r an operation'and maintenance (O&M) contract in effect at all times for your system.
Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees I/A septic system management and compliance efforts for the Board of Health in-your town.We
are authorized by your Board of Health to contact you to inform you of the above requirement and to request your
compliance. Accordingly, please forward a copy of a signed contract via mail,fax or e-mail within fifteen (15) days of
receipt of this letter.
For your convenience, I am enclosing a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you do not respond,within fifteen (15)days of your receipt of this letter by forwarding a
copy of a signed contract,I may refer you to the Barnstable Board of Health for further enforcement action,You mayy
be required to appear before the Barnstable Board of Health to show cause as to why you halVnot maintained '
required contract. P�-
c
I can be reached at (508)375-6901; my Fax number is (508)362-2603. 1 can also be cached viay� mail..a
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter.
t Lindsey Wright
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
Certified Mail Number: 70023150000492087789
of B BARNSTABLE COUNTY"
ice. DEPARTMENT OF HEALTH AND ENVIRONMENT
v - BARNSTABLE COUNTY COMPLEX
3195 MAIN.STREET/PO BOX 427 Phone: (508) 375-6613
9ssA S�� BARNSTABLE, MASSACHUSETTS 02630 508 - 603
CHV
TDD -(508) 362 5885
June 27th, 2013
Raymond Schnieder
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract forthe Innovative/Alternative Septic System Installed at 102 Falling Leaf
Lane in the town of Barnstable.
ko S T'
Dear Raymond Schnieder,
Our records" indicate that the operation and maintenance, contract. with Unknown for your innovative/alternative
wastewater treatment system'may have expired or cancelled as of 12/31/69.To date.we have not received evidence that you
have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP),and the Town of
Barnstable require you to keep an operation and.maintenance (0&M) contract in effect at all times for your system.
Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees I/A septic system management and compliance efforts for the Board alth in Mr tov8 We
are authorized by your Board of Health to contact you to inform you of the above requirer�Y and to '"uest*our
compliance. Accordingly, please forward a copy of a signed contract via mail, fax.or e-mail wif� n fifteen�,45) ds of. "
receipt of this letter:
Na
For your convenience, I.am enclosing a list of wastewater operators we are aware of that do husiness in Barn?table
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technolo� or
vendor.
Please be advised that if you do not respond within fifteen 15 days of your receipt of this.letter y forward
lag of
a signed contract, I may refer you to the Barnstable Board of Health for further enforcement action. You may be required to
appear before the Barnstable Board of Health to show cause as to why you have not maintained the required contract.
I can be reached at (508)375-6901; my Fax number is (508)362-2603. I can also be reached. via email at
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter.
Sincerely
Lindsey Wright.
Enclosures:Certified Wastewater Operators List
CC:-Barnstable Board of Health
of B BARNSTABLE COUNTY
DEPARTMENT OF HEALTH AND ENVIRONMENT .
v "• BARNSTABLE COUNTY COMPLEX
3195 MAIN STREET/ PO BOX 427 Phone: (508) 375-6613
�I CHMU BARNSTABLE, MASSACHUSETTS 02630 EAX--4508j3 - 662 03
TDD (508) 362-5885
June 27th, 2013
Raymond Schnieder
102 Falling Leaf Lane
Osterville, MA 02655
RE. Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 102 Failing Leaf
Lane in the town of Barnstable.
Dear Raymond Schnieder,
Our records indicate that the operation and maintenance contract with Unknown for your innovative/alternative
wastewater treatment system may have expired or cancelled as of 12/31/69.To date we have not received evidence that you
have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and the Town of
Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system.
Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees VA septic system management and compliance efforts for the Board . : alth in Mr tove We
are authorized by your Board of Health to contact you to inform you of the above requirenigbi and.to Ye'ques# ,your
compliance. Accordingly, please forward a copy of a signed contract via mail,fax ore-mail w n fifteene5)days of
receipt of this letter. ®Co
,�
For your convenience, I am enclosing a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular to hnol - or
vendor. � -�_{
co
Please be advised that if you do not respond within fifteen (15)days of your receipt of this letter y forwarding a c of
a signed contract, I may refer you to the Barnstable Board of Health for further enforcement action. You may be required to
appear before the Barnstable Board of Health to show cause as to why you have not maintained the required contract.
I can be reached at (508)375-6901; my Fax number is (508)362-2603. 1 can also be reached via email at
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter.
incerely '
.i
Lindsey Wright
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
y
Town of Barnstable Barnstable
°p tHF T°�y
Board of Health AH'" �`"
D ►
saetvsrns�.E,
� 200 Main Street, Hyannis MA.02601
1659. 2007
Alf��a
OFFICE: 508-862-4644 Wayne Miler,M.D.
FAX: 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
Raymond F. Schneider, 102 Falling Leaf Lane, Osterville, MA 02655 T
ATTENDANCE REQUIRED.
November 5, 2013
qhe Board of Health requests you to attend the Board of
Health meeting re: 102-Falling Leaf Lane, Ostemille . The
records show you.are out of compliance with the required
maintenance contract for your 11A septic system:
ghank you for your attendance.
HEALTH Phone 508-862-4644
Your item will be heard at the Board of Health Meeting on the:
Date of: Tuesday,November 12,2013
You, or a representative for you, is expected to be present to answer questions
the Board may have.
Meeting.Location: Town Hall, 367 Main St, Hyannis
Hearing Room, Second Floor. '
Time: 3:00—6:00 P.M.
Approximately three days prior.to meeting, an agenda will be sent out to you—
once it is available. It will also be available on line at the town website:
www.town.barnstable.ma.us
Go to ..."Boards & Committees > Board of Health
- or- Go to Official
Agendas
I
QAAGENDAS BOMet Receipt of BOH Submission 102 Failing Leaf Ln Ost Nov2013.doc
Bob Ala V / ,_:)L�1�
y.. Pile
own of Barnstable Barnstable '
Regulatory Services Department
'"M`� ' Health Division
r Public Hea t
ibgp'
039 0. 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL #7012 1010 0000 285
October 2, 2013
Raymond F. Schneider
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative Septic System
? installed at 102 Falling Leaf, Lane in the Town of Barnstable.
The Barnstable County Department of Health and Environment has informed us
that the operation and maintenance contract for your innovative/alternative
wastewater treatment system may have expired or was cancelled as of July 19th
2013. To date they have not received evidence that you have entered into a new
Operation and Maintenance contract.
Therefore we are writing to instruct you that the Massachusetts Department of
Environment Protection (MA DEP) and the Town of Barnstable require you to
keep an Operation and Maintenance (O&M) contract in effect at all times for your
system. Information about these requirements may be found at
http://www.barnstablecou ntyhealth.org/ia-systems/ia-owners-guide.
The Barnstable County Department of Health and Environment oversees I/A
septic system management and compliance efforts for the Board of Health in
your Town (Osterville). The Public Health Division is hereby contacting you to
inform you of the above requirement and to order you to comply. Accordingly
please forward a copy of a signed contract via mail, fax or e-mail within
thirty (30) days of receipt of this letter.
Q:\SEPTIC\O&M Itr\102 Falling Leaf Ln Ost Oct 2013
C�
Please be advised that if you do not respond within thirty (30) days of your
receipt of this letter by forwarding a copy of an assigned contract, you will
be scheduled to appear before the Board of Health at a show cause hearing
on November 12, 2013 to provide information relative to the required
contract.
PER ORDER OF THE BOARD OF HEALTH
Thomas McKean, R.S. CHO
Agent of the Board of Health
Q:\SEPTIC\O&M Itr\102 Falling Leaf Ln Ost Oct 2013
Town of Barnstable Barnstable
Regulatory Services Department A14inwfloCft
MASS. Public Health Division I
'�fo►+► " 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL #7012 1010 0000 2850 9965
September 4, 2013
Raymond F Schneider
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative Septic System
-installed at 102 Falling Leaf Lane in the Town of Barnstable.
The Barnstable County Department of.Health and Environment has informed us
that the operation and maintenance contract for your innovative/alternative
wastewater treatment system may have expired or was cancelled as of July 19th
2013. To date they have not received evidence that you have entered into a new
Operation and Maintenance contract.
Therefore we are writing to instruct you that the Massachusetts Department of
Environment Protection (MA DEP) and the Town of Barnstable require you to
keep an Operation and Maintenance (O&M) contract in effect at all times for your
system.:Information about these requirements may be found at
http://www.barnstablecountVhealth.org/ia-systems/ia-owners-guide.
The 'Barnstable County Department of Health and Environment oversees I/A
septic system management and compliance efforts for the Board of Health in
your Town (Osterville). The Public Health Division is hereby contacting you to
inform you of the above requirement and to order you to comply. Accordingly
please forward a copy of a signed contract via mail, fax or e-mail within
thirty (30) days of receipt of this letter.
Q:\SEPTIC\Letters Septic Inspection Failures or Future Evahl02 Falling Leaf In Ost Aug 2013.doc
i
I
Please be advised that if you do not respond within thirty (30) days of your
receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing
on November 12, 2013 to provide information relative to the required
contract.
PER ORDER OF HE BOARD OF HEALTH -
as McKe n, R.S. CHO
Agent of the Board of Health
CC: Barnstable Department of Health and Environment
I
i
r
I
Q:\SEPTIC\Letters Septic.Inspection Failures or Future Eval\102 Falling Leaf In Ost Aug 2013.doc
t
Flynn, Judith
�rom: Crocker, Sharon
ent: Monday, December 02, 2013 5:47 PM
To: Flynn, Judith
Subject: 102 Falling Leaf Lane'Ost-
Hi Judith,
I don't recall if this is one of the properties you had figured out the contact name for or not.
At any rate, this one was sold in November. The new owners are: Lawrence John Morency and Mary Ellen
Morency of 82 Fox Meadow Lane, Dedham, MA 02026-6229 Phone#781-326-4538 (per Registry of Deeds and White
pages)
Please send them a letter requesting an I/A monitoring contract be implemented for 102 Falling Leaf Ln, Osterville
Thank you.
1
� 5r
! Ln ..
� Ir
o
.0 Postage $ \S M A 0
Certified Fee �� `?
M
Retum.Re Postmark
ceipt Fee >,
O (Endorsement Required) 3
o
Restricted Delivery Fee
1-3 (Endorsement Required) /
Total Postage&Fees
USQ
ru
o Raymond F Schneider j
N
102 Falling Leaf Lane �' I
Osterville, MA 02655-
r
Certified Mail Provides:
o A mailing receipt
o A unique identifier for your mailpiece
o A record of delivery kept by the Postal Service for two years
Important Reminders:
o Certified Mail may ONLY be combined with First-Class Mail®or Priority Maila.
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o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
■ For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is
required.
o For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
In If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.
PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047
r
o Complete items 1,2,and 3.Also complete A. S' ture
item 4 if Restricted Delivery is desired. ❑Agent
o Print your name and address on the reverse X ddressee
Re
so that we can;return the card to you. B. ceived b (Printe Nam ) C. Date o Delivery
o Attach this card to the back of the mailpiece,
I or on the front if space permits.
D. Is delivery address different from item 1? ❑Yes
E 1. Article Addr ed to: VES,enter delivery address below: 0 No
(+
LRaymondhneidersf Lane
02655 3. Se ice Type
I I Certified Mail ❑Express Mail I
�.Registered ❑Return Receipt for Merchandise
G].Insured Mail ❑C.O.D.
M 4. Restricted Delivery?(Extra Fee) 0 Yes
' 2. Article Number �—
(Transfer from service iabeq `7 12 1010 ;0,0 0101, 2 8 5 0 `9 9 6 5 m
PS Form 3811.February 2004 Domestic Return Receipt, 102595-02-.M-1540
i
UNITED STATES POSTAL.SERVICE First-Class Mail-
Postage&Fees Paid
LISPS
Permit No.G-10
I
� I
Sender! Please print your name, address,and ZIP+4 in this box • I
I
I
Town of Barnstable f
I
Public Health Division
200 Main Street
Hyannis, MA 02601 I
I
' I
I
I
I
j.
c4
Town of Barnstable Barnstable
��SHE l�L,r
Regulatory Services Department
16
Public Health Division
2007
.200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: _508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL #7012 1010 0000 2850 9965
September 4, 201-3
Raymond F Schneider
102 Falling Leaf Lane
Osterville, MA 02655
RE: Operation and Maintenance Contract for the Innovative Septic System
-installed at 102 Falling Leaf Lane in the Town of Barnstable.
The Barnstable County Department of Health and Environment has informed us
that the operation and maintenance contract for your innovative/alternative
wastewater treatment system may have expired or was cancelled as of July 19th
2013. To date they have not received evidence that you have entered into a new
Operation and Maintenance contract.
Therefore we are writing to instruct you that the Massachusetts Department of
Environment Protection (MA DEP) and the Town of Barnstable require you to
keep an Operation and Maintenance (O&M) contract in effect at all times for your
system. Information about these requirements maybe found at
http://www.barnstablecountvheaIth.org/ia-systems/ia-owners-quide.
The Barnstable County Department of Health and Environment oversees I/A
septic system management and compliance efforts for the Board of Health in
your Town (Osterville). The Public Health Division is hereby contacting you to
inform you of the above requirement and to order you to comply. Accordingly
please forward a copy of a signed contract via mail, fax or e-mail within
• thirty (30) days of receipt of this letter.
Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\102 Falling Leaf In Ost Aug 2013.doc !:
I
C�
Please be advised that if you do not respond within thirty (30) days of your
receipt of this letter by forwarding a copy of an assigned contract, you will
be scheduled to appear before the Board of Health at a show cause hearing
on November 12, 2013 to provide information relative to the required
contract.
PER ORDER OF HE BOARD OF HEALTH
as McKe n, R.S. CHO
Agent of the Board of Health
CC: Barnstable Department of Health and Environment
f
Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\102 Falling Leaf In Ost Aug 20.13.doc
t
• Parcel Detail http://issgl2/intranet/propdata/ParcelDetaii.aspx?ID=9315
r�
./��Ts-� "x
MASS, 41
1
Logged In As Parcel Detail Monday, August 26
2013
Parcel Lookup
Parcel Info
Parcel i144-003-008 ( Developer LOT 8
ID Lot
Location 102 FALLING LEAF LANE I Pri
Frontage
Sec f Sec
Road frontage
Village!OSTERVILLE � District
I Fire rC 0-MM
Town sewer exists at this Road
address No Index�989
Interactive �
L
Map
Owner Info ___
Owner SCHNEIDER, RAYMOND F _ 1 Co-�� I
Owner
Streetl j102 FALLING LEAF LANE Street2
City OSTERVILLE State[MA 1 Zip 02655 Country
Land.Info_ _
Acres 10.34 Use Isingie Fam MDL-01 ] Zoning jRC Nghbd Fc0108
Topography I.Sloping Road,Paved
Utilities Public Water,Gas,Septic Location I
Construction Info
Building 1 of 1
Year�1998 S Roof IGable/Hip I Wall
Clapboard I
Living Roof AC - ter
1'633 Asph/F GIs/Cmp None wvr� ri
Area Cover Type" 4r '1�.
Bed
StyleIP.anch = Walll Plastered Rooms 3Bedrooms 1�
Model Residential Int Hardwood Bath 2 Full -
Floor Rooms.---
ooms.
Heat Total r 1 a�,
Grade Average Plus Hot Water 6 Rooms
Type Rooms k � �_
urn .
Stories 1 Story Heat Gas Found- Pour d Conc.
Fuel ation
Gross
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=9315 8/26/2013
I_
Wornjane Mmm o F.F auo> 0.r7ra � zei511ap uge wn43e4 el a zaildab Glad
a sall,e¢sailanb 3
Innovative RUCKS ystems nc -copy -
A Denitrifying Septic System
205 worcester court, unit A4
falmouth,ma 02540 f
508-548-3564.800-874-7373-fax 508-548-9672
email:tsantos@holmesandmcgrath.com
Chip Schneider
102 Falling Leaf Lane
Osterville, MA 02655 1
}
Re:. #102 fallinr Leaf Lane, Osterville MA
Dear Mr. .Schneider:
The Department of Environmental Protection requires that. every: ;
innovative alternative sewage disposal system be maintained and under: &
service contract. The RUCK® system serving your house is an innovative
alternative sewage disposal system. Below you will, find the required:
service contract. Please review this, sign it and return it to us. `We
will perform the required' inspections and ':monitoring and bill you for ` II
the service.
RUCK® System Thr �)
Y ee Year,,Maintenance Agreement
Innovative ' RUCK® Systems Inc. agrees, to perform, on an annual
bad., the following services to the RUCK® system located.at the address
above. RUCK® -systems are served by a series of septic tanks.. The RUCK
system also has a RUCK filter and a soil absorption system. The fee for.
the operation and maintenance and issuance of. the- DEP report will be
$150.00 per inspection, plus expenses. The Barnstable County Health
Department applies a $50/year charge per system that will be billed to
you as an annual expense. The services are described below: '
The services are described below:
A) Inspect Septic Tanks for Required Pumping under the Following
Criteria:
1. Inspect the condition of the tanks
2. Measure the distance between- bottom .of scum/grease layer and
bottomzof the outlet baffle.,
3. Measure the distance between _top of scum layer and top of outlet tee.
4. Measure the thickness of the'-scum/grease layer.
5. Measure the sludge layer and 'distance from sludge to outlet tee.
6. Inspect the condition of the','inlet and outlet tees.
7. Report any evidence of leakage 'into or- out of the tank.
8. Report any evidence of any backup of effluent.
B) Inspect the Vents for Evidendq ,of Blockage:
9. Inspect vent tee and insure ;insect screen is in place and that no
bird or insect nest is blocking the vent.
wia6p3 dn-dod.asodxa T
o� 1 jaded,Pasd -- - -- ®d9L5 ale dwa1 and asta &9V9@ANMV� aull 6uole
w
pose
® slagel®load Ase3
• Y
C) Monitoring:
10. Your system was approved under the General Use Certificate. The DEP
and Barnstable Board of Health require monitoring of the system. The
applicable procedures set forth in the most recent "General Use
Certificate Approval - Pursuant to Title 5, 310 CMR 15.000" (See
"Conditions Applicable to the System Owner" attached) shall be strictly
adhered to. The laboratory tests will be billed to you as an expense.
After 12 months of monitoring, if the System is approved as acceptable
by the DEP and Board of Health, in accordance with 310 CMR 15.285,
General Certificate Approval, and at the written request of the System-
owner, the DEP and local Board of Health may reduce the monitoring
requirements.
D) System Failure:
11. Within twenty-four (24) hours of a system failure or alarm event,
this office will notify the Massachusetts D.E.P. and the local Board of
Health by both telephone and letter of this fact along with whatever
corrective measures are to be taken immediately. Also as part of this
service & maintenance agreement please find a detailed contingency plan
(attached) to be implemented immediately upon first learning of a system
failure. A failure is defined by a final effluent TN concentration.
exceeding 19 mg/L. In addition, Innovative RUCK Systems, Inc., hereby
agrees to comply with all criteria outlined in the "Conditions Applicable
to the System Owner" section outlined in the most recent version of
Massachusetts D.E.P.'s . General Use Certificate Approval Pursuant to
Title 5, 310 CMR 15.000, Section IV (See Attached) .
TERMS: Statements will be rendered at the completion of the work,
or monthly, and are due upon presentation. A FINANCE CHARGE of 1- 1/2%
per month (18% per year) on all sums under five hundred ($500.00)
dollars, and 1 1/2% per month (18% per year) on all sums over five
hundred ($500.00) dollars will be added to the then unpaid balance after
thirty (30) days from the date of the billing. Innovative RUCK Systems,
Inc. reserves the right to terminate work in progress in the event
payment is not received in accordance with the payment provisions.
COLLECTIONS: The Client agrees to pay all costs of collection, including
reasonable attorney's fees.
This Agreement is null and void unless executed by the Client and
returned to Innovative RUCK Systems, Inc. within thirty (30) days.
COORDINATING INSTRUCTIONS: The inspector will need to uncover the septic
tank covers, inspection ports and pump chamber hatches. Obviously, there
will be holes dug in lawns or landscaped areas. We will endeavor to
protect lawns and landscaping but the covers have to be. exposed. Please
call our office and discuss the particulars with Luis Coelho or Timothy
Santos.
Issued By: Date: July 24, _2013
Accepted By. AJ Date: e C �` �Jd. 2ao r 3
Telephone : 1-978-340-8987
Billing Address:
1� /
McKean, Thomas
From: Crocker, Sharon
Sent: Tuesday, November 12, 2013 8:44 AM
To: McKean, Thomas; Jimmy Sawayanagi Wayne Miller, M.D.; Paul J. Canniff, D.M.D.
Subject: FW: Concerning 102 Falling Leaf Lane...
102_Falling—Leaf_L
ane_O&M_cont...
II
I
i
-----Original Message-----
From: ddc@ddc.is [mailto:ddc@ddc.is]
Sent: Tuesday, November 12, 2013 7:12 AM
To: Crocker, Sharon; Bcobb2l
Subject: Concerning 102 Falling Leaf Lane. . .
Good Morning!
I was contacted yesterday by Ray Schneider's brother, who informed me of
today's hearing. Mr. Scheider is currently hospitalized recovering from
hip surgery, and will be unable to attend.
Last month I did a title 5 inspection of the property and did note that
the O & M contract had expired. I explained to Mr. Schneider that he was
obligated to maintain a current contract, and he did agree to enter into
a new contract with Holmes and McGrath. A signed copy of that agreement
was attached to the report, and I am also attaching it to this email.
I hope this will satisfy the Board. If you need me to attend the
meeting, I am available this afternoon.
David D. Coughanowr
Eco-Tech Environmental
508 364-0894
1 ,
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
December31,2002
Raymond Schnieder
102 Falling.LeafLane
Barnstable,MA 02630
Re: 102 Falling Leaf Lane,Barnstable,MA
DEP Facility ID'.RUCK10
Operation&Maintenance Requirements
Dear Mr. Schnieder:
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.Ciccoteili at the DEP/Boston Office at(617)292-5657.
Si rely,
Sharon M.Pelosi,Director
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.state.ma.us/dep
Z� Printed on Recycled Paper
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617:292-5500
JANE SWIFT
Governor BOB DURAND
Secretary
LAUREN A.LISS
Commissioner
December 31,2002
Raymond Schnieder
102 Falling.Leaf Lane
Barnstable,MA 02630
Re: 102 Falling Leaf Lane,Barnstable,MA
DEP Facility ID:RUCK10
Operation&Maintenance Requirements
Dear Mr. Schnieder:
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 DEP/Boston Office at(617)292-5657.
Si rely,
L
Sharon M.Pelosi,Director
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.state.ma.us/dep
L4 Printed on Recycled Paper
003 -ooc4
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: Raymond Schneider
When filling out Owner
forms on the
computer,use 102 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:
reb
Street Address/PO Box:
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
Installation Date Start of Operation
Approval Type: ®General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ®Yes ❑No
D. Operating Information
10/31/01
Inspection Date Previous Inspection Date
3 Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
normal
Effluent Description
SCHNEIDE• 11/21/02 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
Lill
Treatment and Disposal Systems
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:s
System is sampled annually
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
Massachusetts certified operator in accordance with 257 CMR 2.00.
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 s'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
r e
SCHNEIDE•11/21/02 . Page 2 of 2
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: Lot 8 D-Box Matrix: Aqueous
Project: McShane/99170 Sampled: 10-3 I
Client: Holmes&McGrath Received: 10
Lab ID 37080-08 Container: 1L Plastic Preservation: Cool
,;a, 41
Analyte t aResult � ° Unts AnalyzedrQC„Batch „AlethOd ,
Biochemical Oxygen Demand 32 mg/L 7 11-01-00 BOD-0813-W EPA 405.1
Solids,Total Suspended 11 mg/L 10 11-02-00 TSS-0479-W EPA 160.2
Lab ID: 37080-02 Container: 256 mL Plastic Preservation: Cool
x .%«s ✓ a x°d ' s �Report�ng s , it o--',�v sC .hS '" -; }a .. t,
. A Analyte� , „z £x Result Units &grim -Anatyzed �QGBatch Y $ MMethod
Nitrate(as Nitrogen) 0.12 mg/L 0.02 11-01-00 NI-0951-W EPA 353.2
pH 6.8 pH 2.0 10-31-00 PH-0916-W EPA 150.1
Lab ID: 37080-05 Container: 250 mL Plastic Preservation: H2SO4/Cool
°�
s R rtm
�� Analyte ResultUmts ' ffi Anal zed' 1 G Batch Q A1eth I
.� ,t Y Qom'
^'. +, �x`,..ri;
Ammonia(as Nitrogen) 4.6 mg/L 0.2 11-01-00 AM-0586-W EPA 350.1
Nitrogen,Total Kjeldahl (TKN) 9.5 mg/L 0.5 11-09-00 TKN-0561-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.
V
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 NOV.,21, 200,0
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 LOCATED INNI-TROGEI f S�ENSITIVElAREYES
�2�� v���
CLIENT McShane Constru�ctlon
DATE 11/2.1/00 V LOCATION of 8 Fall n Leaf Lane
O
TOWN B'ar�nstable, Ma ` _x. .
OUTPUT
D-BOX
pH :z68
BOD `32 mg/I
TSS .t11-V mg/I
AMMONIA `46 .
TKN 9 5 mg/I
NO3 y0 ll;p; , mg/I
TN 9 62 _ mg/I
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN
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
r
innovative ruck systems, inc.
200 main street
falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE February 10,Z000
ATTENTION: STEVE CORR P.E. Retest
1 WINTER STREET
BOSTON MA 02108
DEAR MR CORR
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 LOCATED IN NITROGEN SENSITIVE AREYES ,,;
CLIENT McShane Construction
DATE 01/26/00 LOCATION Loft 8 Falling Leaf Lane
RETEST TOWN Barnstable, Ma m„
INPUT OUTPUT APPROX.
REMOVAL
BLACKWATER GREYWATER D-BOX RESULTS
pH 7.8 7..4 73
BOD 10 mg/I 200 mg/I 230 mg/I
TSS 28 mg/I SO mg/I 97 mg/I
FECAL COLIF 100 / 100 ml do. / 100 ml 100 / 100 ml
AMMONIA 25 mg/I 15 mg/I 14 mg/I
TKN 29 mg/I 21 mg/I 20 mg/I
NO3 0.71. mg/I BRL mg/I BRL. mg/I
_ . ,
TN 29.7 mg/I 21.0 'mg/I 20.0 mg/I 21%
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN NO
LEGEND
NT SAMPLE GATHERED TOO SMALL
SAMPLE NOT GATHERED
NM NOT MEANINGFUL
BRL BELOW REPORTING RESULTS
NR NOT REQUIRED
REMOVAL RATE IS AN APPROXIMATE VALUE SINCE THE WASTEWATER FLOWS ARE SPLIT
BLACKWATER IS ASSUMED TO BE 50% OF THE FLOW,
TEST RESULTS ARE ATTACHED
SIGNED
MICHAEL B. MCGRATH, P.E.
innovative ruck systems, inc.
CC:
CLIENT
BOARD OF HEALTH
R. LAAK
BARNSTABLE COUNTY HEALTH DEPT
�.. If
Onn®vatove RUCK Systems, Bin.
A 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
September 22, 1999
Mr. Steve Corr
DEP-Water Pollution Control
One Winter Street
Boston MA 02108
Dear Mr. Corr:
Re RUCK® System
, ot;8Fal_lingLeaf�La`ne, Barnstable
-----------------
Please be advised that the Residential RUCK system at
the above referenced lot has failed, in a recent quarterly
test, to meet the required Discharge Limit for Total Nitrogen
Ddescribed in the General Certificate in that the total
nitrogen concentration in the final effluent exceeded 19
milligrams per liter (mg/1) . The total nitrogen concentration
in the final effluent was 33. 3 mg/l.
The enclosed chart shows the constituents measured in
the black water tank, the gray water tank and the
distribution box. The Total Nitrogen in the Black water
Septic Tank is 130 mg/l . The Total Nitrogen in the Gray Water
Tank is 26. 9 mg/l. The Total Nitrogen in the influent (or the
average of the Total Nitrogen in both septic tanks) is
approximately 58 . 5 mg/l . This is approximate since some of. .
r.•
printed on recycled paper
the Total Nitrogen is lost in denitrification in the gray
water septic tank. The removal rate of 58% is a low but
acceptable rate of denitrification.
The concentration of nitrate in the gray water tank
effluent is the majority of the Total Nitrogen in that
effluent. The concentration of nitrate in the distribution
box effluent is the majority of the Total Nitrogen in that
effluent. The readings indicate that denitrification is
lacking. The low BOD numbers indicate a lack of available
carbon. If there was additional denitrification resulting in
the concentration of nitrate being reduced to below 8 mg/l,
the system would conform to the requirements of the General
DCertificate.
Based on, that condition, on September 21, 1999, we added
more soap manually to the gray water tank of the system and
we will retest the week of September 27, 1999. With
sufficient carbon, there should be good denitrification and
the system should conform to the discharge limits of the
General Certificate.
We have not been able to interview the owner. We are
told by the builder that the owner is a part time resident
who lives there on weekends and. occasionally at P—Per times.
The concentrations of BOD are too low for effect
1 ,
denitrification. The low BOD concentration is indicative of
part time use with lower use of laundry facilities on site.
We will forward results of the new tests upon receipt.
If you have any questions, please call or write me.
Sincerely,
INNOVATIVE RUCK SYSTEMS, Inc.
Michael B. McGr h, P.E. , P.L. S.
President
MBM/gd
cc: Barnstable Board of Health
D
innovative ruck systems, Inc.
200 main street
falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE Cewm-ber 6_, 1999
ATTENTION:STEVE CORR P.E.
1 WINTER STREET
BOSTON MA 02108
DEAR MR CORR
PLEASE FIND ENCLOSED COPIES OF LAB TEST RESULTS FOR THE RUCK SYSTEM AT THE REFERENCE
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
CLIENT McShane Constru ton
DATE 07/27/S9 LOCATION I Lat 8 Falling Leaf Lane
TOWN Barnstable,Ma
INPUT OUTPUT APPROX.
REMOVAL
BLACKWATER GREYWATER D-BOX RESULTS
pH 7.1 6.$ 6.5
BOD 220 mg/l 28 mg/l 20 mg/l
F"2g k
TSS 82 mg/l ORL mg/l 8s mg/l NM
FECAL COLIF 180000 /100 ml 100 /100 ml 800 /100 ml-
AMMONIA 95 mg/l 7.9 mg/l 11 mg/l
TKN 130 mg/l 4.9 mg/l 7.3 mg/l
. :
NO3 BRL mg/l 22 mg/l 26 mg/l
TN 130 mg/I 26.9 mg/l 33.3 mg/I55t3%►
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN .
LEGEND
NT SAMPLE GATHERED TOO SMALL
SAMPLE NOT GATHERED
NM NOT MEANINGFUL
BRL BELOW REPORTING RESULTS
NR NOT REQUIRED
REMOVAL RATE IS AN APPROXIMATE VALUE SINCE THE WASTEWATER FLOWS ARE SPLIT
BLACKWATER IS ASSUMED TO BE 50% OF THE FLOW.
TEST RESULTS ARE ATTACHED
SIGNED
MICHAEL B.MCGRATH, P.E.
innovative ruck systems, Inc.
CC:
CLIENT
BOARD OF HEALTH
R. LAAK
BARNSTABLE COUNTY HEALTH DEPT
_ innovative ruck systems, inc.
200 main street
falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE $eptember 6, 1999
ATTENTION:STEVE CORR P.E.
1 WINTER STREET
BOSTON MA 02108
DEAR MR CORR
PLEASE FIND ENCLOSED COPIES OF LAB TEST RESULTS FOR THE RUCK SYSTEM AT THE REFERENCE
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 NORM
CLIENT McShane ConsI uc tion
DATE 07/27/99 LOCATION JG-&Falling i eat Lane—
TOWN Barnstable;Ma
INPUT OUTPUT APPROX.
REMOVAL
BLACKWATER GREYWATER D-BOX RESULTS
pH 7.1 6.5 6.5
BOD 220 mg/I 28 mg/I 20 mg/I 84%
TSS 82 mg/I BRL mg/l as mg/l NM:
FECAL COLIF 190000 /100 ml 100 /100 ml 600 /100 ml
AMMONIA 96 mg/I 7.9 mg/I 11 mg/I
TKN 130 mg/I 4.9 mg/I 7.3 mg/I
NO3 BRL mg/I 22 mg/l 26 mg/I
TN 130 mg/l 26.9 mg/I 33.3 mg/I 589 t
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN NO
LEGEND
NT SAMPLE GATHERED TOO SMALL
SAMPLE NOT GATHERED
NM NOT MEANINGFUL
BRL BELOW REPORTING RESULTS
NR NOT REQUIRED
REMOVAL RATE IS AN APPROXIMATE VALUE SINCE THE WASTEWATER FLOWS ARE SPLIT
BLACKWATER IS ASSUMED TO BE 50% OF THE FLOW.
TEST RESULTS ARE ATTACHED
SIGNED
MICHAEL B.MCGRATH, P.E.
innovative ruck systems, inc.
CC:
CLIENT
BOARD OF HEALTH
R. LAAK
BARNSTABLE COUNTY HEALTH DEPT
innovative ruck systems, inc.
200 main street
falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE May 13, 1999
ATTENTION: STEVE CORR P.E. REVISED
1 WINTER STREET
BOSTON MA 02108
DEAR MR CORR
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 LOCATED IN NITROGEN SENSITIVE�AREYES�;,
cuENT µ McShane Construction
DATE 04/28/99 LOCATION LL:ot.8-FallingxLeafaLane�
TOWN Barnstable, Ma
INPUT OUTPUT APPROX.
REMOVAL
BLACKWATER GREYWATER D-BOX RESULTS
pH 8.8 7.4 7.7'
BOD 110 mg/I 31 mg/I 28 mg/I 60%
TSS 14 mg/I 18 mg/I 99 mg/I NM
FECAL COLIFORM / 100 ml / 100 ml / 100 ml NR
AMMONIA 66 mg/I 5.9 mg/I 3. mg/I
TKN 76 mg/I 13 mg/I 11 mg/I
NO3 BRL mg/I BRL mg/I 0.05 mg/I
TN 76 mg/I 13 mg/I 11.05 mg/I 75%
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN YES
LEGEND
NT SAMPLE GATHERED TOO SMALL
SAMPLE NOT GATHERED
NM NOT MEANINGFUL
BRL BELOW REPORTING RESULTS
NR NOT REQUIRED
REMOVAL RATE IS AN APPROXIMATE VALUE SINCE THE WASTEWATER FLOWS ARE SPLIT
BLACKWATER IS ASSUMED TO BE 50% OF THE FLOW.
TEST RESULTS ARE ATTACHED
SIGNED
MICHAEL B. MCGRATH, P.E.
innovative ruck systems,, inc.
CC:
CLIENT
BOARD OF HEALTH
DEP LAKEVILLE ATTN JEFF GOULD
R. LAAK
BARNSTABLE COUNTY HEALTH DEPT
f
innovative ruck systems, inc.
200 main street
falmouth, ma 02540
1-800-874-7373
TO:
DEPARTMENT OF ENVIRONMENTAL PROTECTION DATE September 6, 1999
ATTENTION: STEVE CORR P.E.
1 WINTER STREET
BOSTON MA 02108
DEAR MR CORR
PLEASE FIND ENCLOSED COPIES OF,LAB TEST RESULTS FOR THE RUCK SYSTEM AT THE REFERENCE
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
CLIENT McShane Construction.
DATE 07127199 LOCATION LoF -Fallin �eaf Larze.r.
TOWN Barnstabte;Nia
INPUT OUTPUT APPROX.
REMOVAL
BLACKWATER GREYWATER D-BOX RESULTS
pH 7.1 6.5 B.S
BOD 220 mg/I 28 mg/I 20 mg/I °�
TSS 82 mg/I BRL. mg/t. 85 mg/I NM
FECAL COLIF 180000 /100 ml 100 /100 ml 800 /100 ml
AMMONIA 96 mg/I 73 mg/l 11 mg/I
TKN 130 mg/1 - 4.9 mg/I 7.3 mg/l
NO3 BRL mg/I 22 mg/l 26 mg/l
TN 130 mg/I 26.9 mg/I 33.3 mg/I
DOES SYSTEM CONFORM TO DISCHARGE REQUIREMENTS FOR TN Nth
LEGEND
NT SAMPLE GATHERED TOO SMALL
SAMPLE NOT GATHERED
NM NOT MEANINGFUL
BRL BELOW REPORTING RESULTS
NR NOT REQUIRED
REMOVAL RATE IS AN APPROXIMATE VALUE SINCE THEWASTEWATER'FLOWS ARE SPLIT
BLACKWATER IS ASSUMED TO BE 50% OF THE FLOW.
TEST RESULTS ARE ATTACHED
SIGNED
MICHAEL B.MCGRATH, P.E.
innovative ruck systems, inc.
Cc:
CLIENT
BOARD OF HEALTH
R. LAAK
BARNSTABLE COUNTY HEALTH DEPT
t 3G L
°p THE Tp�
Town of Barnstable
s �
+ BARN51'ABLE, +
1639. ,• Board of Health ,
rFD MA'S A ,
367 Main Street,Hyannis MA 02601
Office: 508-790-6265 Susan G.Rask,R.S.
FAX: 508-790 6304 Brian R.Grady,R.S.
Ralph A.Murphy,M.D'
Decision of the Board of Health Regarding Lots 1 Through 14 and Lots 16 Through`25
Falling Leaf Lane, Osterville, Shown on Subdivision Plan dated February 11, 1984, revised
April 23, 1984 and Identified as Parcels 3.001 Through 3.014 on Assessor's Map 144, and
Parcels 3.016 Through 3.025 on Assessor's Map 144.
j
PROCEDURAL HISTORY
On November 18, 1996, the Board of Health agent, Thomas McKean, R.S.,'C.H.O.,
received twenty-four (24) disposal system permit applications along with two checks totaling
$2,400.00 from Peter Sullivan, P.E., of Baxter and Nye Incorporated, who was representing
O.R.E. Associates lncorpo'rated and,Osterville Highlands Trust pertaining to proposed
construction along Falling Leaf Lane, Osterville. .The lots are located off.of Acorn Drive,
Osterville Massachusetts, and are:identified as parcels 3.001 through parcels 3.014 on Assessors
Map 144, and parcels 3.016 through 3.025 on Assessor's Map 144 The disposal system
construction applications indicated that parcels 2, 4, 6, 8, 10, 12,�14, 16, 18, 20; 22; and 24 (all
the even numbered lots) were owned by Osterville Highlands Trust. The remaining applications
indicated that parcels 1, 3, 5, 7, 9, 111 13, 17, 19, 21, 23, and 25 (all the odd numbered lots) were
owned by O.R.E. Associates.
On or about November 21, 1996, Mr. McKean disapproved all twenty-four disposal
construction permit applications due to the fact that the plans lacked maximum feasible
compliance with the State Environmental Code, Title 5. He also returned the checks totaling
$2,400.00 to Peter Sullivan, P.E., of Baxter and Nye, Incorporated, and invited him to attend a
Board of Health hearing scheduled on Tuesday December 17, 1996 in order to provide Mr.
Sullivan the opportunity show why he,'and the owners of the parcels, believed it would be
feasible to construct septic systems on these 24 lots which would meet the provisions of Title 5,
the State Environmental Code.
During the first hearing which was held on December 17; 1996, the applicant requested a
continuance. Then the Board members voted to continue this matter to the February 4,1997.
public meeting. On February 4, 1997, the applicant again requested a continuance; then the
Board members voted to continue this matter to the March 4, 1997 public meeting. Continuation
hearings were also held on the following dates during 1997: June 17th, July 1st, and August
19th. Many documents were submitted into the record by both the applicant(s) and the Board of
Health. The Board members rendered a decision on September 3, 1997 during a special public
paring.
FINDINGS OF THE BOARD OF HEALTH
After discussion and based upon the evidence submitted, the Board of Health made the
following findings:
I. All 25 lots in the subdivision fall Within a.DEP approved Zone II of a-public water supply:
the Centerville-Osterville-Marstons Mills Water district wells CO# 10, CO AR#3,4, and CO MC#2.
The Zone II for these wells was approved by DEP May 3, 1994. Further, these wells are showing
nitrate levels in the range of 1-3 mg/L; these levels clearly exceed background nitrate levels
(generally <0.5 mg/L) and are indicative that nitrogen from human sources is reaching these
wells. Septic systems are known to be the largest source of nitrogen to groundwater on Cape
Cod.
2. All lots in the subdivision•are within a DEP-defined nitrogen sensitive area as defined in
310 CMR 15.215(1).
3. Further, the majority of lots in thesubdivision.(lots 1-10 and.16-25) fall within the town of
Barnstable defined WP zone, the five year time of travel contribution zone to a public water
supply.
4. Septic system effluent is a known source of nitrate and other possible contaminants to the
public water supply. .
5. Increasing density of housing is associated with increased levels of nitrate and other
ntaminants in groundwater.
In recognition of 4 and 5 above, DEP has determined per 310 CMR 15.214(I), that','no
1 serving new construction in a nitrogen sensitive area designated in 310 CMR 15.215 shall
' 3.
be designed to receive or shall receive more than 440 gallons of design flow per day per acre
except as set forth at 310 CMR 15.216 (aggregate flows) or 15.217 (enhanced nitrogen removal).
7. All lots in the subdivision are less than an acre in size. Further, all lots, except lots 23 and
21, are less than one-half acre (20,000 sf). Under the nitrogen loading requirements of 310 CMR
15.214, the half-acre lots would be entitled to a 220 design flow, the lots less than one-half acre
would be entitled to a 110 gpd design flow.
8. Under the Title 5 transition rules, 310 CMR 15.005, the owner of a lot on which
construction of a septic system in full compliance with 310 CMR 15.000 is not feasible.is entitled
to construct a system with a cumulative design flow of up to 330 gpd provided that the system is
constructed in compliance with 310,.CMR 15.000 to the maximum extent feasible as determined
by the local approving authority pursuant to 310 CMR 15.404 and 15.405.
9. 310 CMR 15.404 (maximum feasible compliance) states that a non-conforming system
may be brought into compliance through the installation of an alternative system (i.e. a nitrogen
removal system with associated design flow credit may be used to bring a system into compliance
with the requirements of 310 CMR 15.214).
10. The Board is in receipt of a letter from DEP to William Nye (one of the applicants)dated
February 4, 1997 stating that"the department interprets compliance with the requirements of 310
CMR 15.005 (3)(a) through (c) to require, pursuant to 310 CMR 15.005(c), a considered
assessment by the proponent of approved nitrogen removal technologies when site limitations
prevent attainment of the 440 gallon per acre design flow standard set for new construction under
310 CMR 15.215(1)..."
4
11. The applicant is entitled to pursue an aggregate determination of nitrogen loading per 310
CMR 15.216 and DEP guidelines. It is this board's belief that the cumulative acreage in the
subdivision, minus the acreage devoted to roads, when considered in the aggregate is sufficient
to allow the construction of 2-bedroom homes (220 gpd design flow) on twenty.of the lots and this
will be in general compliance with the nitrogen-loading requirements of 310 CMR 15.214.
12. The applicant has acknowledged that lot 15 will be used for drainage and is not to be
considered buildable.
13. At the hearings held on August 19, 1997 and September 3, 1997, the applicants proposed
to the Board that dwellings located on 20 of the lots, which specific lots they identified, would be
limited to 2 bedrooms unless the system(s) are modified to include enhanced nutrient removal as
approved by the Board of Health in which case.a dwelling served by a modified system may be
permitted to have not more than 3 bedrooms. The remaining four lots would be limited to not
more than 3 bedrooms and said system(s) must be modified to include,enhanced nutrient removal
as approved by the Board of Health.
14. Based upon the evidence presented, the Board finds that the applicants can achieve
maximum feasible compliance with 310 CMR 15.000 through either 1) the construction of 2-
n
bedroom homes on twenty of the lots with the remaining four lots provided with nitrogen removal
technology; the twenty lots must have appropriate restrictions placed upon their deeds to indicate
that only 2 bedrooms are allowed, or 2) the installation of nitrogen removal technology on any lot
will entitle the owner to a design flow of 330 gpd.
15. The applicant may choose in the future to present to this board an
aggregate nitrogen loading which complies with 310 CMR 15.216; this "plan, if
approved by the board, will negate the restrictions in 14 above.
ACTION TAKEN BY BOARD OF,HEALTH
Based upon the Board's unanimous approval of the proposed
findings, the Board of Health voted to take the following action regarding the
pending twenty-four applications for.disposal system construction permits
submitted by the applicants, Osterville Highland Trust, John Alger, Trustee
and ORE Associates, Inc.:
A) Disposal System Construction Permits shall issue to ORE Associates, Inc. for lots 3,
5, 7, 9, 11, 13, 17, 19, 21, 25 and to Osterville Highland Trust, John Alger,.Trustee for lots 2, 4, 6,
8, 10, 14, 16, 18, 20, 24, as designed, said issuance subject to compliance with the following
conditions:
1. All dwellings shall be limited to 2 bedrooms unless the system(s) is modified to
include enhanced nutrient removal as approved by the Board of Health in which case a.dwelling
served by a modified system may be permitted to have not more than 3 bedrooms.
2. Each plan shall be modified by the applicants to include a notation containing the full
text of the language recited in paragraph (A)(1) above. e
3. Deed restrictions, approved as to form by the Town Attorney, limiting the use of the
ellings to two bedrooms on each of the above-referenced lots shall be recorded at the
stable Registry of Deeds. A copy of the recorded deed restriction for the particular lot for
TOWN OF BARNSTABLE ;
LOCATION SEWAGE # / I G9
VILLAGE S t1`�g"rL�.4 ASSESSOR'S MAP & LOT �W1 Ova
INSTALLER'S NAME&PHONE NO. Tr „L
-SEPTIC TANK CAPACITY 1805 n Caw lut.? fboo k iC2 W AkdA&k
i
LEACHING FACILITY: (type) (size)
NOaOF BEDROOMS 23
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Welland Leaching Facility .(If any wells exist
on site or within 200 feet of leaching facility) t
Edge of Wetland and Leaching Facility(If any wetlands-exist .:
within 300 feet of leaching facility) Feet
Furnished by
36
r3
A3-
13 3 _ n '
,4 q NSS
i7
A-� �- S6�6 ,r •
7 S3 i
TOWN OF BARNSTABLE
LOCATION 10Z TelilI t L&71- L«tie SEWAGE#
.VILLAGE OsteryA f ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PHONE NO.
SEPTIC TANK CAPACITY -L f16K5 - (000 Qg1/ah5 E;417C4
LEACHING FACILITY:(type) (size) pc�o
NO.OF BEDROOMS 3
OWNER 'RA yn f44 er
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY �'eCh C b SP
40/t r 12 R -
D-wx p - LEACNNO +
RELD
x .4 - INNOYATIVFGRA
.»' YTAW 2. -
SLACC
I e w,a
RUCK SYSTEM
1
i
LOCATIONS
EXISTING DISTANCES IN DECIMAL FEET
3 BEDROOM A e 8
DWELLING ►, --- 36.5 20
2 --- 38.5 25.5
#102 4 27b 22.5 ---
5 35.5 AS ---
FALLING. LEAF LANE. �
f' a _
i
��il2t-`7f�1' f� �ESIGNING ENGINEER MUST SUPERVISJO
INSTALLATION AND CERTIFY 4ITING
r 1 THE SYSTEM WAS INST
No. ACCORDANCE TO f r n computer:
THE COMMONWEALTH OF MASSACHUSETTS - p
Yes
- PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zlppricatton for Migpogal *pgtem Conwuction Permit
Application for a Permit to Construct(y)Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
I b 4d!1 iv ,a D s %w d/��e Q��e.,.vi/"le 1 la Za %rc�s` ,
Assessor's p/Parcel 4 N`!
_S 4 e, l�tC�.
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building: r '
Dwelling No.of Bedrooms Lot Size JS�600sq.ft. Garbage Grinder Wo
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow Z56 gallons per day. Calculated daily flow gallons.
Plan Date I d-36 - 6 Number of sheets ! Revision Date
Title eft °WI P/CV
Size of Septic Tank- �56 6 Type of S.A.S. I.2'X 0
Description of Soil 0, '�, /ZUdiLc� *-,3 u-'a5®i -a , vin k ',Aeka� cy844d .
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
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 the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. a Date Issued s`
-UE�9ro�9^.GitiGINEER MUST SUPERVISE
THE COMMONWEALTH OF MASSACHUSETTISSTALLATION AND CERTIFY IN WRITING
BARNSTABLE, MASSACHUSETTS THE SYSTEM WAS INSTALLED W STRICT
ACCORDANCE TO PLAN.
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( Repaired( ) Upgraded( )
Abandoned( )by
at has been constructed in accordance
with the provisions of Title 5 an the for Disposal System Construction Permit No. ""/0� dated
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
/
No.
-- _ —�— _ —��= —————————————————————————— —
Fee
%1�; THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
DESIGNING ENGINEER MUST SUPERVISE
Migpogal *pgtem Congtruction NAND CERTIFY IN WRITING
WAS INSTALLED IN STRICT
Permission is hereby granted to Construct CN4 Repair( )Upgrade( )Abandon�CC)ORDANCE TO PLAN,
System located at a� �. !j Na
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.
Provided:Construction must be completed within three years of the date of this permit.
Date: Approved by
W
•� No. / :'�: _ Fee
THE COMMONWEALTH OF MASSACHUSETTS ,. . Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN :OF BARNSTABLE., MASSACHUSETTS
3pprication for 10igpogat �pgtem �tCongtructio"n ntt
. Application for a Permit to Construct(�Repair( )Upgrade`(-,)Abandon Vcomplete System O Individual Components
P .
Location Address or Lot No. Owner's Name,Address and Tel.No.
vl keg kai , dtk�w i Ite 4{59�e i. i/le ;� kla�.td s 7'vu.s t ,//�1''&XV e r
Assessor's p/Parcel �,Hc,., .'Z�li{Q,/G� f.
Installer's Name,Address;,and Tel.No. Designer's Name,Address and Tel.No.
Type of Building: �O' Lot
Dwelling d' No:of Bedrooms Size /S�sq.ft. Garbage Grinder WO
Other Type of Building �� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 3 gallons.
Plan Date /d `.36 Number of sheets Revision Date
Title C�..ts aF4 LT/ PAT ��t — OS*-zli/
Size of Septic Tank /56 6 (5d,/ Type of S.A.S. /.;Z 'X 4/6 c-t -iri eJ6f
J -
Description of Soil 0' —, ' /�0 d w., 0-SaI5d 3 a ' da LAed i[,t int 4,t to� .
f
�1 Pam(%/�trvt 4-0TTltie �e>r4 d AJ6 Gci►-
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: '
Agreement:
\ s-\ 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 the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Board of Health.
Signed Date
Application Approved by Date/,.' trr
Application Disapproved for the following reasons
i
Permit No. Date Issued
---------------------------------------
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 94 ca4l`t / / has been constructed in accordance
with the provisions of Title-5 an the for Disposal System Construction Permit�No. dated V
Installer Designer
T13e issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
———————————————————————————————————————
411� Fee /AV"
'. THE COMMONWEALTH OF MASSACHUSETTS
-PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Migpogar bpgtem Congtruction Permit
Permission is hereby granted to Construct('16 Repair( )Upgrade( )Abandon( )
System located at Q q7 :SW4,,J We '
and as described in the abtove Application for Disposal System Construction Permit. The applicant recognizesNs/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction mtst be completed within three years of the date of this permit.
4..
Date: Approved by /
i $ r
...... . . ..
• D�Si�-+-i yATA
'51WC,4-= FAMIL`{ 3 gIDR St c�l� •e o ff'Z.
}.YO GAIz13ALr- e,4z4QV tom. �
I Jtis �rr�P��� S � b� ha li �c,. Coash=,.cfcc�
VML_ PLOW = 3 x Ito =300 L k G FA ST U ii+ V ,,#Iu fVefz*CAD
S1cPTG TJ4Nl' • 3$U X'lOo =GGD - Sr�,� I.ovicic �5 BcAroarm Una+)
u51: 1500 GAL.
t.S;AGL1 t11G 5'(STl✓�KSfGN 5c.P+mic.
.tYl1ov\0rorjrtJ of ✓rj#lvent 5hc.t1 Be .16 .
AT;pu GATION A¢EA 2GQ'D. D,E=.P Rcp►r'e-ncw+s
30 GPD -LO--) SF : 4-4.(o
,�ppUG1j.T10N AM �1�SlbIJ
IME- TALL Atha= o,
VbtroM A OA.=
-ram /m4 :
PEQLoc�.T IDIJl� �- 5 N1'►:s 5�°r`.'ctt
OF
STEPH ENi
' ALLYNf X.
WILS a
ray.tears
,�°� ,q.�►���� 4-"Pam, P►PE �+� �� . � ,
• � i UN. .32,D
LAL �
C- — SQi1L
D TA►f-
S
7j u"I't
Kt� lb lEL � YizOFtt. - 1� Pa, Tv PAC
�1-'4 PVC.. 5cttrm4c
CEZ-nPjGD PLOT PLAI1
_1Z v-Lv I-OeAT low 05-IGZ/I
WnNr1'
,5 ) sTvUc .56At_ - : ( �. %
I GE�T1 FY. T1-IAT 't-N E. • Row E SAOWW pLAfJ R�Q�N� e
4aZSOr4 cxtPL`JS ViITA •Tj4E SIDEL.1felt= AI.ID . w 1 nL TJ A::� ZZ•
5�-fBAGV- zWUIzSME.WT DF T14 'TOY-P, of p l r..N I?AP1�L
'B at2NSTMLaAQn : L5 pui L-Oe-ATeD W 1 ra i N h
SPs�IAL Fts�c7 �4dZAtLD ZONE. BA)h�Q- !. HyE 1"4C
MID 15LNVEYGILS • �J 1 G I I.16Elu
a5rc -vi LLrr = . MASS•
DF'FSeT MOM 15VILZAW,6 '5PO X?' NOT' DS APPLiCAN r., /qC
USED' �U i�-r�aBcas>a Prsope¢Ty LiIJES. ' shaw,, Cunstrucficn
The dwelling shall be limited to 2 bedrooms unless the septic system is modified to
include enhanced nutrient removal as approved by the Board of Health in which case a
dwelling served by a modified system 1may be permitted to have not more than 3
bedrooms. ,
REVISED:. w.
t t
w/FAvT Unit �X ,
pt O
� Prop,.fkcl�
f '
17 (-
Fjr]r
20/ Ga+�/r( EIh h .
js
�s
Of
fir
1
n Q}�
V4tL DC4
Y SG�}LE
D�st�.►-i _DATA.
'5iWe,L s F4M IL-( 3 gIDR�wl st�� i o f Z
I . .i bils Prap�s�s� .5����s-. bhp(1 (fie, Ca,,s�Y�cfca0
PAIL- FWW = 3 x Ito =C3S0 LJ,4-k PA ST. U ii+ ~WAn u fvaterC4 5(
S�P'i1G T74N� • �aU ><'loo �GG� Sr►, •l.ovcicss.�S Bcdlroaw\ Une+)
use- 15oO GAL. .
L;AGI}IQ6 S`fSf'�JK VEft 1 �its�e.Ilc� In eitla lc lCdca l .
2 rYYlor �ori� o� . � luz.nt 5h«11 Be Tn .
A TTI U GAT10h4 AMA Q�q D. Acc0rc:Qu Acc La i 46k P. l�c�u►t'+ r►cv'�5
30 GPD
APPLIewn0H AarA �tti516N
STF-I44[N 404M
ALLYN 4. -
No.302A6
S T.P7 .c7
`i1=9t l�ac E-- 3Z ea
v' �r
�T
�tJ INS 318
�µ. t 3 31,5 15a� s
M �
30,g '.ibl 1SoIC
_ u•no$
I 3 t'c b.�f 'VEI � Y�OFIL.�- You--' PI, PC- 'tom P.�C
��►.�C �Z� A-I * PVC,. Scl{t �C
P-OT PL.ALI
I'/z 1��A,Tiri . l,c.� Mllc
P G 16* .� �1-U-L( W�S H K) sTv lJc Scat_- "_: ¢v.� `DATE 1:
• ► ���1=Y i-t-+a r �++�.t'�� ��SIN �tJ,.0 �.�a � p
4EZW J CoMpL- !S WIT;A ^T4}E SIDF-L%WZ At.tn l 1� fJ� f�' Z
, B- TN
�.
; V- �EQIJI�EMlrNT OF r- TN Ow of MAP `Lf PAL _g
BNZNsTAdiLGA"'O . I. . pvi LLlGATED WIr4iN A
'Sp6UAL MrOP HA71Atzb ZONE. 2sA)C'1�Q- NyE tl.1G
I_A► r) 5U2VVCV4 • �1JGIN6IrY�f
OFFSeT-, MY-0M 15vILDIW,6 4POUXD WO' g� Af'i�L-lG4NT: c�yaavo� Cuhsfruct�an
L)6M TD S6TAbUSA Pr7OFeaT`/
The dwelling shall be limited to 2 bedrooms unless the septic system is modified to
include enhanced nutrient removal as approved by the Board of Health in which case a
dwelling served by a modified system may be permitted to have not more than 3
bedrooms:
REVISED."
t
RergiAvc-
i
00,
ci
tz��F'PrST Unri w'
Y /
M
0
Prof l�c7C�
7f of
lot
yiplm
J
! 0
Tve o FJ 36,10 .
Zoe
i
o
tb g- .. Y � 1�.i r-L• �T
STEPHEN
YY t
ALLY-N
VALSOM
41131J 20'
�ga2;
i
4" PVC
ROOF VENT
100•00, NOTE: DESIGN FLOW = 330 GALLON S/DAY
SURFACE DENT L OCA T/ON TO
BE DETERMINED IN THE FIELD
— —— —
N X t I RESERVE AREA I LEACH/NG FIELD.• FINISH GRADE = 35 TEE VENT TEST HOLE /NFORMAT/ON BY
BAXTER &• NYE, INC.
DisrRiauno Bo 4" VEN T PERCOLA TION RA TE < 5 MIN INCH
12' I 40'LONG, 12' WIDE PROPOSED HOUSE
————————— AND 1 DEEP (SEE DETAIL) TOP OF FOUNDATION = 35.0E COVER TO GRADE TO HOUSE COVER TO GRADE NO GROUNDWA TER ENCOUNTERED
may,
10' SOIL LOG
100E GALLON � 1.
1000 WA ------ MIN. s= 0.02 SLOPE \/\.�\.\
TCR \ DEPTH SOILS ELEV.
SEP77'C TANK
RUCK FILTER = O.Ot SLOPE i,/
11' WIDE X
14'LONG 1000 GALLON RUCKOSAND 6' MAXIMUM COVER 0 32.E
6'
I 1 6' r, BLACKWATER WITHOUT VENTING
RpOF/ r SEPTIC TANK o FILTER Dist. box 2' LOAMY
N r 00 (0 �? level
s= 0.01 = 001 SOIL ABSORBTION SYSTEM DESIGNED BY BAXTER & NYE, INC. 2 0' SAND 29.0
•� H-10 1000 GALLON II 11 n II
4 co 1000 GALLON
BLKWA TER AC I- I- I—
SEPT/C TANK � w Of X 00 GRAYWATER ,,� d
>_ >_ _ � � SEPTIC TA.NK: N
00
Z N NO Z Z Z Z
00
BOTTOM ELEV. 25.84 MEDIUM
In WW SAND
PROFILE H0 8
24.0o
6 CRUSHED COMPACTED STONE
o EXISTING Y w w 0- X 6 MEDIUM
o FOUNDATION Q w Not to Scale z z z z z TO
m 0 - FINE
BOTTOM OF TEST HOLE = 20.0 12' SAND 20.0
6" CRUSHED COMPACTED STONE DETERMINED BY OTHERS
PROPOSED
GARAGE
8'-6-
PROPOSED HOUSE
PLAN REFERENCE: TOP OF FOUNDATION = 35.00 • ' +..
COVER TO GRADE ALL ACCESS MANHOLE COVERS FOR
CERTIFIED PLOT PLAN BY `.� -2-20" Diameter Access Holes - ':. SEPTIC TANK, DISTRIBUTION BOX,
��� ' �' ' �� ' �� ' �''�'' /''/r'/r' r "' AND LEACHING STRUCTURE SET MORE .� 2-20" Diameter Access Holes .:. o
BAXTER & NYE, INC.SCAL a= 03$ �-- to THAN 6" BELOW FINISHED GRADE,
o E: 1 = 3Q
INLET OUTLET SHALL BE RAISED TO WITHIN 6" OF
PLAN DATE: 5/21/98 t 1
LOT 8 LOT 8 FALLING LEAF LANE FINISHED GRADE. INLET OUTLET
,:.
100E GALLON
OSTERVILLE, MA. GREYWATER
1 APPLICANT: McSHANE CONSTRUCTION Co. 00 SEPTIC TANK nCNI
J
100.00' I N f` (� 'Tc
N N
11 H-20 STEEL REINFORCED PRECAST CONCRETE FRAME & COVER
FALL//VG LEAF LANE II 11 OVER "T'S" WHERE REQUIRED. ' FRAME & COVER
STEEL REINFORCED PRECAST CONCRETE OVER "r'S" WHERE REQUIRED.
W W PLAN VIEW
PLAH MEW
z >
PRECAST CONCRETE
Z Z
REMOVABLE COVERS 6" TANK RISER WHERE PRECAST CONCRETE
REQUIRED �� REMOVABLE COVERS 3" TANK RISER WHERE
6" CRUSHED COMPACTED STONE 6" • ; ,.'^ } ^ 3 .»- �- REQUIRED
3 3" min. clearance required " INLET "T" 4"
PLAN VIEW OF RUCK SYSTEM LAYOUT w 13 ` le r c- requ r " ;
IN 2" min, inlet to outlet 6" min. 3" min. clearance required 13' INLET "7":
OUTLET IN $
1 " — 2 0' 10" min. �-2 min. inlet to outlets min.
GREYWATER F L 14" min. ,D" min. „ OUTLET
o a c II L 14 min,
t� = y r`
E ° TUF-TITE E I 4) E m I
Not to Scale o 9 GAS BAFFLE o t° IIE TUF-TITE
d v a GAS BAFFLE
J
, .
;.
... . —�t
"PERMALON PLY 210 8'
14 0" 5' 3" _ . :y
: ..
-_
CONTAINMENT LINEREND—SECTION
��-�"
m OR APPROVED EQUAL CROSS—SECTION __p
CROSS SECTION END—SECTION
• TYPICAL 1000 GALLON SEPTIC TANK CH-20 LOADLNG) TYPICAL 1000 GALLON ,SEPTIC TANK (H-10 LOA INGPERT. 2" PVC PIPE (VENTS) DeSlgn Clrlterla �
NOT TO SCALE
__________________________________________________�-�___- NOT TO SCALE
11 � I
Number of bedrooms: 3 Equivalent to 330 gal.'s/day
Garbage disposal unit: NO
PERF. 4" PVC PIPE (DISTRIBUTION) Leachingarea - capacity required: 330 al.'s da ALL OUTLET PIPES FROM THE INSTALL TUTLTE SPEED LEVELERS
� I _ , , P y q g / y DISTRIBUTION BOX SHALL BE ON ALL OUTLET PIPES
4" PVC PIPE o_ , , Side area proposed: 0 sq. ft. 5 16. --
SET LEVEL FOR AT LEAST 2 FT. CONCRETE COVER
7 „ Bottom area proposed: 480 sq. ft.
PERF. 4 PVC PIPE (COLLECTION)--,,,.., I I
--�I-------------------------------------------- ------- Total area proposed: 480 sq. ft. „
11' I I ______-" __-- _ _ 5 - 5 OUTLET
--�r------------------------------------------- „ Proposed leaching capacity: 355 gal. s/day r `.� KNOCKOUTS
Water supply: Town ,
I I PITCH i i I � » „
Precast concrete units: H-10 & H-20 loading design , ; 15.5 INLET 19.5
q , I 1 1 A i OUTLET t ' t ' NOTICE
a PERF. 4" PVC PIPE (DISTRIBUTION) I I ��� ri Unless and until such time as the original (red) stamp of the
11.25" responsible Professional Engineer appears on this plan
(A) no person or persons, including any municipal or other
• i i -- -- '� i public officials, may rely upon the information contained herein; and
I IL
B this Ian remains the property of Innovative RUCKS stems, Inc.
J------------------- -1L------ 2O O P P P Y Y
-------------------------------------------
PERF. 2" PVC PIPE (VENTS) PLAN SECTION CROSS- SECTION
SCREEN THE SIDES OF THE FILTER MAY BE SLOPED. THE REQUIRED AREA OF THE
FILTER SHALL BE THE MIDDLE LAYER OF THE INDRAINS.
m HEIGH BE 3' ABOVE THE CONTAINMENT LINER SHALL BE CAPABLE OF WITHSTANDING A PH OF 3.0 6 HOLE DISTRIBUTION BOX THE RUCK DESIGN IS SUBJECT TO A PATENT
T TO
AND REMAINS THE EXCLUSIVE PROPERTY
FINISH GRADE
4" DIA. PVC PIPE OF INNOVATIVE RUCK SYSTEMS, INC.
4" DIA. VENT PIPE TO BE VENTED BACK (VENT) NOT TO SCALE COPYING OR INFRINGEMENT OF
TO THE FACILITY AND UP THROUGH ROOF TO
THIS DESIGN IS PROHIBITED.
SAME ELEVATION AS PLUMBING VENT SLOPE
FILTER CLOTH- TYPAR 3401
AS MANUFACTURED BY LINQ GEOTEXTILE „
18 OVERLAP BETWEEN LINER DIVISION OR APPROVED EQUAL 18 OVERLAP BETWEEN LINER 4" VENT TO FACILITY
AND FILTER CLOTH AND FILTER CLOTH GENERAL ''NOTES
0 0 0 0 0 p p 0 0 0 0 0 0 0 0 0 o o 0 o o 0 0 0 0 0 p p 0 6' STONE- MMM 0 0 0 0 0 0 0 0 0 E DATE DESCRIPTION Drawn Necked
INS I I 7" INDRAINS
2 LAYER OF 1/8 4" PERFORATED
GRATED PVC PIP
No chan o Issystem sa m
.,: .:::,::; �.•::.,:,.,...: . ...:.:::::.:..;�•,.::.,, ,,.:.:. ..... T 1 ' STONE Eapprovedgnwriting
.. ... .. ... .. .:. ... .. . . . .... . .. .. ..:: . .. ... . . .... .. .. ..: ... . .. ..: .. ..:. » .,... ... ,. .. , ., :.. .:....:%.::: :,:.:: I— .. � . „ . I . ,-. :.... :.: :;.-::;.:;�..;; . ,.';:.�., :::•;:.� .. .. . . 0 2 TOE I b nnovative RUCK Systems,a n Inc.
5 SAND. <. � g•. i � 0 N S
r
I.. L. r
PERMALON PLY 210 - 2 STONE-- )
CONTAINMENT LINER 2 Subject to inspection during construction by the PLOT PLAN
>
OR APPROVED EQUAL 1. .. 7" INDRAINS , , z 7" INDRAINS I I _ Board of Health and Innovative RUCK Systems, Inc.
_ » . 4 4 OF PRO SYSTEM
::.:
� I.. 3 Heavyconstruction equipment shall not travel
i 5 SAND` r. 'r: :,.
N — » »
1 0 3/4 To 1 1/2 over disposal system during or after construction. PREPARED FOR
2" STONE- ,
I I 7 INDRAINS I I � 7 IN NS WASHED STONE 4 Disposal system to be constructed in accordance McSHANE CONSTRUCTION
,..:...
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5 SAND, i 4. ►. : : with Title 5 of the State Environmental Code. FOR LOT 8, FALLING LEAF LANE
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� oNE 5 A copy. of these plans must be kept the •t
�•PITCH'`
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Burin time f OSTERVILLE MA
the t e o construction.
BARNSTA L�_3.0' 6.0 B E 30 9
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6) A copy of these plans must be furnished to the
4" PVC PIPE contractor constructing the disposal system.
4" LAYER OF COMPACTED (DRAIN) LEACHING FIELD CROSS SECTION 7 Before backfillin the contractor shall notify SCALE: AS SHOWN DATE: JULY 31 , 1988 n �,,:N,
4 LAYER OF COMPACTED ) 9�
FINE SAND NOTE: DUE TO VARYING METHODS FINE SAND SECTION B � PROVIDE 1-1 4" PITCH FROM (BY BAXTER & NYE, INC.) Innovative RUCK Systems Inc., Or the Board of Health
4" DIA. PERFORATED PVC PIPE OF INSTALLING THE LINER, THE CONTRACTOR EDGE TO CENTER. NOT TO SCALE Agent to inspect the system as constructed. Innovative RUCK Systems, Inc. R;
SHALL FURNISH SHOP DRAWINGS DESCRIBING g P y 200 main Street
SECTION A—A THE INSTALLATION FOR REVIEW AND APPROVAL
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falmouth, ma. 02540 �
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RUCK SAND FILTER DRAWN: TMS CHECKED:
NOT TO SCALE
98314.DWG LIC. NO.: 0201188314 DWG. NO.: 70-1 -27 SHEET 1 of 1