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HomeMy WebLinkAbout0049 MAIN STREET (OST.) - Health a 4' AV t 'teTVllle*,y G� t � k , >P ` A c u ^ . • u � a ° " r � , • Y. u r " , • o , r 1 '.. , ., .. a -: • 1'.�, x, H c A = ' 'Apu v a T _ 4 f Commonwealth of Massachusetts Ine2� `6? Title 5 Official Inspection Form I I a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments t r u 49 Main St t i Property Address r BARR, JAN T TR Owner Owner's Name information is Osterville Ma 02655 2/20/20 required for every } page. Cityrrown State Zip Code Date of Inspection, Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information on the computer, Michael DiBuono use only the tab key to move your Name of Inspector cursor-do not DiBuono Sewer And Drain use the return Company Name key. 35 Content Lane Company Address Cotuit Ma 02635 City/Town State Zip Code Bm 508-364-9587 SI 13522 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 2/20/20 Inspector's Signature Date. The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time'of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osteryille Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System contains a 1500 Gallon septic tank as well as a concrete distribution box and 3 500 gallon chambers in stone 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St V Property Address BARR, JAN T TR Owner Owner's Name information is Osterville Ma 02655 2/20/20 required for every page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ' I ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts : Title 5 Official Inspection Form J. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St V Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osteryille Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ ' Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .� 49 Main St v Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: El ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Fora �= Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 49 Main St Property Address BARR, JAN T TR Owner Owners Name information is required for every Osterville Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? - I ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4(� 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) El Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 322 Gpd 9 ( Y 9 (gP ))� Detail Sum ?p pump. ❑ Yes ® No Last date of occupancy: Date l5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main St u Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Nothing on file Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts ` Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . w 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool I ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: C.O.C. issued on 5/15/2008 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ® cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints,venting, evidence of leakage, etc.): A t5insp.doc rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4� 49 Main St v Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: System is vented at the roof line feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallon Sludge depth: 3 Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 41 Distance from bottom of scum to bottom of outlet tee or baffle 30" How were dimensions determined? Tape Measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St �V Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons I Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St �v Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level and at normal level 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.): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 cam, Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): i * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts �r Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No sign of failure system is functioning as designed I 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 i Commonwealth of Massachusetts 1 Title 5 Official Inspection Form Mle Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St u Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent 9 p Y 9 p e t 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 t � I r t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 I 2/20/2020 Assessing As-Built Cards TOWN OF BARNSTABLE LOCATION �F 9 M '^' s SEWAGE# Z v 0 9 — 15 3` VILLAGE G S Z ASSESSOR'S MAP&PARCEL IU ZU INSTALLER'S NAME&PHONE NO. /yo,.n�C.t,,, J�f�v 4'�'�� �A�.•.,�o SEPTIC TANK CAPACITY /Srb 0 G-nLI. , So g -349- 7tt LEACHING FACILITY:(type I)foe 6—,.- NO.OF BEDROOMS Fu�+ OWNER /ci (7iJ.-,Q,.,or.� t'l9ou�, PERMIT DATE: :i'/Gou 8 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwwer Table to the Bottom of Leaching Facility Feet Private Water Suppl!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 /✓o.-rt.ri-w �/�✓, �- I A t3 f8' 3S 3 �St 4g ' 4 44 ' (0 3 � L6� SSA 3 l 0 O Z. UI https://www.townofbarnstable.us/Departments/Assessing/Property Values/HMdisplay.asp?mappar=185020&seq=1 1/2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10+ 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: 3/12/2008 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: Test hole data on plan - Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t.: 49 Main St Property Address BARR, JAN T TR Owner Owner's Name information is required for every Osterville Ma 02655 2/20/20 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ❑ A. Inspector Information: Complete all fields in this section. ❑ B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ❑ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ❑ D. System Information:, For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form p . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,. 49 Main Street 4 Property Address Nancy Vecchione Owner Owner's Name information is Osteryille MA 02655 '7-10-14 required for every . page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information, n �gttulnlnHq�� _ ' on the computer, ``I \`�.��`��,•(N OF Mgss use onlythe tab �` • '" ` ' • �� ' k 1. Inspector. e to move our Y Y cursor-do not JAMES James D.Sears ;�; use the return Name of Inspector =v — key. :Co�_ CapewideEnterprice,LLC *' CI& ' Company Name � A: V TTF` 153 Commercial Street 'y'�� u�rti nSp�G`\`\``` Company Address Im Mashpee MA � 02649 Cityrrown State Zip Code 508-477-8 .77 '8 S1623 • Telephone Num,ber Lice nse Number , B�. Certification I certify that I have personally inspected the sewage disposal system at this addresl and tha tthe a information reported below is true, accurate and complete as of the time-of the insp coon. Th�insp&ion was,performed based on my training and experience in the proper function and mal tenance o on st sewage disposal systems. I am a DEP approved.system:inspector pursuant to ection 1 40 0f Title 5(310 CMR 15.000).The system: �+ ® Passes ❑ Conditionally Passes Ej,Fails ` ❑ Needs Further.Evaluation by the Local Approving Authority 7-10-14 - nspector's Signature Date The system inspector`shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the-system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be'sent to the system owner , and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3113 Title 5 Offidal Inspecti Subsurface Sewage Disposal System•Pagel of 17 y , Commonwealth of Massachusetts Title 5 Official 'Inspection Form Subsurface Sewage Disposal System Form,Not for Voluntary Assessments 49 Main Street r r { Property Address ; Nancy Vecchione Owner Owner's Name information is Osterville MA 02655 7-10-14 required for every page. Cltyfrown State Zip Code „bate of Inspection B. Certification (cont.)' Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ' ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. f Comments: B) System Conditionally Passes:F ❑ 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 6ver20 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 ifthe 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 Forth:Subsurface Sewage Disposal System•Page 2 of 17 x Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is required for every Osterville MA 02655 7-10-14 page. Cityrrown State Zip Code -` Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms_ not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static-water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced °❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or•replaced - ❑ Y ❑ N ❑ ND(Explain below): , ❑ The system required pumping more than 4 times a year due to{broken'or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced - ❑ Y .,❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): • C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1- System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland ora salt marsh t5ins•3/13 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 49 Main Street Property Address Nancy Vecchione. Owner Owner's Name information is Osterville MA 02655 7-10-14 required for every - page. Cityrrown State Zip Code Date of Inspection B. Certification (coot.), 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 andthe 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 M Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool 0 ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in o9papW is less than 6"below invert or available volume is less than Y2 day flow •L FAC'�i.v� t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 ` k Commonwealth of Massachusetts Title 5 Official Inspectioni.Form Subsurface Sewage Disposal System Form.-Not for.Votuntary Assessments . 49 Main Street Property Address Nancy Vecchione Owner Owner's Name x information is required for every Osterville _ 'MA 02655 7-10-14 page. Citylrown St-ate- ' .W Zip Code Date of Inspection B. Certification (cont:) : . x Yes 'No ® Required pumping more than 4,times in the last year NOT due to clogged or , IT obstructed pipe(s). Number,of:times;pumped: El [E Any portion of the SAS;cesspool:or privy is below high ground water elevation. =!.. 0 ® Any portion of cesspool or privy is within 166feet-of a surface water supply or tributary to a surface water supply: El ® 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'ofa private water supply well. p ❑ -® `" a 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 El 10,000gpd' ® The system fails. [have det4minedthat one or more of the above failure °criteria exist as described in 310 CMR 15:303 therefore t64 system fails.The system owner should contact the Board of.Health to deteFrnine 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 ❑ 0 the system is within 400 feet of.a surface drinking water supply " ❑ 0 the system is within 200.feet of a tributary to a surface drinking water supply -the sEl Elystem'is located in a nitrogen sensitive area(Interirh Wellhead Protection Area—IWPA)'or a mapped Zone,II of a public;water supply welt If you have answered"yes'to any question in,Section E.the system is.considered`a'significaptth"reat, or answered"yes" in Section D above the large system Kas 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: . t t5ins•3/13 Title 5 Official Inspection Forth;Subsurface Sewage Disposal System Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 49 Main Street . Property Address Nancy Vecchione - Owner Owner's Name information is - required for every Osterville MA ,02655 < 77-10=14 C' rr wn ' page. ItY o 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 t ❑ ® 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 a&N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back upT ` ® ❑ 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 f 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. F ❑ ® 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): 4 Number of bedrooms(actual): , - 3 DESIGN flow based on 310 CMR,15:203 (for example: 110 gpd x#of bedrooms): j t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments < 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is Osterville MA '02655 7-10-14 required for every - ' page. Cityrrown State Zip Code Date of Inspection ` D. System Information Description: d The system is a 1500 Gal. tank, D.Box and three chambers. Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?'(Include laundry system inspection information in this report.) El' Yes.® No Laundry system inspected? ` v 0 Yes Z No. Seasonaluse? ❑ Yes Z No Water meter readings, if available last 2 ears usage 2012-48,000Gais 9 ( Y 9 (gPd)Y 2013-66,000Gal's Detail: Sump pump? ❑ ,Yes ® No - ' Last date of occupancy: PresentDate Commercial/Industrial:Flow Conditions: r 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 r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 . r 4 Commonwealth of Massachusetts ' , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is required for every Osterville MA 02655 7-10-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/user Date z Other(describe below): r General Information ` Pumping Records: Source of information: NA 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 x F ❑ 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 l/A system by system operator under contract ❑ ..'Tight tank.Attach a copy of the DEP approval. , ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 49 Main Street Property Address Nancy Vecchione ` Owner Owner's Name , information is Osterville MA 02655 7-10-14 required for every - page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) t r Approximate age of all components, date installed (if known)and source of information: 2008 Permit#2008- 195. ' Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): , Distance from private water supply well or suction line: feet k Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH 40. t Septic Tank(locate on site plan): Depth below grade: _ • 6„ feet Material of construction: ® concrete ❑ metal ❑fiberglass.%, ❑ polyethylene' ❑-other(explain) If tank is metal, list age: years" s Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No . Dimensions: 1500 Gal. Precast H-10 2„ Sludge depth: t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 9 of 17 I - Commonwealth of Massachusetts } Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is required for every Osterville MA 02655 7-10-14 page. Cityrrown 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 28' , Scum thickness , Distance from top of scum to top of outlet tee or baffle 8„ II Distance from bottom of scum to bottom of outlet tee or baffle 17: How were dimensions determined? Asbuilt-Tape- Plan ` Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,' ty liquid levels as related to outlet invert; evidence of leakage, etc.): . " Tank at working level. Tank and covers at 6" below grade.In and outlet tees. No sign of leakage or over loading. ° Grease Trap(locate on site plan): Depth below grade: feet r Material of construction: + ❑concrete 0 metal fiberglass g 0°polyethylene; El other,(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information required for every Osterville MA 02655 7-10-14 page. City/Town + State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons , Design Flow: gallons per day Alarm present: El 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 Forth:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments` M 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is required for every Osterville MA 02655 7-10A4 page. CityrTown State Zip Code Date of Inspection D. System Information'(cont.) Distribution Box(if present must be opened) (locate,on site plan): Depth of liquid level above outlet invert 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 is 16"x16"-1' below grade. Box is clean and solid w/three line's out. No sign of over loading or solid carry over. Pump Chamber(locate on site plan):. Pumps in working order: . , ❑ Yes ❑ No* , Alarms in working order: ❑;-Yes ❑ No" Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): -- *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required):. If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �• 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is required for every Osterville MA 02655 7-10-14 page. Citylrown State Zip Code Date of Inspection D. System Information (coni.) Type: ❑ leaching pits number. ® leaching chambers number: 3 ❑ leaching galleries t number. ❑ leaching trenches - . ^number, length- El 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.): Leaching is three 500 Gal.Dry well chamber's. Chambers are 2' below grade,wet on bottom. No sign of over loading or solid carry over. No sign of holding water or high stain line. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan):. Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer. Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes " ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form: Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , M 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is required for every Osterville MA 02655 7-10-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) F T x Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition'of vegetation, etc.): ' Privy(locate on site plan): ' Materials of constructions: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): • r t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _ 49 Main Street Property Address Nancy Vecchione Owner Owner's Name information is Osterville MA 02655: ' 7-10-14 required for every - � , 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 °NT t a 39 ° /3-3 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 49 Main Street M j Property Address Nancy Vecchione ' Owner Owner's Name information is Osterville MA '02655 7-10-14 required for every - page. Citylrown State Zip Code- Date of Inspection D. System Information (cont.) Site Exam: El Check Slope ❑ Surface watery ❑ Check cellar ❑ Shallow wells ` NO Estimated depth to h ground water: 12 feet" Please indicate all methods used to determine the high ground water elevation:. ® Obtained from system design plans on record If checked; Date date of design plan reviewed:,: ate 07 D , ❑ 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) - g ❑ Accessed USGS database-explain: You must describe how you established'the high ground water elevation: T.H. on design plan no G.W.at 12'. Bottom of chamber's at 4'-6" below grade. Bottom of chambers at T-T above T.H.depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins 3113 Tide 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 Main Street" Property Address Nancy Vecchione Owner Owners Name information is required for every Osterville MA 02655 7-10-14, page. Cityrrown State Zip Code- Date of-inspection E. Report Completeness Checklist ® Inspection Summary:A, B,'C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 r l Town of Barhstal le �tME A Regulatory Services Thomas F. Geiler,Director w IARNSTAI MASS. Public Health Division 94''°TE039. � Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 7,1 20 Cr 9 Sewage Permit# Zddg- ! 9 S Assessor's Map/Parcel 19 s 0 z o Installer &Designer Certification Form Designer: Sa-t,,,�,,,A A (.9Is�., , P.E-. Installer: Address: an `Address: f>o . G r„c 77 5' ?A Alo,�d4.� l-{.ti0 6,0( Dch►�ts�ov-fi MA OZ6,39 On s/is12,00 IF ljorA. "l was issued a permit to install a (date) (installer) septic system at Y9 Ma,.- based on a design drawn by (address) S kig hg , I-sew dated /z — 7—o 7 ' (designer) _ 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 distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. 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. Stripout (if requir ected and the soils were found satisfactory. �IH OF AS. t4 STEPHPN cy" ALLYN uh (Installer's Signature) No.302 16 esigner's Signature) (Affix Desi amp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE, OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification form.doc <'*2oa6- 0,r-a ; aI BENNE.TTENVIRONMENTALAsSOCIATES, INC. LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS SANITARIANS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 6 508-896-1706 6 Fax 508-896-5109.E www.bennett-ea.com BEA09-10081 April 13; 2009 Mr.Melvin and Mary Elisabeth Field 39 Foster Street Cambridge, MA 02138, RE: -PETROLEUM RELEASE INVESTIGATION Residential Property �49 Main Street [Ass&ssor's-Map 185;Parcel 020] Osterville •MA Dear Mr. and Mrs. Field, Pursuant to your request, BENNETT ENVIRONMENTAL ASSOCIATES, INC. (BEA) ` has performed limited physical testing at the above-mentioned property to investigate the presence of petroleum impacts associated with the discovery, and removal of an abandoned - underground storage tank (UST). Based on the purchase date of the current owner, the UST was estimated as at least 50 year old. The physical testing was performed"subsequent to a UST removal in accordance with the MA DEP, Policy WSC-96-402 "Underground Storage Tank Closure Assessment Manual" as regulated under 310 CMR 40.0000'and 527 CMR 9.00. This work was undertaken under the COMM Fire Department with authorizations from the Barnstable Conservation Commission and the Barnstable Health Department: As such;the physical testing of soils and groundwater in the tank grave was conducted to qualify any Release Notification and/or Remedial Response liability under the aforementioned regulations. • On February 13, 2009, BEA'personnel were at the property to perform UST closure activities associated with the recent discovery'of an abandoned UST adjacent to an outbuilding (garage) in a low-lying wetland resource area. Tank Removal Services of Cape Cod (TRSCC) - had arrived previously and uncovered the. vessel with a rubber-wheeled backhoe under Barnstable Conservation authorization wherein-,perimeter hay bales were placed. On initial inspection, standing water was observed within the UST as well as groundwater within the excavation surrounding the UST. Autobody-Solvent Recovery Corp. of Boston, MA was also- on-site with a vac-truck and proceeded to evacuate water from the UST. Subsequent to evacuating the water from the UST; water was observed seeping back into the vessel indicating that the vessel had been breached, 'TRSCC;personnel then_contacted the Centerville-Osterville- Marstons Mills Fire District to witness the removal`of the UST,from the grave. FPO Martin MacNeely arrived at the-Property shortly thereafter.to witness the removal of the-UST. Upon removal of the tank from the grave-a petroleum odor was observed and discolored soils were observed stuck to the bottom of the'tank. The tank was in fair condition with no obvious holes observed.. Due to the suspect conditions noted, Fire Department personnel subsequently contacted Barnstable Health Department personnel (Donna Miorandi), who responded to the property. Subsequent to removing the UST, the hole was dewatered with the EMERGENCY SPILL RESPONSE 6 WASTE SITE CLEANUP SITE ASSESSMENT 6 ENVIRONMENTAL PERMITTING 6 LAND USE PLANNING WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE. APRIL 13,2009 FIELD RESIDENCE=49 MAIN ST.OSTERVILLE/BEA09-10081 PAGE 2 OF 3 PETROLEUM.RELEASE INVESTIGATION vac-truck so that confirmatory soil samples could be collected. Alotal of 100-gallons of.oily- water to Murphy's Waste Oil Service in.Woburn; MA under a MA Hazardous Waste Manifest. The tank was removed by TRSCC personnel and was disposed of at Brockton Iron and Steel in Brockton, MA. 'A copy of the hazardous waste manifest for the disposal of oily water, as well as the UST removal.permit and disposal receipt is'attached for reference. Representative soil samples were collected from each of the four sidewalls and two from the bottom"of hole` area. ;The soil samples_were placed in-8-ounce glass jars, sealed with aluminum septa and agitated'to develop organic vapors. ,The soil samples were then'field , screened for total organic.volatiles (TOV,) with a photoionization detector (PID) [Thermo Environmental 580B OVM, 10.6 eV lamp, calibrated to benzene standard] by "jar headspace"- r method as consistent with the MA DEP Soils Policy (WSC-94-400). .Field screening of soil samples reported low TOV concentrations ranging from(0.4 ppm to 5.7 ppm) in the soil samples collected, with the exception of the sample collected from the southern portion of the bottom of the tank grave; which reported a TOV concentration of 2.9.3 ppm, indicating the presence of petroleum within soils at-the subject property. 'The "worst case" soil sample collected from the southern portion of the bottom of the UST grave (BOH-S@5') was submitted to the laboratory for total petroleum hydrocarbons (TPH) "fingerprint identification", extractable petroleum hydrocarbons (EPH) and volatile petroleum hydrocarbons (VPH) testing, with all target analyfes to qualify field results in review of reporting requirements and exposure considerations under the Massachusetts Contingency Plan'(MCP). } Results of soil sampling analysis were reported on February 24, 2009. The Results of the laboratory analysis reported no' concentrations of EPH or any target PAH analytes reported above the method detection limit of"the analysis; wherein the reporting limits are significantly below the applicable RCS-1 Reportable Concentrations described in. the MCP. Laboratory results reported trace concentrations of fractional VPH and target BTEX analytes in the sample submitted. The concentrations of VPH and target analytes detected were all reported as significantly below the applicable RCS-1 Reportable Concentrations for' the respective compounds. Laboratory analysis of hydrocarbon fingerprint analysis' reported 110 mg/kg of TPH in the soil sample submitted, below the'applicable RCS-l"concentration of 200 ppm. The hydrocarbon "fingerprint" analysis also`identified the`petroleum in the sample as.`Indeterminate petroleum products in the n-C9 to n-b6 range'. However, based on the reporting of VPH fractions, it is likely that the tank had atone time.held gasoline: BEA personnel returned to the property on March 9, 2009 for the installation'of a single groundwater'monitoring well in the area of the former UST. The monitoring well was installed by hand with a 4.25" bucket auger to a depth of 6.5' bgs. Eight feet of#10 slot; schedule 40 PVC was installed immediately southeast of the UST.-grave as intermediate to the river. No visual or olfactory evidence of petroleum-impacted soil was observed during the monitoring well installation. BEA personnel returned to the property on.-March 12, 2009 to sample the newly' installed monitoring.well Upon arrival, the static"water level was gauged and the monitoring well was developed and subsequently sampled in review of environmental impact and risk characterization. The single monitoring well, MW-1, was sampled and sent to'a MA Certified laboratory for EPH and VPH analysis including target analytes. The groundwater samples``were collected in appropriately preserved laboratory containers for EPH/VPH analyses and placed in a cooler with ice. APRIL 13,2009 FIELD RESIDENCE-49 MAIN ST.OSTERVILLEBEA09-10081 PAGE 3 OF 3 PETROLEUM RELEASE INVESTIGATION Results of groundwater sampling were reported on March 20, 2009. The results of analysis reported concentrations of fractional ,EPH and VPH and all target analytes'as BRL, wherein the reporting limits are significantly below the applicable RCGW-1 Reportable Concentrations described in the MCP. As such, the soil and groundwater analytical results indicate that there is no current significant impacts to soil or groundwater associated with the abandoned UST and that there is no Release Notification or Remedial Response, liability apparent in accordance with the'governing regulations. If you have any questions regarding this document or need information,please contact me directly at your earliest convenience. Sincerely BENNETT ENVIRONMENTAL ASSOCIATES, INC. of- -Mu J nD Ta ema- ant Dav' Fen7nett, LSP nior Project Manager ent Encl: Site Sketch Plan COMM Fire Department OHM Release Form Monitoring Well Sample Log(3/12/09) Groundwater Analytical Laboratory Reports (2/24/0,9 and 3/20/09) Hazardous Waste Manifest UST Removal Permit/Disposal Receipt Photographic Documentation . Cc. Eric Kozol, Esq. Donna Miorandi, Barnstable Health Department Rob Gatewood, Barnstable Conservation.Commission FPO Martin MacNeely,•COMM Fire Department Town of Barnstable Geographic Information System April 9,2009 f of .` t0 l g t Not MW_� Y W . ¢ire Ck V \ Dentecv/lle River . : 4. 0 6,.Feet DISCLAIMERS This map is for planning purposes only. It Is not adequate for legal, Map:185_ Parcel:020 bounds determination or regulatory Selected Parcel boundary g ry interpretation Enlargements beyond a scale of Owner.FIELD,MELVIN D '� 1"=100'may not meet established map accuracy standards.The parcel lines on this map f ; , E are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:1.10 acres Abutters ;,) boundaries and do not represent accurate relationships to physical features on the map' Location:49 MAIN STREET(OST.) $fi such as building locations. Buffer // CENTERVILLE-OSTERVILLE-MARSTONS MILLS.FIRE;DISTRICT 1875 ROUTE 28 CENTERVILLE, MA 02632 (508)790-2375/FAK#(508)790-2385 ? i OILIHAZARDOUS MATERIAL RELEASE FORM F.A.# 09-0000453 LOCATION: I ADDRESS OF RELEASE: 49 Main Street r Ogt,-r i l 1 p, MA 02655 i DATE OF RELEASE: tinnkknnnn�� I PRODUCT RELEASED: Gaso inne TAT [ ESTIMATED QUANTITY: n nown CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY: Notifications I I NOTIFICATIONS: FIRE DEPARTMENT: YES(KX) NO( ) DATE: 2/.13/09 TIME: 1146 j NATIONAL RESPONSE CENTER YES( ) NO( Xy, DATE: TIME: DEPT. OF ENVIRONMENTAL PROTECTION YES(x) NO( ) DATE: TIME. Letter OIL SPILL COORDINATOR: YES( ) NO" DATE: TIME: j TOWN BOARD OF HEALTH: YES(xj NO( ) DATE: 2113/09 TIME: 1200hrs TOWN HARBORMASTER: YES( ) N06W DATE: TIME: OTHER AGENCIES: t I. COMMENTS: See incident #09-0000453 for additional information E I r 1 k 1 REPORTED BY: DATE: 9 f?512ooc) i COPY-FIRE DE ARTMENT COPY-D.E.P. COPY-BOARD OF H HE C E E I `i MAR 3 a 2009 f " (F C-O-MM FORM#58 + D.E.P. SOUTHEAST REGION I MM DD YYYY �' Delete NFIRS —1 01920 U 02 13 2009 11 109-0000453 } 000 [1Chan9e Basic FDID Incident t Date Station "Incident Number * Exposure * .. * * * E]No Activity ❑Check this box to Indicate that the address for this incident is provided on the Wildland Fire .Census Tract 1 I— Module In section a"Alternative Location specification". use only for Wildland fires. $ Location* u 4 I ' ®street address 49 " }MAIN ST �� U Intersection Number/Milepost Prefix Street or Highway Street Type suffix ❑in front of J OSTERVILLE }' U 02655 ❑Rear o£ U - • State Zip Code f _ Adjacent to Apt./Suite/Room City} ., } Directions - Cross street or directions as aonlicable Midnight is 0000 C Incident Type * El' Date & Times E2 Shift & Alarms t• Local Option 411 Gasoline or other flammable } Check boxes if Month• Day Year Hr.Min Sec dates are the - �Q I Incident Type same as Alarm ARM always required_ 1_1 " COM21 I Aid Given or Received* Date. Alarm *• 02 '' . 13 2009 11:46:03 i D Shift or Alarms District i Platoon i ARRIVAL required, unless canceled or.did not arrive - 1 ❑Mutual aid received j Arrival* 02 13 2009 11.47'•07 ! uu ❑ U U ��.� E3 , 2 []Automatic aid reCV. Their FDID Their , State CONTROLLED Optional, Except for wildland fires Special Studies 3 [Mutual aid given } Local option 4 Automatic aid given I ❑Controlled 5 Other aid given Their LAST UNIT CLEARED, required except for wildland fires ILA' II�I j Incident Number bast Unit � p9� Special Special j p7 ©Nona ) -JU L 1 J 20091 12} 23:35 } Study IDH Study Value { ETCleared F Actions Taken* GI Resources* G2 Estimated Dollar Losses & Values ❑ Check this box and-skip this ) section if an Apparatus,or LOSSES: Required for all.fires if known. Optional 82 }Notify other agencies. } Personnel form is used. for non fires. None Apparatus Personnel property $1 Id 000 , 000 Primary Action Taken (1) - Suppzession � } Contents $} ( � 000 ,1 000El 80 1 }Information, I ' I Additional Action Taken (2) 3. } 1 PRE—INCIDENT VALUE: Optional i Other 0001 0001 " I } ,. L--� I— Property $1 , 000 • 000 Additional Action Taken (3) El .Check box if resource counts - include aid received resources. Contents- $1 , 000 , 000 ' I Completed Modules Hl*CasualtiesONone E3 Hazardous Materials Release I Mixed Use Property NN Not Mixed Fire-2 Deaths Injuries N None 10 Assembly use } Structure-3 Fire L� 1 Natural Gas: �.leek,ae s,auatiea er Masser aatss Service m 20 Education use ❑Civil Fire Cas.-4 2 Propane gas: <21 zb. taws tan in home 8H4 sal) Medical use 33 t ❑Fire Serv. Cas.-5 CivilianL � , J 3 ❑Gasoline: vehicle feel tank or P—tile contain 40 Residential use } fuel bu..iag'egailmevt or portable storage' 51 ❑EMS-6 4 Kerosene: f Row of stores LTn Detector 53 Enclosed mall ❑HazMat-7 =Required for Confined Fires. 5 []Diesel fuel/fuel oil:--biule fuel task ar Portable 58 Sus. 6 Residential ❑Aildland Fire-8 6 ❑Household solvents: home/affice spill, cleanup only 59 Office use 1❑Detector.alerted occupants 60 In6us trial.Use nX Apparatus-9 7 ❑Motor oil: freed engine er portable container 63 ; Military use = Personnel-10 2❑Detector did not alert them 8 ❑paint: from paint cane totaling<ss gallons - C5 Farm use Arson-11 UEl unknown 0 ❑Other: spauei earMat actions required or spill>esgal., 00 Other mixed use Pleats lets the Hamat fond J Property Use* Structures 341❑Cli.nic,clinic type infirmary 539 []Household goods,sales,repairs 342 Q Doctor/dentist 'office 579 Q Motor vehicle/boat sales/repair 131❑Church, place of worship 3610Prison or jail, not juvenile 571 ❑Gas or service station C 161❑Restaurant or cafeteria 419M 1-or 2-family dwelling 599 ❑Business office 162 ❑Bar/Tavern or nightclubs 429❑Multi-family dwelling - 615 ❑Electric generating plant 213 ❑Elementary school or kindergarten .:439❑Rooming/boarding house 629 [Laboratory/science lab 215 [High school or junior high 449❑commercial,hotel or motel 700 ❑Manufacturing plant. 241 ❑Collage, adult education 459[,Residential, board and care 819 ❑Livestock/poultry, storage(barn) 311 [Care facility for the aged 464❑Dormitory/barracks 882 ❑Non-residential parking garage j 331 ❑Hospital 519❑Food and beverage sales . 891 ❑Warehouse' } Outside 936❑Vacant lot 981 []Construction site f 124 ❑Playground or park 938 [Graded/care for plot of land 984 ❑industrial plant yard i 655 ❑Crops or orchard 946 [Lake, river, stream Lookup and enter a Property Use code only if - f 669.QForest .(timberland) 951,[Railroad right.of way you have NOT checked a Property Use box: 807outdoor. storage area 960other street Property Use 1419 I 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway 962 ❑Residential street/driveway ❑ L1 or 2 family dwelling } 931 Open land or field i NFIRS-1 Revision 03 11 99 i MM DD YYYY U U L� L-I (--JJ C Complete 01920 MA 2 13 2009 1 09-0000453 000 Narrative f FDID * State Incident Date * Station Incident Number Exposure' 1 Narrative: E Caller Name FPO NIACNEELY OIC : MACNEELY , Pats. 0 rcrosby 2009/02/13 12:10:07 329 AT EVENT MANNING IS 1 I rcrosby 2009/02/13 12:13:03 UNDERGROUND TANK REMOVAL - REQUEST. .BOH i rcrosby ; 2009/02/13 12:23:32 CONTRACTORS WAITING FOR BOH 329 on location for removal of 120 gallon ust•.with unknown product. Tank currently contains seawater as it in a marsh location to the rear of the property on side A/B of the boat house. The tank likely previously contained gasoline. Upon removal no obvious holes found in tank (see attached photos) . However, as water from the marsh,filled back in the excavated site what appears to be a petroleum sheen would .also show in the water. An LSP John Tadema-Wielandt from Bennent Environmental Associates (508) 896-1706 took prliminary soil samples which showed readings as high as 29ppm. Those numbers would require further testing and analysis to determine extent of contamination. The Barnstable Board .of Health was i. notified by dispatch with an eta of 30 to 45 minutes. No further action by FD 329 cleared. i scene. i 02/23/2009 15:08:30 mmacneely 1 - i • 1 1 , n�n-4/9009 09-0000453 f f K-1 Person/Entity Involved Local Option Business name (if applicable) - Area Code Phone Number i Check This Box if ) L.� L 11� same address as Mr.,Ms., Mrs. First Name MI Last Name Suffix incident location. I l� Then skip the three duplicate address Number Prefix Street or Highway - Street Type lines. Suffix i ff I Post Office Box Apt./Suite/Room- City - State Zip Code More people involved? Check this:box and attach Supplemental Forms (NFIRS—lS) as necessary K2 Owner Same as person involved? Then check this box and skip The rest of this section. u Local Option Business nave (if Applicable) Area Code Phone Number ' I i L� I I U I I IJ i Check this box if Mr.,Ms., Mrs. First Name MI Last Name Suffix I same address as _ f incident location. Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. Post Office Box I- .Apt./Suite/Room City - State Zip Code u j, Remarks Local Option - Caller Name FPO MACNEELY OIC : MACNEELY 1 Pats. : 0 rcrosby ; 2009/02/13 12:10:07. - 329 AT_ EVENT MANNING IS 1 rcrosby ; 2009/02/13 12:13:03 UNDERGROUND TANK REMOVAL - REQUEST BOH rcrosby ; 2009/02/13 12:23:32 CONTRACTORS WAITING FOR BOH , E 1 329 on location for removal of 120 gallon ust with unknown product. Tank currently contains w seawater as it in a marsh location to the rear of the property on side A/B of the boat house. The tank likely previously contained gasoline. Upon removal .tno obvious holes "found in tank (see attached photos) .' However, as: water from the marsh filled back in the E excavated site what appears to be a petroleum sheen would also show in the water. An LSP John Tadema-Wielandt from Bennent Environmental Associates- (508) 896-1706 took prliminary soil samples which showed readings as high as 29ppm. Those numbers would require further testing and analysis to determine extent of contamination. The Barnstable Board of Health was notified by dispatch with an eta of ,30 to '45 minutes. No further action by•FD 329 , cleared scene. f L Authorization } 18350 (MACNEELY,-MARTIN 0. .ISR. INSPEC I I 021 LL3j2009 " Officer in charge ID - Signature - Position or rank Assignment Month Day Year i- 3ooacif 8350 IMACNEELY, MARTI SR. XVSPEC 1 �. 1 021 U 2009 `II lame Posit' or ran Assignment Month Day Year is Officer Member making report ID Sign re .n charge. i . i , 1 niQ7n n,)nai?nno no_nnnndsz i 1573 Main Street,P.O.Box 1743 BENNETT ENVIRONMENTAL ASSOCIATES, INC. (508)896-1706 Brewster,MA 02631 LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARL4NS fax(508)896-5109 MONITORING WELL SAMPLING LOG Job Name: Field Residence Date(s): 03/12/2009 Time: 1:45 pm Tide: High Location: 49 Main Street Osterville Job Number: BEA09-10081 Sampler: Brian Clarke,Don Douty Measuring Point: Ground Surface or T.O.C. T.O.C. Elev.of,, Total Depth to Standing Water Static Volume HNU Dissolved Well reference Depth Water Water Table Volume Purged H Oxygen Temperature ' Number; point,:. of well g PI-101 P XYB Conductivity. Comments: Height Elevation (gallons) (gallons) ( 910 F (feet) `(g ) (8 ) (PPm) m � ) ' (feet) (feet) (feet) (feet) MW-1 NE 6.5 3.41 3.09 NE 0.5" 3.0 NA 5.83 2.49 1066 40.06' - No odor,no sheen Notes: NE=Not Established Well was sampled using low-flow sampling techniques for EPH/VPH and target naalytes upon stabilization of field parameters. GROUNDWATER Groundwater Analytical,Inc. P.O.Box 1200 ANALYTICAL 228 Main Street Buzzards Bay,MA 02532 v Telephone(508)759-4441 FAX(508)759-4475 www.groundwateranalyteal.com February 24, 2009 { Mr. David Bennett Bennett Environmental Associates, Inc. P.O. Box 1743 i.' Brewster, MA 02631 LABORATORY REPORT Project: Fields Residence/BEA09-10081 Lab ID: 123463 Received: 02-17-09 Dear Dave: t 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`qual.ity control report, and a statement of our state certifications. The analytical results contained in this reportrneet all applicable NELAC or NVLAP 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. 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, Karyn E. Raymond Project Manager KER/elm Enclosures i Page 1 of 19 GROUNDWATER ANALYTICAL Sample Receipt'Report Project: Fields Residence/BEA09-10081 Delivery: GWA Courier Temperature: 2.0°C Client: Bennett Environmental Associates,Inc. Airbill: n/a __Chain of Custody: Present Lab ID: 123463 Lab Receipt: 02-17-09 Custody Seal(s): n/a w Lab ID Field ID, y Matrix h Sampled "`Method otes , 123463-1 BOH-5@5' Soil 2/13/09.12:00 MA DEP VPH with Targets Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C873946 40 mL VOA Vial Proline BX24255 Methanol R-5131 L 12-15-06 n/a ;Lab ID Field ll) c`, a Matrix ;Samped 'Uv thod r" 0 it 94 Notes 123463-2 BOH-S@5' Soil 2/13/09 12:00 MA DEP EPH with PAHs TPH by GC ASTM D3328-00 Mod Con ID Container. Vendor QC Lot Presery QC Lot Prep Ship C1143481 250 mL Amber Glassl Proline BX32846 None n/a n/a n/a j Groundwater Analytical, Inc,, P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532 Page 2 of 19 GROUNDWATER ANALYTICAL Data Certification " Project: Fields Residence/BEA09-10081 Lab ID: 123463 Client: Bennett Environmental Associates,Inc. Received: 02-17-09 18:30 MA1.onpendtuofAialytiDEPCi . z%:. .1 3 : _ Project Location: n/a MA DEP RTN: n/a . This Form provides certifications for the following data set: . MA DEP VPH: 123463-1 MA DEP EPH: 123463-2 Sample Matrices: Groundwater ( ) Soil/Sediment (X) Drinking Water ( ) Other ( ) MCP SW-846 8260E ( ) 8151A ( ) 8330 ( ) 6010B ( ) 7470A/1A ( ) Methods Used 8270C ( ) 8081A ( ) VPH (X) 6020A ( ) 9012A2 ( ) 'As specified in MA DEP,- 8082 ( ) 8021 B ( ) .EPH (X) 7000 S3 O Other-( ) - ,Compendium of Analytical E 1.'List Release Trackin&Numfier(RTN),if kncA..,+ "Q ;'efti _y, •- -. _�, Methods. - 2.,.SW-846 Method 9012A-(Equivalent to_9014)or MA DEP,Mysiologically Available Cyanide(PAC)Method is �' 3 •, (check all that apply) f 3. S'SW-846 Methods'7000 Series.r•List individual method arid`a`nalyte An affirmative response to questions A,B,C and D is required for"Presumptive Certainty"status. A. Were all samples received by the laboratory in a condition consistent with. that described on the Chain-of-Custody documentation for the data set? Yes / > B. Were all QA/QC procedures required for the specified analytical method(s). included in this report followed,including the requirement to note and discuss in a narrative QC data that did not meet appropriate performance standards or guidelines? Yes, C. Does the analytical data included in this report meet all the requirements for"Presumptive Certainty,"as described in Section 2.0 of the MA DEP document CAM VII A,Quality Assurance and Quality Control Guidelines for the Acquisition and Reporting of Anal yti6l Data? Yes D. VPH and EPH methods only: Was the VPH or EPH method run without significant modifications,as specified in Section 11.3? Yes A response to questions E and F below is required for"Presumptive Certainty','status. . E. Were all QC performance standards and recommendations for the / specified methods achieved? Yes F. Were results for all analyte-list compounds/elements for the specified method(s)reported? Yes All No answers are addressed in the attached Project Narrative. I,the undersigned,attest under the pains and penalties of perjury that,based upon my personal Inquiry of those responsible for obtaining the Information,the material contained in this analytical report is,to the best of my knowledge and!belief,accurate and complete. > Signature: Position: . Project Manager Printed Name: aymon x Date: 02-24-09- P Groundwater Analytical;Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532Page 3 of 19 GROUNDWATER ANALYTICAL Massachusetts DEP VPH Method Volatile Petroleum Hydrocarbons by GC/PID/FID '. ., Field ID: BOH-S®5' Matrix: Soil Project: Fields Residence/BEA09-10081 Container:' " 40 mL VOA Vial Client: Bennett Environmental Associates,Inc. Preservation: Methanol/Cool Laboratory ID: 123463-01 QC Batch ID: VP-1546-E Sampled: 02-13-09 12:00 a, Instrument ID: GC-1 HP 5890. Received: 02-17-09 18:30 Sample Weight: 17 g Analyzed: 02-23-09 12:51 Final Volume: 15 mL Analyst: CRL %Solids: 80 Dilution Factor: 1 VPH'Ranges s ,'Concentration :=c:- Notes 4Uriits*' `Reporting Limit n-05 to n-C8 Aliphatic Hydrocarbons to 6.2 mg/Kg 1.4 n-C9 to n-C12 Aliphatic Hydrocarbons to 12 mg/Kg 1.4 n-C9 to n-C10 Aromatic Hydrocarbons t 13 a mg/Kg 1.4 Unad'usted n-05 to n-C8 Aliphatic H•drocarbons t 6.2 mg/Kg 1.4 Unadjusted n-C9 to n-C12 Aliphatic H drocarbons t 26 mg/Kg 1.4 CAS Number ` Anal e - '"Concentration ''Notes `Units• Reporting Li it Yt f P - - 1634-04-4 Methyl tert-bu ('Ether BRL mg/Kg 0.07 7143-2 Benzene° BRL mg/Kg % 0.14 108-88-3 Toluene° BRL mg/Kg '0.14 100-41-4 Eth (benzene# BRL mg/Kg 0.14 108-38-3 and 10642-3 meta-X lene and para-X lene$ 0.16 mg/Kg 0.14 95 47-6 ortho- X lene# 0.23 mg/Kg '0.14 91-20-3 Naphthalene BRL mg/Kg 0.69 QC Surrogate Compound'. n ,Spiked, Measured tQC`Lim :3 its 2,5-Dibromotoluene(PID) 3.4 3.4 R 98 % 70-130% 2,5-Dibromotoluene(FID) 3.4 3.3 96 % 70-130% r , QA/QC Certification 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes. 3. Were any significant modifications made to the method,as specified in Section 11.3.2.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Results are reported on a dry weight basis. 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. t - Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-05 to n-c8 Aliphatic Hydrocarbons range data excludes the method targeeanalyte concentrations. ® n-C9 to n-C12 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations and . the concentration for the n-C9 to n-C10 Aromatic Hydrocarbons range. 1x Analyte elutes in the n-05 to n•C8 Aliphatic Hydrocarbons range._• . # Analyte elutes in the n-C9 to n-C12 Aliphatic Hydrocarbons range. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02532 Page 4 of 19 F GROUNDWATER ANALYTICAL Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GOAD Field ID: BOH-S@5' Matrix: Soil Project: Fields Residence/BEA09-10081 Container: 250 mL Amber Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 123463-2 QC Batch ID: EP-2922-M Sampled: 02-13-09 12:00 Instrument ID: GC-12 Agilent 6890 Received: 02-17-09 18:30 Sample Weight: 16 g Extracted: 02-19-09 11:30 Final Volume: 1 rnL Analyzed(AL): 02-20-09 12:38 %Solids: 80 Analyzed(AR): 02-20-09 13:19 Aliphatic Dilution Factor: 1 Analyst: KMC Aromatic Dilution Factor: 1 EPH Ranges Concentration Notes„ Units; 7*port ng limit t n-C9 to n-C18 Aliphatic Hydrocarbons t BRL'E mg/Kg 36 n-C19 to n-C36 Aliphatic Hydrocarbons t BRL , mg/Kg 36 n-C11 to n-C22 Aromatic Hydrocarbons to BRL mg/Kg 36 Unadjusted n-C11 to n-C22 Aromatic H drocarbons t BRL mg/Kg 36 CAS.Number,: ,Analyte `t, :t, Concentratjon Notes, Units itePortmg Limit 91-20-3 Naphthalene BRL mg/Kg 0.60 91-57-6 2-Methyl naphthalene BRL mg/Kg 0.60 85-01-8 Phenanthrene BRL mg/Kg 0.60 83-32-9 Acenaphthene BRL ' mg/Kg 0.60 208-96-8 Acenaphthylene BRL mg/Kg 0.60 86-73-7 Fluorene BRL mg/Kg 0.60 120-12-7 Anthracene BRL mg/Kg 0.60 206-44-0 Fluoranthene BRL mg/Kg 0.60' 129-00-0 Pyrene BRL mg/Kg 0.60 56-55-3 Benzo[a]anthracene BRL. mg/Kg 0.60 218-01-9 Chrysene BRL mg/Kg 0.60 205-99-2 Benzo[b]fluoranthene BRL mg/Kg 0.60 207-08-9 Benzo[k]fluoranthene . . BRL mg/Kg 0.60 50-32-8 Benzo[a]pyrene BRL mg/Kg 0.60 193-39-5 Indeno[1,2,3-c,d]pyrene BRL mg/Kg 0.60 53-70-3 Dibenzo[a,h]anthracene BRL mg/Kg 0.60 191-24-2 Benzo[g,h,i]perylene BRL mg/Kg 0.60 f3 '` C Limits,,QC Surrogate Compound: S pjked .,Measured „'.• Recove"ry Fractionation: 2-Fluorobiphenyl .3.2 2.5 79% 40-140% 2-Bromonaphthalene 3.2. 2.6 80% 40-140 Extraction: Chloro-octadecane 3.2 2.6 80 % 40-.140% ortho-Terphenyl' 3.2 3.0 94 % 40-140 .,.:QA/QC Certification x, :.h:bsa +'ci�l - 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes ' 3. Were any significant modifications made to the method,as specified in Section 11.3.1.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). Sample extraction performed by microwave accelerated solvent extraction technique. Results are reported on a dry weight basis. 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. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02532 page 5 of 19 ' 7 k a GROUNDWATER ANALYTICAL f ASTM Method D3328-00 (Modified) , Hydrocarbon Fingerprint by GC/FID Field ID: BOH-S,@5' Matrix: Soil Project: Fields Residence/BEA09-10081 Container: 250 mL Amber Glass Client: Bennett Environmental Associates,Inc. Preservation: Cool Laboratory ID: 123463-2 QC Batch ID: HF-2944-M Sampled: .02-13-09 12:00 Instrument ID: GC4 HP 5890 Received: 02-17-09 18:30 Sample Weight: 15 g Extracted: 02-19-09 14:30 Final Volume: 1 mL Analyzed: 02-20-09 18:42 Dilution Factor: 1 ' Analyst: MB %Solids: 80" __Qualitative Identification This sample has CUID characteristics that are similar to: ' 1. Indeterminate petroleum products in the n-C9 to n-C36 range. Analyte _ '. 1Cmicentration .• � Notes: UOIYS Reporting limit 6., Total Petroleum Hydrocarbons 110 mg/Kg 74 . QC Surrogate Compound Spiked Measured ;e,,Recoveryu y., QGLimits ry ` ortho-Terphenyl 3.3 2.7 -, 83 % 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02,, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36..Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. Results are reported on a dry weight basis. 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. Groundwater Analytical, Inc.,, P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02,532 page 6 of 19 ' L , f k GROUNDWATER ANALYTICAL ASTM'METHOD D3328-00 (Modified) Hydrocarbon Fingerprinting by GC/FID Lab ID; 123463-02 Hydrocarboris Laboratory 1.50 4 1.25 1.00 0.75 0.50 0.25 0.00 0 5 10 . f:15 "� 20 25 30 * 35 40 45 Retention Time (Minutes). Page 7 of 19 GROUNDWATER ANALYTICAL Project Narrative Project: Fields Residence/BEA09-10081 j Lab-ID: 123463 Client: Bennett Environmental Associates;Inc. Received: 02-17-09 18:30 ocumentation and'ClientCommunicationr" The following documentation discrepancies,and client changes or amendments were noted for this project: 1 . No documentation discrepancies,changes,or amendments were noted. r. t B Method Modifications�Non-Conformances and Observations1' � r i. 2 I,r ¢:sr .€,._..t�P.t' ;"$3s `;` -: fA Na•; i 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. - f Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532Page 8 of 19 _. -- _ _ � ""'ttae+r+•enzika+v-� i 'A;lr• =-ter j )I - w228 Main Street,P.O.Box 1200 .'GROUNDWATER�--a Bu&ards.Bby',MAD2532 -CHAIN-OF-CUSTODY RECORD ; #,-Telephone(508)759.4441-FAX.(508)759-4475 AND;WORK ORDER ,}! www.grotindwateranaly&al.com Projecl Name Firm: TURNAROUND / ANALYSIS REQUEST 1 I •IL'oc�'' Q�� IJ Volndloe Bemlml.Ma Parl erG er - Matale PMmlem drour4oa Har. General Chemistry elhu W�' VwwH �pY71�W�•(1V1, O STANDARD(10 Business Days), - x rasm a. s wags I ProjecLNumber. Address: )0 PRIORITY(5 Business Days) _❑ RUSH(RAN- "L7Et�.b9_ .137.� / •G<<. S7 /YIV• V(1� 1� (RushmQuirasRush/uahodmwnNumber) 7 nI.IJ ♦. ❑ ❑ I la •Sampler Name: City I Stater/zip: ••, ,pPlease Email to:, JI�'' �__�L�i_ - 6v-tivi�j'•�Lt"r M,Q- D2E3J - ❑Please.FAXto: .3. _ S ° Project Mana agar: Telephone: BILL'ING I 9 Ply pIT a �n _ n ❑ n o ❑ 7 $ ? OR'f _1'7b(p ❑ Purchase Order No.: iGt�cs E @ 3 9 s 2 Ij .�Third Party Billing: a g .F S ❑ A F g- 2 INSTRUCTIONS:Use separate line for each container(except replicates). p GWAOuole: a` 2 m € ° n e o - Sampling - Matrix. Type Contafner(s). Preservation 11 G ❑ ❑- n ❑ m in ❑ u ❑ . g � e ❑ :,' 1 D LABORATORY e. a: 5 Q a y $ a ❑ @ a 1 SAMPLE - 3 c NUMBER _ o. eA " € s ❑ ' IDENTIFICATION } - ,y g a ;e ti a (Leb`Use Only), �'€ �- Z F r 2 s o ❑ ❑ - . w w e a-sue 7 -� _ '01 o ton t � Bs4 ® ssa ;i p 2 ❑❑❑ ❑ ❑ --to ❑ ❑ e ❑ _ n n n ii c'❑ ❑ +v ❑ n n n i.i rr u o = ❑ o di �2'roo Q�01 S S' X I I I x �,.. :._..� a c- � • .». _ }y-s 'd °. - :., g. ��.., s� - �y yt�- - -;� ',u;i � ge �r• ii �+r u* d�'• "`�_' �:;'z'.€ '�'- ";43`. <:•:s`r:.Ass, 4;d(�ty,+"4'?+�'7`a 'A IP'."'et�i gt�<:i:.}�`�'�, �'"rd��'#`w'r�`' a 7F v�i�" ^� '3�+' t�=� +"�:�r 1 �f?�.. �'t�.�' .'�.,?r 7" ' �n'tea �.-..a� +� .. •s��$:c.�'� av I 14 W, - ,`- -- i:il,rti:c'e _... �• ry. - >..a �,. . .- .V, c�. ws ^� T? ;$!"n0i »,. a _ �a+. i:r _ .,. ..:.'� rs arti ,.4 +er a }r yr 3 ,• i 4r�'ra a rr .. _ -.n:r 'z-w+. . -,a! M =.a✓ - i:a W- - r� '. - • 6 - 1•c:^ d c s �-` ts'°k� r b 4 e t t €% r' _V 4 :�* + � 'i ` Qy _ � � "� Sty �e ..- a -p_�w'.� ;�p��.{tyy �„ g�,py yg �µ .�. p +3 .{.75 '�1�.��IK-'. .£'� .'� L'd � +�•-• fltiLd�+'�.�_` �s�P,,�vk td P1'i'i[i si'f j�.�.-"�sJ+6 }.s.� �A' �,p�y ii'°p,.t .y .�.r.art _ 4�r, �y A'ye *f7'':"d`•�.yAt�a`:,�t'-�.'i�y j 4 i,`4� u 7k�.1��+"Fi�' 71?e uL�.K», _. t. !R - c A± .. 4%.rN.:r� 1 REMARKS/SPECIAL INSTRUCTIONS DATA QUALITY.OBJECTIVES :X _ CHAIN-OF-CUSTODY RECORD j t MA DF-P MCP Data Enhancement AfllrmaBon Regulatory'Program Project Specific QC NOTEI All sa es submlttadsubject to Standard Terms and Condltions,on reverse hereof. YES,.❑NO MCP Data Certification re ulreM .Slate Standard Deliverables Marty regulatory programs.and EPA,meihods:require.ptojecl .Rolle u b pi �� �, Date Time Received by: Reraipt Tamperature: $ 111jj q a {s eoifle.00:Project-s aclflc.C1Wnctudes;Sam le Du lZles, Il pP. P P.. . lln�,/, I rrm,naems.tsbe ❑;YES;�[NOMCP OYyaterSranplefncluded. ❑CT f MCPGWTT/Si O'PWSfrorm. Matrix'Spikes.andforldalrix.Spike•pupHoates Leboretory:OCls 130� �,3U IiF/ cSOttil .'t-. snssnese ,(Requirs c confl ent'duplicale sample; ❑MEJ.❑MCPfGW'-2/S2--❑MWRA.. inoFproject'spedfle:uniees preertanged.Project speclrie'OG R uish re� Dale Time Received by: Container Count. '(1 Tnp;t fa ere i ad,f VOA samplepolleded). ;samples are charged ome per,sampla bests:Icaeh MS'MSD, i( lXMA, O NY STARS'- --0� ' 'and SampliDupllcate requiree;en additional sample`ellquot �y r b h Sign'ure O NH O Drinking.lNeler '- " ' �� �' t1 ' "- Relinquished' ale Time Received Iry Laboratory. ShlpplrtgrAlrbllf yl. W _ [I NY' ❑Waslewaler, ,Y Project Specific OC Required'-' }Selectloi otac Semple' c n.. igis`�Number: �- ,❑�RI ❑Waste Disposal' ,0Sampla Duplicate ❑Pleas sample .�` f '- - I b �3G ' ,,,,.(,`' .r...a� CD s, a ❑VT ❑,Dredge.Mate_nal -0 Matrix Spike Melhad of ShlpmenL•ijLGWA. urlor,G Express Mail C'Federal Expr's Custody5eal - . O '' ❑_ O 0 Matrix SPlke'Dup CUPS llcate - Number. �"" > ❑Hand C' �;,# GROUNDWATER ANALYTICAL Quality Assurance/Quality Control r ^'-"--r-'�--•:.- .� +,; .ate." ^.:r- 44. l .� A Program Overview r1,u w,.• A'' v s-� ;s �- i x .7 4. .3 F ,, Ityy r d';,�. •1:. {°,. 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. k Standards are prepared from commercially obtained reference materials 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. B Definitions ,. 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 .measu'red 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 10 of 1.9 i - GROUNDWATER ANALYTICAL , Quality Control Report., Laboratory Control Samples, LCS LCSD Category: MA DEP EPH Method Instrument ID: GC-12 Agilent 6890 Instrument ID: GC-12 Agilent 6890 QC Batch ID: EP-2922-M Extracted: ` 02-19-09 11:30 Extracted: 02-19-09 11:30 Matrix: Soil Analyzed(AL): 02-20-09 12:41,. Analyzed(AL): 02-20-09 14:12 Units: mg/Kg Analyzed(AR):. 02-20-09 13:26 Analyzed(AR):' 02-20-09 14:58 Analyst: KMC Analyst: KMC 'CAS Number Analyte, LCS LCS Clupleate QC Limits" Spiked n+easuredf Recovery Spiked Me��«d `Recovery4 y _RPD s''•Spike ;RPD„ 111-84-2 n-Nonane(C9) 3.3 1.7 53 % 3.3 .1.7 50% 5 % 30-140% 25°% 124-18-5 n-Decane(Cl 0) 3.3 2.0 61 % 3.3 1.9 57 % 6 % 40-140% 25% _ 112-40-3 n-Dodecane(C12) 3.3 2.4 71 % 3.3 2.2 66 % 8 % 40-140% 25%. 629-59-4 n-Tetradecane(C14) 3.3 2.4 72 % 3.3 '2.2 65 % 9 % 40-140% 25% 544-76-3 n-Hexadecane(C1fi) 3.3 2.6 78 % 3.3 2.3 .71 °% 10 % 40-140,% 25% 59345-3 n-Octadecane(C18) 3.3 2.8 85 °% . 3.3 2.4 74 % 15 °% 40-140% 25°% n/a n-C9 to n-C18 Group 20 14 70 °% 20 13 64 °% 9 °%, 40-140% 25°% 629-92-5 n-Nonadecane(C19) 3.3 2.8 84 °% 3.3 2.5 75 % 10 % 40-140% 25°% 112-95-8 n-Eicosane(C20) 3.3 3.0 90 % 3.3 2.7 82 % 10 % 40-140% 25% 629-97-0 n-Docosane(C22) 3.3 2.9 89 °% 3.3 2.7, 81 % 10 °% 40-140°% 25% 646-31-1 n-Tetracosane(C24) 3.3 2.8 84 °% 3.3 2.5 76 % -10 % 40-140% 25% 630-01-3 n-Hexacosane(C26) 3.3 2.7 82 °% 3.3 2.4 73 % 11 % 40-140% 25% 630-02-4 n-Octacosane(C28) 3.3 2.7 81 % 3.3 2.4 73 °% 11_°% 40-140% 25°% 638-68-6 n-Triacontane(C30) 3.3 2.7 83 % 3.3 2.5 74 °% 11 °% 40-140% 25°% 630-06-8 n-Hexatriacontane(C36) 3.3 2.4 72 °% 3.3 2.1 64 °% 12 °% 40-140% 25°% n/a n-C19 to n-C36 Group 26 22 83 °% 26 20 75 °% 11 % 40-140°% 25°% 91-20-3 Naphthalene 3.3 2.0 60 % 3.3 1.8 56 °% 7 % 40-140% 25% _ 91-57-6 2-Methyl naphthalene 3.3 2.2 67 °% 3.3 2.0 62 °% 7 % 40 140°% 25% 208-96-8 Acenaphthylene 3.3 2.2 68 % 3.3 2.1 63 % 8 °% 40-140°% 25% 83-32-9 Acenaphthene 3.3 2.3 69 °% 3.3 2.1 64 °% 8 % 40-140°% 25% 86-73-7 Fluorene 3.3 2.5 75 % 3.3 -2.3 . 68 °% 9 % 40-140% 25°% 85-01-8 Phenanthrene 3.3 2.7 82 % 3.3 2.4 74 % 10 % 40-140% 25°% 120-12-7 Anthracene 3.3 3.0 91 % 3.3 2.7 83 °% 9 °% 40-140°% 25°% a . 206-44-0 Fluoranthene 3.3 3.1 94 % 3.3 2.8 86 % 9 °% 40-140°% 25% 129-00-0 Pyrene 3.3 3.1 93 °% 3.3 2.8 85 % 8 % 40-140%- 25°% 56-55-3 Benzo[a]anthracene 3.3 3.2 96 % 3.3 3.0 90 °% 7 °% 40-140% 25% 218-01-9 Chrysene 3.3 3.0 91 °% 3.3 2.8 85 % 7 °% 40-140% 25°% 205-99-2 Benzo[b]fluoranthene 3.3 3.0 90 °% 3.3 2.7 83 % 8 % 40-140% 25°% 207-08-9 Benzo[k]fluoranthene 3.3 3.0 91 °% 3.3 2.8 ' 84 % 8 % 40-140% 25% 50-32-8 Benzo[a]pyrene 3.3 3.2 97 °% 3.3 3.0 90 °% 8 °% 40-140°% 25% 193-39-5 Indeno[1,2,3-c,d]pyrene 3.3 3.0 89 °% 3.3 2.7 82 % 8 °% 40-140% 250. 53-70-3 Dibenzo[a,h]anthracene 3.3 3.2 98 % 3.3 3.0 91 % 7•% 40-140% 25°% 191-24-2 Benzo[g,h,i]perylene 3.3 2.9 89 °% 3.3 2.7 82 % 9 % 40-140% 25°% n/a PAH Group 56 47 85 °% 56 44 78 % 8 % 40-140% 25°% QC Surrogate Compound" Spiked Me-�.ed Reco"very ;Spiked Me g+�d Recovery" ,,, , ;�w QC Limits ' Fractionation: 2-Fluorobiphenyl 2.7 2.1 78 °% 2.7 2.0 74 °% 40-140% 2-Bromonaphthalene 2.7 2.2 81 % 2.7 2.1 78 °% 40-140% Extraction: Chloro-octadecane 2.7 2.0 74 °% 2.7 1.8 67 % 40-140% ortho-Terphenyl 2.7 2.4 89 °% 2.7 2.3 85 % 40-140% t• „. ,p, r , „` , . ,+ .% `Fractionation Breaktlirou•g h Evaluations r� ,1,, !•y;, r t, R. 7,a.., x QC Limits k.. 91-20-3 Naphthalene LCS 0 °% LCSD 0 % 5% , 91-57-6 '2-Methylnaphthalene LCS 0 % LCSD 0 % 5% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision'i.1,2604). Method modified by use of microwave accelerated solvent extraction technique. i 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. 4 The LCS and LCSD are prepared from separate source standards than those used for calibration. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 025320age 11 of 19 ' GROUNDWATER ANALYTICAL Quality Control Report Method Blank Category: MA DEP EPH Instrument ID: GC-12 Agilent 6890 QC Batch ID: EP-2922-M Extracted: 02-19-09 11:30 Matrix: Soil Analyzed(AL): 02-20-09 15:44`• Analyzed(AR): 02-20-09.16:29 Analyst: KMC „ EPH Ranges r .� ;Concentration Notes " - _ Utits Iteportinglfinit n-C9 to n-C18 Aliphatic Hydrocarbons t BRL mg/Kg 30, n-C19 to n-C36 Ali hatic Hydrocarbons t BRL mg/Kg 30 n-C11 to n-C22 Aromatic Hydrocarbons t0 BRL mg/Kg 30 Unad'usted n-C11 to n-C22 Aromatic Hydrocarbons t BRL mg/Kg, 30 CAS Number- ' Analyte 9: ''' "concentration -Nofes Units' €lieportmg um(t 91-20-3 Naphthalene BRL mg/Kg 0.50 91-57-6 2-Methyl naphthalene 3:: BRL mg/Kg 0.50 85-01-8 Phenanthrene BRL mg/Kg 0.50 83-32-9 Acenaphthene BRL mg/Kg 0.50 208-96-8 Acenaphthylene BRL mg/Kg " 0.50' 86-73-7 Fluorene" BRL mg/Kg 0.50 120-12-7 Anthracene BRL mg/Kg 0.50 206-44-0 Fluoranthene BRL mg/Kg 0.50 129-00-0 Pyrene BRL mg/Kg 0.50 56-55-3 Benzo[a]anthracene BRL mg/Kg 0.50 218-01-9 Chrysene BRL mg/Kg 0.50 205-99-2 Benzo[k]fluoranthene BRL mg/Kg .0.50 207-08-9 Benzo[k]fluoranthene BRL mg/Kg 0.50 50-32-8 Benzo[a]pyrene BRL mg/Kg 0.50 193-39-5 In den ? BRL ' mg/Kg 0.50 53-70-3 Dibenzo[a,h]anthracene BRL - mg/Kg 10.50 - 191-24-2 Benzo[g,h,i]perylene BRL mg/Kg 0.50 QC Surrogate Compound ",,, s Spiked; Measured _, Recovery_` F ,�_ QC L'imits ' Fractionation: 2-Fluorobiphenyl 2.7 2.1 77% 40-140% 2-Bromonaphthalene 2.7 2.1 79 % 40-140% Extraction: Chloro-octadecane 2.7 2.0 74% 40-140% ortho-Terphenyl 2.7 2.2 84 % -40-140%. Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). . Sample extraction performed by microwave accelerated solvent extraction technique. 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. t 'Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-022 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. i Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532page 12 of 19.- GROUNDWATER - ANALYTICAL Quality Control Report Laboratory Control Samples` LCS LCSD Category: MA DEP VPH Instrument ID: GC-1 HP 5890 Instrument ID: GC-1 HP 5890 QC Batch ID: -VP-1546-E Analyzed: 02-20-09 12:27 Analyzed: 02-20-09 13:07. Matrix: Soil Analyst- TRA Analyst: TRA Units: mg/Kg CAS Number Analyte �LCS. '' 4 ' '`'`'LCS Duplicate � z _ "'QC Limits' 1 Spiked Me �.ed Recovery Spiked M�.�«d =Recovery;, RPD „• '• Spike RPD! 109-66-0 n-Pentane 2.5 3.1 122 % 2'.5 3.1 123 % 1 % 70-130% 25 107-83-5 2-Methylpentane 2.5 3.1 122 % 2.5 3.1 123 % 0'% 70-130°% 25% 540-84-1 2,2,4-Tri methyl pentane 2.5 2.9 " 114 % 2.5 2.9 115 % 1 %: 70-130% 25% n/a Aliphatic Group 1 7.5 9.0 120 % 7.5 9.0 120 % 1 % 70-130% 25% 111-84-2 n-Nonane 2.5 2.7 109 % 2.5 2.7 109 % 1 % 70-130%_ 25% 124-18-5 n-Decane 2.5- 3.1 124 % 2.5 3.0 119 % 4 % 70-130% 25% 1678-93-9 n-Butylcyclohexane 2.5 2.9 114 % 2.5 2.8 113 % 1 % 70-130% 25% n/a Aliphatic Group 2 7.5 8.7 116 % 7.5 8.5 114 % 2 °% 70-130% 25% 1634-04-4 Methyl tert-butyl Ether 2.5 2.7 109 % 2.5 2.7 107 % 2 V 70-130%, 25% 7143-2 Benzene .. 2.5 2.7 109 % 2.5 2.7 107 % 1 °% 70-130% 25°% 108-88-3 Toluene 2.5, . 2.9 114 % 2.5 2.8 112% 1 % 70-130% 25% 100-41-4 Ethylbenzene 2.5 2.8 113 % 2.5 2.8 112 % 1 % 70-130% 25% 108-38-3 and 10642-3 meta-xylene and Para-xylene : 5.0 5.7 115 %` 5.0 5.6- 113'% 1 % - 70-130% 25°% 95-47-6 ortho- Xylene 2.5 2.8 111 °% 2.5 2.8 110 °% 1 % .70-130% 256/6 95-63-6 1,2,4-Tri methyl benzene 2.5 2.9 116 % 2.5 2.9 114 % 2 % 701-130% 25% 91-20-3 Naphthalene 2.5 2.7 108 % 2.5 2.6 105 % 3 % 70-130% 25% n/a Aromatic Group 23 25 1 111 °% 23 25 111 % 0 % 70-130% 25% QC Surrogate Compound.," a Spiked�Iured ;Recovery Spiked Me �.ea. Recovery t 4r,11,'; ",QC Limits" 2,5-Dibromotoluene(PID) 2.5 3.0 119 °% 2.5 2.8 114 % 70-130% 2,5-Dibromotoluene(FID) 2.5 . 3.0 120 °% 2:5 1 2.9 118 % 70-130% Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). 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. Groundwater Analytical, Inc.,P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532Page 13 of 19 GROUNDWATER ANALYTICAL Quality Control Report i Method Blank Category: MA DEP VPH Instrument ID: GC-1 HP 5890 QC Batch ID: VP-1546-E Analyzed: 02-20-09 13:48 Matrix: Soil Analyst: TRA VPH.Ranges s ;Concentration ,t; i` Notes. ' ;Units.; ','"Reporting Limit , n-05 to n-C8 Aliphatic H drocarbons t0 BRL mg/Kg 1.0 n-C9 to n-C12 Aliphatic Hydrocarbons t® BRL mg/Kg 1.0 n-C9 to n-C10 Aromatic Hydrocarbons t BRL mg/Kg 1.0 Unadjusted n-05 to n-C8 Aliphatic Hydrocarbons t BRL mg/Kg 1.0 Unndiusted n-C9 to n-C12 Aliphatic Hydrocarbons t BRL mg/Kg 1.0 CAS Number; Analyte._ s w .Concentration Not `Units' 'Reporting Limit. 1634-044 Methyl ten-butyl Ether : BRL mg/Kg 0.05 71-43-2 Benzene° BRL mg/Kg 0.10 108-88-3 Toluene° BRL mg/Kg 0.10 100-41-4 Eth (benzene$ BRL mg/Kg 0.10 108-38.3 and 106-42-3 meta-X lene and para-k lene# BRL - - - mg/Kg 0.10 i ' 95-47-6 ,BRL m K .10 ortho- X lene g/ g 0 , 91-20-3 Naphthalene BRL mg/Kg 0.50 QC Surrogate Compound: "*ked` Measured Recovery;, 1.QC Limits w 4 2,5-Dibromotoluene(PID) 2.5 2.8 112 % 70-130% 2,5-Dibromotoluene(FID) 2.5 2.8 112 % 70=130% Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). 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. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-05 to n-C8 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations. ® n-C9 to n-C12 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations and the concentration for the n-C9 to n-C10 Aromatic Hydrocarbons range. 1t �Analyte elutes in the n.-05 to n-C8 Aliphatic Hydrocarbons range. , t Analyte elutes in the n-C9 to n-C12 Aliphatic Hydrocarbons range. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay, MA.02532page 14 of 19 GROUNDWATER ANALYTICAL Quality Control Report Laboratory,Control Category: ASTM D3328-00 Mod Hydrocarbon Fingerprint Instrument ID: GC4 HP 5890 QC Batch ID: HF-2944-M Extracted: 02-19-09 14:30 Matrix: Soil ` Analyzed: 02-20-09 20:38 Units: mg/Kg Analyst: MB Analyse ""� '.Spiked Measured ;Recovery �;QC Liinits ' Fuel Oil No.2 130 120 89 % 60-140% QC Surrogate Compound_ _, F z Spiked t. Measured, :, Recovery a r 'w_ QC Limits.: ortho-Terphenyl 2.7 2.7 1 101 % 30-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, American Society for Testing and Materials(2000). Method modified to quantify total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons,using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. 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. 4 Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 02532Page 15 of.19 GROUNDWATER ANALYTICAL Quality Control Report Method Blank. 4 Category: ASTM D3328-00 Mod Hydrocarbon Fingerprint Instrument ID: GC4 HP 5890 QC Batch ID: HF-2944-M Extracted: 02-19-09 14:30 Matrix: Soil Analyzed: 02-20-09 19:43 Analyst: MB Analyte _, "`" " ""_ `C6-6ntiation r' Notes Ur11t5 Reporting Limit. Total Petroleum Hydrocarbons BRL mg/Kg 60 'QC-Surrogate Co'rripound; -' Spiked, Measured r ,,' Recove - .'` ry, , : _ �'QG Limits „ ortho-Terphenyl 2.7 1 2.6 1 96 %. 60-140% Method Reference: Comparison of Waterborne Petroleum Oils by Gas Chromatography,Annual Book of ASTM Standards,Volume 11.02, z American Society for Testing and Materials(2000). Method modified to quantif/total petroleum hydrocarbons in the range n-C 9 through n-C 36. Results are quantified on the basis of a series of aromatic and aliphatic hydrocarbons;using 5-alpha-androstane as an internal standard. Sample extraction performed by microwave accelerated solvent technique. 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. Groundwater. Analytical, Inc.; P.O. Box 1200, 228 Main Street; Buzzards Bay,MA 025320age 16 of 19 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.groundwateranalZical.com/qualifications.htm CONNECTICUT e a�tom' s i i `' Department of Health Services,PH-0586 Potable Water,Wastewater,Solid Waste and Soil http://www.ct.gov/dpM ib/dph/environmental_health/environmental_laboratories/pdf/0ut_State.pdf MASSACHUSETTSe .z �k, tt, :yC .i�,i• .e ra �` .,a ,`ar« Lt'. .t�rx '�4a .e � ��'�� Department of Environmental Protection, M-MA-103 Potable Water and Non-Potable Water http://public.dep.state.ma.usAabcerttlabcert.aspx Department of Labor, Asbestos Analytical Services,Class A Division of Occupational Safety, AA000195 http://www.mass.gov/dos/f`orms/la-rpt_list aa.pdf NEW HAMPSHIRE �•. 1 ,' ,` e r „', "` .;(: ��.e� Department of Environmental Services, 202708 Potable Water,Non-Potable Water,Solid and Chemical Materials http://www4.egov.nh.gov/DES/N HE LAP s NEWYORK ".. Department of Health, 11754 Potable Water,Non-Potable Water,Solid and Hazardous Waste http://www.wadswonh.org/labcert/elap/comm.html NIST NATIONAL,VOLUNTARY.LABORATORY,ACCREDITATION PROGRAM'(NVLAP) :.�; NVLAP Lab Code 200751-1 Bulk Asbestos Fiber Analysis(PLM) http://ts.nist.gov/Standards/scopes/plmtm.htm RHODE ISLAND - � - r• Department of Health, Potable and Non-Potable Water Microbiology,Organic and Inorganic Chemistry Division of Laboratories, LA000054 http://www.health.ri.govAabs/outofstatelabs.pdf . ''eh c -tea ^, .'.s,: er .wt+ +.ua is^ -rp- i _EYi ce•.;',p '` ..' 'k.�..ti .. U.S. DEPARTMENT OF AGRICULTURE 4 USDA,Soil Permit, S-53921 Foreign soil import permit VERMONT; ,a ,r� � ' t<�- •,y a ` t �• f.4 y �'# wd' ..'7NFs �. ,•.tis ,1{V`+K, h�1tK�s..r`�.Ti. •_rk..J" .,a-�i��"M ^Yr: .K.,�^T�+., sfy„48 tknr�� k Department of Health, VT-87643 Potable Water http://healthvermont.gov!envi ro/ph_lab/ovate r_test.as px#cert Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532 Page 17 of 19 GROUNDWATER ANALYTICAL Certifications and Approvals A MASSACHUSETTS ." .�. vr, n i • «, , .;' .x :P. ,C)'epartment of.Environmental•Protectton; M-MA-]03. 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. r Potable Water(Drinking Water) +Non-Potable Water(Wastewater) Analyte Method Analyte ,, Method 1,2-Dibromo-3-Chloropropane EPA504.1 Ammonia-N Lachat 10-167-06-1-B 1,2-Dibromoethane EPA 504.1 Antimony EPA 200.7, Alkalinity,Total SM 2320-B Antimony. EPA 200.8 Antimony EPA 200.8 Antimony. EPA 200.9 Antimony EPA 200.9 Arsenic EPA 200.7 Arsenic EPA 200.8 Arsenic EPA 200.8 Arsenic EPA 200.9 Arsenic EPA 200.9 Barium EPA 200.7, - Beryllium EPA 200.7 Barium EPA 200.8 a Beryllium EPA 200.8 -� { Beryllium EPA.200.7 Beta-BHC. EPA 608 Beryllium EPA.200.8 Biochemical Oxygen Demand SM 5210-B Cadmium EPA 200.7 Cadmium EPA 200.7 Cadmium EPA,200.8 Cadmium EPA 200.8 Calcium EPA,200.7 Calcium EPA 200.7 Chlorine,Residual Free SM 4500-CL-G Chemical Oxygen Demand SM 5220-D . Chromium EPA 200.7 Chlordane ''. EPA 608 a Copper EPA 200.7 Chloride EPA 300.0 Copper EPA 200.8 Chlorine,Total Residual SM 4560-CL-G Cyanide,Total Lachat 10-204-00-1-A Chromium EPA 200.7 E.Coli(Treatment and Distribution) EC-MUG SM 9221-F "Chromium EPA 200.8 " E.Coli(Treatment and Distribution) Enz.Sub.SM 9223 Cobalt EPA 200.7 E.Coli(Treatment-and Distribution) NA-MUG SM 9222-G Cobalt EPA 200.8 Fecal Coliform(Source Water) MF SM 9222-D Copper EPA 260.7 Fluoride EPA 300.0 Copper EPA 200.8 Fluoride SM 4500-F-C Copper EPA 200.9 Heterotrophic Plate Count SM 9215-8 Cyanide,Total. Lachat 10-204-00-1-A Lead EPA 200.8 DDD EPA 608 Lead EPA 200.9 DDE EPA 608 Mercury EPA 245.1 DDT EPA 608 Nickel EPA 200.7 +` Delta-BHC" EPA 608 Nickel EPA 200.8 Dieldrin . EPA 608 Nitrate-N EPA 300.0 Endosulfan I EPA 608 Nitrate-N Lachat 10-107-04-1-C Endosulfan 11 EPA 608 Nitrite-N EPA 300.0 Endosulfan Sulfate EPA 608 Nitrite•N Lachat 10-107-04-1-C Endrin EPA 608 pH SM 4500-H-B Endrin Aldehyde EPA 608 Selenium EPA 200.8 Fluoride EPA 300.0 Selenium EPA 200.9 Gamma-BHC EPA 608 Silver EPA 200.7 Hardness(CaCO3),Total EPA 200.7 Silver EPA 200.8 Hardness(CaCO3),Total SM 2340-B Sodium EPA 200.7 Heptachlor_ EPA 608 Sulfate EPA 300.0 `Heptachlor Epoxide EPA 608 Thallium EPA 200.8 Aron" EPA 200.7 Thallium EPA 200.9 Kjeldahl-N Lachat 10-107-06-02-D Total Coliform(Treatment and Distribution) Enz.Sub.SM 9223 Lead EPA 200.7 Total Coliform(Treatment and Distribution) MF SM 9222-B Lead EPA 200.9 Total Dissolved Solids SM 2540-C Magnesium EPA 200.7, Trihalomethanes EPA 524.2 Manganese EPA 200.7 Turbidity SM 2130-B Manganese EPA 206.8 Volatile Organic Compounds EPA 524.2 Mercury . EPA 245.1 Molybdenum. _ EPA 200.7 Non-Potable Water(Wastewater) Molybdenum EPA 200.8 Analyte Method Nickel EPA 200.7 Nickel EPA 200.8 Aldrin EPA 608. Nickel EPA 200.9 Alkalinity,Total Lachat 10-303-31-1-A Nitrat&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 Aluminum EPA 200.8 Oil and Grease EPA 1664 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 18 of 19- d . GROUNDWATER ANALYTICAL 'Certifications and Approvals Departm"ent,of,,EndironmentAFProtectia, '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. Non-Potable Water(Wastewater) Analyte Method Orthophosphate Lachat 10-115-01-1-A± pH SM 4500-H-B Phenolics,Total EPA 420.4 Phenolics,Total Lachat 10-210-00-1-13 Phosphorus,Total Lachat 10-115-01-1-G Phosphorus,Total SM 4500-P-B,E Polychlorinated Biphenyls(Oil) EPA 60074-81-045 Polychlorinated Biphenyls(Water) EPA 608 Potassium EPA 200.7 Selenium EPA 200.7 Selenium EPA 200.8 .. Selenium EPA 200.9 Silver EPA 200.7 Sodium EPA 200.7 Specific Conductivity SM 2510-B 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 Thallium EPA 200.9 Titanium EPA 200.7 Total Dissolved Solids SM 2540-C Total Organic Carbon SM 5310-8 Toxaphene EPA 608 Vanadium EPA 200.7 Vanadium EPA 200.8 Volatile Aromatics EPA 602 , J Volatile Aromatics EPA 624 Volatile Halocarbons EPP.624 Zinc EPP,200.7 Zinc EPP.200.8, Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 19 of 19 GROUNDWATER ,— Groundwater Groundwater Analytical,Inc. P.O.Box 1200 ANALYTICAL Buzzards 228 Main Street " • Bay,MA 02532 Telephone(508)759-4441 FAX(508)759-4475 www.grou ndwateran alyti cal.co m March 20, 2009 Mr. David Bennett Bennett e ett Environmental Associates .Inc. P.O. Box 1743 Brewster, MA 02631 LABORATORY REPORT . Project: Field/10081 Lab ID: 123971 Received: 03-13-09 Dear Dave: Enclosed are the analytical results for the above referencedproject. The project was processed for Priority turnaround. This letter authorize's 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 or NVLAP 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. 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 beilief, accurate and complete. Should you have any questions concerning this report„please do not hesitate to contact me. Sincerely, . .. Eric H.Je sen Operatio s Ma ages EHJ/elm Enclosures Page 1 of 18 GROUNDWATER r ANALYTICAL Sample Receipt Report Project: Field/10081 Delivery: GWA Courier Temperature: 2.0°C Client: Bennett Environmental Associates,Inc. Airbill: n/a Chain of Custody: Present Lab ID: 123971 Lab Receipt: 03-13-09 Custody Seal(s); n/a ' Lab ID Field ID Matrix ' Sampled Method' Notese` ' 123971-1 MW-1 Aqueous 3/12/09 13:30 MA DEP VPH with Targets Con ID Container I Vendor QC Lot Presery QC Lot Prep Ship C1151704 40 mL VOA Vial Proline BX31948 HCL R-5500D 10-30-08 12-05-08 C1138350 40 mL VOA Vial BX32683 HCL R-5614B 01-16-09. 03-09-09 C1138349 40 mL VOA Vial BX32683 HCL R-5614B 01-16-09 03-09-09 I Lab ID Field ID` _ Mkrix ,Sarripled Metho8dk. Notes , 123971-2 MW-1 Aqueous 3/12/09 13:30 MA DEP EPH with PAHsby 8270C-Mod SIM Con ID Container Vendor QC Lot Presery QC Lot Prep Ship C1149031 1 L Amber Glass Proline BX31905 H2SO4 n/a n/a 11-14-08 C1149030 1 L Amber Glass Proline BX31905 H2SC4 n/a n/a 11-14-08 _ k µ Groundwater Analytical, Inc., P.O..,Box 1200,228 Main Street, Buzzards Bay, MA 02532 Page 2 of 18 �Y. GROUNDWATER ANALYTICAL Data Certification Project: Field/10081 Lab ID: .123971 Client: Bennett Environmental Associates,Inc. Received: 03-13-09 17:30 MA DER,Compendium of Analytical Methods Project Location: n/a MA DEP RTN: ' n/a This Form provides certifications for the;following data set: MA DEP VPH: 123971-1. , MA DEP EPH: 123971-2 Sample Matrices: Groundwater (:X) Soil/Sediment ( ) Drinking Water ( ) Other ( ) MCP SW-846 8260E ( ) 8151A ( ) 8330 ( ) 6010E ( ) 7470A/1A ( ) Methods Used 8270C ( ) 8081A ( ) VPH '(X) 6020A ( ) 9012A2 ( ) As specified in MA DEP 8082 ( ) 8021 B ( ) - EPH, (X) 7000 S3 ( ) •Other Compendium of Analytical 1. List Release Tracking Number(RTN),if known. Methods. 2.Sw-846 Method 901.2A(Equivalent to 9014)or MA DEP,Physiologically Available Cyanide(PAC)Method (check all that apply) s.s-Sw-846 Methods 7000 Series.List individual method and'analyte. 7 An affirmative response to questions A,B,C and D is required for"Presumptive Certainty"status. A. Were all samples received by the laboratory in a condition consistent with / that described on the Chain-of-Custody documentation for the data set? Yes J B. Were all QA/QC procedures required for the specified analytical method(s) included in this report followed,including the requirement to note and discuss in a narrative QC data that did not meet appropriate performance . standards or guidelines? Yes C. Does the analytical data included in this report meet all the requirements for"Presumptive Certainty,"as described in Section 2.0 of the MA DEP _ document CAM VI A,Quality Assurance and Quality Control Guidelines ` for the Acquisition and Reporting of Analytical Data? Yes D. VPH and EPH methods only: Was the VPH or EPH method run without / significant modifications,as specified in Section 11:3? Yes A response to questions E and F below is required for"Presumptive Certainty"status. E. Were all QC performance standards and recommendations for the specified methods achieved? Yes F. Were results for all analyte-list compounds/elements for the specified method(s)reported? / Yes All No answers are addressed in the attached Project Narrative. I,the undersigned,attest under the pains and penalties of perjury that,based upon my personal - Inquiry of those responsible for obtaining the information,the material contained in this analytical report Is,to the best of my knowledge and belief,accurate and complete. Signature: Position:` Operations Manager Printed Name: Eric H.J Date: 03-20-09 s , Groundwater Analytical, Inc.., P.O. Box 1200,228 Main Street, Buzzards Bay, MA 02532Page 3 of 18 4 GROUNDWATER ANALYTICAL Massachusetts DEP VPH Method Volatile Petroleum Hydrocarbons by GC/PID/FID Field ID: MW-1 Matrix: Aqueous Project: field/10081 Container: 40 mL VOA Vial Client: Bennett Environmental Associates,Inc. Preservation: HCl/Cool Laboratory ID: 123971-01 QC Batch ID: VGt-1422-W Sampled: 03-12-09 13:30 Instrument ID: GC-1 HP 5890 Received: 03-13-09 17:30 Sample Volume: --5 mL Analyzed: 03-17-09 15:40 Dilution Factor. 1 Analyst: CRL VPH Ranges Concentritionm Notes Units Reporting Limit n-05 to n-C8 Aliphatic Hydrocarbons t0 BRL ug/L 20 n-C9 to n-C12 Aliphatic Hydrocarbons to BRL ug/L 20 n-C9 to n-C10 Aromatic Hydrocarbons t BRL ug/L 20 Unad'usted n-05 to n-C8 Aliphatic Hydrocarbons t BRL ug/L 20 Unadjusted n-C9 to n-C12 Aliphatic Hydrocarbons t BRL ug/L 20 CAS Number _ Analyte Concentration ,' Notes ',Units- Reporting Limit 1634-044 Methyl tert-butyl Ether BRL ,ug/L 5 7143-2 Benzene° BRL ug/L 1 108-88-3 Toluene° BRL ug/L 5 100-414 Eth (benzene# BRL ug/L. 5 108-38-3 and 106-42-3 meta-X lene and ara-X lene# - BRL ug/L 5 9547-6 ortho- X lene$ BRL ug/L 5 91-20-3 Naphthalene BRL ug/L 5 QC Surrogate Compound__ ,-. rSpikedh Measured - Recovery r- _ QC Limits 2,5-Dibromotoluene(PID) 50 48 97 % 70-130% 2,5-Dibromotoluene(FID) 50 48 95 % , 70-130% A/ C Certification. a 1. Were all QA/QC procedures required by the method followed? r Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3.2.1? No Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DER(Revision 1.1,2004). 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. t (Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range., 0 n-05 to n-C8 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations. ® n-C9 to n-C12 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations and the concentration for the n-C9 to n-C10 Aromatic Hydrocarbons.range. R .Analyte elutes in the n-05 to n-C8 Aliphatic Hydrocarbons range. _ - # Analyte elutes in the n-C9 to n-C12 Aliphatic Hydrocarbons range. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532 Page 4 of 1.8 GROUNDWATER y ANALYTICAL r Massachusetts DEP EPH Method Extractable Petroleum Hydrocarbons by GC/FID Field ID: MW-1 < ; Matrix: Aqueous Project: Field/10081 Container:. 1 L Amber Glass Client: Bennett Environmental Associates,Inc. Preservation: H2SO4/Cool Laboratory ID: 123971-2 QC Batch ID: EP-2182-F Sampled: 03-12-09 13:30 . Instrument ID: GC-9 Agilent 6890 Received: 03-13-09 17:30 Sample Volume: 980 ml. - Extracted: 03-17-09 17:00 Final Volume:, 1 mL Analyzed(AL): 03-19-09 03:13 Aliphatic Dilution Factor. 1 Analyzed(AR): 03-19-09 03:58 Aromatic Dilution Factor: 1 Analyst: KMC EPH.Ranges n B 3 _: ;Concentration:. N'otes'° ` Units Report ingiimit„ n-C9 to n-C18 Aliphatic Hydrocarbons t BRL ug/L 510 n C19 to n C36 Aliphatic Hydrocarbons t BRL ug/L 510 n-C11 to n-C22 Aromatic Hydrocarbons t0 BRL ug/L 150 Unadiusted n-Cl1 to n-C22 Aromatic Hydrocarbons t• BRL ug/L- 150 C Surrogate Compound _ S tkedl-=Measured Recove - ' °Q g P � P rY. �_ QGtiinits Fractionation: 2-Fluorobiphenyl 41 43 105 % 40-140 2-Bromonaphthalene• 41 43 105 % 40-140% Extraction: Chloro-octadecane 41 30 72 % 40-140% ortho-Terphenyl 41 40 99 % 40-140% ,QA/QC-CertificAion 1. Were all QA/QC procedures required by the method followed? Yes 2. Were all performance/acceptance standards for the required QA/QC procedures achieved? Yes 3. Were any significant modifications made to the method,as specified in Section 11.3? No ' Method non-conformances indicated above are detailed below on this data report,or in the accompanying project narrative'and project quality control report. Release of this data is authorized by the accompanying signed project cover letter. The accompanying cover letter,project narrative and quality control report are considered part of this data report.- Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DER(Revision 1.1,2004). Sample extraction performed by separatory funnel technique. 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. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 Page 5 of 18 GROUNDWATER ANALYTICAL EPA Method 8270C(Modified) MA DEP EPH Polynuclear Aromatic Hydrocarbons by GC/MS-SIM Field ID: MW-1 Matrix: Aqueous Project: Field/10081 Container: 1 L Amber Glass Client: Bennett Environmental Associates,Inc. Preservation: H2SO4/Cool Laboratory ID: 123971-02 QC Batch ID: EP-2182-F Sampled: 03-12-09 13:30 Instrument ID: MS-6 HP 6890 Received: 03-13-09 17:30 Sample Volume: 980 mL Extracted: 03-17-09 17:00 Final Volume: 1 mL. Analyzed: 03-19-09 19:36 Dilution Factor: 1 Analyst: MJB 'CAS Number`. Analyte TConcentration 'Notes 'Units Reporting Limit 91-20-3 Naphthalene BRL ug/L 0.5, 91-57-6 2-Methyl naphthalene BRL ug/L 0.5 208-96-8 Acenaphthylene BRL� ug/L 0.5 83-32-9 Acenaphthene BRL ug/L 0.5 86-73-7 Fluorene BRL ug/L 0.5 85-01-8 Phenanthrene BRL, ug/L 0.5- 120-12-7 Anthracene BRL ug/L 0.5 206-44-0 Fluoranthene BRL ' ug/L 0.5 129-00-0 Pyrene BRL ug/L 0.5 56-55-3 Benzo[a]anthracene BRL ug/L 0.1 218-01-9 Chrysene BRL ug/L 0.1 205-99-2 Benzo[b]fluoranthene BRL ug/L 0.1 207-08-9 Benzo[k]fluoranthene BRL ug/L 0.1 50-32-8 Benzo[a]pyrene BRL ug/L 0.1 193-39-5 Indeno[1,2,3-c,d]pyrene BRL ug/L 0.1 53-70-3 Dibenzo[a,h]anthracene BRL ug/L 0.1 191-24-2 Benzo[g,h,i]perylene BRL ug/L 0.1 C Surrogate Compound Spiked.-''Measured Recove Q g Pry QC-Limits...ct':•�_ ortho-Terphenyl 41 ..- 137 90 % 40-140% Method Reference: Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Method modified by use of selected ion monitoring(SIM)in accordance with-Section 7.5.5 of the method. Method protocol modified to include acidification and the surrogate compound in accordance with the MA DEP Method for the Determination of Extractable Petroleum Hydrocarbons. Sample extraction performed by EPA Method 3510C. 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. F i Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street,:Buzzards Bay,MA 02532 Page 6 of 18 GROUNDWATER ANALYTICAL Project Narrative Project: Field/10081 Lab 1D: 123971 Client: Bennett Environmental Associates,Inc. Received: 03-13-09 17:30 u•_/ KY*t A.�Documentation'and'Client Co muncaton �° .h i.uf' r 'i#y'' �"• The following documentation discrepancies,and client changes or amendments were noted for this project:' 1 . No documentation discrepancies,changes,or amendments were noted. .4 . Y h 8.Method Modifications,"n=Conformances and Obsetvations . _ ° k t #' " 7�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 . MA DEP EPH Note: Sample 123971-2. Polynuclear aromatic hydrocarbon(PAH)target analytes were identified and quantified by GUMS-SIM,in accordance with the method provision for alternate determinative methodologies. GUMS-SIM was used to achieve low quantification limits necessary for regulatory compliance. Target analytes were determined utilizing the same sample extract used for carbon range determination by GC/FI D. ; Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532Page 7 of 18. {` t, , 'y'p.*-t, -T1•ar,,#t!;:,vSP+�*,,y..i^s [�. .,, ,r -- . , , •- „ki ;+dam _ ,. - ...-,.-..,+-.-r•--.,m �"-. ''"'° a g228 Malri Streel.P.Ol Box 1200 r ' �46 , ►NDWi4TER i:BDZZarda.9ay;MAD2592 `. CHAIN-OF-CUSTODY RECORD' - ANAL ^/�a q . Telephone:(508)'759-4441-'FAX(508)759A475 AND-WORK ORDER '/"{N�4 'Y<TICAL x :Www.gmundwaleranalyllcal:com Project-Name: Firm: 1: TURNAROUNDS- ANALYSIS REQUEST �,I��,' _ 'J�N �'�(Vv•�-1Srd�. +6�ta [I STANDARD(10 Buslriese'Days)'�r,. ,,,� M :Vot»aor aunlw4utm ';I'see 'Hhab r`ucnumH dnu,ton hl.TM WHua, evoanlcnemtnn minr. Project Numlber: Address: PRIORITY`(5 Business Days) gl 1 p/�� (fit O RUSti(RAN. ra a a W G •(Flush requires Rush AuUnrimtlon Number),` :1 n. O�`` ' ❑ [ n, Sampler Name: City'/-State I Zip: 6(Pleeaa Email to: ❑Please FAX to: ` t JSrfZ "Wzll - e ! Project Manager. Telephone: BILLING:: �;', `1 cA e o o g o •d�W - - - Purchase Order No.: •� a, € a x ; o • . _ ❑ Third Party Billing: D.. . e " _ INSTRUCTIONS:.Use separate linaforeach container(axc apt replicates):. ❑ GWA'Cluote: g tb ° g.° e ❑ Sa matrixTypel Conleier(s) Preservation -❑ ❑ ❑ ❑ ^ ❑ C ❑ c. n mpling ` 19 _ psp p LABORATORY s_ a p g g� 3 ❑ U .❑ SAMPLE. wi& '� NUMBERIDENTIFl CATION s •„ it. (tab!Use Only). a. A s s is _❑❑ ❑❑ ❑ n ❑ u ❑ ❑ ❑ ❑_❑,¢ ❑ n a ❑ o n a n n a n t ❑ I:t ":►r..1�3,�''�'";'�5�'Yi+�r�,r'."�"�s� a'�1,�"�' ±� x#•?k � ,•t�?�$t•�F �=� awtk �,� -��'��w,w'a'� � �f�', '' �...-� !�'"� �* "`. ,. �` �r^� ., .. R n g��@ 6 y,;i, i 4 any y 5� y� �s p t �y !•; aN^4�a e++-..++�,. :�! +.. S�A.�. f .y�.y.�*J ��',((Fy.a fY.+ya�4 �[' q` }1: ,�`;.yp�'�*�y �� �i3�'�r'S:`is� �6 y',+(4.,A h,�'7,"� _ - nl�,i+4r+�liY lii i� �i�F�x[:�7f;.:}•iC � ��i ''h 4' `ft tl�., � . .,.... _ CF!'�' � l➢+ _ rR � rt _..yjF'�!'?[ lrje «.. �� � R }}��.1��� _ 'T � _ ` 1 O V�' �'p. y' r,�p�yp �, � 0=*Mwz" IR!•,'y.'.'Y '9 W 3 ,ib � ,`i!" .-2 - �wo „ "M, ' '12W+' 44 7i� �{ 1Y' '1M YU Ci 1?. i A¢[a•. ,5,•.• A.',q. REMARKS I SPECIAL INSTRUCTIONS DATA•QUALITY'OB, IVES CHAIN-OF-CUSTODY RECORD' MA DEP MCP Date'Enhancement:ANlrmetlon Regulatory Program Pro(ect+SpeCifle QC NOTE::Allsamples submitted subject to Standard Terms and Conditions on reverse hereof.. YES 0 NO MCP Data Cenillcatlon required. +}Slate Standaid - 'Dellverables Many regulatory programs.and'EPA'methodssrequire project inquis .pier. .'.Dale Time Recelved by:'- Receipl Temperawre: _•..h„ ., sea: .• ,,.,,-;��,.,,- ;:-� ,.....: ',specific OC:Piojed specific OCdncluCes Sample Duplicates '., r - 40• ;r .ice,.�t.. ❑YES:O.NO MCP'Ddnking.WaterSrimple'included. iOCT- il� 6P6W-17S•1'�OPWS,Form, eMatrixSpikes?andlor,Matfix,Spike;•Duplidates;.L`eboratory•OQis.T t „ �7���Y� 1 Q ez"J m?s,,;e. '(Require-collectlon;ot'continge Ifcetesantple.; ;O ME'xx.p MCP aW=2lS-2 1j:MWRA �oGproJectspedfic unless;preanariged..,Projac4specllfcAC p regal sample.00llected): aam lesare;charged:on a..pdrsam Ie;desls.Each'.MS MSD R81inquishetl Date Time R eived by: Container Count Td blanks are (MA O NV STAR5r' O' r d Same Ie Du IlcaWre uires ao addltlonelsam le ell uot. Signature: V r q NH' ❑Drinking Watelr s _ p `- -D - 7 .` -_ { yRellnqulahed by; • .Dale Time ecelved by Laboratory: Slupping/Alrbill,� - •t7•NY •❑WesleviAlef' Project SpectRrOC`Requiied Selaettoa or OC Semple _ Number: O.YYasle;Disposald., Semple.0uplicate. CD "3VT O_DredgaMatedet - �' r�Melrix Splkei , xrt.. Method elSNpment:• 6WA'Courler.C;ExpresS�Mas=p Fedora',Express- - Custody Seal;, >•v rTLL s Number.; O - p'_ 0 p Matrix SPllk,,e Duplicate - ;,., - ;y=` jbUPS;p Heed-p GROUNDWATER ANALYTICAL a Quality Assurance/Quality Control _.2_ --A '.. ,,xy.. .aw r... .a.:s++-tr :: ." .sir.--•^S^e*- p °.Program Overview � t 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 of certified purity, and documented for traceabi l ity. F 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 incl6de 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. i `.. B Definitions Batches are used as the basic unit fortQuality 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 asses's 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. F Groundwater Analytical, Inc., P.O.Box 1200, 228 Main Street, Buzzards Bay,MA 02532 Page 9 of 18 n GROUNDWATER ANALYTICAL Quality Control Report Laboratory Control Samples LCS LCSD Category: MA DEP EPH Method Instrument ID: GC-9 Agilent 6890 Instrument ID: GC-9 Agilent 6890 QC Batch ID: EP-2182-F Extracted`. 03-17-09 17:00" Extracted: 03-17-09 17:00 Matrix: Aqueous Analyzed(AL): 03-18-09 13:55 Analyzed(AL): 03-18-09 15:24 . Units: ug/L Analyzed(AR): 03-18-09 14:40 Analyzed(AR): 03-18-09 16:08 Analyst: KMC Analyst: "KMC CAS Number Analyte LCS LCS Duplicate gg 4QC-Limits; Spiked n4 ured Recovery_ Spiked Mewured Recovery. RPID Spike RPID 111-84-2 n-Nonane(C9) 50 26 52 % 50 24 47% 9 % 30-140% 25% 124-18-5 n-Decane(Cl 0) 50 30 61 % 50 28 56 % 8 % 40-140% " 25% 11240-3 n-Dodecane(C12) 50 35 69 % 50 32 63 % 9 % 40-140% 25% 629-594 n-Tetradecane(C14) 50 35 70 % 50 34 67 % ' 5 % -140% 25% 544-76-3 n-Hexadecane(C16) 50 38 77 % 50 38 76 °% 1 % 40-140% 25% 59345-3 n-Octadecane(C18) 50 41 83 % 50 41 82 % 1 % 40-140% , 25% n/a n-C9 to n-C18 Group 300 210 69 % 300 200 65 % 5 % -40-140% 25% 629-92-5 n-Nonadecane(C19) 50„ 42 85 % 50 42 84 % 1 % 40-140% 25% 112-95-8 n-Eicosane(C20) 50 42 83 % 50 41 82 % 2 % 40-140% 25% 629-97-0 n-Docosane(C22) 50 41 82 % 50 41 82 % 0% 40-140% 25% 646-31-1 n-Tetracosane(C24) 50 42 83 % 50 .40 81 % .3 % - 40-140% 25% 630-01-3 n-Hexacosane(C20 50 40 80 % 50 40 79 % 1 % 40-140% 25% 630-024 n-Octacosane(C28) 50 40 80 % 50 39 79 % 2 °% 40-140% 25°% 638-68-6 n-Triacontane(C30) 50 40 81 % 50 -40" 180 % 1 % 40-140°% 25°% 630-06-8 n-Hexatriacontane(C36) 50 36 72 % 50 36 71 % 1 °% 40-140°% 25°% n/a n-C19 to n-C36 Group 400 320 81 % 400 320 80 % 1 % 40-140% 25% 91-20-3 Naphthalene 50 37 74 % 50 37 74 °% T% 40-140°% 25°% 91-57-6 2-Methyl naphthalene 50 42 83 °% 50 41 81 % 3 % 40-140% 25% 208-96-8 Acenaphthylene 50 42 84 % 50 42 83 %. 0 % 40-140% 25% 83-32-9 Acenaphthene 50 42 84 °% 50 42 83 % 1 % 40-140% 25% 86-73-7 Fluorene 50 44 89 % 50 44 89-% 0 % 40-140% 25°% 85-01-8 Phenanthrene 50 47 95 °% 50 47 95 °% 0 % 40-140% 25°% 120-12-7 Anthracene 50 50 99 °% 50 50 99 °%. 0 °% 40-140% 25°% 20644-0 Fluoranthene 50 48 96 % 50 48 96 % 0 % 40-140% 25% 129-00-0 Pyrene 50 47 94 % 50 47 94 °% 0 °% 40-140°% 25°% 56-55-3 Benzo[a]anthracene 50 50 100 % 50 48 96 % 3 °% _ 40-140°% . 25°% 218-01-9 Chrysene 50 46 92 % 50 46 92 % 0 °% 40-140% 25°% 205-99-2 Benzo[b]fluoranthene 50 45 90 % 50 45 91 % 1 % 40-140°% 25°% 207-08-9 Benzo[k]fluoranthene 50 46 92 °% 50 46 91 % 1 % 40-140°% 25% 50-32-8 Benzo[a]pyrene 50 49 98 °% 50 -49 98 % 0 % 40-140°% 25°% 193-39-5 Indeno[1,2,3-c,d]pyrene 50 49 99 % 50 50 99 °% 0 % 40-140% -25% 53-70-3 Dibenzo[a,h]anthracene 50 49 98 °% 50 49 98 % 0 % 40-140°% 25°% 191-24-2 Benzo[g,h,i]perylene 50 47 94 % 50 47 94 % 0 % 40-140°% 25°% n/a PAH Group 850 786' 92% 850 780 91 °% 0 % 40-140% 25% QC Surrogate Compound 'Spiked n+.�, 'Recovery, Spiked MeaSr�d Recovery QC Limits. . _ _ Fractionation: 2-Fluorobiphenyl •40 . 41 103 % 40 41 -102 % 40-140°% 2-Bromonaphthalene 40 . 42 .104 % 40 42 104 % 40-140% Extraction: Chloro-octadecane. 40 31., 77 % 40 30 75 %' 40-140°% ortho-Terphenyl 40 41 103 % 40 41 L102 °% 40-140 Fractionation Breakthrough,Evalu a a ation. r. '.{ •z _ '. QG Limits 91-20-3 Naphthalene LCS 'or°% LCSD 0 % 5% 91-57-6 2-Methyl naphthalene LCS 0 °% LCSD 0%- 5% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004).. Sample extraction performed by separatory funnel techriique. 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. The LCS and LCSD are prepared from separate source standards than those used for calibration. Groundwater Analytical, Inc., P.O. Box 1200,228 Main Street, Buzzards Bay,MA 025320age 10 of 18 . GROUNDWATER ANALYTICAL Quality.Control Report Method Blank Category: MA DEP EPH r Instrument ID: GC-9 Agilent 6890 QC Batch ID: EP-2182-F Extracted: • 03-17-09 17:00 Matrix: Aqueous Analyzed(AL): 03-18-09 16:53 Analyzed(AR): 03-18-09 17:37 Analyst: KMC EPH Ranges - 'C6ncentration Notes Units. Reporting limit n-C9 to n-C18 Ali hatic H drocarbons t BRL ug/L 500 n-C19 to n-C36 Ali phatic H drocarbons t BRL ug/L 500 n-C11 to n-C22 Aromatic Hydrocarbons to BRL ug/L 150 Unadjusted n-C11 to n-C22 Aromatic Hydrocarbons t BRL ug/L" 150 ;QC Surrogate Compound Spiked Measured Recovery ,__ ,QC Limits _ Fractionation: 2-Fluorobiphenyl 40 43 _ 107%° 40-140%° 2-Bromonaphthalene 40 42 106 % 40-140% Extraction: Chloro-octadecane 40 36 89 %. v 40-140% . ortho-Terphenyl 40 42 105 % 40-140% Method Reference: Method for the Determination of Extractable Petroleum Hydrocarbons,MA DEP(Revision 1_1,2004). . Sample extraction performed by separatory funnel technique. Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyze. 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. t Hydrocarbon range data excludes concentrations of any surrogate(s)and/or internal standards eluting in that range. 0 n-C11 to n-C22 Aromatic Hydrocarbons range data excludes the method target analyte concentrations. ti • . Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards`Bay, MA 025320age 11 of 18 GROUNDWATER ANALYTICAL Quality Control Re o Prt .. Laboratory Control Samples LCS LCSD Category: EPA 8270C Modified Instrument ID: MS-6 HP 6890 Instrument ID: M"HP 6890- QC Batch ID: EP-2182-F Extracted: 03-17-09 17:00 Extracted: 03-17-09 17:00 Matrix: Aqueous - Analyzed: 03-19-09 13:30 Analyzed: 03-19-09`14:11 Units: ug/L Analyst: MJB Analyst: MJB CAS Number Analyte LCS LCS Duplicate _., QC. imits Spiked Measured Recovery Spiked Measured Recovery RPD Spike ,RPD', 91-20-3 Naphthalene 5.0 3.3 66 % 5.0- 3.7 74 % 11 % 40-140% 20% 91-57-6 2-Methylnaphthalene 5.0 3.3 66 % 5.0 3.7 74 % 11 % 40-140% 20% 85-01-8 Phenanthrene 5.0 3.3 66 % 5.0 3.6 72 % 9 % 40-140% 20% 83-32-9 Acenaphthene 5.0 3.6 72 % 5.0 4.0 80 % 11 % 40-140% 20% 208-96-8 Acenaphthylene 5.0 3.3 66 % 5.0 3.6 72 % 9 % 40-140.% 20% 86-73-7 Fluorene 5.0 3.4 68 % 5.0 3.7 74 % 8 % 40-140% 20% 120-12-7 Anthracene 5.0 3.2 64 % 5.0 3.6 72 % .12 % •40-140% 20% 206-44-0 Fluoranthene 5.0 3.4 68 % 5.0 3.9 78 % 14 % 40-140% 20% 129-00-0 Pyrene 5.0 4.1 82 % 5.0 4.6 92 % 11 % 40-140% 20% 56-55-3 Benzo[a]anthracene 5.0 3.6 72 % 5.0 4.0 80 % _ 11 % .40-140% 20% 218-01-9 Chrysene 5.0 3.6 72 % 5.0 4.0 80 % 11 % 40-140% 20% 205-99-2 Benzo[b]Fluoranthene 5.0 3.6 72 % 5.0-1 3.9 78 % 8 % 40-140% 20% 207-08-9 Benzo[k]fluoranthene 5.0 3.7 74 % 5.0 4.1 - 82 % 10 % 40,-140% 20% 50-32-8 Benzo[a]pyrene 5.0 3.8 76 % 5.0 4.1 82 % 8 % 40-140% 20% 193-39-5 Indeno[1,2,3-c,d]pyrene 5.0 3.8,. ' . 76 % 5.0 4.2 84 % 10 % 40-140% 20% 53-70-3 Di ben zo[a,h]anthracene • 5.0 4.0 80 % 5.0 4.4 88 % 10 % 40-140% 20% 191-24-2 Benzo[g,h,i]perylene 5.0 3.8' 76 % 5.0 4.2 84 % 10 % 40-140% 20% QC Surrogate Compound Spiked Mea:urea' Recovery Spiked I Measured Recovery _ _QC Limits ortho-Terphenyl 40 35 88 % 40 1 40 1 100% 40-140% Method Reference: Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). ' Method modified by use of selected ion monitoring(SIM)in accordance with Section 7.5.5 of the method. f Method protocol modified to include acidification and the surrogate compound in accordance with the MA DEP Method for the Determination of Extractable Petroleum Hydrocarbons. Sample extraction performed by EPA Method 3510C. 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. The LCS and LCSD are prepared from separate source standards than those used for calibration. a s Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532Dage 12 of 18 GROUNDWATER ANALYTICAL ; Quality Control Report Method Blank Category: EPA Method 8270C(Mod.)-EPH PAHs by GC/MS-SIM instrument ID: _ MS-6 HP 6890 QC Batch ID: EP-2182-F Extracted: 03-17-09 17:00 Matrix: Aqueous Analyzed: 03-19-09 14:51 Analyst: MJB CAS Number Analyte Concentration 'Notes Units - ReportingOrniit 91-20-3 Naphthalene BRL ug/L 0.5 91-57-6 2-Methyl naphthalene BRL. ug/L 0.5 208-96-8 Acenaphthylene BRL. - ug/L 0.5 83-32-9 Acenaphthene BRL ug/L 0.5 86-73-7 Fluorene BRL ug/L 0.5 85-01-8 Phenanthrene BRL ug/L 0.5 120-12-7 Anthracene BRL ug/L 0.5 20644-0 Fluoranthene BRL ug/L 0.5 129-00-0 Pyrene BRL ug/L 0.5 56-55-3 Benzo[a]anthracene BRL ug/L 0.1 218-01-9 Chrysene BRL ug/L 0.1 205-99-2 Benzo[b]fluoranthene BRL ug/L 0.1 207-08-9 Benzo[k]fluoranthene BRL ug/L 0.1 50-32-8 Benzo[a]pyrene BRL ug/L 0.1 193-39-5 Indeno[1,2,3-c,d]pyrene BRL ug/L 0.1 53-70-3 Dibenzo[a,h]anthracene BRL ug/L 0.1 191-24-2 Benzo[g,h,i]perylene BRL ug/L 0.1 QC$urrogate Compound - _ Spiked Measured ,a Recovery "''' -" . QC-Units ` ortho-Terphenyl 40 1 47 1117 % 40-140% Method Reference: Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Method modified by use of selected ion monitoring(SIM)in accordance with Section 7.5.5 of the method. ' Method protocol modified to include acidification and the surrogate compound in accordance with the MA DEP Method for the Determination of Extractable Petroleum Hydrocarbons. Sample extraction performed by EPA Method 3510C. - s 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. Groundwater Analytical, Inc.,P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 0253�Page 13 of 18 I - GROUNDWATER ANALYTICAL Quality Control Report- Laboratory Control Samples LCS _ LCSD Category: MA DEP VPH Instrument ID: GC-1 HP 5890 Instrument ID: GC-1 HP 5890 QC Batch ID: VG1-1422-W Analyzed: 03-17-09 11:31 Analyzed: 03-17-09 12:12" Matrix: Aqueous Analyst: CRL Analyst: CRL Units: ug/L CAS Number Analyte _ LCS LCS`.Duplicate _- `QC Limits Spiked meau«d Recovery Spiked nit—d Recovery, RPD _ Spike RPD 109-66-0 n-Pentane 50 41 82 % 50 42 85 % 4 % 70-130% 25% 107-83-5 2-Methylpentane 50 43 85 % 50 44 89 % 4 % 70-130% 25% 540-84-1 2,2,4-Trimethylpentane 50 47 93 % 50 48 96 % 3 % 70-130% 25% n/a Aliphatic Group 1 150 130 87 % 150 130 87 % 0 % 70-130% 25% 111-84-2 n-Nonane 50 45 91 % 50 45 90 % " 1 % 70-130% 25% 124-18-5 n-Decane 50 1 50 1 100 % 50 47 93 % 7 % 70-130% 25% 1678-93-9 n-Butylcyclohexane 50 47 94 % 50 46 93 % 2 % 70-130% 25% n/a Aliphatic Group 2 - 150 140 93 % 150 140` 93 % 0 % 70-130% 25% 1634-04-4 Methyl tert-butyl Ether 50 48 97 % 50 49 98 % 1 % 70-130% 25% 7143-2 Benzene 50 46 91 % 50 46 92 % 1 % 70-130% 25% 108-88-3 Toluene 50 48 97 % 50 49 98 % t % ' 70-130% 25% 100414 Ethylbenzene 50 48 ,97 % 50 49 98 % 2 % 70.-130% 25% 108-38-3 and 106-42-3 meta-xylene and pars-xylene 100 98 98 % 100 99 99 % 1 % 70-130% 25% 9547-6 ortho- Xylene 50 48 96 % 50 47 95 % 1 % 70-130% 2516 95-63-6 1,2,4-Trimethylbenzene 50 49 98 % 50 50 99 % 1 % 70-130% 25% 91-20-3 Naphthalene 50 49 98 % 50 51 102 % 4 % 70-130% 25% n/a Aromatic Group. 450 430 96 % 450 440 98 % 2 % 70 130% 25% QC Surrogate Compound Splkeds�?easureJ Recovery,' Spiked M6,—d 'Recovery QC Lirtiits` 2,5-Dibromotoluene(PID) 50 51 103 % 50 50 99 % 70-130% 2,5-Dibromotoluene(FID) 50 52 104 % 50 50 101 % 70-130% Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). 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. w '7 r Groundwater Analytical,,Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532page 14 of 18 GROUNDWATER ANALYTICAL Quality Control Report Method Blank Category: MA DEP VPH Instrument ID: GC-1 HP 5890 QC Batch ID: VG1-1422-W Analyzed: 037,17-09 12:53 Matrix: Aqueous Analyst: CRL VPH Ranges " y fConcentration R Notes Units" ReportmgLimit n-05 to n-C8 Aliphatic H drocarbons t 0 BRL ug/L 20 n-C9 to n-C12 Aliphatic Hydrocarbons f® BRL ug/L 20' n-C9 to n-C10 Aromatic Hydrocarbons f BRL ug/L 20 Unacrus ed n-05 to n-C8 Aliphatic Hydrocarbons+ BRL ug/L 20 Unadjusted n-C9 to n-C12 Aliphatic Hydrocarbons t BRL ug/L 20 ,.CAS Number Analyte: _ , - 'Concentration Notesn- Unit3,..- :Reporting tmtt,` - - 1634-04-4 Methyl tert-butyl Ether° BRL ug/L 5 71-43-2 Benzene° BRL ug/L 1 108-88-3 Toluene° BRL ug/L. 5 100-41-4 Eth (benzene# 'BRL ug/L 5 108-38-3 and 10642-3 1 meta-X leneand ara-X lene# BRL'' ug/L 5 95-47-6 ortho- X lene: A BRL ug/L 5 91-20-3 Naphthalene BRL ug/L 5 'QC Surrogate Compound "Spiked Measured , Recovery ! ,QC Limits 2,5-Dibromotoluene(PID) 50 49 97 % 70-130% 2,5-Dibromotoluene(FID) 50 48. 96 % 70-130% Method Reference: Method for the Determination of Volatile Petroleum Hydrocarbons,MA DEP(Revision 1.1,2004). 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. f Hydrocarbon range data excludes concentrations of any surrogate(s)an internal standards eluting in that range. 0 n-05 to n-C8 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations. ® n-C9 to n-C12 Aliphatic Hydrocarbons range data excludes the method target analyte concentrations and the concentration for the n-C9 to n-C10 Aromatic Hydrocarbons range. r( Analyte elutes in the n-05 to n-C8 Aliphatic Hydrocarbons range. # Analyte elutes in the n-C9 to n-C12 Aliphatic Hydrocarbons range. t Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532page 15 of 18 • s 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 Ff t - - - - t et Department of Health Services,PH-0586 Potable Water,Wastewater,Solid Waste and Soil http://www.ct.gov/dpM ib/dph/environmental_health/environmental_laboratories/pdf/Out_State.pdf MASSACHUSETTS_ Department of Environmental Protection, M-MA-103 Potable Water and Non-Potable Water http://public.dep.state.ma.us/labcertAabcert.aspx Department of Labor, Asbestos Analytical Services,Class A Division of Occupational Safety, AA000195 _ http://www.mass.gov/dos/f`orms/la-rpt_list—aa.pdf NEW HAMPSHIRE , Department of Environmental Services, 202708 Potable Water,Non-Potable Water,Solid and Chemical Materials http://www4.egov.nh.gov/DES/NHELAP NEWNCIRK Department of Health, 11754 Potable Water,Non-Potable Water,Solid and Hazardous Waste http://www.wadsworth.orgAabcert/elap/Comm.htmi NISI NATIONAL°,V.OLUNTARY LABORATORY..ACCREDITATION PROGRAM'(NVLAP) aye NVLAP Lab Code 200751-1 Bulk Asbestos Fiber Analysis(PLM) http://ts.nist.gov/Standards/Scopes/plmtm.htm RHODE ISLAND Department of Health, Potable and Non-Potable Water Microbiology,Organic and Inorganic Chemistry Division of Laboratories, LA000054 http://www.health.ri.gov/labs/outofstatelabs.pdf U:S:,DEPARTMENT,OF'AGRICULTURE, r ;''"' n•� ,h� ".' . +�,_ '. . , :'�..� .',. -f ., ..1 a,' USDA,Soil Permit, S-53921 Foreign soil import permit VERMONT � °�«a' "A'x.$'S, '.n•t:.�,�, ,+� .,,'ifi'�. sT +�;3 �r'ra ,� a: 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 16 of 18-` r GROUNDWATER ANALYTICAL ' Certifications and'Approvals •MASSACHUSETTS. ��_e"A ra711.• artment of Environmenta6 Protection,rM-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 Ammonia-N Lachat 10-107-06-1-B 1,2-Dibromoethane EPA 504.1 Antimony EPA 200.7 Alkalinity,Total SM 2320-B Antimony EPA 260.8 Antimony ERA 200.8 Antimony EPA 200.9 Antimony EPA 200.9' Arsenic EPA 200.7 Arsenic v EPA 200.8 A'" Arsenic EPA 200.8 Arsenic EPA 200.9 Arsenic . EPA'200.9 Barium EPA 200.7 Beryllium EPA 200.T Barium EPA 200.8 Beryllium EPA 200.6 Beryllium EPA 200.7 Beta-BHC EPA 608 Beryllium EPA 200.8 Biochemical Oxygen Demand SM 5210-B Cadmium EPA 200.7 Cadmium EPA 200.7 Cadmium EPA 200.8 Cadmium EPA 200.8 Calcium EPA 200.7 Calcium EPA 200.7 Chlorine,Residual Free SM 4500-CL-G Chemical Oxygen Demand SM 5220-D " Chromium EPA 200.7 Chlordane EPA 608 Copper EPA 200.7 Chloride EPA 300.0. Copper EPA 200.8 Chlorine,Total"Residual SM 4500-CL-G Cyanide,Total Lachat 10-204-00-1-A Chromium EPA 200.7 E.Coli(Treatment and Distribution) EC-MUG SM 9221-F. Chromium EPA 200.8 E.Coli(Treatment and Distribution) Enz.Sub.SM 9223 Cobalt EPA 200.7 E.Coli(Treatment and Distribution) NA-MUG SM 9222-G Cobalt EPA 200.8 Fecal Coliform(Source Water) MF SM 9222-D Copper EPA 200.7 Fluoride EPA 300.0 Copper EPA 200.8 Fluoride SM 4500-F-C Copper EPA 200.9' Heterotrophic Plate Count SM 9215-B Cyanide,Total Lachat 10-204-00-1-A Lead EPA 200.8 DDD EPA 608 Lead EPA 200.9 DDE EPA 608 Mercury EPA 245.1 DDT EPA 608 Nickel EPA 200.7 Delta-BHC EPA 608" Nickel EPA 200.8 Dieldrin EPA 608 Nitrate-N EPA 300.0 Endosulfan I EPA 608 Nitrate-N Lachat 10-107-04-1-C Endosulfan 11 EPA 608 Nitrite-N EPA 300.0 Endosulfan Sulfate EPA 608 Nitrite-N Lachat 10-107-04-1-C Endrin EPA 608 pH SM 4500-H-B Endrin Aldehyde !EPA 608 Selenium EPA 200.8 fluoride EPA 300.0 Selenium EPA 200.9 Gamma-BHC EPA 608 Silver EPA 200.7 Hardness(CaCO3),Total EPA 200.7 Silver EPA 200.8 Hardness(CaCO3),Total SM 2340-B Sodium EPA 200.7 Heptachlor EPA 608 Sulfate EPA 300.0 Heptachlor Epoxide EPA 608 Thallium EPA 200.8 Iron EPA 200.7 Thallium EPA 200.9• Kjeldahl-N " . Lachat 10-107-06-02-D Total Coliform(Treatment and Distribution) Enz.Sub.SM 9223 Lead EPA 200.7 Total Coliform(Treatment and Distribution) MF SM 9222-B"' Lead EPA 200.9 Total Dissolved Solids SM 2540E Magnesium EPA 200.7 Trihalomethanes EPA 524.2'• Manganese EPA 200.7 Turbidity SM 2130-8 Manganese EPA 200.8 Volatile Organic Compounds EPA 524.2 Mercury EPA 245.1 Molybdenum EPA 200.7,, Non-Potable Water(Wastewater) Molybdenum EPA 200.8 Analyte Method Nickel EPA 200'7 Nickel EPA 200.8 Aldrin EPA 608 ' Nickel EPA 200.9 Alkalinity,Total Lachat 10-303-31-1-A 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 Aluminum EPA 200.8 Oil and Grease EPA 1664 Groundwater Analytical, Inc., PD..Box 1200, 228 Main Street, Buzzards Bay, MA 02532 . _ Page 17 of 18 f GROUNDWATER ANALYTICAL Certifications and Approvals MASSACHUSETTS -••� ;-. •. - , '- r=Department of Environmental Protectibriv A=103 Groundwater Analytical maintains Mass'DEP 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-H-B Phenolics,Total EPA 420.4 Phenolics,Total Lachat 10-210-00-1-13 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 Selenium EPA 200.9 Silver , EPA 200.7 Sodium EPA 200.7 ' Specific Conductivity SM 2510-B 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. Thallium EPA 200.9 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 � r , Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,MA 02532 Page 18 of 18 1573 Main Street,P.O.Box 1743 BENNETT ENVIRONMENTAL ASSOCIATES, INC. (508)896-1706 Brewster,MA 02631 LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS fax(508)896-5109 MONITORING WELL SAMPLING LOG Date(s): February 24,2009 Job Name: BB's Auto Time: 11:30 am Tide: Location: 805 Main Street,Harwichport,MA Job Number: BEA98-2026 Sampler: Don Douty(ET) Measuring Point: Ground Surface or T.O.C. Elev.of Total Depth to Standing Water Static Volume HNU Dissolved Well reference Depth Water Water Table Volume Purged H Oxygen Temperature Number 'point of Well g PI-101 P XYg Conductivity P Comments: (feet) Height Elevation (gallons) (gallons) (ppm) (mg/L) (F) (feet) (feet) (feet) (feet) MW-3 12.11- 15.00 10.67 4.33 1.44 .69 2.0 : NT 7.64 4.96 224 48 No odor,no sheen MW-4 12.12 14.30- 10.71 3.59 1.41 .57 1.7 NT 7.46 9.80 . 141 48 No odor,no sheen MW-7 11.66 - 15.40 10.32 5.08 1-34 .81 2.4 NT 6.95 7.09 155 44 No odor,no sheen Notes: Sample MW-3 - MW 4 and - for H with MW 7 o VP w target anal es P g Yt _ Sample MW-7 for Nitrate and Magnesium. NA=Not Applicable NT Not Tested 0 Please print or type.(Form designed for use on elite(I 2-pitch)typewriter.) Form-Approved.OMB No.2050-0039 UNIFORM HAZARDOUS 1.Generator ID Number 2.Page 1 of 3 Emergency Response Phone 4 Manifest Tracking Number 5. . € £ � ir . JJ-WAS7E MANIFEST K GeneratofsName and Iplaifing Address _ Generator's Site Address(if different than mailing address) gear Geperatoes Phone: '�°...;'Y 4 r 3 r a t c +n :::.tr 6.Transporter 1 Company Name ' U.S.EPA ID Number '1+oc N .l:-_i�l v._a a....,.F. .ice �. 4k�b�a. - 2� � rb .a -Y !f_ 7.Transporter 2 Company Name U.S.EPA ID Number 8.Designated Facility Name and Site Address U.S.EPA ID Number r g' Est a -_o. ....>caiaJ. —4. .Facility's Phone: ga. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total; 12.Unit 13.Waste Codes HM and Packing Group(dairy)) No. Type, Quantity WtNol. CC e AJ- Z 2. a W 0 _ 3. ) 14.Special Handling Instructions and Additional Information 2 _:.. '+s:•s t?.i.T'•=a,3 _.r...•f �....,-.�x� .> :..-. ri. s:� 15. GENERATOR'S10FFEROWS CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described above by the proper shipping name,and are classified,packaged, marked and labeledfplacarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary Exporter,'I certify that the contents of this consignment conform to the terns of the attached EPAAcknowledgment of Consent I certify that the waste minimization statement identified in 40 CFR 262.27(a){d I am a large quantity generator)or(b)(if t am a small quantity generator)is true. Generato'slOfferor's Printedflgped Name Month Day Year t .y J 16.International Shipments j r— ❑Import to U.S. s` ❑Export from U.S."` _.-,-:P6rt of enbylexll: Transporter signature(for exports only): Date leaving U.S.: W .17.TransporterAdmowledgment of Receipt of Materials Transporter 1 Printedflyped Name j .¢¢Y:<. Signature - Month Day Year CA Za Transporter 2 PdntedlTyped Name Signature t Month Day Year 18.Discrepancy 18a.Discrepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection Manifest Reference Number. 18b.Aftemate Facility(or Generator) U.S.EPA ID Number V LL Fadlit?s Phone: W 18c.Signature ofAltemate Facility(or Generator)-.:, Month Day Year z y19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment disposal,and recycling systems) LU 1• 4. . 20.Designated Facility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Rom 18a Prirriedlfyped Name Signature Month Day Year EPA Form 8700-22(Rev.3-05) Previous editions are obsolete. GENERATOR'S INMAL ®PY ' RECEIVED APR 0' 6 200q Make application to local Fire Department. Fire Department`retains original application and issues duplicateAs Permit. ' APPLICATION and PERM11T for storage tank removAl.�nd transportation to approved tank disposal yard in accordance with the'provisions of M.G.L.Chapter 14t3, Section 38A, 527 CMR 9.00, application is hereby made by: "TankOwner Name(please print} �Yi t�i Irl r�,�� X name aaa rpermd) M btvy Ste .� Address K`� weer , SMte aP . • Company Name���^� � ��� Co.or Individual Print Address ' ynl6 w( � /—X / ` Address Pant PmH Signature 'h-Y lying for rm ) NAC> G Z6CA Signature('rf applying for permit) p IF rued Other 0 IFCI*Certified ❑LSP# Other Tank • • Tank Location 1 V� S1 ` oS �!►v. - - Steet Address Ofy Tank Capacity(gallons) Z� Substance Last Stored r Tank Dimensions(diameter x length) Remarks U�11L- G ZdC-hVX� a�� T�Vut2. .. . • / 'CAI Firm transporting.wast {sc)kD �to L 7' �� ic.# Z Z— r ---'7 Hazardous waste manifest# 00 5.�, 5 � / E.P.A.# CK- Approved tank disposal yard Tank yard# c Type of inert gas Tank yard address NOW City or Town �� n�}e rv► 1�2 FDID#= Q 1 2� Permit# I l Date of issue ('oar-it Date of expiration- r1;1brU11r.Y of /. 9 009 Dig safe approval number. Z� O`?< 05$ Dig S e Toll F T I.Number-800-322-4844 Signature/Title of Officer granting permit 0/4 T1 I IRA(] After removal(s)("Consumptive Use°fuel oil tanks exempted)send Form FP-290R sig by ire Dept to US to Compliance Unit,Department of Fire Services,P.O.Box 1025,State Road,Stow,MA 0 *Intemational Fire Code Institute �. BROCKfiON fAON&.S,TEEC Cp a��QHi 3T:----- FP-292(revised 4/97) BROr MA 0232 ' G Photo of 120-gallon i� UST in tank grave prior to removal. a Photo of bottom of UST after removal from tank grave. No obvious holes # ?' observed in bottom of UST. k• i No. Zoo 6 s 1,qs Fee /,rL7 r THE COWWONWEALTH OF MASSACH'USETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for �Di$ oal *p$tem Cotulruction Permit Application for a Permit to Construct(X)Repair( )Upgrade( )Abandon( ) (Complete System ❑Individual Components Location Address or Lot No. Cfcy h? �-f/ r�S� /� Owner's Name,Address and Tel.No. +Nt�ltrin T=i�ld? Assessor's Map/Parcel 3`t igbs ficr 51�: Maio /&S/gpia""I OZO Ce,_n,br, VNlaa5 r�2/32' Ins e s N Address,and Tel.No. 0 �91�Y.r ✓ M— Designer's Name,Address and Tel.No. So$•77l-750Z J ` tiLphc, A. Wi lsa^ )Off s 13e,c)-cr &j3e Type of Building: Dwelling No.of Bedrooms -Q—� Lot Size &+4. Garbage Grinder(Ale) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow I I gallons per day. Calculated daily flow lygo gallons. Plan Date 12 Number of sheets Q VW Revision Date Title Oe-41-iKa Pt roncf 06,3 Q j2 q eX AL'L Size of Septic Tank IS�6 figms Type of S.A.S. Description of Soil; A-D so'-l l c a,,t r ia!j P^ )l� 1.9 f. Nature of Repairs or Alterations(Answer when applicable) Rc pi g g ut s h 8i -z s s j2,c o js Date last inspected: Agreement: The undersigned a the cons a mai enance of the afore described on-site sewage disposal system in accordance with the provisio s of Title the nvir ent Code and not to place the system in operation until a Certifi- cate of Compliance has b=1 is ar a Signed Date J 0 Application Approved by Date S_"�C-Zd 06 Application Disapproved fort following reasons N Permit No. 2.,OO;6 IS' Date Issued No. �dd l�s, • ° ¢ Fee 1`T/fO b n 71, d TIE CO113fMtO4 EALTH OF_MASSzAC �ETTS M� Entered in computer. r/ PUBLIC-HEALTHDIVISION OWN OF BARNSTABLE- MASSACHUSETTS Yes r 2por action for Migoo vem on5truction Permit Application for a Per t to Consir )Repair( )Upgrade( )Abandon'( Complete System/O Individual Components Location Address or Lot No. Cfy we,y _T't/ as lerdi//G Owner's Name,Address and Tel.No:_" �»• + Assessor's Map/Parcel 3R Moshe � N1ah '/PaWtc/ bZtj Ca,.nb r Vv1as5 C�2J3P' ,�.X , oA in a le's e,Address,and Tel.No. 0 A,*)r . ✓ Designer's Name,Address and Tel.No. SO&-27/-75bZ J r 1/3 Afo�w _ `�I_, hen A, I:Ji tsr.� ►-"E + 13cX4 ', Il� 76 ' Type of Building: Dwelling No.of Bedrooms �r -s�-ft. Garbage Grinder(�✓0) Lot Size /�/ Ate' t Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 io G12,41 har..r,.a gallons per day. Calculated daily flow 1VN0 gallons. Plan Date 12-?'Z-6o7 Number of sheets' o vw- Revision Date Title (4 f'17.uP Pc rtnif- 621&,1 _ 5 f, U n rr.CL L Size of Septic Tank ISoo je.Uc#is Type of S.A.S. Description of Soil: 4-r, soi I 1 cam,s 121ati P=/I 9 f f� Nature of Repairs or Alterations(Answer when applicable) h1&e P e,u s h nti c r s s v�co ts Date last inspected: Agreement: 'The undersigned a _reps-EasieE�ihll ,• e the co_nnsst-r-uc' a /mai/enance of the afore described on-site sewage disposal system in accordance with the visi Title o� the nvir. enta Code and not to place the,system in operation until a Certifi- cate of Compliance has b -B ar e f>1�� /- ao _ Signed U Date' l�"� Q Application Approved by Date S-/S-ZO06 ' 0 ,Application Disapproved for e following reasons lk Permit No. ZOol3- Date Issued ——— —————————-- THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS - Certificate of Compliance � THIS IS 1T0 CERTIFY, that the On-site sewage Di�sp�°sal Sy�1tem Cnovstruct j`d/( Repaired ( ' )Upgraded (' ) Abandoned( )by — �CVP`.�""-- -1-ZyC'1') tV 0 1ti'E�I V IV �1�;�"� y at G q M ra w1 S i ©S Z rt.d-V i e_L has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.Z t,06- 5' S dated -- I f- Z 0 0 5 Installer f t " G0 h-S-r e-vL-c Designer i�t-1 -j ,%,<'(C4 i N f- The issuance of this permi ��11 not be construed as a guarantee that the s stem illifunetitc> des* cd. Date f Inspector t� 1 • ( No. Z OOP I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi.gozat *p5tem Construction Permit Permission is hereby granted to Construct(X)Repair( )Upgrade( )Abandon( ) System located at y9 M4/A/ S7, 0 UJLC.f. and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this pe it. Date:_._ S� 1" 0 Approved by Barnstable Town of Barnstable r A&Amedca city °A AS& Board of Health i j 1659. �4 N AIfDA, 200 Main Street, Hyannis MA 02601 ` 2007 I Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 PaLdCanniff,D.M.D. Junichi Sawayanagi January 22, 2008 Mr. Stephen Wilson, P.E. Baxter Nye. Engineering and Surveying 78 North Street Hyannis, MA 0260.1 RE: 49 Main Street, Osterville y_ A=,186-02Q Dear Mr. Wilson, You are granted variances on behalf of your client, Melvin Field, to construct an onsite sewage disposal system at 49 Main Street, Osterville. The variances granted are as follows: Section 360-1, Town of Barnstable Code: To construct a soil absorption system 78 feet- away from a coastal bank, in lieu of the minimum 100 feetseparation distance required. Section 360-1, Town of Barnstable Code: To construct a septic tank 67 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions: (1) No more than four (4) 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 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 four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3). The. septic system shall be installed in substantial conformance with engineered plans dated December 7, 2007, signed on December 13, 2007 by the professional.engineer. QAWPFILES\WiI son Field 49MainStreetOsterviI1e2008.doc (4) The designing engineer shall supervise the construction.of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system . , was installed in. substantial, compliance with the plans dated. December 7, 2007, - signed on December 13, 2007.by the professional.engineer. These variances are granted because the physical constraints. at the site severely restrict the location of the septic tank and soil absorption system due it's close proximity, to wetlands. i Sincer ly yours, Wayne Iler, M.D. Chairma Q:\WPFI LES\W i lsonNM49MainStreetOsterville2008.doc i DATE: C� • : FEE: R b � 1ARNSiABLE, • MASS. / REC. BY Town of Barnstable SCHED. DATE: Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Paul J.Canniff,D.M.D. `rARUNCE REOUEST FORM LOCATION Property Address: t19 tnam Strcej i Assessor's Map and Parcel Number: WI I b5'P_f Z0 Size of Lot: (,l Wetlands Within 300 Ft: Yes X Business Name: No Subdivision Name: APPLICANT'S NAME: Mciyth Ir',c._td Phone Did the owner of the property authorize you to represent him or her? Yes �_ No PROPERTY OWNER'S NAME CONTACT PERSON Name: YN of o t p C-.>. .1=t t1 Name: S hn,i A. W i t �P s Address: 3ci FOSJtr, 5t Lc.vnbrtcQec N114 42138'Address: 132X1z uaf. .78 "air si- 1-'�.WCKri1�'� c;. �, _7 Phone: Phone: (.50 ') 77/— 750 , ,v+ 13 7� v VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) co NATURE OF WORK: House Addition ❑❑❑❑❑❑ House Renovation ❑ Repair of Failed Septic System Checklist (to be completed by-ofce staff-person receiving variance request application) Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) l Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) 1\ 1 Signed letter stating that the property owner authorized you to represent him/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 (forTitle V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only], outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systerns[only-if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Paul J.Canniff,D.M.D. REASON FOR DISAPPROVAL C:\Documents and Settings\decollik\Local Settings\Temporary Internet Fi1es\0LK1\VARIREQ.D0C Town of Barnstable Geographic Information System December 12, 2007 1 4 j !.pia 185056 185001 ° #832 j? 185004 " #48 185015 85002 f #32 "M prr w'•.s,.;...^..• 185018 At 835 „M°m°"' ,•«'""m•'•""' '- ;:;M%'"� u,.+!"'P"w it a' N `isatc:'{.i`;:i:'-:•:�':'::::i;"::``•;i fir,,'•.::::;';r:::;`:?;;:,::::,;.;.•,: F,� litl 185064 #10 o �g 185062 "' At 87 r � 185022001 �,. #103 '% 13� �� 185017 d � a 17 10t { s80504 DISCLAIMERS:This map is for planning purposes only. It Is not adequate for legal - Map:185 Parcel:020 Board of Health N boundary determination or regulatory Interpretation. Enlargements beyond a scale of Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map Abutter List Type-Direct abutters(no set distance)and the properties located are only graphic representations of Assessor's tax parcels. They are not true property aCrOSS the Street. - Abutters ' "... boundaries and do not represent accurate relationships to physical features on the map -- _ such as building locations. - - - Buffer ,;3rW,,., AbutterReport Page 1 of 1 Board of Health Abuttek List for Map & Parcel(s): '185020' Direct abutters (no set distance) and the properties located across the street. Total Count: 5 Close Map&Parcel Owners Owner2 Addressi Address 2 Mailing CityStateZip 185003 RENZ, A JOHN III 60 MAIN ST OSTERVILLE, MA 02655 185019 BARNSTABLE, TAX TITLE 367 MAIN STREET HYANNIS, MA TOWN OF(MUN) 02601 185020 FIELD, MELVIN D P O BOX 81 OSTERVILLE, MA 02655 185021 PAYNE, MICHAEL I PAYNE, FRANCES E 539 STRAWBERRY, CONCORD, MA TR& TR HILL RD 01742 185053 RENZ, JOHN& 60 MAIN ST OSTERVILLE, MA BARBARA 02655 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 12/12/2007. http://www.town.bamstable.ma.us/arcims/appgeoapp/AbutterReport.aspx?type=BOH 12/12/2007 • i. TIJI - II�.cc�reoin t � Bcdroo� I GIS S{•r.�rs - Dining Rrn. I�itchcn ►I J I Ott r i y Llosc+ ' � sia,r5 i ' down 1 , u 0 K�tcl � 'i`I Yr1v�N �i� 2nd r(on yr �1i— 1 —CS%I n�, T KOZOL LAW OFFICES, P.C. COUNSELLORS AT LAW 6 BEACON STREET,SUITE 400 BOSTON, a U AQfUJ8 rJ 02108 TELEPHONE: , FACSIMILE: (617)557COtt Zyhnskl (617)557-9908 R&H Construction 996 E. Falmouth Highway Falmouth, MA 02536 Re: Fee For Disposal Works Installer's Permit Application Your Client: Jeffrey J. Kaschuluk Property Address: 49 Main Street, Osterville, Massachusetts Property Owner: Melvin D. Field Dear Mr. Zylinski: Enclosed please find a check in the amount of$150.00 payable to the Town of Barnstable - Board of Health for the above referenced permit application fee. As you are aware, our client is paying this fee as the owner and seller of the above referenced property and your client is the buyer of the property who is planning to use your services to install such septic system. We have provided this $150.00 amount instead of the $100.00 permit fee amount because it is our understanding that Mr. Kaschuluk desires to have certain demolition/construction work done to the existing structure in conjunction with the installation of the septic system. My understanding is that you have been in touch with the Engineer, Steve Wilson, P.E., of Baxter Nye Engineering& Surveying, 78 North Street, Hyannis,MA 02601, 508-771-7502 x13 and will pick up the application he has prepared for you at Baxter Nye on Monday, May 5, 2008. If you are not already aware,please be advised that Mr. Wilson will not be at his office from.mid-day Friday,May 2, 2008 until Thursday, May 8, 2008. I also understand that Mr. . Kaschuluk's attorney, KeithYankow, Esq., will provide to you a copy of the recorded Deed Restriction once it is on record with the Barnstable County Registry of Deeds so that you may file such with the Town of Barnstable - Board of Health when you file the permit application. I have attached a copy of such Restriction as it was sent for recording today to the Barnstable County Registry of Deeds. I have also attached for your information a copy of a letter from the Town of Barnstable Board of Health dated January 22, 2008 granting a variance for the installation of such septic system. If you have any questions or concerns,please feel free to contact me at the above referenced address, fax or phone: Thank you for your time and attention. Very truly yours, c . EJK/cd Enclosures cc: Kith Yankow, Esq. (via e-mail w/o attachments) Jennifer E. Greaney, Esq. (via e-mail w/o attachments) Jonathan W. Fitch, Esq. (via e-mail w/o attachments) U .y` '" Town of Barnstable Barnstable P O� AI-AmeeicaClty Board of Health. ► Y MgSS. 63q• 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi January 22, 2008 Mr. Stephen Wilson, P.E. Baxter Nye.Engineering and Surveying 78 North Street Hyannis, MA 02601 RE 4.9 Main Street, Ostervl11 A 186 020 Dear Mr. Wilson, You are granted variances on behalf of your client, Melvin Field, to construct an onsite _ sewage disposal system at 49 Main Street, Osterville. The variances ranted are as follows: O U 9 Section 360-1, Town of Barnstable Code: To construct a soil absorption system 78 feet away from a coastal bank, in lieu of the minimum 100_feet separation distance'required. Section 360-1, Town of Barnstable Code: To construct a septic tank 67 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions: (1) No more than four (4) 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 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 four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The septic system shall be installed in substantial conformance with engineered plans dated December.7, 2007, signed on December 13, 2007 by the professional,engineer. Q:\WPFILES\WilsonField49MainStreet0sterville2OO8.doc i (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the plans dated. December 7, 2007, signed on December 13, 2007 by the professional engineer. These variances are granted because the physical constraints at the site severely restrict the location of the septic tank and soil absorption system due it's close proximity to wetlands. Sincer ly yours, Wayne Iler, M:D. Chairma O Q:\WPFILES\WilsonField49MainStreet0sterville2OO8.doc F=B-26-2009 03:47P FP,OM:B!>XTER NYE ENGINEEF'I 1=50e-771-7622 TO:eIG175579902 P. 6arnstable Town of Barnstable + TA M$GAbLE. � �g L Board of Health �r w3,,s�,L' ° 200 Main Street,Hyannis MA 02601 2fnJ7 { Office: 509-962-4644 Wayne MIIICr;'fA.D FAX: `0$•79M304 Paul Canniff,D.M.D. Junichi Sawayunugi January 22; 2008 Mr. Stephen Olson, P.E. Baxter Nye Engineering and Surveying 78 North Street ` Hyannis, MA 02601 (RE 49 Main Street, Osterville A= 186-020 Dear Mr. Wilson, You-are granted variances on behalf of your client, Melvin Field, to construct an onsite sewage disposal system at 49 Main Street, 4sterville. The variances granted are as follows: Section 360.1 Town of Barnstable Code: To construct a soil absorption system 78 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1, Town of Barnstable Code: To construct a septic tank 67 feet away from a . coastal bank, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions, (1) No more than four (4) 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 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 four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining' a disposal works construction permit. (3) The septic system shall be installed .in substantial . conformance; with' engineered plans dated December 7, 2007, signed on December 13, 2007 by the professional engineer. Q1W!'FILE3�Wilsonlicld4hMeinStrcetOsterv;Ile200B,dac FES-26-2009 03:47P FR.ON:GAXTER NYE ENGII iEERI 1-509-771-7622 TO:616175579902. P.3 (4) The designing engineer shall super'.ise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the"plans dated. December 7, 2007, signed on December 13, 2007 by the professional engineer. These variances are granted because the physical constraints at the site severely . restrict the location of the septic tank and soil absorption system due it's close proximity to wetlands. Sincer ly yours, Wayne ler, M.D. Chairma Q:\W1)Fi1.rq\b'ilsonl'ield49PAuinStre(AOslerville2009,dor s Bk 22B97 Ps 129 4 r 05 , 01511-21008 a 03 Z 123:31 Property Address: 49 Main Street,Osterville,MA DEED RESTRICTION WHEREAS, Melvin D.Field of 39 Foster Street, Cambridge,Middlesex County, Massachusetts is the owner of certain parcel of land-together with the buildings and improvements P V (J thereon situated at 49 Main Street in the Village of Osterville,Town of Barnstable,Barnstable County, Massachusetts(Hereinafter referred to as the"property")and being shown on a plan 3 entitled Plan of Land in Osterville,Mass.,drawn by Nelson Bearse-Richard Law �1 J Surveyors ,dated Jul 10 N Y � y 1 957 and duly recorded in Barnstable County Registry of `\ Deeds in Plan Book 136,Page 73. 3 WHEREAS,Melvin D. Field as the owner of said property has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be o ` included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; - WHEREAS,the Town of Barnstable Board of Health,as a pre-condition to granti.n a _ t9 g disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,and authorizing the issuance of a building permit for the construction of a single family home on this property,is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW,THEREFORE,Melvin D.Field 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: 49 Main Street in the Village of Osterville, Town of Barnstable, Barnstable County,Massachusetts may have constructed upon the property a - house containing no more than four(4)bedrooms maximum(dens,study rooms, offices, finished attics, sleeping lofts and similar-type rooms are considered "bedrooms"according to the MA Department of Environmental.Protection). Melvin D. Field agrees that this shall be a permanent deed restriction affecting the premises located at 49 Main Street in the Village of Osterville,Town of Barnstable,Barnstable County,Massachusetts and being shown on the plan recorded in Plan Book 136, Page 73. In the event that the property no longer is reliant on the use of a septic system because the property becomes served by the sewage system for the.Town or Municipality,this deed restriction shall be automatically released. Bk 22897 Pg 130 #25136 T For title of Melvin D.Field see Barnstable County Registry of Deeds Book 977,Page 186,Book 19189,Page 239 and Barnstable County Probate Court Docket No. 03P1861EP-1. Executed as a sealed instrument day of 2008. Melvin D.Field' :b�.: y r` COMMONWEALTH ,y' ��'•�7r�.= NWEALTH OF MASSACHUSETfS sex, ss. y l 2008 0`�A" Then personally appeared to me the above-named Melvin D.Field,who provided '�hMNa,W,-,%1Vroo£bf identification through bis.driver's license,and acknowledged to me the execution of the.foregoing instrument for its stated purpose to be his free act and deed,before me . y Notary Public My Commission Expires: WANDA 1.MEf?C Common otary of M . Ms rrtmisston ExA es Setts tember,,,g a , 2 BARNSTABLE REGISTRY OF DEEDS Barnstable P�oF�NE,owti Town of Barnstable �k A �. .�, Regulatory Services Department t natt�s-r.�ut.t:, �;y Mass. m �, Public Health Division �ArFD MA't tv L_ r 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO January 3, 2008 Melvin Field P.O. Box 81 Osterville, MA 02655 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 49 Main Street Osterville, MA was inspected on August 315 2067 by Robert Paolini, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system FAILED under the guidelines of 1995 TITLE V (310'CMR 15.00) due to the following: A single cesspool system with no overflow is an automatic failure with the Town of Barnstable. You are ordered to repair or replace the septic system within Two (2) years from the date of this notification. Failure to repair/replace the septic,system within the deadline period will result in future enforcement action. PER ORDER OF TH OARD OF HEALTH ma cKean, R.S., y Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\49 Main Street.doc 7005 1160 0000 0191 0614 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 49 Main St. 1-`J Property Address Melvin Field r (� Owner Owner's Name information is required for Osterville Ma... r02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form."Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC Company Name P.O.Box 763 Company Address ICI Centerville Ma. 02632 City/Town State Zip Code (508)-428-4028 S14454 Telephone Number License Number -Y--� B. Certification ` ' E.7 C� c I certify that I have personally inspected the sewage disposal system at this addr699 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 1-5.346" f rn Title 5 (310 CMR 15.000). The system: `" ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs further Evaluation b ocal Approving Authority 8/31/2007 Inspector's'Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow-of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the'system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 2 i 1- Commonwealth of Massachusetts W Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main St. Property Address l Melvin Field Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) - Inspection Summary Check A;B,C,D or E/always complete all of Section 0 A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: House has single cesspool system with no overflow.This is a failure in the Town of Barnstable. B.) System Conditionally Passes: ❑ .One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the-replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old"or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20,years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will r pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 2 Commonwealth of Massachusetts W Title 5 Official .Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St. Property Address Melvin Field - Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. CityTown State Zip Code Date of Inspection B. Certification (cont.) B), System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: .❑ The system required pumping?more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: I ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in,a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a-surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. 0 . 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. 49 main st.•W06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 3 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 49 Main St. Property Address Melvin Field Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health-(cont.): ❑ 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: l ' "*This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 El ® Discharge or ponding of effluent to'the surface of the ground or surface waters - due to an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded' or clogged SAS or cesspool ` ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 4 J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 49 Main St. Property Address Melvin.Field r Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): _ Yes No ❑ ® 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. i E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. 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. 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 5 Commonwealth of'Massachusetts { Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 49 Main St. Property Address Melvin Field - Owner Owner's Name information is,required for Osterville Ma. 02655 8/31/2007 every 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 dwell ing,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? ® 0 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 lof 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. ® El 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)] 49 main st.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 6 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System.Form - Not for Voluntary Assessments y 49 Main St. Property Address Melvin Field Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection D. System_ Information Residential Flow Conditions: Number of bedrooms (design)- 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?jif yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage (gpd)): NA 9 ( Y 9 Sump pump? ❑ Yes ❑ No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No J Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 49 main st.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 7 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form =Not for Voluntary Assessments °M 49 Main St. Property Address Melvin Field Owner . Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date'of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: 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) Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1957 Were sewage odors detected when arriving at the site?. ❑ Yes ® No 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 8 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , 49 Main St. Property Address Melvin Field Owner Owner's Name information is Osterville Ma. 02655 8/31/2007 required for - every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: feet ' Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): 10, Distance from private water supply well or suction line: 'N y feet - Comments (on condition of joints, venting, evidence of leakage, etc.). Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age; years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------- ------ Dimensions: Sludge-depth: Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? 49 main st.-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Pa ge 9 of 9 i Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System-Form - Not for Voluntary Assessments 49 Main St. Property Address Melvin Field J Owner Owner's Name . information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Traplocate on site plan): ( P ) 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, bate Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): J 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): 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 10 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 Main St. Property Address Melvin Field Owner ' Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection C D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): 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.): Pump Chamber(locateI(on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 11 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form- Not for Voluntary Assessments °M 49 Main St. Property Address Melvin Field Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): _ I � 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 12 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 49 Main St. M Property Address, Melvin Field . Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page.. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Split system 2single cesspools. Depth—top of liquid to in invert Dry Depth of solids layer 1' Depth of scum layer Dry Dimensions of cesspool 6'x8' Materials of construction Concrete Block Indication of groundwater inflow ❑ Yes ® No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): System was dry at time of inspection.Cesspool#1 is 60'from egde of marsh.Cesspool#2 is 51'from edge of marsh. 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.): 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Main St. Property Address Melvin Field Owner Owner's Name information is r required for Osterville Ma: 02655 8/31/2007 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposaf System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or.benchmarks. Locate all wells within'1.00 feet'. Locate where public water supply enters the building �` Iil ..�....., ���\1 bm u.... r ' r 1 \ 1 ' i 1 , 1 , 't1 , 'S J IL 5` - f 1 JI , 1 - , J J Itl r r 1 � , 'r J , t , f ! 1 f ' Commonwealth of-Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 49 Main St. Property Address Melvin Field Owner Owner's Name information is required for Osterville Ma. 02655 8/31/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to ground water: Bottom of cesspools 1-5 24 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used:Gaherty& Miller Modell 12/14/94 ground water elevations. Used: USGS Observation Well Data June 1995. Used:TechnicaB Bulletin 92-000-01 plate#2 Annual ranges of ground water elevations. 49 main st.•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 Town of Barnstable = THE 1p� Q. yP o� Regulatory Services _ -�BaxxsTasLe, Thomas F. Geiler,Director y Mass, g $pTEv9. rA�a Public Health .Division Thomas McKean,Director.., 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified` by the State of Massachusetts,Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy'of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and.interpretations ' contained within this report. In addition, by receiving this report the Town of Barnstable Health Division'does not automatically approve the number of bedrooms listed within this"report. The actual . number of bedrooms approved-at a particular property wouU be listed on the "Dispo'sal- Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic s System Inspector who conducted the inspection. .f , may' Massachusetts.Department of Environmental Protection Bureau of Resource Protection•- Wetlands o� WPA Form 2 -;Determination of LApplic --bility _ ST"M A A..�.n., L. 44- 1 A/.17 ! n r_ • _ A _1 O A � r w n w n i n MASS. .IV7taJJatJnUJeu.7,VT L01tUJ lr- ULI: lCU fI HGL IVI.l7.L. L. ISI, s4U 9 and Chapter 237 of the Code of the Town of Barnstable DA 08007 A. General Information Important: When filling out From: forms on the computer;use Barnstable - only the tab Conservation Commission . key to move To: Applicant your cursor- Property Owner(If different from,applicant): do not use the Melvin Field return key. Name" ; Name 39 Foster Street .. ICI Mailing Address Malting Address Cambridge MA 02138 City/Town State n Zip Code Cityrrown State Zip Code 1.. Title and Date (or Revised Date if applicable)of Final Plans and Other Documents:. Wetlands Permit Plan Septic Upgrade 12/07/2007 Title Date Title Date Title - Date 2. Date Request Filed: z December 18,2007 B. Determination Pursuant to the authority of,M.G.L. c. 131, §40,the Conservation Commission considered your Request for Determination of Applicability,with its supporting documentation, and made the following Determination. Project Description (if applicable): ' Construct new septic system to replace existing cesspools Project Location: 49 Main Street Ostetville Street Address Village 185 020 Assessors Map Number Assessors Parcel Number , wpaform2.doc•.Determination of Applicability •rev.10/5/05 - - Page 1 of 5 i • Massachusetts Department of Environmental Protection `Bureau of Resource Protection -Wetlands WPA.;Form 2 — Deter M- inatio" w'd Applicability �>TAHU. L�►'lal Massachusetts Wetlands.Protection Act M.G.L. C. 131, §40' A,!°9. FD MAf and_:Chapter 237 of the Code of the Town of'Barnatable DA- 08007 B. Determination (cont.) The following Determinations)is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No,work within the jurisdiction of the Wetlands.Protection Act may proceed until a final Order of Conditions (issued following submittal of a Notice of Intent.or Abbreviated.Notice of Intent)or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD)has been received from the issuing authority-(i.e.., Conservation Commission or the Department of Environmental Protection). ❑ .1. The.area described on the referenced plan(s)is an area subject to-protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. - ❑.,2a.The boundary delineations of the following resource areas described on the referenced plan(s)are _,confirmed as accurate.Therefore,the resource area boundaries confirmed.in.this Determination are binding as.to all decisions rendered pursuant to the Wetlands Proiectiori Act and its regulations regarding such boundaries for as long as this Determination is valid: ❑ 2b..The boundaries of resource areas listed below are not confirmed by this Determination; regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s)and docume.nt(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work' requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s)and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ❑ 5. The area and/or work described on referenced plan(s)and document(s)is subject to review and approval by: Name of Municipality VilaPursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation 1 wpaform2.doc•Determination of Applicability•rev.10/5/05 - - Page 2 of 5 i i l Massach usetts Department f o Environ p - mental Protection ���►� Bureau of Resource Protection Wetlands o WPA Form 2 - Determination of Applicability It A tvfaaSaCilusetts vvetlands Protection'Act'lVl G L--c. 31, §40 and Chapter 237 of the Code of the Town of Barnstable - DA- 08007 B. Determination (cont.) ❑ 6. The following.area and/or work, if any, is subject to a municipal ordinance or bylaw but not- subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a'Notice of Intent is filed for the work in the,Riverfront Area described on referenced plans) and document(s), which includes all or part of the work described in the Request, the applicant must consider.the;followingalternatives. (.Refer to the wetland regulations,at 10.58(4)c.:for,more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the,project is located. ❑ Alternatives:limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑. Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within. the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action;under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue_a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of.lntent. ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions (if any). Distrurbed area shall be rom tl locmed and seeded. Sediment controls shall be deployed. _ D ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone).Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•Determination of Applicability rev.10/5/05 Page 3 of 5 IILI I Massachusetts Department of Environmental Protection Bureau of Resource Protection-Wetlands F'"E'�. J o PA Form.2 - Determination of Applicability �L& IMMNM�11 I lvtaaoat,IluSeus vvellands Protection-Act M.G.L. c. 131, §40 _- and Chapter 237 of:the Code of the Town of Barnstable DA 08007 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act.Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity ty(site applicable statuatory/regulatory provisionsEl ) -• - r 6.;The area'and/or-work described in the Request is not subject to review and approval by Name of Municipality Pursuant to a municipal wetlands.ordinance.or"bylaw: Name Ordinance or Bylaw Citation C.. Authorization This Determination is issued to the applicant and delivered as follows: ❑, by hand delivery.on Date:.. . ® by certified mail-return receipt requested on :JAN 2 € 2�08 Print Name Signature Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from compf.ying with all other applicable federal, state, or local statutes,ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission.A copy must be sent to the appropriate DEP Regional Office (see Attachment)and the property owner(if different from the applicant). Signatures: a -- On this g"/t d of � 8 before me personally appeared, me known to be the person described in and who executed the foregoing _ in and acknowledged that he/she executed the same as his/her fr t and deed No ary uhlt� GL.AUQFTTF RFiiVPwnr:R- My co ^ xpirWTARY Punt IC COMMOfWEALTH OF MASSACHUSETTS My COMMISSION EXPIRES 11/21/08 wpaform2.doc•Determination of Applicability -rev,10/5/05 Page 4 of 5 Massachusetts Department of Environmental Protection tom► Bureau of Resource Protection - Wetlands �''�� WPAL .f or_m 2-- Determination of Applicability 1�03 q• �o �� MassacnusetitsN etlands'Protection Act M.C.L. c. 131 A40 and Chapter 237 of.the Code of the Town of Barnstable DA- 08007 D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional.Office (see Attachment)to issue a Superseding Determination of Applicability. The request°must be made by certified mail or hand delivery to the.Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form)as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the:same'time be sent by certified mail or.hand delivery to the Conservation Commission and to the applicant if,he/she is not the appellant.The request shall state clearly and concisely the objections to the Determination which is being appealed. To'the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. D wpaform2.doc Determination of Applicability •rev.10/5/05 Page 5 of 5 Town of Barnstable P# CF 1ME Tp� • Department of Regulatory Services 8ARN8TABLE : Public`Health Di-Osion Date 200 Main Street,Hyannis MA 02601 A�f0 MAC ' Date Scheduled Time Fee Pd. Soil Suitabilit Assessment for Sewage Disposal Perfonned By: W i i s-&I Witnessed By:,11,h nZ ►,`o ra#)I, LOCATION & GENERAL INFORMATION Location Address ref m �� �$�NU,�� Owner's Name M e I v h 1^ie lCQ ` 30 F:6% -r.- Address a A 0213Ir Assessor's Map/Parcel: rrle�o /FrS//�c� O ZO Engineer's Name-nl cvka.a A •lJ tl c t L'a x)7,- PEW CONSTRUCTION REPAID: Telephone.# Sa t � Land Use YZ.G sk 6L A�-t Q_k Slopes.(%o) Surface Stones Distances fran: Open Water,Body_/06 ft Possible Wet Area ft Drinking Water Well - ft Drainage Way• ft Property Line ft Other tt SKETCH:(Street nnine,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 90UTH.COUNTY ROAD AKA MAIN STREET _ .. / � �em asn.v„a.uem■.n �I ;TP102 0. A f�� x 0.33 O.P9 OY - 0.5 N �a Parent material(geologic) (c,e la,l d v4- ,a 5 H' Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: hi: Depth to weeping from side of obs.hole:. in. Groundwater Adjustment - Index Well N Reading Date; Index Well level Adj.factor Adj.Groundwatee,Level _ .. ,;PERCOLATION TEST' DRte 10 4, 0 Time!10'Od hAi Observation Hole t✓ Tin /o, y teat9" '2 Depth of.Perc (gyp fir'.. Time at 6" 6/ 27 Start Pre,-soak Time u, Time(9%6") End Pre-soak Rate Min./Inch > - rW A,4&4` \ Site Suitability Assessment.. Site Passed. Site Failed; Additional Testing Needed(Y/N) L= Original: Public Health Division Observation Hole Data Tb Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)weelc prior to beginning. Q:HEALTH/WP/PERCFORM DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture. Soil Color Soil . Other Surface(in.) (USDA) (Munsell) Mottling, (Structure,Stones,Boulders. i 0/..Gravel) /,b yre ZL -- 60�1— �N�f" � C2 !'ylx�rv►t7 b�7N6t' IC :.y� '��� . .�. : DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil' Other" { Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,-Boulders. on ten •Ap 5;k-mf Loam ` .0 Yr< DEEP OBSERVATION HOLE LOG Hole# Depth from, Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil : Other Surface(in.) (USDA) (Munsell) Mottling. (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Man: : Above 500 year flood boundary':No._. Yes X Within 500 year boundary. No ZC Yes Within 100 year flood boundary No_ Yes 1K_ Denth of Naturally Occurring Pervious Material - Does at least four feet of naturally occurring pervious mates ial exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on i 5 (date)I have passed the soil evaluator examination approved by:the Department of Envirotunental Protection and that the above analysis was performed"by me consistent with the required training,expertise and experience described in 310 CMR 15.01T.' t Signariue Date216 Q:HEA.LTH/W P/PERCFORM TOWN OF BARNSTABLE LOCATION 4 9 �"7 ''" `� SEWAGE# VILLAGE AS��SE��SSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. /(/o nT c:�t �y SEPTIC TANK CAPACITY LEACHING FACILITY. (type)<3) ra o &e,% C'."`(size) Z, NO.OF BEDROOMS OWNER P"LLV 1 rl lf' .S-p 39 /=e,S�1:�- f, niJr-i��.�u�� pU33 PERMIT DATE: S�� �Zou °� I COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching,facility) Feet FURNISHED BY /�/U•• r�} i-w �/�✓•r..i- A s3 4 44 63 ' a. 0 O z- U i A A INTERIOR DOOR SCHEDULE 7 DOOR SYMBOL ELEVATION ROOM NAME ROO.I DOOR TYPE LEAF 512E(VMHI THICKNESS MANUFACTURER THCKNESS PANEL TYPE FINISH LOCKSET HINGE TYPE NOTES RELATED DRAWINGS -—- -—-—-—— ----_ - -- —-—-—- __-. _-_- -_-_- / __ _ Z NN STORAGE f03 SINGLEDOOR viNl, 0-Il/8' EXTERIOR DOOR SCHEDULE EXTERIOR WINDOW SCHEDULE 1) DESIGNATION AA AB AC. DESIGNATION A B C 0 '•81/<' n s 79 OOORTYPE OPENING GLASS WALL OPENING GLASS WALL FIXED GLASS WALL WINDOW TYPE AWNING DOUBLE HUNG AWNING POLYGON „ +� UNIT SIZE(W x HI 19-8'k8'-0" 19'-BYB-0' 3'A 1/2"x8'-0' UNIT SIZE IW nHI 3'-6'xl'-N' 1'0"xA'-81/9' 4'-0'n1'-111/8" 1-4-11' QUANTITY 1 1 3 QUANTTY I i 2 2 L, MANUFACTURER NANA.— NANUWALL NANAWALL MANUFACTURER MARVIN INTEGRITY MARWN INTEGRITY M VIN INTEGRITY MARAN IXTEGRITV /-`' SERIES SUS SUS SU5 SERIES W000-ULTREA WOOD-ULTREK WOOD-ULAEX WOOD-ULATE I I S/ O_ _ I _ ��^' v I/e'SLNUUTED 1/8'SW.UTATEO ]/8'SIMULATED )/8'SIMULAttO I-9/11 5/11 O MUNTIN N/A N/A N/A MUNTIN OEVIOED LITE W/ DEVIDFD LITE W/ DEVIDED LITE W/ OEWDED LITE W/ SPACER BAR(SULSI SPACER BAR ISDLS) SPACER BAR(SOILS) SPACER BAR(SDLij I O I (/] L) a� MUNTIN PATTERN N/A N/A N/A MUNTIN PATTERN Ix3 6 OVER 6 S. AxI I N I 1•••1 U GLAZING 1/4'SIN TEMPERED t11SINGETWERED —SINGE TFIAPERED GLAZING TEMPERED GLASS TEMPERED GLASS TEMPERED GLASS TEMPERED GLASSGLASS GLASS Kw \W I i 0 i I I y_ U Fa STORM TEST PERERMANCE 1.11 1.11 N1.th STORM TESV PERFORMANCE U—U0.27 0.27 0.27 0.2] I q 2'-61/T 3'-61/3" INTERIOR FINISH PURE WHITE(9010) PURE WHITE(9010) PURE WHITE(9010) INTERIOR FlNISH PREFlNISHED WHITE PREFlNISHED WHITE PREFINISHEO WHITE PREFlNISHEO WHITE N Wy EKTERIOR COLOR PURE WHITE(9010) PURE WHITE(%10) PURE WHITE(9010) EXTERIOR COLOR STONE WHITE STONE WHITE STONE WHITE STONE WHRE HARDWARE SET T.B.D. T.B.O. N/A HARDWARE SET STANDARD STANDARD STANDARD N/A I I I Z LOOGET STANDARD STANDARD STANDARD N/A MIILWITH TLOCKING MUL—LALOCKING WffHLATAN WRHLAT AN HINGES STANDARD STANDARD STANDARD NIA - a `\r GRIPI LOCKSET OFAOBOLT ANO OUOBOLT AND NIA _________ _______�_____ _- ____ _______ �jl To TOP/BOTTOMLOCKING SCREEN STA I— STANDAILO STANOARE N/A -� RODS RODS SNARE SYSTEM N/A N/A N/A HINGES STANDARD STANDARD N/A NOTES n CUPOLA OOF PLAN n CUPOLA PLAN D,tl6.00 SCREEN N/A N/A N/A I V SCALE:T/9' 1'-0" I D SCAIf:I/4' - 1'-0' SHADE SYSTEM N/A N/A N/A NOTES m FRONT ELEVATION IVAN�i BFR6HIC A550C.,IXC. +` p FRONT ELEVATION(SEE FLOOR PLANT FOR D000. SWING) a 01 to C lJ O LL O 1 1 1 Zt'2 1 1 1 I I I I S'-]sm 1 I - . . _._. __)/8• _ -- -- II , -Z ✓- C I I II 11 II I �I II I 11 II 16< I II I I - O_- I I i III 11 II II AA II I II 11 111/A'll II '1 1 II 11 I I -I--r - -5 I I 1 I 1 I I 1 1 I I 1 I T':15 �'�. 0.FRAME 11 �,52 T.O.PLATE ------ /� F ffi S OR GE' I - .... .... ------------ .1 T.O.SLAB 927TIN AREA 11 NATION n SOUTH ELEVATION i 2B SEALS:,/.- I'-0' 1-0' ♦♦ ^1\ . QQ R - / ♦\♦♦�♦ - —_— I O SCALE:AS NOTED •;\f 1 I ` _ s - _ _ /' I _ I♦ DATE:11/w115 1 I I I i b REVISIONS: I I O.FRAME ♦♦\® I —_—_— —_—_�___ _—_____— _ F.O.FRPM I AB REBNIa STAIR. I I /MTFCcH NEW FOOTPRINT. I � I I I LL � ti k I STING. I �TTT rA 'LS J.' --T"l`I r I tl'4 tl.• 10.8 S/B" i3. �r r.r 1 s I I r r 1Zx r3 s.kI1 3�r z.t �i 1 z I R)/B' 1'.75/8" 3 r u z Jj crrrT 1 Lr Cz -xr f 1_ L� ' X �-]-�.s=l.'ux T_.I'Zt.L�ST:C .. ' ., .+..,-'��}.i.2:`I-;.L T�.,:�.1.�:�a'4'-Y-�L'7.` LC 3I GA S} •�_=Z3 x ._' T_-��. �z:er-x n•--3.r:;,.. "n T""_._,_..T='t-�Tz,--I" :,-rs -.xT` Tim,-.-r ..—-iT-,..rz ., .:.c'.-.�.'. -.- _ T.O.PLATE FLOOR _- -- --------- , - - I � PLANS 8L A ------ --- ELEVATIONS II II REBUILD OUSTING FENCE fl SHOWER. I I 1, b BUILDING SETPERMIT JEJ .T- SLAB U PROJECT NORTH hgto EAST ELEVATION n NORTH ELEVATION n FLOOR P AN 1 2. 1 2D SG E:,/. - 1'-0" V SCA E:I/.-- i Q 1 A SCALE:I - I' i o u C84a1a o I I 0 F m� e F. a C Iix10 RAFTER,TYP. 3 AZEK TRW NWEft-STRUT 61/8' 61/e' STEEL BEAM txN NOM.AZFK SNEET '� I f 01<16.00 I x<NOM.AZEK SHEET - 3/8'PLYWOOD Z 6 1xN NOM.CASING Z b �ELEV.:.16-0' Z 6 BRUK AWAY LINE 2 6 — 6 Z IVAN BE0.EZNICN�ASSOC INC. 1.NOM.AZEK SHEET 1z4 NOM.AZEK SNEET 3 n EAVE&DOOR HEAD SEC ON DETAIL EAVE/DOOR HEAD&TRELLIS SECTION DETAIL I ® ® 6CALE:11/Z• 1"-0" I � a, z = U NEw coNc.sue ., `^______ _____ i•RIGID INSULATION BOARD —_____ _ Y •:�' .1 __ —_—_\1 CkT.o.PLATE w ✓ y . I 1 I .� ,. Q �F SEJTING BED OVF0.BASTING SLAB ( I �{ z — — — - ---------- - m .R NEW 10'CONC / v y.FOUND.WdLL/SUB r7 LEI 00 p m 4.1 1 1 J -------- E%nNG CONC.WALL lo'ASTING CONC.SALB Y .o.s �A TO—. TO REMAIN. Y .T-8•lAB -y v 10,HRMS B DOOR SILL DETAIL n DOOR SILL&PA TI DETAIL n BUILDING SECTION @ SITTING AREA (WESTI JD SCALE:11/2"- 1'-0' `B SCALE:11/2'- 1'-0' I D SCALE: r/ _ ._. __ 6 1/8- adN = _ I�BR_WAY LAN 6 I I 1/8'I Y �____ _ _ ____ _________ ________________Z _______ __I____-___-______-______________ I I k 2 16 ` ' � SLOPED CEILING "' ''� a �•1 Tear.. _-___- ___- -_- -___-_- T.0 PLATE _-___-_ - �, C 2x6 WALL& <� -' BUILDING ��—'. , u 3iC�nA�i Nci_ —_—_ _ � • e ____ �, 3` ftEv'a6 v ---�ra 1rz• m ___�_____ __ -RA �_-_Tv I _ NCE T0_0O STRUCTURE b __-_-_ CIA a SECTIONS& FF_O.COLUMN SH AFT_ _ -_-__ _� _ _FLOQDEIEVATION__ ✓•I•DETAILS - 23/4' 111/2' I STRUCTURAL STL COLUMN STRUCTURAL STRUCTURAL STL.COLUMN SR.COLUMN. 1'-211A' FOLDING DOOR-WIDTH•19'-8' BUILDING PERMIT c.L.COWMN TO C.L.COLUMN-21'-611., C.L.COLUMN TO C.L.COLUMN-5v 7/8• 2 J/a- SET ' F.O.FRAME TO C.L.COLUMN•21'-8 7/0' C.L.COLUMN TO F.O.FRANE-5'-)5/00 i ELEV.:•T-0'~ s, .0 3 PROP14 CORNER PLAN DTL. PILASTER PLAN DTL. CORNER PL N DTL. BUILDING SECTION @ SITTING AREA (EAST) A SALE:,,a. 26 SGLE:11/i'- 1-0 C SCA E:1,/2'- 1'-0' lA SCA E:1 10' 3/P BASEPLATE W/ 0131,UN.HOfFS,IYP. COLUMN'"'WELDED TO PLATE FILW/LECONTINUOUS G�3/la" T WELD,TVP. V HIS/B"DN. P.EPDXY 4NCH00.BOLR,tt W ' 0�/ A �'y - W n m w vi W n BASE PLATE DTL. IDI m V �- _ � Vm F SLABTIE/DEVELOPMENTBARS: IIII i ,1/Y z13" ,I/Z' �J 9;PR VIDE®ir I.24-H.°ROUNDEMIRS P4RAMETRE0.,TYP. WTI P0.0vI0E MIN.la"HORIZONTAL F00.W WM LAP,TYP. 31,BAS.LATE W/ 3l/9 I I/,' W .']F- REINFORCED CONC.SLAB: ' ' 3/,"BAS'PLATEHOWUp. PROVIDE CONTINUOUS N5 PERIMETET BAR I "'II COLUMN N.Y WELDED TO NI S/B'DW. p 6x6i.9x3.9 WWM IN SHEER,NO ROLLS,ttP. n I I615/B"OIA. , 1,1 3/P DIA.NOLES,TYP. PLATE W,CONTINUOUS EPDXY ANCHOR BOLR,ttP. Z SUPPORT MAT ON 3"MECHANICAL CHAIRS.TVP. TIED BELOW SLAB TIE BARS,TYP. EPDXY ANCHOR BOLTS,TYP. (IS/B'DIA COLUMN FULLY WELDED TO Q^7 EPDXY ANCHOR BOLR,ttp. PLATE W/CONTINUOUS 3/,6'FlLLEL WELD,ttp. - 3 T.O.NEW CONC. �.....__ -'OLUAIASNEPLATEW/(4)3i"DU..HOLES,T`TP. 3116 lD,ttP. HIP RA n` I E WE I I ' I I i 8 H FTER,TYP T. C FULL O PLATE CONTINUWS3„a"F1UETWELO.ttP. ..,.> .. W0-1LAB/PERIMETER CONC.FOOTING,TYT. 1x -- --- SETTING BEO (MIN.FC-,000 P51, D R COARSE.COMPARABLE 3/B TO]/,'RESHOT - GPANULARMATERIAL.TVP. •'..� n _L_ - � n « _ . .. A T.0_IXISTING CONC.55/l-_ V.P./0..U. CHIP DISTRESS PERIMETER CONC.FOR MECHANIGLBONO,ttP. _---_— WASH CLEAN W/PORTABLE WATER fi DAMPEN FACE _ ,5 AfTEA CHIPPING,NP. ,.MIN. I >r - ,4' •. RI/3' o NAN BOTEINICMDA550C IN[. SNB TIE/ -OEVELOPMEM BARS — -- ------ I I I I I txB RAFTER DRILL)C 014 OLFS 6 DEEP fi E%6TING FOUND.WALL INSTALL kSB 0.1N EP0%V� r TO REZAAIN. I I I 12b1/3'' 1a"O.C.,TYp. S'1• n PERIMETER SLAB DETAIL n BASE3PL ATE DTL.(AI o BASE3PL ATE DTL. (BI n B,AS LATE DTL IC) o OOF R AM NG PLAN @ CUPOLA �W I O LLI LLI LLI of �j x 0 0 u u U U II I (3I u U I I I I I fir— , n 3 Z .O.FRAME ,. 2 Z N. U, STEEL HEAD BENA.HSS 9x5x MINUOU51 f --3x10 RAfTEA ^^3x10 RAFTER-- _ 110 RAFTER--- i m HEADER .251C0 .I Eors I I I ,I II ®16'O.C. ®16"O.C. y ? COLL. L zD ..y I f, "V , I I c. T.O. REINFORCED CONC.SIAB L..C.L jOLUMN G I yf C.L COLUMN O nCI C AQ I I I S2.p f I SM. 3D 31 Zx,2 O R 'GALE.1/r - ,FASTEN HIP RAFTERS TO 20 1 - ROOF BENTS W/ Y ? I I 32.0 ; sRDGESPAPS CONNECTO (COMPRESSIONS M: i 04TE 11/OI/,S I C.L.COLUMN I C L g4SEp K v RIDGE CONNECT00.S,TYP. q�q qkq' I_ Kf�_ I31 REVISIONS: I W ? I I szo t3 31 I s y ` ��o LCOLUMN 9 ?a P += 32.0 I I I Y aRRP �� R n ,TCt2 I pl I `9(`<�, I �O,I.t I 3I iII'I 2xfO RAFTER Ix10 PAFIER G- 3atO RAFTER 916.O.C. 0,6"O.C. i o .. ..V.. e' STEELHGOER.STRUTB -M59xsa.121COMINU01121 __—___—_____ _—____ —___— ZB 2C S 0 H'.6 VB• 22.0 j S3.D- N I n D,/.' 5•-,'= - „Ui, ROOF FRAMING& 3Td/2' TEEL FRAM COORDINA CJII O CJ jl w wl 3 =ate___ -ION PLANS u� OB C A Uj:o l_ __.___-__Ve:::_::::____:-_ �� BUILDING PERMIT ___ SET i ;1 CONCRETE COORDINATION PLAN n STEEL FRAME COORDINATION PLAN n ROOF FRAMING PLAN t'A G SOLE:1l,• t'-0' SULE:2 - lA PROTECT NORTH \\JJ �/ S2.0 iS B'-s 3/4' n _ NNkENT CONTIONNECTION, WELD I ` • u N MOMENT CONNECTION,TVP. W S SUAPSON HU�11-21FACETMOUNTMANGERS. ✓��'�9, �0 0 <r � U E� 60 jFlITCHPIATESENT 11/ 1/1I: 0.OVIDE 9/16"1A.HOLES STAGGER SPACED®16"O.C.,TL7'. FASTEN BENT PLATE TO LVL SIDE PLATES W/ O ,IT'THRU-BOLTS W/WASHERS EACH SIDE,xP. Z BENT BRACKET: RI SIMPSON HLA,O.13 - EACH BEM/SEAT CUT,xP, I j I+� 01416.00 T.O.P ATE :....__...._........._.... .._._.._._.._.._._......I W/ covrRlcxTm 2Du nAN eiBizNlcu Axsoc.,INc. R13x6 PLATES: . . ATTACH I SCREWS .STAGGERED ALONG ALONG PLATES O 16'O.C.,TYP. n RAOOF BENT DETAIL I I ' I BOLTING END PLATES I O __ --- T.O.PLATE C.L.WIND BEM BEAM �1 F _—_—__.. _— —_—___—_ _— _—_—_— �I F DIAGONAL BRACE: i O = (1)HSA.44.2S j I _ �1 C) ,1 ,J CUTBWELDEOTO f-I orl COLUMN B BE0.M.M. ,'\ I d I O y of _L7 ' D000. ' D00R ' DOOR l) ``1�,\ OPENING / `,,� OPENING ,\ - , OPENING O23/d' 1'4Y 141 EA.A325GAL 5/B"OIA.BOttt W/ /4' ,+ 141 EA.Al25LAL 5/0'OU.'BOLR W/ `+I I� \1 �I / - �I �I LL U� L��1 NUTS B WASHERS,TYP. NUTS R WASHERS,TYP. �, Zy5 ._---_—_— 2 6 _—2 6 O IV ,,\ /'I Vj ..// ul ", J,/ J `\,\ ul ,\ /,/ Vj O 2 6 I 6 I` �'-1/d' S' 2/' ,�'. ', -1' O O C. CO- O , CO.-5 r^ v O C.L_HEADER STRUT BEAM _— I —_C.L. ,HEADER-STRUTBEAM _—_ _—_—_— —_—___—_ O1/f / , OVE V %SSEMB O,X\ -----_ F.O.FRAME TO F.O.FRAME-22'-01/2" F'`I +zn I IIDO M,1.54.25U(CON INu.mI.TYP. I NS�A3x(I.35(ON NW U51.TYP. ' I HSS.Sx5x.25 CO—,TYP. - \ -W1046 CO—,M j - H55 5,5,.25 COLUMN,M. i' / i I HSS 4x 15 CO—,TYP. I - / � / I I'3/f BASE PIATE W/ H7 1/1 I.—LINL PLATE B I/a'NON-SHRIIAKORROIR, 3 W`SHAPE COL.&HEADE -STRUT BEAM CONNECTION HISS COLo&HSS EAM CONNECTION \� HSS COL.&HSS B AM CONNECTION n WEST ELEV ATION 40A • 1'-M,1 Ili-• 1'-0" 11'-01/4' 5'4' 11'-01/4' j - I GATE:I1/01/15 -- --- BEM BMCKET: - - - FLITCH PLATE BENTS: - (21 SBVSON MW10Ki® 1/25,9112'MCH 1"..1 REVISIONS: EACN BEM/sEAT CUT,TSR. (211 3/4'k91 R"LVL SIDE PLATES,TYP. I I I IA IB BEAM END PLATES COONECTION.IYP. I �_----� 52.1 BEAM END PLATES COONECTION.xP. I I 53.1 52.1 / ----- i�------ 2 T.O.PLATE _j L—_—___—___—_—_—c_L.HEAOER-STRTBFdM_U _—_—___—_—_—_—_—_—_____—_—___— I _ �_� C.L.HEADER.STRUT BEAM I BOLTING END PLATES NEADE0.-STRUT BEAM: - BOLTING END PLATES COLLWELOEDTO (213/81d 1/ 14%xP. 1\ / _I COLUMN WELDED TO d I �_-•``)\815 1R1td xP. H 559xS.0.25ICONTIN000SI.Mi MNSTEEL HEADER-STRUTBEM.TYP. I L/ a I I P I I STEELHEADER-STRUT BEAM. I I b D00R OPENING / OPENING '•�OPENING� 20l,H/•"• ° % \ "j , L Y•22'd Lj '' � �u0,/-••" MOMEN T � j DOORUNTTWT1a 5-7 x• FRAME& OEAL ABY ' " 2`'CL COL TO C.L COL.!-3'1'-61/8' C.L.COL.TO C.L.COL. 5'4 7/8" C O TO 4 BRACE i.0.iRAl6E TO F.O.FRAME-2T4,rz' F.O.FRAME TO P FRAME•22-01/2' FRAME I % \ ELEVATIONS j7_11'Gu� 2)NBUILDING PERMIT PATE (2I Hss4xlx0.25eASE,TYP. I I CUT R WELOEO IN X. ,\.\ SET _ LAP 5 MLLY WELDED. I • • 3/4"BASE PIATE.1 I/4'BASE PLATE w/ 1/d'LEVELING PRATE R 1/4:LEVELING PLATE R NON-SHRINK GROUT,TYP. 3/f NON-SHRINK GROIfT,xP— _ _ _—_— _—_—___—_—_—_ __—_—_—_ _—_—_—_—_—_—_—_—_—_ +T 9'•SLAR B SOUTH ELEVATION (NORTH ELEVATION:MIRROR IMAGE) n EAST ELEVATION S2. 1 l V SCALE:1/2' 1'-0' 1 SCALE:1/2' I'-0' DIRECTIONS: From Hyannis - Take Main Street to the West End Rotary , and take a right onto Scudder Avenue. Take a right onto, Smith Street and follow as it turns into Croigville Beach ` r Road. Follow to the end and at the stop sign take a left , onto South Main Street. Continue straight over Bumps River ' of Jv• Bridge onto Main Street, and house is first on the left, #49. ee I r e Wd a s fiaet'B Location Map Jolte te vP `�` ,IVc / ,tlh 1"=2,000t' i ASSESSORS REF.: , Map 185, Parcel 020 IL OVERLAY DISTRICT: AP — Aquifer Protection District E °`` 1 ;2- ; ; �� I lALZONE: AL oe ! 5 { 1 RF-1 Area (min) 87,120 SF (RPOD) va°is0v" �j o Frontage (min) 20' Width (min) 125' \' ` ' , . I C ;`I��\ 0 2 Setbacks: Fron t 30' \\ \ A m Side 15' FLOOD ZONE Rear 15' E: F.d _s�- 90!�(Y��1�/ I1 r l �����' \ m'p m See Plan _ ( Based on FIRM l/25001C0563J July 16, 2014 it`. n i :� Lti1m�� . \ 1 / It #49 I 131 Sty W/F V + 4 �` AL AIL I Dwelling 1 ea! \ 1 '100 Per SE3-4757 Top Of Coastal Bank As Shown On Plan By..Baxter Nye Engineering.=- ` ie./ &Surveying(see note 2). It Top of Coastal Bank ,Ills - AL - As Shown On Plan By Baxter Nye Engineering , - / �f• % J I, &Surveyfng(see note 2). i . AL �• f I t�f.1...1 J / �. qh f 1 / l l ( 1 Bordering Vegetated Wetland As Flagged By Donald Scholl 22/OCT/07 �. /10/ 1. I. ,1 1 i sWr As Shawn On Plan By Baxter Nye Engineering _ Legend' / /l/� /ft / / &Survey ng(see note 2). AL Driveway to be Removed • I z.2s Deciduous Tree 1731 SF I; tb Holly Tree �s ! S� / f M I nd / . ....' Edge Of-Salt Marsh - OJ. r 1 I' As Fiogged By Donald Scholl 22/0CT/07 Coniferous Tree As Shown On Plan By Baxter Nye Engineering e 1-• _ &Surveying(see note 2). r r� Sign Iwvn /� \ # Light Post v �� \ � ® Water Gate (round) '4'J' .o ♦ svp° d4 ® Sewer Manhole \ Q�0i4P Hydrant O IP — Iron Pipe �' •'s\_ Qc��+y` O CB/DH — Concrete Bound �,., fSWWIF a n• FEMA Zone Line ElBRB — Barnstable Road Bound � r •, . As Shown On FIRM io Be lYbuR � r ■ MHB — Mass Highway Bound )t25001CO563f 5• 7 av ',' LN -0 Guy July J6;2014 d4'` Utility Pole ° $ - g8 OtR .;ew Proposed Roof& erg. / •` o Stormwater Drainage q Notes: •sooig� g • Existing outdoor 4 w - Shower Platform r Q 1.) The property line information shown was o ge� to be Rebuilt ; compiled from available record information. o o., 2.) The topographic information was obtained from Foo AL a plan prepared by Baxter Nye Engineering & o e, Surveying dated 12-7-07(see BA-08007), and by o d '' v an on the ground survey performed on or between d TBM EI=2.63'NA Io 98 t 27/MAY/08 and 02/JUN/08. °r of CB H Fnd - Off- Caastol Resource Line • As Flagged By Donald Scholl 221OCT107 3.)The datum used is NAVD '88 (NGVD '29 =0.87), AL As Shown On Plan By.Boxter Nye Engineering based on bench marks M28QS and M28QT. &Surveydng(see note 2). AL REV.: Remove pro deck, rebuild deck & Shower 1012115 REV.: Convert Deck Over Drive To Patio 1 09129115 TITLE- PREPARED FOR. PREPARED BY. Site Plan � • CapeSury m Proposed Improvements fan r Barr 201 o Revocable trust gnoee ft& 23 West Bay Rd, Suite G eoneunang, Osterville MA 02655 Dover MA 02030 suffival 49 Main Street (508) 420-3994 /f420-3995 �' ?� 0°°■ www.capesurv.com Barnstable (Osterville) MA zo o ,o so ao so DATE: I I I I 1 1 Field. RRL/MLL Review: RRL September 15.2015 Comp/Draft: RRL 7 lDrOwing # C239_4g1 ' • I • GROSS FLOOR AREA(GFA)CALCULATION . C F G H 1 w 7 F - H + Q FLOOR SNEN NAME ,GROSS AREA t:TFRRACE 00 BASMEM FL000.Om o1 FIRST FLOOR 95.15 02 SECOND FLOOR f 9 1'-I1/2' 12 79940 r _ _ _ ___ __ ____ _ JA'HIGH GUARDRAIL 0l F 9'-101/4' _ _2'.I 11'__ -5' -- ''31/2' __ EQUAL ___i'-l1/i' _ EQUAL 1'-11"'-� ______________________________ W/BAWSTERT°� _ I •.;`��':'.c•(t w� . JLL' Z 9'.• +'-311i' iLt s.t ATTIC FL000. L12 PEWPORCH _ E E 4-B1/i N_____J -------------- REMOVE DRLIICOLUMN FOUNDATIONS 9 § ORT II P; %WAY :rAI'-105/B' 2'III/4' 2'-tt lla' ` / '-0 5'- 4"FIELDSTONE ,,`---------------------- V NEER A __ _ ___ �___i-�---- FOUNDATION 1 _ _ F.O..FR�: -WALE-_ tom. ________r_ _____________ __ _________________-----------_� ------------ ___® -B'-0'1/4'T.o.R. ® r r �\I �N i-I - I s- 4 - REMOVE - 11 WA RPROOF D1 _______ BDG.AB V I Y.0' pp 3 (T) GAB.BEL W J 1 EXISTING WINDOW - ' 1 51 / v FlLL INOPENING \Y -Btt'/2'T.O.SLAB H♦ �__ ____�! i a 102 $TAIRA'Y I' 1 - 1 I a< STEP UP [Kw]r STEP UP SA CUT CONC, r f\ FOVE G� w I'I III - V 4 -- -11 3112 I ♦ REQU REMST ENTT IPERti/ SD® IUI -y _ Ig j LIBRARY m I ( II N i UP i b - 1 ICI 1NRn RATEDI `� \♦Xi ° __ UP--- a5 B1 Sm P9 EI f"G"I PARTITION `♦®`♦ ' 'B - _____________ FlODUM 39 _ C.L.BAYWIN°OWi NEW GARAGE = I ✓MwM• -_ I I `♦� DOOR.EXIST. ' _ / - ' i OPENING BED OOM —COAT$ I �! ' 1 ,Ilw y $AW CUT CONC. 04 - IDl 8'-B 1/2' ;z a . i -- --- ALL PER �h++ - __ 'BI I ♦�I♦ ri RE UCNML A9 _ ___ CASED 1 ; _ : + ♦`♦`♦♦♦ L___,.________\\_y REQUIREMENTS m lO _ _ __ _ ___ OPENING____ .. . I I STORAGE qI _ I ' GARAGb 1 e'-e l/4' S'.I 1/i' I'-11' S'-11' -- - NEW FIREPLACE + ,, I'-)I/4' i Dt O _____ - 005 SUPPORT FRAMING NEW STRUCTUML I ABOVE _ BEAMABOVE! - III NNICNE ^♦ - I _—_—_—_—_—_—_ _ _____ _ _—_—_ _—_— �a� _ _ _—_—_ _—_—_ _ _—_—_—_ —_ _—_ _ _ 1 _—_— _ _ = _ _ _ _—_ _____ 4 C.L.RO__ OF/1 °1416.00 r �l w F — T r- kj47::j 1. - - I ^II r Fa i i i T i I 1 I I M L ___L_ _ ISOKE T Da0.D a2 1 , ,�,ISH ' r I _ '- ------ -----J F♦ SAW CUT coxc § IDA i IDs I I �J 1 c I c YRenal`+ic�°a I 4 I rV RNEAN F SLOPED GWBRNEA -�J NEW STRUCTURAL STRUCPER TURAL „ O 4 I I FIREPLACE I , NB ¢ IN ®STAIR UNDERNEATH I F i I COLUMNSfi n REQUIREMENTS - I7o I1 FOOTINGS, P. .. + • _ 1 „ NEN'GARAGE I A4 I ` 1 ; I I ' OPENING EX TT I 1 C L.B1 WINDOW I r - ( _ ' I NEW STRUCTURAL .I I I I a BEANABOIE AS AI IX 'IN(JROQIY) .. ..II i I I I SAw CUT CONC.' v I I WALL PER - - A6 r ♦ I I __ _ \4♦ STRUCTURAL PAN' ____ __ ., r Y_l _ r a r �'r I r I Z' NEQUIREMENR. p L--- NEW STRUCTURAL ' ------ -- ------- , II 10R II Ib / I II I • BEAM ABOVE I . 1 1 I r L___ B2 " 01 Dt r A.1I __ J L J L J 1 I I I I , L ___ L ___ ________ ___ _ , r , r _ , r T, r I_ ___J L_ J L__ J L_=_J L_ __J L_ J L__ J 4 I k F.O.FRAM _____ u/ - I _ I _y Ji I '_ 1I I E%ISTING I i 1 REMOVE CHANNEL TO I I =__J ------ uHTI - OI AC I I V PFAWAY i"'� _____ _____ _ r _____J I�..�___J.L_ __J 1 I , CHANNEL TO 1 ---- 11 M'1 6( LII l4'HIGH IT'HIGH < 1 r EXISTING WINNOW i FLOOD VEM L J L J 1' E DLL IN OPENING L ti HI§ r r r 1 r r O SOUTH ORCH i ' li I+ ^ 1 ANDRDRAI WU BAL STE'RS L S I ' ' REMOVE , r______�____-_, I I P5'O CSTERT Q .. OOD VEM I o -0'-I+/4'T.O.DECK .. W T'O.C. IXRTING WINDOW ■��CL P o L / U 1S ' FILL IN OPENING I P____! a OIT®10'A F.S j _ „I _ _Y_J LJ L_____J L_____J I__-__-J L______J -w F.O_FRAM e i I nil 1 — — — — T — --- — — — — — — — — ---- ----=--------� W — 3 z >N — - RFMovE Exlmxc --i--i---i ------- , ' I CHIMNEY FOUNDATION _ , I � F' K r r r I ' sroR�Ce az ' r L{IJ 1 NEW GRAM J L J I L J ' 1 OM j STAIR. /. _____J L_____ _____ _____J L r to ^ O ------ r-----I r-----� r------ r----- L i _AY_ J - ' I I , I I I cL Dooaw O1 $ I L_ Y J L J LRdTAARbVJ L J L J I a l j l fi RAIL NGS 5-0 y PARTITION ' LOCATION T.B.D. I I _---------- - ----- - I' L Cl J L 1 J.L J IL. J ' --- TIRING WALL ___ � - r - -'-" r'----1 "--1 , ---- BEDROOM COUNT CALCULATION ' NEW FIREPLACE r ' I 1 r , r I r r •. i SUPPORT r - I I CONCRETE SLAB FERRACF 'I ABOVE EXISTING FOUNDATION wa , I I KltcheR/Family(307) ' MODIFYED SEE SECTION 5Q".3 r LI O r m' I Ei J 'L - J L _-JIL J L-_= J L _J IIIN Library llOSI(1�) _ FIRST FLOOR ROOMS Bedroom \ DI _ I ISOKERN MAGNUM 41 I I I I i III ' SOUTH TERRACE SECOND FLOOR ROOMS Bedroom a20(208) It /•' -\ FIREPLACE - y Bedroom#3(211) SCALE:AS NOTED t MECII 11CAL �. ( ' --- - L _J L __J -- -1 L-----DC,ORT fi FIREPLACE-J N _NV - I I PATE:3/20/15 i - r'-- �- =7�rr- r---- r Master Bedroom 202 I I 5 B/' Study(207) ' I Ez i i I i ATTIC ROOM Finished Attic(301) REVISIONS: F- __ ____ ___ __ _ _____ ____ __ r HEW POACH __ ____ J L J L J L J L J L J ?♦♦♦ r l r r r r 1 1 b i TOTAL k OF ROOMS -9 REMOVE EXISTING WINDOW .FOUNDATION ♦ 1 III I I� DIVIDED BY 2 4.5 EXISTING WINDOW TO RFAWNx0'T.O.I SUBFLOORj FILLINOPfNING Dt ICRCAEM SPACE I I I N♦`j l I I'i l I 1.EDROOM COUNT(ROUNDED ___ _____________________________'= �! ;. I I ____ L_____ � _ - DOWN TO WHOLE NUMBER) < I ROM P +—_—_—_—_—_—_—_—_—_—_—_—_ _—_ P— _— _—_ _ _-- ----------- _ I __ _ E 1 y ___________________________F_C____________y___________ I�______�_r 12 1/2' I r rt +_____ AC I a-1- __L______J III � TD.R00R j III j 91II j j Ili j ! ;III I� 5J BASEMENT I •I I I I 1 I LEGEND .. SCREE.JPORCN I ; I TYPE SYMBOL FIRST FLOOR l i I I i I I 1 2 I I CARBON MONOXIDE DETECTOR PLANS I 11 '�� `.` 8I ,,, �. .�I I I I I I ♦�♦♦ I ,�� 1-!-� I j E%NAUSTFAN o 11 \ DUN \` A`\•` �I .' DRE[N WALLS 3.1 +/i' \`.♦ 5' i, 12'.t EST DETECTOR / o _ __ __ H PERMIT SET i : NEw i F an I I —a—_+___ —% 1- 9_— 2'.61/i' I�—_—_—♦ ��_ _—_—_�I—_ _—_—_—_—_—_—_ CTOR —_—_---_—___�_—_ V __ _ F.O.FR _ SMOKE OfTE 1 11-t � - PROJECT NORTH L .0 IyOLEMENT FLOOR PLAN0FIRST FLOOR PLANU /a1-0" B CI EO ' IIVJJ ��VJl 3 GROSS FLOOR AREA IGFAI CALCULATION 7 4H e f DOD R RA NEM FLOOR GROSS R5 5ARB A M. 01 FIRST FLOOR t,95d.t5 I 02 SECOND FLOOR 1'-1/2' - 'I - 03 ATTIC BOOR -AG. 4.t ' 2'•21/16' T-5I H 2'-21I11 _--_- I -___ 1'-1P 1'-10' B' - 6,-23 p/t - i `------- I / S7 2.15 ' I5 .� BAZrRpd ______ ST HAjLo3 j UP MECHANICAL 1p V AYz—_ STUDYt7 BF,DRUIOM N2H: 8 - T A.HN HANDRORAIL STORA E w a W/BALUSTERS ® 303 C,� Y A fO _ - � ®350C yy.� 3,HIGH HAND0.DR41L CL M GU RDRAIL 2 5 ti Z W/BALU SHELVES 21 I I I I = i /BALUSTERS I FLUE CXASE 2 /' i .3'0 ._ b --- - FIREPLACE FLUE$ , BATIItl6 l HIGH HIEING (CNBNIEY) J $d a TO CHWNEY ABOVE ( O I I - 02 I %i 1 U l` m , I' L_J A I'�q; _� a. 4. _ C.L.RDOFO LAUNDRY - i F SHED ATTIC - q �_/ A4 § UNFINISHED ATT C/STD GE yI� N 1"sT /BAL ON D1 3'-Y 3'3 i/a' i8tli'' �� 1 DORMER VJAQ'FlNRB- f n I•ii v.P.l 0..U./C E. 1 l COvva GniER 3D15 NH 43 v. _— ^ j e9i ,9i (( i / 1-- II ' O -OD ?Ofi "HIGH 1 V<BEREEn CR A550C Inf. j GUARDRAIL /BALUSTER SHELVES 1 E E 1 /� STORp E DN r ' W 11 1 N U F2 Ij _ O b Alt IjIjj IIj(Il j e jIlI J _3' 3O 3O ICAL E- ------ ATH S r T . T t/2 I { ___ ____ __ _ ____________ O5 zA I — - - ------------- — —-—-— — — — — — — — QWw NG—k F.O.FRAME � r___ KI H M H l I_ I UN llf ED ATTIC Ij I I I j I I r 1 MAS'ER BEDROOM SCALE:AS NOTED 4 DATE:3/20/15 REVISIONS: —� IN- - - - — —!f §- - - - - - - - - - - - —1 - - — - - - - - - - - — - - - - - - - -- - -- I —I I _—_—_—_—_—_—_—_—_—_—_-1__ - _—_—_—_—__ _ f 1'.011 4' I I IliiAL E I I I I I I I SECOND RooFTE FLOOR& 36'NIGN RNLING W/ j j I I I I j I 'r j l j ArnC PLANS I I \•\ I /'/ I I I I i t \'\ I / I � I I PERMIT SET 12.1 PROJECT NORTH <j pjaIIjj �. 1 �ZSECOND FLOOR PLAN :E ATTIC FLOOR PLAN o. o a tm Li 7I�v s` ,:I u L ��D E �J LLL t`3�sCALE:,l4 1-0 4 � �J . _ cI Street�eA FLOOD ZONE: vt See Plan N7 70'35 E Based on FIRM 200.00 125001CO563J Y ' July 16, 2014 `�•y> t•-^"� j' / `+" •,� �'- ' {~Fes. W_ 1 FEMA Zone Lice As SM1—On nW 1 /251)OIC0563J 049 1 Ally 16•20I4 Location Map Q41 '0S'e/IMwy Existmv DweNny / 1 Dndr Gmxlru=lim ASSESSORS REF.: \ Mop 185. Parcel 020 1 OVERLAY DISTRICT: 1 1 AP-Aquifer Protection District ' � 1 ZONE: RF-1 Area(min.)87,120 SF(ROOD) +" l Frorta a in 20- in) 125' Setbacks: Front 30' Side 15' Rear 15' W O DIRECTIONS: / / From Hyannis- Take Main Street to the West End Rotary and take a right onto Scudder Avenue. Take o right onto /' Smith Street and follow as it turns into Craigville Beach / N ti Rood.Follow to the end and at the stop sign take a left onto South Main Street. Continue straight over Bumps River Bridge onto Main Street, and house is first on the left, p49. s'_Tq \ / r 1 Sty W/F \�' - �s•E, Poo'a Garage A paJ/F wrY �p i+o r e r 9 J G37• '1y ?� 2-x 6-YIN.DECKING(TYP.), ` !/1-Mel.SPACING MY IXCEPY-FWERGLASS GRATING OVER 4n - '_ qs ?e SALT MARSH MONDING A MWWUY 1'-0- FY RO yp Or 65X LIGHT PENEWARON r 2-x4 HANDRAIL(TYPJ 0 16' 2a - . I JFOR - ALL STRUCTURTUR AL MEMBERS r - uFLw z.9 - -... .____.._t4j............... ► I tloM C TYP 1. Salt ' 154' .._- a`............-.._..._...._ Morsh 30 ' r n O.a',.,'01 tA�ShBRACING ONLY + CG WEA TEO PLLINC AND STRUCTURAL IWBER WA AND tl�TRl ----CROSS BR (CREA TER THAN,THREE r3 UItl/E5 THICK)ARE FOR PIER kA.VIS�oE,d9a ALLOWED.OTHERWSE,ND ICA-IREATED qt ................................. '"`-• CREOSOTE-TREATED MAiERAkS SHALL BE USED. ... f. :- 4' • Pa.E TIP.) ''�`�Bs 4G'- a/ -_•_ -_ _- .FOR RER � J Shell is Shellfish ' Rating 7 25''`fi o `g�. Rating 4 QJ J3 `J Section View +.f'`J -!a .. p +`�7 T��•9 '.1 1�/y `��d ``�� 4QJf � �'lJ a +�'t/ scale 1'd4' / — — _ _ _ _ 35' +.SB a`wJ Overall Plan View '`eJ ea `se Edge of Channel • scale 1 160' As Par Dredge Plan ` &Channel Markers a'46 Centerville River .. LENGTH OVERALL - _ - 142' / BOAROWALK 83" 24' to' 25' ACCESS STAIRS PIER RAMP FL°AT (BOTH SIDES) LEVATION 5.0' ErISRNC „ 4'Min. - M.H.W. 2.8 r r .... M.L-W.O.P... EXIS71NG a _ GRADE ` 37' UPLAND BEACH. 30• - 59• SALT MARSH LAN°UNDER OCEAN 10-12-PILE(TYP.) Profile View - 10'D.C. scale i-10, ?ewisionlRoduce dock leng1h b 1-51 per Harbor Masters office 1 12 2 2015 TITLE: PREPARED BY: PREPARED FOR: NOTES Site Plan CapeSury Proposed Boardwalk 1.) The property line information shown was J • ea 23 West Bay Rd, Suite C compiled from available record information, m Pier Ram & Float At ulllVan ,>, >� °stores MA 02655 y J P (508)420-3994/f420-3995 Jan T Barr 2010 Revocable Trust y 2.) The topographic information was obtained 49 Main Street °:�'�a� ww .copesurvcom Dover MA 02030 frorn an on the ground survey performed on or between 51DEC12014 and 22/JULY/2015. V Osferville 45.Uon Yrew 2 4 8 1B Barnstable ( ) Mass. IOPraMe Yaw 0 5 10 20 40 3.) The datum used is mlw, a fixed mean 7 Oroft: CTR Field. MOH/WHL/MLL 20Roe v1e. D 10 20 40 BO sea level datum. DarE: August 31, 2015 SCALE 1" - 20' Revsor: J00 Comp./Review: MDH/RRL Protect: 340024 Project: C284.5 _ �' r . �• . SYSTBA PROFLECONSTRUCTION NOTES: GENERAL NOTES . �j Nair TO WN • r I 1.THE PROPOSED SEPTIC SYSTEM MAY REQUIRE RECONFIGURATION OF 1.) LOCUS AREA COMPRISED OF .�` •r s - a :; f0VW W UM wM MM oree sn�r- �- (Min) corm INTERNAL PLUMBING AND/OR RELOCATION OF UNDERGROUND UTIU11E5 ASSES40R'S MAP 185. PARCEL 020; CERTIFICATE OF TRLE 175 ...c t ` - c �Yc Cam 9w1 K wnmmw eww"m woa�r 3r Cm=) Cmw SERVICING THE HOUSE r� . a ,t' i1� t• - �a> CamoiaoOWNER/APPLICANT: MELVIN D. HELD f 'Eti �owr 2.ALL SYSTEM COM�PONEMS SFUU. BE INSTAU.ED IN /iCCORD►ANCE 39 FOSTER STREET FI aMOE aee a Eac FN►M a of WITH TITLE V OF THE STATE SANITARY CODE DATED MARCH 31. CAMBRIDGE, MA 02138 ,,'' ,`% •:� ` ` \ \ \ 1995, AS AMENDED THROUGH THE DATE OF THIS PLAN, & ANY • • p , _ / / 2•) PROJECT DATUM: THIS PLAN IS ON NGVD .r .a we S •�,ws LOCAL RULES � REGULATIONS APPLICABLE.� . gas TOP of c�wweFlt � wr our ' • = r .• �� _.__.__-� -, PRIMARY BENCHMARK : MHD 10 9203, STATION M 280T .•: W W , �YC � aur- ,e.0 FRST 2' (f0 �LEVIWASHED DST ONE.1' ' ' .- °1` • . �'�.�• • •� 3. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN 'WRITING,BY DISK IN MONUMENT NORTH SIDE OF • , 101I • r'`' •, o.., •""P : .'_�.: 4. 3a+. �o 5W GN1.ON 3/4 Tb t-1/2 SOUTH COUNTY ROAD 4 BELOW GRADE 1300 WEST " �: a ti --. � �, FLOOR- Lae °1 My Asa av N• t3.3•i' PRECAST CFIAI�Qt DO�J� WASHED THE ENGINEER. ELEVATION INFORMATION MUST NOT BE CHANGED .....�._..� dye_ � • _ •� � , • •; "` '- f•.6ir• ='` I� SIP our-tsd Wlll•IOl1T WRITTEN PRIOR APPROVAL BY THE ENGINEER. STONE OF THE CENTERLINE 0�' BUMPS RIVER. �' •, r 4' �.s ,�.--r!r :,`'"d'�"' �` r �°"cED cmvm - e'ca�rE�" N g�prj�� OF • ELEVATION = 46.78' (DATUM: NGVD29) • •i e� /1 �- --' r/ # , - p.r.; �* 6- STONE CFWABER .�► � EL 13.3 U• .-M!t/AR> C '-t •.S•� i` •'s.y•:a;• s..!:•,�,. .... ..t,. .;✓•; • • BASE i,._tr, ;JS•,�, �yy/ r !� ` �!' :2 : G.1J 4. WHEN CONSTRUCTION IS COMPLETED,- PRIOR TO BACKFlLUNG, y •°`� �°`' �" `t n'°"°'w'�1• NOTIFY THE BOARD OF HEALTH AGENT FOR INSPECTION. PROJECT BENCHMARKS : SEE PLAN 0ti b :0' l' +�« �� 5 MIN . , f GEC E8 if, .' ��AR �,n M ' ,+•;, ! ,.: .Orr'.. _�,- l9 DOESlilON= LVIS IPW ems. F E14CO NTEM RIM C m ee wpm ON saes ErDE i1E Pf/13701E REV (lot+ of SFMLL ee 3•) ZONING INFORMATION �w ja ° .. ., rwarim ON 5• ED DISTRICT' - < m w uwo.suevF seF a�,m�� ��� No c�.�a.�oar oe..M.a a E�.�► �,.o ' ALL SANITARY DISPOSAL. SYSTEM PIPING TO BE 4 SiCH 40 ZONING RF 1 ' PVC. UNLESS OTHERWISE NOTED HEREIN. OVERLAY DISTRICTS . AP & RPOD 6. EXCAVATE UNSUITABLE MATERIAL AS NOTED, TO THE C MINIMUM ZONING REQUiREMENTS LOCUS MAP Scale: 1 w = 2000' S MO'3r w 832.04' / HIS HORIZON" , FOR A HORIZ. DISTANCE OF 5' SURROUNDING THE ANN. LOT AREA = 2 ACRES (RPOD) LEACHING FIELD. AND REPLACE WITH CLEAN SAND PER 310 CMR MIN. LOT FRONTAGE _ 20' 15.255 TO THE TOP ELEVATION OF THE SAS. FRONT YARD = 30' SOUTH COUNTY ROAD A. K. A MAIN STREET INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN SIDE A REAR YARD = 15 7. _ _ - - - -- - - -- MIN. LOT WIDTH = 125' - LESS THAN 3' OF COVER. r,,, 1938 STATE DISCONTINUANCE N LAYOUT No. 3275 8. THE SEPTIC SYSTEM DESIGN DOES INCLUDE GARBAGE 4.) A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE IF DETERMINED GRINDER TO BE NECESSARY A TITLE SEARCH SHALL BE PERFORMED BY OTHERS. i,9 9 ., h - .N�s 8st�96v + 14 _ -- ` ' k 1 5,) THE PROPERiY LIE MFnRIM110N ON CURRENT AVMA9LE RECORD _ ; + t- ct99.y3' ' ,'`,(,- - --__ __ �� 9. � THE CONTRACTOR SHALL CONTACT DI S AM DEED& AFE (AT INFORMATION CQrSTiNG OF PLANS c33/bH FND ,` _ of WORK , �. r __ 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE ALL THE EXISTING FEATURES SHOM►N 1#REON WERE OBTAINED FROM A FIELD SURVEY -` / i r H HELD ... x-1��-�--z'a-- `� , � .���\�./ 1:�g � � � __- EXISTING UTILITIES, AT LEAST 72 HOURS BEFORE TfIE START, OF PERFORMED BY BAXTER NYE E]OVEERIMG A SEAQVEYING FROM OCiITBER 4, 2006 TFMOM - ___ - m �- '�,, ,'��'�,-,. r. , 35 . THE CONTRACTOR SHALL DETERMINE THE EXACT NOVEi1BER 10, M. VARIANCES REQUESTED: ? _ -- �, `, ` -i/`k ' r' 1 / `� / r LOCATION, BOTH HORIZONTALLY AND VERTiCALLY, OF' ALL EXISTiNc �� %'s C,- `� �� /,�•,' ,' I UTILITIES BEFORE THE START OF ANY WORK. THE LOCATION' OF 6.) BORDERING VEGETATED WETLAND FLAGGING BY DONALD BEFALL. ETVSR/AECOM ON 10/22/m. 1.) BARNSTABLE BOARD OF HEALTH CHAPTER 360-1 , ` v�, .��T -�t3_ '` ,, 9'f, ,�.'' � EXISTING UNDER UTILITIES ARE SHOWW IN AN APPROXIMATE TO ALLOW A SAS. TO BE 78 FEET FROM A 1 7 �,� -� i'�, `, _ % �/ '� .'� /,• WAY ONLY, MAY NOT BE LIMITED TO THOSE SHOWN HEREON AND T " r w ,/ SM p HAVE NOT BEEN INDEPENDENTLY VERIFIED BY THE OWNER FOR ITS COASTAL BANK IN LIEU OF 100 FEET: x � , h , , �' , r, f 2.a (/ // REPRaENTATNE. THE C� AGREES TO BE FULLY PLAN BOOK f36 PAGE 73/F1 _✓ 11 r ' BRUSHi i �' 3,8 ALSO TO ALLOW A SEPTIC TANK TO BE 67 FEET � k'. ,� `� _„-f � r i `-12--- � i RESPONSIBLE FOR ANY.AND ALL DAMAGE'S WHICH ALIGHT � f / , , , i _ OCCASIONED 6Y THE CONTRACTOR'S FAILURE TO-LOCATE THE - FROM A COASTAL BANK IN LIEU OF 100 FEET. ` 7.) COMMUNTTY PANEL NUMBER 250001-0016 D �'� � UTILITIES EXACTLY. IF ELEVATION INFORMATION DIFFERS FROM PLAN THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS f �) i ,, ,, z,� INFORMATION, THE CONTRACTOR SHALL NOTIFY THE ENGINEER ZONES C A: A13 (EL I V NGVD) do V16 (EL 15' NGVD) 1-7IMMEDUTELY FOR POSSIBLE REDESIGN. AT UTILITY. CROSSINGS. X , 11,5 �. ; `, ; } ,t VERIFY IN HELD THE LOCATION / INVERTS OF airTRiC. GAS, a.) ENVIRONMENTAL TELEPHONE & DATA/COMM AND RELOCATE IF CONF:ICTING WITH • SITE IS NOT WITHIN AN A.C.EEC. (AREA OF CRITICAL ENVIRONMENTAL CONCERN). PROPOSED INVERTS PER THE ENGINEERS DIRECTION. THE CONTRACTOR.. SHALLPRESERVE ALL UNDERGROUND UTILITIES AS • SiTE APPEARS TO BE WITHIN THE AREA OF ESTIMATED FWBI AT OF RARE WILDUM �✓� ,' N9 REQUIRED. PER NHESP MAP OCTOBER 1. 2006 "ESTIMATED HABITATS OF WILDUFr DA-0 SOY , FOR USE WiTH THE MA WETLANDS PROTECTION ACT REGULATIONS(310 CUR 10). 11, , 11�MI00 Oo �,`, , x ; 81 , , , •SITE DOES NOT APPEAR TO CONTAIN A CERTIFIED VERNAL POOL PER NHESP MAP E.8 S A LT 3/4=1-1/2'.DOU WASHED E OCTOBER 1, 2006 'CERTIFIED VERNAL POOLS." , 1. COASTAL BANK DELINEATIONS ARE FOR BOTH TOWN AND STATE SITE APPEARS APPEARS TO BE WHCHH! THE PRIORITY HABITAT, PER NHESP MAP MARSH DEFINITION. 16,9 13.i �. , t` y` �� + x 1 Q 1 g>3 ! y .� OCTOBER 1, 2w6 o'f_'RIORIiY HABITATS OF RARE SPECIES FOR SPECIES 2.) LIMIT OF WORK TO BE MAINTAINED iN GOOD CONDITION UNTIL 7 ` ;,,i }y � �` ,` , �• , UNDER THE IIIIiS'Sie1CHUSE11r ENDANGERED SPECIES ACT, REGULATIONS (321 CMR10) SITE IS STABIUIZED WITH VEGETATION. ` , , a y_ ,• LOT 1 g _ r / e _ 1 � STEPS k q 6 , N/F TOWN OF BARNSTABLE `, "' '�•,jt, r 7 x , 3 4 20 4 r i y � t1 r t SM /4 rw y8p , .om 16 Z p li • 7.J ,` \l > ! rt '' l /! ! �, l ..� .► _ _ FINISHED GRADE N 11.2 �; y > / Ord q�� + f tl t t '. � ,� ' - \ \ \ .♦ .� . \ \ \ 0. . 71 r 1 , , + 9. 36"AAAX.-9 N. �����COMP F%7 ��\ c, -J r� : /' • �'`' ,� o'�f3,' ��,� ,�� a 2 LAYER DOUBLE WASHED -L- TOP OF CHAMBER • �•i 'rj j/''�' /�� '/ �� Q.8 /�8.Q' �' PIS VIEW STONE 1/8" TO 1/2" . . . . z.� OR GEOTEXTILE FILTER FABRIC •, i ,' i SM /5 NOT TO SCALE 5OO GN.I.ON x' / / -' " 1� 18t� 3/4" TO 1-1/2• PRECi�ST Ci�BER �� , y/ ' AIaC� '` DOUBLE WASHED 6' STONE BASE 1 10 ACRES � ��- , - i r� -- f^ � r , ` , � , -8--• � ' /� SM,+o STONE ------------ LOT 21 L ISECTION • l _ � G N F MICHAEL PAYNE, TRUSTEE o NOT TO SCALE 'f ' j , a / N ,'' ,'� �. ��,1 �.� ll LEACHING CHAMBER DETAIL co Q r ' • ,/ r 1,dr'"�/ ,'� ;, 3.r �r NOTE: PLASTIC LEACHING CHAMBERS SiTE t OGI110N yw �> MAY BE SUS FOR 49 Main Stfee! ,� REVCN°NPRROVPofIEWADPROVAL 1 OsteMlle II&A 02655 3,6 - � DESIGNING ENGINEER 7- � /L � / f , ! r , � PREPARED OBSERVED MEAN HIGH WATER FOR D. FIELD f 6' BI �i NOVEMBER 6, 2006 • 7,5 4.. 6 tr A 3.7SM JIB/ ' F, l�ti ;j /�• �� H.�� TITLE FINISHED FLOOR - 20.1 Wetland Permit Plan • Septic Upgrade 3 ;! P pg • ` 1`� SAL T ' SEINER INVERT OUT OF HOUSE M A R S H_ 16.5 Sm fg SEWER INVERT INTO SEPTIC TANK 16.3 • v� l SEINER INVERT OUT OF SEPTIC TANK �» BAXTER NYE ENG G & SURVEYING 3.5 SEWER INVERT INTO DISTRIBUTION BOX 15.7 0 SOL LOGO DATE�IVt4/0�7 15.5 Registered Professional Engineers and Land Surveyors z.e � �p SEINER INVERT OUT OF DISTRIBUTION BOX y evw�2 SEWER INVERT INTO LEACHING CHAMBER • 78 North Street-3rd Floor,Hyannis,Massachusetts 02601 CBI FNp BARNSTABLE BOTTOM OF LEAACHING CHAMBER 13.3 Han SOIL EVALUATOR: BOARD OF HEALTH AGENT NO GROUNDWATER OBSERVED TO 0"ATI011 4.0 Phone-(508) 771-7502 Fax-(508)771-7622 d` SIEVE WILSON, P.E DONNA-MORANDI LEACHM AFEA FEMMEiu8VTS P-BM 3 STOC KAK l 4 9 TEST PiT 1 TEST PIT 2 NITROGEN LOMNG UMITATiON: NA 2 0 20 40 OBSERVED MEAN HIGH WATER CB DH FOUND (HELD) FENCE �,12 STONE SHELLS G.S.E 21.0 G.S.E. = 15.0 RESIDENTIAL: 4 BEDROOMS OCTOBER 10, 2006 EL =4.53 (MLW DATUM) x 110 QMANDROOM SCALE IN FEET EL = 3.53 (NGVD DATUM) #4 at 4.0s A • IM 5/2 • SANDY LOAM A IM 5/2 ; SANDY TOTAL DESIGN FLOW = 440 GPD � � SCALE: 1" = 20' X d •� GARBAGE GRINDER (NOT INCLUDED) = N/A x ; 3. B ; 10YR 2/2 ; SANDY LOAM B ; 10YR 2/2 SANDY LOAM PERC RATE = c5 MIN• f INCH (CLASS 1) � 6 � X d` . . • ' k _ , 4 LIAR - 0.74 GPD/SF. cU Q ; i `� 14 15 MIN. LEACHING AREA OF SAS REQUIRED: DATE: 12-7-07 • Cf 1oYR 5/6 ; FINE MED. C1 ; 10'YR 7/6 ; MED. SaVD 440 GPD/ 0.74 GPI = 595 S.F. MIN. SANDPROPOSED SYSTEM., WITH 4' OF UN 132' (ELEV 4.0) 3 - 5w GALLON LEACHING mwBER ITS a �, , STONE BASE 11� t or r w STONE ON SIDE AND ENDS, 6 s • V�•�D • C2 ; 10YR 7/4 MO. SANG SIDEwALL AREA: (28' + 16')2 x 2' DEPTH = 176 SF C . . . . . MEANT LOW x sonDm AREA: ( ' x 163 = 448 SF NO. BY DATE REMARKS -- - 144 (ELEV 9.0) TOTAL EFFECTIVE LEACHING AREA = 624 SF 4 WIDE WATER NO WATER AT 132 (ELEV 4.0) DOCK y k �� X . . . . . . . . . . . . TE�<2 ELEV N•0) SEPTIC TANK SIZING: 440 GPD x 20OX = O80 GAL .� 0: 2006 06-058 su worksht 2006-058WPP.DWG g CLASS I SOn. USE 1500 GALLON TANK MIN. 2006-058 TYPICAL SYSTEM PROFILE CONSTRWI]ION NOTES GENERAL NOYES WIT zzz Z I wawwwwmmwm ISEPTIC SYSTIEM MAY WOUIRE WCO*VMMN OF 1.) LOCUS AM IS COMPRISED OF 1.m PROPOSED r (gym) C~ INTERNAL PLUMBING *V/M RELOCATION W UNDIERGROUND UTILITIES ASSESSORS MAP 185, PAJM OM CERTIFICATE OF TITLE-- 175 NEM A OMM 31ML WE WXMMM [4U 01001101m OW UVOMMUmm" W, (mm) Caw .k C a SERVICING THE h%M MW FNEW mW VM NNNI a cum iK*09mg MMVIN D. F70D O%fNER/APPUCW. 2.ALL MTEM COMPONENTS SHALL BE INSIAM IN ACCORDANCE FNM Off No D. so 39 FOSTER STRW CAMBRIDG& MA 021-38 1995. AS AMENDED THROUGH THE DATE OF THIS 1 PLAN, & MY 1w dw laus WITH ME V OF DE STATE SANIIARY CODE DATIED MARCH 31, 0 UNC US 40 Rt ODOM r LAYER DOURE TOP OF CHMeER LOCAL RULES & REGULATIONS APPLIGABIL Z) ORMff DATUM: THIS PLAN IS ON NGV!D w ­­w OLW- I"- WASHED STCNE PRIMARY BENCHMARK MHD 0 9203, STATION'M 2WT FWr r(YO ME LEM) 1/8- Tc 1/2- 3/r To i-i/r 31. ANY CHANGE 70 THIS PLAN MUST BE APPROVED DISK IN CONCRETE MONUMENT' NORTH SIDE OF IN WRITING 9( V r SM 40 PC w" ft -- w No WASHED DOMME SOUTH COUNTY ROAD 4* BELOW GRADIE 1300' WEST THE ENGINIM 8"ATION INF ORMATION MUST' Nff BE CHANGED star olff-m STONE WTHOUT' WlRfTrEN PRIOR APPROVAL BY THE ENGINEER. OF THE CENTERLINE OF BUMPS RIVER. iy: OF 8"AWN ".78- (DATUM: NGVD29) W. -Z 60 BASE 4. Wm CONSTRUCTION is Cmam. PRIOR TO BACKFILM, SEE PLAN PROIECT` BENCHAAW . 59 NOTIFY ME BOARD OF WALTH AGENT' MR INSPECTION aim 90M IF INCCUN� inAM MIN UNKNOW 10 ME NNALM ON A UML SME M IM MOTIONE Rel t�01F 3��SKML K 3.) ZONING *VWTM 10 K NMM ON A UIAL ME W mmow"70 Im WC No mckmbr bb 0 Ow- 4-0 5. AM SWM?y DOMAL, SYSTEM WING-TO BE 4s SCHIED 40 sm cmmmxmm "m MOK T-o PVC. UNLESS OTHERIVISE NM HEI?EIN. ZONING DISTRICT W-1, OVERLAY DISTRICTS # AP & RPOI) S 7810`3r W 83ZO4! ACL AlIM101 8111MI EXCAVATE UlNWABLE MATERIAL AS NOTED, TO THE OC LINIMUM ZONING REOUREAENTS LOCUS MAP Scale: In 2OW HORIZON'v, , FOR A HORL7_ DISTANCE OF 5" SURROUNDING THE MIN. LOT AREA = 2 AM (RPOD) LF"ING FIELD, AM REPLAM WITH CLEAN SAND PER 310 CMR MIN. LOT FRONTAGE 20 15.2.% TO ME TOP 8"ATION OF ME SAS. SOUTH COUNTY ROAD A. K A MAIN STREET FRONT' VARD - 30' 7. INSULATE ALL PIPES AGAINSI` FRffZING AS REQUIRED WHEN SIDE & REAR YARD 15' LESS THAN 3" OF COVER. MIN. LOT WIDTH 125' 38 STATE DISCONTMMCE 1AYOUT No. M5 1100. 19 OOS A& THE'SEPTIC' Sym DEM DOES INCLUDE GARBAGE 4.) A ME SEA" HAS NOT BEEN PERFORMED FOR THIS S17E IF DET9?MlNED /-, 1/ 9 GRINDER DISI ALS. , A SHALL BE PERFORMED BY OTHERS. I I so 14 7 IL zr_-ON 00111111111111 v 5.) THE PWTRTY LINE NFMM710N SIM 6 StISED ON MW AWL40LE MM CI3/" FND_ ---------- 9. THE CONTIWIOR,SMALL CON7ACT DIG SAFE (AT INFORIAMN COMM OF PLANS AND DElEDS., HELD L OF,WORK i 1-1 1 ll � I-NO-DIG-S" AND UTILITY COWANIES JO LOCATE ALL,, 7W DOM FEAXM SHM fUMN MEW 0111TANED V * LD FROM A FIELD &MY I HE" A DMING UMMES, AT LE4ST:72 HOURS BMW THE START' OF PERFI)RMED BY WIIER NYE 9011IMMIG & MUM FROM WTOM 4, 2M6 DOM VISTRUCTION.I THE CONTRACTOR SHALL DETERMW THE V= NOVEMBER 10, 2006. VARIANCES REQVESTED: k LOCATION, BOTH HORIZONTALLY AND VERTICAMY, OF ALL�DaSTING evor 1.) BARNSTABLE BOARD OF HE&TH CfIAPTIER 360-1 UIXITIES BMW THE STMT,OF ANY'*M. TW'LOCATION OF,,: BORDSM VEGETATED WEUw FtAGGING BY DOWD SOIALL. ENSRIAEM ON 10/22/07. TO ALLOW A S.A.S. TO BE 78 FEET FROM A EWNG UNDERGROUND UTILITIES ARE SHOWN IWAN APPROXIMATE WAY. OWX MAY NOT BE LIMITED M 7HOSE %M HEREON AND COASTAL BANK #4 LIEU, OF 100 ffff sm 01 PLAN REMMICE HAVE NOT BEEN IMD87ENDENXY VERIFIED BY THE OWNER OR ITS 32 REPRESENIATW THE CONTRACTOR AQWM TO BE FULL.Y nAN WW 136 PAGE 731n , ALSO TO ALLOW A SEPTIC TAW TO BE 67 FEET RESPONME FOR MY AND ALL DAMWB WHICH MIGHT BE FROM A COASTAL BANK IN LIEU OF 10D FEET. 'Ar 14 OCCASIONED,BY THE CONTIWIDIrS FAILURE �TO LOCATE 'HE 7.) UTXITIES E)XkY. IF,ELEVATION INFORMA71M DITFIERS FROM PLAN COMMUNITY PANEL NUMBER: 25=1-OD16 D 2.7 THE FLOOD INSURANCE RATE MAP. DEFINES THIS AREA AS jr sm #2 WORMATM, THE CONTRACTOR SHALL NOTIFY,THE DOM ZONES C & A13 (EL ll"NGVD) & V16 (EL 15- NGVD) IMMEDIATELY FOR POSSIBLE REDESIGN.:AT,UTILITY,CROSSINGS. 1 3. VERIFY Of FIELD,THE LOCATION / INVM OF BMW, GAS, Q lk INFORMATION. TELEPHONE &:DATA/CM AM RELOCA7E F CONF=NG WITH SITE 6 NOT WITHIN AN AC.EQ (AM OF CRITICAL ENVIRONIMAL CONCERN). 8 . of, PROPOSED WfiM PER THE ENGINEERS DIRECTION. TW. ,, CONTRA= SHAM PRESERVE AM UNDEI?GROUND (MUM AS *SITE API)EARS TO BE WININ THE AM OF ESTIMATED HAWAT OF RARE REQUIRED. PER NHESP MAP OCTOBER 1. 2M ,PESTIMATED HWATS OF RARE *tDUW SM MR USE WITH THE U4 WETLANDS PROTECTION ACT REGULATIONS (310 CM 10). sm 0 SITEDOES 2.8 S A L T COASTAL BANK DWWATIONS ARE FOR BOTH TOWN AND STATE mios 3.. OCTOBER 1. MW 'CERTIFIED VERNAI. POOmm M A R S H DEFINITIO14. 2.) LIMIT OF WOW TO BE MAINTAINED IN GOOD 6.9 13.1 /10,1 1 SUE APPEARS M BE WITHIN THE PRIORITY HAWIAT, PER NHEISP MAP CONDITION UN17L OCTOBER 1, 2006 ,`PRIORITY HABFTATS,OF RARE SPECIES* FOR SPECIES' SITE IS SIABIUIZED WIT H VEGETATION. UNDER THE MASSACHU%TTS ENDANGERED SPECIES AU, REGULATIONS (321 CMR10) LOT 19 STONE 1 1 �411 STEPS It ) 1 9,6 N/F TOWN OF BARNSTABLE 3. 49 1� SM 04 4! 20 14,31 9 pa t4 18,0 Ig 16 44 FINISHED GRADE 6 91 1 11 1 _T �36-140.-%?-qllkl., 8,8 LAYER DOUBLE WASHED TOP, OF CHAMBER - TO 1/20 3 Ss STONE 1/8 2.7 , PIAN 'OR GEOTDMLE FILTER FABRIC '9 Ael SM 05 NOT TO SCALE GNIM 0 31e,TO 1-1/21' PFdW,CHMW DOUBLE WASHED -y vi I T116 STONE BASE KEN 'A STONE �7 'Its LOT 21 rk L4 J cc /A19 89 4' ji SKCTIO A N/F MICHAEL PAYNE. TRUSTEE 0 3.7 NOT�M SCALE __0 3.1 MACHM , CHAMR '�,DZAL 71 NOW PLASTIC : SM:LOCIM sm. LEACHING CHAMBERS 07 MAY, BE,SUBSTITUTED FOR 49Afalit PRECAST.,,CONCRErE UPON REVIEW AND APPROVAL OF ' 031 NA 02M 3.6 7- nASERVED MEAN HIGH WATER DESIGNING ENGINEER, 6,0 BRU§4 NOVEIMER 6. 2008 FREPARM FOR A :3.7SM UELVIN Dn FIELD , DO= ACHIM 7, ri 20.1 weian nan Plan ftoic ,Unrede' S A L T FINIM FLOOR sm p :M A R S N WMT OLff OF HOUSE SBWR W#W INTO SEPTIC TAW SEWER NNW OUT OF SEPTIC TANK' 3AA 16.0 �BM= NYE ENGINEERING &SURVEYING SEWER INVERT INTID DISTRIBUTION BOX 7, sm 010 SEWER INVERT OUT,OF MYWW BOX 2 SM LOW DATE tMOT Registered Professional En&=and Land Smveyors A,l loor,il 3.5 -SEWER INVERT' INTO fffiDW CHkVBEI? 15.3 yanniS, BARNSTABLE '78 Norffi Sftd 31d F Mamchusetts 02601 CB/bH FM BOTTOM OF LE4CHING CHAMBER 1.3-3 Hm SOIL EVALUATOR: I � � - . I i -(5ffi) 771-7502 Fax-(508)771-7622 9_F AGENT. NO GROUNDINATER OBSERVED TO 9"ATION 0 Plione AT" 4. STM WILSON, P.E - �, I I I - I rN"RANDI 4, f-I P_BM STOCKADE .9 TEST PIT 1 2 LEACKNO.AM' ll KweAws OBSERVED MEAN HWH FENCE f2 AREA OF TEV NITROGEN,LOADING, LIM[TATM.- _. , NA 0 40 5.0 WATER CB DH FOUND (H STONE & SHELLS G.S.E ::i 21.0 . G.S.E., = I RESIDENT 1AU 4 BIEDROOMS CCTOM 10, 2006 EL -4.53 (MLW DATUM) 4,0!i 110 EL 3.53 (NGVD DATUM) , MEWN �I I,SCALE IN FEET AP; 10YR 5/2 .; SANDY LOW A� 10YR 512 SANDY,:�� TOIAL DESIGN FLOW - 440 GPD SCALE 1 10 6 GARBAGE GRINDER (NOT PaUDED) N/A -' s -RATE <5 Mix wN (CLASS, 1) 9 10M 212 %AM LOAM B ­ IMR 2/2 v . ANDY LOAM PEW X LTAR - 0.74 GM/&F. >( (6 42 JR ,64 0.44 , 11 : , I " 14 15 Mllf,� 1.154CHING AREA OF SA.1 REQUIRElk- X 12 . . ...... DATE. -7-07 $-C IOYR 5/6 FINE MIED. Cl - 10YR 7/6 MED. _qW 40 GPD/ 0.74 GPDISF. 595'&F. MIN. 9 X X SAND 4 6 0,5 MrOSED SYSTE*. 0, OBSERM MI.W 4 60 132" M& 4.'0) .3 GALLON LEACHING CHAAW UNITS WITH 4 , OF' jj,.�.... L­_!�111431 ID STONE ON.SIDE AND ENDS, r STONE RAW, . . . . . . . . . . C2 I OYR 7/4 MO. SAND SIDENAU 1,AREA' (28' + 16'P x 2' DEPTH 176 SF A4EA* N 0,81 Low AREA- (29 x�163 448 DATE, ICIill�=D By, 701AL EFFECTIVE LEACPW AWA 624 SF Ff-, 4' WIDE 10,a(13 , ME offim MUM ; WATER NO,WATER AT 132 tV 4.0) (ELL DOCK X PERC 0 60* (ELEV L 10.0) �0 x 058wpp. Gm x SM-""M O.-\2W6 6-0.w\Sumy\wOI*Sht\2W6_' ING RATEm <2 M1141% SEPI CLASS I SOL 'i IJSL 1500,CALLON TAW IM 2006-058