Loading...
HomeMy WebLinkAbout0049 JOBY'S LANE - Health 49 Joby's`Larie ®sterville A = 120 - 084 17 IW 14 IV o F a .. .' .z• -.. ., , .,.. a ,.' . ° .. ;. ., _ ,,' m "° � .. - ti . _ � s ' 0 x ° a _ m m s v a m < _ v N m • 1 n c a ° � u n , r c n e m II S 4S � 6 ` . ° a o r ° Crocker, Sharon From: Crocker, Sharon Sent: Thursday, April 22, 2021 3:03 PM To: Malkus, Karen Cc: _ Crocker,-Sharon Subject: r +� 49 Joby's Ln Ost - OMNI System New owner, Ed Walker called to see if he had a system which needs monitoring. I told him yes. He is going to contact Bennett Environment, etc and get a contract signed to monitor 2xyr—per last owner. Sharon Crocker Office Manager Town of Barnstable—Health 508-862-4739 The information contained in this electronic transmission("e-mail'),including any attachment(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative and pre-decisional in nature.As such,it is for internal use only.The Information may not be disclosed without the prior written consent of the Director of Public Health and/or the Town Attorney's Office of the Town of Barnstable. If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward it.Thank you for your cooperation. iy y. 1 ; G� Inspection report stored on Q drive : Q:\IA Systems\I-A Inspection Reports Cis 6 F BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (A Natural Systems Utilities Company) LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 508-896-1706 Brewster,MA 02631 Fax 508-896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental 9/12/19 K11005DA.S.IA.700 Protection Attention:Title 5 Program v 1 Winter Street-6th Floor Boston, MA 02108 REGARDING: Curtis Residence 49 Joby's Lane SHIPPING METHOD: Osterville, MA 02655 Regular Mail ❑ Pick Up Priority ❑ Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑ Green Card/RR ❑� COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems (December 2018; March and June 2019) 1 OMNI Environmental Systems, Inc. RSP Operation and Maintenance Checklist(December 2018; March and June 2019) 1 12/13/18 Alpha Analytical laboratory report 1 3/28/19 Alpha Analytical laboratory report 1 6/13/19 Alpha Analytical laboratory report ` For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑ REMARKS: r` Please find enclosed the DEP Inspection and O&M Forms, OMNI RSF.Operation and Maintenance Checklists, and laboratory analytical reports for operation and maintenance conducted at the above referenced property during the reporting period. At the time of this reporting, completion of the September 2019 operation event is pending. If you have any questions or require additional information, please contact us at your earliest convenience. Thank you. cc: Barnstable Board of Health[via email] Cathy Curtis-Property Owner[via email] FROM: Samantha Farrenkopf, Operations and Compliance Coordinator If enclosures are not as noted,kindly notify us at once f i Inspection report stored on Q drive: Q:\IA Systems\I-A Inspection Reports y � J Inspection report stored on Q drive : Q:\IA Systems\1-A Inspection Reports ti r ENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508) 896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: . Massachusetts Department of Environmental Protection 9/25/17 BEA17=11005 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Curtis Residence 49 Joby's Lane SHIPPING METHOD: Osterville;MA 02655 Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑X Green Card/RR ❑ 1. COPIES DATE DESCRIPTION, 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(June and September 2017), 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist(June and September 2017) - 1 6/20/17 Alpha Analytical laboratory report 4 'T(*J 1 9/12/17 Alpha Analytical laboratory report- Tt\j z)? ," !� !�11 For review and comment: [] For approval: ❑ As requested: ❑ For your use: ❑x REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI RSF Operation and Maintenance Checklists,and laboratory analytical reports for operation and maintenance conducted at the above referenced property during the reporting period. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health[via email] Cathy Curtis-Property Owner[via email] 8 FROM: Samantha Farrenkopf,Wastewater Program Manager If enclosures are not as noted,kindly notify us at once BENNETT ENVIRONMENTAL, ASSOCIATES, INC. ENN�T I N�II2®1V1@�N,IAL�SS(ICL�TES� INC. SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 - (508)896-1706 LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS 6 ENGINEERS -Brewster,MA 02631 - F fax(508)896-5109 - 1573 Main Street-P.O,Box 1743.Brewster,MA 02631 6 508-8.90-1706 6 Fax 508.896-5169 6 www.betinett-ea.com LETTER OF TRANSMITTAL TO: DATE: - JOBNUMBER: PROPOSAL . Massachusetts Department of Environmental Protection 4/12/17 Attention:Title 5 Program Match 3Q 2017 Various 1 Winter Street-6th Floor Boston,MA 02108 REGARDING:- Cathy J.Curtis , Alternative Septic.System Operation and Maintenance Contract 49 loby's Lane - Osterville,MA 02655 via email:ccurt]s0811@gmail.com SHIPPING METHOD: - RE: OPERATION AND MAINTENANCE CONTRACT Regular Mail ❑ Pick Up ❑ Innovative/Alternative,Wastewater Treatment System 491oby's Lane—Osterville,MA Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Dear Ms.Curtis, Certified Mail 0 GreenCard/RR 0 I BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provideyou with a budget estimate for professional services relative to the operation and maintenance of the COPIES DATE DESCRIPTION - Innovative/Alternative(IA)system located at the above referenced property. The collection and laboratory analysis of samples collected from the effluent ofthe septic treatmentsystemis a required 1 3/30/17 49 JOceon Cove Condominiums 16t Rome 28-West Harwich condition ofthe approved IA Wastewater Treatment System,as set forth b the Barnstable Board of 1 3/30/17 49]oby's Lane-Osterville � � - PP Y by the and the MassachusettsDepartment of Environmental Protectionto qualify treatment capacity on a quarterly basis. As such,work proposed by BEA includes the system inspection and collection of wastewater samples for laboratory analysis,as well as the preparation ofthe required fork for distribution to the appropriate town and state offices. Additionally,at the time of such sampling,blowers,filters and associated piping will be inspected to assure working condition, and regularly scheduled maintenance performed on a fixed cost basis Will be invoiced quarterly. Should any repair of For review and comment: ❑ For approval: As requested: ❑ For your use: 0 treatment system components replacementbe required,oradditional sampling beyond the quarterly requirements necessary,you willbe notified to authorize the additional expenses.Suchworkwil[be REMARKS: conducted on a time and expense basis,portal to portal. Please find enclosed the authorized Operation and Maintenance Contracts for operation of the alternative septic systems located at the The following budget rapl•esents estimated annual costs through one year ofservica to include above referenced properties.Thank you. _ - four sampling and inspection events, These annual costs are valid for two years subsequent to the cc.Harwich Board of Health[Ocean Cove Condominiums-via email] first inspection. PIease note that this contract runs With the property. As such, it is your Barnstable Board of Health[49 Joby s Lane-via email] responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore,you are required to notify any buyer for the transfer'ofthis"' """""' " contract. t • i EMERGENCYSPILLRESPONSE 6 wAsTESrrE CLEANUP 6 SREASSESSMENT C PERMITTING 6 SEPTIC DESIGN INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION 8 MAINTENANCE FROM: Samantha Farrenkopf,Wastewater Program Manager If enclosares are not as noted,kindly notify to at once _ I (S , MARCH2o,2017 - CURTIStPROPOSAL _ PAGE 2 OF 2 VA Wwr O&M - QUARTERLY INSPDCTION/MAINTENANCE/SAMPLING bwPmtl/Asystem andtakefield meosurernmts of dissolved oxygen,pH andtmbidlty.Collectquarterlyaeakd effluent , wastewater•samples under aproperchain-of-custody for analysis by a MAeertifredlaboratoryof dtrite/nitrateiTKmfor total nitrogen,BOD and TSS. At the time of sampling events the conditions of the system will be inspected and documented with regards to die blower units,sludge level and associated piping. REPORTING/FILING Review laboratory results relative to conditional requirements of the system under the MA DEP and local Board of I-Iealthapprovals.Submit inspectionand sampling reports tothe Barnstable County Septic Database onaquarterlybash. - Prepare DEP transmittal forms on a quarterly basis.Submit laboratory report and DEP transmittal forms to MA DEP, local Board of Health,and associated wadors/contmctors,as appropriate,on an annual basis. Professional Services $1,025.00 _ Laboratory Analysis[4X—nitrite/nitrateMCN,BOD,TSSI $ 345.92 TOTAL ANNUAL EXPENSE: $1,370.92° TOTAL COST PER EVENT: $342.73 - *Note.YA systemslocated in Barnstable County arc required to report inspection andsemplingresulis on the MA Septic i online database for use by the Barnstable County Department of Health and Environment(BCDHE)and Ore local Boards. - ufl3ea0b.At this time,BCDHE bas found itnecessaryto institute annual user fees for filing on this required database. j This fee is$50 per year.This fee will be included in an invoice to you on an annual basis Therefore,ifyou are in agreement and wish to proceed with the work as outlined,please sign the authorization belowindicating acknowledgement and acceptance ofourT'eons&Conditions and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. i very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES,INC. bO-1R�l�AS'�' SamanthaFarrenkopf,WWTO Wastewater Program Manager cc: Kam Risk-Business Manager encl. Abbreviated Termsry&Conditions(2011)/Fee Schedule(2016) AUTHORIZATION' DATE: '4�- t I / ! u KJ�wW`+1I2 INC*' BENNETTENVIRONMENT'AL 'ASSOCIATES� INC LICENSED SITE PROFESSIONALS © ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS ©-SANITARIANS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631.0 508-896-1706 0 Fax 508-896-5109 www.bennett-ea.com ro 2,y PROPOSAL February 8,2010 Ms. Chapman Greeley P.O.Box 662 Osterville,MA 02655 t NLEe p Y RE: OPERATION AND MAINTENANCE CONTRACT Innovative/Alt ent Svsten� ` 49 Joby's Lane,.Osterville,MA Dear Ms. Greeley; BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for professional services relative to the operation and maintenance,of the _ innovative/alternative septic system located at the above referenced property. The-semi-annual system inspection and laboratory analysis of samples collected from the effluent of the septic treatment system is a required condition of the approved Innovative Wastewater Treatment System, as set forth by the Massachusetts Department of Environmental Protection (MA IDEP) and the Barnstable Board of Health to qualify treatment capacity. As such, work proposed by BEA includes the collection of wastewater samples for field screening and the preparation of the required forms for distribution to the appropriate town and state offices as well as you. Additionally,at the time of such sampling,blowers,filters and associated piping will be inspected to assure working.condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced on a semi-annual basis. Should any repair or treatment system component replacement be required, or additional sampling beyond the semi-annual requirements necessary,you will be notified to authorize.the additional work and expenses. The following budget represents estimated annual costs through one year of service to include two sampling and inspection events. These annual costs are valid for two years subsequent to the date of the first inspection. 3 SEMI-ANNUAL INSPECTION/.MAINTENANCE/SAMPLING Inspect I/A system and take field measurements of dissolved oxygen,pH and turbidity._,Collect semi-annual treated effluent wastewater samples under a proper chain-of-custody for analysis by a MA certified laboratory for analysis of BOD,TSS,and nitrite/nitrate/TKN for total nitrogen. At the time of sampling events the conditions of the system will be inspected and documented with regards to the blower units,sludge level and associated piping: .EMERGENCY SPILL RESPONSE WASTE SITE CLEANUP Q SITEASSESSMENT 6 ENVIRONMENTAL PERMITTING LAND USE PLANNING WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE Q WASTEWATER TREATMENT,OPERATION&MAINTENANCE FEBRUARY 8,2010 GREELEY/PROPOSAL PAGE 2 OF 2 ` 49 JOBrS LANE,OSTERVE LE,MA REPORTING/kUlNG Review laboratory results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms on a semi-annual basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Fees Operation&Maintenance and Monitoring $ 370.00 Laboratory Analysis[2X—TSS,BOD,TN(nitrite,nitrate,TKN)] $ 236.51 TOTAL ANNUAL EXPENSE:.. $606.51r TOTAL COST PER EVENT: $303.26, Note:I/A systems located in Barnstable County are required to report inspectionand sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of l-lealth. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. While the alternative septic system at your residence is currently classified as requiring quarterly operation and maintenance,the Barnstable-Health A�ent has specifically requested'us to rovide a semi-annual contract in recognition of the seasonal use of the residence. Operation and maintenance will be performed in accordance with the schedule approved by the Barnstable Board of 6614 Health and you will be notified of any necessary changes to this contract as a result of their approval.af Therefore,if you are in agreement and wish to proceed with the work as outlined,please sign the authorization below to indicating acknowledgement and acceptance of our Terms&Conditions, and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office. e t Very truly yours, , BENNETT ENVIRONMENTAL ASSOCIATES,INC. Samantha Farrenkopf Wastewater Program Coordinator cc: Kara Risk,Business Manager Dr. Wayne Miller, Chairman,Barnstable Board of Health encl. Terms &Conditions(2009)/Fee Schedule(2010) AUTHORIZATION: ATE: IC' Sod-4z�- Hq I _ ^w ct - ° Town of Barnstable " , Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MS Wayne Miller,M.D. June 6, 2005 Mr. Peter Sullivan Sullivan Engineering, Inc. P.O. Box 659 Osterville, MA 02655 RE::,'�149_Ioby's Lane, Osterville_ A= 120-084 Dear Mr. Sullivan, You are granted permission on behalf of your client, Peter Marney, to construct and utilize an innovative/alternat_ive(I/A) nitrogen reduction system at 49 Joby's Lane, Osterville, Massachusetts. This permission is granted with the following conditions: (1) No more than two (2) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The floor plan shall be revised to show no more than two bedrooms at this property. (3) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to two (2) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent.prior to obtaining a disposal works construction permit. (4) The system shall be installed in strict accordance with the engineered plans dated April 19, 2005. (5) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health Sullivan mameyLA System I u that the system was installed in substantial compliance with the submitted plans dated April 19, 2005. (6) The wastewater effluent shall be tested quarterly for the first two years of operation. (7) In addition to testing the effluent for total suspended solids, BOD, and total Nitrogen as originally proposed to the Board, the effluent shall also be tested for the following parameters: Nitrate, and TKN. (8) The applicant shall submit a copy of the signed two-year Operation and Maintenance Agreement (O&M) between the contractor and the homeowner to the Board of Health. The engineer or O& M contractor shall conduct inspections to the I/A system a minimum of twice yearly, (9) The effluent discharge concentrations shall meet the requirements and standards detailed in 310 CMR 15.202 (4) of the State Environmental Code, Title 5. The total nitrogen (TN) effluent discharge concentration shall not exceed 19 mg/liter. This permission is granted because the proposed plan appears to meet all of the provisions of the State Environmental Code, Title 5 and all of the Town of. Barnstable Board of Health Regulations. Sinc rely yo4rP, Wayn iller, M.D. Chairm n Sullivan mameyIASystem TOWN OF BARNSTABLE LOCATION qq Onk S Lune— SEWAGE # VILLAGE :ST&r Vi l le ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO..Alin baa4 �e.in t� �t��3(Q1--Z 2� SEPTIC TANK CAPACITY l.S'-D GRah Le N�o i e LEACHING FACILITY: (type) Q (size) AS,a®3 NO.OF BEDROOMS a� BUILDER OR OWNER RTer A,R N l=l/ PERMTTDATE: COMPLIANCE DATE: 4 Z Z 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 t Ro _ > � s . t 0 1 y, 14' 17K I� 1 eyy" , q7P ��, _ ' t No: �� J— — • _ .;� Fee Sd THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppftratton for 30t5pozal Opotem Con!6truction Permit Application for a Permit to Construct('Repair( )Upgrade( )Abandon( ) C�Complete System ❑Individual Components Location Address or Lot No. Y9 3b6y S L-^k, 64crAjtq Owner's Name,Address and Tel.No. �1ec �1�^R7 Assessor's Map/Parcel cis Vale s Installer's Name,Address,and Tel.No. Desiggner's N Su(1� ame,Address�and, Tel.No. J4� E�ih4R�.� v VA e o Jke, MA- oz,ss Sa�3- 28 Type of Building: Dwelling No.of Bedrooms Lot Size S_I,SZZ sq.ft. Garbage Grinder(IUO) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design.Flow ZZ-0 gallons per day. Calculated daily flow 33 gallons. Plan Date c;` 11 ZM'5_ Number of sheets Z Revision Date' Title Pvv tie, P rk ��,g��L 5)6" + '/T ;jjQVS L_4 n.e Size of Septic Tank 00 (v" Type of S.A.S. 2—Sob&A(- P acn6m i7` Description of Soil 0-8" L 0--1 " — 6; S- e � e 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 Environmednt, Code nd not to place the system in operation until a Certifi- cate of Compliance has been issued by •hid of Idealth. Si Date �. Application Approved b Date Application Disapproved for the following reasons Permit No. Jam' �"(1 Date Issued v t, No: C� O -, -• `�` , r 1 Fee So r , tr . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ` PUBLIC HSA..LTH DIVISION -TOWN OF BARNSTABLES'MASSr U(SETTS Yes 0(pprtcation for Mfgpogar bps tem Congtruction Permit Application for a Permit ,to, (L- 'Repair( )Upgrade( )Abandon( ) flZomplete System ❑Individual Components Location Address or Lot No. Y9 Za6y5 L-in-e, ()� rvdR Owner's Name,Address and Tel.No. t \ 4�'�er 1�kn Q r Assessor's Map/Parcel /ZO _0 P.O`soy,Z A �� � C�efv�l UZ(aSS- Installer's Name,Address,and Tel.No ' Designer's Name,Address and Tel.No. �°inn k? hn2c�✓f C� r v;lie . 1q— UZ..(oSs Sb8-yZB-334� Type of Building: / Dwelling No.7of Bedrooms Z Lot Size .S� ,SZZ sq.ft. Garbage Grinder(Na) Other Type of Building No.of Persons Showers( ) Cafeteria.( ) 4 t Other Fixtures o( Design Flow ZZy gallons per day. Calculated daily flow 33 l gallons. ;z Plan Date Ot,t 19 .ZCb Number of sheets Z. Revision Date Title 400#.,e rk Al Size of Septic Tank 0 (,A1-" Type of S.A.S. ?_-Sow&At_ Q"gen6(rs 'in Iz*ZS FIcZ D Description of Soil 04% 0-1-7`i i L _Z !3k4. M ec w .`Y 17-9 e-( t-c er Ze ZY(�p ) (q AA,uv.� 4, Nature of Re pairs-or Alterations(Answer when applicable) Date last inspected: � Agreement: ° " ,Th-6un4e`rsigned 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 Environmerital Code nd not to place the system in operation until a Certifi- cate of Compliance has been issued by thy"-B-and of ealth. Signed Date Application Approved Date _ Application Disapproved for the following reasons \ i .� Permit No. .-Z�C� S c� 7�' Date Issued h P20 {! ------------------ --------�' -------------- THE COMMONWEALTH OF MASSACHUSETTS ' h BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned( )by k 0-VI h,,^Q 6 ` at L1 b J-- l,a-.12 - j �1�8c '; has been constructed in acco'dance with the provisions of Title 5 and the for Disposal System Construction Permit No. -)Cc 5 `)'9dated adInstaller nVn•+.-.05�_ `Designer U The issuance of this ermit shall not be construed as a guarantee that the syster6`wj u �o�as designed. �- Date ---r1 ( 'S :r I Inspector �y i l,e►_ _.- i No. �J 5 � t/v �' ----------.—----------- —Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migool *pgtem Congtruction Permit Permission is hereby granted to Construct(- )Repair( )Upgrade( )Abandon( ) System located at � nj2j< Long,r (J utA�,p _ 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: Construe 'on must be completed within three years of the date of this permi . Date: s_ Approved by r Town of Barnstable ` Regulatory Services . Thomas F. Geiter,Director Public Health Division rEoi` Thomas McKean,Director .200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: US Designer: . Installer: Address: 7� l�c�r 1fZa,c Address: ��/ On �)_016 S �ekivr was issued a permit to install a (date) (installer) septic system at b Lc,,,-P 0Sr'.r��� based on a design drawn by (address) v1 eer, dated (Zlesigner)-3 V/10" I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribi4tion box id/or septic tank.-Or tj-Z1314%\'"LA-e-re CTc,q'neAkA by�+5r th��rJ bA r%A - revi,,ef �' � "I';}\e V. t1-io Tams were �s O I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical.relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. _' -- OF SU AN (Inst 'e'?s Si NO.29733 CIVIL (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO B ARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COyIPLLAINCE WILL NOT BE :ISSUED UNTIL BOTH THIS FORM ILND AS- BUILT CARD ARE RECEIVED BY THE B_ARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form xv... (SEA ) 54 -0343 OFFICE I'.Q. L3QX 128 MANUFACTURING 465 East Falmouth Highway Falmouth Technology Park East Falmouth, MA 02536Systems,mv,, 520 Thomas B. Landers lead Fast Falmouth, MA 02535 April 27, 2005 Mr. Peter Marney P.O. Box 29 Osterville, MA 02655 RE: 49 Jobys Lane, Osterville—Sampling Services Dear Mr. Marney: / OMNI Environmental Systems, Inc. (OMNI) is pleased to submit the following Testing Contract for your review and approval. This contract is an agreement by OMNI to provide the services necessary for performing the sampling(testing)of an Innovative/Alternative(I/A)Septic Technology located at the above referenced property as required and outlined in the local and/or state septic system approvals. The OMNI Sampling (testing)Contract has been designed to fulfill the Department of Environmental Protection (DEP) and local Board of Health requirements for sampling of an approved (I/A) technology. This contract is based-on the information supplied to OMNI by the system owner and/or their representative(s) with regard to sampling requirements. OMNI will supply all lab fees and equipment outlined in the proposed contract.OMNI will also supply certified wastewater technicians specially trained with regard to operation and maintenance standards and practices for Innovative and Alternative Technologies. The outlined contract does not include any operation and maintenance services or repairs. The homeowner is responsible for the following: supplying OMNI with all local and state septic system approvals, payments as outlined for sampling services, and contracting with qualified personnel for operation and maintenance of the system as recommended by the manufacturer. For your convenience OMNI accepts all maior credit cards and is now offering payment options for customers with accounts in good standing. Please note,for monthly payments options a credit card is required. If you choose the monthly payment options you will be contacted by OMNI to setup your account. Please carefully read all Terms and Conditions listed below. Should you have any questions with regard to the Contract, Terms and Conditions or any additional services, please feel free to contact our office. You may authorize the contract by signing and returning a copy with the first payment installment. Sincerely your Mathew.C. Costa, President OMNI Environmental Systems, Inc. Alternative Septic Technology p OMNI Environmental Systems, Tr=c, Contract for Sampling lTesting) Services Owners Name Peter Marney Home Address System Location 49 Jobys Lane City,State Zip Town Osterville Phone 617 212-5961 DEP File No. Billing Address P.O.Box 29 System Type OMNI RSF City,State Zip Osterville,MA 02655 Contract Terms 2 Years Contract Start I Upon issuance of Occu an Permit NOTE:OMNI Environmental Systems shall not be responsible for any misuse or improper operation by non-omni personnel or the system owner,and any operation NOT in accordance with the OMNI RSF System Owner's and Operator's Manual. Terms and Agreement for Sampling Services Innovative/Alternative Technology OMNI is hereby authorized to render sampling(testing)services for the Innovative/Alternative Technology listed at the above address for the contract period specified above under"Contract Terms". This agreement may be terminated or extended by the system owner by providing OMNI Environmental Systems, Inc(OMNI)with 30 days written notice of intent. OMNI will provide the system owner with thirty (30) days written notice of its changes to the current pricing schedule. The system owner will not be obligated to renew contract in the event of any pricing changes. OMNI will be obligated to provide all prepaid services in the event of any pricing changes. This Contract DOES NOT INCLUDE any Standard and Preventative Maintenance,costsloccasioned by neglect;misuse and accident or consumables, and any travel costs for the Islands or locations not within a 20 mile radius of East Falmouth. This Contract DOES NOT COVER ANY OPERATION AND MAINTENANCE SERVICES. This Contract includes monthly testing for the first six months of operation,and quarterly samples thereafter tested for Total Suspended Solids(TSS),Nitrate Nitrogen(NO3-N),Total Kjeldahl Nitrogen(TKN),Nitrite Nitrogen(NO2- N),influent Carbonaceous Biochemical Oxygen Demand(CBOD)and/or effluent Carbonaceous Biochemical Oxygen Demand,and pH by a Commonwealth of Massachusetts certified laboratory. In consideration of the services contained in this agreement the system owner agrees to pay OMNI Environmental Systems, Inc. the sum specified in the payment options section for the above referenced sampling contract on a prepayment basis.Payment is due fifteen(15)days from Invoice Date prior to execution of services and will be subject to any applicable late charges. Monthly payees are excluded from prepayment requirements and must contact OMNI for account setup. This agreement is not assignable by either party and is non-refundable for any prepaid services.This agreement will not become effective until the first payment(outlined below)has been received by OMNI. If the terms and conditions contained herein,including the terms and conditions set forth on the enclosed documentation titled TERMS AND CONDITIONS,are acceptable,kindly sign and return one(1)copy of this contract along with the first payment. It is understood and agreed that the foregoing, including the TERMS AND CONDITIONS set forth will constitute the full and complete agreement between the parties to this agreement. The contract offer expires thirty(30)days from the date hereof,but may be accepted at any later date at the sole option of OMNI. The undersigned agrees to the following payment schedule: Select payment option below by marking appropriate box. See Terms and Conditions for details on pa ments options. L. Payment 0 tions: $63 Monthly $195 Quarterly0 $385 Semi-Annual❑ $750 Yearly' The above costs, Project Scope of Work, terms and conditions are satisfactory and are hereby accepted. OMNI is hereby authorized to provide the services as specified. Auth ri ed OifnNI ersonn I Date / T IZrt E- nt Name(Owner) ' stem Owner Signature Dat Alternative Septic Technology Man€ifatitUring o TestEng o Mainte,nanc VOL,IPA tJ Ervirr i'Mental Systerns, Inc. TERMS AND CONDITIONS 1.DEFINITIONS OMNI Environmental Systems, Inc.will be referred to as"Provider"and the person or company purchasing as indicated on the"Contract for Operation and Maintenance Services"will be referred to as"Consumer" 2.ACCEPTANCE Unless otherwise stated on the contract, it is subject to acceptance within thirty(30)days of the date on the proposal. Acceptance of the Consumer's request for services is expressly made conditional on the Consumer's assent to the terms and conditions in the proposal and the attachments hereto which shall constitute the complete agreement between the parties. This contract shall remain valid and in effect until the Consumer is otherwise notified from Provider for reasons including but not limited to, pricing schedule change,and termination due to payment default and/or improper use. Contract will also expire upon any change of system ownership. See CHANGE OF OWNERSHIP for details. 3. CHANGE OF OWNERSHIP Any new or proposed Consumer(s)shall take title to the equipment and should be notified of operation and maintenance requirements by the Seller and/or Seller's agent and the Terms and Conditions of this contract. Existing Consumer(s)are fully responsible for supplying the Provider information of such ownership transaction including but not limited to,date of purchase, name, address,and telephone number of any new Consumer. It will be the sole responsibility of the existing Consumer(s)to notify prospective Consumer(s)of any and all system requirements including but not limited to Maintenance and Testing/Sampling requirements. In the event that the Provider is not notified of a change of ownership a$25 setup fee shall be applied to the first scheduled payment of the new Consumer. 4. PAYMENT OPTIONS Payment options are available for customers and are to be made on a prepayment basis for Quarterly, Semi-annual,and Annual payees. Quarterly payments shall consist of four(4)payments per year. Semi-annual payments shall consist of two(2)payments per year.Yearly payments shall consist of one(1)payment per year. The prices show above for quarterly and semi-annual payment options will be higher than the monthly and annual payment options due to administrative fees that have been added. Monthly options are only available for payment by credit card. Consumers who select the Monthly payment option do not need to include fist payment. Monthly payees will be contacted by OMNI for account setup. Monthly payments will be charged on the first week of every month and shall remain in effect throughout the terms of the contract. Upon cancellation or termination of said contract monthly payees shall be responsible for all services rendered to date of the cancellation request and all balances shall be paid in full on the final scheduled payment. In the event of a"credit"to the newly terminated account a refund shall be issued to the payee and applied to the credit card from which the payments were made within thirty(30)days of the termination or cancellation date. In the event that payments are not made within the allowable time frame the subject contract shall be automatically terminated and all applicable late and/or reinstatement fees shall apply. At the option of the Consumer the contract shall be reinstated upon receipt of all owed payments and applicable fees. The Provider reserves the right to deny any payment options to any Consumer(s)whose contracts have been terminated due to payment defaults. 5. PRICING Sampling service prices are set by the Provider and are subject to change. Upon any change in the current pricing any existing Sampling(testing)Contracts will be terminated thirty days after notifying current Consumer and Provider will issue a new Sampling Contract outlining the current pricing schedule. It is the sole any Sampling Contract changes. option of the Consumer to continue services with Provider and under no circumstances is the Consumer obligated to 6. CREDIT If the Provider shall at any time doubt the Consumer's financial responsibility, Provider may decline to continue services hereunder except upon receipt of cash payment in advance or security,satisfactory to Providers, in advance. If Consumer fails in any way to fulfill the terms and conditions on the"Contract for Sampling Services" Provider may defer further services until such default is corrected and may at the option of the Provider treat such. default as refusal by Consumer to accept further services hereunder. 7. LATE CHARGES AND FEES A finance charge of 1 Y2% (18%per annum)will be charged on all past due invoices. A$25 reinstatement fee will be assigned to all Sampling Agreements that have been terminated by the Provider for misuse and/or payment default and all past balances shall be paid in full. All applicable payments, finances charges and fees shall be paid in full prior to contract reinstatement. 8. OPERATION Consumer shall take title to the services and results only upon Provider's receipt of all payments due for said services, including payments for all applicable options, late charges and fees. In the event of damage or loss due to improper operation and/or maintenance by unauthorized personnel and or the Consumer;the Consumer shall be responsible for all damages and non-compliant sampling results. Consumer shall NOT hold the Provider liable for damages or associated costs for any services or advice rendered as corrective action in the event of system failure due to improper operation and/or maintenance by unauthorized personnel and/or the Consumer. It is the Consumer(s)responsibility to insure that all personnel, agents,tenants,or other,operating and/or using the Alternative Septic Technology Manufaa�tClnng Testing Maintenance 4 rvap Im I I I I I . ;sl� ataeat ;l ? texY In r. r system, read the Operation and Maintenance Manual provided by the system Manufacturer. 9.TECHNICAL ADVICE AND ASSISTANCE Provider's warranty shall not be enlarged, and no obligation or liability shall arise,as a result of Providers rendering of technical advice,facilitates or services in connections with Consumer's order for the services furnished.Although any technical advice furnished, or recommendation made, by Provider or any representative of Provider concerning any use of application of any products or services furnished under this contract is believed to be reliable, Provider makes no warranty,expressed or implied, of results to be obtained. 10..DELIVERY OF SERVICES The time for services rendered is approximate and is estimated from the date of Sampling Contract inception with complete information and local and/or state approvals and drawings as may be necessary. The obligation of Provider to deliver or perform services and the obligation of Consumer to furnish specifications for purchase and take the products or services stated on the front hereof shall be suspended by fire, floods,accidents,act of God,war or acts of war,strikes, lock-outs,slow-downs, picketing or other labor controversies, sabotage, riots,civil commotions,default or failure of carriers, shortage of labor, inability to obtain materials from regular sources,whether or not a kind hereinbefore specified,to the extent that such happening or contingency limits or prevents the services, sale or delivery of any products or the performance of any services by the Provider or the purchase or taking thereof by the Consumer,except, however,that not withstanding the foregoing,the Consumer shall not be excused from accepting and paying for services which are completed or in the process of being completed at the time. Upon the elimination of cessation of any such happening or contingency the obligation of Provider to deliver or perform services and the obligation of Consumer to purchase and take the products or services shall be reinstated. If by request of the Consumer with acquiescence by the Provider, service is delayed beyond the original service date for a reason other than as set forth above in this Section 4,the Consumer will pay a reasonable charge for expenses caused by the delay, and after the delay is ended,the agreement will be completed at the prices and on the terms and conditions agreed to in this document. The products contracted for under this Contract cannot be canceled except with the written consent of the Consumer and then only with reimbursement for services rendered as agreed upon by the Consumer. 12.ASSIGNMENT The Consumer may not assign any of the Consumer's rights hereunder. 13. DISPUTES The parties'agreement in respect of the services shall be deemed to be entered into in Massachusetts and to be a Massachusetts contract and shall be governed and construed in accordance with the laws of the Commonwealth of Massachusetts. Provider and Consumer specifically agree that any legal action brought relating to services purchased or relating to this contract will be commenced in Massachusetts within one(1) year after the relevant claim arises,failing which such claim shall be barred notwithstanding any longer statutory period of limitations. All objections to venue are hereby waived by both parties,and Consumer consents to service of process by certified mail addressed to the same address at that address designated for delivery of the services purchased hereunder. In the event of any such litigation under or arising out of the agreement,the prevailing party shall be entitled to its costs, including reasonable attorney's fees. 14. SEVERABILITY In the event that any work, phrase,clause sentence,or other provision hereof shall violate any applicable statue,ordinance, or rule of law in any jurisdiction in which it is used, such provision shall be ineffective to the extent of such violation without invalidating any other provision hereof. 15. ENTIRE AGREEMENT This document contains the entire agreement between Provider an Consumer and constitutes the final,complete and exclusive expression of the terms of the agreement, all prior or contemporaneous written or oral agreements or negotiations with respect to such terms as are included herein or are the subject matter hereof being merged herein. By way of illustration and not limitation, Consumer's order shall be deemed to incorporate,without exception,all the terms and conditions hereof notwithstanding any order form of Consumer containing additional or contrary terms or conditions, unless Consumer shall have expressly advised Provider to the contrary in a writing apart from the printed provisions of such order form,and no acknowledgment by Provider of, or reference by Consumer to, or performance by Provider under an order of Consumer shall be deemed to be acceptance by Provider of any such additional or contrary printed terms or conditions by a written instrument signed by one of Provider's office. 16.GOVERNING LAW This document and the sale of an products hereunder by ad construed in accordance with the laws of the Sate of Massachusetts. Whenever there lis a confl cteof awsn he laws of the State of Massachusetts shall prevail. Alternative Septic Technology Manuractur nr; Testing Maintenance i g TOWN OF BARNSTABLE LOCATION - c �j` VII.LAGE��Tpt"Vi I I SEWAGE # $'— .g- ASSESSOR'S MAP& LOT t INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY / s LEACHING FACILITY: (type) NO.OF BEDROOMS BUILDER OR OWNER e PERMTTDATB: p/ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and I.eachin FacilityFeet on site or within 200 feet of leaching facility any wells cost Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by Feet 1 i 1 1 + (78tl ifs I Sy', 256` sell They are agreeable to a two hour time frame for specifically the cheese, tartar sauce, sliced tomato, sliced lettuce, mayonnaise, and onions. The dried onions pickles, bacon, ketchup, and mustard do not pertain to this deadline. The Board voted to approve a two hour allowance time before disposing of products. The products on the "Main Board" area GRANTED C. Larry Thayer, owner of property, and Centerville Pie Company— 895 Mary Dunn Road, Hyannis, Map/Parcel 332-014, variance for vacuum packaging. Larry and Kristin Broadley (the owner of Centerville Pie Company) discussed how they make all their own products from scratch and vacuum seal them. The Board voted to approve the variance of the vacuum sealing the product. Vill. Innovative Monitoring Plan: Removed Gregg Brehm —49 Joby's Lane, Centerville, Map/Parcel 120-084, Not Owner's occupied 6 months/year, requests monitoring reduced to twice per Rep. year. IX. Variance — Septic Failed (Cont.): GRANTED Rosanie Joseph and Severe Philogene, owners - 33 Stetson WITH Street, Hyannis, Map/Parcel 306-055, septic failure, variance CONDITIONS requested for 15.722 — no engineering plans, sewer connection in future (continued from Jan. 2010 and Nov. 2009 meetings). The Board voted to approve a variance for no engineering plan be submitted as the failed chambers will be replaced in the same location with the following condition: 1) an Administrative Consent Order (ACO) be signed before the compliance of the septic permit is given. The ACO will be requiring the hookup to sewer once it is available, etc. X. Old/New Business: TO BE A. Proposed Bedroom Count Policy.— Request to be updated. DRAFTED Dr. Canniff mentioned that it should say "a finished room,". 'Mr. McKean also asks for a Deed Restriction to placed stating the number of,bedrooms allowed at the premises. Mr. McKean will draw up a final version for the March 9 Board of Health meeting. DENIED B. Proposed Additional Counter Variance Approval — Repair/Replace Existing Well with setbacks to existing septic. Mr. McKean would like to allow the inspectors to approve a repair/replacement of an existing well from setbacks between 50-100 feet from the septic tank. (This does not apply to SAS). Page 4 of 5 BOH 2/09/10 "°OW OFFICE (508) 540-•0343 P,0- Box 123 = MANUFACTURING 465 East Falmouth Nighir=ay Falrytouth,TeChriology Park East: Falmmjth, PEA 02536 OMNI' 520 Thomas B, Landers Road Ennr n m, Sys;t ar�s East FalrnOLIth, MA 62536 April 27, 2005 Mr. Peter Marney P.O. Box 29 Osterville, MA 02655 RE: 49 Jobys Lane, Osterville— Operation and Maintenance Services Dear Mr. Marney: OMNI Environmental Systems, Inc: (OMNI) is pleased to submit the following Maintenance Contract for your review and approval. This contract is an agreement by OMNI to provide the services necessary for the operation and maintenance of an OMNI Recirculating Sand Filter (RSF) located at the above referenced property. The OMNI Operation and Maintenance Contract has been designed to fulfill the Department of Environmental Protection (DEP) requirements-for maintenance of an RSF by a licensed wastewater technician. DEP requires that a valid maintenance contract be kept on file with the local and state authorities. OMNI will supply all materials and equipment outlined in the proposed contract. OMNI will also supply certified wastewater technicians specially trained with regard to operation and maintenance standards and practices for Innovative and Alternative Technologies. The outlined contract does not include any testing or repairs not covered under warranty. The homeowner is responsible for the following: supplying OMNI with all local and state septic system approvals, payments as outlined for operation and maintenance services, and any testing requirements required by state and/or local authorities. For your convenience OMNI acce is all mamor credit cards and is now offering payment options for customers with accounts in good standing. Please note, for monthly payments options a credit card is required. Please carefully read all Terms and Conditions listed below. Should you have any questions with regard to the contract, scope of work or any additional services, please feel free to contact our office. You may authorize the contract by signing and returning a copy with the first payment installment. Sincerely, Matthew C. Costa, President OMNI Environmental Systems, Inc. U N q. ¢g Contract for Operation and Maintenance Services � � � * 7,7,, Owners Name Peter Marney 49 Jobys Lane Home Address Osterville City,State Zip Phone 617 212-5961 OMNI RSFBilling Address P.O.Box 29 Life of Ownership Ci ,State Zi Osterville,MA 02655 ontract Upon Use and Occu anc Issuance NOTE:OMNI Environmental Systems shall not be responsible for any misuse or improper operation by non-omni personnel or the system owner,and any operation NOT in accordance with the OMNI RSF System Owner's and Operator's Manual Terms and Agreement for Standard and Preventative Maintenance Innovative/Alternative Technology OMNI is hereby authorized to render Standard and Preventative Maintenance for the OMNI Recirculating Sand Filter listed at the above address for the contract period specified above under"Contract Terms". This agreement may be terminated or extended by the system owner by providing OMNI Environmental Systems,Inc(OMNI).with 30 days written notice of intent. OMNI will provide the system owner with thirty(30) days written notice of its changes to the current pricing schedule. The system owner will not be obligated to renew contract in the event of any pricing changes. OMNI will be obligated to provide all prepaid services in the event of any pricing changes. This agreement consists of all Standard and Preventative Maintenance listed.in the Owners and Operators-Manual. This agreement will include quarterly inspections as required by the Department of Environmental Protection(DEP). It is the responsibility of the system owner to supply any local or state septic system approvals and/or conditions to OMNI. This agreement includes routine maintenance inspections and does not include costs occasioned by neglect,misuse and accident or consumables. This agreement does not include travel costs for the Islands and any locations outside a 20 mile radius of East Falmouth. This agreement DOES NOT COVERANY TESTING/SAMPLING REQUIREMENTS. In consideration of the services contained in this agreement the system owner agrees to pay OMNI Environmental Systems,Inc.the sum.specified in the payment options section for the above maintenance agreement on a prepayment basis. Payment is due fifteen (15) days from Invoice Date prior to execution of services and will be subject to any applicable late charges. Monthly payees are excluded from prepayment requirements. This agreement is not assignable by either party and is non-refundable for any prepaid services.This agreement will not become effective until the first payment as outlined below has been received by OMNI Environmental Systems, Inc. If the terms and conditions contained herein,including the terms and conditions set forth on the enclosed documentation titled TERMS AND CONDITIONS,are acceptable,kindly sign and return one(1)copy of this contract along with the first prepaid payment. It is understood and agreed that the foregoing,including the TERMS AND CONDITIONS set forth will constitute the full and complete agreement between the parties to this agreement. The contract offer expires thirty(30)days from the date hereof,but may be accepted at any later date at the sole option of OMNI. The undersigned agrees to the following payment schedule: lm �� �� nn below ng ap ro riate bnd Conditions fo �tyent tions: Monthly $185 Semi-Annual❑ 50 Yearly The above costs, Project Scope of Work, terms and conditions are satisfactory and are hereby accepted. OMNI is hereby authorized to pro ide a services as specified. Authorize OM erso nel Date P/ri N me(Owner) System Owner Signature Dat f TERMS AND CONDITIONS I- DEFINITIONS OMNI Environmental Systems, Inc.will be referred to as"Provider"and the person or company purchasing as indicated on the"Contract for Operation and Maintenance Services"will be referred to as"Consumer" Z ACCEPTANCE Unless otherwise stated on the contract, it is subject to acceptance within thirty(30)days of the date on the proposal. Acceptance of the Consumer's request for services is expressly made conditional on the Consumer's assent to the terms and conditions in the proposal and the attachments hereto which shall constitute the complete agreement between the parties. This contract shall remain valid and in effect until the Consumer is otherwise notified from Provider for reasons including but not limited to, pricing schedule change,and termination due to payment default and/or improper use. Contract will also expire upon any change of system ownership. See CHANGE OF OWNERSHIP for details. 3. CHANGE OF OWNERSHIP Any new or proposed Consumer(s)shall take.title to the equipment and should be notified of operation and maintenance requirements by the Seller and/or Seller's agent and the Terms and Conditions of this contract. Existing Consumer(s)are fully responsible for supplying the Provider information of such ownership transaction including but not limited to,date of purchase, name,address,and telephone number of any new Consumer. It will be the sole responsibility of the existing Consumer(s)to notify prospective Consumer(s)of any and all system requirements including but not limited to Maintenance and Testing/Sampling requirements. In the event that the Provider is not notified of a change of ownership a$25 setup fee shall be applied to the first scheduled payment of the new Consumer. 4. PAYMENT OPTIONS Payment options are available for customers and are to be made on a prepayment basis for Quarterly, Semi-annual,and Annual payees. Quarterly payments shall consist of four(4)payments per year. Semi-annual payments shall consist of two(2)payments per year. Yearly payments shall consist of-one-(1)payment per year. The prices show above for quarterly and semi-annual payment options will be higher than the monthly and annual payment options due to administrative fees that have been added. Monthly options are only available for payment by credit card. Consumers who select the Monthly payment option do not need to include fist payment. Monthly payees will be contacted by OMNI for account setup. Monthly payments will be charged on the first week of every month and shall remain in effect throughout the terms of the contract. Upon cancellation or termination of said contract monthly payees shall be responsible for all services rendered to the date of the cancellation request and all balances shall be paid in full on the final scheduled payment. In the event of a"credit"to the newly terminated account a refund shall be issued to the payee and applied to the credit card from which the payments were made within thirty(30)days of the termination or cancellation date. In the event that payments are not made within the allowable time frame the subject contract shall be automatically terminated and all applicable late and/or reinstatement fees shall apply. At the option of the Consumer the contract shall be reinstated upon receipt of all owed payments and applicable fees. The Provider reserves the right to deny any payment options to any Consumer(s)whose contracts have been terminated due to payment defaults. 5. PRICING Maintenance service prices are set by the Provider and are subject to change. Upon any change in the current pricing any existing Maintenance Contracts will be terminated thirty days after notifying current Consumer and Provider will issue a new Maintenance Contract outlining the current pricing schedule. It is the sole option of the Consumer to continue services with Provider and under no circumstances is the Consumer obligated to any Maintenance Contract changes. 6. CREDIT If the Provider shall at any time doubt the Consumer's financial responsibility, Provider may decline to continue services hereunder except upon receipt of cash payment in advance or security, satisfactory to Providers. If Consumer fails in any way to fulfill the terms and conditions on the"Contract for Operation and Maintenance Services"the Provider may defer further services until such default is corrected and may at the option of the Provider treat such default as refusal by Consumer to accept further services hereunder. 7. LATE CHARGES AND FEES A finance charge of 1 Y%(18%per annum)will be charged on all past due invoices. A$25 reinstatement fee will be assigned to all Maintenance Agreements that have been terminated by the Provider for misuse and/or payment default and all past balances shall be paid in full. All applicable payments, finances charges and fees shall be paid in full prior to contract reinstatement. 8. OPERATION Consumer shall take title to the equipment only upon Provider's receipt of all payments due for said services, including payments for all applicable options, late charges and fees. In the event of damage or loss due to improper operation and/or maintenance by unauthorized personnel and/or the Consumer;the Consumer shall be responsible for all damages. Consumer shall NOT hold the Provider liable for damages or associated costs for any services or advice rendered as corrective action in the event of system failure due to improper operation and/or maintenance by unauthorized personnel and/or the Consumer. It is the Consumer(s)responsibility to insure that all U €le€z r s l ystems, Inc, personnel, agents,tenants,or other,operating and/or using the system read the Operation and Maintenance Manual provided by the system Manufacturer. 9. WARRANTY OMNI warrants its products will perform the process function for which they were recommended by the OMNI for a period of three(3)years from the date of installation, provided pertinent and accurate items of data were submitted buy the Consumer to the OMNI and the Provider and further provided that the products are used under normal and proper use in accordance with instructions of OMNI. If this warranty is breached,the warranty is terminated and Consumer shall be liable for any and all corrective actions and/or repairs. 10.TECHNICAL ADVICE AND ASSISTANCE Provider's warranty shall not be enlarged,and no obligation or liability shall arise,as a result of Provider's rendering of technical advice,facilitates or services in connections with Consumer's order for the services furnished.Although any technical advice furnished, or recommendation made, by Provider or any representative of Provider concerning any use of application of any product furnished under this contract is believed to be reliable, Provider makes no warranty,expressed or implied,of results to be obtained. 11. DELIVERY OF SERVICES The time for services rendered is approximate and is estimated from the date of Maintenance Contract inception of order with complete information and local and/or state approvals and drawings as may be necessary. The obligation of Provider to deliver or perform services and the obligation of Consumer to furnish specifications for purchase and take the products or services stated on the front hereof shall be suspended by fire,floods, accidents,act of God,war or acts of war,strikes,lock-outs, slow-downs, picketing or other labor controversies, sabotage, riots,civil commotions,default or failure of carriers,shortage of labor, inability to obtain materials from regular sources,whether or not a kind hereinbefore specified,to the extent that such happening or contingency limits or prevents the services, sale or delivery of any products or the performance of any services by the Provider or the purchase or taking thereof by the Consumer,except, however,that not withstanding the foregoing,the Consumer shall not be excused from accepting and paying for services which are completed or in the- process of being completed at the time. Upon the elimination of cessation of any such happening or contingency the obligation of Provider to deliver or perform services and the obligation of Consumer to purchase and take the products or services shall be reinstated. If by request of the Consumer with acquiescence by the Provider, service is delayed beyond the original service date for a reason other than as set forth above in this Section 4,the Consumer will pay a reasonable charge for expenses caused by the delay,and after the delay is ended,the agreement will be completed at the prices and on the terms and conditions agreed to in this document. The products contracted for under this Contract cannot be canceled except with the written consent of the Consumer and then only with reimbursement for services rendered as agreed upon by the Consumer. 12.ASSIGNMENT The Consumer may not assign any of the Consumer's rights hereunder. 13. DISPUTES The parties'agreement in respect of the services shall be deemed to be entered into in Massachusetts and to be a Massachusetts contract and shall be governed and construed in accordance with the laws of the Commonwealth of Massachusetts. Provider and Consumer specifically agree that any legal action brought relating to services purchased or relating to this contract will be commenced in Massachusetts within one(1) year after the relevant claim arises,failing which such claim shall be barred notwithstanding any longer statutory period of limitations. All objections to venue are hereby waived by both parties,and Consumer consents to service of process by certified mail addressed to the same address at that address designated for delivery of the services purchased hereunder. In the event of any such litigation under or arising out of the agreement,the prevailing party shall be entitled to its costs, including reasonable attorney's fees. 14. SEVERABILITY In the event that any work,phrase,clause sentence,or other provision hereof shall violate any applicable statue, ordinance, or rule of law in any jurisdiction in which it is used, such provision shall be ineffective to the extent of such violation without invalidating any other provision hereof. 15. ENTIRE AGREEMENT This document contains the entire agreement between Provider an Consumer and constitutes the final, complete and exclusive expression of the terms of the agreement, all prior or contemporaneous written or oral agreements or negotiations with respect to such terms as are included herein or are the subject matter hereof being merged herein. By way of illustration and not limitation, Consumer's order shall be deemed to incorporate,without exception, all the terms and conditions hereof notwithstanding any order form of Consumer containing additional or contrary terms or conditions, unless Consumer shall have expressly advised Provider to the contrary in a writing apart from the printed provisions of such order form, and no acknowledgment by Provider of,or reference by Consumer to, or performance by Provider under an order of Consumer shall be deemed to be acceptance by Provider of any such additional or contrary printed terms or conditions by a written instrument signed by one of Provider's office. 16. GOVERNING LAW This document and the sale of any products hereunder shall be governed by and construed in accordance with the laws of the Sate of Massachusetts. Whenever there is a conflict of laws,the laws of the State of Massachusetts shall prevail. OFFICE 7" MANUFACTURING I'.. Box .'.2i: - l� l\'1 - I'i11;'i'ii.%€:� €1 t.'t;�li'i��(;tt f Park •65 East€'a.irouth Hig,,WZ Environmental Systems,Inc. S20-hcmas B. Lar3dz-s Ron ; Eas` Fair,N)LIth, MA �:ast FalMout" MA 025 b April 27, 2005 Mr. Peter Marney P.O. Box 29 , Osterville, MA 02655 RE: 49 Jobys Lane, Osterville —Sampling Services Dear Mr. Marney: OMNI Environmental Systems, Inc. (OMNI) is pleased to submit the following Testing Contract for your review and approval. This contract is an agreement by OMNI to provide the.services necessary for performing the sampling (testing)of an Innovative/Altemative(I/A)Septic Technology located at the above referenced property as required and outlined in the local and/or state septic system approvals. The OMNI Sampling(testing)Contract has been designed to fulfill the Department of Environmental Protection (DEP) and local Board of Health requirements for sampling of an approved (I/A) technology. This contract is based on the information supplied to OMNI by the system owner and/or their representative(s) with regard to sampling requirements. OMNI will supply all lab fees and equipment outlined in the proposed contract.OMNI will also supply certified wastewater technicians specially trained with regard to operation and maintenance standards and practices for Innovative and Alternative Technologies. The outlined contract does not include any operation and maintenance services or repairs. The homeowner is responsible for the following: supplying OMNI with all local and state septic system approvals, payments as outlined for sampling services, and contracting with qualified personnel for operation and maintenance of the system as recommended by the manufacturer. For your convenience OMNI accepts all major credit cards and is now offering payment options for customers with accounts in good standing. Please note,for monthly payments options a credit card is required. If you choose the monthly payment options you will be contacted by.OMNI to setup your account. Please carefully read all Terms and Conditions listed below. Should you have any questions with regard to the Contract,Terms and Conditions or any additional services, please feel free to contact our office. You may authorize the contract by signing and returning a copy with the first payment installment. Sincerely yours, atthew C. Costa, President OMNI Environmental Systems, Inc.. Alte €zebus Septic Technology 4 Contract for Sampling (Testing) Services - eo Owners Name Peter Marney System Location 49 Jobys Lane Home Address Town Osterville City,State Zip DEP File No. Phone 617 212-5961 System Type OMNI RSF Billing Address P.O.Box 29 Contract Terms 2 Years City,State Zip Osterville,MA 02655 Contract Start Upon issuance of Occupancy Permit NOTE:OMNI Environmental Systems shall not be responsible for any misuse or improper operation by non-omni personnel or the system owner,and any operation NOT in accordance with the OMNI RSF System Owner's and Operator's Manual. Terms and Agreement for Sampling Services Innovative/Alternative Technology OMNI is hereby authorized to render sampling(testing)services for the Innovative/Alternative Technology listed at the above address for the contract period specified above under"Contract Terms',. This agreement may be terminated or extended by the system owner by providing OMNI Environmental Systems,.Inc(OMNI)with 30 days written notice of intent. OMNI will provide the system owner with thirty (30) days written notice of its changes to the current pricing schedule. The system owner will not be obligated to renew contract in the event of any pricing changes. OMNI will be obligated to provide all prepaid services in the event of any pricing changes. This Contract DOES NOT INCLUDE any Standard and Preventative Maintenance,costs occasioned by neglect,misuse and accident or consumables, and any travel costs for the Islands or locations not within a 20 mile radius of East. . Falmouth. This Contract DOES NOT COVER ANY OPERATION AND MAINTENANCE SERVICES. a . This Contract includes monthly testing for the first six months of operation,and quarterly samples thereafter tested for Total Suspended Solids(TSS),Nitrate Nitrogen(NO3-N),Total Kjeldahl Nitrogen(TKN),Nitrite Nitrogen(NO2- N),influent Biochemical Oxygen Demand(BOD)and/or effluent Carbonaceous Biochemical Oxygen Demand(CBOD) and pH by a Commonwealth of Massachusetts certified laboratory. In of the services contained in this agreement the system owner agrees to pay OMNI Environmental Systems, Inc. the sum specified in the payment options section for the above referenced sampling contract on a prepayment basis.Payment is due fifteen(15)days from Invoice Date prior to execution of services and will be subject to any applicable late charges. Monthly payees are excluded from prepayment requirements and must contact OMNI for account setup. This agreement is not assignable by either party and is non-refundable for any prepaid services.This agreement will not become effective until the first payment(outlined below)has been received by OMNI. If the terms and conditions contained herein,including the terms and conditions set forth on the enclosed documentation titled TERMS AND CONDITIONS,are acceptable,kindly sign and return one(1)copy of this contract along with the first payment. It is understood and agreed that the foregoing, including the TERMS AND CONDITIONS set-forth will constitute the full and complete agreement between the parties to this agreement. The contract offer expires thirty(30)days from the date hereof,but may be accepted at any later date at the sole option of OMNI. The undersigned agrees to the following payment schedule: select payment option below by marking appropriate box. See Terms and Conditions for details on payments options. Payment Options: 1 $60 Monthly(save$30)❑ 1 $195 Quarterly❑'1 $385 Semi-Annual❑ 1 $750 Yearly❑ The above costs, Project Scope of Work, terms and conditions are satisfactory and are hereby accepted. OMNI is hereby authorized to provide the services as specified. Authorized OMNI Personnel Date Print Name(Owner) System Owner Signature Date Alternative Septic i echgology TERMS AND CONDITIONS 1. DEFINITIONS OMNI Environmental Systems, Inc.will be referred,to as"Provider"and the person or company purchasing as indicated on the"Contract for Operation and Maintenance Services"will be referred to as"Consumer" 2.ACCEPTANCE Unless otherwise stated on the contract, it is subject to acceptance within thirty(30)days of the date on the proposal. Acceptance of the Consumer's request for services is expressly made conditional on the Consumer's assent to the terms and conditions in the proposal and the attachments hereto which shall constitute the complete agreement between the parties. This contract shall remain valid and in effect until the Consumer is otherwise notified from Provider for reasons including but not limited to, pricing schedule change, and termination due to payment default and/or improper use. Contract will also expire upon any change of system ownership. See CHANGE OF OWNERSHIP for details. 3. CHANGE OF OWNERSHIP Any new or proposed Consumer(s)shall take title to the equipment and should_ be notified of operation and maintenance requirements by the Seller and/or Seller's agent and the Terms and Conditions of this contract. Existing Consumer(s)are fully responsible for supplying the Provider information of such ownership transaction including but not limited to, date of purchase,name, address, and telephone number of any new Consumer. It will be the sole responsibility of the existing Consumer(s)to notify prospective Consumer(s)of any and all system requirements including but not limited to Maintenance and Testing/Sampling requirements. In the event that the Provider is not notified of a change of ownership a$25 setup fee shall be applied to the first scheduled payment of the new Consumer. 4. PAYMENT OPTIONS Payment options are available for customers and are to be made on a prepayment basis for Quarterly, Semi-annual, and Annual payees. Quarterly payments shall consist of four(4) payments per year. Semi-annual payments shall consist of two(2) payments per year.Yearly payments shall consist of one(1) payment per year.,The prices show above for quarterly and semi-annual payment options will be higher than the monthly and annual payment options due to administrative fees that have been added. Monthly options are only available for payment by credit card. Consumers who select the Monthly payment option do not need to include fist payment. Monthly payees will be contacted by OMNI for account setup. Monthly payments will be charged on the first week of every month and shall remain in effect throughout the terms of the contract. Upon cancellation or termination of said contract monthly payees shall be responsible for all services . rendered to date of the cancellation request and all balances shall be paid in full on the final scheduled payment. In the event of a"credit"to the newly terminated account a refund shall be issued to the payee and applied'to the credit card from which the payments were made within thirty(30)days of the termination or cancellation date. In the event that payments are not made within the allowable time frame the subject contract shall be automatically terminated and all applicable late and/or reinstatement fees shall apply. At the option of the Consumer the contract shall be reinstated upon receipt of all payments and applicable fees. The Provider reserves the right to deny any payment options to any Consumer(s)whose contracts have been terminated due to payment defaults. 5. PRICING Sampling service prices are set by the Provider and are subject to change. Upon any change in the current pricing any existing Sampling (testing)Contracts will be terminated thirty days after notifying current Consumer and Provider will issue a new Sampling Contract outlining the"current pricing schedule. It is the sole option of the Consumer to continue services with Provider and under.no circumstances is the Consumer obligated to any Sampling Contract changes. 6. CREDIT If the Provider shall at any time doubt the Consumer's financial responsibility, Provider may decline to continue services hereunder except upon receipt of cash payment in advance or security, satisfactory to Providers, in advance. If Consumer fails in any way to fulfill the terms and conditions on the"Contract for Sampling Services" Provider may defer further services until such default is corrected and may at the option of the Provider treat such default as refusal by Consumer to accept further services hereunder.. 7. LATE CHARGES AND FEES A finance charge of 1 '/z% (18%per annum)will be charged on all past due invoices. A$25 reinstatement fee will be assigned to all Sampling Agreements that have been terminated by the Provider for misuse and/or payment default and all past balances shall be paid in full. All applicable payments, finances charges and fees shall be paid in full prior to contract reinstatement. 8. OPERATION Consumer shall take title to the services and results only upon Provider's receipt of all payments due for said services, including payments for all applicable options, late charges and fees. In the event of damage or loss due to improper operation and/or maintenance by unauthorized personnel and or the Consumer;the Consumer shall be responsible for all damages and non-compliant sampling results. Consumer shall NOT hold the Provider liable for damages or associated costs for any services or advice rendered as corrective action in the event of system failure due to improper operation and/or maintenance by unauthorized personnel and/or the Consumer. It is the Consumer(s) responsibility to insure that all personnel, agents,tenants, or other, operating and/or using the Alternative Septic Technology ?<;nu:4acwrin c, te.,u:n,Ce system, read the Operation and Maintenance Manual provided by the system Manufacturer. 9.TECHNICAL ADVICE AND ASSISTANCE Provider's warranty shall not be'enlarged, and no obligation or liability shall arise,as a result of Provider's rendering of.technical advice,facilitates or services in connections with Consumer's order for the services furnished.Although any technical advice furnished, or recommendation made, by Provider or any representative of Provider concerning any use of application of any products or services furnished under this contract is believed to be reliable, Provider makes no warranty, expressed or implied, of results to be obtained. 10. DELIVERY OF SERVICES The time for services rendered is approximate and:is estimated from the date of Sampling Contract inception with complete information and local and/or state approvals and drawings as may be necessary. The obligation of Provider to deliver or perform services and the obligation of Consumer,to furnish specifications for purchase and take the products or services stated on the front hereof shall be suspended by fire, floods, accidents, act of God,war or acts of war, strikes,.lock-outs, slow-downs, picketing or other labor. controversies, sabotage,riots,civil commotions, default or failure of carriers, shortage of labor, inability to obtain materials from regular sources,whether or not akind hereinbefore specified,to the extent that such happening or contingency limits or prevents the services, sale or delivery of any products or the performance of any services by the Provider or the purchase or taking thereof by the Consumer, except, however,that not withstanding the foregoing,the Consumer shall not be excused from accepting and paying for services Which are completed or in the process of being completed at the time. Upon the elimination of cessation of any such happening or contingency the obligation of Provider to deliver or perform services and the obligation of Consumer to purchase and take the, products or services shall be reinstated. - If by request of the Consumer with acquiescence by'the Provider, service,is delayed beyond the original service date. for a reason other than as set forth above in this Section 4,the Consumer will pay a reasonable charge for expenses . caused by the delay, and after the delay is ended,the agreement will be completed at the prices and on the terms and conditions agreed to in this document. The products contracted for under this Contract cannot be canceled: except with the written consent of the Consumer and then only with reimbursement for services rendered as agreed upon by the Consumer. 12.ASSIGNMENT The Consumer may not assign any of the Consumer's rights hereunder.. 13. DISPUTES The parties' agreement in respect of the services shall be deemed to be entered into in Massachusetts and to be a Massachusetts contract and shall be governed and construed in accordance with the laws of the Commonwealth of Massachusetts. Provider and Consumer specifically agree that,any legal action brought relating to services purchased or relating to this contract will be commenced in Massachusetts within one(1) year after the relevant claim arises,failing which such claim shall be barred notwithstanding any longer statutory period of limitations. All objections to venue are hereby waived by both parties, and Consumer consents to service of process by.certified mail addressed to the same address at that address designated for delivery of the services purchased hereunder. In the event of any such litigation under or arising out of the agreement, the prevailing party shall be entitled to its costs,.including reasonable attorney's fees. . 14. SEVERABILITY In the event that any work, phrase, clause sentence, orother provision hereof shall violate any applicable statue, ordinance, or rule of law in any jurisdiction inwhich it is used, such provision shall be ineffective to the extent of such violation without invalidating any other provision hereof. 15. ENTIRE AGREEMENT This document contains the entire agreement between Provider an Consumer and constitutes the final, complete and exclusive expression of the terms of the agreement,all prior or contemporaneous written or oral agreements or negotiations with respect to such terms as'are included herein.or are the-subject matter hereof being merged herein. By way of illustration and not limitation, Consumer's order shall be deemed to incorporate,without exception, all the terms and conditions hereof notwithstanding any order,form of:Consumer . containing additional or contrary terms or conditions, unless Consumer shall have expressly advised Provider to the contrary in a writing apart from the printed provisions of such order form, and no acknowledgment by Provider of, or reference by Consumer to, or performance by Provider under an order of Consumer shall be deemed to be acceptance by Provider of any such additional or contrary prnted'terms.or conditions by a written instrument signed by one of Provider's office. 16. GOVERNING LAWN This document and the sale of any products hereunder'sl all be governed by and construed in accordance with the laws of the Sate of Massachusetts. Whenever there is a.conflict of laws, the laws of the State of Massachusetts shall prevail. Al"arna'dve Sept. .Zch, 0109y. DATE: FEE: + ■ARNSI'AB1E, MASS. t679 REC. BY .r Town of Barnstable SCHED. DATE: 0, d s Board of Health 200 Main Street,,Hyannis MA 02601 . 1 Office: 508-862-4644' Susan G.RasL.R.S. FAX: 509-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: Li e �S�ei-U 4' Assessor's Map and Parcel Number: 1 zy ' O�` Size of Lot: 153 2- Wetlands Within 300 Ft. Yes Business Name:_ No_ �— 'Subdivision Name: APPLICANT'S NAME: � Phone Did the owner of the property authorize you-to rep esent him or her?e Yes ✓ No PROPERTY OWNER'S NAME CONTACT PERSON Name: ?C`e_r Name: jv\��v<:,rt En.Slnez^�fl� Address: UCN Lq — _— . Address: P 0• Aj wM 01 0zks5___ Gs--UQ IO nhA :oz ss Phone: -- — -- Phone: � �zi2 -3"3`1y VARIANCE FROM REGULATION(List Reg) REASON FOR VARIANCE(May attach if more space needed) NATURE OF WORK House Addition i_ ????? House Renovation l Repair of Failed Septic System vv r1 Checklist (to he completed by office stall-person receiving variance request application) Please submit copies in 4 separate completed sets. Dour(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) .� Four(4)copies of labeled dimensional Floor plans submitted(e.g:house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represenrhim/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense or Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) i sa C:\Documents and Settings\decollik\Local Settings\Temporary Internet Fi1es\0LK3\VARIREQ.D0C r�e_s-At-S 3,t S t 7 April 19, 2005 Board of Health Town of Barnstable s 200 Main Street Hyannis,MA. 02604 Dear Board,. This letter is my permission for Sullivan Engineering, Inc. to represent me before the Board of Health of the Town of Barnstable on the matter of a Septic System for my property at 49 Joby's Lane. ; Yours truly, Peter E. Marney ! 1 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 MITT ROMNEY ELLEN ROY HERZFELDER Governor Secretary KERRY HEALEY . Lieutenant Governor ROBERT W.GOLLEDGE,Jr. Commissioner April 4, 2005 Christopher Costa OMNI Environmental Systems, Inc. P.O. Box 128, 465 East Falmouth Highway Falmouth, MA 02536 RE: BRPWP61b: Approval of Alternative Systems for Pilot Use Technology: OMNI Recirculating Sand Filter System DEP Transmittal No.: W054298 Dear Mr. Costa: The Department of Environmental Protection'has completed its review of your Application for Piloting Approval for the Omni Recirculating Sand Filter System. We are pleased to issue the enclosed Piloting Approval for the System. Should you have any questions regarding this Approval, or should you wish to meet witli us to discuss any questions or concerns you may have,please do not hesitate to contact Ron White at 617-292-5790. Thank you for your interest in seeking approval for the use of your innovative technology in Massachusetts. Sincerely, �ns,. Uirecto Division of Watershed Management, Enclosure:PILOT APPROVAL: OMNI Recirculating Sand Filter System This information is available in alternate format.Call Donald M.Gomes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://www.mass.gov/dep L� 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 MITT ROMNEY ELLEN ROY HERZFELDER Governor Secretary KERRY MALEY ROBERT W. GOLLEDGE,Jr. Lieutenant Governor Commissioner PILOTING APPROVAL Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: OMNI Environmental Systems, Inc. P.O. Box 128/465 East Falmouth Hwy Falmouth, MA 02536 Trade name of technology and model numbers: OMNI Recirculating Sand Filter System (hereinafter the "System"). Schematic drawings illustrating the System and a technology checklist are attached and are part of this Approval. Transmittal Number: W054298 Date of Issuance: April 4,2005 Date of Expiration: April 4, 2010 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Approval to: OMNI Environmental Systems, Inc. 465 East Falmouth Hwy, Falmouth,MA 02356 (hereinafter "the Company"), to Pilot in the Commonwealth of Massachusetts the System described herein. Sale and use of the System are conditioned on and subject to compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with'the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000: G enn Haas, Director ate Division of Watershed Management Department of Environmental Protection This information is available in alternate format.Call Donald M.Gomes,ADA Coordinator at 617-556-1057.TDD Service-1-800-298-2207. DEP on the World Wide Web: http:/Iwww.mass.gov/dep i�� Printed on Recycled Paper ONM Recirculating Sand Filter Piloting Approval Page 2 of 10 I Purpose 1. The purpose of this Approval is to provide field-testing and technical demonstration of the System in Massachusetts, on a Piloting Approval basis,so as to evaluate whether the System can effectively reduce'total nitrogen(TN) in the effluent to 19 milligrams per liter(mg/L)or less and to evaluate whether the System can'provide an effluent that can be discharged to thesoil absorption system (SAS) at increased loading rates. 2. With the necessary permits and approvals required by 310 CMR 15.000,this. Piloting Approval authorizes the use and installation of the.System in Massachusetts, and requires testing so that the Department can determine whether the System consistently can or cannot function effectively at one or more pilot facilities. 3. The System may only be installed on facilities that meet the criteria of 310 CMR 15.285(2). 4. This Piloting Approval authorizes the use of the System,with the approval of the local approving authority, for upgrades of existing failed, failing or substandard systems and for new construction for systems with design flow_ s less than 10,000 gallons per day. II. Design Standards 1. The System consists of a recirculating sand filter module filled with a 3/8 inch fractured double washed stone filter media. Effluent from a minimum 1000-gallon recirculation tank is applied to the filter. The flow from the recirculation tank is pumped via timed dosing to a distribution structure on the surface of the recirculating sand filter. This pressure dosing aerates the liquid. The filtered effluent is collected in an underdrain system.Up to 50 percent of the filtered effluent is returned to the recirculation tank and the remainder is returned to influent end the septic tank for denitrification. A septic tank designed in accordance with Title 5 and equipped with an approved effluent tee filter discharges effluent to the recirculation tank. Approximately 75 percent of the filtrate is returned to the recirculation tank and 25 percent of the filtrate is.discharged either by gravity to a, Title 5 soil absorption system(SAS)or to a pump chamber for pressure distribution to the SAS.. 2. The System shall be covered only with mul&type material.No other materials, fill or plantings shall be allowed on top of the System. 3. The System shall be provided with visible and audible alarms that are activated in event of equipment malfunction. The alarms and controls shall be housed within an enclosure mounted in a location readily accessible to the operator. f OMNI Recirculating Sand Filter Piloting Approval Page 3 of 10 4. All access ports and manhole covers shall be installed and maintained at grade to allow for maintenance of the System. 5. New Construction less than 2,000 gpd: When the System is used in areas subject to the nitrogen loading limitations of 310 CMR 15.214, an increase in calculated allowable nitrogen loading per acre is allowed for facilities with a design flow of less than Z 000 gallons per day(gpd)as provided in 310 CMR 15.217(2). When used in such areas: a i. for residential facilities, the design flow shall'not exceed 660 gallons per day per acre(gpda),and the System shall not exceed 19 mg/L total nitrogen(TN) concentration in the effluent measured as the total TKN (total Kjeldhal Nitrogen),NO3-N(Nitrate nitrogen) and NO2-N(Nitrite nitrogen). ' ii. for non-residential facilities, the design flow shall not exceed 550 gpda, and the System shall not exceed 25 mg/L TN concentration in the effluent. 6. New Construction 2,000 gpd to less than 10,000 gpd: For all facilities with design flows of 2,000 gpd to less than 10,000 gpd,the design flow shall not exceed 440 gpda and the System shall not exceed 25 mg/L TN concentration in the effluent. 7. Soil Absorption System: The Company seeks to demonstrate that the System can function with a SAS designed with increased loading rates by producing an effluent from the System that meets the following parameters: a. Carbonaceous biochemical oxygen demand(CBODS) of 15 mg/L, b. Total suspended solids (TSS) of 10 mg/L, and C. 95 percent removal of Fecal Coliform bacteria. i. The Company seeks to demonstrate that the quality of effluent discharged to an SAS reduced in size by 50 percent as compared to a standard Title 5 SAS, is likely to be at least equivalent to that of a system designed and constructed in accordance with 310 CMR 15.100 through 15.293. The Company may install Systems on remedial sites to evaluate effluent quality in accordance with the following: a. Increased Loading Rates: SAS shall be designed to allow maximum application rates in accordance with the following table and the effluent from the System shall be monitored in accordance with Section V item 1.1 of this approval: Soil Textural Classes Maximum Application Rates' Class (GPD per sq.foot) I 1.5 II f 1.2 III 0.75 IV 0.40 f ' OMNI Recirculating Sand Filter Piloting Approval Page 4 of 10 1. Trench configuration and pressure distribution when the System is installed on remedial sites shall be designed in accordance with Department guidance. III. General Conditions 1. No more than 15 Systems may be installed under this Approval. A representative of the Company shall be onsite to inspect and approve each System installation. 2. All provisions of 310 CMR 15.000 are applicable to the use of this System, the System owner and the Company,except those that specifically have been varied by the terms of this Approval. 3. Any required operation and maintenance shall be performed in accordance with a Department approved plan. Any required sample analysis shall be conducted by an independent U.S. EPA or DEP approved testing laboratory, or a DEP approved independent university laboratory. It is a violation of this Approval to falsify any data collected pursuant to an approved testing plan, to omit any required data or to fail to submit.any report required by such plan. 4. The following table lists the monitoring requirements for Systems installed under this Approval. The following parameters shall be monitored: pH, influent biochemical oxygen demand(BOD5) and/or effluent carbonaceous biochemical oxygen demand(CBOD5),total suspended solids (TSS), alkalinity, and TN. All monitoring data shall be submitted to the Department and local approving authority within 45 days of the sampling date. i Facility Type ( d Design Flow Stream Frequency Sample Type Residential <2,000 Effluent Monthly for at least the first three Grab months, quarterly thereafter Residential >2,000 Influent & Monthly for at least the first 18 Composite* Effluent months, Non-residential All Influent & Monthly for at least the first 18 Composite* Effluent months, *Unless otherwise specified by the Department, composite shall be determined based on facility operation 5. The facility served by the System and the System itself shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 6. In accordance with applicable law, the Department and/or the local approving authority may require the System owner to cease operation of the system and/or to take any.other action as it deems necessary to protect public health, safety, welfare and the environment. t OMNI Recirculating Sand Filter Piloting Approval Page 5 of 10 7. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least equivalent to that of a sewer system. Accordingly,no System shall be installed, if it is feasible to connect the facility to a sanitary sewer,unless as allowed by 310 CMR 15.004. 8. Design and installation of the System shall be in strict conformance with the Company's DEP approved plans and specifications, 310 CMR 15.000 and this Approval. IV. Conditions Applicable to the System Owner 1. The System is approved in connection with the discharge of sanitary wastewater only. Any non-sanitary wastewater generated or used at the facility served by the System shall not be introduced into the System and shall be lawfully disposed of 2. All samples shall be taken at a flowing discharge point, i.e.=distribution box,pipe entering a pump chamber or other Department approved location from the treatment unit. Any required influent sample shall be taken at a point that will provide a representative sample of the influent. Influent sampling locations shall be determined by the system designer, subject to written approval by the Department 3. Effluent discharge concentrations shall not exceed treatment standards listed in Section V item 9. For Systems designed to demonstrate increased loading rates to the SAS effluent discharge concentrations shall not exceed treatment standards listed in Section V item 11. 4. Operation and Maintenance plan and agreement: i. Throughout its life, the System shall be under an operation and maintenance(O&M) agreement. The first O&M agreement shall be for at least 18 months with the Company or its licensed agents.Each subsequent O&M agreement shall be for at least one year. ii. No System shall be used until an O&M plan is submitted to the Department and the local approving authority which:_ a provides for the contracting of a person or firm competent in providing services consistent with the System's specifications and the operation and maintenance requirements specified by the designer and any specified by the Department; b contains routine O&M activities specified by the Company necessary for proper operation of the System; c contains procedures for notification to the Department and the local approving authority within five days of a System failure or alarm event and for corrective measures to be taken immediately; Y OMNI Recirculating Sand Filter Piloting Approval Page 6 of 10 d provides the name of an operator, which must be a Massachusetts certified operator as required by 257 CMR 2.00,-that will operate and monitor the System: m (1) for.a System serving a facility the operator must operate and maintain the System at the frequency specified in Section III item 4 and anytime there is an alarm event;and (2) contains an agreement to monitor the System for at least_the first 18 months as described in Section V, items 8 through 13. 5. After the first 18 months of operation, if the System is approved as acceptable by the Department,the owner shall sign at least a one year agreement with any individual or firm with a Massachusetts certified operator of the appropriate grade. i. Effluent discharge limits shall remain as prescribed in Section V. Should the System exceed the applicable TN limit on two consecutive sampling events, the System owner shall have the System operator submit within 60 days a report to the Department on the reasons for the exceedances with, recommendations of how future violations will be prevented, ii. The System owner shall submit monitoring data and O &M inspection results to the Department and the local approving authority within 45 days of each sampling date and each inspection date. The inspection results must be recorded on a DEP approved inspection form and a technology checklist. The forms must be completed and signed by the System operator. The System owner may request,in writing, a change in the monitoring requirements from the Department. 6. The System owner shall at all times have.the'System'properly operated and . maintained in accordance with the Company's and the designer's operation and maintenance requirements and this Approval. 7. Anytime the operator is changed,within seven days of such change,the System owner shall notify the Department and the local approving authority in writing and submit a copy of the new agreement to operate and monitor the System. 8. The System owner shall furnish the Department any information, which the Department may request regarding the System,within 21 days of the date of receipt of that request. 9.11 The System owner shall provide a copy of this Approval,prior to the signing of a purchase and sale agreement for the facility served by the System or any portion thereof,to the proposed new owner. OMNI Recirculating Sand Filter Piloting Approval Page 7 of 10 10. Prior to installation of the System, the proposed owner shall submit to the Department the written approval of the local approving authority, together with a copy of the complete application submitted to the local approving authority and a complete BRP WP 64b application and obtain DEP.written approval. 11. Prior to the issuance of a Certificate of Compliance for the System, the System owner shall record and/or register in the appropriate Registry of Deeds and/or Land Registration Office, a Notice disclosing both the existence of the alternative septic system subject to this Approval on the property and the Department's approval of the System. If the property subject to the Notice is unregistered land, the Notice shall be marginally referenced on the owner's deed to the property. Within 30 days of recording and/or registering the Notice, the System owner shall submit the following to the Department and the local approving authority: (i) a certified Registry copy of the Notice bearing the book and page/instrument number and/or document.number; and (ii) if the property is unregistered land, a Registry copy of the owner's deed to the property,bearing the marginal reference. 12. Within fourteen days of the local approving authority's issuance of the Certificate of Compliance, the System owner shall submit a copy of the Certificate of Compliance to the Department. V. Conditions Applicable to the Company 1. By January 31. of each year, the Company shall submit to the Department a report, signed by a corporate officer, general partner or Company owner, that contains information on the System, for the previous calendar year. The report shall state: the number of units of the System sold for use in Massachusetts during the previous year; the address of each installed System, the owner's name and address,the type of use(e.g. residential, commercial, school, institutional), and the design flow; and for all Systems installed since the date of issuance of this Approval for the System, all known failures, malfunctions, and corrective actions taken and the date and address of each such event. 2. The Company shall notify the Director of the Watershed Permitting Program at least 30 days in advance of the proposed transfer of ownership of the technology for which this Approval is issued. Said notification shall include the name and address of the proposed new.owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership, responsibility, coverage and liability between them. All provisions of this Approval applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 3. The Company shall make available to owners, operators, and installers of the System, in printed and electronic format: minimum installation requirements; an operating manual, including information on substances that should not,be OMNI Recirculating Sand Filter Piloting Approval Page 8 of 10 discharged to the System; a protocol for collecting samples; a maintenance checklist; and a recommended schedule for maintenance of the System 4. The Company shall develop and submit to the Department within 60 days of the effective date of this.Approval a standard protocol essential for consistent and accurate measurement of performance of'installed Systems, including procedures for sample collection and analysis of the System. The protocol shall be in accordance with the latest edition of Standard Methods for the Examination of Water and Wastewater. 5. The Company shall institute and maintain a program of operator training and continuing education. The Company shall maintain and annually update, and make the list of qualified operators available by March 1st of each year. The Company shall also make the list known to the local approving authorities, the Department and users of the technology. 6. The Company shall furnish the Department any information that the Department requests regarding the System,within 21 days of the date of receipt of that request. 7. Prior to its sale of the System, the Company shall provide the purchaser with a copy of this Approval. In any contract for distribution or sale of the System,the Company shall require the distributor or seller to provide the purchaser of the System, prior to any sale of the System,with a copy of this Approval.. 8. For at least the first 18 months of operation, the Company shall be responsible for operating, maintaining and monitoring the Systems in accordance with Section III, item 4 of this Approval. The Company shall submit monitoring data and O & M inspection results to the Department and the local approving authority within 45 days of each sampling date and each inspection date. The inspection results must be recorded on a DEP approved inspection form and'a technology checklist. Accurate completion of the forms shall be the responsibility of the Company 9. For nitrogen reducing Systems the effluent discharge concentrations shall meet or exceed`secondary treatment standards of 30 mg/L CBOD5 and 30 mg/L TSS. The effluent pH shall not be less than 6.0 or more than 9.0 standard units. The TN concentration in the effluent discharged from the System shall not exceed 19 mg/L for Systems serving residential facilities with design flows less than 2,000 gpd or 25 mg/L for Systems serving residential facilities with design flows of 2,000 gpd or greater and all Systems serving non-residential facilities. 10. During the first 18 months of operation, excluding the first three months of startup operations, if the effluent concentration from the System exceeds the applicable TN limit on two consecutive sampling events, the Company shall within 60 days submit a report to the Department explaining the reasons for the exceedances with.recommendations for operational or design changes.to prevent future violations. OMNI Recirculating Sand Filter Piloting Approval Page 9 of 10 11. For systems installed to demonstrate reduced'SAS, effluent discharge concentrations from the System shall not exceed 15 mg/L CBOD5, 10 mg/L TSS and a minimum of 95 percent Fecal Coliform removal must be achieved. In addition: i. A groundwater monitoring well shall be installed within 10 feet and directly downstream of the SAS in accordance with the Department's published guidelines and a groundwater piezometer or other DEP approved device for measuring water depth shall be installed within the SAS. The monitoring well shall be tested at the same frequency as listed in Section III item 4 and for the following parameters: Fecal Coliform and ammonia. Each time the System is monitored, the water meter reading, the groundwater elevation in the monitoring well and the water level in the groundwater piezometer shall be recorded.' 12. During the first 18 months of operation, excluding the first three months of startup operations, if the effluent concentration for or the System installed to demons trate strate reduced SAS exceeds 15 mg/L CBOD5, 10 mg/L TSS or fecal coliform reduction is less than 95 percent on two consecutive sampling events, the Company shall within 60 days submit a report to the Department explaining the reasons for the exceedances with recommendations for operational or design changes to prevent . future violations. 13. Within 30 days of the end of the first 18 months of operation the Company shall submit a summary report on each system describing the operations of the system, any changes in operation or design that were made during the Piloting period, the final results of the Piloting program for that system and whether the system met. the effluent limits for the previous 12 months of operation. That report shall also include either recommendations for approving and ending the Piloting program . for that system or recommendations for continuing Piloting for any system that has not performed as planned. 14. The Department will review the report in item 13 above and determine if additional Piloting of the system is required. The Company shall either.continue the Piloting program for that system as required.by the Department or remove the system and replace it with a fully complying Title 5 system. If the Department_ determines that the system has performed at the relevant level for at least 12 months, the Company can turn the responsibility for operation and monitoring of the system over to the owner in accordance with Section IV, item 5 of this Approval. 15. If the Company wishes to continue this Piloting Approval after its expiration date, the Company shall apply for and obtain a renewal of this Approval. The Company shall submit a renewal application at least 180.days before the expiration date of OAM Recirculating Sand Filter Piloting Approval Page 10 of 10 this Approval, unless permission for a later date has been granted in writing by the Department. VI. Reporting 1. All notices and documents required to be submitted to the Department by this Approval shall be submitted to: Director Watershed Permitting Program Department of Environmental Protection One Winter Street- 6th floor Boston, Massachusetts 02108 VIL Rights of the Department 1. The Department may suspend, modify or revoke this Approval for cause, including, but not limited to, non-compliance with the terms of this Approval, non-payment of the annual compliance assurance fee, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law.The Department reserves its rights to take any enforcement action authorized by law with respect to this Approval and/or the System against the owner, or operator of the System and/or the Company. VIII. Expiration date 1. Notwithstanding the expiration date of this Approval; any System sold and installed prior to the expiration date of this Approval, and approved, installed and maintained in compliance with this Approval (as it may be modified) and 310 CMR 15.000,may remain in use unless the Department, the local approving authority, or a court requires the System to be modified or removed, or requires discharges to the System to cease. OMNIrsfapprovall PIPING NOTES 3" RETURN LINE FROM FILTER MODULES AND 4" INLET FROM SEPTIC TANK ALL ENTER ON SAME SIDE OF TANK 3" RETURN LINE FROM FILTER MODULES ENTERS ONE SIDE OF FLOW SPLITTER AND EXITS ON OPPOSITE SIDE TO LEACHING FIELD' AC 1-1/2" PVC FORCE TO RSF MODULE AD POWER 24 HR RESERVE CAPACITY SUPPLY LOCATED .. }- IN ELECTRICAL - INLET FROM SEPTIC TANK HAND-HOLE INLET TEE W1TH EFFLUENT FILTER - I-1/4"CONDUIT FLOAT NOTES PULL CORD— ALL PUMP FLOATS ARE TO BE LOCATED DRAIN HOLE (`1 AWAY FROM INLET FLOW ' r FLOAT POLE ALL FLOATS TO HAVE.4" TETHER ZIP TIE TYPE= 3 - CHSCKFA N VALVE 2 1. PUEI MP ON/OFF 2. TIMER OVERRIDE d 1-1/2'PVC FORCE TO RSF MODULE 3. HIGH WATER ALARM 00 OMNI FLOW N�) SPUTTER WITH EFFLUENT PUMP I N FLOAT VALVE N NOTES - 2"BLOCK �,r r .:• :' r:SIDE VIEW 1.) OMNI RSF RECIRCULATION TANK (NO SUBSTITUTES) - - - INLET FROM 2.) PUMP CHAMBER SHALL BE STEEL REINFORCED CONCRETE. RSF MODULES - - jPUMP CHAMBER TO WITHSTAND H-10 LOADING UNLESS UNDER PAVEMENT, DRIVES OR 8'-6 - 3.) TRAVELED WAYS,WAYS, WHEREIN H-20 LOADING SHALL APPLY. 4•) ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL BE WATERTIGHT. V 5. 27" MANHOLE COVER TO BE BROUGHT TO FINAL GRADE. INLET FROM o 6.) INLET AND OUTLETS TO BE SCHEDULE 40 PVC. SEPTIC TANK �� I PREPARED BY.• kvl- pi " - 3" � TOP VIEW OUTLET TO FLOW SPUTTER OMNI S.A.S. r v" tv ntal, )evem$;h Inc; 1 ,000 G. OMNI RSE RECIRCULATION TANK DETAIL P.O. Box 128/465 East Falmouth Hwy.' 508.548.0350 FAX NOT TO SCALE East Falmouth, MA 02536 508.548.0343 PHONE www.om.nirsf.com matt@omnirsf.com z 1-1/2" FORCED MAIN FRO MM RECIRCULATION TANK 3" PVC OUTLET RSF DESIGN Cal rw an N FILTER CLOTH BUBBLER SYSTEM COVER Sand Filter Media 24" minimum depth <1% #200 sieve, 2mm to 4mm size � MULCH COVERING OMNI RSF BUBBLER SYSTEM Average Doily Flow Flow = 110 gpd per bedroom a, - .,, , Wastewater Strength-BOD5 Residential = 230 mg/I Recirculation Ratio 3:1 T Recirculation Tank Size 150% of Design Flow (Use o 1000 gallon tank) 1'<p s i t p ;'r t tgt > E nei4Tefiilk `Irr Sand Filter Loading Rate (Residential) Loading Rate = 1150 / BOD5 = 5 gpd/ft2 Sand Filter Surface Area SA = (Flow gpd) / (Loading Rate gpd/ft2) FRONT VIEW SIDE VIEW I 330 gpd / 5 gpd/sq. ft = 66 sq. ft. Required (64 sq. ft. Provided) 2 OMNI RSF Filter Modules Required a r7 I d $,_6„ Recirculation Pump Size Average Daily Flow + Recirculated Flow + Back Flow ''''' + <'." e-••.•... .•. ; 330 +'(4x330).+ 10 = 1.660 gpd 1,660 / 24hrs = 70 gal per 60 Minute Cycle Use Myers Model #ME40 or Equal (65 gallons/min ® 12 ft. Total-Head) Sand Filter Module Setbacks Some as Title V Septic Tank O_ i "OMNI RSF" SAND FILTER DETAIL NOT TO SCALE TOP VIEW NOTES 1•) OMNI RSF MODULES.(NO SUBSTITUTIONS). 2.) FILTER MODULES SHALL BE COVERED WITH MULCH TYPE MATERIAL ONLY. PREPARED BY., 3.) ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL BE WATERTIGHT. , 4•) OUTLETS TO BE SCHEDULE 40 PVC. _ '5•). 1-1/2 PRESSURIZED LINE TO BE BACK FILLED BY HAND. O"I( /(N1 46� nVir0"m, e, t0,1 .Y s,r. Ci6 P.O. Box 128/465 East Falmouth Hwy. 508.548.0350 FAX East Falmouth, MA 02536 508.548.0343 PHONE www.pmnirsf.com matt@omnirsf.com OM NI OMNI RSF System Operation and Maintenance Inspection Checklist A. Installation & Service Information Facility Street Address Date of Service City - Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required:: Yes❑ No❑ ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yes ❑ No❑. If yes, inspect❑ &.clean at least yearly❑ If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler, if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank ❑ Check if sludge accumulating Pumping required: Yes ❑ No ❑ Odor problems: Yes ❑ No ❑ If yes,description Effluent tee filter: Yes❑ No ❑ If yes, inspect❑ &clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank (if installed) Sludge Pumping Required: Yes❑ No ❑ ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yes ❑ No❑ If yes, inspect❑ &clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault (if Installed) ❑ Pump Inspections (all units) If problems,describe ❑ Float switches Check all switches for operation , Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats,,Alarm System ❑ Pump Inspections (all units) If problems,describe ❑Test pump alternator, or record hours Hours of operation ❑ Float switches Check all switches for operation ❑Test alarm If non-functioning,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") ❑ Inspect for ponding Ponding Present: Yes ❑ No❑ ❑ Clean bed: Yes ❑ No❑ ❑ Distribution pipes flush:Yes ❑ No ❑ Brush: Yes ❑ No❑ ❑Any obstruction of airflow to filter modules: Yes❑ No ❑ If Yes, explain below(i.e. snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).The Recover the filter,beds as they were found. H. Sample Collection Yes ❑ No ❑ If yes: ❑BOD ❑TSS ❑pH [ITN -[]Other All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers. In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: DEED RESTRICTION WHEREAS, Peter E. Marney of 15 Oldham Way, Osterville, Barnstable County, Massachusetts is the owner of a certain parcel of vacant land at 49 Joby's Lane, Barnstable (Osterville), Barnstable County, Massachusetts and shown at LOT 15 on a plan of land entitled "Plan of Land in Barnstable, Mass. `Osterville Woods' Property of the Lanza Corp." dated May 1, 1971, drawn by Robert G. McGlone, recorded at the Barnstable County Registry of Deeds in Plan Book 247 Page 137 by deed from Sally A. Marney recorded in Barnstable County Registry of Deeds in Book 19156 Page 191; WHEREAS, Peter E. Marney as the owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a variance from the State Environmental.Code, 310 CMR 15.21.A and to obtaining a building permit for this lot; WHEREAS, the Town of Barnstable'Board of Health, requires that said restrictions be put on record in the Barnstable County Registry of Deeds; NOW, THEREFORE, Peter E. Marney does hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: Until such time as technology changes and the Barnstable Board of-Health changes its regulations or otherwise grants permission, said premises at 49 Joby's Lane, Osterville may have constructed upon the lot a house containing no more than two (2) bedrooms and agrees that this shall be a permanent deed restriction affecting saidpremises. For title of Peter E. Marney see the following deed: Book 19156 Page 191. Executed as a sealed instrument this day of ,,�:y , 2003 TER E.MARNEY \W OFFICES OF d R.ALGER,P.C. PARKER ROAD ?0.BOX 449 i IERW.LE.MA 026SS-0449 COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. 2005 On this day of , 2005, before me, the undersigned notary public, personally appe ed;Peter E:Marney proved to me through satisfactory evidence of .identification, which was�Prsosre//' u� to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. � BETTY ANN M.TUPPER ` NOTARY PUBLIC Notary P is �t COMMONWEALTH OF MASSACHUSETTS My commission expires: Ms Y COMMISSION EXPIRES 2117� I�00� APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION Lot 15_ - Jehy' s NO. ,� C 9 t n VIUAGE Oste'rville DATE 6/7/88 APPLICANT�o�PrS Marne FEE $75. 00 (Non-refundable) ADDRESS ' p n Box 31 n - ngT TELEPHONE NO. 428-6106 ENGINEER•BaxtPr R NvA/p TELEPHONE NO. 428-913 DATE.SCHEDULED (Applicant's Signature) ....:: ;.... .. ........... ....................................... ... ...... ................................................................. ASSESSOR"S.MAP & LOT NO: 120/84 SOIL LOG SUB-DIVISION NAME 6sT vi�t� GJoo�s `� DATE Tung e-o tR% TIME fo Awl EXPANSION AREA:.YES x NO . ENGINEER TOWN WATER x PRIVATE WELL —Du nnLu BOARD OF HEALTH Prl f0 I �e r EXCAVATOR SKETCH: (Street name, etc., dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES: A10 79�00®i/ -o/rl S o OLATION RATE: nch - . ELEVATION: `t TEST HOLE NO: ELEVATION: ' HOLE NO.. 1 1 2 2 3 3 4 5-�r-h f«J 4 5 rrt&Jw n, 5 6 6 7 sar►eQ 7 e ,8 8 9 9 ,0 10 i 11 ' 11 12 �� Gc �ir�) ►44 11 12 13 13 14 14 4 15 15 16 16 TABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES ;UITABLE FOR SUB-SURFACE SEWAGE. REASONS: 'E: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION :GINAL: COMPLBTED N ENT RET Y P AND ETU®NED TO .BOARD OF HEALTH >y RETAINED BY APPLICANT Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name 07 information is Osterville ✓ MA 02655 4/25/16 required for every page. City/Town State Zip Code Date of Inspection N q 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: A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Greg Brehm use the return Name of Inspector key. Bennett Environmental Associates, Inc. Company Name P.O. Box 1743 Company Address Brewster MA 02631 City/Town State Zip Code 508-896-1706 13633 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 E aluation the Local Approving Authority Inspector's Sigfattire 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �D Commonwealth of Massachusetts H v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. CitylTown 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: None of the failure criteria described in 310 CMR 15.303- 15.304 existed at the time of inspection. The system appeared to be working as designed and functioning adequately under current use. 13) 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 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ' ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 49 JobY's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts d Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, 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): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. City/Town State Zip Code Date of Inspection D. System Information Description: Omni Recirculating Sand Filter System with engineered design plan by Sullivan Engineering of Osterville, MA dated 4-19-05. The system is comprised of a 1,500 gallon septic tank, a 1,000 gallon recirculation tank, 2 OMNI filtration modules, a d-box, and 2 leaching galleries 25'Lxl2'Wx2'D. Number of current residents: 0 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 Water meter readings, if available last 2 ears usage See Detail 9 ( Y 9 (gpd)): Detail: 2015: 131,000 gallons= 358.90 gpd, 2014: 96,000 gallons =263.01 gpd. High water gpd attributed to the use of an inground irrigation system that services the property tied into town water. Sump pump? ❑ Yes ® No Last date of occupancy: November 2015Date 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. City/Town 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: Homeowner, pumped in August 2015 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osteryille MA 02655 4/25/16 page. CityTTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 6/20/2005. Town of Barnstable Certificate of Compliance for Disposal System Construction, Permit No. 2005-282 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3.0' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 15+ feet Comments(on condition of joints, venting, evidence of leakage, etc.): Joints and venting were inspected and are in working order, no evidence of leakage encountered while inspecting main sewer line. System vented through roof. Septic Tank(locate on site plan): Depth below grade: 2.0 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1,500 gallon septic tank with outlet riser to 1"of final grade. Schedule 40 PVC inlet and outlet tees functioning correctly. Septic tank outlet tee is fashioned with an effluent filter. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1,500 gallons Sludge depth: 3" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. CityFrown 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 38" 0" Scum thickness Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Tape measure, sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not recommended at time of inspection. Inlet and outlet tees are functioning properly, septic tank is structurally sound. Liquid levels as related to the outlet invert was at a normal height. No evidence of leakage or backup observed while inspecting septic tank. Outlet riser to withing V of final grade. 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. CitylTown 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 i Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25116 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): 0" Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box appears structurally sound with no evidence of backup or leakage. No evidence of solids carryover. The D-box is level and distributing flow appropriately with flow equalizers to the soil absorption system. Risers to within 12" of grade. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16' page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 225'Lx12'Wx2'D ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil is sandy, no signs of hydraulic failure, vegetation normal. Design Plan indicates 331 gpd provided, 220 gpd required. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osteryille MA 02655 4/25/16 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 r Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 y Job 's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 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 all t$yii fir, 47 vG �rs k t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. Cityrrown 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: 61+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 4/19/2005 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater determination was accomplished using percolation test data from the Design Plan by Sullivan Engineering dated 4-19-05. Soil Testing (Permit No. 6980)was conducted on 6/20/1988, conducted by Steve Wilson and withnessed by Jerry Dunning. Soil test logs indicated that no groundwater was encountered at elevation 23.0 in Test Pit#1, the bottom of the leaching galleries is at elevation of 29.2 which leaves a 6'+ estimated seperation to high groundwater. The Design Plan also notes that groundwater is approximately at elevation 13.0. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 49 Joby's Lane Property Address A. Chapman Bailey Owner Owner's Name information is required for every Osterville MA 02655 4/25/16 page. CitylTown 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 r BE14NETT. EPqViffRONMfEPqTALAssocilA,,, T,h 59 1-1\"TIcoj LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS GEOLOGISTS 6 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 v 508-896-1706 i Fax 508-896-5109 L) www.bennef-ea.com BEA10-10214 March 4,2016 ry Ms. Chapman Bailey F I Irp C P.O. Box 662 I Osterville, MA 02655 RE: OPERATION AND MAINTENANCE CONTRACT Innovative/Alternative Wastewater Treatment System 49 Joby's Lane- Osterville,MA Dear Ms. Bailey, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for the continuation of professional services relative to the operation and maintenance of the innovative/alternative septic system located at the above referenced property. The semi-annual system inspection and laboratory analysis of samples collected from the effluent of the septic treatment system is a required condition of the approved Innovative Wastewater Treatment System, as set forth by the Massachusetts Department of Environmental Protection(MA DEP)and the Barnstable Board of Health to qualify treatment capacity. As such, work proposed by BEA includes the collection of wastewater samples for field screening and the preparation of the required forms for distribution to the appropriate town and state offices, as well as you. Additionally, at the time of such sampling,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance will be performed. You will be invoiced for this work semi-annually on a fixed-cost basis. Should any repair or treatment system component replacement be required, or additional sampling beyond the semi-annual requirements necessary, you_will be notified to authorize the additional work and expenses. The following budget represents estimated annual costs through one year of service to include two sampling and inspection events. These annual costs are valid for two years. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore,you are required to notify any buyer for the transfer of this contract. SEMI-ANNUAL INSPECTION/MAINTENANCE/SAMPLING Inspect I/A system and take field measurements of dissolved oxygen,pH and turbidity. Collect semi-annual treated effluent wastewater samples under a proper chain-of-custody for analysis by a MA certified laboratory of BOD,TSS,and nitrite/nitrate/TKN for total nitrogen. At the time of sampling events the conditions of the system will be inspected and documented with regards to the blower units,sludge level and associated piping. I EMERGENCY SPILL RESPONSE WASTE SITE CLEANUP 6 SITE ASSESSMENT 6, PERMITTING Cj SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 0 WASTEWATER TREATMENT,OPERATION&MAINTENANCE MARCH 4,2016 BAiLEYBEAIO-10214 PAGE 2 OF 2 49 JOBY'S LANE-OSTERVILLE,MA REPORTING/FILING Review laboratory results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms and submit inspection and sampling reports on the Barnstable County Department of Health and Environment online database on a semi-annual basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Services $535.00 Laboratory Analysis[2X BOD,TSS,TN(nitrite,nitrate,TKO] $ 162.84 TOTAL ANNUAL EXPENSE: $697.84x TOTAL COST PER EVENT: $348.92 *Note:UA systems located in Barnstable County are required to report inspection and sampling results on the MA Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. In addition,the noted fee is based on appropriate accessibility to the system wherein all components should be at grade level. While the alternative septic system at your residence is currently classified as requiring quarterly operation and maintenance,the Barnstable Health Agent has specifically requested that we provide a semi-annual contract in recognition of the seasonal use of the residence. Operation and maintenance will be.performed in accordance with the schedule approved by the Barnstable Board of Health and you will be notified of any necessary changes to this contract as a result of their approval. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Please sign and date this contract for our records acknowledging acceptance of our Terms & Conditions and return one copy to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES,INC. Samantha Farrenkopf, WWTO , Wastewater Program Manager cc: Kara Risk,Business Manager encl. Abbreviated Terms& Conditions (2011)/Fee Schedule (2014) F AUTHORIZATION:kt IDATE: —,� 1 n viro,nmewd-Systems, Inca OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information 0 Facility St pet Address k Date of Service City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank �` ���• Sludge Pumping Required: Yes❑ NQA ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: YNo❑ If yes, inspe &clean at least yearly❑ If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler, if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank ❑ Check if sludge accumulating Pumping required: Yes❑ NO( Odor problems: Yes❑ N If yes,description Effluent tee filter: Yes❑ NdX If yes, inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules. Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) ❑ Pump Inspections(all units) If problems,describe ❑ Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch; if the pump is not operational immediate corrective actions need to be taken. I F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) \ Iflf rs �obleme e be/ �J Q-7�". Test pump alternator, or record hours G \ Hours of operation Float switches Check all switches for operation IXTest alarm If non-functioning.,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are functional, if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes❑ N�1 J Clean bed: Yes❑ N&K Distribution pipes Flush:Yes❑ N Brush: Yes❑ N04 ❑Any obstruction of airflow to filter modules: Yes❑ N6i4 If Yes, explain below(i.e. snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Y Ns No❑ If yes OD%kTSS ❑p TN 40ther j ) \-J \\' All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e. rubber gloves). System Notes: BE D EwmoN ENtAL 1573 Main St.,P.O.Box 1743 Brewster,MA 02631 508-896-1706 www.bennett-ea.com Date&time of visit: A site visit was conducted today for: O&M _AYES ❑ NO Testing YES ❑ NO Repair ❑YES NO Alarm Call ❑YES 1NO Your system is operating correctly �_E\YES ❑ NO Tank(s) in need of pumping ❑YES NO Further maintenance required El YES NO `Repairs needed ❑YES ONO Please contact our office ❑YES NO Contract renewal required ❑YES NO Field testing WPass ❑ Fail Sample pulled x. YES ❑ NO Laboratory sampling conducted YES ❑ NO pZA gENNETT ENVIRONMENTAL -ASSOCIATES.INC. •ASSESSMENT -•REMEDIATION 't i a RESOURCE MANAGEMENT r•: s 6 a15 No. - Fe THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE.,MASSACHUSETTS Rpplication for �Dwpooaf bp!gtem COU trust= Permit components Application for a Permit to Construct(,'17epair( )Upgrade( )Abandon( ) Complete System ❑Individual Location Address or Lot No. yq Jzby S L Iwe, d,54__r tjW Owner's Name,Address and Tel.No. Assessor's Map/Parcel �ox'Z`l i ze =c� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4 i1,3tr. (aS�l Type of Building: Dwelling No.of Bedrooms Z- Lot Size SI_s�sq.ft. Garbage Grinder(A1Q Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures r Design.Flow ZZ� gallons per day. Calculated daily flow 35 � gallons. Plan Date c;1 I C1 Zcx3 Number of sheets Z Revision Date • Title r, S � � �. f S.A.S. Size of Septic Tank 150-0 fa�k� Type o '7-5c�(oAi ('!'�m�� i7.xZS-�t=�cZ C Description of Soil, O-8" O t L�3 1 -` 'l Li zy. rt1 o� 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- e sate of Compliance has been issued by thfs Iro d of ealth. Si �` Date - Date '� a Application Approved b Application Disapproved for the following reasons Permit No. '� 0 rj -�` Date Issued � � y 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 has been constructe4 in accqr.dance at L41 \12VJT _ 'dated with the provisions of Title 5 and the for Disposal System Construction Permit No. �� Installer nYJ Designer The issuance of this permit shall not be construed as a gu antee that the syewil'1\t as des igne Date � Inspector ----- gd° r 6 ---------- Type of Building: Dwelling No.of Bedrooms Lot Size S,S-Z�_sq.ft. Garbage Grinder(rt)Q e of Building No.of Persons Showers( Cafeteria( ) Other Typ. g . Other Fixtures De§iga Flow ZC7 Z gallons per day. Calculated daily flow 3 , gallons. Plan'Date oc;1 I�iTZ l Number of sheets Z Revision Date Title A+ `-l� `^c Size of Septic Tank �(� Sri Ty S.A.S.pe of ?-Sc�(_ � ('41�m i 7. ZS- i IGz C Description of Soil; 0_8 -- (. O i " Lc - S S e :w a 1_7`10" L-1 Lc, k�- Z4 n1 c 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'a�nd not to place the system in operation until a Certifi- r cate of Compliance has been issued by this Board of ealth. Si S�5!�Date .N Date �+ Application Approved b — Application Disapproved for the following reasons �j Date Issued Permit No. ---_�--- �` _.---- ——----- --- 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 `_ -� has been constructed in acc rdance at I� L� 1 n n (:`t r�) :l c with the provisions of Title 5 and the for Disposal System Construction Permit No. , dated -'5 *Q rrr�ti2��� {' `.Designer Installer The issuance of this permit ermit shall not be construed as a gu4antee that the systerfi wilt as designed--, Date Inspector —-------------------------------------- --^ e ��-- Fee No. C�Ci 5 v u THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION e BARNSTABLE} MASSACHUSETTS *p0tem ConMruction Permit Permission is hereby granted to Construct Repair( ),Upgrade( )Abandon( ) System located at 'iq 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:Construc:on mu t be completed within three years of the date of this p�ermi. Date: 5 Approved by APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION Lot 15 - Joky' s NO. c^ t VILLAGE O terville DATE 6/7/88 APPLICAN FEE $75 . 00 (Non-refundable) ADDRESS • p n Box 31 o - nsm_ TELEPHONE NO. 4 2 8-610 6 ENGINEER•paxt-pr K Nva/P sill i iy6 TELEPHONE NO. 428-913 DATE.-SCHEDULED 45,51 (Applicant's Signature) ....;:::.....................................:.....................................<....................................................................... ASSESSOR"S MAP & LOT NO: 120/84 SOIL LOU- SUB-DIVISION NAME �'GsTy2usL�� G1ocazs " DATE �� s?, t�r"is�� TIME d o mti EXPANSION AREA:.YES 'X , NO Si--Vt W;i Sa41 ENGINEER TO,WN.WATER X PRIVATE WELL �"arP..i duv�nrn. BOARD OF HEALTH -� EXCAVATOR SKETCH: (Street name, etc., dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES: 4 � -a40 � * A0.raC9 � . ' OLATION RATE: m�r��in4l� ELEVATION: TEST HOLE NO: ELEVATION: HOLE N0: `• 1 1 2 2 •.: i 3 .3 S-}rztiiz f«` 4 4 6 6 7 8 y 10 10 11 .......:......;.-•--------------------- ASSESSOR"S MAP & LOT NO: 120/84 SOIL LOG SUB-DIVISION NAME { ' sTL r/s�e-� tjQ� " DATE 0"i�n E , t 9`s~41 TIME r EXPANSION AREA:.YES 'C . NO Si-•cyt, Wf,I aov, ENGINEER TQWN.WATER x PRIVATE WELL �'r-rr-iu v�r:in_re BOARD OF HEALTH EXCAVATOR • SKETCH: (Street name, etc., dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) , 1 NOTES: r OLATION RATE: ELEVATION: HOLE N0: ELEVATION: TEST HOLE NO: • 1 1 2 II 2 3 l 3 4 4 6 . 6 7 •7 8 • y - 10 . 10 11 11 ' 12 1 : 13 3 14 14 15 i5 16 16 TABLE FOR SUB—SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES_� :UITABLE FOR SUB—SURFACE SEWAGE. REASONS: N INEEtRING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION AND ETURNED TO BOARD OF HEALTH ;GINALI COMPLETED N ENT RET Y P ®® _,Y:. RETAINED BY APPLICANT Land Records Public Search Page 1 of 1 <Previous Zoom In Zoom Qut.° Rotate Left Rotate Riht Barnstable County ' Capeview Internet Access Book - Page 29721-122 97 1 191 T 9460 Select the next action you want to perform. mpt W2 - 016 & 01*04D When done viewing, click on the <Previous button below. All Pg ViewjPrintjAdd to Cart Pg 122 ViewjPrintjAdd to Cart Pg 123 ViewjPrintjAdd to Cart MOINMETTS S1ATE a T��..._ MORE C INfiY MIMI V 0 Previous ' Main Menu:, �Otgs D6�t3�20l6�Q �� � ��i4fl b6l f d7J VYSTI TWU Full 41P7�1;o4 �4ii5i E�12tt�9i� E�R����DL--�GQoNiY EXCISE 1R� :.• C�fiPiSI��IE�aim DEGIs Y�Otis Alii CttwrM Date 29b Ftr�I Itl3"l, o C���� I t ►CCO OHITCLAI,I DEED I, Aj CIP PMAN BAILEY, fdtmedl bow as Chapm n B,Greeley,TRUSTEE OF AF � [ jl#I FY DECLARATION OF TRUST, under Declaration of TO dated Pebrraary 11,1999 rccorded is Barnstable Coorq Registry of Deeds Rook 23359 Page 221,4 amended by i inneut dated 00ober S, N121 records in Book MT1 Page 162 of 34 Waterfowl Road, 111tonj South Carolina 2010 in cousiderafioi of FI E HUNDRED �- VELVF,THOUSAND AND NOAN(SSI2;O UO)DOLLARS,paid,grant to CATHY I Cf 1RTIS,Iodividuallyi o(N L,atcro tne,Wellesley, 02481 MTH QUITCLAIM COVIJN1tNTS;it a emin parcel of land,together with the baildiigs thereon:more oariiculdy bounded and described as follows; = LOT IS ou a plai of land entitled"Plan of.Land iu Bamstable,Massi'Oster�illc Woods' Property of the.Uiza Corp,daled 1 May Nil Scale 1°`=d Y Robed 0,Malone Suneyor Engineer Main Street`Veit Daristable"which said Plan is duly recorded the Barnstable Loom}Registry of De ds in Plan Book 20'.Page 137. The Omnlot hereby certifies as follows 1, I am the meat and sole trustee of A.CHAPMRIti BAILEY DPCL ARAM OF TRUST; https:Hsearch.bamstabledeeds.org/ALIS/WW400R.HTM?WSIQTP=SY00 2/27/2017 (ZI�BCDHE ./�,,,� ' BAPxV$um Cow,"DEPAaTmw OF HEALTH MO EMWHOH'mN u ^_ PROMOTE-PROTECT-SUPPORT .: .� September 1st, 2016 Cathy Curtis 24 Lantern Lane Wellesley, MA 02481 RE: Operation andMaintenance Contract for.the Innovative/Alternative Septic:System Installed at 49 Jobys Lane in the town of Barnstable. Dear Cathy Curtis, Our records indicate that the operation and maintenance contract with Bennett Environmental Associates, Inc.for your innovative/alternative wastewater treatment system may have expired or was canceled as of May 26th, 2016. 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 https:Hseptic.barnstablecountyhealth.org. 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 have enclosed 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, you may be referred to the Barnstable Board of Health for further enforcement action. I can be reached at 508-375-6901; my Fax number is (508)362-2603. 1 can also be reached via email at emilymichele.omsted@barnstablecounty.org. Thank you for your prompt attention to this matter. Sincerely, S Emily,Michele Olmsted CC: Barnstable Board of Health Enclosures (2): Certified Wastewater Treatment System Operators List, Inspection and Testing Requirements BARNSTABLE COUNTY COMPLEX 3195 MAIN STREET/PO BOX 427 BARNSTABLE,MASSACHUSETTS 02630 Phone:(508)375-6613 1 Fax:(508)362-2603 1 TDD:(508)362-5885 Web:barnstablecountyhealth.org I Twitter:@BCHDCapeCod i BENNE7[T ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS 1573 Main Street,P.O.Box 1743 (50a 896-1706 Brewster,MA 02631 fax(50*896-5109 m LETTER OF TRANSMITTAL TO: DATE: JOB NUMBEIG Massachusetts Department of Environmental Protection 6/3/16 BEA10-10214� Attention: Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Termination Notice Bailey Residence 49 Joby's Lane SHIPPING METHOD: Osterville,MA Regular Mail ❑ Federal Express ❑ Certified Mail ❑X UPS ❑ Priority Mail ❑ Pick Up ❑ Ex ress Mail ❑ Hand Deliver ❑ COPIES DATE DESCRIPTION For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Through this letter,Bennett Environmental Associates,Inc.(BEA)is formalizing our termination as operator of record for the above referenced Innovative/Alternative Septic System effective as of 5/26/16. At this time sale of the residence is imminently pending and BEA has not been provided with contact information for the new owners. Thank you. �—cBarnstable Board of Health 7�, FROM: David Bennett WWTO#6243/Samantha Farrenkopf WWTO#13265/Joseph Smith WWT0#12529/Greg BrehmWWTO#16149 If enclosures are not as noted,kindly notify us at once 0,�5h io C�- >30 BENNETT ENVIRONMENTAL ASSOCIATES, INC. J�- LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS en 1573 Main Street,P.O.Box 1743 (508)896-1706 110 Brewster,MA 02631 fax(508)896-5109 �J LETTER OF TRANSMITTAL 9 TO: DATE: JOB NUMBER: C:h1 Massachusetts Department of Environmental Protection 9/23/15 BEA10-10214 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Bailey Residence 49 Joby's Lane SHIPPING METHOD: Osterville,MA 02655 Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(June and September 2015) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist(June and September 2015) 1 6/24/15 Alpha Analytical laboratory report 1 9/22/15 Alpha Analytical laboratory report For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: Fxj REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI RSF Operation and Maintenance Checklists,and laboratory analytical reports for operation and maintenance conducted at the above referenced property during the reporting period. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:`Barnstable_Board-of_Health Ms.Chapman Bailey,Owner FROM: David Bennett WWT046243/Samantha Farrenkopf WWT0413265/Joseph Smith WWTO#12529/Greg BrehmWWTO#16149 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection LiBureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/17/15 9/10/14 Inspection Date Previous Inspection Date 10"sludge, 0.5"scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 3 a 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 E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑ turbid ❑ Other(specify): Odor: M musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.0 mg/L Turbidity 4.95 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: The system was turned off upon arrival. The power was turned on to the system, and the system observed to go through its cycles. All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 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 H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257' {1CMR 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 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, 6t5 Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection LlBureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's Lane key to move your Facility Street Address cursor-do not Osteryille 02655 use the return key. City Zip Mailing address of owner, if different: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 9/14/15 6/17/15 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 LIMassachusetts 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 E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 5.0 mg/L Turbidity 1.43 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 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 M TSS ❑ TN M Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257 {CMR 2.00. 964S Operator Signature _ Date, — System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 'Ingot. OMNQ- &� Environmental Systems, Inc. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information `r' S an.. Facility Street Ad ess Date of Service V$i -7 6��Lf rZ, -etj —1 city Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required., Yes E] No Et Sludge Depth: Scum Depth: Effluent tee filter: Yes jo No El If yes, inspect E]&clean at least yearly F1 If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank Check if sludge accumulating Pumping required: Yes El No El Odor problems: Yes❑ No If yes,description Effluent tee filter Yes❑ No If yes,inspect 0&clean at least yearly❑ If the sludge layer is greater than 4'request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules-Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) lj[A- Sludge Pumping Required: Yes E] No E] [I Sludge Depth: ❑Scum Depth: Effluent tee filter. Yes El No f-1 If yes,inspect 0&clean at least yearly El Same inspection criteria as septic tank: E. Pump Chamber!Vault(if Installed) [] Pump Inspections(all units) If problems,describe F1 Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats,Alarm System ®Pump Inspections(all units) `��( t1 'e-f,Y,-, If problems,describe L'J Te pump alternator, or record hours Hours of operation Flo t switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") 5,)r' Inspect for ponding Ponding Present:Yes❑ No-M LPI Clean bed: Yes❑ No ❑ Distribution pipes Flush:Yes❑ No Brush: Yes❑ No-g ❑Any obstruction of airflow to filter modules: Yes❑ Nod If Yes, explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes No❑ If yes:❑BOD ❑TSS ❑pH ❑TN ❑Other All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: ' P1�7 LL�� /j.�� ��J t V/� /Jl ��I ( , �( /l L`C �+ f 4irr✓�� � it . C"� Lt D 7'Cr fit.Pi` :� J � 'r C� J ✓/YI'� L( }} G� 1 � /Vv �c /)C)� �; �3 > f M Q _ En vi;ranmenlR Systems,fne. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information _ Facility St eet Address Date of Service _ City Operator/O&M Firm System Startup Date Weather Conditions � �VA B. Septic Tank Sludge Pumping Required: Yes❑ N'b-,'-W ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: YtNo❑ If yes, inspelak&clean at least yearly❑ If the sludge layer is within f 2°of the outlet invert,recommend that the homeowner have the.septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank (1XV, ❑Check if sludge accumulating Pumping required: Yes❑ NQk Odor problems: Yes❑ NkN If yes,description Effluent tee filter: Yes❑ NdX1 If yes, inspect❑ &clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank (if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes,inspect❑ &clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber 1 Vault(if Installed) ❑Pump Inspections(all units) If problems,describe ❑ Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats,Alarm System Pump Inspections(all units) Test pump alternator,or record hours �gne!31be X � v`j t�('�a Q � Hours of operation ` Float switches Check all switches for operation XTest alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. ;\ `-S G. Filter Modules ("Sand Filters") 5�-f��s �"`"� \-<o V',— Inspect for ponding Ponding Present:Yes ElNc y i Clean bed: Yes❑ No vv�` Distribution pipes Flush:Yes❑ Nk4 Brush: Yes❑ 4 ❑Any obstruction of airflow to filter modules: Yes❑ N44 If Yes,explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one comer of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be dogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Y Ws No❑ f. If esO80D ❑TSS Other Y � p N � 3 All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: Ilk uO i ���~ Q� Serial No:06241515:31 K ANALYTICAL REPORT Lab Number: L1513775 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN-. David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 06/24/15 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),VA(460195),MD(348),IL(200077),NC(666),TX(T104704476),DOD(1-2217),USDA(Permit #P-330-11-00240). Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com *j3H� /X. ...,.,o. Page 1 of 16 Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Alpha Sample Collection Sample ID Client ID Matrix Location Date/Time Receive Date L1513775-01 EFFLUENT WATER OSTERVILLE, MA 06/17/15 14:00 06/18/15 Page 2 of 16 I BHA Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC for all NELAC accredited parameters.The data resented in this report is organized b parameter i.e.VOC SVOC etc. .Sample P P P 9 YP ( ) P specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.Tentatively Identified Compounds(TICs),if requested,are reported for compounds identified to be present and are not part of the method/program Target Compound List,even if only a subset of the TCL are being reported.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific%recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.All specific QC information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples(with the exception of Air canisters)free of charge for 21 calendar days from the date the project is completed.After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples.Air canisters will be disposed after 3 business days from the date the project is completed. Please contact Client Services at 800-624-9220 with any questions. Page 3 of 16 ` ��' Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Case Narrative(continued) BOD, 5 day The WG795086-2 LCS recovery(122%), associated with L1513775-01, is outside the acceptance criteria. Due to the expiration of the method required holding time, no further action was taken. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: 4S.aao;t� Lisa Westerlind Title: Technical Director/Representative Date: 06/24/15 Page 4 of 16 Serial No:06241515:31 INORGANICS MISCELLANEOUS Page 5 of 16 Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 SAMPLE RESULTS Lab ID: L1513775-01 Date Collected: 06/17/15 14:00 Client ID: EFFLUENT Date Received: 06/18/15 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst eneral Ch, emistry=.Westborough G Solids,Total Suspended 19. mg/I 5.0 NA 1 06/23/15 13:55 30,2540D DW Nitrogen,Nitrite ND mg/I 0.050 1 06/18/15 19:58 44,353.2 MR -----._....---- --- ---- -- -- - ----- -- -- -- - ... -----._._.._.._.—_............ ------ - Nitrogen,Nitrate ND mg/I 0.10 -- 1 06/18/15 19:58 44,353.2 MR Nitrogen,Total Kjeldahl 30.9 mg/1 3.00 - 10 06/19/15 18:14 06/22/15 23:06 30,4500N-C AT BOD,5 day 68. mg/I 12 NA 6 06/18/15 22:30 06/23/15 16:40 30,5210B SE AkeF,r1L Page 6 of 16 Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst ., ..�r.v arc. N,` *" ;e w,s+ .'cm `r .--mac.'.' General Chemistry MWestborough Lab for�sampl'e(s) 01 Batch WG795022 1 * r f Nitrogen,Nitrate ND mg/I 0.10 — 1 06/18/15 18:46 44,353.2 MR General Chemistry ;Westborough Lab for samples) 01 Batch VVG795023 ... 3.�.r Nitrogen,Nitrite ND mg/I 0.050 — 1 06/18/15 18:48 44,353.2 MR .�,.., ..,,. ,..� �•,:rr r=.,+� s ,,.. a rwrr� rwa ;+^a-.s tn:f^� �"t3i'p e•• r�`s�ir 'tl�w- a,,�^.� r,_., a�, "v , , Generaf emistry �Westborough Lab BOD,5 day ND mg/I 2.0 NA 1 06/18/15 22:30 06/23/1516:40 30,5210E SE General Chemistry Westborough Lab for samples) 01 Batch WG795431 1 Nitrogen,Total Kjeldahl ND mg/I 0.300 — 1 06/19/15 18:14 06/22/15 22:47 30,4500N-C AT General;Chemistry Westborough Lab for sarnple(s) �01 'Batch V1IG796102 1p ." Ar �� Yp' " .....�.'... _ tF Solids,Total Suspended ND mg/I 5.0 NA 1 06/23/15 13:55 30,2540D DW 7- A� 1-eA Page 7 of 16 Serial No:06241515:31 Lab Control Sample Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits Ge.neralFChemistry-Westborough<Lab ;Assoclatetlt ample s 01 Batch WG795022 2 ' =* m � Nitrogen,Nitrate 100 90-110 ......- .. -.._. - -........ ... _'.u_....: _ —_ ..--- _ .._ ................ .._......... _............... .......... _. ..,...._._. ..... ... ...........-........... __._.........._ .. General Chemist Westborou hrLab "Associatedsam le s 01' Batch:WG795023 2 ry- o r 9 p O' >.,. t �. .. .�_.. *..w. x. � k ,'...�....-. .:v:,;.-m...,-.P.....�..-:c..Tv ..+..« ....;.:•.....:_.. -..w:......». ...�:_-..^.. � .....-,- �.,. ..an-..... �.... ..��.,..»«sr». �. :. �.+, ..,. .zv.++.... a-i...� +, ... m .. Nitrogen,Nitrite `'' 102r 90-110 20 General;Chemist -`..Westborou h.:Lab Associatedaam le s:01=.; Batch1NG795086 �ry _ .E. . .w.�� ng:.z.. . .. , wp ,�..�„,. , .,;��� BOD,5 day 122: Q 85-115 20 ... y . ? General,Chemistry-West6oroughaLab .Assoclated,8arnple(s): 01' ~_Batch 54 2 V1/G79 31 Nitrogen,Total Kjeldahl 1041: 78-122 Page 8 of 16 I Serial—No:06241515:31 Matrix Spike Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits «.. ,.p , '.: .....i.. Y ..� 1'� T,,r : :y, ,. , •s _ i'•1 E u- - V'1,2; Gen.e.ral,Chernistry Westb6r60 h,k,Lab,Associatedsarn le s . 01,. .QC Batch�ID.;WGZ95,022 4 . QC,Sam. Le..,,L1513716 02 ' Client:ID MS Sam F,. er- .. �..: . . „ . Nitrogen, Nitrate 3.2 4 7.3 :;'.102' "":; - 83-113 6 4�. ' r, i F » ' ":• fit' General,Ghemist W.•.estborou hLabAssociatedwsam ,le,s : 01, NQC�.Ba#chID WG795923 4, QC.}.Sam le L15.1.37.16.02, _Client.ID,; Nitrogen, Nitrite 1.8 4 5.8 C' =�.100`1 ..1 - 80-120 20 -La�b.K.A.:.ss octed .. �.. Q. eBateh P 3�6.., .,nn.t�,Dw�r aMz S.:.;�S.�a m lef 'enerahCist ry-Westboro h a mk01 , m l f7".". Q r _ BOD,5 day ND 100 140 gam"' :140 - 50-145 35 f 3'a%";. ....: ... .a;,:. w "' 1 rt, .,q., .t- 4.+e „ ;r,.•ucw. d a:F+ tr ',, G,eneral,Chemist ,-Westborou hLabAssociated yarn le s ?01�....QCsBatchxlD fWG795.4.3ri1.-4 .,QC'.Sam Ie.,L1513556,...0.1.. Client ID...aMSSam le ,: , rYt g . :. P ..wm., :>:A. »..:.,�4„ti �... w...Z.;.-.,.., ,.�'a: _ .s � :._..,, - ._I. .,m. ., ,..__..o_. ,»...r.. -.._._.,a _.. < ...-..� ,f.>.�s;:�s,..».�.....d`. ,......wwa:.•a Nitrogen,Total Kjeldahl 0.595 8 8.32 96 77-111 24 Page 9 of 16l, A;A �r Serial No:06241515:31 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General-Chemist .--hW..estborou h.Lab�;-Assoclate. sail" fi :` o ry g pl (s,). 01tQCBatch ID WG795022 3QC,Sample.,,L1513716 02i,.Cllent,ID- DUP Sample„ . Nitrogen, Nitrate 3.2 3.2 mg/I 0".,, 6 General,Chemistry==-:W,estbor0ugh Labp'Assocla#ed sam `le s ?01,y.QC.Bafch ID„ V1lG795.Q23 :QC Sam.le:`.7L`1513.716-02.�Client-ID pIJP Sam lei 3. i P ( ) .,- ..-_.Y., _� .. .�.s _ Nitrogen, Nitrite 1.8 1.8 mg/I "` 0' .r;~ 20 . . q3 _QC' m 37ryWestoroughabAoasample(sGeneral Che ID NG795086 a.CllenttlD DUP Sample BOD,5 day 330 330 mg/I 0-"f 35 _...... - ...................... ..-........ -_ .............. ..., M 4 t h : 4t tin` ' General.C.hemistry. Westborough{Lab,AssoclatedGsample(s)...01, QC,Bateh4lD..WG795431 3_ QC,Sample....L15:13556 01';Cllent:ID .;DUP Sarple 4= , Nitrogen,Total Kjeldahl 0.595 0.671 mg/I '.-OF12; -�' 24 y; _. _,,.,, w General Ghemist :11Vestborou hbLab:Assocl.atedgsam' le s :rl .QCfBatch`ID,.:ING79.61;02 2 * QC Sam le J1,ll.151'3660=01' Cllent:,ID. DIJP ..:.: .: , ,,. , r. . >. . ._ . ... Solids,Total Suspended 240 250 mg/I '4` 29 -- --------- Page --- ----Page 10 of 16 'HA, Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1513775-01A Plastic 250m]H2SO4 preserved A <2 4.9 Y Absent TKN-4500(28) L1513775-01 B Plastic 950m]unpreserved A 7 4.9 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1513775-01 D Plastic 950ml unpreserved A 7 4.9 Y Absent TSS-2540(7) *Values in parentheses indicate holding time in days Page 11 of 16 Serial No:O6241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: . 06/24/15 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA -Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. NP Non-Plastic:Term is utilized for the analysis of Atterberg Limits in soil. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. TIC Tentatively Identified Compound:A compound that has been identified to be present and is not part of the target compound list (TCL)for the method and/or program.All TICs are qualitatively identified and reported as estimated concentrations. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Total:With respect to Organic analyses,a'Total'result is defined as the summation of results for individual isomers or Aroclors.If a'Total' result is requested,the results of its individual components will also be reported.This is applicable to'Total'results for methods 8260,8081 and 8082. Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(IOx)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit.For NJ-related projects(excluding Air),flag only applies to associated field samples that have detectable concentrations of the analyte,which was detected above the reporting limit in the associated method blank or above five times the reporting limit for common lab contaminants(Phthalates,Acetone,Methylene Chloride,2-Butanone). C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. Report Format: Data Usability Report \, Firs Page 12of16 Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 Data Qualifiers D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I -The lower value for the two columns has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search. P The RPD b:tween the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. RE -Analytical results are from sample re-extraction. S -Analytical results are from modified screening analysis. J -Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND -Not detected at the reporting limit(RL)for the sample. Report Format: Dana Usability Report Page 13 of 16 Serial No:06241515:31 Project Name: BAILEY RESIDENCE Lab Number: L1513775 Project Number: BEA10-10214 Report Date: 06/24/15 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA_-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to, damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 14 of 16 Serial No:06241515:31 Certification Information Last revised December 16,2014 The following analytes are not included in our NELAP Scope of Accreditation: Westborough Facility EPA 524.2:Acetone, 2-Butanone(Methyl ethyl ketone(MEK)),Tert-butyl alcohol, 2-Hexanone,Tetrahydrofuran, 1,3,5-Trichlorobenzene,4-Methyl-2-pentanone(MIBK), Carbon disulfide, Diethyl ether. EPA 8260C: 1,2,4,5-Tetramethylbenzene,4-Ethyltoluene, lodomethane(methyl iodide), Methyl methacrylate, Azobenzene. EPA 8270D: 1-Methylnaphthalene, Dimethyl naphthalene,1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,4-Methylphenol. SM4500: Soil:Total Phosphorus,TKN, NO2, NO3. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Mansfield Facility EPA 8270D: Biphenyl EPA 2540D: TSS EPA TO-15: Halothane,2,4,4-Trimethyl-2-pentene,2,4,4-Trimethyl-1-pentene,Thiophene, 2-Methylthiophene, 3-Methylthiophene, 2-Ethylthiophene, 1,2,3-Trimethyl benzene, Indan, Indene, 1,2,4,5-Tetramethylbenzene, Benzothiophene, 1-Methyl naphthalene. The following analytes are included in our Massachusetts DEP Scope of Accreditation,Westborough Facility: Drinking Water EPA 200.8: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI; EPA 200.7: Ba,Be,Ca,Cd,Cr,Cu,Na; EPA 245.1: Mercury; EPA 300.0: Nitrate-N, Fluoride, Sulfate; EPA 353.2: Nitrate-N, Nitrite-N; SM4500NO3-F: Nitrate-N, Nitrite-N; SM4500E-C, SM4500CN-CE, EPA 180.1, SM213013,SM4500CI-D,SM23206,SM2540C, SM4500H-B EPA 332: Perchlorate. Microbiology: SM921513; SM9223-P/A,SM9223B-Colilert-QT, Enterolert-QT. Non-Potable Water EPA 200.8:AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn; EPA 200.7:AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn; EPA 245.1,SM45001-1,13, EPA 120.1,SM251013, SM2540C, SM234013,SM23206,SM4500CL-E, SM4500E-BC, SM426C, SM4500NH3-BH, EPA 350.1:Ammonia-N, LACHAT 10-107-06-1-B:Ammonia-N,SM4500NO3-F, EPA 353.2: Nitrate-N,SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, SM4500P-B, E, SM52201), EPA 410.4, SM521013,SM5310C,SM4500CL-D, EPA 1664,SM14 510AC, EPA 420.1, SM4500-CN-CE, SM25401). EPA 624:Volatile Halocarbons&Aromatics, EPA 608: Chlordane, Toxaphene,Aldrin, alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT, Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs EPA 625: SVOC(Acid/Base/Neutral Extractables), EPA 600/4-81-045: PCB-Oil. Microbiology: SM9223B-Colilert-QT; Enterolert-QT,SM9222D-MF. For a complete listing of analytes and methods, please contact your Alpha Project Manager. Page 15 of 16 Serial No:06241515:31 y� CHAIN OF CUSTODY PAGE 1 OF 1 Date Rec'd in Lab: ALPHA Job#: t�� � '3�77� 7. *& � BP� Project . . .. . . Data deliverables ❑ FAX ® EMAIL Same as Client info PO M 10214 Westborough,MA Mansfield,MA project Name:Bailey Residence TEL:508-898-9220 TEL:508-822-930D ❑ ADEX ❑ Add'1 Deliverables FAX 508-898.9193 FAX:508-822-3288 • o .• Project Location:Osterville,MA State/Fed Pro ram Criteria Client:Bennett Environmental Associates Project#:BEA10-10214 Address:1573 Main Street/P.O.Box 1743 Project Manager:David C.Bennett Brewster,MA 02631 1 ALPHA Quote A Phone:508-896-1706 . ANALYSIS Fax:508-896-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Email:sfarrenkopf@bennett-ea.com Filtration ❑ Done ❑These samples have been Previously analyzed by Alpha Due Date: Time: ® Not Needed Other Project Specific Requirements/Comments/Detection Limits: ❑ Lab to do Preservation • ❑ Lab to do Q (Please specify i 0O below) di ALPHA Lab ID Sample ID Collection Sample Samplers z (Lab Use Only) Date Time Matrix Initials rh :C Y sample Specific F- Z f— comments D Y s0 77S— Effluent -1 6- T,00 WVV T!./ ® ® ® ❑ ❑ ❑ ❑ 01010 ❑ ❑ 3 ❑ ❑ . ❑ 1 ❑ El 0 ❑ ❑ ❑ 0 R 0 0 0 ❑ ❑ ❑ ❑ ❑ ❑ ' ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 3 s f' Container Type P P P - - Preservative 0 o D - Please Print Clearly.legibly and completely. Samples can :nol be logged In and Relin t(sped y. Daterrime Received By: DateTme .turnaround lime clock YAIInot / �j/ /� -// 1 �aiaR until any amblguitles are Z' �� �� / S resolved.All samples t :Submitted are.sub)ecl to sosa Rio:01.er(M) :Alpha's Payment Terms. (reY.24AP0.d91 '� Page 16 of 16 Serial—No:09221519:16 it3 IL I H ;Y.,T I C A L ANALYTICAL REPORT Lab Number: L1522576 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 09/22/15 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),VA(460195),MD(348),IL(200077),NC(666),TX(T104704476),DOD(1-2217),USDA(Permit #P-330-11-00240). Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com Page 1 of 15 Serial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 Alpha Sample Collection Sample ID Client ID Matrix Location Date/Time Receive Date L1522576-01 EFFLUENT WATER OSTERVILLE, MA 09/14/15 10:45 09/14/15 Page 2 of 15 c HA A Serial_No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.Tentatively Identified Compounds(TICs),if requested,are reported for compounds identified to be present and are not part of the method/program Target Compound List,even if only a subset of the TCL are being reported.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific%recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.All specific QC information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples(with the exception of Air canisters)free of charge for 21 calendar days from the date the project is completed.After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples.Air canisters will be disposed after 3 business days from the date the project is completed. Please contact Client Services at 800-624-9220 with any questions. I, the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. t�Qyf,Authorized Signature: 1 Kelly Stenstrom Title: Technical Director/Representative Date: 09/22/15 Page 3 of 15 =�• -• Serial No:09221519:16 INORGANICS MISCELLANEOUS Page 4 of 15 Serial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 SAMPLE RESULTS Lab ID: L1522576-01 Date Collected: 09/14/15 10:45 Client ID: EFFLUENT Date Received: 09/14/15 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry Westborough Lab Solids,Total Suspended ND mg/I 5.0 NA 1 09/15/15 19:20 30,2540D RP Nitrogen,Nitrite ND mg/I 0.050 - 1 - 09/15/15 00:18 44,353.2 ML _.. ---------------------------------..--- -------------..---------------------------- - ----- __._..----- __..__...... ----------------------------------__.--- ---- --- -------- - Nitrogen,Nitrate 15. mg/I 0.50 -- 5 - 09/15/15 00:39 44,353.2 ML —-------—-- -- ---- -..._..-------------.-......._..._...................-- -- ---- Nitrogen,Total Kjeldahl 4.70 mg/I 1.50 -- 5 09/16/15 07:27 09/16/15 22:21 4,351.3/.1 (M) AT BOD,5 day 41. mg/I 2.0 NA 1 09/14/15 23:55 09/19/15 17:55 30,5210B SE _. _.... .._._.._..- ------------ t' IL 15 Page 5 of 15 Serial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA1.0-10214 Report Date: 09/22/15 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst n � a5 n"`�±r�M+"`r w � t r��•r x o-• r s .r y^ a. Z^r^ x ,.. General Chemistry Westborough Labtfor samples) 01 :Batch ;WG8211811 4 R BOD,5 day ND mg/l 2.0 NA 1 09/14/15 23:55 09/19/15 17:55 30,521013 SE y...�, R�Y7p5' :•-...r. �,;"[: ..M1+. �.« :�, . a-..�...,r..�„„.4t�"«- .w ti"V"" ...� �. GeneraL.Chemistry Westborough Lab for samples) 01 _Batch WG821189 1,£ y �� .�.....a: .... a.. x. \ .,v• . ♦ ... a,._ _ n • v. . .v. ' ...:n .. Nitrogen,Nitrate ND mg/I 0.10 1 09/14/15 23:37 44,353.2 ML General4Chemistry UVestboroughwLab for samples) 01 ,Batch `WG821190�1 � w _ .. Nitrogen,Nitrite ND mg/I 0.050 1 09/14/15 23:39 44,353.2 ML General Chemistry Westborough Lab for'sarrl s) 01 %.Batch WG821531 1 Solids,Total Suspended ND mg/I 5.0 NA 1 09/15/15 19:20 30,2540D RP General Chemistry Westborough Lab for samples) 01 Batch:WG821720 ,1 iM:`... x.•...a+.. «..... .;M .. ... r..»..v..,.. > - ..:i" %.... ..... .#. ... m _.e 4 o .. N . . Nitrogen,Total Kjeldahl ND mg/l 0.300 — 1 09/16/15 07:27 09/16/15 22:14 4,351.3/.1 (M) AT .._...... ...... ._._ ... ......__........... ._....... ......... .._...._ _- ------ ..._....................... ..._.._... _ .......... ....._...... Page 6 of 15 Serial No:09221519:16 ' Lab Control Sample Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qua[ RPD Limits General{Chemistry 4Westb.orou h'.,Lab :Associated"sam le s `01., Batch. 1NG821'181 g-. p - ..cu.:. BOD,5 day 8 7 " - 85-115 - 20 ..e: General Chemist W'.estborou h..Lab ;Associated sam le s : 1 .:,8 < .. 9. rY g r. P (.):t0 atch WG821:189 2i Nitrogen,Nitrate 96E' - 90-110 - .._..... _ ........._.. _......... - . ...y'Rx -,vn f✓' ':_^W.tir... to � General Chemist -Westborou h Lab.-:Associated�sam le s. 0 Batch..WG821.190 2 k rY .�g, p O P :,..�_3t_ F # .h Nitrogen,Nitrite '{ 1.02 " _ 90-110 20 _ = Geiser iLChbrn t=.W.es,b r,rye t o ought Lab Associated sample(sr)?041 Batch ,WsG821720 2 w ,+` c b r Nitrogen,Total Kjeldahl 91 78-122 - W<, ------ Page7of15 Serial No:09221519:16 Matrix Spike Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits ..�.:,:. :". •..�°.�"r'� .. '.' '.' •. W :.. General Chemist., W,estborou h:Lab.Assoclatetl_sam le°s c 01. ' QC.Batch ID,_WG821r181.4 . QCSam IefL'1522584'=01 Client ID,:CMS;Sam leer. �..,,� R+�a �s BOD,5 day 16 100 140 125 - - 50-145 35 �. s ;•,-�,��� �� �,��, ,., n>�-ems.. ;�:;: ,,;..,.� ,.�..,..a�,u.,;-,,.. ^M-_^,:^.�,�.M, ---•:,,a..,...�---,�:.,.r.-� .:� �-^�,�, GeneralChernist. - .Westborou h"Lab'4ssociated`sam le s, 01 ,: C+B`atchID�'s1l1/ 21 ' - ��.,� rn ry,k g._ p .O Q y, G8 , 189 4 . QC,Sa p,e.,L1,522515 0 Client ID MS.Sample .; . Nitrogen,Nitrate 0.33 4 4.1 °"94 - - 83-113 - 6 General�Chemist,. ..��WestborouQh.Lap Associatetl am le.(s . 0,1QC�Batch ID. IYUG82�1:190.4-.. QC`'Sam Le,..L1;52�2515,01.4 .F-.++, ,-+.• A`.'.. ..aM.. ... .,,, P..r.A,. ,. .,- E ,ry r P ..>. n,.. .._�s ? ,_. , , Nitrogen,Nitrite ND 4 4.1102 µ - - 80-120 - 20 ._._._..._. ................ ....._._._..... d3s :b.'s`...,�. fyrr . ��uk�—>••tw�w...� ..� �.:....r � �,''.. geymq,.aN_rxw::.. General Chemist estb,orou h.Lab,+Associatetl sam le s: 01." ',,.QCBatchllD:;WG,821a720 4w, QCBam':Ie: L1;522161 17 GlientmlD MSxSam le ..r rY 9 P �.-.:.t. . ,.. .:.. �� .x t Nitrogen,Total Kjeldahl 0.550 8 7.95xtw. 92 - - 77-111 - 24 Page 8 of 15 / L HA Serial No:09221519:16 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits ._« .. . GeneraliChemist UUestk orou h Lab 'Associated,'sam le s : :01 QC;Batch,ID. 1IUG8211,81 3..- C Sam le. '.L1.522584 01 f.C11ent;ID DUP Is le P P BOD,5 day 16 13 mg/I r" `21 :j 35 General!'Chemistry 1Nestborou h,Lab.:Qssoclated yarn le s 01'h,,QC?:Batch LD .p:WG.821989 3:;°:''QC_Sam Ie;::L1522515,01'.Clrert.ID _ D.UP„ Sam le, ' Nitrogen,Nitrate 0.33 0.34 mg/1 3 6 General:, emist ;Westbo�ou h=Lab:.Assoclated :r ry g sa ple(s),-01 QC Batch ID .WG821;1.90 3 , QCSample...;L1522515 01 _CUent.ID DUP Sample= _._ Nitrogen, Nitrite ND ND mg/1 NG' 20 .:.. ..mow..,. w� .r.. General:Chemist :-:W,estborou h;'Lab.:Associatedsam le s ,;'01, ,<QC,Batcf .ID WG82:1531 2 ;L1522297 01=!ClieritID .DUP'Sam le m_...-.. .. ry . P P P Solids,Total Suspended 420 460 mg/l 29 ;:..., .�,,.... ,.,.. ,.w._, .,,.x.. ..:-- .�,...,......,,. , -.•,;. .�.,,...-.., .-�..�-. ,.,W,,..w. ..,.., --,_-:_-.�._.__ .P,. ,..:,... .-mod-�� •;,... .,.. ,_�_tl,. ,....,,_ _...,. _ ._-�.;Tw ,.,.�_�.. . ... _..,,.,.., a ti.- - - -. .. �. General.,.Che,mist Westboco.ta h:Lab.=Assoclatedaam le s QC.aBatch ID, WG821T720 3.:-,:QC„Sam Ie.r,L1.522;161 1..7,=,Glient;ID, .rDUP.>Sam le P Nitrogen,Total Kjeldahl 0.550 0.578 mg/I 5' 24 - — - --- - —----- _.. —-... _....--.... ---... - ---- -.. n Page 9 of 15 040,A Serial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1522576-01A Plastic 950ml unpreserved A 7 3.7 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1522576-01 B Plastic 250ml H2SO4 preserved A <2 3.7 Y Absent TKN-351(28) L1522576-01 C Plastic 950ml unpreserved A 7 3.7 Y Absent TSS-2540(7) *Values in parentheses indicate holding time in days Page 10 of 15. Serial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. NP Non-Plastic:Term is utilized for the analysis of Atterberg Limits in soil. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. TIC Tentatively Identified Compound:A compound that has been identified to be present and is not part of the target compound list (TCL)for the method and/or program.All TICS are qualitatively identified and reported as estimated concentrations. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Total:With respect to Organic analyses,a'Total'result is defined as the summation of results for individual isomers or Aroclors.If a'Total' result is requested,the results of its individual components will also be reported.This is applicable to'Total'results for methods 8260,8081 and 8082. Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit.For NJ-related projects(excluding Air),flag only applies to associated field samples that have detectable concentrations of the analyte,which was detected above the reporting limit in the associated method blank or above five times the reporting limit for common lab contaminants(Phthalates,Acetone,Methylene Chloride,2-Butanone). C -Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. Report Format: Data Usability Report a�� �. Page 11 of 15 Serial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 Data Qualifiers D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The lower value for the two columns has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICs),where the identification is based on a mass spectral library search. P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. S Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report Page 12 of 15 ISerial No:09221519:16 Project Name: BAILEY RESIDENCE Lab Number: L1522576 Project Number: BEA10-10214 Report Date: 09/22/15 REFERENCES 4 Methods for Chemical Analysis of Water and Wastes. EPA 600/4-79-020. Revised March 1983. 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100, August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to, damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 13 of 15 Serial No:09221519:16 Certification Information Last revised December 16,2014 The following analytes are not included in our NELAP Scope of Accreditation: Westborough Facility EPA 524.2: Acetone, 2-Butanone (Methyl ethyl ketone(MEK)), Tert-butyl alcohol, 2-Hexanone,Tetrahydrofuran, 1,3,5-Trichlorobenzene,4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260C: 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene, lodomethane(methyl iodide), Methyl methacrylate, Azobenzene. EPA 8270D: 1-M ethyl naphthalene, Di methyl naphthalene,1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,4-Methylphenol. SM4500: Soil: Total Phosphorus,TKN, NO2, NO3. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Mansfield Facility EPA 8270D: Biphenyl. EPA 2540D: TSS EPA TO-15: Halothane, 2,4,4-Trimethyl-2-pentene, 2,4,4-Trimethyl-1-pentene,Thiophene, 2-Methylthiophene, 3-Methylthiophene, 2-Ethylthiophene, 1,2,3-Trimethylbenzene, Indan, Indene, 1,2,4,5-Tetramethylbenzene, Benzothiophene, 1-Methylnaphthalene. The following analytes are included in our Massachusetts DEP Scope of Accreditation,Westborough Facility: Drinking Water EPA 200.8: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI; EPA 200.7: Ba,Be,Ca,Cd,Cr,Cu,Na; EPA 245.1: Mercury; EPA 300.0: Nitrate-N, Fluoride, Sulfate; EPA 353.2: Nitrate-N, Nitrite-N; SM4500NO3-F: Nitrate-N, Nitrite-N; SM4500E-C, SM4500CN-CE, EPA 180.1, SM213013,SM4500C1-D,SM232013, SM2540C, SM4500H-B EPA 332: Perchlorate. Microbiology:SM921513; SM9223-P/A,SM9223B-Colilert-QT, Enterolert-QT. Non-Potable Water EPA 200.8:AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn; EPA 200.7:AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn; EPA 245.1, SM4500H,B, EPA 120.1, SM251013, SM2540C,SM234013, SM232013,SM4500CL-E, SM4500E-BC, SM426C, SM4500NH3-BH, EPA 350.1: Ammonia-N, LACHAT 10-107-06-1-B:Ammonia-N, SM4500NO3-F, EPA 353.2: Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, SM4500P-13, E,SM52201), EPA 410.4, SM5210B, SM5310C,SM4500CL-D, EPA 1664, SM14 510AC, EPA 420.1,SM4500-CN-CE, SM25401). EPA 624: Volatile Halocarbons&Aromatics, EPA 608: Chlordane,Toxaphene, Aldrin, alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT, Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs EPA 625: SVOC(Acid/Base/Neutral Extractables), EPA 600/4-81-045: PCB-Oil. Microbiology: SM9223B-Colilert-QT; Enterolert-QT, SM9222D-MF. For a complete listing of analytes and methods, please contact your Alpha Project Manager. Page 14 of 15 Serial No:09221519:16 • i Date Recd in Kati:. ALPHA_Job#: CHAIN OF CUSTODY' PAGEIOF1 -� P14A e. e- A"sNµ>A G A L' Westborough,MA Mansneld;MA ❑ FAX ® EMAIL- ® Same as Client info PO.#:10214. e TEL:5os+ess-022o TEL:.508+322-9300 Project'Name:Bailey Residence ❑,gDEX ❑ Addl'DellverableS FAX:508-a9&9193;. FAX:-508•822-3288: • Project Locaiion:'Osterville,.MA State/FedPro ram • `Criteria Client:Bennett Environmental AsSOCiates: Pro ect#:BEA10-10214 v Address: 1573:Maln Street I'P,D'.Box 1743:' Pro eet.Mana er;David C.-Bennett Brevyster,MA 02639 ALPHA Quote#;.' Phone:508-896.M6 ANALYSIS Fax:508.896-5.1 W 0 Standard ❑Rush(ONLY IF PRE-APPROVED] SAMPLE.HANDLING a Email::sfarrenkopf@ bennett=ea com. FlftmNori ❑::Done' z ❑Theseaamplas have,been Prevlouslyanalyzed by Alpha Due Date: Time: ®"Not Needed E3 Lab.to do Other Project Specific:R6quirements/Comments/Detection Limits: rreservaaoa • s p.Lab.to do . 0 (Please sped!r O : below) m k ALPHA Lab'ID Sample ID collection Sample Sampler's ' :z !Labalse Only; I' Date Time Matrix initials to E. z �fn' Y. Serifple'SP•�ifi0. g H z Comments i4 i(aEffluent' WtiN ❑ ❑ ❑: ❑.' ❑ a y ❑. ❑ ❑ o o a M ❑ ❑ a ❑ ❑ a E 0 O ❑ M D n: ❑ ❑ ❑ O ❑ y ❑ O O ❑ OLJ : O O O o0 . ❑: ❑ o a ❑ o, ao ❑ ❑ ❑ .0M 3 . Container Type.: P P P 0 0, D se.print clean a,legibly Preservati a Nlea anU'campletely s mPlea can nct beaeggeld in and. elinquish i, Datefrime Received By: a Daterrime- tumarounothneoldckwillnot \ star(until any ambigultiea are ,� 2 1� tesolved.'.Msamples 1 ' submitted are subjertto FORM N0:01-0t(I-NJ)' / t .- . l � �wJ Alp ra's�Payment>Temis., . c r IBbS Page 15 of 15 BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection [9/24/14 BEA10-10214 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Bailey Residence 49 Joby's Lane SHIPPING METHOD: Osterville,MA 02655 Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(June and September 2014) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist(June and September 2014) 1 6/13/14 Alpha Analytical laboratory report 1 9/17/14 Alpha Analytical laboratory report ,J --4 V-4 8 -' 2„ t �. For review and comment: ❑ For approval: ❑ As requested: ❑ For your used 0 REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI RSF Operation and Maintenance Checklist and laboratoryanalytical reports for operation and maintenance conducted at the above referenced property during the reporting period. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Chapman Bailey,Owner David C.Bennett,President[Internal] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once c LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 �I Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/5/14 9/9/13 Inspection Date Previous Inspection Date 6" Sludge, 0" Scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev. 11-07-05 Page 1 of 3 i 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 E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 6.0 mg/L Turbidity 2.27 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. t5aiom.doc^rev. 11-07-05 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 H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 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 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc^rev. 11-07-05 Page 3 of 3 r4h Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 9/10/14 6/5/14 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended El Yes ® No t5aiom.doc^rev. 11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OEM Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 6.0 mg/L Turbidity 1.42 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 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) Nitrate Nitrite TKN . Other 1 Other 2 Other 3 ti G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 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 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: - Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc^rev. 11-07-05 Page 3 of 3 A M Envr'r anme*R Systems,Inc. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information Facility Street Add ess Dail vice City Operator/O&M Firm System Startup Date Weather CondiflotTs B. Septic Tank Sludge Pumping Required: Yes ElNo Sludge Depth: Scum Depth: Q Effluent tee filter: YesV,No❑ If yes, inspecIX&clean at least yearl}A If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also, inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank Q1 Check if sludge accumulating Pumping required: Yes❑ NdA Odor problems: Yes❑ No%k If yes,description Effluent tee filter: Yes❑ NdX If yes,inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ ' Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) ❑ Pump Inspections(all units) If problems,describe ❑ Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. 5A F. Pumps, Switches, Floats, Alarm System l Pump Inspections(all units) If problergs,describe j Test pump alternator,or record hours 3'-3 c�) Hours of operation `(Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes El Nary Clean bed: Yes❑ Nov Distribution pipes Flush:Yes❑ No Brush: Yes❑ N4 Any obstruction of airflow to filter modules: Yes❑ Nc'A�­j If Yes, explain below(i.e. snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one comer of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes No❑ If yes:11NOD %hTSS ❑pH V[TN KOther P ► .>J p z• ►Z wN All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: u Q qq TA r ---- Envii ammental Systenns, Inc. OMNi RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information Facility Street Address Date of S6rvice S City Operator/O&M Firm :513\rl System Startup Date Weather Conditions (AA B. Septic Tank Sludge Pumping Required: Yes❑ N� ❑ Sludge Depth: ❑Scum Depth: No[IIf yes, inspect clean at least yearly ElEffluent tee filter: Yest If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank �"��s -V\—� U-, 4 < 1 tV' ❑Check if sludge accumulating Pumping required: Yes❑ No tPt Odor problems: Yes❑ Nck If yes,description Effluent tee filter: Yes❑ No% If yes, inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules. Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. l D. Equalization Tank (if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber 1 Vault(if Installed) ❑Pump Inspections(all units) If problems,describe ❑ Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. i i F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) i If problems,d_scribe Test pump alternator,or record hours C�� 6�5� V� �`^ Hours of operation Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") tIInspect for ponding Ponding Present:Yes❑ No l Clean bed: Yes❑ N t+' Distribution pipes Flush:Yes❑ N� Brush: Yes❑ NOO Any obstruction of airflow to filter modules: Yes❑ No( If Yes,explain below(i.e. snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one comer of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yeo No❑ If yes:XBODNTSS ❑pH OTN Other NO3 ,V)U,-t—'I���N All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers. In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: Serial No:06131413:43 HA 1:1A,N A-L,Y T I C A L ANALYTICAL REPORT r Lab Number: L1412350 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 06/13/14 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com TA ,FHA Page 1 of 16 Serial_No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Alpha Sample Collection Sample ID Client ID Location Date/Time L1412350-01 EFFLUENT OSTERVILLE, MA 06/05/14 09:00 l�a?HA Page 2 of 16 I I Serial_No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L141235O Project Number: BEA10-10214 Report Date: 06/13/14 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples(with the exception of Air canisters)free of charge for 21 calendar days from the date the project is completed.After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples.Air canisters will be disposed after 3 business days from the date the project is completed. Please contact Client Services at 800-624-9220 with any questions. ?s,a Page 3 of 16 Serial No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Case Narrative (continued) Nitrogen, Total Kjeldahl L1412350-01 has an elevated detection limit due to the dilution required by the sample matrix. BOD, 5 day The WG695854-2 LCS recovery(118%), associated with L1412350-01, is outside the acceptance criteria. Due to the expiration of the method required holding time, no further action was taken. The WG695854-4 MS recovery(146%), performed on L1412350-01, is outside the acceptance criteria. Due to the expiration of the method required holding time, no further action was taken. I,the undersigned, attest under the pains and penalties of perjury that, to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: � •u ' Michelle M. Morris Title: Technical Director/Representative Date: 06/13/14 Page 4 of 16 A� �'� i Serial No:06131413:43 INO R G A N I C S MISCELLANEOUS Page 5 of 16 Serial No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 SAMPLE RESULTS Lab ID: L1412350-01 Date Collected: 06/05/14 09:00 Client ID: EFFLUENT Date Received: 06/06/14 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab Solids,Total Suspended ND mg/I 5.0 NA 1 06/12/14 14:30 30,2540D DW —----- -- -- -----._.... ----._ _....- -- -.. -- _....... .. ......_..... _._.._ Nitrogen,Nitrite 0.16 mg/1 0.050 -- 1 - 06/07/14 01:11 44,353.2 DB -- ..-.. -._... Nitrogen,Nitrate 15. mgA 0.50 -- 5 - 06/07/14 02:37 44,353.2 DB ._....- -------------------- ..... ........._. __ .... Nitrogen,Total Kjeldahl ND mg/I 1.50 -- 5 06/07/14 14:30 06/09/14 20:46 30,4500N-C AT . .._--— _._.._._. - BOD,5 day 7.7 mg/I 2.0 NA 1 06/06/14 21:25 06/11/14 16:10 30,5210E SE Page 6 of 16 I Serial No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab for sam 'le(s). 01 ..;Batch µ WG6958541 y BOD,5 day ND mg/1 2.0 NA 1 06/06/14 21:25 06/11/14 16:10 30,5210E SE General Chemistry=Westborough Lab for sample(s): 01 ';Batch:' WG695861=1 Nitrogen,Nitrate ND mg/I 0.10 1 06/07/14 00:03 44,353.2 DB General Chemistry-Westborough Lab for.sample(s):' 01 ` Batch.'..WG695862 1;'. Nitrogen,Nitrite ND mg/I 0.050 1 06/07/14 00:05 44,353.2 DB General Chemistry.-Westborough Lab for sample(s). 01 Batch: W6695997.,-1 Nitrogen,Total Kjeldahl ND mgA 0.300 1 06/07/14 14:30 06/09/14 20:28 30,4500N-C AT _............._........- ..... .............. .._ ...... ..... ............ . ........ . ...... . ... . ... .... General Chemistry-Westborough Lab•for samples) 01. Batch:,;WG697229-1 Solids,Total Suspended ND mgA 5.0 NA 1 06/12/14 14:30 30,2540D DW �L FAA Page 7 of 16 Serial No:06131413:43 Lab Control Sample Analysis Project Name: .BAILEY RESIDENCE Batch Quality Control Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 LCS LCSD %Recovery Parameter V %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry-Westborough Lab Associate&sample(s)`. 01 Batch: WG695854-2 BOD,5 day 118 Q 85-115 - 20 .......... ..._.......-. _ _... -. ..... __.------ --- ---- - Gerieral Chemistry Westborough,L-ab -Associated ample(s):.Q1 ;Batch:WG695861-2 , Nitrogen,Nitrate 93. - 90-110 - General-Chemistry--Westborough Lab,^Associated sample(!): 01 Batch: W.G695862-2 } Nitrogen,Nitrite 100 - 90-110 - 20 General Chemistry Westborough&ab Associated sample(s): 01 �Batch:,WG695997-2 Nitrogen,Total Kjeldahl 96 - 78-122 Page 8of16 A \. Serial_No:06131413:43 Matrix Spike Analysis Project Name: BAILEY RESIDENCE batch Quality Control Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits General,Cliemisfry -Westborough La.b'Associated�sample(s)..01 QC'Batch ID:.WG695854-4 QC Sample. L1412350-01 Client ID; EFFLUENT' BOD,5 day 7.7 100 150 146_ .,yP Q - 50-145 35 General-Chemistry Westborough Lab Associated sample(s) 01.; QCBatch ID`.WG695861=4.._ QC Sample: LA412252-03 ' Client ID .MS:Sample_r Nitrogen,Nitrate 0.53 4 4.4 98 - 83-113 6 r _ r General Chemistry Westborough Lab Associated'sample(sy: 01, -QC-Batch1D::WG695862-4`' QC Sample:114123.11-01 ;'.Client][): 'MS`Sample Nitrogen, Nitrite NO 4 4.4 109 - 80-120 20 General Chemistry Westborou h Lab,Associated sam le s 01 QC Batch ID .WG695997.-4, QC..,Sam Ie `L1412205=0.1 : Client ID. MS Sam le 9 p O P _ Nitrogen,Total Kjeldahl NO 8 7.52 94 - 77-111 - _ w 24 Page 9 of 16 A`' Serial No:06131413:43 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General Chemistry:-,Westborough Lab Associated sample(s): 01 QC Batch ID: WG695854-3 QC Sample: L1412336-01 Client ID: DUP Sample BOD,5 day 16 16 mg/I 0 35 General Chemistry--Westborough Lab Associated sample(s):- 01 'QC Batch ID: WG695861-3 QC Sample:, L1412252-03 Client ID: DUP-Sample Nitrogen,Nitrate 0.53 0.53 mg/I 0 6 General Chemistry: Westborough"Lab Associated sample(s): 01 QC Batch ID: WG695862-3 QC Sample: L1412311-01 Client ID: DUP Sample Nitrogen,Nitrite ND ND mg/I NC 20 General Chemistry,J-Westborough4Lab :Associated,Sam ple(s): -01- .QC"Batch ID`. -WG695997-3--QC':Sample: L1412205-01 :Client ID: DUP Sample Nitrogen,Total Kjeldahl ND ND mg/I NC 24 General Chemistry-We`stborouglh Lab`'Associated,sample(s): 01 QC-Batch-ID: WG697229-2 QC�Sample: 1-1412212-01 Client ID: DUP Sample Solids,Total Suspended 400 390 mg/I 3 29 Page 10 of 16L?f;a Serial_No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information 'temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1412350-01A Plastic 250ml H2SO4 preserved A <2 3.8 Y Absent TKN-4500(28) L1412350-01B Plastic 1000ml unpreserved A 8 3.8 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1412350-01C Plastic 1000ml unpreserved A 8 3.8 Y Absent TSS-2540(7) Container Comments L1412350-01B *Values in parentheses indicate holding time in days tLFa;,a Page 11 of 16 �� Serial No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Total:With respect to Organic analyses,a'Total'result is defined as the summation of results for individual isomers or Aroclors.If a'Total' result is requested,the results of its individual components will also be reported.This is applicable to'Total'results for methods 8260,8081 and 8082. Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(I Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. Report Format: Data Usability Report r AL?HA Page 12 of 16 i Serial No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 Data Qualifiers H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The lower value for the two columns has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICs),where the identification is based on a mass spectral library search. P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R Analytical results are fiom sample re-analysis. RE Analytical results are fiom sample re-extraction. S Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report v Page 13 of 16 Serial_No:06131413:43 Project Name: BAILEY RESIDENCE Lab Number: L1412350 Project Number: BEA10-10214 Report Date: 06/13/14 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater. APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100, August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to, damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 14 of 16 Serial_No:06131413:43 Certification Information Last revised April 15,2014. The following analytes are not included in our NELAP Scope of Accreditation: Westborough Facility EPA 524.2: Acetone,2-Butanone(Methyl ethyl ketone (MEK)),Tert-butyl alcohol,2-Hexanone, Tetrahydrofuran, 1,3,5-Trichlorobenzene,4-M ethyl-2-penta none (MIBK), Carbon disulfide, Diethyl ether. EPA 8260C: 1,2,4,5-Tetramethylbenzene,4-Ethyltoluene, lodomethane(methyl iodide), Methyl methacrylate, Azobenzene. EPA 8330A/B: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270D: 1-Methyl naphthalene, Dimethylnaphthalene,1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,4-Methylphenol. SM4500: Soil: Total Phosphorus,TKN, NO2, NO3. EPA 9071: Total Petroleum Hydrocarbons, Oil &Grease. Mansfield Facility EPA 8270D: Biphenyl. EPA 254OD: TSS EPA TO-15: Halothane, 2,4,4-Trimethyl-2-pentene, 2,4,4-Trimethyl-1-pentene,Thiophene, 2-Methylthiophene, 3-Methylthiophene, 2-Ethylthiophene, 1,2,3-Trimethyl benzene, Indan, Indene, 1,2,4,5-Tetramethylbenzene, Benzothiophene, 1-Methylnaphthalene. The following analytes are included in our Massachusetts DEP Scope of Accreditation,Westborough Facility: Drinking Water EPA 200.8: Sb,As,Ba,Be,Cd„Cr,Cu,Pb,Ni,Se,TI; EPA 200.7: Ba,Be,Ca,Cd,Cr,Cu,Na; EPA 245.1: Mercury; EPA 300.0: Nitrate-N, Fluoride, Sulfate; EPA 353.2: Nitrate-N, Nitrite-N; SM4500NO3-F: Nitrate-N, Nitrite-N; SM4500E-C, SM4500CN-CE, EPA 180.1, SM2130B,SM4500CI-D, SM232013, SM2540C, SM450OH-B EPA 332: Perchlorate. Microbiology: SM92151B; SM9223-P/A,SM9223B-Colilert-QT, Enterolert-QT. Non-Potable Water EPA 200.8:AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn; EPA 200.7:AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn; EPA 245.1,SM4500H,B, EPA 120.1, SM2510B, SM2540C,SM2340B, SM2320B, SM4500CL-E,SM4500E-BC, SM426C, SM4500NH3-BH, EPA 350.1: Ammonia-N, LACHAT 10-107-06-1-B: Ammonia-N, SM4500NO3-F, EPA 353.2: Nitrate-N,SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, SM4500P-B, E, SM52201), EPA 410.4, SM5210B, SM5310C,SM4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. EPA 624: Volatile Halocarbons&Aromatics, EPA 608: Chlordane,Toxaphene, Aldrin,alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT, Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs EPA 625: SVOC (Acid/Base/Neutral Extractables), EPA 600/4-81-045: PCB-Oil. Microbiology: SM9223B-Colilert-QT; Enterolert-QT, SM9222D-MF. For a complete listing of analytes and methods, please contact your Alpha Project Manager. Page 15 of 16 Serial No:06131413:43 ' e;r - �a "�$;r•, `aE:� - �r PAGE 1 OF 1 r CHAIN OF CUSTODY ;o teRec'd;inlab: � s� "� 'A1 �A�Jots = fix �k, '.:"' _: 3 .•:� �" s� < Report Information Data Deliverables Billing: Inform; ation ❑ FAX ® EMAIL ® Same as Client Info PO#:10214 Westborough,MA Mansfield,MA Project Name:Bailey Residence — TEL:50"98-9220 TEL:5CB-822-9300 ❑ ADEx ❑ Add'i Deliverables FAX:506-898-9193 FAX 5OM22-3288 Regulatory -•• InformationClient Project Location:Osterville,MA StatelFedProgram Criteria Client:Bennett Environmental Associates Pro ect#:BEA10-10214 Address: 1573 Main Street/P.O.Box 1743 Project Manager: David C..Bennett, Brewster,MA 02631 ALPHA Quote#: Phone;508-896-1706 Arouqd Time ANALYSIS Fax:508-896-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Filtration ' Email:sfarrenkopf@bennett-ea.com ❑ Done ❑These samples have been Previously analyzed by Alpha Due Date: / j Ime: 0 Not Needed O Lab to do Other Project Specific Requirements/Comments/Detection Limits: Preservation • ❑ Lab to do fl (Please specify 0 below) 1n ai •c ALP, Aq,tLab1D:::::;i'; Sample ID Collection Sample Sampler's Z E. (Lt} `Use°.Onlyj;: Date Time Matrix Initials Z 'tp Y Sample Specific tr� Comments ,i Effluent (O �� �.C�a WW ® ® ® ❑ ❑ ❑ ❑ ❑ ❑ 3 :i' ,,,,jj,,A� :,of z.: y����� ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ a r ❑ ❑ ❑ ❑ ❑ ❑ _ ;s;. ❑ ❑ ❑ El 0 ❑ 11 El El ❑ ❑ ❑ 13 Container Type P P P ;Rleaseprl°cl'eery',, Preservative 0 0 D - - - - - dco. plelely3as.,can. Reli%iulsheW. Date rime Rec bed By: DateMme ti,rriaroundtlina:lac•:,W.IjIlnoL`:.: ` r starC,untll^any:artitiigulkiereY s. >(� . r(� tp `� 2 ,res samples; � �..r 'submltted��;su6jeElto.>r: ,; AI'.fia'a3:PeVVRj'e`�lTerr�si:;<::' FORM NO:01.01(t-NJ) TA Page 16 of 16 Serial No:09171414:41 N'A L-: H ANALYTICAL REPORT Lab Number: L1420885 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 09/17/14 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com Page 1 of 16 Serial No:09171414:41 ` Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Alpha Sample Collection Sample ID Client ID Matrix Location Date/Time Receive Date L1420885-01 EFFLUENT WATER OSTERVILLE, MA 09/10/14 15:45 09/11/14 Page 2 of 16 Serial_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(Le.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.All specific QC information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments, solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples(with the exception of Air canisters)free of charge for 21 calendar days from the date the project is completed.After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples.Air canisters will be disposed after 3 business days from the date the project is completed. Please contact Client Services at 800-624-9220 with any questions. /, A Page 3 of 16 �'� Serial_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Case Narrative(continued) BOD, 5 day The WG721285-2 LCS recovery(79%), associated with L1420885-01, is outside the acceptance criteria. Due to the expiration of the method required holding time, no further action was taken. I,the undersigned, attest under the pains and penalties of perjury that, to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: d f-1-T— Lura L Trov Title: Technical Director/Representative Date: 09/17/14 Page 4 of 16 '�^ � Serial_No:09171414:41 INORGANICS MISCELLANEOUS Page 5 of 16 Serial_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 SAMPLE RESULTS Lab ID: L1420885-01 Date Collected: 09/10/14 15:45 Client ID: EFFLUENT Date Received: 09/11/14 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab Solids,Total Suspended ND mg/I 5.0 NA 1 - 09/15/14 14:20 30,2540D DW Nitrogen,Nitrite 0.43 mg/I 0.25 — 5 - 09/12/14 00:56 44,353.2 DB .......... . . .. ... _ . . .-..... - —.--- -----.- -_---.. - _.... .. .... Nitrogen,Nitrate 28. mg/I 0.50 5 - 09/12/14 00:56 44,353.2 DB - - ....__..._.. .. -- ._..... ...- ._.... ........... ... -- ... _. ._.-. _.. . _.-_.. ... ......_...._ . .......-..... _... .. .. ...---. ........ ..._....,,_.... .... ..__.- . ........... Nitrogen,Total Kjeldahl ND mg/I 0.300 — 1 09/11/14 23:15 09/15/14 21:34 30,4500N-C AT BOD,5 day 2.6 mg/I 2.0 NA 1 09/11/14 22:20 09/16/14 17:00 30,5210E SE Al�LFHA Page 6 of 16 Seri al_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab for sample(s): 01 Batch WG721285 1 . BOD,5 day ND mg/1 2.0 NA 1 09/11/14 22:20 09/16/1417:00 30,5210B SE General Chemistry Westborough Lab for sample(s): 01 Batch; WG721296-1 Nitrogen,Nitrate ND mg/I 0.10 -- 1 09112/14 00:19 44,353.2 DB General Chemistry'-,Westborough Lab for sample(s): 01, .Batch :WG721298,1 Nitrogen,Nitrite ND mg/l 0.050 1 09/12/14 00:29 44,353.2 DB Geheral Chemistry Westborough Lab for sample(s)`. 01 Batch W6721-315 1 Nitrogen,Total Kjeldahl ND mg/I 0.300 — 1 09111/14 23:15 09/15/14 21:15 30,4500N-C AT General Chemistry-Westborough Lab for sample(s): 01 Batch: WG721926-1 Solids,Total Suspended ND _ mg/I 5.0 NA 1 - 09/15/1414:20 30,2540D DW _... ...... ....... . ..... ............. ...... ........................ .... ..._.....:.. .......... ........ ........ .._..... ......._ _... ... .... ... ............ - x , li �HA Page 7 of 16 Serial No:09171414:41 Lab Control Sample Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry-Westborougli Lab Associated sample(s): 01 -Batch: WG721285-2 BOD,5 day 79 Q 85-115 - 20 General,ChemistrY Westborou hrLab.-Associated sam le(s): 01,'.= Batch: WG721296-2 Nitrogen,Nitrate `100 90-110 - General'Chernistry:'Westborough:-Lab Associated-sarriple(s): 01 . Batch:WG72.1298-2 Nitrogen,Nitrite „',98 90-110 - 20 General'Chemistry Westborough.Lab Associated�sample(s) 01 Batch:`WG721315-2 _., Nitrogen,Total Kjeldahl 104 - 78-122 - Page 8 of 16 i Serial No:09171414:41 Matrix Spike Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L142O885 Project Number: BEA10-10214 Report Date: 09/17/14 Native MS iVIS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits Gen.eral Chemistry Westborough Lab Associated samples) 01` "QC'Batch ID:'WG721285 4: QC:Sample L1420885-01- -'Client ID: EFFWENT..:.,- BOD,5 day 2.6 100 110 11.1,- - - 50-145 35 General;Chemistry Westborough°Lab Associated samples) 01; 'QC,Batch ID;WG721296-4 QC Sample L1420859=02 . Client'ID MS'Sarnple Nitrngen,Nitrate ND 4 3.9 98 ,'..., - 83-113 6 GeneraLChemistry Westborough Lab'Associated:.sample(s): 01 QC Batch ID .WG7212984. QC Sample ,L1-420859-02 Client,ID:,WS Sample.1 Nitrogen,Nitrite 0.12 4 4.1 100- - 80-120 20 Generat`Chemistry Westborough1ab'Associated-samples) 01 QC Batch ID`WG72:1315.4; QC.Sample L1.420914.-05 Client ID;. MS:Sample' Nitrogen,Total Kjeldahl 0.582 8 9.13 ":•-:107 - 77-111 24 .,\ Page 9 of 16d�Cr?E;A Serial No:09171414:41 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Parameter Native Sample Duplicate Sample Units RPD Qua[ RPD Limits General Chemistry-Westborough tab .Associated sample(s): 01 QC Batch ID:. WG721285-3 QC Sample: L1420859-01 Client ID: DUP Sample BOD,5 day 71 73 mg/I 3 35 General Chemistry-;Westborough,Lab Associated sample(s): 01 QC-Batch ID: WG721296-3 QC Sample: 1_1420859-02 Client ID: DUP Sample Nitrogen,Nitrate ND 0.10 mg/I NC 6 General,Chemistry--Westborough-,Lab Asso6iate&sample(s): 01_ QC Batch ID:- WG721298-3 QC Sample: -Ll420859-02 Client ID: DUP Sample Nitrogen,Nitrite 0.12 0.11 mg/I 9 20 General Chemistry-(Westborough Lab,Associated'sample(s): 01- QC Batch']D: WG721315-3` -QC'Sample: L1420914-05 Client ID:.DUP.'Sample Nitrogen,Total Kjeldahl 0.582 0.648 mg/1 11 24 General Chemistry Westborough,.Lab Associated sample(s): 01 QC Batch ID: WG721926 2 QC Sample: L1420859=01 Client ID:.'DUP Sample _:....l Chemistry_ _ . ,, _ Solids,Total Suspended 64 69 mg/l 8` 29 Page 10 of 16 i v, Serial_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1420885-01A Plastic 250ml H2SO4 preserved A <2 4.0 Y Absent TKN-4500(28) L1420885-01 B Plastic 1000ml unpreserved A 8 4.0 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1420885-01C Plastic 1000ml unpreserved A 8 4.0 Y Absent TSS-2540(7) *Values in parentheses indicate holding time in days AAL „ .. Page 11i of 16 Seri al_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,fi-ee from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Terms is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Total:With respect to Organic analyses,a'Total'result is defined as the summation of results for individual isomers or Aroclors.If a'Total' result is requested,the results of its individual components will also be reported.This is applicable to'Total'results for methods 8260,8081 and 8082. Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit.For NJ-related projects(excluding Air),flag only applies to associated field samples that have detectable concentrations of the analyte,which was detected above the reporting limit in the associated method blank or above five times the reporting limit for common lab contaminants(Phthalates,Acetone,Methylene Chloride,2-Butanone). C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. Report Format: Data Usability Report Page 12 of 16 Serial_No:09171414:41 Project Name: BAILEY RESIDENCE Lab Plumber: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 Data Qualifiers G -The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The lower value for the two columns has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search. P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. S Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format. Data Usability Report j \-HA Page 13 of 16 Serial_No:09171414:41 4 Project Name: BAILEY RESIDENCE Lab Number: L1420885 Project Number: BEA10-10214 Report Date: 09/17/14 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater. APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100, August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to, damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 14 of 16 y Serial_No:09171414:41 Certification Information Last revised April 15,2014 The following analytes are not included in our NELAP Scope of Accreditation: Westborough Facility EPA 524.2: Acetone,2-Butanone (Methyl ethyl ketone (MEK)),Tert-butyl alcohol, 2-Hexanone, Tetrahydrofuran, 1,3,5-Trichlorobenzene,4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260C: 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene, lodomethane(methyl iodide), Methyl methacrylate, Azobenzene. EPA 8330A/B: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270D: 1-Methyl naphthalene, Dimethyl naphthalene,1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,4-Methylphenol. SM4500: Soil: Total Phosphorus,TKN, NO2, NO3. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Mansfield Facility EPA 8270D: Biphenyl. EPA 2540D: TSS EPA TO-15: Halothane, 2,4,4-Trimethyl-2-pentene, 2,4,4-Trimethyl-1-pentene,Thiophene, 2-Methylthiophene, 3-Methylthiophene, 2-Ethylthiophene, 1,2,3-Tri methyl benzene, Indan, Indene, 1,2,4,5-Tetramethylbenzene, Benzothiophene, 1-Methylnaphthalene. The following analytes are included in our Massachusetts DEP Scope of Accreditation,Westborough Facility: Drinking Water EPA 200.8: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI; EPA 200.7: Ba,Be,Ca,Cd,Cr,Cu,Na; EPA 245.1: Mercury; EPA 300.0: Nitrate-N, Fluoride, Sulfate; EPA 353.2: Nitrate-N, Nitrite-N; SM4500NO3-F: Nitrate-N, Nitrite-N; SM4500E-C, SM4500CN-CE, EPA 180.1, SM213013,SM4500CI-D, SM232013, SM2540C, SM450OH-B ,. EPA 332: Perchlorate. Microbiology: SM92151B; SM9223-P/A,SM9223B-Colilert-QT, Enterolert-QT. Non-Potable Water EPA 200.&AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn; EPA 200.7:AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn; EPA 245.1,SM4500H,B, EPA 120.1, SM2510B,SM2540C,SM2340B, SM2320B,SM4500CL-E,SM4500E-BC, SM426C, SM4500NH3-BH, EPA 350.1:Ammonia-N, LACHAT 10-107-06-1-B:Ammonia-N, SM4500NO3-F, EPA 353.2: Nitrate-N,SM4500NH3-BC-NES, EPA 351.1,SM4500P-E, SM4500P-B, E, SM5220D, EPA 410.4, SM5210B, SM5310C,SM4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. - EPA 624:Volatile Halocarbons&Aromatics, EPA 608: Chlordane, Toxaphene, Aldrin,,alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT, Endosulfan 1, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs EPA 625: SVOC(Acid/Base/Neutral Extractables), EPA 600/4-81-045: PCB-Oil. Microbiology: SM9223B-Colilert-QT; Enterolert-QT, SM9222D-MF. For a complete listing of analytes and methods, please contact your Alpha Project Manager. Page 15 of 16 Serial No:09171414:41 ..�t .:; aie Rec'd.in Lab;: CHAIN OF CUSTODY PAGE 1 OF 1 :.- - L hr� Pr ect hiformation Report Information Data Deliverables Billing InIfOrmation — ❑ FAX ® EMAIL ® Same as Client info PO#:10214 Westborough,MA Mansfield,MA Project Name:Bailey Residence,TEL:508.898-9220 TEL:508-822-9300 ❑ ADEx ❑ Add'I Deliverables FAx:.508-898-4193. FAX;508-822-3285 OW Regulato • ••• • Project Location:Osterville,MA State/Fed Program Criteria Client:Bennett Environmental Associates Pro ect#:BEA10-10214 Address:1573 Main Street/P.O.Box 1743 Project Manager:David C,Bennett Brewster,MA 02631 ALPHA Quote#: Phone:508-896-1706 I • ► - ANALYSIS Fax:508-896-5109 ®Standard' ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Filtration _ Email:sfarrenkopf@bennett-ea.com ❑ Done ❑These samples have been Previously analyzed by Alpha Due Date: f/ !me: 0 Not Needed. l� II Lab.to do Other Project Specific Requirements/Comments/Detection Limits: Preservation • ❑ Lab to do. 0 (Please specify 0 below) m Q) ,ALPHFC"La,llb Sample ID Collection Sample Sampler's Z Date 1. Time Matrix Initials YSample specific I Z I..., comments y Effluent ..� l. _E1 El El vLS°t. 1 ;.Lr ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ El El El D El El r El 1-1 11 Container Type P P P ;°:r;'..: ,. ..4.. ` Plea*ptint clearly,Iegl6ly,L}: Preservative 0 0 0 - +- and cotliplgtely;i-Sample's:ican ; *-not befogged inapd D -- Reli quished By: Date/Time Receiv d By: bate/Time turnaround time cwo villl not .. s� i , etarLuntifari]'ambigultieszaie�, N 11 Ul resolVedi6All$arnP.lea,.';:: :;> submttfetl.'are subjeot.ro.::.' .` FOR Mwo:o a((Fru) Phi Alpha's'PaymentTetms: G (reY.2&APR-09) hb 2 Page 16 of 16 BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/18/13 BEA10-10214 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Bailey Residence 49 Joby's Lane SHIPPING METHOD: Osterville,MA 02655 Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail FX1 Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(June and September 2013) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist(June and September 2013) 1 6/17/13 Alpha Analytical laboratory report 1 9/16/13 Alpha Analytical laboratory report For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist and laboratory analytical reports for operation and maintenance conducted at the above referenced property during the reporting period. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Chapman Bailey,Owner David C.Bennett,President[Internal] Matthew Costa-OMNI Environmental Systems,Inc. [via email] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once { Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. 0&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/10/13 9/4/12 Inspection Date Previous Inspection Date 4" Sludge, 0" Scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown H clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 6.0 mg/L Turbidity 3.14 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: Effluent quality passed field testing parameters. t5aiom.doc•.rev. 11-07-05 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 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 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, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 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 A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 9/9/13 6/10/13 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 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 E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 6.0 SU DO 6.0 mg/L Turbidity 1.28 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: Effluent quality passed field testing parameters. t5aiom.doc•rev.11-07-05 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 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 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 . OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facilit Street ddress Date of S rvice City Operator/O&M Firm System Startup Date Weather Conditio s B. Septic Tank Sludge Pumping Required: Yes❑ Nd) Sludge Depth: t4Scum Depth: 0 Effluent tee filter: Yes�No❑ If yes, inspeclk&clean at least yearly If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is us -C. Recirculation Tank ' V(Check if sludge accumulating Pumping required: Yes ❑ Nov, Odor problems: Yes ❑ NCj If yes,description Effluent tee filter: Yes❑ NoM If yes, inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank (if installed) Sludge Pumping Required: Yes❑ No ❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) ❑Pump Inspections(all units) If problems,describe ❑Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problems describe c� Test pump alternator, or record hours '� c, rr� cc,�) 010 Hours of operation ( Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes ❑ No Clean bed: . Yes❑ No[� Distribution pipes Flush:Yes ❑ No Brush: Yes❑ No� Any obstruction of airflow to filter modules: Yes❑ No(A�'_ If Yes, explain below(i.e. snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes No❑ If yes:10VOD*SS ❑pH MTN NOther 1.1�Z l�ti�� \V All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers. In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e,rubber gloves). System Notes: 0 ©y) - -UQ!3 ap �p 0 - 1 11 7 V _ Ito 1ko Envir.onmentR Systems,I= OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Add rehs DA of Aervlce C).5 y NIy- , Iy\k 5M T IV city ' Operator/O&M Firm �\1V� System Startup Date Weather Conditions V\-t-� 0"'- . B. Septic Tank Sludge Pumping Required: Yes❑ No% ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Ye4 No❑ If yes,inspect(&clean at least yearly❑ If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,If not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank ❑Check if sludge accumulating Pumping required: Yes❑ NcK Odor problems: Yes❑ No If yes,description Effluent tee filter. Yes❑ No If yes,inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank In order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes,inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) ❑Pump Inspections(all units) If problems,describe j ❑Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the.pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If robtems,describe Test pump alternator,or record hours I-6 � � �� I l -\%�� ���►r,� Hours of operation Float switches VCheck all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes❑ Nd MI Clean bed: Yes❑ No% Vv- Distribution pipes Flush:Yes❑ No Brush: Yes❑ NoIIVI ki Any obstruction of airflow to filter modules: Yes[] N If Yes,explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes No❑ t , If yes:NBOD ,�TSS ❑pH TN Wther,0 All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative'sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: v k),juv� t,Cb 1 Serial No:06171315:00 t 'l HA . ,A.'N,'A L+Y.T 1 C A L ANALYTICAL REPORT Lab Number: L1310525 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 06/17/13 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com y/1Lti?HA Page 1 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 Alpha Sample Collection Sample ID Client ID Location Date/Time L1310525-01 EFFLUENT OSTERVILLE, MA 06/10/13 08:45 Page 2 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples free of charge for 30 days from the date the project is completed.After 30 days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples. Please contact Client Services at 800-624-9220 with any questions. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Cynthia McQueen Authorized Signature: Title: Technical Director/Representative Date: 06/17/13 {d%Pwa Page 3 of 18 Serial No:06171315:00 I N GAN I CS MISCELLANEOUS Page 4 of 18 Serial No:06171.315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 SAMPLE RESULTS Lab ID: L1310525-01 Date Collected: 06/10/13 08:45 Client ID: EFFLUENT Date Received: 06/10/13 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough.Lab ",i;. xii Solids,Total Suspended 11. mg/I 5.0 NA 1 - 06/11/13 10:25 30,2540D DW Nitrogen,Nitrite 0.13 mg/I 0.050 -- 1 - 06/10/13 23:42 44,353.2 DB Nitrogen,Nitrate 12. mg/I 0.20 - 2 - 06/11/13 00:05 44,353.2 DB - ...........----......... .._...._.._................ -...._.. ... ..._......_.__......... Nitrogen,Total Kjeldahl 2.63 mg/I 0.600 2 06/11/13 12:52 06/12/13 21:26 30,4500N-C AT BOD,5 day 5.1 mg/I 2.0 NA 1 06/11/13 22:30 06/16/13 17:35 30,5210E SE AR vlr�Firl �,. Page 5 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry,_Westborough Lati for sampie(s) 01 "batch WG614001 1' . .. Nitrogen,Nitrate ND mgA 0.10 1 06/10/13 23:27 44,353.2 DB i stry Westborough Lab for samples) 01 Batch WG614002 1 i;,Generall Cheml Nitrogen,Nitrite ND mgA 0.050 1 - 06/10/13 23:29 44,353.2 DB General Chemistry ,..Westborough Lab for sample(s): 01 Batch: VVG614062 1 �. U Solids,Total Suspended ND mg/l 5.0 NA 1 06/11/13 10:25 30,25401) DW General Chemistry=Westborough Lab for sample(s): 01 Batch: WG614174 1 Nitrogen,Total Kjeldahl ND mgA 0.300 1 06/11/1312:52 06/12/13 21:21 30,4500N-C AT General Chemistry Westborou h L ab for sample(s): 01 °Batch: WG614323-1 ... , 9 BOD,5 day ND mgA 2.0 NA 1 06/11/13 22:30 06/16/13 17:35 30,521013 SE ,�l�Lt�Firl Page 6 of 18 I Serial No:06171315:00 Lab Control Sample Analysis Project.Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits _.. _ General Chemist^n,,;'INestborounh:Lab�-AssociatedrsamPle s\J 01 Batch aUVG6140012 x�:•:m..:..,L.=sa:..s" r•«s.ac;a,c;e.�•'e.,�.r.:..ix...rot?�..�:v.. ::§. �, "+. :. ..x. . ... .. Nitrogen,Nitrate ° 100_- - 90-110 - Genera l.Chemistry.,c`,V tborounh;'Lab}Assoclated,sam le s :r01 Batch 1NG614002 2 : x r n Y r �:..--,..::.�...w:.y-='`•sti-c..»::�.:ob-:.��..� �:'r..���n.�-..-<..n...:.�.a:d+.�e.m` -^-':.*� ..,"..,.e:i>aa:..,a......�i•.. ..»"u''%.,��a....,,...�;..�.:....f. * .�,-csi, .a .. ._.. ... .... �.._.. 3..:� Nitrogen;Nitrite rya y98 - 90-110 - 20 GeneralrChemistry ;Westborough L'abAssociated+sample(s) iij N_._. - .. Nitrogen,Total Kjeldahl 78-122 - GerleralrGhernlstry,--:Westboroughlab `Associated:sam le s :°01= Batches.1N,G614323x2 .':" <-< 6 _ >. -1 � - 'a$� = ,; t- _ u+e.:=....w.e,;.,�,• - - r- - .�.;.,�._..Y,,.i.-.s...��..,.-.,..:-�..:.......:.A...:,..:.:�r._..�.�.-. BOD,5 day 85-115 - 20 Page 7 of 18 :� Serial No:06171315:00 Matrix Spike Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits Gene ral.Chemistry-:Westborough Lab Associated'sample(s):'01 QC BatchFlD: WG614001'-4 QC'.Sample L131..0493-01. Client ID:. MSSample: Nitrogen,Nitrate 0.41 4 4.7 _107 - - 83-113 - 6 General-Chemistry-'Westborough Lab`Associated sample(s): 01-_ QC:Batch ID:WG61'4002=4' QC',Sample L1310493=01.: _-.Client ID .;MS Sample Nitrogen,Nitrite 0.070 4 4.3 106 - - 80-120 - 20 General Chemistry;-Westborough Lab_fAssociated'sample(s):;01 QC Batch ID.'WG614.174-4' QCSample`=L1.310511 '0.1` Client'ID MS Sample. , u. .. __.. :.�.r..._ �_ . - _._. v..3 Nitrogen,Total Kjeldahl 10.9 8 18.7 98 - - 77-111 - 24 General Chemistry`-Westborough Lab Associated'sample(s)s 01, ;QC Batch'ID:`',WG6T4323-4: QC=Sample 'L131:0502=01, :Client iID .MS Sample BOD,5 day ND 100 73 " .'<73 - 50-145 - 35 V..::N Page 8 of 18t;.?� Serial No:06171315:00 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L131O525 Project Number: BEA10-10214 Report Date: 06/17/13 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General4Chemist 'Westborou h{LabtAssociated sa mple ;L1310493 01 C.IientID "DUP Sample .,... :_ _ .. �_... .. . Nitrogen,Nitrate 0.41 0.41 mg/I 0 6 Generah.Chemist Westborou h LabsAssociatedsam le s`/ 01 QC"BatchYlD WG6140023� QC Sample::k L1310493 01 Client IDDUPSample �z. g �x:r.,,:.�ei.�:.� Nitrogen,Nitrite 0.070 0.054 mg/I25 Q 20 ............. GeneralChemist _;.W.:estborou h±Lab; Associatedsam le s. 01 ..:QCBatchID, 1NG614062 2 , QCwSample ;L13.10528 02 ;Cllent`ID ;DUPtSample Solids,Total Suspended 100 100 mg/I 20 ....:. . .... . ...... . _. .._.... _....... ..............-_ ... ..-. _...- _.. .._ GeneralChemist Westborou h Lab .Associated sample s 0:1 QC:BatchlD ��WG694174 3kQG Sample ,`L1310511 01CIIentIDDUP Sample �._ .. wry tborou . ���a _., ..._.� _. :._ 3. ._ �. .. _-. _._ Nitrogen,Total Kjeldahl 10.9 10.8 mg/I .. +?;;. 24 GeneraLChemist Westborou h"Lab :AssoclatedsamDle s `01# 'QGBatch`=1D .WG61`4323 3 , QCSampleL13310579 01Cllent-llD 'DUP Sample x�di:.m.v.aw.,,: .�:. �r.�...:-.::s. Y..rn.:..,.+ ...az�x�,..o....:aa:....r[:.u. :...o.c.+�sa�i�..;�e,',..x±:n»' .N:_ r ..�..err;...Yxwr..� ,,,�!^.;;x .,..x,....7;•-�r�.t:...ar.«, +�z:. ,.7._. ..._.... BOD,5 day ND ND mg/I '=<;NC = 35 1,'•` YL?F;A _ Page 9 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1310525-01A Plastic 250ml H2SO4 preserved A <2 2.4 Y Absent TKN-4500(28) L1310525-01B Plastic 1000mi unpreserved A 7 2.4 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1310525-01C Plastic 1000ml unpreserved A 7 2.4 Y Absent TSS-2540(7) r *Values in parentheses indicate holding time in days �'ALPHA Page 10 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC .Not Calculated: Tennis utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 -The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA MOB is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(IOx) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported Report Format: Data Usability Report L1LiFHA Page 11 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 Data Qualifiers due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search: P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report 'LILPHA Page 12 of 18 Serial No:06171315:00 Project Name: BAILEY RESIDENCE Lab Number: L1310525 Project Number: BEA10-10214 Report Date: 06/17/13 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error, the sole and exclusive responsibility of Alpha Analytical shall be to.re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. v PHA Page 13 of 18 Serial No:06171315:00 Certificate/Approval Program Summary Last revised December 19,2012 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water (Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Selenium, Silver, Sodium, Thallium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2,Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane(DBCP)504.1, Ethylene Dibromide(EDB)504.1, 1,4- Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform - Colilert (SM9223, Enumeration and P/A), E. Coli. - Colilert (SM9223, Enumeration and P/A), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC (SM9222D), Fecal Coliform-EC Medium (SM 9221 E). Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics, TPH (HEM/SGT), CT- Extractable Petroleum Hydrocarbons(ETPH), MA-EPH, MA-VPH. Microbiology Parameters:Total Coliform-MF mEndo (SM9222B), Total Coliform-MTF (SM9221 B), E. Coli-Colilert (SM9223 Enumeration), HPC- Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth (SM9221 E), Enterococcus-Enterolert. Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, CT-Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Dalapon, Volatile Organics (SW 8260), Acid Extractables (Phenols) (SW 8270), Benzidines (SW 8270), Phthalates (SW 8270), Nitrosamines (SW� 8270), Nitroaromatics & Cyclic Ketones (SW 8270), PAHs (SW 8270), Haloethers (SW 8270), Chlorinated Hydrocarbons (SW 8270). ) Maine Department of Human Services Certificate/Lab ID: 2009024. Drinking Water(Inorganic Parameters: SM9215B, 9222D, 9223B, EPA 180.1, 353.2, SM2130B, 2320B, 2540C, 4500Cl- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters: 504.1,524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, SM2320B, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH37B, 4500NH3-G, 4500NO3-F, 4500P-B, 4500P-E, 5210B, 5220D, 5310C, 9010B, 9040B, 9030B, 7470A, 7196A, 2340B, EPA 200.7, 6010B, 6010C, 200.8, 6020, 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 625, 8081A, 8081B, 8082, 8082A, 8330, 8151A, 8260B, 8260C, 8270C, 8270D,3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.) Solid Waste/Soil (Inorganic Parameters: 9010B, 9012A, 9014, 9030B, 9040B, 9045C, 6010B, 6010C, 6020, 6020A, 7471A, 7471B, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-VPH, 8260B, 8270C, 8270D, 8330, 8151A, 8081A, 8081B, 8082, 8082A, 3540C, 3546, 3580A, 3630C, 503013, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM213013, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM9215B; ENZ. SUB. SM9223; Y�Page lil q2T SM9223B; MF-SM9222D.) Serial No:06171315:00 Non-Potable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 for: AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1, SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane,Toxaphene,Aldrin, alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT,Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables),600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM9223B; Enterolert-QT:SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited. Drinking Water(Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 300.0, SM4500CN-E, 4500H+B, 4500NO3-F,2320B,2510B,2540C,4500E-C,5310C,2120B, EPA 332.0. Organic Parameters:504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM9222D, 9221 B,9222B, 9221 E-EC, EPA 3005A,200.7, 200.8,245.1, SW- 846 6010C, 6020A, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 426C, 1664A, SW-846 9010B, 9010C, 9030, 9040B, 9040C, SM2120B, 2310B, 2320B, 2340B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 4500S03-B, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D, 3060A. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082A, 8081 B, 8015C, 8151A, 8330, 8270D-SIM.) Solid& Chemical Materials(Inorganic Parameters: SW-846 6010C, 6020A, 7196A, 7471 B, 1010, 101 OA, 1030, 9010C, 9012B, 9014, 9030B, 9040C, 9045C, 9045D, 9050, 9065, 9251, 1311, 1312, 3005A, 3050B, 3060A. Organic Parameters: SW-846 3540C, 3546, 3050B, 3580A, 3620D, 3630C, 5030B, 5035, 8260C, 82701), 8270D-SIM, 8330, 8151A, 8015B,8015C,8082A, 8081B.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.1, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. O_rganic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, 2340B, SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F,4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM51.0ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM2520B, SM15 426C, 9222D, 9221B, 9221C, 9221E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 7470A, 5540C, SM4500H-B, 4500S03-B, SM35000r-D, 4500CN-CE, EPA 245.1, SW-846 9040B, 9040C, 3005A, 3015, EPA 6010B, 6010C, 6020, 6020A, 7196A, 3060A, SW-846 9010C, 9030B. Organic Parameters: SW-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8011, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 1,4-Dioxane by NJ Modified 8270, 8015B, NJ EPH.) Solid& Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010, 1010A, 1030, 1311, 1312, 3005A, 3050B, 7471 A, 74718, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D, 9050A, 9065, 9251. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 8260B, 8260C, 8270C,82701), 8270C-SIM, 8270D-SIM, 3540C, 3546, 3580A,3620C, 3630C, 5030B, 5035L,5035H, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148.NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0, SM2320B, EPA 300.0, SM2120B, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B,,5210B, 5310C, EPA 410.4, SM5220D, 2310B-4a, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH,. EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6010C, 6020, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 7470A, SM2120B, LACHAT 10-204- 00-1-A, 4500CN-CE, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 3005A, 3015, 9010C, 9030B. Organic Parameters: EPA 624, 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 625, 608, 8081A, 8081B, 8151A, 8330,8082, 8082A, EPA 3510C, 5030B.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010B, 6010C,7196A, 7471A, 7471B,9012B, Page 065, 9050A, EPA 1311, 1312, 3005A, 3050B, 9010C, 9030B, 9040C, 9045D. Organic Parameters: EPA 8260B; RU8270C, 8270D, 8270C-SIM, 8270D-SIM, 8015B, 8015C, 8081A, 8081B, 8151A, 8330, 8082 8082A, 3540C, Serial No:06171315:00 3546, 3580A, 5030B, 5035A-H, 5035A-L.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID : 666. (Inorganic Parameters: SM2310B,2320B,4500CI-E,4500Cn-E, 9014, Lachat 10-204-00-1-X, 1010A, 1030, 4500NO3-F, 353.2, 4500P-E,4500SO4-E, 300.0,4500S-D, 5310B, 5310C, 6010C,6020A, 200.7, 200.8, 3500Cr-B, 7196A, 245.1, 7470A, 7471B, 1311,1312.Organic Parameters:608, 8081B,8082A,624, 826013, 625,8270D, 8151A, 8015C, 504.1, MA-EPH, MA-VPH.) Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters: 524.2) Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited. Drinking Water(Inorganic Parameters:200.7, 200.8, 300.0, 332.0,212013, 23206, 2510B, 2540C,4500-CN-CE, 4500E- C,4500H+-B,4500NO37F, 5310C. Organic Parameters:EPA 524.2, 504.1) Non-Potable Water(Inorganic Parameters: EPA 120.1, 1312, 3005A,3015, 3060A, 200.7, 200.8,410.4, 1664A, SM254013, 521013, 52201),4500-P,BE,245.1, 300.0, 350.1, 350.2, 351.1, 353.2,420.1, 6010C, 6020A, 7196A,7470A, 90306,212013,2310B,232013, 2510B, 25406,2540C, 3500Cr-D,426C,4500CN-CE,4500CI-E,4500E-B,4500E-C, 4500H+-B,4500NH3-H,4500NO2-B,4500NO3-F,4500S-D,4500SO3-B, 5310BCD, 5540C, 9010C,9040C. Organic Parameters: EPA 3510C, 3630C, 503013,625, 624, 608, 8081B, 8082A, 8151A, 8260C, 82701), 8270D-SIM, 8330, 8015C, NJ-EPH.) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3005A, 30506, 3060A, 6010C, 6020A, 7196A, 747113, 9010C, 901213, 9014, 904013, 90451), 9050A, 9065, SM 4500NH3-131-1, 903013, 9038, 9251. Organic Parameters: 3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081B, 8082A, 8151A, 8260C, 82701), 8270D- SIM,8330, NJ-EPH.) Rhode Island Department of Health Certificate/Lab ID:.LAO00065. NELAP Accredited via NJ-DEP. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476. NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7, 200.8, 245.1, 245.2, 300.0, 350.1, 351.1, 353.2, 410.4,420.1, 6010,6020, 7196,7470, 9040, SM 212013,2310B,232013,2510B,254013,2540C, 25401),426C,4500CL- E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO213,4500P-E,4500 S2 D, 510C, 5210B, 52201), 5310C, 5540C. Organic Parameters: EPA 608, 624,625, 8081, 8082,8151, 8260,8270, 8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312, 9012, 9014, 9040, 9045,9050,9065.) Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited. Drinking Water(Inorganic Parameters: EPA 200.7, 200.8, 300.0, 2510B, 21206,2540C,4500CN-CE,245.2, 232013, 4500E-C,4500NO3-F,5310C. Organic Parameters: EPA 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A,200.7, 200.8, 245.1,300.0, 3005A, 3015, 1312, 6010B, 6010C, 3060A, 353.2,420.1, 6020, 6020A, SM4500S-D, SM4500-CN-CE, Lachat 10-204-00-1-X, 7196A, 7470A, 9010B, 9040B, 2310B,23206, 2510B, 25406,2540C, 3500Cr-D,426C,4500CI-E,4500E-B,4500E-C,4500PE, 510AC, 5210B, 5310E 5310C,5540C. Organic Parameters: EPA 3510C, 3630C, 5030B, 826013, 608, 624,625, 8081A, 8081 B, 8082, 8082A, 8151A, 8270C, 82701), 8270C-SIM, 8270D-SIM, 8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 3050B, 1311, 1312, 6010B,6010C, 6020, , 7196A, 7471A,7471 B,6020A, 903013, 9010B,9012A, 9014 9040B, 9045C, 9050A, 9065. Organic Parameters: EPA 50306, 5035, 3540C, 3546, 355130, 3580A,3630C, 6020A, 826013,801513, 8015C, 8081A, 8081B,8082, 8082A, 8151A, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330.) Department of Defense, L-A-B Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters: SM 4500H-B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: EPA 200.7, 200.8, 601013, 6010C, 6020, 6020A, 245.1, 245.2, 7470A, 904013, 90106, 180.1. 300.0, 332.0, 6860, 353.2,410.4, 9060, 1664A, SM 4500CN-E,45001-1-13,4500NO3-F,4500CL-D, 52201), 5310C, 2130B, 23206, 2540C, 3005A, 3015, 9010B, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 82606, 8260C, 8270C, 82701), 8270C-SIM, 8270D-SIM, 8330A, 8082, 8082A, 8081A, 8081B, 3510C, 50306, MassDEP EPH, MassDEP VPH.) Page �1i s Hazardous Waste(Inorganic Parameters: EPA 200.7,6010B,6010C, 7471A, 6860, 1311, 1312, 3050B, 7196A, 9012A, 904013, 9045C, 3500-CR-D,4500CN-CE, 2540G, Organic Parameters: EPA 826013, 8260C, 8270C, . Serial No:06171315:00 8270D, 8270C-SIM, 8270D-SIM, 8330A/B-prep, 8082, 8082A,8081A, 8081B, 3540C,3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAPITNI Scope of Accreditation: EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Dimethylnaphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Ch loroani line, 4-Methylphenol. Total Phosphorus in a soil matrix, Chloride in a soil matrix,TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Page 17 of 18 Serial No:06171315:00 - Da�e:Rec'djintGAU:i` e C AI iV F _ ® CUSTODY PgGE 1 OF t Project Information Report Information Data Deliverables Billing Information ❑ FAX ® EMAIL ® Same as Client info PO#:10214 Westborough,MA Mansfield,MA Project Name:Bailey Residence TEL 508-89M220 TEL 608-822-9300 ❑ ADEx ❑ Add'I Deliverables . ...FAX:.508-8964193.. FAX:508-822-3268 .:. ... .. Regulatory '• -•. InformationClient Project Location:Osterville,MA State/FedProgram Criteria Client:Bennett Environinental Associates Project#:BEA10-10214 Address:1573 Main Street[P.O.Box 1743 Project Manager:David C.Bennett Brewster,MA 02631 ALPHA Quote#: Phone:.508-896-1706 Turn-Around Time ANALYSIS. ; Fax:508-896-5109 ®Standard: ❑Rush(ONLY IFPRE-APPROVED) SAMPLE HANDLING Em_ail:sfarrenkopf@bennett-ea:com Flltreflon ❑ Done ❑These samples have been Previously analyzed by Alpha Due Date:lb/ !me: M Not Needed. ❑ Lab to do Other Project Specific Requirements/Comments/Detection Limits: Preservation • a .. ❑ L b to do (Please spet!/y ' p belo%W m ALfHA:Lab.:ID:.` = ampeIDoecon Sa . :•;< ..... : .., Collection mple ampler Z S l 1 S s :Use�Only).'' Date Time Matrix Initials .. .. .. � �� •• 9ampte specific ' H 'Z Comments., ' ";.`;'.- "` t.::" Effluent �s �� + IhfUV l�'� ® .:® ® DID : ❑.. ❑ .❑ El : : ❑ 3 ❑ El I El +ri raj= RD ❑ ❑ El❑ ❑ El ❑ ElV :• El El El Container Type P P P - - P�eservative O 0 D `:�nd'CompAtellaSa�mp!e'st�o�'� -not,, pigged nand. Relin hed By Date/Time Received By: Daterrime turn0idph..time clocx w;lj do T j Kstait:Untll;any�amblguIDes lireadlved:AII so [as 3� r - §uEittUtteii'ere subject;to) roaM No. I All al mtr n�) a ;Alpha`s`PaymenrTerpl`sr. :'::'s: . .. (m,29APR.09) ... t �� Page 18•of 18 Serial_No:09161314:09 A HA A.WA L,Y T I C A L ANALYTICAL REPORT Lab Number: L1317692 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 09/16/13 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(L2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com a &PHA Page 1 of 19 Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Alpha Sample Collection Sample ID Client ID Location Date/Time L1317692-01 EFFLUENT OSTERVILLE, MA 09/09/13 10:00 PHA Page 2 of 19 Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report,Date: 09/16/13 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples free of charge for 21 calendar days from.the date the project is completed. After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples. Please contact Client Services at 800-624-9220 with any questions. Page 3 of 19 H'A Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Case Narrative(continued) Nitrogen, Total Kjeldahl L1317692-01 has elevated detection limits due to the dilution required by the sample matrix. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and. based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. C��fC%�!`��1�.�. Cynthia McQueen Authorized Signature: Title: Technical Director/Representative Date: 09/16/13 Page 4 of 19 ------,�` Serial No:09161314:09 INORGANICS MISCELLANEOUS Page 5 of 19 Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 SAMPLE RESULTS Lab ID: L1311692-01 Date Collected: 09/09/13 10:00 Client ID: EFFLUENT Date Received: 09/10/13 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab Solids,Total Suspended ND mg/I 5.0 NA 1 - 09/12/13 14:10 30,2540D DW ------ -— - --- - ..__.... - -- -- - ------ -.. - ... .._...... ........_.. .......-_. ..._,_..._... __ ., ........... ........... . Nitrogen,Nitrite 0.11 mg/I 0.050 1 - 09/11/13 01:04 44,353.2 DB _. _. ......... Nitrogen,Nitrate 23. mg/1 1.0 - 10 - 09/11/13 01:23 44,353.2 DB .... ...... ......_._..._.. .... .........._..... - Nitrogen,Total Kjeldahl ND mg/1 1.50 5 09/11/13 08:45 09/11/13 20:53. _....._ ..- . _.. ._... ......._-. BOD,5 day 2.8 mg/1 2.0 NA 1 09/10/13 23:20 09/15/13 17:45 30,521013 SE �L�LPt;�i Page 6 of 19 f Serial_No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry'-Westborough Lab for samples) 01 Batch 'VVG635114p1 a ,ym . .'° BOD,5 day ND mg/I 2.0 NA 1 09/10/13 23:20 09/15/1317:45 30,521013 SE General Chemist Westborou h Lab for samples) 01 Batch WG635,122'1 Nitrogen,Nitrate ND mg/I 0.10 — 1 09/11/1300:35 44,353.2 DB General Chemistry .Westborough Lab for samples) 01°:Batch WG635124`1µ , Nitrogen,Nitrite ND mg/I 0.050 1 09/11/1300:38 44,353.2 DB General Chemistry Westborough Lab for,sample(s) +01 �Batch} WG6352681is. Nitrogen,Total Kieldahl ND mg/I 0.300 — 1 09/11/13 08:45 09/11/13 20:14 30,4500N-C AT General Chemistry-Westborough Lab for sa�mple(s) 01 =Batch 'VVG635523 1 "' �' Solids,Total Suspended ND mg/I 5.0 NA 1 09/12/1314:10 30,2540D DW Page 7 of 19 Serial No:09161314:09 Lab Control Sample Analysis Batch Quality Control Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry=West6oroughi Lab;Associated sample(s): 01 Batch:'.WG635114:=2,'_ BOD,5 day -113: 85-115 - 20 General Chemistry-Westborough Lab Associated'sample(s): 01. Batch:-,WG635122-2 Nitrogen,Nitrate 1.99 - 90-110 General Chemistry s'1Nestborough:L'ab Ass66iatedasample(s):.01:.,,Batch. WG63'5124 2 ` Nitrogen,Nitrite .99 - 90-110 20 General'Chemis try—Westborough:L"ab:Associatedsample(s): 01- 'Batch:-WG635268=2'- -� Nitrogen,Total Kjeldahl .99-, 78-122 - Page 8 of 19 j' f[��t;.a _ Serial No:09161314:09 Matrix Spike Analysis Batch Quality Control Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits ry;- g Y d sample(s): 01 rQC.Batch ID:WG635114 4 . QC`Sample: L1317555 01F ,Client ID MSSample GeneralChemist Vllestborou hLab-Associate A s , . : BOD,5 day 6.0 100 150 ' 711 3 - - 50-145 - 35 General;:GhemistryK'Westborough Lab Associated sample(s):01 ;QG:Batch,ID..WG635122-4_ry QC:Sample:,L131!7689 01 ,CIiegt,ID !MS'Sample z Nitrogen,Nitrate 1.3 4 '5.2 97 '.` - - 83-113 6 General:Chemist. Westborough6Lab_Associated}sample(s): 01, QC:Batch ID ,WG635.124 4�.;; QC Sample:L1317.689,01: ClientalD MS Sampleti :;i< Nitrogen,Nitrite 0.094 4 3.9 `" 9.6 - 80-120 - 20 General' emistr W.estborou h Lab Associated>sample(s:) {01t;."QCiBatch ID WG635268#4-- QC Sample:,L1317619.0.5., ClientilD,.MSJSample y .�yran..;&�d....a,,^ia✓n- r ':+ �L - g �+ .�* ,„.k.a..-r..+.,-... ..+1.-..'�;".y..r w... .. �`.., .. ,. ..,v-+rr-•..M iv„• ., .... ..,-... .� •QR.'S-� .....,c.^.:: .o,. .-r. w .d Nitrogen,Total Kjeldahl ND 8 7.13 Yh89 ': - 77-111 - 24 Page 9 of 19 A HA Seri a l_N o:09161314:09 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General Chemistry.--Westborough.Lab._.Associatedsample(s):-.01 QC;Batch,ID: WG635114-3' •,QC Sample:::L1317693-01 .Client'ID:::DUP..Sample BOD,5 day 300 250 mg/I 18= 35 General'Chemistry:-Westborough;Lab Associated sample(S): 01= QC Batch ID:,=WG635122-3 . QCZample:- L1317689-01 .Client!ID:' DUR`Sample Nitrogen,Nitrate 1.3 1.3 mg/I ".0, 6 General Chemistry ..Westborough,Lab Associated sample(s): 01 'QC Batch ID: WG635124-3 QC Sample: Ll317689-01 -Client ID:-DUP.Sample Nitrogen,Nitrite 0.094 0.096 mg/I 2 20 General Chemistry.-.Westborough.Lab;Associated.-sample(s):..01 -.QC;Batch'[D.: WG635268-3 QC Sample: L1.317619-05 Client•.ID:.,DUR,Sample Nitrogen,Total Kjeldahl ND ND mg/1 *.NC- ,'T 24 General Chemistry,-:Westborough Lab Associated!Sample(s):..01 QC,Batch ID:MG635523-2 QC.Sample;. L•13.1.7,668-01.. Client1D:.- DURSample Solids,Total Suspended 2100 2300 mg/I 9`-` 20 Page 10 of 19 ! ��� Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1317692-01A Plastic 250ml H2SO4 preserved A <2 3.1 Y Absent TKN-4500(28) L1317692-01B Plastic 1000ml unpreserved A 7 3.1 Y Absent NO2-353(2),l3OD-5210(2),NO3- 353(2) L1317692-01C Plastic 1000ml unpreserved A 7 3.1 Y Absent TSS-2540(7) *Values in parentheses indicate holding time in days � ha Page 11 of 19 Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes i The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldo]Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyze at less than ten times(1 Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extraqted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The lower value for the two columns has been reported due to obvious interference. Report Format: Data Usability Report Page 12 of 19 Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 Data Qualifiers M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search. P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. S Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report j�L.1\z?F;A Page 13 of 19 Serial No:09161314:09 Project Name: BAILEY RESIDENCE Lab Number: L1317692 Project Number: BEA10-10214 Report Date: 09/16/13 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental,consequential or special damages, including but not limited to,damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. HA Page 14 of 19 Serial No:09161314:09 Certificate/Approval Program Summary Last revised August 29,2013 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods, please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water (Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Selenium, Silver, Sodium, Thallium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP)504.1, Ethylene Dibromide(EDB)504.1, 1,4- Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform - Colilert (SM9223, Enumeration and P/A), E. Coli. - Colilert (SM9223, Enumeration and P/A), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-EC Medium (SM 9221 E). Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0 Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics, TPH (HEM/SGT), CT- Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH. Microbiology Parameters:Total Coliform-MF mEndo (SM9222B), Total Coliform-MTF (SM9221 B), E. Coli-Colilert (SM9223 Enumeration), HPC- Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth (SM9221 E), Enterococcus-Enterolert. Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP.Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, CT-Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Dalapon, Volatile Organics (SW 8260), Acid Extractables (Phenols) (SW 8270), Benzidines (SW 8270), Phthalates (SW 8270), Nitrosamines (SW 8270), Nitroaromatics & Cyclic Ketones (SW 8270), PAHs (SW 8270), Haloethers (SW 8270), Chlorinated Hydrocarbons (SW 8270). ) State of Illinois Certificate/Lab ID: 003155. NELAP Accredited. Drinking Water (Inorganic Parameters: SM212013, 2320B, 2510B, 2540C, SM4500CN-CE, 4500E-C, 4500H-B, 4500NO3-F,5310C, EPA 200.7, 200.8,245.1, 300.0. Organic Parameters: EPA 504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: SM2120B, 2310B, 2320B, 2340B, 2510B, 2540B, 2540C, 2540D, SM4500CL-E, 4500CN-E, 4500E-C, 4500H-B, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-E, 4500S-D, 4500SO3-B, 5210B, 5220D, 5310C, 5540C, EPA 120.1, 1664A, 200.7, 200.8, 245.1, 300.0, 350.1, 351.1, 353.2, 410.4, 420.1. Organic Parameters: EPA 608,624, 625.) Hazardous and Solid Waste (Inorganic Parameters: EPA 1010A, 1030, 1311, 1312, 6010C, 6020A, 7196A, 7470A, 7471 B, 9012B, 9014, 9038, 9040C, 9045D, 9050A, 9065, 9251. Organic Parameters: 8011 (NPW only), 8015C, 8081 B, 8082A, 8151A,8260C, 8270D, 8315A,8330.) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM921513, 9222D,.9223B, EPA 180.1, 353.2, SM212013; 2130B, 2320B, 2510C, 2540C, 4500CI-D,4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, 5310C,EPA 200.7, EPA 200.8,245.1, EPA 300.0. Organic Parameters: 504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 300.0, 350.1, 351.1, 353.2, 410.4, 420.1, 8315A, 9010C, SM21206, 2310B, 2320B, 2510B, 2540B, 2540C, 2540D, 426C, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-C, 4500NH3-13, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-B, 4500P-E, 4500S2-D, 4500S03-B, 5540C, 5210B, 5220D, 5310C, 9010B, 9030B, 9040C, 7470A, 7196A, 2340B, EPA 200.71 6010C, 200.8, 6020A, 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 625, 8011, qRPage 01�,98082A, 83301 8151A,8260C,8270D,3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.) Serial No:09161314:09 Solid Waste/Soil(Inorganic Parameters: 9010B, 9012A, 9014, 9040B, 9045C, 6010C, 6020A, 7471 B, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B, 9038, 9251. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA- VPH, 8260C, 8270D, 8330, 8151A, 8081B,8082A,3540C,3546, 3580A, 3620C,3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM2130B, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM9215B; ENZ. SUB. SM9223; ColilertQT SM9223B; MF-SM9222D.) I Non-Potable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 for: AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1, SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane, Toxaphene,Aldrin, alpha-BHC, beta-BHC,gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT,Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables), 600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM9223B; Enterolert-QT:SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited. Drinking Water(Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 300.0, SM4500CN-E, 4500H+B, 4500NO3-F,2320B,2510B, 2540C,4500E-C,5310C,2120B, EPA 332.0.Organic Parameters:504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221 E-EC, EPA 3005A, 200.7, 200.8, 245.1, SW- 846 6010C, 6020A, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 426C, 1664A, SW-846 9010B, 9010C, 9030, 9040B, 9040C, SM2120B, 2310B, 2320B, 2340B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 4500S03-B, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D, 3060A. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082A, 8081 B, 8015C, 8151A,8330, 8270D-SIM.) Solid& Chemical Materials (Inorganic Parameters: SW-846 6010C, 6020A, 7196A, 7471 B, 1010, 1010A, 1030, 9010C, 9012B, 9014, 9030B, 9040C, 9045C, 9045D, 9050, 9065, 9251, 1311, 1312, 3005A, 3050B, 3060A. Organic Parameters: SW-846 3540C, 3546, 3050B, 3580A, 3620D, 3630C, 5030B, 5035, 8260C, 8270D, 8270D-SIM, 8330, 8151A, 8015B,8015C, 8082A, 8081B.) New Hampshire Department of Environmental Services Certificate/Lab ID:2064. NELAPAccredited. Drinking Water(Organic Parameters: EPA 524.2: Di-isopropyl ether(DIPE), Ethyl-t-butyl ether(ETBE),Tert-amyl methyl ether(TAME)). Non-Potable Water(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene. EPA 8015C(M): TPH.) Solid&Chemical Materials(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.1, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM52201), 4500CI-E, EPA 300.0, SM2120B, 2340B, SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F,4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM15 426C, 9222D, 9221 B, 9221 C, 9221 E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 7470A, 5540C, SM4500H-B, 4500S03-B, SM3500Cr-D, 4500CN-CE, EPA 245.1, SW-846 9040B, 9040C, 3005A, 3015, EPA 6010B, 6010C, 6020, 6020A, 7196A, 3060A, SW-846 9010C, 9030B. Organic Parameters: SW-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8011,8015C, 8081A, 8081B,8082, 8082A,8151A, 8330, 1,4-Dioxane by NJ Modified 8270, 8015B, NJ EPH.) g li sChemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010, Page TOMA, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471 B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D, Serial No:09161314:09 9050A, 9065, 9251. Organic Parameters: SW-846 8015B, 8015C, 8081A, 808113, 8082, 8082A, 8151A, 8330, 8260B, 8260C,8270C, 8270D,8270C-SIM, 8270D-SIM, 3540C, 3546, 3580A, 3620C, 3630C, 5030B, 5035L, 5035H, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B; 921513, EPA 200.8, 200.7, 245.1, SM5310C, EPA 332.0, SM23206, EPA 300.0, SM212013, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 922113, 922213, 92156, 5210B, 5310C, EPA 410.4, SM5220D, 23106, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B,4500P-E, 2340B, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010C, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 7470A, SM212013, 4500CN-CE, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 8395A, 3005A, 3015, 9010C, 9030B. Organic Parameters: EPA 624, 8260C, 8270D, 8270D-SIM, 625, 608, 8081 B, 8151A, 8330, 8082A, EPA 3510C, 503013, 8015C, 8011.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010C,6020A, 7196A, 7471 B,8315A, 901213, 9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 305013, 9010C, 903013, 9040C, 9045D. Organic Parameters: EPA 8260C,8270D, 8270D-SIM, 8015C, 8081 B, 8151A, 8330,8082A,3540C, 3546, 3580A, 5035A-H, 5035A-L.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID:666. (Inorganic Parameters: SM2310B,232013,4500CI-E,4500Cn-E,9012B, 9014, Lachat 10-204-00-1-X, 1010A, 1030,4500NO3-F, 353.2,4500P-E,4500SO4-E, 300.0,4500S-D,5310B, 5310C, 6010C, 6020A,200.7,200.8, 3500Cr-B, 7196A,245.1, 7470A, 7471 B, 1311,1312. Organic Parameters:608,8081 B, 8082A, 624, 8260B,625, 8270D, 8151 A,8015C, 504.1, MA-EPH, MA-VPH.) Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters: 524.2) Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited. Drinking Water(Inorganic Parameters:200.7,200.8, 300.0, 332.0,2120B, 2320B,2510B, 2540C,4500-CN-CE,4500E- C,4500H+-B,4500NO3-F, 5310C. Organic Parameters: EPA 524.2, 504.1) Non-Potable Water(Inorganic Parameters: EPA 120.1, 1312,3005A,3015, 3060A, 200.7, 200.8,410.4, 1664A, SM2540D, 5210B,52201),4500-P,BE,245.1, 300.0,350.1, 350.2, 351.1, 353.2,420.1, 6010C, 6020A,7196A, 7470A, 90306,2120B,2310B,232013,2510B,254013,2540C,3500Cr-D,426C, 4500CN-CE,4500CI-E,4500E-B, 4500E-C, 4500H+-B,4500NH3-H,4500NO2-B,4500NO3-F,4500S-D,4500S03-B, 5310BCD, 5540C, 9010C,9040C.Organic Parameters: EPA 3510C, 3630C, 5030B,625,624,608, 8081 B, 8082A, 8151A,8260C,82701), 8270D-SIM, 8330, 8015C, NJ-EPH.) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3005A, 3050B, 3060A, 6010C, 6020A, 7196A, 7471 B, 9010C, 901213, 9014, 904013, 9045D, 9050A, 9065, SM 4500NH3-BH, 9030B, 9038, 9251. Organic Parameters: 3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081 B, 8082A, 8151A, 8260C, 8270D, 8270D- SIM, 8330, NJ-EPH.) Rhode Island Department of Health Certificate/Lab ID: LA000065. NELAP Accredited via NJ-DEP. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476. NELAPAccredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7,200.8,245.1, 245.2, 300.0, 350.1, 351.1, 353.2, 410.4,420.1, 6010, 6020, 7196,7470, 9040, SM 212013, 2310B,232013,2510B,25406,2540C, 25401),426C,4500CL- E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500N0213,4500P-E,4500 S2 D, 510C, 5210B, 52201), 5310C, 5540C. Organic Parameters: EPA 608, 624,625,8081,8082, 8151,8260, 8270, 8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312, 9012,9014, 9040, 9045,9050, 9065.) Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited Drinking Water(Inorganic Parameters: EPA 200.7,200.8, 300.0,2510B,21206,2540C,4500CN-CE, 245.1,2320B, 4500E-C,4500NO3-F,4500H+B, 5310C. Organic Parameters: EPA 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A,200.7,200.8,245.1, 300.0, 350.1, 351.1,351.2, 3005A, 3015, 1312, 6010B, 6010C, 3060A, 353.2,420.1,23406, 6020, 6020A, SM4500S-D, SM4500-CN-CE, Lachat 10-204- Page 4 ( t 16 3 � 1 O45A3H4500NO2�B4500NO3F,4500 S03-B 4500HB,45OPE 50AC, 52106,5310B530C 0C901 Cm Serial No:09161314:09 90306, 9040C. Organic Parameters: EPA 3510C, 3630C, 50306,8260B, 608, 624,625, 8011, 8015C, 8081A, 808113, 8082, 8082A, 8151A,8260C, 8270C,8270D, 8270C-SIM, 8270D-SIM, 8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 3050B, 1311, 1312, 60106, 6010C, 6020, , 7196A, 7471A, 7471B, 6020A,9010C, 901213, 903013, 9014, 9038, 9040C, 9045D, 9251,9050A, 9065. Organic Parameters: EPA 503013, 5035, 3540C, 3546, 35506, 3580A, 3620C, 3630C,6020A, 8260B,8260C, 8015B, 8015C, 8081A,8081B,8082,8082A,8151A, 8270C, 8270D, 8270C-SIM, 8270D-SIM,8330.) Department of Defense, L-A-B Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters:. SM 4500H-B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: EPA 200.7, 200.8, 6010C, 6020A, 245.1, 7470A, 9040B, 901013, 180.1, 300.0, 332.0, 6860, 351.1, 353.2, 9060, 1664A, SM 4500CN-E, 4500H-B, 4500Norg-C, 4500NO3-F, 5310C, 213013, 232013, 2340B, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A, 8260C,8270D, 8270D-SIM, 8330A, 8082A, 8081 B,3510C, 5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010C, 6020A, 7471A, 6860, 1311, 1312, 3050B, 7196A, 9040B, 9045C, 9010C, 9012B, 9251, SM3500-CR-D,4500CN-CE, 2540G, Organic Parameters: EPA 8015C,8151A, 8260C, 8270D, 8270D-SIM, 8330A/B-prep, 8082A, 80816, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAPITNI Scope of Accreditation: EPA 524.2: Acetone, 2-Butanone (Methyl ethyl ketone (MEK)), Tert-butyl alcohol, 2-Hexanone, Tetrahydrofuran, 1,3,5- Trichlorobenzene, 4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260B: 1,2,4,5- Tetramethyl benzene, 4-Ethyltoluene. EPA 8260 Non-potable water matrix: lodomethane (methyl iodide), Methyl methacrylate. EPA 8260 Soil matrix: Tert-amyl methyl ether (TAME), Diisopropyl ether (DIPE), Azobenzene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methyinapthalenes, Total Dimethyinaphthalenes, 1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline, 4-Methylphenol. Total Phosphorus in a soil matrix, TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Page 18 of 19 Serial No:09161314:09 CHAIN OF CUSTODY Date Reo'dlnLab: :IO 13 ALPHA-Job ::.P.. PAGE 1 OF f ALPHA• . 'A Report • • ti. a" • . • • sr�k ❑ FAX ® EMAIL. ® Same as Client Info PO#:10214 Westborough MA• Mansfield,MA Project Name:Bailey Residence TEL:5M898.922D TEL 608-822.9300 ❑ ADEx ❑ Add 'I Deliverables FAX 608.898-9193 FAX 508-8223288 - . • • ••IClient nformation Project Location:Osterville,MA State/Fed Pro ram Criteria Client:Bennett Environmental Associates Project#:SEA10-10214 Address:1573 Main Street/P.O.Box 1743 Project Manager:David C.Bennett _ Brewster MA 02631 ALPHA Quote#: Phone:508-896-1706 ANALYSIS Fax:508-896-5109 ® SAMPLE HANDLINGStandard ❑Rush(ONLY IF Fl/tratlon - Email:sfarrankopf@bennett-ea.com t ❑ Done ❑These samplev have been Previously anayzedbyAlpha DueDate011-`3 Time ® Not Needed `❑ Lab to do Other Project Specific Re quirements/Comments]Detection Limits: PreservaUen ' ❑ Lab to do � (Pleasespeclry O below) m i..;ALPHA.Lab ID Sample ID Collection Sample Sampler's Z Date Tlme Matrix Initials (Cab:UseOnly)_,' N 5 7 Sampl•specific . Ioz FX- cmnmanrs Z J Effluent ww ,.7 ® ® ❑ a El 0 ❑ ❑ 0 1 El ❑ ❑ .D ❑ ❑ ❑ ❑ ❑ ❑ El El ❑ El I El 0 ❑ ❑ ❑ ❑ ❑ 1 El ❑ ❑ ❑ D ❑ El El ❑ D ID El 11 D ❑ ❑ 0 ❑` ❑ L1D. Container Type P P P - - PMservative 0 0 D a"PInd completely;Samples,can not be logged In'and i� R Ished Daterrima eceivedBy. DateMme turnaround tlmexlockwilcnot start untif6ny ambiguities are ��� \ �� resolved.%All.satnples submitted arasubject to b Alpha's Payment Terms. . FORM HOAS-01CM4 `w. Page 19 of 19 r BENNETTENVIRONMENTALAssOCIATES, INC. LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS 0 GEOLOGISTS 0 ENGINEERS 1573 Main Street- P.O. Box 1743, Brewster, MA 02631 0 508-896-1706 0 Fax 508-896-5109 www.bennett-ea.com BEA10-10214 March 8,2012 Ms. Chapman Bailey P.O. Box 662 '71 --� Osterville, MA 02655 V, N r RE: OPERATION AND MAINTENANCE CONTRACT -- `'' Innovative/Alternative Wastewater Treatment System N 49 Joby's Lane- Osterville, MA- CM Dear Ms. Bailey, Na r. �;. rn BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for the continuation of professional services relative'!:to the operation'-and maintenance of the innovative/alternative septic system located at the above referenced property. The semi-annual system inspection and laboratory analysis of samples collected from the effluent of the septic treatment system is a required condition of the approved Innovative Wastewater Treatment System, as set forth by the Massachusetts Department of Environmental Protection(MA DEP)and the Barnstable Board of Health to qualify treatment capacity;. As such, work proposed by BEA in the collection Hof wastewater samples for field screening and the preparation of the required forms for distribution to the appropriate town and state offices, as well as you. Additionally, at the time of such sampling,blowers, filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance will be performed. You will be invoiced for this work semi-annually on a.fixed-cost basis. Should any repair or treatment system component replacement be required, or additional sampling beyond the semi-annual requirements necessary, you will be notified to authorize the additional work and expenses. The following budget represents estimated annual costs through one year of service to include two sampling and inspection events. These annual costs are valid for two years. Please note that this contract runs with the property.As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore,you are required to notify any buyer for the transfer of this contract. SEMI-ANNUAL INSPECTION/MAINTENANCE/SAMPLING Inspect I/A system and take field measurements of dissolved oxygen,pH and turbidity. Collect semi-annual treated effluent wastewater samples under a proper chain-of-custody for analysis by a MA certified laboratory of BOD,TSS,and nitrite/nitrate/TKN for total nitrogen. At the time of sampling events the conditions of the system will be inspected and documented with regards to the blower units,sludge level and associated piping. 1 EMERGENCY SPILL RESPONSE 0 WASTE SITE CLEANUP 6 SITE ASSESSMENT 0 PERMITTING 0 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE MARCH 8,2012 BAMEYBEA10-10214 PAGE 2 OF 2 49 JOBTS LANE-OSTERVILLE,MA REPORTING/FILING Review laboratory results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms on a semi-annual basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Fees Operation&Maintenance and Monitoring $ 470.00 Laboratory Analysis[2X—TSS,BOD,TN(nitrite,nitrate,TKN)] $ 153.87 TOTAL ANNUAL EXPENSE: $623.87x TOTAL COST PER EVENT: $311.94 *Note:I/A systems located in Barnstable County are required to report inspection and sampling results on the NIA Septic online ,database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filing on this required database. This fee is$50 per year. This fee will be included on your invoice on an annual basis. In addition,the noted fee is based on appropriate accessibility to the system wherein all components should be at grade level. While the alternative septic system at your residence is currently classified as requiring quarterly operation and maintenance,the Barnstable Health Agent has specifically requested that we provide a semi-annual contract in recognition of the seasonal use of the residence. Operation and maintenance will be performed in accordance with the schedule approved by the Barnstable Board of Health and you will be notified of any necessary changes to this contract as a result of their approval. We are proceeding with this work as outlined. Immediate notification in writing is required if you do not wish to proceed. Please sign and date this contract for our records acknowledging acceptance of our Terms & Conditions and return one copy to our office. Should you have any questions or need additional information,please contact me directly at our office. Very truly yours, ,NNETT ENVIRONMENTAL ASSOCIATES, INC. Kara Risk, S Business Manager cc: Samantha Farrenkopf, Wastewater Program Coordinator Dr. Wayne Miller, Chairman, Barnstable Board of Health encl. Terms & Conditions (2011)/Fee Schedule (2010) AUTHORIZATION: , DATE: STATEMENT OF TERMS AND CONDITIONS BENNETT ENVIRONMENTAL ASSOCIATES,INC. FEBRUARY 4,2011 COMPENSATION FOR PROFESSIONAL SERVICES: Fees for environmental and engineering services will be based on the time worked on a given project. They are computed by multiplying total payroll cost by a factor(to include overhead and profit) for all members of the staff. Total payroll cost is defined as direct salary cost plus payroll taxes and fringe benefits. Clients are advised that all fees are subject to increases. Refer to the current fee schedule. TRANSPORTATION: Time spent traveling, when travel is in the interest of work,will be charged for in accordance with the fee schedule. Automobile or truck expenses for personal or office vehicles will be charged at a rate of$0.32 per mile plus tolls and parking charges SUBCONTRACT SERVICES: We may engage subcontractors and/or other professionals to perform required services such as soil boring, drilling, construction,etc. Those contractor's fees are subject to a service charge of fifteen percent(15%)and will be added to our invoices. OTHER EXPENSES: All expenses will be billed at cost plus a service charge of.fifteen percent (15%). Examples of expenses ordinarily charged to,projects are printing and reproduction,,equipment and materials;travel.expenses and associated meals,fees,permits and licenses. RIGHT OF ENTRY: Unless otherwise agreed, the client will furnish right-of-entry on the land for us to make measurements,conduct soil tests,or other required explorations. We will take reasonable precautions to minimize damage to the land from the use of equipment. If we are required to restore the land to its former condition,the cost of doing so will be added to our fee. INVOICES: Invoices will be submitted periodically, at the completion of work or monthly as work progresses and are payable within 30 days from the date of the invoice. Interest at the prevailing rates will be charged on invoices over 30 days. INSURANCE: We are covered by Workmen's Compensation Insurance and Liability Insurance. We will furnish certification upon request. COLLECTION OF OUTSTANDING BILL(S): The Client(s)shall be responsible for the payments of reasonable attorneys fees and any reasonable audit fees incurred in the collection of any debt due to BENNETT ENVIRONMENTAL ASSOCIATES,INC.for services rendered by them. If BENNETT ENVIRONMENTAL ASSOCIATES, INC. is hired by a contractor as a subcontractor on a job, a lien will be attached directly on the real property owned by the client/owner for compensation due to BENNETT ENVIRONMENTAL ASSOCIATES,INC. for services rendered by them. BENNETT ENVIRONMENTAL ASSOCIATES,INC.may institute an action directly against the owner. OWNERSHIP OF DOCUMENTS: All documents, including original drawings, estimates, specifications, field notes and data are and shall remain the sole and exclusive property of BENNETT ENVIRONMENTAL ASSOCIATES, INC. as instruments of service. The Client may,at his/her expense,obtain record prints of drawings,with the understanding that the Client will use them solely in connection with the described project and not for the purpose of making subsequent extensions or enlargements thereto,unless otherwise agreed in writing. PROFESSIONAL LIABILITY: The Client will agree to limit our liability resulting from errors and/or omissions in environmental consultation and engineering design information furnished to the Client to those portions of the design or consultation prepared by us and in an amount not to exceed our fees. The Client will agree to require like limitations from any contractor engaged to perform work for which we have provided reports,plans or specifications. The Client shall further indemnify and hold us harmless from any liability resulting from the acts,errors or commission of the Client or Client's agents. On request,we will provide personnel to observe constriction in order to ascertain that it is being performed in general, in accordance with plans or specifications. This does not make us a guarantor of any contractor's work. WARRANTY: Our professional services will be performed in accordance with generally accepted environmental and engineering practices. This warranty is in lieu of all other warranties expressed or implied. BENNETTENVIRONMENTAL AsSOCIATES, INCO LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS GEOLOGISTS ENGINEERS 1573 Main Street- P.O. Box 1743, Brewster,.MA 02631 6 508-896-1706 0 Fax 508-896-5109 www.bennett-ea.com September 1,2010 PROFESSIONAL FEE SCHEDULE The following represents the hourly billing rates for various personnel within the BENNETT ENVIRONMENTAL ASSOCIATES, INC. organization for your project. Refer to our Statement of Terms and Conditions of employment. LICENSED SITE PROFESSIONAL(LSP).................. .... ...................... $150.00/hour PRINCIPAL(PL)..................:...........:..::.......:.:............:...... $125.00/hour . . n i PROFESSIONAL ENGINEER(PE)...:.................. ..............:. $125.00/hour PROJECT MANAGER/SR.ASSOCIATE (PM/RS/LPG)..... ............. $95.00/hour ENVIRONMENTAL SCIENTIST/ENGINEER(ES).. ................ ..... $ 80:00/hour. ENVIRONMENTAL/ENGINEERING FIELD TECIINICIAN T $65.00/hour PRIMARY WASTEWATER OPERATOR ..;,:.: .....: $80.00/hour SECONDARY WASTEWATEROPERATOR ,....: ... : ;:,. $75.00/hour PRIMARY WATER SUPPLY OPERATOR...................................... $80.00/hour SECONDARY WATER SUPPLY-OPERATOR.................................. :..: $75.00/hour .SURVEY CREW(2 men)... $125.00/hour DRAFTING/CAD/COMPUTATIONS........................... ......... ....... ............. $65.00/hour SECRETARIAL............................................... .........:............................................ $50.00/hour NOTE: Fees associated with field materials and/or equipment rental are provided on the back of this page. EMERGENCY SPILL RESPONSE WASTE SITE CLEANUP SITE ASSESSMENT PERMITTING 0 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE & WASTEWATER TREATMENT,OPERATION&MAINTENANCE FIELD MATERIALS . " PER UNIT Dexsil/Petro Flag $ 40.00 Dolphin Locks $ _ 2.80 Wisdom Locks $ 4.99 2"Locking Expandable Plugs $ 12:27 2"Round Aluminum Locking Caps $ 11.13 3'Bailer $ : .. :5.33 Gatebox/Roadbox $ 65.00 Inline Filters $ 1729 Hole Plug/Bentonite 501b $ 8.00 5'X 12"Sock/Boom ' $ 45.00 1 1/2"X 24"Sock $ •4.25 Oil Absorbent Pads(Bail) $ 55.00 Oil Absorbent Pads(1/2.Bail) $ 30.00 Oil Absorbent Pads(each)_ $ 1.50 Soil/GW Probes $ 13.74 Silicone Tubing 3/8" $: 1.50 Silicone Tubing 5/8" $ 2.45 LDPE tubing 1/4" $ 0.10 LDPE tubing 3/8"rigid $ :' 0.17 LDPE tubing 3/8"flexible $ 0.20 Turbine $ 167.75 Concrete Bounds $ 9.98 EQUIPMENT RENTAL HALF-DAY RATE FULL-DAY RATE Photovac 2020/HNU $ 12.50 $ 25.00 LEL. $ . 10.00 $ 20.00 YSI $" 20.00 $ 40.00 Water Level Meter $ 5.00 $ 10.00 Bladder Pump $ 8.00 $ 16.00 Whale Pump $ 6.00 $ 12.00 Peristaltic Pump $ 8.50 $ 17.00 Thermo Environmental _ $ 12.50 $ . 25.00 Truck $ 25.00 $ 50.00 Confined space gas kit $ 26.25. $ 52.50 CO2 Meter $ 26.25 $ 52.50 Grundfos Pump- $ 66.00 $ 131.25 Vent/Tubing $ 18.50 $ 37.00 Hitachi Coring Unit l day minimum $ 70.00 Composite Sampler(2 day min) NA $ 75.00 t BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/21/12 BEA10-10214 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Bailey Residence 49 Joby's Lane SHIPPING METHOD: Osterville,MA 02655 Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(June and Sept 2012) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist(June and Sept 2012) 1 7/6/12 Alpha Analytical laboratory report 1 9/12/12 Alpha Analytical laboratory report For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0 REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI Environmental Systems,Inc.RSF Operation and Maintenance Checklist and laboratory analytical reports for operation and maintenance conducted at the above referenced property during the reporting period. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health- Ms.Chapman Bailey,Owner David C.Bennett,President[Internal] Matthew Costa-OMNI Environmental Systems,Inc. [via email] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 �I Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/28/12 9/8/11 Inspection Date Previous Inspection Date 3"sludge, 1"scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev. 11-07-05 Page 1 of 3 I LlMassachusetts 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 E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 11.05 mg/L Turbidity 1.67 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 Samples Taken: ❑ Influent M 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 M TSS M TN ® Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance visit. Collect effluent samples for field testing and laboratory analysis. Effluent quality passed field testing parameters. Notes and Comments: t5aiom.doc•rev. 11-07-05 Page 2 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 H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257 CMR 2.00. 90�OIAL(]�C !7117 Opera or 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 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 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 A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's Lane key to move your Facility Street Address cursor-do not Osterville 02655 use the return key. City Zip kMailing address of owner, if different: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 9/4/12 6/28/12 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 6.5 SU DO 9.05 mg/L Turbidity 5.60 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 p 9 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 M TN ® Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Effluent quality passed field testing parameters. Notes and Comments: None t5aiom.doc•rev.11-07-05 Page 2 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257 CMR 2.00. &WWL��� ,,-"n 9 v- Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 ON I E�urro��ner�turfSy�te�s,I�c�, OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information A� 4 Q vu Fa ility Street Addressl Date of Se ice City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank Il ii I) Sludge Pumping Required: Yes El \,•Sludge Depth: ,Scum Depth: 1 Effluent tee filter: Yes No El If yes, inspe t &clean at least yearly If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank (�,` s�J �� `►`^� �` i��� '� +�- ° Check if sludge accumulating Pumping required: Yes ❑ N(�A Odor problems: Yes ❑ N6A� If yes,description Effluent tee filter: Yes ❑ N If yes, inspect❑ &clean at least yearly❑ If the sludge layer is greater than 47 request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this May indicate that the filter bed may need servicing. �t D. Equalization Tank (if installed) Sludge Pumping Required: Yes❑ No ❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No ❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber I Vault(if Installed) ❑ Pump Inspections(all units) If problems,describe ❑ Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problems,d scribe Test pump alternator, or record hours �- Hours of operation �] Float switches Check all switches for operation Test alarm "\ If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding �[ Ponding Present: Yes❑ No Clean bed: Yes❑ Ncl 11� Distribution pipes V ` Flush:Yes ❑ No�x Brush: Yes ElNov ElAny obstruction of airflow to filter modules: Yes El , No Nf Yes, explain below(i.e. snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yeslo\ No ❑ If yes ODOTSS ❑pH �TN ❑Other PT, �3 I All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers. In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: OTf - l a00 OVfi�?C- Qn h 5 NU Emir onrr/eht-Syste/ns,Inc, OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facili y Street Ad r ss Date of ervice City Operator/O&M Firm w System Startup Date Weather Conditions B. Septic Tan Sludge Pumping Required: Yes❑ No�A ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yet No❑ If yes,inspect&clean at least yearly If the sludge layer is within 12"of the outlet invert recommend-that-the homeowner have the septic tank --- --- pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank 5w �"�`�v�s" `�S �`�`'w' `"" �'�� � �� W\' )\J,Check if sludge accumulating Pumping required: Yes❑ No Odor problems: Yes❑ Nt If yes,description Effluent tee filter: Yes ElNo� If yes, inspect El&clean at least yearly El If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) ❑Pump Inspections(all units) If problems,describe ❑Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. i F. Pumps, Switches, Floats,Alarm System Pump Inspections(all units) If problems,describe —I Test pump alternator,or record hours ��(�S "CIAO pp b Z l _,,�_ Ck%111) Hours of operation Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes❑ Nd[A Clean bed: Yes❑ No� Distribution pipes Flush:Yes❑ NoVOA Brush: Yes❑ NA Any obstruction of airflow to filter modules: Yes❑ If Yes,explain below(i.e.snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely.expose.the.fiilter.modules,and.rake the filter.beds thoroughly,then wash.the.filter_beds down with... . .. ... ._ a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yekk No❑ If yes BOD TSS ❑pH I OQTN OtherV_V t �43 ,03 All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: CrD a��r. Svti. 0\1�i•'� — U ®Vqt Q C� . c C.Q 1� Serial_No:07061216:15 t� HA ANA LYTI CAL ANALYTICAL REPORT Lab Number: L1211565 Client: Bennett Environmental Associates 1573 Main Street Brewster,MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 07/06/12 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M7MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com AL Page 1 of 17 Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Alpha Sample Collection Sample ID Client ID Location Date/Time L1211565-01 EFFLUENT OSTERVILLE, MA 06/28/12 09:15 AAAL Page 2 of 17 Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples free of charge for 30 days from the date the project is completed.After 30 days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples. Please contact Client Services at 800-624-9220 with any questions. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any andall pages of this report. Authorized Signature: L s�l�nd1�. Elizabeth Simmons Title: Technical Director/Representative Date: 07/06/12 Page 3 of 17 � �� Serial No:07061216:15 INORGANICS MISCELLANEOUS Page 4 of 17 Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 SAMPLE RESULTS Lab ID: - L1211565 01 Date Collected: 06/28/12 09:15 Client ID: EFFLUENT Date Received: 06/28/12 Sample Location: OSTERVII_I-E,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab Solids,Total Suspended ND mg/I 5.0 NA 1 07/05/12 17:15 30,2540D DW Nitrogen,Nitrite 0.13 mg/I 0.05 -- 1 06/29/12 03:33 44,353.2 DB ------ --... _.. .. _._._-.. _....... Nitrogen,Nitrate 6.7 mg/I 0.50 5 06/29/12 04:43 44,353.2 DB Nitrogen,Total Kjeldahl 1.8 mg/I 0.30 -- 1 07/03/12 16:30 07/05/12 21:55 30,4500N-C AT BOD,5 day 3.2 mg/I 2.0 NA 1 06/30/12 02:15 07/05/12 02:00 30,5210B SC LI �l;� Page 5 of 17 Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst 4GeneralYChemistry Westborough Lab, for sample(s): 01 Batch. WG545389-1 Nitrogen,Nitrate ND mg/I 0.10 — 1 06/29/12 02:06 44,353.2 DB r. .� .. -� _ . w_ .. General Chemistry--Westborough Lab for.sample(s): 01 Batch: WG545391-1 Nitrogen,Nitrite P ND _ mg/l 0.05 - 1 - 06/29/12 02:08 44,353.2 DB General ChemistryWestborough:Cab focsample(s): 01 Batch'. WG545661'-1 __. . BOD,5 day ND mg/I 2.0 NA 1 06/30/12 02:15 07/05/12 02:00 30,521013 Sc General Chemistry.=Westborough Lab for sample(s): 01 Batch: WG546261,1 Nitrogen,Total Kjeldahl ND mg/I 0.30 1 07/03/12 16:30 07/05/12 21:28 30,4500N-C AT ,General Chemistry.`-Westborough Lab for sample(s): 01 Batch: WG546399-1 Solids,Total Suspended ND mg/I 5.0 NA 1 07/05/12 17:15 30,2540D DW Page 6 of 17 Serial No:07061216:15 Lab Control Sample Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry-Westborough,Lab Associated sample(s): 01 Batch: WG545389-2 Nitrogen,Nitrate90`—"" 90-110 - General Chemistry--Westborough-Lab Associated sample(s): 01 Batch:WG545391-2 Nitrogen,Nitrite 102� - 90-110 20 General Chemistry-Westborough.L•ab. Associated sample(s):.01 Batch:1NG545661-2 i BOD,5 day 85-115 - 20 General Chemistry:-Westborough'Lab Associated samples)01 Batch: W.G546261:=2 Nitrogen,Total Kjeldahl -105- - 85-110 Page 7 of 17 Serial No:07061216:15 Matrix Spike Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits General Chemistry.-Westborough Lab Associated sample(s): 01 1QC Batch ID WG545389-4 QC Sample .L1211528=01 Client ID: MS Sample Nitrogen, Nitrate 3.1 4 6.5 85-' 83-113 � � W � J �-s General Chemistry-Westborough Lab Associated sample(s): 01 QC Batch ID: WG545391-4 QC Sample:t1211564301= Client ID: MS.Sample Nitrogen,Nitrite 3.7 4 7.8 102'_ - 80-120 - 20 General Chemistry-Westborough Lab Associated,sample(s):01 y QC Batch,ID:.WG545661-3 QC Sample: L1211614-02 Client ID_: NIS.Sample� BOD,5 day 4.0 100 130 d —U4'7 - - 50-145 - 35 General,Chemistry-Westborough Lab Associated sample(s): 01 QC Batch ID:`WG546261--4 QC Sample: L1211180-01. Client ID:MS Sample Nitrogen,Total Kjeldahl 1.9 8 10 a 101-1 - - 77-111 - 24 Page 8 of 17 Serial No:07061216:15 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits Genecal..Chemistry ^Westborough Lab Associated sample(§): 01 �QC Batch ID: WG545389-3 QC Sample: L121'1528�-01 Client ID: DUP Sample Nitrogen,Nitrate 3.1 2.3 mg/I 30 Q 6 General.Chemist Westborou h Lh Labe Associated samyle s 01 - QC Batch.IDC WG545391 3w QC Sample: -' Y^ry 9 p O ample: L121-1564-01 Client.ID. DUP Sample Nitrogen,Nitrite 3.7 3.5 mg/I " ` 6 "-`. 20 General Chemistry-Westborough,Lab Associated;sample(s): 01 QC Batch ID: WG545661-4 QC Sample: L1211566-01� Client ID: DUP Sample BOD,5 day 140 140 mg/I 0- 35 ------------------ -- -��. ._........ _.......... .. .. .._...... General Chemistry-Westborough Lab Associated sample(§): 01 QC Batch.ID: WG546261v3 QC Sample: L1211180-01 Client ID: DUP Sample Nitrogen,Total Kjeldahl 1.9 1.9 mg/I _ 0`€ 24 -.. .. ..__......._ --- ...... General Chemistry-.Westborough Lab Associated,sample(s): 01 QC BatchJD`. ,WG546399-2 QC-Sample: L121,1560=01 .Client-ID: DUP°Sample _... Solids,Total Suspended 74 78 mg/I -'S Y'4 20 Page 9 of 17 �\PHA Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1211565-01A Plastic 1000ml unpreserved A 7 2.7 Y Absent TSS-2540(7) L1211565-01B Plastic 1000ml unpreserved A 7 2.7 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1211565-01 C Plastic 250ml H2SO4 preserved A <2 2.7 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days " t;,a Page 10 of 17 Serial No:07061216:15 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits eneral,Chemistry Westborough Lab. Associated sample(s). 01 QC Batch ID: WG545389-3, QC'Sample: L121'1528-01 Client ID: DUP Sample Nitrogen,Nitrate 3.1 2.3 mg/I -'30 Q 6 __.. _ _ m iWestborou h Lab;Associated sam le s 01 .QC B t h�iD:WG545391`:3 iQC Sam le: .L12' Nitrogen,Nitrite 3.7 3.5 mg/I 6 20 Genera Chem stry^ estborough Lab Assoclatedrsample(s): 01 QC Batch ID: WG545661-4 QC Sample: L121,1566=01.'CIientdD.,^DUP Sample � BOD,5 day 140 140 mg/I -"f0""- .' 35 - _........ _.__ __.. _ ._ _.._.._.._ ___. . ........... ............. ............ _... GeneraLeChemist Westborou hLati.-Associated°sam le s : 01° `QC Batcli�ID WG54626,1 ..'QC`Sample ; L1211180 01 'Client ID. I,UP-"Sample .. . .k..�« .�_ ry � ,....�_9 _ate, -.- ,. ,p ._.� - � Nitrogen,Total Kjeldahl 1.9 1.9 mg/I r-- o7-7 24 General°Chemist Westborou ti Labr A§sociafedvsa Batch ID:°.1NG546399-2 QCMSarri le: L1211560 01e`,ClieIitaID: ;DUP Sam le 6 .a • g gym- Solids,Total Suspended 74 78 mg/I 5"� 20 Page 9 of 17 ?ti? Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1211565-01A Plastic 1000ml unpreserved A 7 2.7 Y Absent TSS-2540(7) L1211565-01 B Plastic 1000ml unpreserved A 7 2.7 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1211565-01 C Plastic 250ml H2SO4 preserved A <2 2.7 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days Page 10 of 17 Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. ' NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(I Ox) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ -Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICs),where the identification is based on a mass spectral library search. Report Format: Data Usability Report Page 11 of 17 i Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 Data Qualifiers P -The RPD between the results for the two columns exceeds the method-specified criteria. Q -The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND -Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report �LYL�HA Page 12 of 17 Serial No:07061216:15 Project Name: BAILEY RESIDENCE Lab Number: L1211565 Project Number: BEA10-10214 Report Date: 07/06/12 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation,cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 13 of 17 Serial No:07061216:15 Certificate/Approval Program Summary Last revised May 11,2012 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water (Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Vanadium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP) 504.1, Ethylene Dibromide (EDB) 504.1, 1,4-Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform = Colilert (SM9223 P/A), E. Coli. - Colilert (SM9223 P/A), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC (SM9222D, Fecal Coliform-EC Medium 9221 E). Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics, TPH (HEM/SGT), Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH. Microbiology Parameters: Total Coliform - MF mEndo (SM9222B), Total Coliform - MTF (SM9221 B), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth (SM9221 E), Enterolert, E.Coli 9223. Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Dalapon, Volatile Organics, Acid Extractables (Phenols), Benzidines, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated Hydrocarbons. ) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM9215B, 9222D, 9223B, EPA 180.1, 353.2, SM2130B, 23206; 2540C, 4500CI- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters: 504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, SM2320B, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NO3-F, 4500P-B, 4500P-E, 5210B, 5220D, 5310C, 9010B, 9040B, 9030B, 7470A, 7196A, 2340B, EPA 200.7, 6010B, 200.8, 6020, 245.1, 1311, 1312, 3005A, Enterolert, 9223D, 9222D. Organic Parameters: 608, 624, 625, 8081A, 8082, 8330, 8151A, 8260B, 8270C, 3510C, 3630C, 5030B, ME- DRO, ME-GRO, MA-EPH, MA-VPH.) Solid Waste/Soil(Inorganic Parameters: 9010B, 9012A, 9014A, 9030B, 9040B, 9045C, 6010B, 7471A, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-VPH, 8260B, 8270C,8330,8151A, 8081A,8082, 3540C, 3546,3580A, 3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: B6,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM213013, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM921513; ENZ. SUB. SM9223; ColilertQT SM922313; MF-SM9222D.) N n fP able Wafer(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 Pagefo :° I,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1, S e ri a l_N o:07061216:15 SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM25401). Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane,Toxaphene,Aldrin, alpha-BHC, beta-BHC,gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT,Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables), 600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM9223B; Enterolert-QT:SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307.NELAP Accredited. Drinking Water (Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 245.2, 300.0, SM4500CN-E, 4500H+B, 4500NO3-F, 2320B,2510B, 2540C,4500E-C, 5310C,2120B, EPA 332.0. Organic Parameters: 504.1,524.2.) Non-Potable Water (Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, 245.2, SW-846 6010B, 6010C, 6020, 6020A, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 426C, 1664A, SW-846 9010B, 9030B, 9040B, SM426C, SM2120B, 2310B, 2320B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260B, 8270C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082,8081A, 8081B, 8151A.) Solid & Chemical Materials (Inorganic Parameters: SW-846 6010B, 6010C, 7196A, 7471A, 1010, 1030, 9010, 9012A, 9014, 9030B, 9040B, 9045C, 9050, 9065,1311, 1312, 3005A, 3050B, 3060A. Organic Parameters: SW-846 3540C, 3546, 3550B, 3580A, 3630C, 5030B, 5035, 8260B, 8270C, 8270D, 8270C-SIM, 8270D-SIM,8330, 8151A,8015B,8082, 8082A, 8081 A, 8081 B.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935.NELAPAccredited. Drinking Water (Inorganic Parameters: SM92226, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.2, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, 2340B, SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F,4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, 2540G, EPA 120.1, SM2510B, SM15 426C, 9222D, 9221B, 9221C, 9221E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 7470A, 5540C, SM4500H-B, 4500S03-B, SM3500Cr-D, 4500CN-CE, EPA 245.1, 245.2, SW-846 9040B, 3005A, 3015, EPA 6010B, 6010C, 6020, 6020A, 7196A, 3060A, SW-846 9010B, 9030B. Organic Parameters: SW-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 1,4-Dioxane by NJ Modified 8270, 8015B, NJ OQA-QAM- 025 Rev.7, NJ EPH.) Solid& Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C,6020, 6020A, 7196A, 3060A, 9010B, 9030B, 1010, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471B, 9014, 9012A, 9040B, 9045C, 9050A, 9065. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 8260B, 8260C, 8270C, 8270D, 8270C- SIM,8270D-SIM, 3540C, 3546, 3580A, 3630C, 5030B, 5035L, 5035H, NJ OQA-QAM-025 Rev.7, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0, SM232013, EPA 300.0, SM2120B, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B.'Organic Parameters: EPA 524.2,504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4, SM5220D, 2310E-4a, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6010C, 6020, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 245.2, 7470A, SM2120B, LACHAT 10- 204-00-1-A, 4500CN-CE, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 3005A, 3015, 9010B, 9030B. Organic Parameters: EPA 624, 8260B, 8270C, 8270D, 625, 608, 8081A, 8081B, 8151A, 8330, 8082, 8082A, EPA 3510C, 5030B.) Solid& Hazardous Waste (Inorganic Parameters: EPA 1010, 1030, EPA 6010B, 6010C, 7196A, 7471A, 7471B, 9012A, 9014, 9065, 9050A, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA 8260B, 8270C, 82701), 8270C-SIM, 8270D-SIM, 8015B, 8015C, 8081A, 8081B, 8151A, 8330, 8082 8082A, 3540C, 3546, 3580, 3580A, 5030B, 5035.) Page 15 of 17 Serial No:07061216:15 North Carolina Department of the Environment and Natural Resources Certificate/Lab ID : 666. Organic Parameters: MA-EPH, MA-VPH. Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters: 524.2) Pennsylvania Department of Environmental Protection Certificate/Lab ID: 68-03671. NELAP Accredited. Drinking Water(Organic Parameters: EPA 524.2, 504.1) Non-Potable Water(Inorganic Parameters: EPA 1312, 3005A,200.7,410.4, 1664A, SM2540D, 521013,5220D, 4500- P,BE. Organic Parameters: EPA 3510C, 3630C, 503013, 625,624,608, 8081A, 8081 B,8082, 8082A, 8151A, 8260B, 8270C, 8270D, 8330) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3050B, 3060A, 6010B, 6010C, 7196A, 7471A, 9010B, 9012A, 9014, 9040B, 9045C, 9050, 9065, SM 4500NH3-1-1. Organic Parameters: 3540C, 3546, 3580A, 3630C, 5035, 8015B, 8015C, 8081 A, 8081 B,8082, 8082A, 8151A,8260B,8270C, 8270D, 8330) Rhode Island Department of Health Certificate/Lab ID: LA000065. NELAP Accredited via NY-DOH. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1. NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7,200.8,245.1,245.2, 300.0, 350.1, 351.1, 353.2, 410.4,420.1,6010, 6020, 7196, 7470, 9040, SM 2120B, 2310B,232013, 251013,254013, 2540C,2540D,426C,4500CL- E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C, 5210B, 5220D,5310C, 5540C. Organic Parameters: EPA 608,624, 625,8081,8082, 8151, 8260, 8270,8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012, 9014, 9040,9045, 9050, 9065.) Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 3005A,3015,1312,601013,6010C,SM4500S-D,SM4500-CN-CE, Lachat 10-204-00-1-X. Organic Parameters: EPA 826013) Solid&Hazardous Waste(Inorganic Parameters: EPA 3050B, 1311, 1312, 6010B, 6010C, 9030B, 9010B, 9012A, 9014. Organic Parameters: EPA 5035, 5030B, 82606,80156,8015C.) Department of Defense, L-A-B Certificate/Lab ID: L2217. Drinking Water(lnorganic Parameters: SM 45001-1-13.Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: EPA 200.7, 200.8, 60106, 6010C, 6020, 6020A, 245.1, 245.2, 7470A, 9040B, 9010B, 180.1. 300.0, 332.0, 6860, 353.2,410.4, 9060, 1664A, SM 4500CN-E, 4500H-B,4500NO3-F,4500CL-D, 5220D, 5310C, 21306, 23206, 2540C, 3005A, 3015, 901013, 9056. Organic Parameters: EPA 8260B, 8260C, 8270C, 8270D,8270C-SIM,8270D-SIM, 8330A, 8082, 8082A, 8081A,8081B,3510C, 5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010B, 6010C, 7471A, 6860, 1311, 1312, 3050B, 7196A, 9010B, 9012A, 9040B, 9045C, 3500-CR-D,4500CN-CE, 2540G, Organic Parameters: EPA 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330A/B-prep,8082, 8082A, 8081A, 808113, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAPITNI Scope of Accreditation: EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Dimethyl naphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Chloroaniline, 4-Methylphenol. Total Phosphorus in a soil matrix, Chloride in a soil matrix;TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix, SO4 in a soil matrix. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease Page 16 of 17 f5afe.tlec:d:l�'I a5: CHAIN l ... F CUSTODY PAGE 1 OF 1 ^+�'� - s - Information Project Information Report Information Data Deliverables [I FAX.. ® EMAIL.. ® Sameas.Clientinfo. . ..PO#16214 77 Westborough,MA Mansfield,MA .: Project Name:Bailey Residence TEL:508 896-9220 TEL:508 822 e300. ❑ ADEx ❑ Add'I Deliverables " .N"FAX.508-898-9193 .FAX:508-822-.3288 ClientRegulatory Requi rem ents/Re port Limits Project Location:Osterville,MA State/Fed.Program Crrterra . Client:Bennett Environmental Associates Project.#:BEA10-10214 Z]Address;1573 Main Sfreet].P.O.Box 1743 Pr nj.1 Manager.David C.Bennett 7B --- - L MMI Brewster,MA 02631 ALPHA Quote#: Phone:.508-896-1766Turn-Around Time A..NALYSIS Fax:608 896-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING • Email-sfalTenkopf@bennett-ea:com • Filtration ❑ Done ' ❑These samples have been Previously analyzed by Alpha'. Due:Date ��:i Time: 0 Not Needed '-Other Project Specific Requirements/Comments/Detection Limits: ❑ Lab to doPreservation . .... .... ❑ Lab to do (Please specify 0 below} ALPHA'La6�ID . Sample ID Collection Sample.:... Sampler's... z .... Yj".":. Date .Time Matrix Initials _'u ._:.:... ... .. .. .. _ .. .. .. ,. Sample Specific . N Z F— Comments Effluent:..... a"M El ❑ ❑ ❑ v:. ❑ El „yT ❑ �.. ❑ ❑ ❑: El ❑ i ❑ ❑ ❑ ❑ ❑ ❑ ❑ -EJ El . . ....... . ❑ ❑ ❑ El El ❑ ❑ a ❑ ❑ 0. DID :01010 0 El El El Container Type P. P P Preservative O O D _ _ _ _ _ Please pr otclearryi legit tyr:,. andcomptetety'a'Samples;can not be to ed:ln)`a`nd!"°V' Relin wished Da te✓ ime Received By: DateMme tumatdund time ctock'wllnot start'until.enq.amblguitiesaie:ti resolved.All'samples,' L submlde i are subject to (ev23APR49) .. MO"r AZP,, / Alpha's Payment Terms. O a CHAIN OF CUSTODY PAGE 1 OF 1 Date Rec'd in Lab: ALPHA Job,#:. Project Information Report Information Data Deliverables Billing Information A�N''A_a1::YI.yT t C A L ❑ FAX ® EMAIL ® Same as Client info PO#:10214 Westborough,MA Mansfield,MA Project Name:Bailey Residence TEL:508-898-9220 TEL:508-822-9300 ADEx ❑ Add'I Deliverables FAX.,508-898-9193 FAX:508-822-3288 Regulatory Requirements/Report InformationClient Project Location:Osterville, MA State/Fed Program Criteria Client:Bennett Environmental Associates Project#:BEA10-10214 Address: 1573 Main Street/P.O.Box 1743 Project Manager^David C. Bennett Brewster, MA 02631 ALPHA Quote#: Phone:508-896-1706 ANALYSIS • Fax:508-896-5109 ®Standard ❑ Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Email:sfarrenkopf@bennett-ea.com Filtration ❑ Done ❑These samples have been Previously analyzed by Alpha Due Date: Time: ® Not Needed Other Project Specific Requirements/Comments/Detection Limits: ❑ Lab to do Preservation • ❑ Lab to do (Please specify mbelow) N ALPHA Lab ID Sample ID Collection Sample Sampler's z (Lab Use Only) Date Time Matrix Initials m Z U) "' Y Sample Specific i f Z I-'• Comments Effluent �� � )- !. ww ® ® ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 3 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ El El El ❑ ❑ ❑ El ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 3 Container Type P P P Preservative 0 O D Please print clearly,legibly and completely. Samples can -1-5157 Relinquished Date/Time Rec 'ved By: not be logged in and DateiTime turnaround time clock will not Z r, v�� > r start until any ambiguities are i� C� C� ( 5-� resolved. All samples submitted are subject to (,vv.2 FORM N R-09)(I•NJ)&APR-0e) Alpha's Payment Terms. 5 Serial No:09121216:12 13 AL . A I Y T i C A L ANALYTICAL REPORT Lab Number: L1215774 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY RESIDENCE Project Number: BEA10-10214 Report Date: 09/12/12 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com 11L_i?HA Page 1 of 19 Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Alpha Sample Collection Sample ID Client ID Location Date/Time L1215774-01 EFFLUENT OSTERVILLE, MA 09/04/12 10:00 Page 2 of 19 Serial_No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples free of charge for 30 days from the date the project is completed.After 30 days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples. Please contact Client Services at 800-624-9220 with any questions. Page 3 of 19 Z=���. L Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Case Narrative(continued) Nitrogen, Nitrite L1215774-01 was analyzed with the method required holding time exceeded;the results are reported at the client's request. L1215774-01 has an elevated detection limit due to the dilution required by the sample matrix. Nitrogen, Nitrate L1215774-01 was analyzed with the method required holding time exceeded;the results are reported at the client's request. BOD, 5 day L1215774-01 was analyzed with the method required holding time exceeded;the results are reported at the client's request. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: � �� Michelle M. Morris Title: Technical Director/Representative Date: 09/12/12 HA Page 4 of 19 Serial No:09121216:12 INORGANICS MISCELLANEOUS Page 5 of 19 Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 SAMPLE RESULTS Lab ID: L1215774-01 Date Collected: 09/04/12 10:00 Client ID: EFFLUENT Date Received: 09/06/12 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry-Westborough Lab Solids,Total Suspended 18 mg/I 5.0 NA 1 09/11/1---- _... _...,_, ._ ......... Nitrogen,Nitrite ND mg/1 0.20 - 10 09/06/12 14:55 30,4500NO2-13 ML Nitrogen,Nitrate 17 mg/I 0.50 - 5 09/06/12 23:30 44,353.2 DB Nitrogen,Total Kjeldahl 2.0 mg/I 0.60 -- 2 09/07/12 13:57 09/11/12 20:07 30,4500N-C AT BOD,5 day 14 mg/I 5.0 NA 2.5 09/06/12 18:56 09/11/12 16:45 30,52106 SL ��L�L�f-irl Page 6 of 19 Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst ,.,,,. General Chemistry-Westborough Lab for sample(s): 01" Batch; W6559186=1 Nitrogen,Nitrate ND mg/I 0.10 — 1 09/06/12 22:05 44,353.2 DB General Chemistry=.Westborough Lab for sample(s): 01 Batch: WG559,188711. BOD,5 day ND mg/I 2.0 NA 1 09/06/12 18:56 09/11/1216:45 30,521013 SL General Chemistry_y Westborough Lab. for sample(s): 01 . Batch: WG559228-1 Nitrogen,Nitrite ND mg/1 0.02 — 1 09/06/12 14:39 30,4500NO2-B ML General Chemistry_Westborough Lab for samples) 01 Batch: WG55935571 Nitrogen,Total Kjeldahl ND mg/1 0.30 — 1 09/07/12 13:57 09/11/12 20:02 30,4500N-C AT General Chemistry=Westborough Lab for samples) 01:`Batch: WG559926-1 ;x Solids,Total Suspended ND mg/I 5.0 NA 1 09/11/1210:45 30,25401) DW Page 7 of 19 Serial—No:09121216:12 Lab Control Sample Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1215774 Project Number: BEA1 0-10214 Report Date: 09/12/12 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qua[ RPD Limits General Chemistry-Westborough Lab Associated sample(s): 01 Batch: WG559186-2 Nitrogen,Nitrate 92 90-110 ........... General Chemistry=Westborough Lab Associated sample(s): 01 Batch:WG559188-2 BOD,5 day 100 85-115 20 ................... General"Chemistry-.Westborough Lab: Associated sample(s)::O 1 Batch: WG559228-2 Nitrogen,Nitrite 90 90-110 20 General Chemistry-Westborough Lab Associated sample(s): 0.1 -Batch:MG559355-2 Nitrogen,Total Kjeldahl 88 85-110 ---------- ---------- ---------- Page 8 of 19 a- Serial No:09121216:12 Matrix Spike Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits Genera l"Chemistry-Vestborough.L'ab'Associated-sample(s): 01. QC Batch ID:--1NG559186-4: QC,Sample:.L1215784=01< . Client ID: :MS Sample Nitrogen,Nitrate ND 4 3.6 90. - - 83-113 6 General=Chemistry='Westborough L'"ab Associated='sample(s)::01 QC'Batch ID: ING559188=3 QC Sample:,L1215774-01: --Client-.ID:. EFFLUENT BOD,5 day 14 100 140 M - 50-145 35 Gerieral`Chemistry,=:Westborough:Lab.Associatedsample(s) e01; `QC Batch ID:1NG559228=4. QC.-Sample:iL1215775701 ­�1Client-lD: MS"Sample.- Nitrogen,Nitrite 0.05 0.1 0.11 `106 - - 85-115 20 GenerafeChemistry;`1Nestboroagh Lab Associatedaample(s) 01, =QC°Batcli'ID: WG559355-4: -.QGSample..L121589Z=0,1 rClient ID: MS:Sample` Nitrogen,Total Kjeldahl 7.6 8 17 ;118: Q - - 77-111 - 24 Page 9 of 19tiA-,., Serial No:09121216:12 Lab Duplicate Analysis Project Name: BAILEY RESIDENCE Batch Quality Control Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General Chemistry-Westborough-Lab Associated..sample(s): 01. QC Batch.ID: WG559186-3 QC Sample: .L12.15784-01 ,Client ID: .DUP Sample Nitrogen,Nitrate ND 0.12 mg/I NC' 6 General e'Chemistry-Westborough'Lab Associated sample(s): ,01 QC Batch ID: WG559188-4 QC Sample: L'12157.77-01 Client]D:.-DUP:Sample BOD,5 day 83 80 mg/I 4 35 General Chemistry-Westborough Lab Associated sample(s): 01 QC Batch,.ID: .WG559228-3 QC Sample: 11215775-01 Client ID: DUP:Sample Nitrogen,Nitrite 0.05 0.05 mg/I 0 20 General'.Chemistry--_.Westborough Lab:Associated sample(s):,01 i QCBatch,ID .WG559355-3 -QC Sample:.: L1215897-01 Client-ID:..DUP-.Sample Nitrogen,Total Kjeldahl 7.6 7.7 mg/I 1. 24 General'Chemistry-Westborough Lab .Associated-sample(s): 01_ QC<Batch'ID: WG559926-2 QC Sample:'L121577.7-01 Client,.ID::. DUP_Sample Solids,Total Suspended 37 42 mg/I 13' 20 Page 10 of 19 A ?N— Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1215774-01A Plastic 1000mi unpreserved A 7 4 Y Absent TSS-2540(7) L1215774-01B Plastic 1000ml unpreserved A 7 4 Y Absent NO2-4500NO2(2),BOD- 5210(2),NO3-353(2) L1215774-01 C Plastic 250ml H2SO4 preserved A <2 4 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days Page 11 of 19 Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA1O-10214 Report Date: 09/12/12 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes I The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A .Spectra identified as"Aldo]Condensation Product". B -The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(IOx) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICs),where the identification is based on a mass spectral library search. Report Format: Data Usability Report fjvL'PHA 1�-= Page 12 of 19 Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 Data Qualifiers P -The RPD between the results for the two columns exceeds the method-specified criteria. Q -The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. RE -Analytical results are from sample re-extraction. J -Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND -Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report Page 13 of 19 Serial No:09121216:12 Project Name: BAILEY RESIDENCE Lab Number: L1215774 Project Number: BEA10-10214 Report Date: 09/12/12 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/6001R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error, the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. \ti-HA Page 14 of 19 Serial No:09121216:12 Certificate/Approval Program Summary Last revised August 16,2012 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water (Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Selenium, Silver, Sodium, Thallium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2,Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP)504.1, Ethylene Dibromide(EDB)504.1, 1,4- Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform - Colilert (SM9223, Enumeration and P/A), E. Coli. - Colilert (SM9223, Enumeration and P/A), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC (SM9222D), Fecal Coliform-EC Medium (SM 9221 E). Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics, TPH (HEM/SGT), CT- Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH. Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform -MTF (SM9221 B), E. Coli-Colilert(SM9223 Enumeration), HPC- Pour Plate (SM9215B), Fecal Coliform-MF m-FC (SM9222D), Fecal Coliform-A-1 Broth (SM9221 E), Enterococcus-Enterolert. Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, CT-Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Dalapon, Volatile Organics (SW 8260), Acid Extractables (Phenols) (SW 8270), Benzidines (SW 8270), Phthalates (SW 8270), Nitrosamines (SW 8270), Nitroaromatics & Cyclic Ketones (SW 8270), PAHs (SW 8270), Haloethers (SW 8270), Chlorinated Hydrocarbons (SW 8270). ) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM9215B, 9222D, 9223B, EPA 180.1, 353.2, SM21306, 2320B, 2540C, 4500CI- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters: 504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, SM23206, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NO3-F, 4500P-B, 4500P-E, 5210B, 5220D, 5310C, 9010B, 9040B, 9030B, 7470A, 7196A, 2340B, EPA 200.7, 6010B, 200.8, 6020, 245.1, 1311, 1312, 3005A, Enterolert, 9223D, 9222D. Organic Parameters: 608, 624, 625, 8081A, 8082, 8330, 8151A, 8260B, 8270C, 3510C, 3630C, 5030B, ME- DRO, ME-GRO, MA-EPH, MA-VPH.) Solid Waste/Soil(Inorganic Parameters: 9010B, 9012A, 9014A, 9030B, 9040B, 9045C, 6010B, 7471A, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-VPH, 8260B, 8270C,8330, 8151A, 8081A, 8082, 3540C, 3546, 3580A, 3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM21306, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM92156; ENZ. SUB. SM9223; ColilertQT SM92236; MF-SM9222D.) Page A15oRfAable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 Serial No:09121216:12 for: AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1, SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane, Toxaphene,Aldrin, alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT,Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables), 600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM92236; Enterolert-QT:SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited. Drinking Water (Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 300.0, SM4500CN-E, 4500H+B, 4500NO3-F, 2320B,2510B,2540C,4500E-C,5310C,2120B, EPA 332.0. Organic Parameters:504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8,245.1, SW- 846 6010B, 6010C, 6020, 6020A, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 426C, 1664A, SW-846 9010B, 9030B, 9040B, SM212013, 2310B, 2320B, 2540B,.2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D, 3060A. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260B, 8270C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082, 8082A, 8081A, 8081B, 8151A, 8330, 8270C- SIM, 8270D-SIM.) Solid & Chemical Materials (Inorganic Parameters: SW-846 6010B, 6010C, 7196A, 7471A, 1010, 1030, 9010, 9012A, 9014, 9030B, 9040B, 9045C, 9050, 9065,1311, 1312, 3005A, 3050B, 3060A. Organic Parameters: SW-846 3540C, 3546, 3050B, 3580A, 3630C, 5030B, 5035, 8260B, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330, 8151A, 8015B, 8015C,8082, 8082A, 8081A, 8081B.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.1, 2540C, SM212013, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, 2340B, SM4500E-BC, EPA 200.7,200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F, 4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, 2540G, EPA 120.1, SM2510B, SM2520B, SM15 426C, 9222D, 9221B, 9221C, 9221E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 7470A, 5540C, SM4500H-B, 4500S03-B, SM3500Cr-D, 4500CN-CE, EPA 245.1, SW-846 9040B, 3005A, 3015, EPA 6010B, 6010C, 6020, 6020A, 7196A, 3060A, SW-846 9010B, 9030B. Organic Parameters: SW-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8015C, 8081A, 8081 B, 8082, 8082A, 8151A, 8330, 1,4-Dioxane by NJ Modified 8270, 8015B, NJ EPH.) Solid & Chemical Materials (Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9010B, 9030B, 1010, 1030, 1311, 1312, 3005A, 3050B, 7471 A, 7471 B, 9014, 9012A, 9040B, 9040C, 9045C, 90451), 9050A, 9065, 9251. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3540C,3546, 3580A, 3630C, 5030B, 5035L, 5035H, NJ OQA-QAM-025 Rev.7, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0, SM2320B, EPA 300.0, SM2120B, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4, SM5220D, 2310B-4a, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6010C, 6020, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 245.2, 7470A, SM212013, LACHAT 10- 204-00-1-A, 4500CN-CE, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM251013, SM4500S-D, SM5540C, EPA 3005A, 3015, 9010B, 9030B. Organic Parameters: EPA 624, 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 625,608, 8081A,8081B,8151A, 8330, 8082, 8082A, EPA 3510C, 5030B.) Solid&Hazardous Waste (Inorganic Parameters: EPA 1010, 1030, EPA 6010B, 6010C, 7196A, 7471 A, 7471 B, 9012A, 9014, 9065, 9050A, EPA 1311, 1312, 3005A, 3050B, 9010B, 9040C, 9045D. Organic Parameters: EPA 8260B, 8260C, Q 82 06,�5035A-SIM, 270 jSIM, 8015B, 8015C, 8081A, 8081B, 8151A, 8330, 8082 8082A, 3540C, 3546, 3580, Page NO Serial No:09121216:12 North Carolina Department of the Environment and Natural Resources Certificate/Lab ID:666. (Inorganic Parameters: SM2310B, 2320B,4500CI-E,4500Cn-E,9014, Lachat 10-204-00-1-X, 1010A, 1030,4500NO3-F, 353.2, 4500P-E,4500SO4-E, 300.0,4500S-D, 5310B, 5310C, 6010C, 6020A,200.7, 200.8, 3500Cr-B,7196A,245.1, 7471A, 7471B, 1311,1312.Organic Parameters: 608, 8081 B,8082A, 624, 8260B,625,8270D, 8151A, 8015C, 504.1, MA-EPH, MA-VPH.) Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters: 524.2) Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited. Drinking Water(Inorganic Parameters:200.7,200.8,245.2, 300.0, 332.0, 2120B,2320B,2510B, 2540C,4500-CN-CE, 4500E-C, 4500H+-B, 4500NO3-F, 5310C. Organic Parameters: EPA 524.2, 504.1) Non-Potable Water(inorganic Parameters: EPA 120.1, 1312, 3005A,3015, 3060A, 200.7,200.8,410.4, 1664A, SM2540D, 5210B, 5220D,4500-P,BE, 245.1, 300.0, 3501., 350.2, 353.2, 420.1, 6010B, 6010C,6020, 6020A, 7196A, 7470A, 9010B, 9030B, 9040B, Lachat 10-107-06-2-D, NJ-EPH,2120B,2310B,2320B,2340B, 2510C, 2540B,2540C, 3500Cr-D,436C,4500CN-CE,4500CI-E,4500E-B,4500E-C,4500H+-B,4500NO2-B,4500NO3-F,4500S-D, 4500S03- B, 5310BCD, 5540C. Organic Parameters: EPA 3510C, 3630C,5030B, 625, 624, 608, 8081A, 8081 B, 8082,8082A, 8151A, 8260B, 8270C, 82701),8330, 8015B, ) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3005A, 3050B, 3060A, 6010B, 6010C, 6020A, 7196A, 7471A, 7471B, 9010B, 9012A, 9014, 9040B, 9045C, 9050, 9065, SM 4500NH3-BH, 9030B, 9.038, 9251. Organic Parameters: 3540C, 3546, 3580A, 3630C, 5035, 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8260B, 8270C,8270D, 8270C-SIM, 8270D-SIM, 8330, NJ-EPH.) Rhode Island Department of Health Certificate/Lab ID: LA000065. NELAP Accredited via NJ-DEP. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1. NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664, 200.7, 200.8,245.1, 245.2, 300.0,350.1, 351.1, 353.2, 410.4,420.1, 6010, 6020, 7196, 7470, 9040, SM 2120B, 2310B, 2320B, 2510B, 2540B, 2540C,25401),426C,4500CL- E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C, 5210B, 52201),5310C, 5540C. Organic Parameters: EPA 608, 624, 625, 8081,8082, 8151, 8260,8270, 8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012, 9014, 9040, 9045, 9050, 9065.) Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited. Drinking Water(Inorganic Parameters: EPA 200.7, 200.8, 300.0,2510B,2120B,2540C,4500CN-CE, 245.2,2320B, 4500E-C,4500E-C,4500NO3-F, 5310C. Organic Parameters: EPA 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A, 200.7, 2..08, 245.1,300.0, 3005A, 3015, 1312, 6010B, 6010C, 3060A, 353.2,420.1,6020, 6020A, SM4500S-D, SM4500-CN-CE, Lachat 10-204-00-1-X, 7196A, 7470A, 9010B, 9040B,2310B,2320B,2510B,2540B,2540C, 3500Cr-D,426C,4500CI-E,4500E-B,4500E-C,4500PE, 510AC, 5210B, 5310E 5310C, 5540C. Organic Parameters: EPA 3510C, 3630C, 5030B, 8260B, 608,624, 625, 8081A, 8081 B, 8082,8082A, 8151A, 8270C,8270D, 8270C-SIM, 8270D-SIM, 8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A,3050B, 1311, 1312, 6010B, 6010C,6020, , 7196A, 7471A, 7471 B, 6020A,9030B, 9010B, 9012A, 9014 9040B, 9045C, 9050A,9065. Organic Parameters: EPA 5035, 3540C, 3546, 3550, 3580, 3630C, 8260B, 8015B, 8015C, 8081A, 8081 B, 8082,8082A, 8151A, 8270C, 8270D, 8270C-SIM,8270D-SIM, 8330.) Department of Defense, L-A-B Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters: SM 4500H-B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: EPA 200.7, 200.8, 6010B, 6010C, 6020, 6020A, 245.1, 245.2, 7470A, 9040B, 9010B, 180.1. 300.0, 332.0, 6860, 353.2,410.4, 9060, 1664A, SM 4500CN-E,4500H-B,4500NO3-F,4500CL-D, 52201), 5310C, 2130B, 2320B, 2540C, 3005A, 3015, 9010B, 9056. Organic Parameters: EPA 8260B, 8260C, 8270C, 8270D,8270C-SIM, 8270D-SIM, 8330A,8082, 8082A, 8081A,8081 B, 3510C, 5030B, MassDEP EPH, MassDEP VPH.) Page 17 of 19 Serial No:09121216:12 Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 601013, 6010C,7471A, 6860, 1311, 1312,3050B, 7196A, 9010B, 9012A, 9040B, 9045C,3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 826013, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330A/B-prep, 8082, 8082A, 8081A, 8081B, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAP/TNI Scope of Accreditation: EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Dimethyl naphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Chloroaniline, 4-Methylphenol. Total Phosphorus in a soil matrix, Chloride in a soil matrix, TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix, SO4 in a soil matrix. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Page 18 of 19 '". �: •, ;,_.:.� ALPMA CHAIN OF CUSTODY PAGE OF1 '., ? _-� .• "��..*,. -�^�::.F,; .A 4�_ �-:�" y:-� C14 Project Information Report Information Data Deliverables Billing Information ❑ FAX ® EMAIL ® Sameas.Client info PO ik 10214 w Westborough,MA Mansfield,MA "' Project Name:Bailey Residence N TEL 508-8W-9220 TEL:508M2-9300 ❑ ADEx ❑ Add'I Deliverables N FAX 509.898.9t93.:. FAX 508-0223288 " Regulatory Requirements/Report Limits C) Project Location:Osterviile,MA 8tate/Fed Program Criteria 0 Z Client:Bennett Environmental Associates Pro ect#:BEA10-10214 2 Address:1573 Main Street/P.O.Box 1743, Project Manager David C.Bennett co Brewster,MA 02631 ALPHA Quote#: Phone:508-896-1706 . . .• .. ANALYSIS Fax 508-896-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Email: �tratlon sfarrankopf@bennett-ea.com " " •. ❑ Done ❑Tbese samples have been Previously analyffid by Alpha Due Date: 17,Time: ® Not Needed LabtUdo Other Project Specific Requirements/Comments/Detection Li its: Preserve on • ... ❑ Lab to do p (Please spealy ' 0. berow) m .S AL•P_I1A`[a1 Sample-ID Collection Sample Samplers z 7. tab:Use_Onl = Matrix Initials Date Time w CMmm•MB eHie Z Effluent,- 1� ems: 11UI111• - a M El E ❑ ❑ 00 ❑ ❑ ❑ ❑ o r - ❑ o 0 r a " . El 0 El IT 0 ❑ ❑. ❑ ❑ •❑ ❑ ❑ -❑. . ❑ ❑ 0 El ❑ a ❑ o ❑ ❑ 3 Container Type P P -P - Preservative 0 o D - - - ;4ateaseprin�cjeaily;°ieyiwy:.?,. i;andCariipletelya<rySamPle's'can. Relinqui d By DateMme Received By. Date/Time 'tiiot'Eie loggeii.irt aril;,;= turriafoiiilif timeaciocKCvufYiiri ? �Q, r;sti31�3uatil,"Aiy�3iCdiigii6ea�fe� . l �, 0 ;resoiVe"d".'l -saiiiples)�:'::;,•.gyp.. ubmitted are:suti et to> -2M 0w.n�vwoW dea" ' ./� � Iplia'sP'eymeMTeritis. `. m BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/26/11 BEA10-10214 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Bailey Residence `=49 7oby's'Lane J SHIPPING METHOD: Osterville,MA 02655 Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(Oct 2010; June,Aug and Sept 2011) 1 10/13/10 Alpha Analytical laboratory report 1 6/15/11 Groundwater Analytical laboratory report 1 9/22/11 Alpha Analytical laboratory report For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Please find enclosed the DEP Inspection and O&M Form,and laboratory analytical,for operation and maintenance conducted for the above referenced property. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Chapman Bailey,Owner David C.Bennett,President[Internal] Matthew Costa-OMNI Environmental Systems,Inc. FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 10/6/10 8/11/10 Inspection Date Previous Inspection Date 5"of Sludge, and 1"of Scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 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 E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.04 SU DO 6.74 mg/L Turbidity 1.45 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System is operating correctly. System passed field sampling parameters and effluent samples were collected for laboratory analysis. Notes and Comments: Seasonally used residence. Shut the system down for the season during this O&M visit. t5aiom.doc•rev.11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection -Lll� Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257 CMR 2.00. sr'.,a �'a a �'Q AtQs cil77-111 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc-rev.11-07-05 Page 3 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 A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/7/11 10/6/10 Inspection Date Previous Inspection Date 4"of Sludge, and 1"of Scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5ai6m.doc•rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 11.40 mg/L Turbidity 1.49 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance . Description of any maintenance performed since previous inspection &during this inspection: System is operating correctly. System passed field sampling parameters and effluent samples were collected for laboratory analysis. Notes and Comments: Seasonally used residence. The system was started up on 5/18/11. t5aiom.doc•rev.11-07-05 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 H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257 CMR 2.00. q'22�1 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 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 t5aiom.doc•rev.11-07-05 Page 3 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 A. Installation Important:When Chapman Bailey filling out forms Owner on the computer, use only the tab 49 Joby's 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: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. 0&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF DEP ID Manufacturer ID Model Number Unknown Unknown Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 9/8/11 6/7/11 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection'- Title 5 DEP Approved Inspection and O&M Form for Title 5 .1/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 12.18 mg/L Turbidity 1.33 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 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: System is operating correctly. System passed field sampling parameters and effluent samples were collected for laboratory analysis. Notes and Comments: None t5aiom.doc•rev.11-07-05 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature A Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Prohgram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 Serial No:10131014:45 HA ANALYTICAL REPORT Lab Number: L1015595 Client: Bennett Environmental Associates 1573 Main Street PO Box 1743 Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: GREELEY RESIDENCE Project Number: BEA10-10214 Report Date: 10/13/10 Certifications&Approvals: MA(M-MA086),NY.NELAC(11148),CT(PH-0574),NH(2003),NJ(MA935),RI(LA000065),ME(MA0086), PA(Registration#68-03671),USDA(Permit#S-72578),US Army Corps of Engineers,Naval FESC. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com Page 1 of 17 Serial—No:10131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 Alpha Sample Collection Sample ID Client ID Location Date/Time L1015595-01 EFFLUENT OSTERVILLE, MA 10/06/10 09:00 Page 2 of 17 Serial No:10131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container.Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. For additional information,please contact Client Services at 800-624-9220. Nitrogen, Nitrate L1015595-01 has an elevated detection limit due to the dilution required to quantitate the result within the calibration range. Nitrogen, Total Kjeldahl L1015595-01 has an elevated detection limit due to the dilution required by the sample matrix. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: "`` •• Michelle M, Morris Title: Technical Director/Representative Date: 10/13/10 HA Page 3 of 17 ' Serial—No:10131014:45 INORGANICS MISCELLANEOUS Page 4 of 17 Serial No:10131014:45 Project Name: GREELEY RESIDENCE Lab Number: 1_1015595 Project Number: BEA10-10214 Report Date: 10/13/10 Data Qualifiers RE Analytical results are from sample re-extraction. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICs). ND -Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report ALPHA Page 12 of 17 Serial—No:10131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA -Not Applicable. NC -Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI -Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration. The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values;although the RPD value will be provided in the report. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example: EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(IOx)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I •The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported due to obvious interference. P -The RPD between the results for the two columns exceeds the method-specified criteria. Q -The quality control sample exceeds the associated acceptance criteria.Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. Report Format: Data Usability Report L�LPHA Page 11 of 17 Serial NoA0131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 ~ Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1015595-01A Plastic 1000ml unpreserved A 7 3.7 Y Absent TSS-2540(7) L1015595-01B Plastic 1000m]unpreserved A 7 3.7 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2) L1015595-01 C Plastic 250ml H2SO4 preserved A <2 3.7 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days 'ALPHA Page 10 of 17 Serial_No:10131014:45 , Lab Duplicate Analysis Project Name: GREELEY RESIDENCE Batch Quality Control Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 Parameter Native Sample Duplicate Sample Units RPD Qua[ RPD Limits General Chemist.. .-.,Westbo.rou hLab��Assoclated.sam le s ., "01t�t.QC.,Batch ID.. WG43.6.1,47�4�:QC,Sam le;:;��L:1:0�1t5603-0.$ Client ID. DU,P...Sarm le.. .., �-.� Nitrogen,Nitrite 0.34 '0.33 mg/I A .3' 20 ................. ............................_......._........................................_.........._...._........................................................................................_..........................._......_......................._...................................................................................._............................................................................................._.........._....__...__................................EW W ......................................................................_..._.............. v., ,u,Wem*s° �� General.-C•h,ern�s r stboro.0 h Lab Associatetl:saris leis.. 0,1 . ,QC�Batch.ID_,�WG4.3:6,1:4$-4., .QC. am .le'...L1.0.1��' 90.01 Client LD����.UP.Sa. lei. �;. �,4: <�:..._. _ _. 9,: .. . . .. ,.. . ,�.P: ��_). ..�,� r_ �.. P.a m:��� . c _ Era u� _�� - �• - - � �. . Nitrogen,Nitrate 12 12 mg/I _.;,6%D 6 h Assoc„�.` :,. iatetl GeneraL,Chemi tr , ,Westbo.rou La z; ,, Solids,Total LSuspended .._........................._.................................._...................._....._.............................._.........._.........._.............._..........._......_630........ .. ......... 690 mg/I 9! 32 u.. .F p GeneralCh.e.mi trr; Westborou h Lab Asso lit tl iris le s 0a1.,. 1 Batch ID. 'VUG43" � QC ,_. _..: . 6 9.-4, QC S.arn Le. ,L 1,5592�Q. C ent�l U �Sa et �J. .,,..*r, Y.;:t,,.�.�.x,.,`a�"..s�,.�, �.,,:�. Nitrogen,Total Kjeldahl 17 18 mg/I 6 24 General,Chemist Westborou hLab fAssocl am Ie: L_10�1�5569A04 Client L®,: DUP:Sam le :,:- BOD,5 day 9.2 11 mg/I1f$t 35 ?FiA Page 9 of 17 Serial No:10131014:45 Matrix Spike Analysis Project Name: GREELEY RESIDENCE Batch Quality Control Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits 5.603=0$ L1.0�1 x Nitrogen, Nitrite 0-34 4 4.4 �-�,g1;02 �-; - - 80-120 - 20 - --......._..__.._......__....._._._......._._.... .._............................... _.....................__............._................... ......_.........:.::.:...............--.........._.... -- .._.. -.._..--..-. - - -..... -... ....__...... .......—-----------------..... �. ,x:� i":^z -°-..:�6���=x^ �'�"`rc�� �F'4• � ��r, ��,Via. ., .� t� � a��a .. � � ,z ���-,,,o�yr. n x�- ;sW„. : s� s � ,. .. ��c ..:. Nitrogen, Nitrate 12 4 16 r00 - 83-113 - 6 _._...-. I` .x_ �-:,�'�e5'!�'"--v� �r°�^"�' a�r+r•fi°gym<,3;<:, .. :.. :.� ,. .. �a ....:_.. � ,:_.,., .. ..,..' .... ,. .:;'.. r': ..:. .: ::.-. , ..�:.- ..-..; - - - - - General�@�e. h. m_ ..,. ,. r. u(ryh,Lab Associated saris Le s,..01 :�"�C Batch LD;tW..G436241 .3. ,. C.Samnle:uL1=0�15592 02'.,.,.Ghent ID. M,S Sam. Le �� x=� °`�< Nitrogen,Total Kjeldahl 2.8 8 111s02 - - 77-111 24 . . _........................................................................_...._................................................................................_............_............._....__........ ..... ....._ ,_ .� 4� GeneralChemist 4:,. Westborou h,Lab�Assoclated sam Ie rs�,.01 . QGBatch ID W.G436294-3��QG;.Sam 1e-.4L101;5569 03 lent I13-..<MSSam iije #!��.....;.�..�... �:x�,�,.�� ��L.,..L�, `��'� ,��:.�»�.-°,..,;.��. :=c.---..._�r.�.csM::;�._..,. -° ;a��. �'�,�..�sak�ar.s. �� k,•�s: „�,,.s.:.,�..,... :�xr."�.�:s,.. ,,..,,� .,,�«.; r.,� ,:.,� ��:�„�*�,.,�:s,ki.'�ttw� .w: BOD,5 day ND 100 100 NV5'M""02 - 50-145 - 35 --- _...._....._..........__.....- .._..__...._.._.._ _...:...:_....._.._....s:..............._----------- - --._..._....... -........-......--............._..--...._...................................-- ...._.__.._............._._............._..........................._. Page 8 of 17 4MPHA ,t Serial_No:10131014:45 Lab Control Sample Analysis Batch Quality Control Project Name: GREELEY RESIDENCE Lab Number: L1O15595 Project Number: BEA10-10214 Report Date: 10/13/10 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qua[ Limits RPD Qual RPD Limits GeneralChe,rnist,:, Westborou. hLab' Assaciated sam ,le s. O1,�BatahWG436.147 1 v If r . +i Nitrogen,Nitrite 1'00 - 90-110 20 __.................._.................... ::. General.Chemist� ,Westb.orou h�Lab,��,Assoctated sam le s.. 01>� Batch.,WG436�148 1; � 1� . ��,F ,a 3:. �. �� ,�... ,�� Nitrogen,Nitrate �100 90-110 ..........._....----..._..._._..------------._..__...._.-..._....._.....---------..----._......_�..,........ .N_^'4.R;N^p"J".'7�4:��' .:....:.....r» .,, «,".:.v.-..,r.. ..,.�" ✓ .r .,rts.., .. �.i ....�.- :T,f""`o-'^S' N� n'p;p;. .g=l. .:Z;'. ;,y.�, :sAfii, Gener,.alwChern�st; ._- Westborou h Lab Associated sam le s�.Q1, - B.atch.:WG436241.,2 -� �. ' '• t _'-" -. .. .�.�� . -:- 4 ¢� Nitrogen,Total Kjeldahl ....... 85-110 ..�"X^. .. .., n.,r.. � ?"sY1?F.�-.. ,'I,.� '.�;."a;.-:;# �," #'.-," o.., ,. '� e."Y.... i� ,,�. re°.�a'�." ".'..• :,'�"a,t> �,.{r.-- aT':�'":,., m�3 r�cx-s•;a�+.a�.�`x,s''�s�tm"�uw�s��.i� i.':#sJ-'�& t :�. � �$ � ��p�.a�����0 "". �``�``•s�xa° �:�.� �s'1��a�.`.."' - ;'��`''_ •.'�;w, �`-. r' °'" �+�,�'_� BOD,5 day ,104 - 85-115 20 - --.......... _......._......—-...--- -- Page 7 of 17 FAA Serial No:10131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 N Report Date: 10/13/10 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst w.-wxr� #"�'P� .eC�'pY�.•""q" �z.:.`.`�`�"^�. ai�`4�"�,i'' gts�'s'�,w::�.�' w.. :a..., x » �, ..as�n�u me.s.._er.» ._� s,,a.�w t � }. � .. .� Nitrogen,Nitrite ND mg/1 0.05 — 1 10/07/10 03:00 44,353.2 DID Gene al Chemistry klNestbo gh'`La bfor sample('s}�0a1'` Ba ch.. 'WG436148 21i`r y �t :�:t7sn.,..::t:,.:stYi4., Nitrogen,Nitrate ND mg/1 0.10 — 1 10/07/10 02:58 44,353.2 DID General emist `1Nestborough,ab or sample(s) 01`B tch� eVl/G 34 6187 t`'" " w ry xx,�a3e;:�... 3iss:,,ar Solids,Total Suspended ND mg/1 5.0 NA 1 10/08/10 12:55 30,2540D DW �ener�al�che�mistry�tfiWestbor_°u9h, ,Lab�f°r�sample(s) 01�Batch WG4 36241� .x.F� � ,�?`,; fi _ , Nitrogen,Total Kjeldahl ND mg/I 0.30 1 10/07/1013:15 10/11/1019:21 30,4500N-C AT BOD,5 day ND mg/I 2.0 NA 1 10/07/1016:30 10/12/10 16:30 30,5210B DW L�iL?FiA Page 6 of 17 Serial No:10131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 10/13/10 SAMPLE RESULTS Lab ID: L1015595-01 Date Collected: 10/06/10 09:00 Client ID: EFFLUENT Date Received: 10/06/10 Sample Location: OSTERVILLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst Solids,Total Suspended ND mg/I 5.0 NA 1 - 10/08/10 12:55 30,2540D DW _.._..9......._..-.—._._..................- - .__..-..._.._....._._...__......_.__...--- ---- ----.....__._....-.-__._._.._-.._....--------.-. ---...................-_........--- -...._...._.._....--._..... Nitrogen,Nitrite 0.26 mg/1 0.05 - 1 10/07/10 03:14 44,353.2 DD _._._......._......--------..._._..._..._......-..-----._--.-. ------- ------------.—....- .—._._...-- -......-----._...._..........._..._._......__.._....-_......__._..._....._...._......_......--.._._.._.._-.._. Nitrogen,Nitrate 26 mg/1 1.0 -- 10 - 10/07/10 03:37 44,353.2 DD - --- ----------- - --- - - - - ---------------------------------------------------------------....---------------------- - .... .._....- - ----------- Nitrogen,Total Kjeldahl 9.3 mg/1 1.5 - 5 10/07/10 13:15 10/11/10 19:25 30,4500N-C AT BOD,5 day 5.8� mg/1 2.0 NA 1 10/07/10 16:30 10/12/10 16:30 30,5210B DW ' L1 3?i•irl x.s Page 5 of 17 Serial NoA 0131014:45 Project Name: GREELEY RESIDENCE Lab Number: L1015595 Project Number: BEA10-10214 Report Date: 1OM3/10 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in_Environmental Samples, EPA/600/R-93/100,August 1993. t I } LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation,cooling, containers,sampling procedures, holding time and splitting of samples in the field. HA Page 13 of 17 Serial-No:10131014:45 Certificate/Approval Program Summary Last revised July 19,2010 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574.NELAP Accredited Solid Waste/Soil. Drinking Water(Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Vanadium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP), Ethylene Dibromide (EDB), 1,4-Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform-Colilert(SM9223 P/A), E. Coli.-Colilert(SM9223 P/A), HPC-Pour Plate(SM9215B), Fecal Coliform- MF m-FC(SM9222D)) Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics,TPH (HEM/SGT), Extractable Petroleum Hydrocarbons(ETPH), MA-EPH, MA-VPH. Microbiology Parameters: Total Coliform - MF mEndo (SM9222B), Total Coliform - MTF (SM9221B), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth(SM9221 E).) Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Volatile Organics, Acid Extractables (Phenols), 3.3'-Dichlorobenzidine, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated r Hydrocarbons. ) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM9215B, 9222D, 9223B, EPA 180.1, 300.0, 353.2, SM213013, 2320B, 4500CI- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters: 504.1,524.2.) Wastewater/Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, Lachat 10-107-06-1-B, SM232013, 2340B, 2510B, 2540C, 2540D,426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NH3-H, 4500NO3-F, 4500P-B.5, 4500P- E, 5210B, 5220D, 5310C, EPA 200.7, 200.8, 245.1. Organic Parameters: 608, 624, ME DRO, ME GRO, MA EPH, MA VPH.) Solid Waste/Soil(Organic Parameters: ME DRO, ME GRO, MA EPH, MA VPH.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water Inorganic Parameters: (EPA 200.8 for:Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for:Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate) 353.2 for: Nitrate-N, Nitrite-N; SM4500NO3-F,4500E-C,4500CN-CE, EPA 180.1, SM2130B, SM4500CI-D,2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes,Volatile Organics) (504.1 for: 1,2-Dibromoethane, 1,2-Dibromo-3-Chloropropane),314.0,332. Microbioloqv Parameters: SM9215B; ENZ.SUB. SM9223; MF-SM9222D Non-Potable Water Inorganic Parameters:,(EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn) (EPA 200.7 for: AI,Sb,As,Be,Cd,Cr,Co,Cu,Fe,Pb,Mn,Mo,Ni,Se,Ag,Sr,Ti,TI,V,Zn,Ca,Mg,Na,K) 245.1, SM4500H,B, EPA 120.1, SM2510B,2540C,2540B,2340B,2320B,4500CL-E,4500E-BC,426C,SM4500NH3- BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F,353.2 for Nitrate-N, SM4500NH3-B,C-Titr, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E,4500P-B,E,5220D, EPA 410.4, SM 5210B, 5310C,4500CL-D, EPA 1664,SM14 510AC, EPA 420,SM4500-CN-CE,SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics) Page 14 of 17 Serial-No:10131014:45 (608 for: Chlordane,Aldrin, Dieldrin, DDD, DDE, DDT, Heptachlor, Heptachlor Epoxide, PCBs-Water), EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables,600/4-81-045-PCB-Oil New Hampshire Department of Environmental Services Certificate/Lab ID:200307.NELAP Accredited. Drinking Water(Inorganic Parameters: SM6215B, 922213, 9223B Colilert, EPA 200.7, 200.8, 245.2, 120.1, 300.0, 314.0, SM4500CN-E, 450011+13, 4500NO3-F, 2320B, 251013, 2540C, 4500E-C, 5310C, 21206, EPA 331.0. Organic Parameters:504.1, 524.2,SM625113.) Non-Potable Water(Inorganic Parameters: SM9222D, 9221 B, 92226, 9221 E-EC, EPA 200.7, 200.8, 245.1, 245.2, SW- 846 60106, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 351.1, 353.2, 420.1., 1664A, SW-846 9010, 9030,904013, SM426C, SM2310B,254013,2540D,4500H+B,4500NH3-H,4500NH3-E,4500NO2-B,4500P-E,4500-S2- D, 5210B,23206,2540C,4500E-C, 5310C, 5540C, LACHAT 10-117-07-1-B, LACHAT 10-107-06-1-13, LACHAT 10-107- 04-1-C, LACHAT 10-107-04-1-J, LACHAT 10-117-07-1-A, SM4500CL-E, LACHAT 10-204-00-1-A, LACHAT 10-107-06- 2-D. Organic Parameters: SW-846 3005A, 3015A, 3510C, 503013, 8021 B, 826013, 8270C, 8330, EPA 624, 625, 608, SW-846 8082, 8081A.) Solid & Chemical Materials(Inorganic Parameters: SW-846 601013, 7196A, 7471A, 7.3.3.2, 7.3.4.2, 1010, 1030, 9010, 9012A, 9014, 903013, 9040, 9045C, 9050C, 1311, 3005A, 305013, 3051A. Organic Parameters: SW-846 3540C, 3545, 3580A, 503013, 5035, 8021B, 82606, 8270C, 8330, 8151A, 8082, 8081A.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935.NELAP Accredited. Drinking Water (Inorganic Parameters: SM92226, 9221 E, 9223B, 9215B, 4.500NO3-F, 4500E-C, EPA 300.0, 200.7, 2540C, 2320B, 314.0, SM212013, 251013, 5310C, SM4500H-B, EPA 200.8, 245.2. _Organic Parameters: 504.1, SM6251 B,524.2.) Non-Potable Water (Inorganic Parameters: SM521013, EPA 410.4, SM5220D, 4500CI-D, EPA 300.0, SM212013, SM4500E-BC, EPA 200.7, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F, 4500NO2-B, EPA 1664A, SM531013, C or D, 4500-PE, EPA 420.1, SM4500P-B5+E, 254013, 2540C, 2540D, EPA 120.1, SM2510B, SM15 426C, SM92210E, 9222D, 9221B, 922213, 9215B, 231013, 232013, 4500NH3-H, 4500-S D, EPA 350.1, SM5210B, SW-846 3015,6020,7470A, 5540C,4500H-B, EPA 200.8, SM3500Cr-D, EPA 245.1,245.2, SW-846 904013,3005A, EPA 6010B, 7196A, SW-846 9010B, 9030B. Organic Parameters: SW-846 82606, 8270C, 3510C, EPA 608, 624, 625, SW-846 5030B,80216,8081A, 8082,8151A,8330, NJ OQA-QAM-025 Rev.7.) Solid&Chemical Materials(Inorganic Parameters: SW-846 9040B, 3005A, 6010B, 7196A,503013, 9010B,9030B, 1030, 1311, 305013, 3051, 7471A, 9014, 9012A, 9045C, 9050A, 9065. Organic Parameters: SW-846 802113, 8081A, 8082, B151A,8330,826013, 8270C, 1311, 1312,3540C,3545,355013,3580A,5035L, 5035H, NJ OQA-QAM-025 Rev.7.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM92236, 92226, 92156, EPA 200.8, 200.7, 245.2, SM5310C, EPA 314.0, 332.0, SM232013, EPA 300.0, SM2120B, 4500CN-E, 4500E-C, 45001-1-6, 4500NO3-F, 2540C, EPA 120.1, SM 2510B. Organic Parameters: EPA 524.2,504.1.) Non-Potable Water(Inorganic Parameters: SM9221 E, 9222D, 9221 B, 922213, 921513, 5210B, EPA 410.4, SM52201), 23106-4a, 23206, EPA 200.7, 300.0, LACHAT 10-117-07-1A or B, SM4500CI-E, 4500E-C, SM15 426C, EPA 350.1, LACHAT 10-107-06-1-B, SM4500NH3-H, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, LACHAT 10-107-041-C, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 254013, 2540D, EPA 200.8, EPA 60106, 6020, EPA 7196A, S\M3500Cr-D, EPA 245.1, 245.2, 7470A, SM212013, SM4500-CN-E LACHAT 10-204-00-1-A, EPA 904013, SM4500-1-113, EPA 1664A, SM5310C, EPA 420.1, SM14 510C, EPA 120.1, SM251013, SM4500S-D, SM5540C, EPA 3005A, 3015. Organic Parameters: EPA 624, 826013, 8270C, 625, 608, 8081A, 8151A, 8330, 8082, EPA 3510C, 503013, 90106, 9030B.) Solid & Hazardous Waste (Inorganic Parameters: 1010, 1030, SW-846 Ch 7 Sec 7.3, EPA 60106, 7196A, 7471A, 9012A, 9014, 904013, 9045C, 9065, 9050, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA 8260B,8270C,8081A,8151A,8330,8082, 3540C,3545,3546, 3580,503013,5035.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID :666.Organic Parameters:MA-EPH, MA-VPH. Pennsylvania Department of Environmental Protection Certificate/Lab ID:68-03671.NELAP Accredited. Non-Potable Water(Organic Parameters:EPA 3510C,50306,625,624.608,8081A,8082,8151A,826013, 8270C, 8330) Solid & Hazardous.Waste (Inorganic Parameters: EPA 1010, 1030, 1311, 3050B, 3051, 60106, EPA 7.3.3.2, EPA 7.3.4.2, 7196A, 7471A, 901013, 9012A, 9014, 904013, 9045C, 9050, 9065. Organic Parameters: 3540C, 3545, 3580A, 5035,8021B,8081A,8082,8151A,826013,8270C,8330) Rhode Island Department of Health Certificate/Lab ID: LAO00065.NELAP Accredited via NY-DOH. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NY-DOH Certificate for Potable and Non-Potable Water. Page 15 of 17 Serial-No:10131014:45 Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1.NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7;200.8,245.1,245.2,300.0,350.1,351.1,353.2, 376.2,410.4,420.1,6010, 6020, 7196,7470,9040,SM 2120B,2310B,2320B,2510B,254013,2540C, 2540D,426C, 4500CL-E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500N0213,4500P-E,4500 S2 D,510C,52106,5220D, 5310C,5540C.Organic Parameters: EPA 608,624,625, 8081,8082,8151,8260,8270,8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012, 9014,9040,9045, 9050, 9065.) Department of Defense Certificate/Lab ID: L2217. Drinking Water(Inor-ganic Parameters:SM 4500H-B.Organic Parameters:EPA 524.2,504.1.) Non-Potable Water(Inorganic Parameters: EPA200.7,200.8, 6010B, 6020,245.1,245.2, 7470A, 9040B, 300.0,9251, 9038,350.1,353.2,35.1.1, 120.1,9050A,410.4,9060, 1664,420.1,LACHAT 10-107-06-1-B,SM 4500CN-E,4500H-B, 4500CL-E,4500E-BC,4500SO4-E,426C,4500NH3=B,4500NH3-H,4500NO3-F,4500NO2-B, 4500Norg-C, 4500PE, 2510B,5540C,5220D, 5310C,254013,2540C,2540D, 510C,4500S2-AD, 3005A,3015,9010B,9030B. Organic Parameters: EPA 82606,8270C,8330,625, 8082,8151A,8081A,3510C,5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7,6010B,7471A,9040B,9045C,9065,420.1,9012A,6860, 1311, 1312,3050B,9030B,3051,9010B,3540C, SM 510ABC,4500CN-CE,2540G, SW-846 7.3, Organic Parameters: EPA 8260B, 8270C, 8330,8082,8081A,8151A,3545,3546, 3580,5035, MassDEP EPH, MassDEP VPH.) Analytes Not Accredited by NELAP Certification is not available by NELAP for the following analytes: EPA 6260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Dimethyl naphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Chloroaniline. EPA 350.1 for Ammonia in a Soil matrix. Page 16 of 17 �1 ):ss:.. RP': �;:r,r';i+ tiwz _;n;Y• .�:i .eG .��.? �l^'-sa:.�..Xt � s.,. `':� .� > `a•�:: '3!=�i4�`>:<%" ",;;iij!J,'l;.i?:� :Y:.e:! §�'. :r$�l':./.�„L�s�.� �g Ylr, ��++ q;?I:�.t...sn,• �:��' ,•1.. ,y�.'2 lit:" 3{�3-i .i_, �,4',: .�.- n!�ft_sx.;x5s, :'a�.•- ,.L' ,�..:-.. u -.<t_ ftk;f•°'� '•:f.:.c 2a....:,.., ..f,......- .r.�:•.,. .,te•:s;,,yj^.1�iF. i.. c,!?.,t. 'z '"; `)i, - ?`{' :.,�rv`;`h;'rx.,>h ..t,<r� n.."'.-'�k CHAIN OF CUSTODY PAGE , OF >DaRe`<Rep!d in'rl, �,•��'U. ,� �;� •�`�,��,_• �LF�.EI�A:,;�J:Ob.���`r>,/ ;�cw „�.;' '`=s � r. .. ry ) ���Aa����a,��y�l�������y.eta Visa �� r.\""ZaW s ,i.�l.sl'�'1��v q .�,y,3•?ski EJ•;• r wL Project eli era s Billing Information WESTBORO,IMA MANSFIELD,MA ■' ■ le 1 TEL, 508-898-9220 TEL: 50"22-9300 _ ..'...`,.�. .. Project Name: " 0 FAX. EMAIL (Same as Client info PO AX:508-898-9193 FAX: 508-822-3288 � �J echLpcatipn: t ©ADEx:. Q Add'I Deliverables .. ...- • . Proj ' nt; chi .. . ... .. ....._ :.ZIP{:"c':`:::;:`°:•';:;;_-'`.:'`:..-..:�:.: Sfa. /Fed P_rogratrr' " Criferia �ddress: it _C3:�� PtojectNlana er. `'�`S:: --ti; . F. (03 ALPHA.QuoteTurn-Around Time #: 0. •.U- =� t� � gYes`.,;•0.t6_`.-:A4:MCR:Anatytieal Methods Required? ax . . Q Yes ❑,Np Are.CT RCP Reasonable Confidence Protocols .. .. .. .. - .. .. P Standarki. ❑RUSHroty�e.n..t.err:eaPPtoreae '+ wit'•. ``,, fired? Date Due:.:= Time: f SAMPLE HAN ❑ These samples have been previously analyzed by Alpha a /(`jy y1Z DLI NG , .Other Prpject"Specific.Requirements/Comments/Detecti'h"L`IfIIItS: . l �: Flftraffon :..- ':.. O Not needed .. :. ... _ " ❑Lab to do:... tn., Preservation t t(�r�1 ❑Lab x:3;A ..,kIAyL a Las ✓J -Y � dl do. Collection Sample. Sampiers r�� SPleaseapedfy:below) j .<�pap;Us2sQ Sample ID Matrix ,� ! -S ,r Date Time. . Initials . / .. Sample-Specifie'.ComMents :s; VT .,�..... fir. ........ .. .. .. .. `.:. .-,t„it -• - ,., ' �aIt,FA . : u t� PLEASE ANSWER QUESTIONS ABOVEi :Container T e 4Y=s- x •iu-' ^' `ha ca-" ;Y f' P. fi. .Preservative p; �!fd�•fikn;i,��a IS YOUR PROJECT in . eCy.t 'i? elin uished Date/T•ime IVI/a MCP R"ceived S D to Ime ! i� -"'` } C or CT ? v' $ spa a}1esolve�! o RCP (f} 6 0 :cp uq� !ap�, rc t r ➢"Iphs#Te FORM NO:01-0V(rev.140CT-07) M 1 GROUNDWATER Groundwater Analytical,Inc. P.O.Box 1200 ANALYTICAL 228 Main Street Buzzards Bay,MA 02532 Telephone(508)759-4441 FAX(508)759-4475 www.groundwateranalytical.com June 15, 2011 Mr. David Bennett Bennett Environmental Associates, Inc. . P.O. Box 1743 Brewster, MA 02631 LABORATORY REPORT Project: Bailey/BEA10-10214 Lab I D: 142468 Received: 06-08-11 Dear Dave: Enclosed are the analytical results for the above referenced project. The project was processed for Priority turnaround. This letter authorizes the release of the analytical results, and should be considered a part of this report. This report contains a sample receipt report detailing the samples received, a project narrative indicating project changes and non-conformances, a quality control report, and a statement of our state certifications. The analytical results contained in this report meet all applicable NELAC standards, except as may be specifically noted,or described in the project narrative. The analytical results relate only to the samples received. This report may only be used or reproduced in its entirety. I attest under the pains and penalties of perjury that, based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the best of my knowledge and belief, accurate and complete. Should you have any questions concerning this report, please do not hesitate to contact me. Sincerely, 4"Wel( `• Karyn E. Raymond Project Manager KER/nfm Page 1 of 11 GROUNOWATER ANALYTICAL Sample Receipt Report Project: Bailey/BEA10-10214 Delivery: GWA Courier Temperature: 3.5°C Client: Bennett Environmental Associates,Inc. Airbill: n/a Chain of Custody: Present Lab ID: 142468 Lab Receipt: 06-08-11 Custody Seal(s): n/a tLatilD 'exField ID?'wn,.2 -' Matrix�k : Sampled Me"thod uNotes 142468-1 Effluent Aqueous 6/7/2011 12:20 Lachat 10-107-06-2-D(EPA 351.2)TKN Con ID Container Vendor QC Lot Presery QC Lot Prep Ship Receipt Notes C2012034 250 mL Plastic Industrial BX38885 H2SO4 R-6314A 05-02-11 n/a ,�,s :.Ivtatnx t i::_ Sampled " 1'tlNethodx. -- rvs-';' ,,„ , 142468-2 Effluent Aqueous 6/7/2011 12:20 Lachat 10-107-04-1-C(SM 4500-NO3 F)Nitrate Lachat 10-107-04-1-C(SM 4500-NO3 F)Nitrite Con ID Container Vendor QC Lot Presery QC Lot Prep Ship Receipt Notes C2019275 250 mL Plastic n/a n/a None n/a n/a n/a Lati ID s.Feld lD p,<t� „° hlatnx r y Sampled xJL-Ivtethod m. . _ _. 142468-3 Effluent Aqueous 6/7/2011 12:20 SM 5210 B Biochemical Oxygen Demand Con ID Container Vendor QC Lot Presery QC Lot Prep Ship Receipt Notes C2019274 1 L Plastic n/a n/a None n/a n/a n/a Lab ID a Field ID Matnx Sampled` Method r' ` a y a Notes ,,y ,n 1„, 142468.4 Effluent Aqueous 6/7/2011 12:20 SM 2540 D Total Suspended Solids Con ID Container Vendor QC Lot Presery QC Lot Prep Ship Receipt Notes C2034267 1 L Plastic Proline BX39291 None n/a n/a n/a Groundwater Analytical, Inc., P.O. Box 1200, 228_Main Street, Buzzards Bay, MA 02532 Page 2 of 11 GROUNDWATER ANALYTICAL Inorganic Chemistry, Field ID: Effluent Matrix: Aqueous Project: Bailey/BEA10-10214 Received: 06-08-1116:50 Client: Bennett Environmental Associates,Inc. Lab ID: 142468-01 Sampled: 06-07-11 12:20 Container:250 mL Plastic Preservation: H2SO4/Cool ',�`,„,°, `AnalyteT�� t t ;. Result ; ' yUnits, RL DF volu eAnalyzed QCBatchMethodj lost nlri Nitrogen,Total Kjeldahl(TKN) 7.4 mg/L 1 0.5 1 20 mL 06-12-11 10:26 TKN-2938-W " "o-,ozcszo¢r 1 )R J513) Lab ID: 142468-02 Sampled: 06-07-11 12:20 Container:250 mL Plastic Preservation: Cool t 'jA alyte k} _ Result Units xRL`+»' DF Vol me Aralyzed ` QC Batch tMethod Inst airn Nitrate(as Nitrogen) 25 mg/L 0.2 10 0.5 mL 06-08-11 20:40 NI-0882-W "nm:a,or oa,c tsm 1 LIDsO W n Nitrite(as Nitrogen) 0.40 mg/L 0.02 1 5 mL 06-08-17 1.9:12 NI.4882-W " "a1'— (SM 1 LD /sUONOJ it Lab ID: 142468-03 Sampled: 06-07-11 12:20 Container: 1 L Plastic Preservation: Cool AnalyteResult Units aRLFn, DF Volu'me >4naljzed ,, QCBatch� Method lost A?In? ., Biochemical Oxygen Demand 26 mg/L 10 6 50 mL 06-08-11 22:42 BOD-3863-W SM 5210 B 2 LID Lab ID: 142468-04 Sampled: 06-07-11 12:20 container:1L Plastic Preservation: Cool �,, Result .Units a RL` DF yoiume i Analyzed ::`QC Batch Method I'nst n�alvsi Solids,Total Suspended 3 mg/L 2 1 500 mL 06-09-11 09:48 TS5-1929-W SM 2540 D 3 CG Method Reference: Methods for Chemical Analysis of Water and Wastes,US EPA,EPA-600/4-79"20(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,Twentieth Edition(1998),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. RL Reporting Limit. DF Dilution Factor. 1 Instrument ID: Lachat 8000 Autoanalyzer 2 Instrument ID: YSI 5100 3 Instrument ID: Mettler AT 200 Balance Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page3of11 � GROUNDWATER ANALYTICAL Project Narrative Project: Bailey/BEA10-10214 Lab ID: 142468 Client: Bennett Environmental Associates,Inc. Received: 06-08-11 16:50 � w?�� `A Documentation M lime°t anon The following documentation discrepancies,and client changes or amendments were noted for this project: 1 . No documentation discrepancies,changes,or amendments were noted. w`w ,�� '• � �sc,.' q, �..„,Z B.Method Modifications;Non Conformances and Observations X ,'''� �� ,• �� .��.,o�n »��.� v.���>•a,� The sample(s) in this project were analyzed by the references analytical method(s),and no method modifications, non-conformances or analytical issues were noted,except as indicated below: 1 . No method modifications, non-conformances or analytical issues were noted. I Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532Page 4 of 11 r v, .: -... ... ... .. i :. 'Version 104010!, 228:MamS[ree P.O�Bbx1200 -> Gd?QUd1�DIN rER BuzgardaBay MA'D2$32 CKAIN OE-CMTODY'RECORD' ; Telephone(606)759-44411 FAX(508)759.4475 nr�ac�rrre�c yvW�ygtoundvratemnalynlcaLcgm' AND WCRK ORDE�t i Project Name, Hrm: ` TURNAROUND '' � ANALYSIS REQUEST Yulameu 6emPmSeWa. ANWa — -- SmamlG,,dwy � C IJ� \ �.� {•,•'�. ..:� ..3:4'C7v: y.,w\ �`SUC:.. G 10�.BusmesaDaYs. �.: -... Pmject Number. Address lt§5 @usiness Oays 9 G'RUSH(RAN rr V. � C►1 ti �, '�:.0.U I'1 � Jwsn're amcity ymree Rucn numomraua,�.rn:mtxr; n n n� u p � ❑ � �; � � SpierName:. Gityl-StetelZlp � ;Em LPleaseatito�5m�1, . ❑Please FAXto' - < ,.: Q..J c :' Project Manager. Telephone:, BILLNCa'i : c .o .�' s ' II n oo wg', 16 ' 111 GJ n Purchase Order.No.: .. G Third Party Biill�g:.. Yt x W a t.7 9 Y NSTRUC110NSt Use se arete line for each:container'ezce t re licatee: [' a €' n R GWAOucte. s s e n o' z R z iampiing Matri r.,. type Containor(s) '"' Preservation tm.ua : � n tl ._ ,'p � 7 2, �' f, LABORATORY\ _ g e ` € :� d d .F o a SAMPLE S:::S y sn: NUMBER .' $ gg ,_ .: �� 'S S �S a . e ..r IDENWICArtON , :.rf 3 PZ:'$ �. `tlJ (Lab On .5 � n 3 � i. d a C S s (LS h'�- 9S -� c'i F•.. - " & �.a. .8:oF G'�a fi € a F .r3 $'� s �d �. 'N d- '. $a:e a x. b C a `:a a _ n ❑ n o ❑ t 1 .r„e.. `v..:!'° <3k...: ..>.� , A. - r t zn ..;�- ,.<s •r§r -.Mu ,,.. .a, ::: n B- ,,. , " r^a ` � zx `3` ?� - - .. ..:. :. 1 . <r -:a. ,..: r?' :,�.,� ..r .. .. :.. ,. ,.a<.:-t'�r .• .,: �'� - :A k 4✓N:�:�- ,h..s'*" p'<,,:,. 4 :,`� 4 3- 0_. s.,.. a.'.. , .: :es t.». ... '+,„ =T ,.�, 1$::. '( .,.,, :,_•. '.: =" t`: ,.... ..''j r 1y M.R St -� . �a x..�� �._��. .,.�:� �'�p-�r� � . ��;r� ,��, � ��- r,R � ��; ; . .. « �; �g :. , :r. , -.. ,. s:. s, .�... .:.,., .. .., �..:, ,".f "r .x v1 ::._. :>- R. . ...:y!.t+'... 'zt.�a:".�;.,._ .,.: i :�:. rr?:�.`, � � >:�� �, .s.� h J', f ...�, .... n d .,..- !, .n':,n i tiX F '„,# £s::i[; i'. $.Y •,S,i` t'. �Y^ - _.... ., qq�� .. .p�.:s ..,..- :.g..rp'•F,::::. $1,: : 4i .. + REMARKS/SPECIAL INSTRUC7I6N5 DATA C}UALITY 06JEGTIVES CHAIN rOF.-CUSTQDY'RECdRD.`' ES ❑NO:MCP Data Certification requi ed Regulatory:;Program �. - ,::�Pro ect,Spacifie.QC" - -` - .: _ w ) NOTE`.Ail samplas.submitted sulkectto Standard erme and Con8lncns:on'reverse hereof.: ". GY NO:MCP Or nk g.Watar.Samgeanciuded. SEa[e Standard Deliverafile$ rMany'rogulaory programs andrEPA matitod§.raquire,praject RoMgp so Sam' t)o Time,: cal (/ HeoxlpiTemperalute: f :` 's Gtie00.Pro'eds et(to,OC'.Includes'SamPleDu (p (Volaule;anelyses-regtttre duplicate mLectlonand Tnp.Blanla}.= 1 fin nomoxaxe .� .S ❑:GT' G:MCP:GW:11S-1 ❑PWS Form .,Matriz:Spikes;and/or Matrlx:Spiko;Dupllcatos,Laboratory OC:is: Analyze._Dupfl®tasandTelps,PlantsJ.pr�Y�;lftaoslliva,tesulis: .i_JME GMCPGW:215.2 MNdRA not.prdjectspectf(q.unlassprearrangatl.Projectspe^, - _ " '- G ;samples ere,charged on a persam[•a basis;;Each W,-MSD p elin +ish - ::Ttmo Re l!d by rm,Wner Coln . ❑NY:STARS .G and Sampte Dupl(cate requires an adtllt€onal stimplealiquot W' - GNH GDrinktng Wator CJYE9tpN CYRtI]ataCerl' i r Cn :required. ',x, .: n dnqulehed by .;. eta.:..,:Time Hece7vetl by.l.ahaietrxy. a .._ 5nipping#Nrtzrcl) - . t. t ❑rrilastevratec projact`Speeliio QCRequfrad ->'Selection or Semple. Numberf Si g UJII a_RI C Wasta Dlsppsai - - Sample Duplicate. ❑Plesse use sample G VT ❑Dredjje Material. �"Mat5lz.Sp - _ —". ❑_ G .: s Martz Sptke 0ujxtaate - s e sro Number.; . :tMelnadof Shipmem. 'GLVA Counei,pExpres tdajLLf d- I,Exproes l .. "' ... �LPS❑Hand{3" GROUNDWATER ANALYTICAL Quality Assurance/Quality Control Program Overview tip ,, f . s �� �" '� ,..c . a �,rs.'z. s ..2.' ,::3.v N°.-.;.f°s."fa+.,�a+,.x _ ..,»x'. ,4 4•. nti .:a na.: , Groundwater Analytical conducts an active Quality Assurance program to ensure the production of high quality, valid data. This program closely follows the guidance provided by Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans, US EPA QAMS-005/80 (1980), and Test Methods for Evaluating Solid Waste, US EPA,SW-846, Update III (1996). Quality Control protocols include written Standard Operating Procedures (SOPS) developed for each analytical method. SOPS are derived from US EPA methodologies and other established references. Standards are prepared from commercially obtained reference materials s of certified purity, and documented for traceability. Quality Assessment protocols for most organic analyses include a minimum of one laboratory control sample, one method blank, one matrix spike sample, and one sample duplicate for each sample preparation batch. All samples, standards, blanks, laboratory control samples, matrix spikes and sample duplicates are spiked with internal standards and surrogate compounds. All instrument sequences begin with an initial calibration verification .standard and a blank; and excepting GC/MS sequences, all sequences close with a continuing calibration standard. GC/MS systems are tuned to appropriate ion abundance criteria daily, or for each 12 hour operating period,whichever is more frequent. Quality Assessment protocols for most inorganic analyses include a minimum of one laboratory control sample, one method blank,one matrix spike sample, and one sample duplicate for each sample preparation batch. Standard curves are derived from one reagent blank and four concentration levels. Curve validity is verified by standard recoveries within plus or minus ten percent of the curve. "it Z '` t' '✓ .-:7 * p 4 , '� Y °g; E n ! B Definitions f �t _,• � kL�. S: «.�. .x t .x, r`F� �: •ry•�= ^, i'��"".�.'.,.. k'.w«'".,`"e.+;'�.s.. i i Ya. �' !�� �.a w Batches are used as the basic unit for Quality Assessment. A Batch is defined as twenty or fewer samples of the same matrix which are prepared together for the same analysis, using the same lots of reagents and the same techniques or manipulations, all within the same continuum of time, up to but not exceeding 24 hours. Laboratory Control Samples are used to assess the accuracy of the analytical method. A Laboratory Control Sample consists of reagent water or sodium sulfate spiked with a group of target analytes representative of the method analytes. Accuracy is defined as the degree of agreement of the measured value with the true or expected value. Percent Recoveries for the Laboratory Control Samples are calculated to assess accuracy. Method Blanks are used to assess the level of contamination present in the analytical system. Method Blanks consist of reagent water or an aliquot of sodium sulfate. Method Blanks are taken through all the appropriate steps of an analytical method. Sample data reported is not corrected for blank contamination. Surrogate Compounds are used to assess the effectiveness of an analytical method in dealing with each sample matrix. Surrogate Compounds are organic compounds which are similar to the target analytes of interest in chemical behavior, but which are not normally found in environmental samples. Percent Recoveries are calculated for each Surrogate Compound. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 6 of 11 GROUNDWATER ANALYTICAL Quality Control Report Laboratory Control Sample Category: Inorganic Chemistry Matrix: Aqueous K Analyte p. :, _ Ornts Sp(ked M=d Recove ;_C Limits_' Anal ed e C Batch°ry Q yz "Q Method Inst Analyst Solids,Total Suspended mg/L 100 110 112 % 80-120% 06-09-11 09:48 TSS-1929-W SM 2540 D 3 CG Total Kjeldahl Nitrogen(TKN) mg/L 30 32 108% 80-120% 06-12-11 10:02 TKN-2938-W "n„o-,mabao 1 )R (EPA 351.2) Nitrite(as Nitrogen) mg/L 1.0 1.1 105 % 80-120% 06-08-11 18:59 NI4882-W L.OM a,oro. 1 LD (SM 4500NO3 F) Nitrate(as Nitrogen) mg/L 2.0 2.0 98 % 80-120% 06-08-11 18:59 NI4882-W =n.,,o-,o»+u 1 LD (SM 4500-NO3 F) Biochemical Oxygen Demand mg/L 1 200 1 210 1 106 % 1 85-115%1 06-08-11 19:14 1 BOD-3863-w I SM 5210 B 2 LD Method Reference: 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,Twentieth Edition(1998),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Report Notations: All calculations performed prior to rounding. Quality Control Limits are defined by the methodology, or alternatively based upon the historical average recovery plus or minus three standard deviation units. 1 Instrument ID: Lachat 8000 Autoanalyzer 2 Instrument ID: YSI 5100 3 Instrument ID: Mettler AT 200 Balance Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 7 of 11 GROUNDWATER ANALYTICAL Quality Control Report Method Blank Category: Inorganic Chemistry Matrix: Aqueous _Analyzed kQC Batch Method „lost Analyst Solids,Total Suspended BRL mg/L 2 06-09-11 09:48 TSS-1929-W SM 2540 D 3 CO Total Kjeldahl Nitrogen(TKN) BRL mg/L 0.5 06-12-11 10:02 TKN-2938-W ahm to-mou0 1 )R (EPA 351.2) Nitrite(as Nitrogen) BRL mg/L 0.02 06-08-11 18:59 NI-4882-W 16 w-10—" 1 LID (SM 4500-NO3 F) Nitrate(as Nitrogen) BRL mg/L 0.02 06-08-11 18:59 NI-4882-W a nanaimauc 1 LID (SM 4500dd03 F) Biochemical Oxygen Demand BRL mg/L 2 06-08-11 19:14 BOD-3863-W SM 5210 B 2 LD Method Reference: 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,Twentieth Edition(1998),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. RL Reporting Limit. 1 InstrumentlD: Lachat8000Autoanalyzer 2 Instrument ID: YSI 5100 3 Instrument ID: MettlerAT20OBalance Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA02532 Page 8 of 11 GROUNDWATER ANALYTICAL Certifications and Approvals Groundwater Analytical maintains environmental laboratory certification in a variety of states: Copies of our current certificates may be obtained from our website: http://www.groundwateranalytical.com/qualifications.htm �`- �CONNECTICUT�; Department of Health Services,PH-0586 Potable Water,Wastewater,Solid Waste and Soil http://www.ct.gov/dph/lib/dph/environmental_health/environmental_laboratories/pdf/Out_State.pdf IlIaft ems ' n' £ a* A«::MtL�4t�zq df w s _MASSACHUSETTS .. Department of Environmental Protection, M-MA-103 Potable Water and Non-Potable Water http://public.dep.state.ma.us/Iabcertliabcert.aspx Department of Labor, Asbestos Analytical Services,Class A Division of Occupational Safety, AA000195 http://www.mass.gov/dos/forms/la-rpt_list-aa.pdf -:NEW HAMPSHIREr - i `� � '`� svm Department of Environmental Services, 202708 Potable Water,Non-Potable Water,Solid and Chemical Materials http://www4.egov.nh.gov/DES/NHELAP NEW«YORK�_,` $R s- r r e. •. k r .< f �. .:s#marSSEs�€ `' k:; g; Cir Department of Health, 11754 Potable Water,Non-Potable Water,Solid and Hazardous Waste http://www.wadsworth.org/labcertlelap/comm.htmi .� r.., rr;:n+xy RHODEISLAND. �: �raa�4 ,. �_. Department of Health, Potable and Non-Potable Water Microbiology,Organic and Inorganic Chemistry Division of Laboratories, LA000054 http://www.health.ri.gov/1abs/outofstatelabs.pdf ;U.S. DEPARTMENT OF;'AGRICULTURE; ;"� „ � �� ,>f � : ' USDA,Soil Permit, S-53921 Foreign soil import permit VERMC►NT, T4-11� t, " , ' %r Department of Health, VT-87643 Potable Water http://healthvermont.gov/enviro/ph_lab/Water-test.aspx#cert Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 9 of 11 GROUNDWATER ANALYTICAL Certifications and Approvals ^MASSACHUSEITS,» I'" R* `#. ttDepartmertof Environmental Protection;'<M-MA-103 Groundwater Analytical maintains MassDEP environmental laboratory certification for only the methods and analytes listed below. Analyses for certified analytes are conducted in accordance with MassDEP certification standards,except as may be specifically noted in the project narrative. Potable Water(Drinking Water) Non-Potable Water(Wastewater) Analyte Method Analyte Method 1,2-Dibromo-3-Chloropropane EPA 504.1 Aluminum EPA 200.8 1,2-Dibromoethane EPA 504.1 Ammonia-N Lachat 10-107-06-1-B Alkalinity,Total SM 2320-B Antimony EPA 200.7 Antimony EPA 200.8 Antimony EPA 200.8 Arsenic EPA 200.8 Arsenic EPA 200.7 Barium EPA 200.7 Arsenic EPA 200.8 Barium EPA 200.8 Beryllium EPA 200.7 Beryllium EPA 200.7 Beryllium EPA 200.8 Beryllium EPA 200.8 Beta-BHC EPA 608 Cadmium EPA 200.7 Biochemical Oxygen Demand SM 5210-8 Cadmium EPA 200.8 Cadmium EPA 200.7 Calcium EPA 200.7 Cadmium EPA 200.8 Chlorine,Residual Free SM 4500-CL-G Calcium EPA 200.7 Chromium EPA 200.7 Chemical Oxygen Demand SM 5220-D Copper EPA 200.7 Chlordane EPA 608 Copper EPA 200.8 Chloride EPA 300.0 Cyanide,Total Lachat 10-204-00-1-A Chlorine,Total Residual SM 4500-CL-G E.Coli(Treatment and Distribution) Enz.Sub.SM 9223 Chromium EPA 200.7 E.Coli(Treatment and Distribution) NA-MUG SM 9222-G Chromium EPA 200.8 Fecal Coliform(Source Water) MF SM 9222-D Cobalt EPA 200.7 Fluoride EPA 300.0 Cobalt EPA 200.8 Fluoride SM 4500-F-C Copper EPA 200.7 Haloacetic Acids EPA 552.2 Copper EPA 200.8 Heterotrophic Plate Count SM 9215-B Cyanide,Total Lachat 10-204-00-1-A Lead EPA 200.8 DDD EPA 608 Mercury EPA 245.1 DDE EPA 608 Nickel EPA 200.7 DDT EPA 608 Nickel EPA 200.8 Delta-BHC EPA 608 Nitrate-N EPA 300.0 Dieldrin EPA 608 Nitrate-N Lachat 1D-107-04-1-C Endosulfan I EPA 608 Nitrite-N EPA 300.0 Endosulfan 11 EPA 608 Nitrite-N Lachat 10-107-04-1-C Endosulfan Sulfate EPA 608 pH SM 4500-H-B Endrin EPA 608 Selenium EPA 200.8 Endrin Aldehyde EPA 608 Silver EPA 200.7 Gamma-BHC EPA 608 Silver EPA 200.8 Hardness(CaCO3),Total EPA 200.7 Sodium EPA 200.7 Hardness(CaCO3),Total SM 2340-B Sulfate EPA 300.0 Heptachlor EPA 608 Thallium EPA 200.8 Heptachlor Epoxide EPA 608 Total Col iform(Treatment and Distribution) Enz.Sub.SM 9223 Iron EPA 200.7 Total Col iform(Treatment and Distribution) MF SM 9222-B Kjeldahl-N Lachat 10-107-06-02-D Total Dissolved Solids SM 2540-C Lead EPA 200.7 Trihalomethanes EPA 524.2 Magnesium EPA 200.7 Turbidity SM 2130-B Manganese EPA 200.7 Volatile Organic Compounds EPA 524.2 Manganese EPA 200.8 Mercury EPA 245.1 Non-Potable Water(Wastewater) Molybdenum EPA 200.7 Analyte Method Molybdenum EPA 200.8 Nickel EPA 200.7 Aldrin EPA 608 Nickel EPA 200.8 Alkalinity,Total SM 2320-B Nitrate-N EPA 300.0 Alpha-BHC EPA 608 Nitrate-N Lachat 10-107-04-1-C Aluminum EPA 200.7 Non-Filterable Residue SM 2540-D Oil and Grease EPA 1664 Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 Page 10 of 11 GROUNDWATER ANALYTICAL Certifications and Approvals 'MASSACH USETTS tea::Department of Environmental Prdtecti6K111 1-Md=103 Groundwater Analytical maintains MassDEP environmental laboratory certification for only the methods and analytes listed below. Analyses for certified analytes are conducted in accordance with MassDEP certification standards,except as may be specifically noted in the project narrative. Non-Potable Water(Wastewater) Analyte Method Orthophosphate Lachat 10-115-01-1-A pH SM 4500-1-1-13 Phenolics,Total EPA 420.4 Phenolics,Total Lachat 10-210-00-1-8 Phosphorus,Total Lachat 10-115-01-1-C Phosphorus,Total SM 4500-P-B,E Polychlorinated Biphenyls(Oil) EPA 600/4-81-045 Polychlorinated Biphenyls(Water) EPA 608 Potassium EPA 200.7 Selenium EPA 200.7 Selenium EPA 200.8 Silver EPA 200.7 Sodium EPA 200.7 Specific Conductivity SM 2510-13 Strontium EPA 200.7 Sulfate EPA 300.0 SVOC-Acid Extractables EPA 625 SVOC-Base/Neutral Extractables EPA 625 Thallium EPA 200.7 Thallium EPA 200.8 Titanium EPA 200.7 Total Dissolved Solids SM 2540-C Total Organic Carbon SM 5310-B Toxaphene EPA 608 Vanadium EPA 200.7 Vanadium EPA 200.8 Volatile Aromatics EPA 602 Volatile Aromatics EPA 624 Volatile Halocarbons EPA 624 Zinc EPA 200.7 Zinc EPA 200.8 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 11 of 11 Serial No:09221120:26 HA . -ANrA �Y71CAL ANALYTICAL REPORT Lab Number: L1114016 Client: Bennett Environmental Associates 1573 Main St.. PO Box 1743 Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: BAILEY Project Number: BEA10-10214 Report Date: 09/22/11 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY NELAC(11148),CT(PH-0574),NH(2003),NJ(MA935),RI(LA000065),ME(MA0086), PA(Registration#68-03671),USDA(Permit#S-72578),US Army Corps of Engineers,Naval FESC. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com Page 1 of 17 Serial No:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Alpha Sample Collection Sample ID Client ID Location Date/Time L1114016-01 EFFLUENT 1573 MAIN ST., BREWSTER MA 09/08/11 09:40 Page 2 of 17 Serial No:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. For additional information,please contact Client Services at 800-624-9220. Nitrogen, Nitrate L1114016-01 has an elevated detection limit due to the dilution required to quantitate the result within the calibration range. BOD, 5 day L1114016-01 was set at the correct dilution for BOD analysis according to prep screening; however, not enough depletion occurred.Therefore,the sample is reported as"non-detect"at an elevated detection limit. Due to the expiration of the method required holding time, re-analysis could not be performed. I,the undersigned,attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: Michelle M, Morris Title: Technical Director/Representative Date: 09/22/11 Page 3 of 17 �`�` Serial No:09221120:26 INORGANICS MISCELLANEOUS Page 4 of 17 Seria l_N o:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 SAMPLE RESULTS Lab ID: L1114016-01 Date Collected: 09/08/11 09:40 Client ID: EFFLUENT Date Received: 09/09/11 Sample Location: 1573 MAIN ST.,BREWSTER MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Solids,Total Suspended ND mg/I 5.0 NA 1 - 09/13/11 09:50 30,2540D DW Nitrogen,Nitrite 0.07 mg/I 0.05 — 1 - 09/09/11 23:02 44,353.2 JO Nitrogen,Nitrate 9.3 mg/I 0.50 — 5 - 09/10/11 00:01 44,353.2 JO Nitrogen,Total Kjeldahl 4.0 mg/I 0.30 1 09/09/11 22:00 09/13/11 22:04 30,4500N-C AT BOD,5 day ND mg/I 5.0 NA 2.5 09/10/11 01:40 09/14/11 21:40 30,5210B KL L.YL''i?I;a Page 5 of 17 Serial No:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General,Chemistry;,Westborough Lab for,s—a"mp16(s) 01 r,Batch:!'WG489102-2 g = _ . _ . Nitrogen,Nitrate ND mg/I 0.10 — 1 09/09/11 22:48 44,353.2 JO General Chemistryi Westborough Lab for sample(s) '01 Batch: WG489104-21� Nitrogen,Nitrite ND mg/I 0.05 — 1 09/09/11 22:51 44,353.2 JO General Chemistry 'Westborough Lab for sample(s): 01 Batch:'�WG489109-1"- Nitrogen,Total Kjeldahl ND mg/I 0.30 — 1 09/09/11 22:00 09/13/11 21:31 30,4500N-C AT General Chemistry-Westborough Lab for sample(s): 01 Batch: WG489262-1 Solids,Total Suspended ND mg/I 5.0 NA 1 09/13/11 09:50 30,2540D DW General Chemistry-Westborough Lab for sample(s): 01 Batch: WG490027-1 BOD,5 day ND mg/I 2.0 NA 1 09/10/11 01:40 09/14/11 21:40 30,52106 KL Page 6 of 17 Serial_No:0922112O:26 Lab Control Sample Analysis Project Name: BAILEY Batch Quality Control Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General'Chemist Westborou IiL`ab.As so ciat edsam le s :`01-'sBatch ;WG489102 1t Nitrogen,Nitrate .100 90-110 General:Chemistry-Westborough Lab Associatec!}sample(s): 01 „Batch Nitrogen,Nitrite Mt- - 90-110 20 :. -.u.. .,..,.�..<s-.:.. ,. ,v ; omaCm 01 Ba X"w LbAssocatedampe(s.) Goroug W4- Genera s a, ,�. Nitrogen,Total Kjeldahl100 "j - 85-110 — General Chemistry=-°Westborough.,Lab Associated ample(s) 01 Batch tiV11G490027,'2 r _., a.._. . .....ice»ri4�ax�^a.-a.=..:5*.•.-.,..a._ _...-9ac.,+� .n,at..i..�.er:7tc- >r��a.�.n,.Ff3,.2A�.uaa"��.,�:_a.Gs se.��Yt���-�aa.r.e�.,{k �.�,v,::.-r`'t F«'.g'�`5ha�=m�S.3.......!N:..d.,s.Fitt"��+,r.._a,�;�._eS .,..;�1X... BOD,5 day 86g „`" - — 85-115 ---------- 20-------- Page 7 of 17 ALk�;,� Serial No:09221120:26 Matrix Spike Analysis Batch Quality Control Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits General Chemistry-Westborough Lab Associated sample(s):.01° QC.Batch.ID:MG489102-3• =,Sample:;01J4011=02 �Client'ID:'_MS'Sample Nitrogen,Nitrate 10 4 14 100 - 83-113 6 General Chemistry-Westborough Lab Associated,sample(s): 01` QC-Batch�ID:MG489104-3: QC,Sample: L1 1-1 401 1=02 Client!ID: .MS Sample Nitrogen,Nitrite ND 4 4.0 100 - - 80-120 - 20 General Chemistry-Westborough Lab_Associated sample(s):-0.1. QC.Batch•ID: WG489109=3 QC Sample: L11.13913 01� Client ID: WS•Sample Nitrogen,Total Kjeldahl 1.8 8 92 .-., :92:' - - 77-111 -a - 24 r General?Chemistry:-Westborough Lab Associated,'sample(s):,01� QC;'Batch.ID-jWG490027.4' :QC'Sample: L1114031''04`-,-,Client ID" MS Sample BOD,5 day 2.3 100 110 10T� - - 50-145 35 Page 8 of 17 F;q Serial_No:09221120:26 , Lab Duplicate Analysis Project Name: BAILEY Batch Quality Control Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General Chemistry,' Westborough:L6b-4Associated"sa' ple(s): 0'1� aQC+Batch',ID.�;WG489102'4?"QCTSample: L1:1t14011 02aYClient'ID: DUP)Sample a Nitrogen,Nitrate 10 10 mg/I w 0 6 General;,.'Chemistry.-Westborough°Lab:-�°Associafed'isample(s):-�-k0.1i sQC;BatcW4ID kW. G'4891.044. ,QC�'Sample ;�L1�1;14011 02 Clierit'ID Y,'DUP.,,,Sample 20 Nitrogen,Nitrite ND ND mg/1 NC?=. GeneraaltChemistry-.Westborough'kl ab Associated'sample(s):u;01. sQCJBat661I f WG489'.109-4� .QC;-S'ample_aL;11:l39e13 01 'Client ID-- DUPISa pleU,-::; - `7- Nitrogen,Total Kjeldahl 1.8 2.1 mg/I15 24 a stborou h;Lat Assoclatedsam ID �W'G4 89262Y2FQC m 4 045 01 Clie_i ttDDUSpGener PSamp,rl e ' Solids,Total Suspended 72 180 mg/I 86 Q 32 GeneraltChemistry.-Westboroughftab Associated'sample(s),'�0_1�,, C`BatcHilD �WG490027 3TM QCrSample L'11 031 02 Client ID DUP Sample x _ BOD,5 day 120 140 mg/I 15 35 Page 9 of 17 Serial No:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1114016-01A Plastic 1000ml unpreserved A 7 3 Y Absent TSS-2540(7) L1114016-01 B Plastic 1000ml unpreserved A 7 3 Y Absent BOD-5210(2) L1114016-01C Plastic 250ml unpreserved A 7 3 Y Absent NO2-353(2),NO3-353(2) L1114016-01 D Plastic 250ml H2SO4 preserved A <2 3 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days P 9 Y Page 10 of 17 Serial No:O922112O:26 Project Name: BAILEY Lab Number: L1114O16 Project Number: BEA1 O-10214 Report Date:. 09/22/11 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM -Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(IOx) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported due to obvious interference. M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICs),where the identification is based on a mass spectral library search. Report Format: Data Usability Report L�L i?Fi?� Page 11 of 17 Serial No:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 Data Qualifiers P •The RPD between the results for the two columns exceeds the method-specified criteria. Q -The quality control sample exceeds the associated acceptance criteria.Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. J -Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICs). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report ��LIL�iiA Page 12 of 17 Serial No:09221120:26 Project Name: BAILEY Lab Number: L1114016 Project Number: BEA10-10214 Report Date: 09/22/11 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to, damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation,cooling, containers,sampling procedures,holding time and splitting of samples in the field. Am Page 13 of 17 Serial No:09221120:26 z Certificate/Approval Program Summary Last revised September 19,2011 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods, please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil, Drinking Water(Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper; Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Vanadium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP), Ethylene Dibromide (EDB), 1,4-Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform-Colilert(SM9223 P/A), E. Coli.-Colilert(SM9223 P/A), HPC-Pour Plate (SM9215B), Fecal Coliform- MF m-FC(SM9222D)) Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics,TPH (HEM/SGT), Extractable Petroleum Hydrocarbons(ETPH), MA-EPH, MA-VPH. Microbiology Parameters: Total Coliform - MF mEndo (SM9222B), Total Coliform - MTF (SM9221 B), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth (SM9221 E).) Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Volatile Organics, Acid Extractables (Phenols), 3.3'-Dichlorobenzidine, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated Hydrocarbons. ) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(inorganic Parameters: SM921513, 9222D, 9223B, EPA 180.1, 353.2, SM213013, 2320B, 2540C, 4500CI- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters: 504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, SM23206, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NH3-H, 4500NO3-F, 4500P-B, 4500P-E, 5210B, 5220D, 5310C, 9010B, 9040B, 9030B, 7470A, 7196A, 2340B, EPA 200.7, 6010, 200.8, 6020, 245.1, 1311, 1312, 3005A, Enterolert, 9223D, 9222D. Organic Parameters: 608, 8081, 8082, 8330, 8151A, 624, 8260, 3510C, 3630C, 5030B, ME- DRO, ME-GRO, MA-EPH, MA-VPH.) Solid Waste/Soil (Inorganic Parameters: 9010B, 9012A, 9014A, 9040B, 9045C, 6010B, 7471A, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-VPH, 8260B, 8270C, 8330,8151A, 8081A, 8082, 3540C, 3546, 3580A,3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM213013, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM92156; ENZ. SUB. SM9223; ColilertQT SM922313; MF-SM9222D.) NQnt Vable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 Page al,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI, V,Zn); 245.1, SM4500H,B, EPA 120.1, Serial No:09221120:26 w SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane,Aldrin, Dieldrin, DDD, DDE, DDT, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables),600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM9223B;Enterolert-QT: SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited Drinking Water (Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 245.2, 300.0, SM4500CN-E, 4500H+B,,4500NO3-F,2320B,2510B, 2540C,.4500E-C,5310C,2120B, EPA 332.0. Organic Parameters:504.1, 524.2.) Non-Potable Water (Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, 245.2, SW-846 6010B, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 1664A, SW-846 9010, 9030, 9040B, SM426C, SM2120B, 2310B, 2320B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260B,8270C, 8330, EPA 624,625, 608, SW-846 8082,8081A,8151A.) Solid & Chemical Materials (Inorganic Parameters: SW-846 6010B, 7196A, 7471A, 1010, 1030, 9010, 9012A, 9014, 9030B, 9040B, 9045C, 9050C, 9065,1311, 1312, 3005A, 3050B. Organic Parameters: SW-846 3540C, 3546, 3550B, 3580A, 3630C, 5030B,5035, 8260B, 8270C, 8330,8151A, 8015B, 8082, 8081A.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.2, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water (Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, SM4500E-BC, EPA 200.7, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F, 4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM15 426C, 9222D, 9221B, 9221C, 9221E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 6020, 6020A, 7470A, 5540C, 4500H-B, EPA 200.8, SM3500Cr-D, 4500CN-CE, EPA 245.1, 245.2, SW- 846 9040B, 3005A, 3015, EPA 6010B, 6010C, 7196A, 3060A, SW-846 9010B, 9030B. Organic Parameters: SW-846 8260B, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8081A, 8081B, 8082,8082A, 8151A, 8330, NJ OQA-QAM-025 Rev.7, NJ EPH.) Solid& Chemical Materials (Inorganic Parameters: SW-846, 6010B, 6010C, 7196A, 3060A, 9010B, 9030B, 1010, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471B, 9014, 9012A, 9040B, 9045C, 9050A, 9065. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081 B, 8082, 8082A, 8151A, 8330, 8260B, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3540C, 3545, 3546, 3550B,3580A, 3630C, 5030B, 5035L, 5035H, NJ OQA-QAM-025 Rev.7, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0, SM2320B, EPA 300.0, SM2120B,4500CN-E,4500E-C, 4500H-B, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4, SM5220D, 2310B4a, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, LACHAT 10-107-04-1-C, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6020, EPA 7196A, SM3500Cr-D, EPA 245.1, 245.2, 7470A, SM2120B, LACHAT 10-204-00-1-A, EPA 9040B, SM4500-HB, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 3005A, 9010B, 9030B.. Organic Parameters: EPA 624, 8260B, 8270C, 625, 608, 8081A, 8151A, 8330,8082, EPA 3510C, 5030B.) Solid&Hazardous Waste(Inorganic Parameters: 1010, 1030, EPA 6010B, 7196A, 7471A, 9012A, 9014,.9040B,9045C, 9065, 9050, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA 8260B, 8270C, 8015B, 8081A, 8151A, 8330,8082, 3540C,3545,3546,3580, 5030B, 5035.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID: 666. Organic Parameters: MA-EPH, MA-VPH. Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters:Chloride EPA 300.0. Organic Parameters: Page 8§4p ) Serial No:09221120:26 } Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited. Drinking Water(Organic Parameters: EPA 524.2,504.1) Non-Potable Water(Inorganic Parameters: EPA 1312, 200.7,410.4, 1664A, SM2540D, 52106, 5220D,4500-P,BE. Organic Parameters: EPA 3510C, 3005A,3630C, 5030B, 625, 624, 608,8081A,8082,8151A,82606, 8270C; 8330) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3050B, 6010B, 7196A, 7471A, 90106, 9012A, 9014, 904013, 9045C, 9050, 9065, SM 4500NH3-H. Organic Parameters: 3540C, 3545, 3546, 3550B, 3580A,3630C, 5035, 8015B, 8081A, 8082, 8151A, 82606, 8270C, 8330) Rhode Island Department of Health Certificate/Lab ID: LAO00065. NELAP Accredited via NY-DOH. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1. NELAPAccredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7,200.8,245.1, 245.2, 300.0, 350.1, 351.1, 353.2, 376.2,410.4,420.1, 6010, 6020, 7196, 7470,9040,SM 212013,2310B,232013,25106,2540B,2540C, 2540D, 426C, 4500CL-E,4500CN-E,4500E-C, 4500H+B,4500NH3-H,4500NO213,4500P-E,4500 S2 D, 510C, 521013, 52201), 5310C, 5540C. Organic Parameters: EPA 608, 624,625,8081, 8082, 8151, 8260,8270, 8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012,9014, 9040, 9045, 9050, 9065.) Department of Defense Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters: SM 45001-1-13. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water(Inorganic Parameters: EPA 200.7,200.8, 601013, 6020,245.1, 245.2, 7470A, 9040B, 300.0, 332.0, 6860, 353.2,410.4, 9060, 1664A, SM 4500CN-E,45001-1-13,4500NO3-F,5220D, 5310C, 2320B,2540C, 3005A, 3015, 9010B, 9056. Organic Parameters: EPA 82606,8270C, 8330A, 625, 8082, 8081A, 3510C, 5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 601013, 7471A,9010,9012A, 6860, 1311, 1312, 305013, 7196A, 9010B, 3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 826013, 8270C, 8330A/B-prep,8082, 8081A, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAP/TNI Scope of Accreditation: EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Dimethyl naphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Chloroaniline, 4-Methylphenol. Total Phosphorus in a soil matrix, Chloride in a soil matrix, TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix, SO4 in a soil matrix. 4 Page 16 of 17 PAGE of /�� /�,/��//� ,@ 228 Main Street,Po Box 1200 CHAIN OF CUSTODY RECORD & #�I�fMllbalPIlMlFhl►1F1�ATE Buzzards Bay,MA 02532 ANALYTICAL Telephone(508)759-4441-Fax(506)759-4475 WORK ORDER ALPHA Job # � I 1�iO I, www.groundwateranalytical.com Project Name: V t Firm:_Mll ❑ TURNAROUND ANALYSIS REQUEST Project Number C Oil Address:151 3 M El 10 Business Days Sampler Name:';- C State/Zip. v- � ; 1&5 Business Days ro'ect Manager: Telephone: q .—11 U6 RUSH RAN- ) E�p�I�i�lI❑�IiI-Im!l�•I lI�!l Elaii•i"l-!I lAlrIddre s�iiIiI ili�1Il 11!!!II.'i iI1i!.)n't:!kI'�II.;,lI�)!i1�l))i:,i�lII��',i!•I lt1jnt�.�C GJ1�l''E'1sii'!iajii1 i1!,!Ii:lk i'i!l�tl'I!cilf,`I`!l4l!:1 i{,�i�°+d il!I'tI i)!st.!sI1`lr,iIi�'<'{Nv,v.I!,l}t,;I'l.iI)r�s t!�i�a�ulin'ii,.:lt i l(lFl.>i'!:lPii t.•tat ttlItI I�!.I�I l,jtI�IL�;lIj1:ia)�l4I�i�)�r!f:iu,I�1iRi1�•ii(�1 ri�{lhi!iIiffI llSot`!lS!)f!Ili:t i l�P,EI lt+,lIl l�i;iI.G1,l�!(jiI'Il�{"�Ill�I!i/Ei1I'I 3t!f1i,)!!!ii!!1 tIli�I)j'II��°'t!'.�'I II�,I'�III,I.I!iflII!ll��lJill!"ti IiI�l!le!;'!'IIi�'?!I!iI!ni1l'1i.�'t)�1l I'F.,!I,i!E!)!1iiiI lI!�i�l;i,Ii!!°lit):Ii lllI;I►lll!liIl�I ii i,<�(l<4�►1��►I.i!F I�I,t):1;t{�.{�1:Ii 5!I).h�l1 1i 3i�I ItI 5�Ii�'t l�!I iIit.'.❑II;Q—!��1!I,;ll{ti;,f`►i')ta 6:ii!i'ti)liI;JJ�h:'�l►f!�)liI!{�I;;�,,'.«SlBIi;iisi-)-t�.►:EtII.:(I!ll�.r:l It`IItii•,')ltI6,:il�t,)'�1?iII�.I,Im-{'1,i1�)II S'1Ig-I-r 1I!I Iy�I'i{!I1 III��sm i:II�It goEt �B�t�lI:91tiNNI►�)Itl!L Li..'�.oiIittll,N G I 4i{I!IN � FIi! O RiF �MI',II!I!IAtn'iiIIT I1i IION INSTRUCTIONS:Use separate line for each container(except replicates). PO No. Sampling Information Matrx T pe Containers Entered LAB SAMPLE m IL NUMBER!p a n' :ENTIFICATION Use, E' E' E E E]i .`•. i-1 r � 010 O U 2 01 l kill, i REMARKS 1 SPECIAL INSTRUCTIONS DAQALITY OBJECTIVES tiit�,�l i�i::1;!,Ii iii i1i(�lI,!{li l!(I Iill,,u1i't��!!tl iIi►l���:iI'tt©lCHAIN �I tIO F C O'l>i.r •.lIii i1i!1I 1 h n'i)��Il a!�l.,.�'I(��:!;#'i��l•II{ :C'I�ii�y O,t�v l�liA•!l�ll�R'iI! )iD;� on MCP Data Certification Required Regulatory Program Project Specific CIA Note:All samples submitted are subject to Standard Terms and Conditions MCP Drinking Water Sample Included State Standard Many regulatory programs and US EPA-approved methods Reli s D e Time ❑Analyze Duplicates and Trip Blanks only If positive CTMCPGW fitreqp pi . pf /j uire :tI•fi�.l 4i i y�lr(• 1 _ Sample Duplicates,Matrix Spikes,and/or Matrix Spike 00 ME ❑MCP GW-11S-2 Duplicates.Laboratory QC is not project specific,unless pre- inqu" By: Vine R iv Additional Corhme„+s: h MA 0 NY STARS arranged.Project specific QC samples are charged on a per 11 NH ❑Drinking Water sample basis.Each MS,MSD,and Sample Duplicate Relinquished By: Date Time Received By:. NY ❑Wastewater required an additional sample aliquot. RI ❑Waste Disposal Project Specific CIA Required MetW of Shipment: 4 VT ❑Dredge Materials E] Sample Duplicate ❑ MS ❑ MSDS owA Courier �xpress Man [2ed Ex consultant courier tc J cc t 4 BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS . 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 =fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER:. Massachusetts Department of Environmental Protection 8/25/10 BEA10-10214 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Greeley Residence w 49 Joby's Lane Osterville,MA 02655 SHIPPING METHOD: Regular Mail ❑ Federal Express ❑ Certified Mail ❑X UPS ❑ Priority Mail ❑ Pick Up ❑ ' Express Mail ❑ Hand Deliver . ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(August 2010) 1 8/19/10 Alpha Analytical laboratory report a 0 o f ry -n O t" s For review and comment: ❑ For approval: ❑ As requested: ❑ F0$4yourtse: ui r REMARKS: v: rn Please find enclosed the DEP Inspection and O&M Form,and laboratory analytical,for operation and maintenance conducted for the above referenced property. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Chapman Greeley,Owner ' David C.Bennett,President[Internal] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important: Chapman Greeley When filling out Owner forms on the computer,use 49 Joby's Lane only the tab key Facility Street Address to move your Osteryille 02655 . cursor-do not use the return City Zip key' Mailing address of owner, if different: P.O. Box 662 Street Address/PO Box: Osterville MA 02655 City State Zip (508)428-4481 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 102 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI RSF-PF " DEP ID Manufacturer ID Model Number" UNKNOWN UNKNOWN Installation Date' Start of Operation 'Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence=used less than 6 mo./year: ® Yes ❑ No D. Operating Information 8-11-2010 7-6-2010 Inspection Date Previous Inspection Date 5"of Sludge, and 1"of Scum Sludge Depth(to be checked yearly) PUmping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 1 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 E. Field Testing A Field Inspection: + Color: ❑-gray ❑ •brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive''.❑ turbid Effluent Solids: ® no ❑ some, pH 6.46 SU DO ` 6.62 mg/L Turbidity 0.18 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 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) TKN, NO2, NO3 Other 1 Other 2 Other 3 G. Inspection and Maintenance , Description of any maintenance performed since previous inspection &-during this inspection: System is operating correctly, system passed field sampling parameters, and pulled effluent sample for laboratory analysis. Notes and Comments: ` None t5aiom.doc•rev. 11-07-05 Page 2 of 2 Massachusetts Department of Environmental Protection • I Bureau of Resource Protection -Title 5 Ll I DEP Approved Inspection and -O&M Form for Title 5 I/A Treatment and Disposal Systems _ H. Certification I certify: I have inspected the sewage treatment and disposal,system at the address above, have conducted the 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 am a Massachusetts certified operator in accordance with 257.CMR 2.00. .1� 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 31s'of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31t'of each year for the previous 12 months General Use—by September 30t'of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 PrTram One Winter Street, 6 Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 C "Serial No:08191011:57' "r HA g ANALYTICAL REPORT Lab Number: L1012432' Client: Bennett Environmental Associates 1513 Main Street t. PO Box 1743 Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: GREELEY RESIDENCE Project Number: BEA10-10214 Report Date: 08/19/10 Certifications&Approvals: MA(M-MA086),NY NELAC(11148),CT(PH-0574),NH(2003),NJ(MA935),RI(LA000065),ME(MA0086), PA(Registration#68-03671),USDA(Permit#S-72578),US Army Corps of Engineers,Naval FESC. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com ' Page 1 of 17 Serial No:08191011:57 Project Name: GREELEY RESIDENCE Lab Number: L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 Alpha Sample Collection Sample ID Client ID Location Date/Time L1012432-01 EFFLUENT BARNSTABLE, MA 08/11/10 15:45 a Page 2 of 17 FF� Serial No:08191011:57 Project Name: GREELEY RESIDENCE ,. Lab Number' L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report.. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for-each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. For additional information,please contact Client Services at 800-624-9220. s Nitrogen, Nitrate ' L1012432-01 has an elevated detection limit due to the dilution required to quantitate the result within the calibration range. I, the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible.for providing the information contained in this analytical report,such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: tA''^ N'`' Michelle M, MOCfIS Title: Technical Director/Representative Date` 08/19/10 Page 3 of 17 ��'� Serial No:08191011:57 INORGANICS & MISCELLANEOUS Page 4 of 17 Serial No:08191011:57 Project Name: GREELEY RESIDENCE Lab Number:, L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 -SAMPLE RESULTS i Lab ID: L1012432-01 Date Collected: 08/11/10 15:45 Client ID: EFFLUENT Date Received: 08/12/10 Sample Location: BARNSTABLE,MA Field Prep: Not Specified Matrix: Water Dilution Date Date,. Analytical Parameter Result Qualifier Units RL MDL Factor Prepared ` Analyzed Method Analyst Gene al,Chemittry Westborouh Ea Solids,Total Suspended ND mg/I 5.0 NA 1 - 08/13/10 18:15 30,2540D DW -- ._........_...__....__...---._.-._.._......._.._._....._.._.—._—_._.......---......_.........-- -........-- - -...__........_........_ ----- _....-....._......_._...- .._......................_...--........._................_...._._.__._.:.__........__......._. Nitrogen,Nitrite ND mg/I 0.05 1 - 08/12/10 23:06 44,353.2 DD __........._............-......_......_._..._.........-----..._.........—...... --......__...--- --......_.__..............._.__...._.._...._..............................._....__.._._......_........._..............._....._............_._._._.._._..._.__..... --....:..._...._.._.......__._........._........_.....--............ ....................----..._._.....---..._._. Nitrogen,Nitrate 32 mg/I 1.0 -- 10 08/12/10 23:23 44,353.2 DD ---- --- - - —------------------------ --- -,_.._.. -- - - ------ -- -----------....-------------- - -- - --- - Nitrogen,Total Kjeldahl_ 0.40 mg/I 0.30 1 08/13/10 13:00 08/16/10 21:14 30,4500N-C, AT BOD,5 day ND mg/I 2.0 NA 1. 08/13/10 02:25 08/18/10 00:65 30,52106 JT a' ,f1L'r HA Page 5 of 17 Serial No:08191011:57 Project Name: GREELEY RESIDENCE Lab Number: L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General C.tiernlstry §WesfboroughlL�ab��for sarnptce{s)� B�atch�WG7�406 2a_, , .� , ,� , . r r ' {� ��� s Nitrogen,Nitrite ND mg/I 0.05 — 1 08/12/10 22:48 44,353.2 DD General'Chemistry'=Westborough=L�abfoarnpt } 01; Batcf �W42�7408:;2 E ! °' Nitrogen,Nitrate ND mg/I 0.10 — 1 08/12/10 22:47 44,353.2 DD G�en=eraL�Ctremis ry; Westb�orou"h;.Lab`for samtlte(s �.01 �Ba ch ��WG427420 1 � • ;,� BOD,5 day ND mg/I 2.0 NA 1 08/13/10 02:25 08/18/10 00:05 30,5210B JT G�enera�,Ch%emistry.: ,We�stugh Lafortsample�S)01, Bat_.h�WG42758 �, .;� �, c�°� M.�, '" .. . ������c�. Solids,Total Suspended ND mg/I 5.0 NA 1 08/13/1018:15 30,2540D DW Gen al Cfemis� �Wes�t ou hLabfor sam fe s O'�1 Batch WG4�27620--1�'�� ��� ., ��� `` �" Nitrogen,Total Kjeldahl ND mg/I 0.30 — 1 08/13/10 13:00 08/16/10 21:08 30,4500N-C AT Y" L�LPHA Page 6 of 17 Serial No:08191011:57 Lab Control Sample Analysis Project Name: GREELEY RESIDENCE Batch Quality Control Lab Number: L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 o LCS LCSD /oRecove ry Parameter %Recovery Qual %Recovery Qual Limits RPD Quay RPD Limits ;GeneralaChemist,�W,e_stborou h�Lab.. Assooiated�sam le s� '-�.01� Ba ch�F .G 740.6-1 �sw•�•. � ��.� _; � �� ..,;: . „.:.. _.. CYO: -�.�,<, - , 9.:,.9� �•� :�, ,,R, ,(..). �, _�, t -;� W 42 .� � MKS a�. � ��.'',� �' `��s e} � � ;�.. :�.,. Nitro 9 en,Nitrite 00 90-110 20 - ........................................._.._.._...... .................... . :................................. . ... ...... ................................................................. «�,•,�^r�ssa,»s^. � N..�w":"�r` "+"�'��� ,. : .�,r"".�r +.z ,%�' � ..� _ .. - x mar �r: �Y� � . .� . .. hemist �Westborou h LabAssociate saris le s, � ,, t ,-. � F r �,. � � t �� . .�• .::� �� �;�; ems, 4.':�...._i.�.�4:,.�.,.�#��:.'�La:.;. a�s �`.4`1���..•�-Yx�:..�a,�,..t��: "' .i`,' r.'� .k."' ..�u�.si'1�x:�.n^ .am. . 7.° ak�.�-.,5#?:a�'§ "�.,,r:.. 'w»P. &�xr�> ,,....ak�:���«` F":,.�.:�,r: s,�C,�Y�r�� .. ... ( ��� :,a._a.�:.Y�c..� .� �G ,�.w.. Nitrogen,Nitrate T0,4 90-110 :General.C<:ernist.�-.Westboro h Lab �'' - ,.BOD,5 day 89 85-115 20 u " !r'`�"5�...:.�¢,. ." ^"r+x" ,`.. �-,x,..;"". ! .��e..,,*�+ ,�.: �a•��"*'tr�,`i'a::; .:ST.!^�&"'aM?+wr.'•. � ;�'7�""q�' '"�aw�„�.m'7�' - Jig Genet l C t mist-West•orou°���L b, A o _ice. ,.?.. .��,, .-.,►;Y : �.�g - _a.,. � s_ . . ,edsam le s:; 0�°�,Batch- WG4�:T620-2 � ,�: Nitrogen,Total Kteldahl 100. t 85 110 - ._......._.._................ _ _._._.._ ............_...................._. s:- k ,3i,:.:..... ..::_._. - --._..__ ._.. ...... .._..__..._........_.......................-......... --................ Page 7 of 17 Serial No:08191011:57 Matrix Spike Analysis Project Name: GREELEY RESIDENCE Batch Quality Control Lab Number: L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits Gener,.al Chemis#„ o Westborou Lab.AssaclatedsamWG42 06.3 :. CSam Ie:,L:1.0:b2 7 -`1 f. ,. ry g, _ � 74, a Q p, 32. 0- Client D. fVl$ Sample = : �uar: „y.:x.,x'#�a.�fi... '-y�€ .a,...„.:.:x,x,:AHr Nitrogen, Nitrite ND 4. 4.0 00 - 80-120 - 20 ----------- --- -------------.._....-------._..—_.....---------- -- ---------------------------------------------3 5a._..__...----.._....------------------- ..__......_......------------- ----------_._...__..._.....-------_........-....................-............-..........----------....__. }YY$,51.�•j�3 i+ ..- T.E �_ ,".�2s, ,,..�,..x•«,i ,..,,x,r+v,. ,,,.{kH:Y�5' �i%?:'�`f .-Y Yx �„`Svw;'b,x:� ..a... d'.�._ 1.:,,n-: ':'.+. ...�3.. _„'.' .p:� . General Chemist= es �W tboro hgi..ab,�Assoc[ate �sarn leis : 041 ,.QGBatch�ID. - IY Ug, .�. '�.�3.� ,,�. Nitrogen,Nitrate ND 4 4.4 r10 - 83-113 6 ................................................................................................................................................................................................................................................ _�-�.�:.......x..�:..k,3 ' * GeneralChemist Westborou h Lab:Associated sam ,Le.s: 01QC BatchflD..W 427420 4_:ti C'Sam le. L 1 43 01 Clte t D i d �1,0 2 ;:�`� n I EFFaLIJ.ENT�;� BOD,5 day ND 100 100 <'T-103 - 50-145 35 ..................._................................_...._....._..................._1,�:t-- :..:.:.._....._...................._................_....................................................._......._._.._...................._......._......_. ... General Chern st �Westborou h Lab Associated sa,, le sr:01� -� C1B.atch aD WG4f2762 = , '� _ �. , ry, ., _ g.:. ..:� . _.�_�.�...rr►p:. O._.. . Q-, .� _ �� ;_ 0„3 QGSam I,e; L.10.,12447.,Q;1 ',C.IIer1tIDa,. MS Sa�� le -,,; R j Nitrogen,Total Kjeldahl 59 8 68112 Q - 77-111 24 ............. . ........... .........-- ....... .................... Page 8 of 17 f ePHA Serial No:08191011:57 Lab Duplicate Analysis Lab Number: Project Name: GREELEY RESIDENCE Batch Quality Control L1012432 Project.Number: BEA10-10214 Report Date: 08/19/10 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits GerleralChe: is r <, st ti ,. : .L1012327-01,7: CllentID D.U:P' rn•le .. ,. 1r.= ' „r..a ,,. m� t,y�.�We f.�orauryhLab: Assoclated�samllle s,.,0.1�. QCBatph�ID,tiWG4274.pfi-4.�„QC Sample,.. .;�: , , .,.� _ ... .. `k.?,t�-:�:m�.'aXz�". Sn.�s..s.' ."�3 ;:..�.4oc�n,.z`.�r,«s.'�. ..�,..ty.'�+;:, ;dak ,.`�" ,��,�..r�x�. .�.�:����'�..e�...c.,�erxi� .«�da...�•..: ... ,,.. �P.�'.;,r�:�.,.. ..a�d�aad...: .�°.r.«�M�.:,"�a',,� Nitrogen,Nitrite ND ND mg/L............................. tJ'C` r 20 .................................................................................................._....................... _ ............................. .................................................. .... ............... .NY 7.02CllentlD: .D S:UParn _,._. �� ._. h;., , st ,.,Westborou h Lab Associated sam�le.s 01 . .QC,Batch lD,.; WG427408-4. QC+� Sa.le.., L101232. � ...,,..,w �en:-.> .".�d�s��?..�. ��?����. �.: :�,: ,v.�-._:. :a�.r :a`�:n;� .Pa`,a�*�a�.�aa." ��` - �` �'iri.�.w�.• .;w:e �.P. ..�� _ '^ ��F�::. li Nitrogen,Nitrate ..... . ... .. ... . .. .....ND. ...... ......_.. .. ... ...... ... _...ND.. .. . ..... Mg/1 ............ ......... 6 ,:�. .K ..�.. •�� _ ,: �.c.�,.�.-, ,. ,. ,.,_. :.: GeneralChemtsth: West or-u h;Lab:Asso. ated m le1 ID.. G42;-4 3 a e,. L101.2398a02, CllentID. ,pUP Sam. lei_ , � �:x�x.,,�:5�',�xa�..'.;,aw�m .�r,�;.�.,:�u,nn'�.. BOD,5 day 170 160 mg/I 35 �... .. : . General,Chemtst -Westborou hLab...Asso lat d am I 2;< QC�Sarnple_ �L10�1r2234 0,1�� lenfi'.ID DUP Sample ' ,n • .�:.+s�.�:,$�.€:��r�.<x.. .v.�. . � .- � :..,�, x.��.,��.,�.-...� ...;:: a�:arae. „s.:, :� .. a. r� �.:.at:,xw,�aa��r��:.a. � e;a.,t.3.;:•s`,:ik�..�-.�.�-s r�"=�:., �:.�- :e>�-.:as:��.,�'��.�• ..��; ta..,s. Solids,Total Suspended 930 880 mg/I �6 32 ,.- a . ,a,; 5^?: . s r.,, ,� ,;,.,•:.-.at ..:z ,::,, .a,,a ..f w ,,. ` levn ,�.a ,G,eneral Chemistr� -Westborou�h.l_ab. Associated sam Ie s . .01 �Q-C..Batch ID.�WG427.620-4 .,QC�Sam le.. ,L�10�1.244s7 01.,.Chent�ID _„DUP.,Sam �...�_. F... ;, .�� � Nitrogen,Total Kjeldahl 59 59 mg/I '4 24 ........ . .. ........ ................. ...... . _ .................... .......... i Page 9 of 17 vh�,. Serial No:08191011:57 Project Name: GREELEY RESIDENCE Lab Number: L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1012432-01A Plastic 250ml H2SO4 preserved A <2 2.9 Y Absent TKN-4500(28) L1012432-01B Plastic 1000ml unpreserved A 6 2.9 Y Absent NO2-353(2),BOD-5210(2),NO3- 353(2),TSS-2540(7) , f *Values in parentheses indicate holding time in dayst;� Page 10 of 17 Serial_No:08191011:57 Project Name: GREELEY RESIDENCE tab Number: L1012432 Project Number: BEA10-10214 ,. Report Date: 08/19/10 „ GLOSSARY Acronyms EPA -Environmental Protection Agency. e LCS Laboratory Control Sample:A sample matrix,free_&om the analytes of interest,spiked_with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit.(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA -Not Applicable. NC -Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI -Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration. The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). `. Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values;although the RPD value will be provided in the report. r Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example: EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the_concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I •The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported due to obvious interference. P •The RPD between the results for the two columns exceeds the method-specified criteria. Q -The quality control sample exceeds the associated acceptance criteria.Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. . Report Format: Data Usability Report j �L�L?HA Page 11 of 17 Serial No:08191011:57 Project Name: GREELEY RESIDENCE Lab Number: L1012432 Project Number: BEA10-10214 Report Date: 08/19/10 Data Qualifiers RE Analytical results are from sample re-extraction. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICs). ND -Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report 4� Page 12 of 17 . .Y Serial No:08191011:57 Project Name: GREELEY RESIDENCE �~ `. _ Lab Number': L1012432 Project Number: BEA10-10214 ` . Report Date:' . , 08/19/10 REFERENCES' " . 30 Standard Methods for the Examination of Water and Wastewater:APHA-AWWA WPCF. 18th Edition. 1992. 44 Methods for the Determination'of Inorganic SubstancesIin Environmental Samples, EPA/600/R-93/100,August 1993. r a. . . LIMITATIONOF LIABILITIES, 3 Alpha Analytical performs services with reasonable care'and,diligence normal to the analytical testing laboratory industry. In the event of.an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no_event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,damages in�any way, connected with the use of, interpretation;of, information or analysis-provided by Alpha Analytical. �. We strongly urge our clients to comply with EPA protocol'regarding sample volume,preservation,cooling, containers,sampling'procedures, holding time and splitting of samples in the.field. Page 13 of 17 rig .. Serial No:08191011:57 Certificate/Approval Program Summary Last revised July 19,2010 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water(Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Vanadium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP), Ethylene Dibromide (EDB), 1,4-Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform-Colilert(SM9223 P/A), E. Coli.-Colilert(SM9223 P/A), HPC-Pour Plate (SM9215B), Fecal Coliform- MF m-FC(SM9222D)) Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics,TPH(HEM/SGT), Extractable Petroleum Hydrocarbons(ETPH), MA-EPH, MA-VPH. Microbiology Parameters: Total Coliform - MF mEndo (SM9222B), Total Coliform - MTF (SM9221B), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth(SM9221 E).) Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Volatile Organics, Acid Extractables (Phenols), 3.3'-Dichlorobenzidine, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated Hydrocarbons. ) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM921513, 9222D, 9223B, EPA 180.1, 300.0, 353.2, SM213013, 2320B, 4500CI- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters: 504.1,524.2.) Wastewater/Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, Lachat 10-107-06-1-B, SM2320B, 2340B, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 450017-13, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NH3-H, 4500NO3-F, 4500P-B.5,4500P- E, 5210B, 5220D, 5310C, EPA 200.7, 200.8, 245.1. Organic Parameters: 608, 624, ME DRO, ME GRO, MA EPH, MA VPH.) Solid Waste/Soil(Organic Parameters: ME DRO, ME GRO, MA EPH, MA VPH.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water Inorganic Parameters:(EPA 200.8 for:Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate) 353.2 for: Nitrate-N, Nitrite-N; SM4500NO3-F,4500E-C,4500CN-CE, EPA 180.1,SM213013, SM4500CI-D,2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes,Volatile Organics) (504.1 for: 1,2-Dibromoethane, 1,2-Dibromo-3-Chloropropane),314.0,332. Microbiology Parameters: SM921513; ENZ.SUB. SM9223; MF-SM9222D Non-Potable Water Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,T1,Zn) (EPA 200.7 for: AI,Sb,As,Be,Cd,Cr,Co,Cu,Fe,Pb,Mn,Mo,Ni,Se,Ag,Sr,Ti,TI,V,Zn,Ca,Mg,Na,K) 245.1, SM4500H,B, EPA 120.1, SM251013,2540C,2540B,2340B,2320B,4500CL-E,4500E-BC,426C,SM4500NH3- BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-13 for Ammonia-N,SM4500NO3-F,353.2 for Nitrate-N, SM4500NH3-B,C-Titr,SM4500NH3-BC-NES, EPA 351.1, SM4500P-E,4500P-B,E,5220D, EPA 410.4, SM 5210B, 5310C,4500CL-D, EPA 1664, SM14 510AC, EPA 420, SM4500-CN-CE, SM2540D. Organic Parameters:(EPA 624 for Volatile Halocarbons,Volatile Aromatics) Page 14 of 17 Serial No:08191011:57 (608 for: Chlordane,Aldrin, Dieldrin, DDD, DDE, DDT, Heptachlor, Heptachlor Epoxide, PCBs-Water), EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables,600/4-81-045-PCB-Oil New Hampshire Department of Environmental Services Certificate/Lab ID:200307.NELAP Accredited. Drinking Water(Inorganic Parameters: SM6215B, 9222B, 9223B Colilert, EPA.200.7, 200.8, 245.2,,.120.1, 300.0, 314.0, SM450OCN-E, 4500H+B, 450ONO3-F, ,2320B, 2510B, 2540C, 450OF-C, 5310C, 2120B, EPA 331.0. Organic Parameters:504.1, 524.2,SM6251B.) Non-Potable Water(inorganic Parameters: SM9222D„9221 B, 9222B, 9221 E-EC, EPA 200.7, 200.8, 245.11 245.2, SW- 846 601 OB, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 351.1, 353.2,420.1, 1664A, SW-846 9010, 9030,9040B, SM426C, SM231 OB,2540B,2540D,4500H+B,450ONH3-H,450ONH3-E,450ONO2-B,450OP-E,4500-S2- D, 521OB,2320B,2540C,450OF-C,531OC, 5540C, LACHAT 10-117-07-1-B, LACHAT 10-107-06-1-B, LACHAT 10-107- 04-1-C, LACHAT 10-107-04-1-J, LACHAT 10-117-07-1-A, SM4500CL-E, LACHAT 10-204-00-1-A, LACHAT 10-107-06- 2-D. Organic Parameters: SW-846 3005A, 3015A, 3510C, 5030B, 8021 B,,8260B, 8270C, 8330, EPA 624, 625, 608, SW-846 8082,8081A.) I Solid& Chemical Materials (Inorganic Parameters: SW-846 6010B, 7196A, 7471A,.7.3.3.2, 7.3.4.2, 1010, 1030, 9010, 9012A, 9014, 9030B, 9040, 9045C, 9050C, 1311, 3005A, 3050B, 3051A. Organic Parameters: SW-846.3540C; 3545, 3580A, 5030B, 5035, 8021B, 8260B, 8270C, 8330, 8151A, 8082, 8081A.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited.. - Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 450ONO3-F, 4500E-C, EPA 300.0, 200.7, 2540C, 2320B, 314.0, SM2120B, 2510B, 5310C, SM450OH-B, EPA 200.8, 245.2. Organic Parameters: 504.1`, SM6251B, 524.2.) Non-Potable Water (Inorganic Parameters: SM5210B, EPA'410.4, SM5220D, 4500CI-D, EPA 300.0, SM2120B, SM450OF-BC, EPA 200.7, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM450ONO3-F, 450ONO2-B, EPA 1664A, SM531OB, C or D, 4500-PE, EPA 420.1, SM450OP-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM251OB, SM15 426C, SM92210E, 9222D, 9221B, 9222B, 921513; 2310B, 2320B, 4500141-13-1-1, 4500-S D, EPA 350.1, SM5210B, SW-846 3015,6020,7470A,5540C,450OH-B, EPA 200.8, SM350OCr-D, EPA 245.1,245.2, SW-846 9040B,3005A,EPA 601 OB, 7196A, SW-846 9010B, 9030B. Organic Parameters: SW-846 8260B, 8270C,. 351OC, EPA 608, 624, 625, SW-846 5030B,8021B,8081A,8082, 8151A, 8330, NJ OQA-QAM-025 Rev.7.) Solid&Chemical Materials(Inorganic Parameters:SW-846 9040B, 3005A, 601 OB, 7196A,5030B, 901 OB, 9030B, 1030, 1311, 3050B, 3051, 7471A, 9014, 9012A, 9045C, 9050A, 9065. Organic Parameters: SW-846 8021B, 8081A, 8082, 8151A,8330, 8260B,8270C, 1311, 1312,3540C,3545, 3550B,3580A,5035L,5035H, NJ OQA-QAM-025 Rev.7.) New York Department of Health Certificate/Lab ID: 11148.NELAP Accredited. " Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245°2, SM5310C, EPA 314.0, 332.0, SM23206, EPA 300.0, SM2120B, 450OCN-E,'450OF-C, 4500H-B, 450ONO3-F, 2540C, 'EPA 120.1;`SM 2510B. Organic Parameters: EPA 524.2,504.1.) Non-Potable Water (Inorganic Parameters: SM9221E, 9222D, 9221B,-9222B, 9215B, 5210B, EPA 410.4, SM5220D, 231OB-4a, 2320B, EPA 200.7, 300.0, LACHAT 10-117-07-1A or B, SM4500CI-E, 450OF-C, SM15 426C, EPA 350.1, LACHAT 10-107-06-1-B, SM450ONH3-H, EPA 351.1, -LACHAT 10-107-06-2, EPA 353.2, LACHAT 10-107-041-C, SM4500-NO3-F, 4500-NO2-B, 450OP-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6020, -EPA 7196A, S\M350OCr-D, EPA 245.1, 245.2, 7470A, SM21206, SM4500-CN-E LACHAT 10-204-00-1-A, EPA 9040B, SM4500-1-113, EPA 1664A, SM5310C, EPA 420.1, SM14 510C, EPA 120.1, SM251013, SM450OS-D, SM5540C, EPA 3005A, 3015. Organic Parameters: EPA 624,..826013;8270C, 625, 608, 8081A, 8151A, 8330, 8082; EPA 3510C, 5030B, 9010131' 9030B.) , Solid & Hazardous Waste (Inorganic Parameters:'1010, .1030, SW-846 Ch 7 Sec 7.3;•EPA 601.013, 7196A, 7471A, 9012A, 9014, 9040B, 9045C, 9065, 9050, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA 8260B, 8270C, 8081A,8151A,8330, 8082,3540C;3545,3546,3580,5030B,5035.) - North Carolina Department of the Environment and Natural Resources Certificate/Lab ID:666. Or anic Parameters: MA-EPH, MA-VPH. Pennsylvania Department of Environmental Protection Certificate/Lab ID-:68-03671. NELAP Accredited Non-Potable Water(Organic Parameters: EPA 351OC,5030B,625,624.608,8081A,8082,8151A,8260B,8270C, 8330) Solid & Hazardous Waste(Inorganic Parameters: EPA 1010, 1030, 1311,,305013, 3051, 6010B, EPA 7.3.3.2, EPA 7.3.4.2, 7196A, 7471A, 9010B, 9012A, 9014, 9040B, 9045C, 9050, 9065. Organic-Parameters: 3540C, 3545, 3580A, 5035,8021B, 8081A,'8082,8151A,'8260B,8270C,8330) Rhode Island Department of Health Certificate/Lab ID: LA000065.NELAP Accredited via NY-DOH. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NY-DOH Certificate for Potable and Non-Potable Water. Page 15 of 17 Serial No:08191011:57 Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1.NELAP Accredited. Non-Potable Water(inorganic Parameters: EPA 120.1, 1664,200.7,200.8,245.1, 245.2,300.0,350.1,351.1,353.2, 376.2,410.4,420.1, 6010, 6020,7196,7470,9040,SM 212013,2310B,232013,2510B,254013,2540C,2540D,426C, 4500CL-E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500N026,4500P-E,4500 S2 D,510C, 521013,5220D, 5310C, 5540C. Organic Parameters: EPA 608,624,625,8081,'8082,8151,8260,8270,8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012, 9014, 9040,9045, 9050, 9065.) Department of Defense Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters: SM 4500H-B.Organic Parameters: EPA 524.2,504.1.) Non-Potable Water(Inorganic Parameters: EPA 200.7,200.8, 6010B, 6020,245.1,245.2,7470A, 90406,300.0, 9251, 9038,350.1,353.2,351.1, 120.1, 9050A,410.4,9060, 1664,420.1, LACHAT 10-107-06-1-13,SM 4500CN-E,45001-1-13, 4500CL-E,4500E-BC,450OSO4-E,426C,4500NH3-B,4500NH3-H,4500NO3-F,4500NO2-13, 4500Norg-C,4500PE, 2510B,5540C, 52201),5310C,25406,2540C,2540D,510C,4500S2-AD, 3005A,3015,9010B,9030B. Organic Parameters: EPA 826013, 8270C,8330,625, 8082,8151A,8081A,3510C, 503013, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7,60106,7471A, 904013,9045C,9065, 420.1, 9012A, 6860, 1311, 1312,3050B,9030B,3051, 9010B, 3540C, SM 510ABC,4500CN-CE,2540G, SW-846 7.3, Organic Parameters: EPA 826013, 8270C,8330, 8082,8081A, 8151A,3545, 3546,3580, 5035, MassDEP EPH, MassDEP VPH.) Analytes Not Accredited by NELAP Certification is not available by NELAP for the following analytes: EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Di methyl naphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Chloroaniline. EPA 350.1 for Ammonia in a Soil matrix. Page 16 of 17 . :'M"w""4.,+;:c�' .:'Sipe;.;�:�:(`:•',3t�''i`�^:::U'�:a,"r..a..�?;.,;ay�,.q�a,4. ".:y"..'.aniR�w',:4 x*:`F *'�"" 6 ":fu.fu'r: o" 'aa^ .4:wrd „+�e'srj :h..*•^b�.' tw'i'.Sa^c�;4*, 't i'nz.�E•t'e •i�"+. sy+(„�•�.•`' CHAIN OF CUSTODY " '� ,.ti PAGE 1 OF wC1 «`4�!e.Cdv� b;sa 4;.kw `ti;";Ms+.,^?� za '"tea•,-••fi q� y� `�'-":';y.•�: .'"'W'x.�<```4"w �� °4:s.;•i:i+u:'a.�`"?a";>",�•..e.?:s.:<i'ti i'n.sat } �' .?': F {'`"i"z•m t •``cK 5"' .4 Project Report Information -Data Delivera• - Billing Information WESTBORO,,MA MANSFIELD,MA TEL• 508-898-9220 TEL: 508.822-9300 Project Name: Q_ ❑FAX VE EMAIL Same as Client in FAX: 508-898-9193 FAX: 568.822-3288 v � 4M*✓ ` �� u? ❑ADEx ❑Add'I Deliverables �— ject Location Pro : ,�rt,• � ��. Requirements/ReportC) Regulatory Client: Project#: State/Fed Program Criteria 00 Address: " .� Project Manager N -A CONFIDENCE O MA MCP PRESUMPTIVE CERTAINTY---CT ALPHA Quote# REASONABLE - e e t ❑Yes ❑No Are MCP Analytical Methods Required? Phone:' ❑Yes ❑No Is Matrix Spike(MS)Required on this SDG? (If yes see note in Comments) (4 Fax -. ❑Yes No - re CT RCP(Reasonable Confidence Protocols)Required? :C� .M ❑1 Standard ❑RUSH tnly_ edwpre•approved.Q Email,(� r-CC^Aolo Date Due: Time: "'�•'`^_ SAMPLE HANDLING, ❑ These samples have been previously analyzed by Alpha L+ ` men slDetection Limits: i"v> Filtration- Other Protect Specific Requirements/Com t ; ,�^" If MS is required,indicate in Sample Specific Comments which samples and what tests.MS to be performed. /Jf ❑Done (Note: All CAM methods for inorganic analyses require MS every 20 soil samples) CbKNOt needed l7 Lab to do = Preservatlon c ❑Lab to do Sample ample Sampler's , twes••ep•eiyeewwi Sam le ID Matrix Initials Time Sample Specific Comm ents - @ u ,d V ,J '•^4"'`a a�q,w�q•uq a ny .. PLEASE ANSWER QUESTIONS ABOVE[ ContainerT e �t ^�`' �"Kit!t;�e?4.�y�"sleg�I.Y�agty{L�� S YOUR PROJECT Preservative w �1 k • �.y.� �.}} s.Q2in^.o; lfatf¢ rardiidtlrnecipp :willzPo`,� Relinquished y: DateTme Received B Date/Time �§R0:13K•t�i. O, S e P��f�`'Qvs MA MCP or CT RCP $as�rp , %ml t1 A 0J`'Fyt�'go ;R t ' lR Ted C%.aq Q.on LU in._S"tip,,L eah FORM NO:01-01(rev.lBJan-2010) r ;^.,,,;�^tay.,4:��';Cr 4+;1,wyy%:y�c•,+�,i�gF' :iF.`4�Fsi,- i<c`v<<i1 V�'"a:i'4n�,��y'i'iht•�'.iry'vsZti.V�:F.'�aSA,q'f�w�.fi'"4^•`4y,ly - . BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 - LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: " Massachusetts Department of Environmental Protection 8/24/10 BEA10-10210 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Dipilato Residence 4,Gentian Circle Osterville,MA SHIPPING METHOD: Regular Mail Federal Express ❑ Certified Mail ❑X UPS ❑ Priority Mail ❑ Pick Up ❑ Express Mail ❑ Hand Deliver ❑, COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(April and August 2010) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑x REMARKS: r , Please find enclosed the DEP Inspection and O&M Forms for operation'and maintenance conducted for the above referenced property. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Mr.Joe Dipilato,Owner David C.Bennett,President[Internal], FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once • Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A A Treatment and Disposal Systems A. Installation j Important: Joe Dipilato When filling out Owner < forms on the computer,use 4 Gentian Circle only the tab key Facility Street Address to move your Osterville, MA 02655 . cursor-do not use the return City Zip key. Mailing address of owner, if different: . 4 Gentian Circle Street Address/PO Box: Osterville MA 02655 _ 'g°0f1 City State Zip (617) 571 -8470 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES,INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631, City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265. . Certified Operator Name Certification Number C. Facility/System Information = OMNI Environmental Systems OMNI,RSF DEP ID Manufacturer ID Model Number 11/16/2001 9/20/2002 Installation Date Start of Operation Approval Type: ® General ❑ Provisional '❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 4-12-2010 Inspection Date Previous Inspection Date 1"of Sludge, and No Scum Layer Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5Ll u DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems- E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 6.12 SU DO 3.12 mg/L Turbidity 26.8 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 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 A Description of any maintenance performed since previous inspection &during this inspection: General O&M visit for system functionality, and conducted field testing. Notes and Comments: System Functional, and passed field testing. a t5aiom.doc•rev.11-07-65 Page 2 of 2 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 H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 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 31 n 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, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 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 a A. Installation Important: Joe Dipilato When filling out Owner forms on the computer,use 4 Gentian Circle only the tab key Facility Street Address # to move your cursor-do not Osterville, MA 02655 use the return city Zip key' Mailing address of owner, if different: 4 Gentian Circle Street Address/PO Box: Osterville MA 02655 City State Zip (617) 571 -8470 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address " Brewster MA 02631 City State ' Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number r C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 11/16/2001 9/20/2002 " Installation Date 'Start of Operation Approval Type: -® General ❑ Provisional ❑ Piloting ❑ .Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 8-11-2010 4-12-2010 Inspection.Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 1 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 E. Field Testing Field Inspection: Color: ❑ gray ❑: brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑'moldy ❑ offensive ❑ turbid . Effluent Solids: ® no. ❑.some pH 6.55 SU DO 2.20 mg/L_ Turbidity .98 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. F. Sampling Information 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: General O&M visit for system functionality, and conducted field testing. ' Notes and Comments: F System Functional, and passed field testing. t5aiom.doc•rev. 11-07-05 Page 2 of 2 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 H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the 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 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 V'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, 6 Floor Boston, MA 02108 t ti t5aiom.doc•rev. 11-07-05 Page 3 of 3 ' 18. WATER SERVICE' LINE SHALL BE LOCATED AND MAKKtU ALLOWABLE F L 0 W PRIOR TO ANY EXCAVATING AND 10' MIN. SETBACK DISTANCE FROM SAID SERVICE TO' THE SEPTIC SYSTEM .4 TOWN OF BARNSTABLE GENERAL ORDINANCES SHALL BE MAINTAINED. ARTICLE XLVII. REGULATION OF WASTEWATER DISCHARGE 19• ALL SEWER LINES-SHALL BE SLEEVED WITHIN 6" PVC CAN 40 PIPE FOR 10' ON ALLOWABLE FLOW = 330 GPD EACH SIDE OF WATER SERVICE IF A 10' SETBACK CAN NOT BE MET. TI TL V ' 310 CMR 15.285: PILOTING-,APPROVAL SYSBRPWP61b: APPROVAL O ATLTURATINGESANDTEFILTER SYMS FOR STEM USE ' BY APPR TECHNOLOGY: OMN REVISION DATE DESCRIPTION DEP TRANSMITTAL NO.: W054298 , APPLICANT. ALLOWABLE FLOW = 660(151522 / 40,000) = 256.1 GPD - PETER MARNEY- PROPOSED FLOW = 220 GPD (COMPLIE_S) P.O. BOX 29 OSTERVILLE, MA 02655 SOIL EVALUATORS LOGPROJECT: ` TEST `H O L E 1 PROPOSED SEPTIC SYSTEM ` AT-6980 P # i 49 JOBYS INANE 6/07/88 PERCOLATION RATE: 1" IN 2 MIN OR LESS BARNSTABLE (OSTERVILLE) .MASS. , NO GROUNDWATER..ENCOUNTERED , k; DATE: APRIL, 1-9, 2005. ' ✓ ' BOTTOM OF TEST HOLE ® EL. 23 ti SHEET NO.: '1 - OF 2 � M1 TEST HOLE — 2 SCALE: As Noted PRG FILE: D O'DEA;` E.LT. CHECKED BY.• PETER SULLIVAN, P.E. ' BY: SULLIVAN ENGINEERING DESIGN BY.--, JOHN C. PREPARED BY.• ��--- 4/08/05'. EL. 35 c��l�t� �^., ILL EL 4.3 P6 . 8Inc. wA , rin ' - B LAYER 2.5Y 5/4 • - Sullivan Engines �� t` .297a ' - . . LIGHT OLIVE BROWN ,_ PO Box 659 CIVIL 17" MEDIUM SAND EL. 33.6 ` Osterville, MA 02655 C1 LAYER 2.5Y 6/4 (508)42873344 (508)428-3115 fox E S " - LIGHT BROWN A - D T 40 MEDIUM SAND L. 31.7 h C2-LAYER , 2.5Y`-7/2 1ATION 1S BASED ON DRAWING TITLE: NTITLED "OSTERVILLE WOODS" LIGHT GRAY IE, DATED MAY 1; 1971. 126" MEDIUM SAND EL. 24.5 SEPTIC DESIGN PLAN NO GROUNDWATER ENCOUNTERD' BASED ON INFORMATION, APPROX. GROUNDWATER ® EL. 13 ARNSTABLE G.I.S. ASSESSORS INFORMATION: MAP 120 PARCEL 084. MIN. BREAKOUT ACCURACY OF THOSE SHOWN IS IMPLIED OR INTENDLU. =-==_=___- 5. ALL DISTURBED AREAS ARE TO BE LOAMED,- SEEDED AND MAINTAINED =_---OMNI RSF ` 1 g '32.20 BACK SILL �nTM TO PREVENT EROSION. FILTER MODULE _-_ CLEAN FILL . ..........: :: a ou _-_- x °' - . FOR PROPER PERFORMANCE, SEPTIC TANK SHOULD BE INSPECTED AT LEAST eoI 6 AND WHEN THE TOTAL DEPTH OF SCUM AND SOLIDS .EXCEEDS ONCE' A YEAR A 1%3 THE LIQUID DEPTH OF THE TANK, THE TANK SHOULD BE PUMPED. ® � ® ® ®© 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND ACKNOWLEDGED 6 32.10 _ _ __ BY THE MASS. D.E.P. AND THE LOCAL BOARD OF HEALTH; AN �I. CONFORMS WITH THE REQUIREMENTS OF TITLE 5 OF THE MASS. SANITARY CODE. 14 31.60 I. • LINES", Y OccuRRIN� _ � NO GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED. 3 PVC RETURN_ LI 15 31:43 a OF NATURALLY TO RECIRCULATION AND PERVIOUS MATERIAL 8. TEST HOLE INFORMATION SHOWN HEREON IS LIMITED TO SOIL CONDITIONS FOUND SEPTIC TANKS AT THAT PARTICULAR , TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN 16 31.20 USE 2 GALLEYS WITH, IMPLIED OR EXPRESSED WARRANTY OF SOIL CONDITIONS BEYOND LIMITS OF 43' STONE ALONG SIDES, SUCH TEST HOLES. MAIN LINE TO 'SAS' 17 29.20 48' ENDS. 9. ALL -ORGANIC MATERIAL MUST BE REMOVED FROM THE AREA DIRECTLY UNDER ,AND BEYOND THE PROPOSED LEACHING FACILITREA Y. ON THESE PLANSWITH MUST BE BACKFILLED ,TO THE ELEVATIONS 13 •27:05 SELECT ON-SITE OR TO SOIL MATERIAL, CONSISTING OF CLEAN ` GRANULAR SAND OR OTHER GRANULAR MAT L'MIXTURESPANDRLA LAYERS MATTER AND OTHER DELETERIOUS SUBSTANCES., SHALL `NOT BE USED. -THE FILL MATERIAL -SHALL CONFORM TO MA STATE . B HEALTH' CODE TITLE 5 - 310 CMR SECTION, 15.225(3) AND SHALL HAVE cDATA. PERCOLATION RATE OF BETWEEN TWO AND ,FIVE MIN.: PER INCH, BEFORE AND - DESIGN-N _ AFTER PLACEMENT.,. r STONE MUST BE DOUBLE WASHED AND FREE FROM FINES AND .ANY - ` 1. BUILDING TYPE: 2 6EDROOM 10. ALL _• � � ORGANIC MATERIAL AND MUST HAVE LESS .THAN. 0.2 PERCENT MATERIAL - HOUSE - 2.•'DESIGN FLOW: 110 G.P.D. PER BEDROOM = 110 X.`2 = 220 •..G.P.D. FINER THAN A NUMBER 200 SIEVE. 3. DESIGN PERCOLATION RATE: .5 min/inch 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENCONTRAOCTORR CONSTRUCT C`R 4. GARBAGE DISPOSAL: N0 ' SUPERVISE THE CONSTRUCTION. OF THE SYSTEM, TH r ENT: 200� DESIGN FLOW RESPONSIBLE FOR MAKING ARRANGEMEND OFOHEA INSPECTION OF INSTALLATION •5. SEPTIC TANK DESIGN REQUIREMENT:, • OF THE SYSTEM WITH THE LOCAL BOAR 220, X 2 : 440 GAL: (USE 1,500 GAL. MIN. PER TITLE 5) ` 12. THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL AND 6. TOTAL LEACH AREA REQUIRED: VERTICAL CONTROL,OF ALL SYSTEM COMPONENTS. TITLE 5: 220 GP / (0.74 GPD/S.F.) = 297 SQ:FT. {CLASS I SOIL) VE ° .. - 13:- TIGHT JOINT .PIPING TO �CONSIST•OF POLYVINYL CHLORIDE (P.V.C. 7. TOTAL AREA PROVIDED: SCHEDULE 40,, UNLESS OTHERWISE NOTED. . EFFECTIVE LENGTH = 25; WIDTH = 12; DEPTH = 2. 14, THE CONTRACTOR SHALL NOTIFY THE DESIGN ENGINEER AT -LEAST 24 HOURS . w SIDEWALL AREA_ _ (25x2)(2) = 100 SQ.FT. IN ADVANCE FOR AN INSPECTION AFTER EXCAVATION FOR THE. i 300 SQ.FT. • • BOTTOM AREA = (12x25) _ � LEACHING BED (PRIOR TO THE "PLACEMENT OF FILUNG)• AND ALSO AFTER ENDWALL AREA (12x2)(2) 48 SQ.FT. - PLACEMENT OF PPE &, STONE PRIOR 446 SQ.FT. 15. DESIGN ENGINEER SHALL CERTIFY CONSTRUCTION 01: SYSTEM AND MATERIALS TOTAL` AREA 100 + 300 '+ 48 - _ _ - _ . •►• %I °.-c_ OF ►- tLl. _ .r,. I - 4 8 SQ.FT. -'0.4) 33i GPO ��y� 6T1L_,a U. � .. �.. � L. ' - VIDEO = 331 GPD' MATERIAL REQUIRED. AN~AS BUILT PLAN SHALL bE `SUBMITTED _TO HE LOCAL I TOTAL FLOW PRO BOARD OF HEALTH UPON COMPLETION. r ONSTRUCTION MACHINERY SHALL DRIVE OVER THE PROPOSED 16. NO RUBBERRUB BER TIRE C NOTE: SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER. SEPTIC BED -EXCAVATION DURING CONSTRUCTION. 17.-• DIG-SAFE SHALL BE NOTIFIED FOR THE PROPER LOCATION OF EXISTING UTILITIES PRIOR TO AN -tXCAVATION. `e 18. WATER SERVICE LINE SHALL BE LOCATED AND MARKED ALLOWABLE FLOW PRIOR TO ANY EXCAVATING AND 10' MIN. SETBACK. DISTANCE FROM SAID SERVICE TO THE SEPTIC SYSTEM, TOWN OF BARNSTABLE GENERAL ORDINANCES SHALL BE MAINTAINED. ARTICLE XLVII. REGULATION OF WASTEWATER DISCHARGE 19. ALL SEWER LINES SHALL BE SLEEVED WITHIN 6" PVC N00 PI ME OR 10' ON ALLOWABLE FLOW 330 GPD EACH SIDE OF WATER SERVICE IF A 10 SETBAC TITL V . - • L. 1 INIJII UNAUt AI rUUNUA11UN = L. J1.UV o _ ° 3. PIPE INV. AT FOUNDATION = 3 32.45 1 42.50 RISERS :AND COVERS TO WITHIN 4. TOP OF RSF FILTER MODULE _. 4 35.60. 12". QF. FINISH GRdA-, (TYP.) ' ;: • P, 5. INV. OF PIPE AT RSF FILTER MODULE OUTLET = 5 32.40 2 37.00 RISERS AND COVERS TO 6. BOTTOM OF RSF FILTER MODULE = 6 32,10 • Q +' FINISH GRADE (TYP.) 7. INV. OF PIPE AT SEPTIC TANK INLET = 7 32.25 8. BOTTOM OF SEPTIC TANK = 8 27.50 _ 9 36.0.0 • 12 35.60 9. FINISH GRADE OVER SEPTIC TANK = 9 36.00 • ° • " 10. I,NV. OF PIPE AT SEPTIC TANK OUTLET = 10 32.00 7 32.25 I ,:. • '' �: e. 11. INV. OF PIPE AT RECIRCULATION TANK INLET ,= 11, 31.80 12. FINISH GRADE OVER RECIRCULATION TANK = 12 35.60 _ AC 13. BOTTOM OF RECIRCULATION TANK = 13 27.05 14. INV. OF PIPE AT D-BOX INLET = 14 31.60 SUS MAP NOT TO SCALE 15. INV. OF PIPE AT D-BOX OUTLET 15 31.43 J 16. INV. OF PIPE AT START OF LEACHING FIELD = 16 31.20 3 1 32.45 ll o scHD. 40 PVC TEES ° 17. BOTTOM OF LEACHING •FIELD 17 29.20 _ ASSESSORS REF: 18. FINISHED GRADE- OVER LEACHING FACILITY = 18 35.00 10 32.00 Map 120, Parcel 084 19. TOP OF STONE = 19 32.20 I �- 11 131.80 _ ZABEC MODEL 1800 ZONE: • EFFLUENT FILTER RC & RPOD ' I 1500 GALLON SEPTIC TANK I 1000 GALLON 01 Area (mina = 87,120 sf - •=: i� H-20 LOADING PRODUCT H-20 RECIRCULAI . = ACME PRECAST MODEL OR EQUAL (NO SUBSTITUI Frontage (min). 20' Width (min)• = 100' Setbacks: , Front = 20' 6"•MIN. CRUSHED: 'STONE BASE Side = 10' 18 127.50 Rear = 10' OVERLAY DISTRICT: WP - Wellhead Protection District As Shown on Plan Entitled "Revised Groundwater Protection Overlay Districts" - April, 1993 - FLOOD ZONE: - - 0 Community Panel No. #250001 0016 D \� / July Z 1992 J i i 25 TH-2 - O W . I z 4016 PROPOSED sv5t IC ' . \ SYSTEM ram,'` o I \\ - -' 1 � z W � � � cD N, -38- PROP Rp0M oZ _ —4 ------------- a LAYOU T PLAN _ GRAPHIC S C ALE . 20 0 10 20 40 9 00. .. IN FEET a ' 1 inch = 26 it. - t ino SCHEDULE OF ELEVATIONS .� SEWAGE • ° •`� 1. FIRST FLOOR = 1 42.50 ' 2.. FINISH GRADE AT FOUNDATION = 2 37.00 . " 3.` PIPE INV. :AT FOUNDATION = 3 32.45 F RISERS AND COVERS TO 1NITHIN o 4. TOP OF RSF FILTER MODULE =. 4 35.60 12��` .,:.QF.,,FINISH GRADE (TYP.) 5. INV. OF PIPE AT RSF FILTER MODULE OUTLET = 5 32.40 7.00 - TO 6. BOTTOM OF RSF FILTER MODULE 6 32.10INIS RA RISERS AND COVERS, Q FINISH GRADE (TYP.) 7. INV. OF PIPE AT SEPTIC TANK INLET .7 32.25 8. BOTTOM OF SEPTIC TANK = 8 27.50 9. 36.0 112,135.60 0 �� ' 9. FINISH'GRADE OVER SEPTIC TANK 9 36.00' • 10. INV.' OF PIPE AT SEPTIC TANK OUTLET = 10 32.00 o; 0. 11. INV. OF PIPE AT RECIRCULATION' TANK INLET = 11 31.80 - �'f� 12. FINISH,GRADE OVER RECIRCULATION' TANK 12_ -35.60 AC •'' ' - + ►p •' 13. BOTTOM -OF RECIRCULATION TANK 13 27.05 - `ti +� 14. INV. OF PIPE AT .D-BOX INLET = 14 - 31.60 - _ - ,CUS MAP -NOT TO SCALE 15. INV. OF PIPE AT D-BOX OUTLET 15 31.43 , 16. INV. OF 'PIPE AT START OF LEACHING FIELD 16 31.20 3 32 45 - 17. BOTTOM OF LEACHING FIELD 17 29.20 • O SCHD. 40 PVC TEES ASSESSORS REF.. 18. FINISHED GRADE OVER ,LEACHING FACILITY 18 35.00 10 32.00 Map 120' Parcel 084 19. TOP OF STONE T . 19 32.20 . =: 11 31.80 ' f ZABEL MODEL 1800 EFFLUENT FILTER j ZONE: _ RC & RPOD ' 4' ''�• � � 1500 GALLON. SEPTIC:TANK � - 1000.GALLON G Area (min.) 87,_120 sf �� H-20 LOADING PRODUCT'.' H-20-RECIRCULA Frontage, min 20' _ ACME PRECAST MODEL OR EWAL NO SUBSTITU 9 . ( ) Width (min), _ , 100' • Setbacks: Front = 20' 6"• MIN. CRUSHED: STONE. BASE , Side 10' 8 27.50 .6 Rear OVERLAY DISTRICT": � - 'WP - Wellhead Protection District i As 'Shown on Plan Entitled "Revised Groundwoter'Protection - Overlay Districts" - April, 1993 FLOOD ZONE: Zone C. Community Panel No. ,#250001 ,0016 D. Jul • 2 1992 Y A05 2� �� Wig / /� • GENERAL NOTES EM PROFILE 8c DETAILS OT TO SCALE 1. . ALL CONSTRUCTION AND -MATERIALS SHALL CONFORM TO MASS ENVIRONMENTAL CODE (310 CMR 15.00,TITLE 5). AND THE LOCAL; BOARD',•OF HEALTH. 2. THERE SHALL BE NO CHANGES MADE IN THIS PLAN WITHOUT THE WRITTEN 4L HAND HOLE PERMISSION OF THE. LOCAL BOARD OF HEALTH: MULCH 3. ALL ERRORS, OMISSIONS, AND CHANGE OF CONDITIONS AT THE SITE SHALL COVERING: BE BROUGHT TO THE ATTENTION OF THE. ENGINEER PRIOR TO PERFORMING THE 1 1/2' PRESSURIZED S=2% MINIMUM RELATED WORK. PVC LINE S=1% MIN. 4. THIS PLAN HAS BEEN PREPARED SPECIFICALLY AS A SEPTIC SYSTEM DESIGN AND 4 35.60 IS NOT TO BE USED TO ESTABLISH PROPERTY LINES OR BUILDING SETBACKS. - 18 35.00 PROPERTY LINES AND BUILDING LOCATIONS ARE ,GRAPHIC ONLY, PROPERTY LINES MIN.-BREAKOUT NOT HAVING BEEN .VERIFIED. NO REPRESENTATION OR CERTIFICATION AS TO THE., ACCURACY OF THOSE SHOWN IS .IMPLIED OR INTEND15 ED. OMNI RSF i X BACK FILL WITH 5. -ALL DISTURBED, AREAS ARE TO BE LOAMED, SEEDED AND MAINTAINED FILTER'MODULE_`=_• a 19 32.20 CLEAN nLL TO PREVENT EROSION. 6.. FOR 'PROPER PERFORMANCE, SEPTIC TANK SHOULD BE INSPECTED AT LEAST ONCE A :YEAR AND WHEN 'THE TOTAL DEPTH OF SCUM ,AND SOLIDS EXCEEDS ; 1/3 THE.. LIQUID, DEPTH OF THE TANK, THE TANK SHOULD BE PUMPED. 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND ACKNOWLEDGED ® ® ® ® ®® cU D OF HEALTH; .AND 6 32:10 - _ __ - BY THE MASS. D.E.P. AND THE LOCAL BOAR 14 .31.60 CONFORMS WITH THE REQUIREMENTS OF TITLE 5 OF THE MASS. SANITARY, CODE. " 3' PVC :RETURN LINES: .- 4• aF NAruRALLY occuaRiNe NO GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED. TO RECIRCULATION AND; 15 31.43 PERVIOUS MATERIAL'.SEPTIC TANKS 8. TEST HOLE INFORMATION .SHOWN HEREON 1S LIMITED .1'0 SOIL CONDITIONS FOUND SE - AT THAT PARTICULAR TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN 16 31.20 USE 2 GALLEYS WITH - IMPLIED OR EXPRESSED ,WARRANTY OF SOIL CONDITIONS BEYOND LIMITS OF 43' 'STONE ALONG SIDES, SUCH TEST HOLES. MAIN LINE TO 'SAS' , 17 29.20 48' ENDS. L 9. ALL ORGANIC MATERIAL MUST'*BE REMOVED FROM THE AREA DIRECTLY UNDER AND BEYOND THE PROPOSED LEACHING FACILITY. - THIS AREA E BACK LL D T A 'MUST B FI E 0 THE ELEVATIONS INDIC TED ON THESE PLANS WITH 13 27.05 - SELECT .ON-SITE OR IMPORTED` SOIL -MATERIAL, ;CONSISTING ;OF CLEAN GRANULAR SAND OR OTHER GRANULAR MATERIAL, FREE FROM ORGANIC . MATTER AND OTHER DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS SHALL NOT BE USED. THE -FILL MATERIAL SHALL CONFORM TO MA STATE HEALTH CODE TITLE 5 310 CMR SECTION 15.225(3) AND SHALL HAVE - DESIGN DATA PERCOLATION 'RATE OF; BETWEEN TWO .AND FIVE` MIN. PER INCH, <BEFORE AND AFTER PLACEMENT. - - - -. 1 - 1. BUILDING TYPE: 2 BEDROOM HOUSE 0. ALL STONE MUST BE DOUBLE WASHED AND FREE FROM FINES AND ANY = 110 x 2 = 220 G.P.D. ORGANIC MATERIAL AND MUST HAVE -LESS THAN 0.2 PERCENT MATERIAL 2:, DESIGN FLOW: 110 G.P.D. PER BEDROOMFINER THAN. A NUMBER 200 SIEVE. 3. `DESIGN PERCOLATION RATE: 5 min/inch 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENT TO CONSTRUCT OR 4.- GARBAGE DISPOSAL: NO SUPERVISE THE CONSTRUCTION OF THE SYSTEM.; THE CONTRACTOR IS 5. SEPTIC TANK DESIGN REQUIREMENT: 200� DESIGN FLOW RESPONSIBLE FOR MAKING ARRANGEMENTS FOR 'INSPECTION OF INSTALLATION 220 X 2 = 440 GAL. (USE, 1,500 GAL. MIN. PER TITLE 5) OF THE'SYSTEM WITH THE LOCAL BOARD OF HEALTH: 6. TOTAL LEACH AREA REQUIRED: 12. THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL AND 0.74 GPD S.F. _ `297 SQ.FT. (CLASS I SOIL) VERTICAL CONTROL OF ALL SYSTEM COMPONENTS. TITLE 5: 220 GPD / ( / ) 7. TOTAL AREA PROVIDED: 13. TIGHT JOINT PIPING TO CONSIST OF POLYVINYL .CHLORIDE {P.V.C.) SCHEDULE 40, UNLESS OTHERWISE NOTED. - --- .� .• � Inc^ i ti � wpm m � t EE bTE. a ALL CONCRETE PIER BASED ON TO EC VMFIWWH ME 13YHO COMRACTOR W .� - PRIOR TO POLRLNS BA9m ON Gp6TTL1LT10H METHOD AND 94PAN5 . rra 7'-IV 9'-29H•. a' 6'a IS-w• 5-.• '77... sw m --- - z �J J F P b _- W N • , 1 r rr . • r r , ------------ I - rr , r " I3%IO GIRDER '. ______________.______ , --- ----- rn ---- ---- --- -----------" -ORY WHEY iDI/OATWN 1 ( , CLENIWrFOR CNDTEY W �VOW R� � i FOR CNMEY ORNW6E . - PROVIDEFQWATCN D'WCRETE FOMATION WALL FOR FIRMLKE ABOYE. < i. HRH e'x TV CONCPETE FOOTIH5 PROVIDEI .FOORNS MN.48'CCLM FINL916RAVE W OFF FK OF FT'D RNL 1 - - T1PIO4 ALL NVES .•T.ONLRETE J1B OVBL a ML. - I - I K m POLY-VAPOR BARIUM TrP+rx I: 1 ! 5W x 90•x W THGL C4WjWM PADS FOR LN.LY LOI.D7£a,TPKK IMiFS i I z 0r1iPNSE NOTED. ` 7 i 2S4• 7-7 It` T -B' 7/.• e'er 9/.' b'-I 1f4• 54 S''T I 1 � • r � ^� r , r — —. _ I • --------- ----------- i •------ `- _ t11 ..W-0 VA, 3:.C'• �:IW'X BE STEEL R-0' Po+�s•carr�Te 9J•B B6•x sD•x ra Twrx ^� I YfTH IVlF.AT MD-D�iN oYBt� CONCRETE PADS FOR - `P e ML POLY-VAPOR BMi6LRTt LALLY CT.1eD6 • SR LN A LED OF SND \` PJ D x 111!L• - t . FwYlce CAM FcrArT7 - 1 � i' -r C4 WERE• B•COHooEIE PoLT�ATION HALLIUTH B•%15•.CONORETE FOOTIM - z 49•EBDW FIN W 6RADE O HOL - �--e•caaGRETE FOVOATIOlI wu JL F q �' • I Mk.e•x IEFlaI R6RNx: I ' r ' ' I r , • 1 � z 91.OPE AA0 SLI6HiLY r ' 0 ii TONARD'VENKAE � -_ •__p_____________________- - I i , GP171ML4'.TTP r ,_- . i , i r i i 4 --.- _-fi . r i O - r , r r � A I I ry - _ 7q' l 9'-0'. bs'q• 1 FOUNDATION NOTES- j A A� I. ALL WORK SHALL COWRY WRN THE MASSACHU5 TT5 STATE_ -- ELML IN CODE-TDO ALL MUI GIPC�E ORDINAW-E5 ANDR elb-ONE AND B-LAWSY pWELLIN6 LODE, i K FOUNDATION PLAN O, coNC-RETE SHALL SE MINIK M 5pOo P51 REVISIONS ' - SCALE.1/4" 1'-0' AT SH DAYS OR AS SHOWN OTMERYB5E. _5. STEEL.f+EINFORLIN6 SHALL BE ROLLED BILLET Oq.lgpr 6BB1AL STEEL CONFOR H6 To ASTM A615.6RAOE 60- - f 4. CONCRETE SHALT.BEAR ON SUITABLE NRJISTVRBED EARTH. TOO NOT RAGE CONCRETE IN WATER OR -- — ON FROZEN 6ROUHO. JI . 1 ®� 5. RO06H OPENN6 SIZES FOR B•'VENT DOORS.WINDOWS 6 VENTS I TO BE VERIFIED BY CONTRACTOR BEFORE POVRIN6 ,T �y ANY CONCRETE,TYP. CJO: t 1'p7'/I1'�/�//�,1 11 e-REST ALL FOOTINY ON FlRM NAINiAL 6RAWLAR MP`TERI'''L FREE F'RC9i TOPSOIL,OR6AWG5 OR GLAT HAVIt45 A MIMnMI (� .//J 1/ SOLL BEARING OA IL,OR OF I IR TONS PER SOUARE FOOT. ��; - • C`• �� - 1�,Lr(////�./1 IIy �(///�/�Co MECHANICALLY CgMPAOT SIEf6RA.DE BEFORE FORMING�OOTIN65 07-2'-05 ' CONSTRUCTED WITH CONTROL JOIN?5 HAVING A _ - ,�.. DEFTH OF AT LEAST 114 THE.,LAB THICpES5 EUT NOT LESS THAN 6` ONE INCH,AND JOINTS SHALL BE SPACED AT INTERVALS mc0.MORE THAXSIFI!ETINIIA SNAPS ALL HAVEE CONTROL.IOINTS•kRRO`f T REG'AD AT A POINTS 0 WIT.IF OCMR56 EEV5TEN FEET?AIm LNB ATM�P i U �Q I z I II � O v li - et E STOLE SLAt= PATIO Q 9M1XlEAO L p I t� r-J V4' �O rQ 6'Q O' Z S JDa .a � I is U NI I 1 - eoee _ _(�19y�4'X9L4'I.Vl!•,,_, v+'.ID tFAmt1 4 _ . warWIM Iw.L wlll A -'I T9 •>'° " IVa1 D IrELawrul _-- I I � j � "v S s � >• 3 u a-IB Vv gam• rm� �� ' 4 I - _ ` i � � I ur _ t KITOGI Y pYVR' x_ t 3, x� ,� +b,y4 `pO✓� t,+b,y 4�b •F (/ � 9Ery jG..+— s-0VY ti' _, ___TO x90 WA ._._'_'_ - 9 I Q IIJII?'1'x9 W-Vt9 3'�V�' � H 6'-It V7 I'a I 7-a Vf D'O' C � e .LA GL 1 •TJI`S � I lll�LIT i • IY ' I ^ -47V]•'IdY - L'• IA-OI VENT -0 VJ I � I Fnav�s/B'TT.e x•cxrlwL I o Irl. .1 ` � �ti °-0 � I Fa oI oR' nrtale Pool+ . AD94 s 1 'i ENIPY I =�= F Czl IT r______________.t 1 P�11lI' 4.9 1____________; i I E- ' I � I i I ram. JB96 f i F YaM tRA1CalE. �� I 1 MTH TPAICOIs ABWE 008. Y 1 �I ' I- HE VISIONS A-4 IOT-If05 6F1�.^y I TGd 5.F. FItJ51��AIiEM Oa31-05 KI:A9 FIRST FLOOR PLAN Z_ x•LE,I/^ 1'�' Ilf iC17-21-05 - - I • t �� 1 --% l A o m ti411 n� U 4 ~ m ! I h bRAPIERS ^i UI]� e•oc. � m y� ]x n RmeE i z m ioTriG I] RAFT U V :%O RAPTFlYS _ u D O � �n N'OG12 (� y tw nF y/ b nF 1] z l A•-T V7 9-0 Y4 W-0 91 0 Y L4• 74 9/4• 114• Z n� w SQQF PLAN _ El - . 5L 5 Ve•.P-0• ... ]e4e ` ]e+e -- ]!+! .-_..----- 7DM —._3D�e _.. 2w -. Q � I 4 x r ='I i y mpg ilk p BNGORr BEDROOM] -71 I i � Sb l� avcDRr I I J VA SF. LPBITo133OM d VY I�'-O' t ---"--- 4 a R' s § l 0 O L aT'-Ip 9/4' l'-ID 3r<• 4'-]• 9'-1 3/4 S9 V4• 4'-]W4• 7- S4 V,• 9-10 V4• i... — .. !! AJ I 5EGOND FLOOR PLAN FINISHED•AREA GA4..E�v,• ro• C-ENERAL REOUIREMEW5T i r. ALL DINETLSIONI ARE To rA E OI'STUD LTy[gS EmwATED OTrERWISE. ..-_- 7. All EXTERIOR WALL T'RA)TIIL'.SHALL Be]x e LO15TfelLTION l REVISIONS ARD ALL INTEArOR IYMl FRAMINe WM BE 7%4 LONSTR VM VIIIEA I O I—tt9E NOTCD. i �. ALL I'!]RC SHALL LO-PLY WITH TIE W.•s+/•cMbETTS STATE Ml—LODE.TDO LMR l ./v ONAPIER%-OIE AND TWO—LY T—.—LOGE.ALL IY.NtLiPALITY OROINANLES AND BY�A.WS. i FOR FN.M APPLICABLE TTtADE. SHALL 1$T OR ExL®IYL06NIIID INDU`TRY 5. REFER TO O TIC.pRAMNYJ AS PART OF Tn9 9ET FOR MORE OET—RLLVIREMEHT9. I �I I i+E6ARDIN6 EUILDING IMTERIALS.POJtmATIOHS AND STRULTURIL DESIGN LRITERIA , Rey e. ylorx DE-ec-aR LOCAnors NAVE BAH sNovo+off THE PUNS TO Lor4°LY"N n I 0501 S.OG—..._ . t REgIIP[MLITJ OP•r00 cMR 9607.1e-FIRe PROTl4TION 9`fST[MS.MOYRVER tNG ARGAl14GT �^i �Mq No gpgPOM31BILrtY FOR THE D[SISK FIHrLL RALENENT,OPERATION OR WAINTENAMLE --- RtOLEDLRES OF THE IYr15E1171D FUtE WARMN3 SYS . •.• 02-25-05 QLL EWR>E<t5TIN6 rvilllOMt RELOCATED L� DErELTOR SIZE-] M.CLE'J YU1dbH �j NEAT pE;TELTOt f1'LYLD7)•I WM m MILLED To YpIDOI MOOR I .I A-2 Ill o U 1 N NOTE - }{1I —._—— ',.� ALL CONCRETE PIER LOCATIONS TO BE VERIFIED BY CONTRACTOR (9LZ x IZ PT:6IRDL�' _ U — — PRIORTOPOURINGBASEDONCON5TRUCTIONMETHODAND5PAN9 il____________ --- - ------- - ----- I ---- 10'VIA.CONCRETE MER5 FOR FRAMING l7 ABOVE(TO BE LOCATW BY 40MRALTOR Z h ACCORDANCE IWTH ISO CM 2' • 9-E 19'HO' 2'b' 4'-2 9/4' 2'-b' 4'-IC E•-0' 15, • 5'-4• 2 ui , 1 r , ui v �' ° _ m o , n = - CID-- , (91 2%2GIRDER w - ____ ___________ _____ _ _ r i O PROVIDE B"MA.AdRY 4 U ' '_{` CHIMNEY fOLNDATION T PROVIDE MASONRY AID_ CLEA/ICVT FOR CHiM --J U PROVIDE 6'5CUARE 'HOLE'IN FOOTING 50 so FOR CHIM,EY VRAINA6E PROVIDE FOUNDATION . B'CONCRETE FOUNDATION WALL ' FOR FIREPLACE ABOVE. MUTT B'%Ib'CONCRETE FOOTM6 PROVIDE COL'.FOO 4& MIN 481 ELOIN FINI5H&RAVE _ 6-OFF FACE OF FlD W.LL "p TYPICAL ALL 51DLi 4-CONCRETE aAB OJFR 6 MIL - 'x C m POLY-VAPOR BARRIER,TYPICAL W.%SO-%15,THICK CONCRETE PADS w O Z FOR-ALLY COLU"25,TYPICAL UNLESS 4 OTHITRA E NOTED, (1', b m �--0. 2'-31/4' T,-g� 9/4' 6'-4 9/4" 6'-I 1/i" 5'-9• 5.4' ".• y' MAY. - - 4 ' �_________ ____ _____ ________ I ' o ' - --- ' I - - 2 x I2 61RD1 �. - - - - - --0-I---T-a-- -- r , , L* , D'a Irz• 1 TOE sreEL. n'-6• .x, 1 PROVIDE 5'LONCRETE XAB'�7 L—%'%%'X A15 THICK _ C� WITH=IYIF.AT MID DEPTH OlEft �---r C CONCRETE PADS FOR ---ttT .6 MR POLY -VAPOR BARRIER L COLUMY ALLY SET ON A BED OF 54V . • T PRIMDC.'.EAM POCKETS �".• _ ' _ '� YiERZ 5HO ,TYP. - ' a PROVIDE SAHCUT - - - , p" - CONTROL JOINTS - , MHE�E SHOM D'CONCRETE FOUNDATION WALL YNTI B'.X Ib'CONCRETE FOOTN6. - MN.48'Mor(FINISH GFADE tt�� <—D'CONCRETE FOUATION WALL `-O ND ]' Q WI H D'x I6'CONCRETE FOOTING _____ ___ _ _ 7 F M'.N.4H'BELOW FINI:M CrADE � ' ' ,. - r ' SLOP[SLAB XI6MLY ' ' O TOYIARDS VBIICLE ____ ___ OPENINSS,TYP __ _ .T_______________ I m I, 1 ---------- ---- - ______ ___ ____ ___________._____., a . V-V - FOUNDATION NOTES: A 4 I. ALL WORK 5KALL COMPLY WITH THE MA55ACHUSET15 STATE ��•`•'�•'a•" BUILDING CODE-TDO CMR,CHAPTER Be,-ONE AND TWO FAMILY ��o�n��p0X1R•"•°' DWELLING CODE,ALL MUNICIPALITY ORDINANCES AND BY-LAWS. OUNDATION FLAN 2, CONCRETE SHALL Sr MINIMUM 3p00 PSI REASIONS ' SCALE.I/4"•I'-0" AT 26 DAYS OR A5 SHOWN OTHERNI5E. 3. STEEL REINFORCING SHALL DE ROLLED BILLET • STEEL CONFORMING TO A57M ABI5,&RAVE 60. 4. GONCRE-TE SHALL BEAR ON SUITABLE IMDISTURDED - EARTH. DO NOT PLACE CONCRETE IN WATER OR ON FROZEN GROUND. _ 5. ROUGH OPENING SIZES FOR BASEMENT DOORS,WINDOWS R VENTS TO Be VERIFIED BY CONTRACTOR BEFORE POURIN& • ANY CONCRETE,TYP. OSOIS.00 6.REST ALL FOOTINGS ON FIRM HANRAL GRANULAR MATERIAL FREE FROM TOPSOIL,ORGANICS OR CLAY HAVING A MINIMUM 501L BEARING CAPACITY OF 11/1 TONS PER 50UARE F ' . MECHANICALLY COMPACT SU56RADE BEFORE FORMING FOOOT. OTINGS. k02t65 - 1. SLABS SHALL BE CONSTRUCTED WITM CONTROL JOINTS HAVING A DEPTH OF AT LEAST I/4 THE SLED ACBV AT NTE NOT S NO THAN ONE INCH,AND JOINTS SHALL DE SPACED AT INTO-RVALL NOT MORE THAN - THAN BO FEET IN EACH DIRECTION AND SLABS NOT RECTANGULAR IN SHAPE SHALL HAVE CONTROL JOINT5 ACROSS THE 5LA5 AT f POINTS OF OFFSET,IF OPFSE7 E%cEED5 TEN FEET,AND IN ACCORDANCE WITH lDO CMR 56055. Al n; U ' OPEN OEGR z z -7 5(4'5'-4 5/4' 9'-4 5/4' I'-Z 5'-]I/4' 4'-0' b'-0' 4'-0• 15'-]In' -11 9/4' Z'-T' �Ly W 3646 O • _pp N ''� S W 6068 iv ... RVS bObb A]51 �M 2042 _ RAIS HEARTH PANTRY 1 7/b 1 I . y f111� m 1p :p 1 BATHER V LIVING ROOM U 4'-10 1/4• R i im '4 - - - c - n�1 _ p w . WORM I 10-4' QTLHBi '4 Z]'-41n's/4• !'� ` T-5 n' s-4 In• x O� eT I C. ________________I b '� -__ N�Q� !91]X 10 5'fi V3� &Oxb-9 c0 5-GXb-B CO no x 30 Pu15H (3)13/4•X9 V4�'LVL5 b'-II in' O'-d I/4' 8-0' Z-0 I/4" �4. is E- T E �;� Y II'-0 I/]' u•-8 Irz" I x 4•-]In'. "y - I GARAPc SEPARATION MASTER 5EDR00M - PROVIDE 5/b'TYPE•X•DRTYULL N ( • I TYPICAL WALL5 AND CaLIN65 DININSROOM, � T _ OPEN TO _ 7 1_ I ABOVE LP < ]Yb WALL WITH Q' 2 CAR GARAGC 9'-T' b'BAIT INSULATIONHV _ f FOR 50UND [�y r______________� r_ -_____- EMR1' 7T ItZ O •. I I I i I �� 1846 2846 1_ - - - - I I I 2b46 x • 1 WI�•7RANSONG A80JE�� 1 HIiM T4"PROVE�D� w 7e gi- r ` b'-3' II'•6' b'-3' 341/Z' T'-Z In' a T-4' S'-I' -W-5117• B•-15/4' 41-105/4• E ' Rx A �aarra�ma,�vo� A-4 GENERAL REOUIREMENT5: - • r C o RL"VISIONS I� 1 IR5T FLOOR LAN FINI5HED AREA•1-100 S.F. I. ALL DIM® ICH5 ARE TO FACE-OP 5TUD VNLE55 INDICAIL-0 OT —I`..C-. - — 5CALE:1/4"a V-O' 2 ALL EXTERIOR,WALL FRAMING SMALL BE]X 6 CONSTRUCTION AND ALL INI-RIOR WALL FRAMING�1ALL BE]H 4 CONSTRUCTION UNLESS OTHERWISE B. ALL WORK SHALL COMPLY WITH THE MAJAGWSETFS 5TATE WILPNN GORM,T60 LMR - CHAPTER Jb-ONC AND TWO FAMILY DWELLING CODE,ALL MINICIFALITY ORDINANCES Alm BY-LAW5. 4. ALL WORKMANSHIP AND WILDING MATERIALS SHALL MEET OR[✓GEED RECOGNIZCD INDUSTRY - STANDAROS FOR EACH APPLICABLE TRADE. 05015.00 v. RCFER TO OTHER DRAWINGS A5 PART OF THIS SET FOR MORC DETAILCD REGVIREMEMS RE-1N6 SUILDIN6 MATERIALS,FOUNDAT'IOH5 AND STRLk TURAL 005ION GRITERIA. b. SMOKE OETE-GTOR LOCATIONS HAVE BEEN SHOWN ON TIE PLANS TO COMPLY WITH TNC l� REOJIREMENTS OF TBO CMR 3603.1b-FIRE PROTECTION SYSTEM5. HOWEVER,TIE ARCHITECT 02-25-05 BEARS NO RESPONSIBILITY FOR THE DESI6N,FINAL PLACEMENT,OPERATION OR MAIM--NANCL- PROCEDURES OF THE HOV5CHOLD FIRE WARNING 5YSTCM, CEILING Nyen WR i E -EXISTING WINDOW TED RELOCA DETECTOR SIZE-2 c MULLED WINDOW 1 HUT DETL-CTOR AILLED)=TRANSOM HAJSD TO WIIP OKVOOR - w - t,. D ti 'a -- ZN%10 RAFTERS 12 Ib"OO. ' 121. 2 A 12 RIDbC • - 16"O.C. ll 121 12r v L 12 12'-21/2' 15'-T Irz' 5'-05/4" I2'-B I/4- 10'-5' 5'-05/4' S'-O5/4' 5'3 A. 9 V 12 ROOF PLAN 2846 28 2D46 28 2646 2846 2b46 uj b'-I It) � Z ` Q r OC )I, 'A BALCONYBEDROOM 2 ' UNFINISHED •7r a E BALCONY Y 650 S.F. OPEN TO BELOW I 15-21rz' 4'C - -_------ _ Q-I 0 2 -IO W4' T'-IO 3/4' 4'-2' 3-T 5/4- 2'-9 1/4- 2'-9 1/4' 4'-2 S/4' 2'-9 1/4' 2'9 1', 9'-10 1/4" c " SECOND FLOOR PLAN FINISHED AREA=e9s s.r-. 5GALE:114" P-o^ GENERAL REQUIREMENTS: Vr-9kr�&°6Pm%. M G°A IR, . I. ALL nu-¢Nslorvs AR[To FACE Or sTw uNLess 1NDICAiED 0TSrsw155. - 2. ALL E%TERIOR WALL FRAMING SHALL BC 2%b GONSTRUGTION RE MSIONS AND ALL INTERIOR WN.L FRAMING SHALL OE 2%4 C t45 i1CTION MLE55 • - OTHZ—EEC NOTED. -- 9. ALL WORK SHALL 60141LY WITH THC MA65A—TT5 STATE--I-COD[TBO — GHAP 3b-ONE AND TWO FAMILY DWELLING GODC.ALL MUNICIPALITY ORDINAN-5 AND BY-LAWS. " -4. ALL WORKMANSHIP ANO BUILDING MATERIALS SHALL MELT OR CNCEED SC006NIZC0 INDUSTRY STANDARDS FOR GAGH AW' GI -I—C TRAOC. 5. REFER TO OTHER DRAWINGS A5 PART OF THI5 5ET FOR MORE DETAILED REw1 -HCNTS REGARDING BUILDIN6 MATERIALS.FOIMDATIOI45 AND STRUCTURAL DE516N MATE-- • i ` b. SMOKE DETECTOR LOGATION5 HAVE 0-CN SHOWN ON THE FLAW,TO COMPLY WITH TNC [^05D15.00 REfdIIREMEMS OF TBO.MR 5 31,-FIRE PROTECTION SYSTEM5, HOWEVER,THE ARCH'— ' - BEARS NO RC ONSIBILITY FOR THE VIZV6N,FINAL PLACEMENT,OPERATION OR MAIHTCNANCE PROGEDLRCS OF THE HOUSEHOLD FIRE WARNING 5Y5TCM. �J�6rIL[W HEI6HT 02-25-05 ~I/ EWR EXISTING WINDOW RELOCATED {7 eo SMOKE DETL-GiOR .5IZE-2=MULLED WINDOW c w HEAT OCTECTOR MA.LCD)=TRANSOMM/1E0 TO NINOON4�OOF A lF 1 .n e, a� 0 SCHEDULE OF ELEVATI ON S • ` r° �,ti SEWAGE SYSTEM PROFILE & DETAILS GENERAL NOTES 1. FIRST FLOOR = 1 42.50 2. FINISH GRADE AT FOUNDATION = 2 37.00 NOT TO SCALE e 1. ALL CONSTRUCTION AND MATERIALS SHALL CONFORM TO MASS ENVIRONMENTAL 3. PIPE INV. AT FOUNDATION = 3 32.45 CODE (310 CMR 15.00,TITLE 5), AND THE LOCAL BOARD OF HEALTH. h AJF2137.001 RISERS AND COVERS TO WITHIN 4. TOP OF RSF FILTER MODULE = 4 35.60 12" OF FINISH GRADE O WI ELECTRICAL HAND HOLE 2. THERE SHALL BE NO CHANGES MADE IN THIS PLAN WITHOUT THE WRITTEN 5. INV. OF PIPE AT RSF FILTER MODULE OUTLET = 5 32.40 MULCH PERMISSION OF THE LOCAL BOARD OF HEALTH. yea 6. BOTTOM OF RSF FILTER MODULE = 6 32.10 RISERS AND COVERS TO 3. ALL ERRORS, OMISSIONS, AND CHANGE OF CONDITIONS AT THE SITE SHALL a ` +'`` 7. INV. OF PIPE AT SEPTIC TANK INLET = 7 32.25 FINISH GRADE (TYP.) 1 1/2' PRESSURIZED COVERING - BE BROUGHT TO THE ATTENTION OF THE ENGINEER PRIOR TO PERFORMING THE • S=2/. MINIMUM •• PVC LINE RELATED WORK. 8. BOTTOM OF SEPTIC TANK = 8 27.50 9 36.00 12 35.60 S-1% MIN. 9. FINISH GRADE OVER SEPTIC TANK = 9 36.00 7 32 25 4 135.60 4. THIS PLAN HAS BEEN PREPARED SPECIFICALLY AS A SEPTIC SYSTEM DESIGN AND 'a © 10. INV. OF PIPE AT SEPTIC TANK OUTLET = 10 32.00 IS NOT TO BE USED TO ESTABLISH PROPERTY LINES OR BUILDING SETBACKS. fit, ' "' 11. INV. OF PIPE AT RECIRCULATION TANK INLET = 11 31.80 - _ 18 35.00 PROPERTY LINES AND BUILDING LOCATIONS ARE GRAPHIC ONLY, PROPERTY LINES ' - -II _ - MIN. BREAKOUT �•'�3 0i ., ; � � a I, 12. FINISH GRADE OVER RECIRCULATION TANK = 12 35.60 _ _ _ AC _ _ , ,, ,_ CERTIFICATION AS TO THE NOT HAVING BEEN VERIFIED NO REPRESENTATION OR r, •,. • , '`i' ACCURACY OF THOSE SHOWN IS IMPLIED OR INTENDED. e 72 13. BOTTOM OF RECIRCULATION TANK = 13 27.05 :.�� --� --------- 15' = FILER RSF 5.z X BACK FILL WITH 14. INV. OF PIPE AT D-BOX INLET 14 31.60 5. ALL DISTURBED AREAS ARE TO BE LOAMED, SEEDED AND MAINTAINED .,: _ ,.. .. =•• - � __. �� 19 32.20 CLEAN FILL TO PREVENT EROSION. 15. INV. OF PIPE AT D-BOX OUTLET = 15 31.43 -- - LOCUS MAP NOT TO SCALE -==-=----- o• eox -� 6 16. INV. OF PIPE AT START OF LEACHING FIELD = 16 31.20 3 32.45 . FOR PROPER PERFORMANCE, SEPTIC TANK SHOULD BE INSPECTED AT LEAST 17. BOTTOM OF LEACHING FIELD = 17 29.20 ` o SCHD. 40 PVC TEES '_ ONCE A YEAR AND WHEN THE TOTAL DEPTH OF SCUM AND SOLIDS EXCEEDS ASSESSORS REF.: 18. FINISHED GRADE OVER LEACHING FACILITY = 18 35.00 = 10 32.00 5 32.40 ® ® ® ® ®® 1/3 THE LIQUID DEPTH OF THE TANK, THE TANK SHOULD BE PUMPED. 19 32.20 ® ® ® ® ®® ` Map 120, Parcel 084 19. TOP OF STONE _ �- 11 31.80 '_ ® CM ® CS ®Em N " 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND ACKNOWLEDGED • _ _ _ _ _ _ BY THE MASS. D.E.P. AND THE LOCAL BOARD OF HEALTH; AND ZABEL MODEL 1800 14 31.60 CONFORMS WITH THE REQUIREMENTS OF TITLE 5 OF THE MASS. SANITARY CODE. • EFFLUENT FILTER 3' PVC RETURN LINES ZONE: * - - -r T❑ RECIRCULATION AND 15 31.43 4. OF NATURALLY OCCURRING NO GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED. SEPTIC TANKS PERVIOUS MATERIAL RC & RPOD _ 1500 GALLON SEPTIC TANK 1000 GALLON oMNI RSF" 8. TEST HOLE INFORMATION SHOWN HEREON IS LIMITED TO SOIL CONDITIONS FOUND H-20 LOADING PRODUCT H-20 RECIRCULATION TANK AT THAT PARTICULAR TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN Area (min.) = 87,120 sf s- := 16 31.20 _ ACME PRECAST MODEL OR EQUAL (NO SUBSTITUTIONS) USE 2 GALLEYS WITH IMPLIED OR EXPRESSED WARRANTY OF SOIL CONDITIONS BEYOND LIMITS OF Frontage (min) = 20' '' MAIN LINE TO 'SAS' 17 29.20 43' STONE ALONG SIDES, SUCH TEST HOLES. Width (min) = 100' ' - 48' ENDS, Setbacks: 9. ALL ORGANIC MATERIAL MUST BE REMOVED FROM THE AREA DIRECTLY Front = 20' 6" MIN. CRUSHED STONE BASE UNDER AND BEYOND THE PROPOSED LEACHING FACILITY. THIS AREA Side = 10' 18 127.50 13 27.05 MUST BE BACKFILLED TO THE ELEVATIONS INDICATED ON THESE PLANS WITH Rear = 10' SELECT ON-SITE OR IMPORTED SOIL MATERIAL, CONSISTING OF CLEAN GRANULAR SAND OR OTHER GRANULAR MATERIAL, FREE FROM ORGANIC MATTER AND OTHER DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS OVERLAY DISTRICT: SHALL NOT BE USED. THE FILL MATERIAL SHALL CONFORM TO MA STATE IMP - Wellhead Protection District DESIGN DATA HEALTH CODE TITLE 5 - 310 CMR SECTION 15.225(3) AND SHALL HAVE As Shown on Plan Entitled PERCOLATION RATE OF BETWEEN TWO AND FIVE MIN. PER INCH, BEFORE AND "Revised Groundwater Protection _ AFTER PLACEMENT. Overlay Districts" - April, 1993 1. BUILDING TYPE: 2 BEDROOM HOUSE 10. ALL STONE MUST BE DOUBLE WASHED AND FREE FROM FINES AND ANY 2. DESIGN FLOW: 110 G.P.D. PER BEDROOM = 110 x 2 = 220 G.P.D. ORGANIC MATERIAL AND MUST HAVE LESS THAN 0.2 PERCENT MATERIAL P �36 FINER THAN A NUMBER 200 SIEVE. FLOOD ZONE: ✓ / - - _ _ 3. DESIGN PERCOLATION RATE: 5 min/inch ��' �3a / 4. GARBAGE DISPOSAL: NO 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENT TO CONSTRUCT OR Zone C ___, SUPERVISE THE CONSTRUCTION OF THE SYSTEM. THE CONTRACTOR IS Community Panel No. g �0 5. SEPTIC TANK DESIGN REQUIREMENT: 200% DESIGN FLOW RESPONSIBLE FOR MAKING ARRANGEMENTS FOR INSPECTION OF INSTALLATION #250001 0016 D 0 / �� 220 X 2 = 440 GAL. (USE 1,500 GAL. MIN. PER TITLE 5) OF THE SYSTEM WITH THE LOCAL BOARD OF HEALTH. Jul 2 1992 � y , 5 i ��, 6. TOTAL LEACH AREA REQUIRED: 12. THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL AND 32\ 10 TITLE 5: 220 GPD / (0.74 GPD/S.F.) = 297 SQ.FT. (CLASS I" SOIL) VERTICAL CONTROL OF ALL SYSTEM COMPONENTS. ' W /� �� 7. TOTAL AREA PROVIDED: 13. TIGHT JOINT PIPING TO CONSIST OF POLYVINYL CHLORIDE (P.V.C.) EFFECTIVE LENGTH = 25; WIDTH 12; DEPTH = 2; SCHEDULE 40, UNLESS OTHERWISE NOTED. SIDEWALL AREA (25x2)(2) _ 100 SQ.FT. 14. THE CONTRACTOR SHALL NOTIFY THE DESIGN ENGINEER AT LEAST 24 HOURS = �' Z 25 / / / m BOTTOM AREA = (12x25) = 300 SQ.FT. IN ADVANCE FOR AN INSPECTION AFTER EXCAVATION FOR THE O / < ENDWALL AREA = (12x2)(2) 48 SQ.FT. LEACHING BED (PRIOR TO THE PLACEMENT OF STONE) AND ALSO AFTER TH-2 . / W I Z _ PLACEMENT OF PIPLE & STONE PRIOR TO BkCKFILLING. C a;A ARE 100 + �E..O 48 448 SQ.FT. _ .�•, � / OP D 448 SQ.FT. 0.74 331 ,GPD �� �L_� �......s .u�., ,v �� .a , , PR6 �D PR VE ) _ INSTALLED. THE CONTRACTOR SHALL` PROVIDE A SIEVE ANALYSIS OF THE FILL � / . • . ��' pRI ' o Z TOTAL FLOW PROVIDED = 331 GPD k MATERIAL REQUIRED. AN AS-BUILT PLAN SHALL BE SUBMITTED TO THE LOCAL SYSTEM ?y,� � _o � � � �_�'' BOARD OF HEALTH UPON COMPLETION. 10 �• � Z / \\� x� NOTE: SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER. 16. NO RUBBER TIRE CONSTRUCTION MACHINERY SHALL DRIVE OVER THE PROPOSED ' 0 , z SEPTIC BED EXCAVATION DURING CONSTRUCTION. MI 0 -? M 17. DIG-SAFE SHALL BE NOTIFIED FOR THE PROPER LOCATION OF EXISTING UTILITIES � p PRIOR TO ANY EXCAVATION. \ \ ALLOWABLE FLOW 18. WATER SERVICE LINE SHALL BE LOCATED AND MARKED �\\ x�4. / Ep `i PRIOR TO ANY EXCAVATING AND 10 MIN. SETBACK TOWN OF BARNSTABLE GENERAL ORDINANCES DISTANCE FROM SAID SERVICE TO THE SEPTIC SYSTEM pROpO OOM �� SHALL BE MAINTAINED. 2 10 G �� ARTICLE XLVII. REGULATION OF WASTEWATER DISCHARGE , pWE�LIN ALLOWABLE FLOW = 330 GPD 19. ALL SEWER LINES SHALL BE SLEEVED WITHIN 6 PVC SCH 40 PIPE FOR 10 ON i EACH SIDE OF WATER SERVICE IF A 10 SETBACK CAN NOT BE MET. TI TL V i 310 CMR 15.285: PILOTING APPROVAL __ BRPWP61 b: APPROVAL OF ATLTERNATIVE SYSTEMS FOR PILOT USE 0z ____ -_44--- TECHNOLOGY: OMNI RECIRCULATING SAND FILTER SYSTEM DEP TRANSMITTAL NO.: W054298 REVISION DATE DESCRIPTION BY APPR ALLOWABLE FLOW = 660(15,522 / 40,000) = 256.1 GPD APPLICANT v PETER MARNEY can � PROPOSED FLOW = 220 GPD (COMPLIES) � I P.O. BOX 29 1 _ _ OSTERVILLE, MA 02655 SOIL EVALUATORS LOG PROJECT.- TEST HOLE 1 PROPOSED SEPTIC SYSTEM �P5`P P # 6980 AT 49 •JOBYS LANE PERCOLATION RATE, 1 IN 2 MIN OR LESS BARNSTABLE (OSTERVILI,Eo.- N GROUNDWATER OT M O ESTHOLE ® EL. 23 � EN BOTTOM SHEET NO.: 1 OF 2 DA APRIL 19, 2005 / I OF 1 � 1 TEST HOLE- 2 SCALE: As Noted PR FILE: G' PETTED 0 / SUL �,I Y. \ IF P SU LII�VA BY: SULLIVAN ENGINEERING DESIGN B • JOHN C. 0 DEA, E.I.T. CHECKED BY. PETER SULLIVAN, P.E. 29735 CI1lIL 4/08/05 EL. 35 PREPARED BY: - FI LL 42- � �� �i� /DIVA 8„ B LAYER 2.5Y 5 4 EL. 34.3 0 / Sullivan Engineering, Inc. LIGHT OLIVE BROWN 17" MEDIUM SAND EL. 33.6 PO Box 659 Osterville, MA 02655 C1 LAYER 2.5Y 6/4 LAYOUT PLAN NOTES LIGHT YELLOWISH BROWN (508)428-3344 (508)428-3115 fax 4001 MEDIUM SAND EL. 31.7 GRAPHIC SCALE 1. PROPERTY LINE INFORMATION IS BASED ON C2 LAYER 2.5Y 7/2 A SUBDIVISION PLAN ENTITLED "OSTERVILLE WOODS" LIGHT GRAY DRAWING TITLE: zo o 10 zo 4o B0 BY ROBERT G. MCGLONE, DATED MAY 1, 1971. 126„ MEDIUM SAND EL 24.5 2. CONTOURS SHOWN ARE BASED ON INFORMATION No GROUNDWATER ENcouNTERD • SEPTIC DESIGN PLAN ( IN FEET ) FROM THE TOWN OF BARNSTABLE G.I.S. APPROX. GROUNDWATER 0 EL. 13 1 inch = 20 ft. ASSESSORS INFORMATION: MAP 120 PARCEL 084 PIPING NOTES 3" RETURN LINE FROM FILTER MODULES INLET FROM SEPTIC TANK AND 4" INLET FROM SEPTIC TANK ALL ENTER ON SAME SIDE OF TANK 3" RETURN LINE FROM FILTER MODULES 3" PVC OUTLET ENTERS ONE SIDE OF FLOW SPLITTER AND 1-1/2" FORCED MAIN RISER TO FINISH GRADE EXITS ON OPPOSITE SIDE TO LEACHING FIELD FROM RECIRCULATION TANK AC 1-1/2" PVC FORCE FILTER CLOTH �- TO RSF MODULE BUBBLER SYSTEM COVER MULCH COVERING OMNI RSF BUBBLER SYSTEM AC POWER 24 HR RESERVE CAPACITY SUPPLY LOCATED IN ELECTIRCAL ,- K '.�•:_• _ HAND-HOLE s INLET TEE WITH ZOELLERTFILTER EFFLUENT FILTER - 1-1/4" CONDUIT FLOAT NOTES - _ '- ' a ALL-PUMP FLOATS ARE TO BE LOCATED O PULL CORD �- x 3�, M DRAIN HOE = 0j AWAY FROM INLET FLOW _ _ - -! o o e FLOAT POLE 3 ALL FLOATS TO HAVE 4" TETHER `• _ 1 JI I a ZIP TYE TYPE =a:[.-:i� . _.•� t _'' +' ., 't : `-'' :., .•• J_ a FASTENERPUMP •� ?` l0 CHECK VALVE 2 12 ON/OFF o� I R OVERRIDE FRONT VIEW ' SIDE VIEW TO�RSF MODULE RCE d- d- 1 a 3. HIG'-i =WATER ALARM M d- a a 00 OMNI FLOW MYERS ME-40 (L1 �D �0 •, SPLITTER WITH EFFLUENT PUMP :. FLOAT VALVE (3:1) '= RSF DESIGN CALCULATIONS 2" BLOCK 7. SIDE VIEW SIDE VIEW Sand Filter Media 24" minimum depth <1% #200 sieve, 2mm to 4mm size 8'-6" 11 -0 8,-0N �.. _ a: :.._:}: -..• . .;,..,:,.:. ,::...t•:.,:ti.='r ' Average Daily Flow Flow = 110 gpd per bedroom ••• �,' ..q - f -•t•r.. •-t• ' 'r:- i••J ! :7. •fw•• :w.- - �_t..a`" i.: .:Y: • -•t• - �' Wastewater Strength-BOD5 Residential = 230 mg/I f' f Recirculation Ratio 3:1 a cU - - I I Recirculation Tank Size 150% of Design Flow (Use a 1000 gallon tank) 7. Ln T 1 ,f y` Sand Filter Loading Rate (Residential) Loading Rate = 1150 / BOD5 = 5 gpd/ft2 _ Sand Filter Surface Area SA = (Flow gpd) / (Loading Rate gpd/ft2) 220 gpd / 5 gpd/sq. ft 44 sq. ft. Required (69 sq. ft. Provided) TOP VIEW 6 6" TOP vlEw 2 OMNI RSF Filter Modules Required Recirculation Pump Size Average Daily Flow + Recirculated Flow + Back Flow TOP VIEW 220 + (4x220) + 10 = 1,110 gpd ('') FLOW SPLITTER 1,110 / 24hrs = 46.25 gal per 60 Minute Cycle Use Myers Model #ME40 or Equal (65 gallons/min @ 12 ft. Total Head) Timer cycles to be set for 15 minutes. Sand Filter Module Setbacks Same as Title V Septic Tank 1 , 500 GAL. H - 20 SEPTIC TANK DETAIL 1 ,000 GAL. H -20 "OMNI RSF" RECIRCULATION TANK DETAIL "OMNI RSF" SAND FILTER DETAIL NOT TO SCALE NOT TO SCALE NOT TO SCALE NOTES NOTES NOTES 1.) SEPTIC TANK SHALL BE STEEL REINFORCED CONCRETE WITH 1.) OMNI RSF RECIRCULATION TANK (NO SUBSTITUTES) 1.) OMNI RSF MODULES (NO 'SUBSTITUTIONS). THREE (3) 20" MANHOLES. LL 2.) PUMP CHAMBER SHALL BE STEEL REINFORCED CONCRETE. 2.) FILTER MODULES SHALL BE COVERED WITH MULCH TYPE MATERIAL �n,p 2.) SEPTIC TANK TO WITHSTAND H-20 LOADING. ONLY. 3.) SEPTIC TANK TO WITHSTAND H-20 LOADING. PETER 3.) ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL 3.) ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL BE WATERTIGHT. SULLIVA' BE WATERTIGHT. 4.) ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL BE WATERTIGHT. NO.29733 CIVIL 4.) INLET AND OUTLET TEES TO BE SCHED. 40 PVC. 4.) OUTLETS TO BE SCHEDUAL 40 PVC. 5.) 27" MANHOLE COVER TO BE BROUGHT TO FINAL GRADE. TEES TO BE UNDER MANHOLE COVER WITHIN 12" OF END WALL. 5.) 1-1/2" PRESSURIZED LINE TO BE BACKFILLED BY HAND. `� y 6.) INLET AND OUTLET TEES TO BE SCHED. 40 PVC. C� 5.) RECOMMENDED MANUFACTURER- ACME PRECAST OR APPROVED EQUAL. TEES TO BE UNDER MANHOLE COVER WITHIN 12" OF END WALL 6.) TANK SHALL BE EMBOSSED WITH SEAL INDICATING CONFORMANCE 7.) TANK SHALL HAVE A MINIMUM OF 9" OF COVER. WITH ASTM STANDARD C 1229-93. 7.) TANK SHALL HAVE A MINIMUM OF 9" OF COVER. REVISION DATE DESCRIPTION BY APPR APPLICANT.• PETER MARNEY P.O. BOX 29 9" MINIMUM COVER OVER LEACHING OSTERVILLE, MA 02655 3' MAXIMUM COVER OVER LEACHING PLACE FILTER CLOTH OVER STONE _ 500 GALLON PRECAST LEACHING CHAMBER PRIOR TO BACKFILLING. M - - o SLOPE MIN. PROJECT. ••'"�'' :.? '•.- ; ;. .. .-, . •-� tea• f' � y. :.'• .„�� -.'" x..; - -�- • :,, . ; , •r, 0 •0 O � 0 ; = - - � O '� - - - - �" $I PROPOSED SEPTIC SYSTEM f,.•,. �' FLOW EQUALIZERS _ _ OO _ _ . AT :. �= a 49 JOBYS LANE - ...• • :• ter' a•o • a a :- a a �o•a ................... a :. �' a o � a � a a o a 92 0 o BARNSTABLE (osmvmm ,MASS. • _ _ _ 0190 = _ _ _ � = SHEET No.: 2 of 2 DATE: APRIL 19, 2005 4'-10" „ SIDE VIEW TOP VIEW 3/4 TO 1 1/2 DOUBLE WASHED FRACTURED STONE SCALE: As Noted PR FILE: SIDE VIEW 3" OF 1/8" TO 1/2" DOUBLE WASHED FRACTURED STONE DESIGN BY. JOHN C. 0'DEA, E.I.T. CHECKED BY.- PETER SULLIVAN, P.E. PREPARED BY. 6 OUTLET DISTRIBUTION BOX �--- 4' NOT To SCALE LEACHING o FIELD DETAIL Sullivan Engineering, Inc. LE NOTES NOTES PO Box 659 •�•' .r` : ';: ' _ •-_: ='f' ;•` Osterville, MA 02655 1.) THE DISTRIBUTION BOX AND SEPTIC TANK SHALL MEET TITLE 5 1.) SIDES AND BOTTOM OF LEACHING TRENCHES TO BE SCARIFIED. '"=:' ::: '- .:y;- = « (508)428-3344 (508)428-3115 fax 01 CONSTRUCTION CRITERIA. •;:.•:. •. ':. ='::''*?�.ra::: ••• :, ..•;. 2.) PIPING MUST BE SCH. 40 PVC WITH TIGHT JOINTS THE ORIFICES •_:''; - ` " :- "'�' OF THE PIPE MUST BE 3/8" - 5/8" DIAMETER. ''==• `••' ' ' = • "' 2. THE FIRST 2 FEET OF PIPE OUTSIDE OF THE DISTRIBUTION BOX • ' = =. :- . •,• Y = DRA WING TITLE: SHALL BE LAID LEVEL. 3.) PIPE TO BE LAID LEVEL FROM D-BOX TO 2 FT. OUTSIDE D-BOX 3.) ALL PIPE CONNECTIONS AND CONCRETE CONSTRUCTION SHALL DETAILS SHEET BE WATER TIGHT. 4•) NO MORE THAN 3 FT. NOR LESS THAN 9 OF COVER IS ALLOWED OVER THE SYSTEM. TOP VIEW 2 5' ASSESSORS INFORMATION. MAP 120 PARCEL 084 • - Q A'V I 0 ' 00 i � I i p cn m N ++ i-•% 00 00 c ILO • p + 1+ V) cc v N V ^� 0 00 � 23-6 23-O 18-6 •yq) o -� •I'M ' DO ' I p 0 1 n. I I OPEN DECK N � I O �i - ..-...., \ FWG OW FWG 4060 U r� A251 2842 MP cz S., RAISED HEARTH LINENS t _ Q BENCH PANT �121A IAA 22'-10' _ . p I-IOXG-6 LAIJND. 44 I M gT� i ..• . ° BATH R j --—— O 1 LIVING ROOM O0 I WALK-IN �.� °O O i r i I T CLOSET OHIGH Q. - , VANITY U� � � MUD RM 1 d - o I 1-4 I W Q 0 i KI?CHEN I ,. _. .... ... . . .. ._. .! `.aB Q z I PWDR I L----------------------I ! I � 6-oxo-a c 3-aa _ m 1 MECHANICAL Q PLATFORM I I, I I MASTER BEDROOM071 r=.' .. ... .. _.. } LI COINING ROOM m P � ; 2 CAR GARAGE I t, ,III I O � - + o ENTRY ; 1-4 r--- ------ ----- 1 I 12 4 In, I I I I 1 ..•; 1 ae�c 284c ry I-+-1 I I I 1 I I 2646 afiu w 1 I I I I 6'-0' LL X T-O' OVERHEAD DOOR r-0' W. X T-0' OVERHEAD DOOR rrH TRANSOMS ABOVE WRH TRANSOMS ABOVE I j I I • i I I 24'-O' 2V-0' 18'-0' CERTIFICATION: THESE DRAVANCS HAVE BEEN PREPARED TO MEET REFERENCED BUILDING CODE AND PROJECT REQUIREMENTS THE ARCHITECT BEARS i - NOGN OR RRC�SI 901EOR ANY MESS WRITTEN AUTHORIZIATIONS MADE ATION HASSBEEN OVEN BY THE ARCHITECT APPROVING SUCH DEVIATION-THE INFORMATION - - 651-00 PURPOSE OTHER N 16 INTENDED USE.ON THESE DRAWINGS SHALL NOT BE RELIED Cfl ECA ANY OTHER , I j �I �'i' F�00� PLAN FINISHED AREA = moo S.F. REVISIONS - %ALEI 1/4" R I'-O" N0. DATE: DESCRIPTION JOB NUMBER: 05015.00 DATE: 01-27-05 • PRELIMINAR-Y I NOT FOR CONSTRUCTION i C 2 a I m 0 E L c O X V Li d . o Co Ir 00 CID 44 � m j . cp co Lo V 3 co , i . O U cTJ s~ 2e49 2040 2849 28444OF C� ; i • BATHor ° W : m rx d In' 2'-O', f BALCONY BEDROOM 2 ' m so • � I UNFINISHED STORAGE BALCONY 1 , . a OPEN TO BELOW 1 1 O • O; , I 2849 2844 eau MSE DRARRTGS HAVE BEEN PREPARED TO MEET REFERENCED . - - WILDING CODE AND PROJECT REOAREMENTS, THE ARCHITECT BEARS' NO RESP%VWTY FOR ANY DEVIATIONS MADE TO THE DESIGN OR STRUCTURAL DESIGN UNLESS wnEN AUTHORIZATION HAS BEEN OVEN BY THE ARCHITECT APPROVING 10 DEVIATION. THE WOTMATIO1 . ON TIES DRAWS SHALL NOT BE RELED ON FOR ANY OTHER . PILPOSE OMER THAN ITS INTENDED USE REVISIONS 70. DATE: DESCRIPTION SECOND FLOOR FLAN PINISHEV AREA = M5 S.F. �I . JOB NUMBER: 05015.00 DATE: 01-27-05 PRELIMINARY NOT FOR CONSTRUCTION 1;4---------ik- -- - _ -- - _-- -- _ -