Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0140 PINELEIGH PATH - Health
140,Pineaeigh. Path Osterville ` A 071;-,004 -006 v i i 'i i i i I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments u 140 Pineleigh Path Property Address Peters Owner information is Owner's Name required for every Osterville MA 02655 9/11/20 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 an information which indicates that an of the failure criteria described ® Y Y in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria.not evaluated are indicated below. Comments: 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.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 f ' Commonwealth of Massachusetts Title 5 Official Inspection Form �a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 page. Cityrrown 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): ❑ 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 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 L . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 page. Cityrrown 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.7/2612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's-.Name information is required for every Osterville MA 02655 9/11120 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 '/z 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. ❑ ® 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.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner s Name information is required for every Osterville MA 02655 9/11/20 page. Cityfrown 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? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 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: 4 bedroom permit and plan on file at BOH Number of current residents: 0 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 ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump Pum ? ❑ Yes No P Last date of occupancy: 2015 Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner s Name information is required for every Osterville MA 02655 9/11/20 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: No recent pumping Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? f Reason for um in : P P 9 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 140 Pineleigh Path Property Address Peters Owner Owners Name information is required for every Osterville MA 02655 9/11/20 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 ❑ 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: 1989 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 2'6" Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Pineleig h Path Property Address Peters Owner Owners Name information is required for every Osterville MA 02655 9/11/20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) E 6. Septic Tank(locate on site plan): 2' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) H-10 tank appears to be structurally sound If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500g Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle >12" Scum thickness trace Distance from top of scum to top of outlet tee or baffle >2" Distance from bottom of scum to bottom of outlet tee or baffle >2" How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3yrs to prolong the life of the system t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts i- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 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 Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts �. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 page. CitylTown 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 0" 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.): H-10 D-box is 3' below grade, no adverse conditions, it is under an old driveway which has since been planted on with a ivy type ground cover and hence is not part of the actual driveway anymore. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts �s Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owners Name information is required for every Osterville MA 02655 9/11/20 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.): 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: 2 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owners Name information is required for every Osterville MA 02655 9/11/20 page. Cityrrown 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.): The pits were video inspected and are dry at this time, no indication of past hydraulic failure, the pit depicted as"D" is under the old driveway which is now planted and not the driveway at this time 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.): f t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a 140 Pineleigh Path Property Address Peters Owner Owner's Name i information is required for every Osterville MA 02655 '9/11/20 page. Cityrrown 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.): d A 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 Form f Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 page. City/Town 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 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 } o C� t5insp,doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts ,. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 page. Cityrrown 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: >12 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 NGW 12' Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: 4'seperation per compliance on file at BOH ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: TOPO mapping puts the site at24'msl and nearby surface water at 2'msl You must describe how you established the high ground water elevation: See above 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 (o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Pineleigh Path Property Address Peters Owner Owner's Name information is required for every Osterville MA 02655 9/11/20 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 I t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 TOWN OF BAR.NSTABLE LOCATIONLC-r IC 7Pl ive lf-t c t,1ASEWAGE #9-�-70q — VILLAGE. (9<Mg-v,j1- ASSESSOR'S MAP & LOTO1/-aO'I-Oa6 INSTALLER'S NAME & PHONE NO.. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ;;Z �� `� �� (size) NO' OF BEDROOMS p , PRIVATE WELL OR PUBLIC WATE�t 0 BUILDER OR OWNER_ /VA�- ^ DATE PERMIT ISSUED: jl "'�® ` DATE COLSPLIANCE ISSUED: -- VARIANCE GRANTED: Yes No y ��� � . r r V i' r . , ,� � ,i � �i -�-� A d ��` � Z `fiC a �� _ — ' � � � C � _ —�+ �*-, �, No.1 .:7a.y Fss..7 ;.... ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH T, . .v. ............oF....... .t .1-A .......... ApplirFation for Eliipna ai Works Tontitrnrtion Pumit Application is hereby made for a Permit to Construct ( ) or R:pair ( ) an Individual Sewage Disposal System at: .................._....... .W : ......J)ArH.......a.'A...... .� L 6 77 Lo ation-Addre s - o- Lot --o.- w Owner Address W Installer Address Type of Building \ Size Lot-�. ----Sq. feet �-, Dwelling—No. of Bedrooms................. .......................Expansion Attic ( ) Garbage Grinder (i4 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures .-----------•-----------------------------------------.----...•------------•---•-•------...------... •--•-- w Design Flow...........56.......................... allons er erson er da Total dail flow....................... gg P P P Y• Y �-------------•--_._dons. WSeptic Tank—Liquid capacityl.,22P.gallons Length................ Width................ Diameter___---_--______ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No._.....2_--__-- Diameter.__.......t_0--- Depth below inlet........ -....... Total leaching area...✓5.. .sq. ft. Z Other Distribution box (U_� Dosing tank ( ) �,y P a Percolation Test Results Performed by.. tA�C. _.. ,... Y. _... L.................. Date...10...Z 9. ------------ Test Pit No. 1.... ......minutes per inch Depth of Test Pit...... Depth to ground water----- ---- .-_.-_ G4 Test Pit No. 2.......-....minutes per inch Depth of Test Pit.......L.-..... Depth to ground water_______ ____________ a ---•----•---•••••......•----••----•-•••••-•--•••-•-•--••-----•--....--•--•--••-••-----•----•---------------------••••......------•-•-•--- -----------•- 0 Description of Soil................................................... ------------------------•----------------------------------------------•----------•-•••--- x w UNature of Repairs or Alterations—Answer when applicable................................................................................................ --------------------------------------------------------------------------------------••-----....•••••••--•.....••••••---------•-----•••••----••-••---••-•••••-------------•-•-•-•••----•••-•---....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the revisions of,L-I p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the boar of health. Signed .I............. ----------------------•-•--•-•••............•... ....................... •--••- Date Application Approved BY.........�-----�---- ---- --- ....................................... ------•---iDate ApplicationApplication Disapproved for the following reasons:................................................................................................................ ...................................................... ................................................................................................................................................. �� - °�Permit No.--------•---•--•--•-�--•------•-------•-------•----•--- Issued....................................................... ----- Datt / . . � � . FFB �,-----' � / '-�-��`�- THE COMMONWEALTH orMAssxcHussrrs U����� U�K� ���� HEALTH � ��~=��" "�� �°" ---'�CJ ............OF--. � �~°� �K � ���/���o��o���u� �x�4 ����������w� Works,Tomitrurtiou Prrutit Application is hereby made for u Pero/it to Construct ( *1 or Repair ( ) an Individual Sewage Disposal S^ �� F� �� �^ � . U ��,� -----_---_---u-��m~�:��:'���z--'z'�zI'��---��'-��---' ---------------------'z���---'�-����-----________ AddmL� Nu | -----' Aa ion ------. �-�~~-� Address� .._ �~ � --_---'----------_'-'---'-_----------------_-'_-- ---------------'---'-----------'-------'---'-'-__-- Instal I er Addres s � Ivne of Building Size ]Lot-A�"���� Sq. feet � Dwelling—No. of Bedroomy-'-----. .......................Expansion Attic ( ) Garbage Grinder /"-� Other--Type of Building ............................ No cf persons............................ Showers ( \ -- Cafeteria ( \ °c Other fixtures- '-'----------'-------------------- '-'------- Design per person per day. Total daily flow'' Septic Tank—Liquidloos Lcooth---_--. Wilth................ Diameter---------------- Depth................ Disposal Trench N -'-''- Width.................... Total .................... Total area ft.Seepage Pit lVu--..��_- Diameter Depth belowTota leaching ft. Z Other Distribution box (V� Dosing tank ( ) Percolation Test Results Performed I -- Test Pit No. l--~3�--oioutcayer - Depth of Test ' Depth to grouod-water- , ' -'--' _' rZ4 Test Pit No. 2......7_-uiouteoper inch Depth of Test Pit--1.7~~..... Depth to ground water------------.- -- .---___-----'-_'__--''--__-----------'--'------'-----'-'--------'-----'---- 0 Description of Soil............................................................ ----'---'--------'--'---'---�'--'-'---`-----'`rr---~--'-----''----------------------------''----- .-__----------_---_.-'_'_---_.__-__..----_---_------_-._.___---_------.--____ U Nature of Repairs or Alterations--Answer when applicable_-_------------------------------------------------------- ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforc6csccibcd Individual Sewage Disposal System in accordance with the provisionsof'Z'IZ- 5 of the State Sanitary Code—The undersigned further agrees not to place the'system in operation until a Certificate of Compliance has.been S. qguod.--........'....--...-'.................-----'.______________ ................................ Dat e Application Approved Dy.-- -'~�`\''�������'------------------- ----'lL�-. ���=��S�- . = ~� "m" Application Disapproved for the following reasons:................................................................................................................ � � .................^...................................................................................................................................................................................... Date � PermitNo .......................... Issued-......................................... .............. D�te � , THE COMMONWEALTH orMxssAonussrrs BOARD OF HEALTH touvw ��------ -.����--.�� ................................. T ����� ratr �,°f 11intpliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired-, :"�� Ins X.'C.�_-_c............. has been installed in accordance with the provisidUs of TI 1E 5 of The State Sanitary Code as described in the THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THATTHE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................ .......................... Ioop«ctor-----------' ...................................... THE COMMONWEALTH oFmxssAc*ussrrs | | | � BOARD OF HEALTH ����W�� /�F ���k�������� ---- --� ------------- Fmo- ~?S-'....... to Construct (_ ) an Individual Sewage Disposal System I s6e�t as shown on the application for Disposal Works eonstruction Permit Noj.!,�;_ 7./,'1- Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS /.vGL E fA/y/L F i O 'L '! l raA� GL- G�2ivoE.e 'PDT,•, ---- ,. -- _. . Z610 54 P1506L OtELEOF- AZE,4 VT;-o,►�.ae` �.a: . : ! g p,Na is,/'4 Ar a �/;7 ale, NA�-B UPS /09${ Z i;oi ik% .a.e LE S5 Q ?ryHAe~:; _ . F if x. 1 T i._ ; := 9r¢ F.G =1 97: 1 ; . . 6: 99,o �A�D STd.✓E- -' _ 9S z 9� �7 -p i i iz o Wg7. I 7;41 1T; 7-/-/6 �'�o�s� ,CaCQT/o t/ c�P�r�� I,1�1✓�c�.5 p 4,,,v-C x)4 �/OWiLr yE.eEO.C/COis-1PL YS;W122V :SCA L G— C'E i 5 'Tom: • ,EA XT,,-,2 o.C.4.v/S X/a7- �gASEU av;4�f/ .eE'G/STE,2Ep �p ,S-U.eYEyo�� Al�T PX�N OF RICHAR6 s�yG �; �` r. � Z 'L OF l— A f rr �a Pao.24048 J 53.7 °P —AV \ �TANk _ \ \ i v- cr �? ��z g l I I \ Per \ I \ tj\ 167 . 97: 76. s Cn Aoe,A4Ev BM �cog.'I i f b D!s — _�9• -- ar- - J PAT 9 ! i ; 0/v leb 126V, t ht3 �AGA'[1Dh1 AC4l A,yct¢i 5t.,1 i1f O::'i E 10 56A 3 Y 5 1� t.� Ir3::t• Commonwealth of Massachusetts- Title 5 Official In Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,0 140 PINELEIGH PATH` Fri Property Address , SMALL I, Owner Owner's Name information is required for OSTERVILLE V MA'_ 7-20-15 every page. City/Town State Zip Code Date of Inspection ,ma, o 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 A. General Information - forms the computer, r,use 1. Inspector: only the tab key - • to move your DOUGLAS A BROWN f cursor-do not Name of Inspector ` use the return key. D.A.BROWN INC ' Company Name P.O. BOX 145 Jy Company Address r rt i CENTERVILLE MA, 02632 City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number; .r B. Certification. I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the'inspection. The inspection was performed based on my training and experience in the-proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of . Title 5(310 CMR 15.000).The system: r ® Passes Conditionally Passes 0 Fails El Needs Further Evaluation by the Local Approving Authority , � '"`' 7-20-15 Inspe Ps 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 DER The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. _ This report"only describes conditions at the time of inspection and under the conditions of use - at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposa System 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 PINELEIGH PATH - Property Address SMALL , Owner Owner's Name information is OSTERVILLE MA, 7-20-15 required for - ' every page. Cityrrown State Zip Code Date of Inspection, B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D r A) System Passes: " ® I have not found any information which indicates'thatl 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. f SYSTEM IS ORIGINAL TO THE HOUSE HOUSE HAS BEEN VACANT WITH NO WATER USAGE IN 2014. AT TIME OF INSPECTION SYSTEM MET ALL PASSING REQUIREMENTS:FUTURE PERFORMANCE CAN NOT BE DETERMINED BY THIS REPORT UNDER THE SAME OR INCREASED USE. HOUSE WAS A SEASONAL PROPERTY FOR YEARS. - 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. t 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 r Compliance indicating that the tank is less than 20 years old is available. , ❑ Y ❑ N ❑, ND' .,, `(Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 PINELEIGH PATH Property Address SMALL Owner Owner's Name information is OSTERVILLE MA required for 7-20-15 every page. Cityfrown 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.): -E] 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 x ❑ ND(Explain below): ❑ o6struction 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: i f ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1: System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑• Cesspool or privy is within 50 feet of a surface water ❑, Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh'-• t5ins•3/13' Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 3 of 17 f Commonwealth of Massachusetts Title 5 Official 'Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 140 PINELEIGH PATH Property Address " SMALL Owner Owners Name information is OSTERVILLE MA 7-20-15' required for ' every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplierjf any) determines that the system is functioning in a manner that protects the putlic'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 withip'.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". ,kf. Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no,other failure criteria are triggered. A copy of the analysis must, be attached to this form. 3. Other: .. D) System Failure Criteria Applicable to All Systems: �. You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or ' clogged SAS or cesspool ❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less° than Y2 day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official„Inspection Form_ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 140 PINELEIGH PATH Property Address r SMALL Owner Owner's Name information is OSTERVILLE MA 7-20-15 required for every page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ; Yes No , ❑ ` Z Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool;or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ;® Any portion of a cesspool or privy is within a Zone 1 of a public well.' ❑ '® Any portion of a cesspool or privy is within 50 feet of a private"water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This x 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. l have determined that one or more of the above failure ❑ . ® criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with:a design flow of 10,000 gpd to 15,000 gpd. For large systems, you•must indicate either"yes';or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑' the system is within 400 feet of a surface drinking water supply ,❑ ❑ tl the system is within 200 feet of a tributary to a surface drinking water supply El} • E] the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"'yes"to any question in Section E the systemyis considered a significant threat, &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.th-e system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 r Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of V ' a • Commonwealth of Massachusetts Title 5 Official, Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments GM ,° °°• 140 PINELEIGH PATH .. - Property Address SMALL Owner Owner's Name ' information is required for OSTERVILLE' MA ' 7-20-15 -� every page. Citylrown 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 a , ❑ ® 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? `` 'Z ❑ . Were as built plans of the system obtained and examined? (If they*were not available note as N/A) ® ❑ ' , Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ° ❑ ® Were all system components,,excluding the SAS, located on site? ' ® ❑ Were the septic tank manholes uncovered; opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ , Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Z '❑ 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 El Z approximation of distance is unacceptable) [310 CMR 15.302(5)) D. System Information • Residential Flow Conditions: Number of bedrooms(design): 4 r , 'Number of bedrooms(actual): 4per * - = assessors DESIGN flow based on 310 CMR 15.203(for example: 110,gpd x#of bedrooms): . 440 t5ins•3/13 i Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 17 4 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments GSM ,.•'' 140 PINELEIGH PATH - Property Address SMALL Owner Owner's Name information is required for OSTERVILLE MA 7-20-15 - every page. City/Town State Zip Code Date of Inspection D. System,Information Description: ACCORDING TO AS-BUILT SYSTEM CONSISTS OF A 1500,GALLON'TANK D-BOX AND 2 6X10 PITS w Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system_? (Include laundry system inspection El Yes.El No information in this"report.)' _- . Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ❑ No Water meter readings,if available (last 2 years usage(gpd)): Detail: 2014------0 2013........701 HOUSE HAS IRRIGATION SYSTEM. DID NOT GO INTO THE HOUSE SO i DONT KNOW IF THERE IS A GARBAGE DISPOSAL. SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL Sump pump? ": ❑ Yes ❑ No Last date of occupancy: 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.): s Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No 'Water.meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts y Title 5 Official Inspection Form ; Subsurface Sewage Disposal System Form-Not for Voluntary Assessments- 140 PINELEIGH PATH - Property Address SMALL Owner Owner's Name + information is r *, required for OSTERVILLE MA, T-20-15 every page. City/Town State Zip Code' - Date of Inspection D. System Information (cont.) - Last date of occupancy/use: Date . :: 41 Other(describe below): e General Information w Pumping Records: :.. ,.;; ..• • .�. ,• • � � - Source of information: josh barrows pumped tank for maintenance Was system pumped as part of the inspection? ® Yes ❑ -No x If yes, volume pumped: r 1500 • .gallons How was quantity pumped determined? tank truck maintenance Reason for pumping: r Type of System: ® Septic tank, distribution box, soil absorption system ❑ • St Single cesspool ' Overflow cesspool _ { ❑ Privy El Shared'syste.m' (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 0' Tight tank. Attach a copy of the DEP approval. a ❑ Other(describe): ; r ' t5ins•3/13 t' - Title 5 Official Inspection Form:Subsurface Sewage Disposal System,-Page 8 of 17. Commonwealth of Massachusetts. Title 5 Official Inspection Form.. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 PINELEIGH PATH Property Address SMALL Owner Owners Name information is E MA 7-20-15 required for OSTERVILL - ' every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) r Approximate age`of all components, date installed (if.known)and source of information: 1989 as per as-built Were sewage odors detected when arriving at the site? El Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ' ❑40 PVC ❑ other.(explain): ri Distance from pnvate water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage;etc.): Septic Tank(locate on site'plan); , Depth below grade: feet Material of construction: h ❑ concrete ❑ metal ❑ fiberglass'• ❑ polyethylene . • El other(explain) • If tank is metal,list age: years Is age confirmedby a Certificate of Compliance?.(attach'a copy of certificate) El,Yes ❑ 'No Dimensions: 1500 -Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments f 140 PINELEIGH PATH Property Address SMALL Owner Owner's Name information is required for OSTERVILLE MA 7-20-15 every 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 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 r How were dimensions determined? ;. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage; etc.): tank was pumped at time of inspection for maintenance Grease Trap(locate on site plan): Depth below grade: . . z -feet , Material of construction: n ❑ concrete ❑ metal ❑ fiberglass ❑polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM z 140 PINELEIGH PATH Property Address SMALL ; tr Owner Owner's Name information is required for OSTERVILLE MA 7-20-15 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: , ❑concrete ❑ metal ❑ fiberglass _ - •❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: .' ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes - ❑ No l Date of last pumping: Date , { Comments(conditio,n'of alarm"and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 + Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 i I Commonwealth of Massachusetts- r F Title 5 Official L Inspection Form'- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s 140 PINELEIGH PATH •.' . ..'., , :. r .. Property Address SMALL " Owner Owner's Name information is required for OSTERVILLE ` MA 7-20-15' - every page. City/Town State Zip Code Date of Inspection- D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): _ of,' 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 was viewed by camera and is in.a.large bed of ground cover and at the edge of asphalt drive way _ f + " Pump Chamber(locate on site plan):'-• r Pumps in working order: ,`� T El Yes -❑ No*,, Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber,,condition of pumps and appurtenances, etc.): r *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 140 PINELEIGH PATH Property Address SMALL Owner Owner's Name information is MA .. 7-20-15 required for OSTERVILLE A • every page. City/Town ' State Zip Code Date of Inspection D. System Information (coot.) Type , r ® leaching pits number: 2 ❑ leaching chamber's number: ❑ A leaching galleries 'number: r ❑ , 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.): one pit is under asphalt in the'area covered!by ground cover the other;pit was opened and:was dry at time of inspection with no signs of failure _ Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert c ` Depth of solids_ layer f Depth of scum layer Dimensions of cesspool Materials of construction f Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts x Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 PINELEIGH PATH Property Address SMALL r ; Owner Owner's Name information is required for OSTERVILLE MA 7-20-15 every page. Cityrrown State Zip Code: ` Date of Inspection D. System Information (cont.) fi Comments(note condition of soil, signs of hydraulic failure, level of pond ing,'condition of vegetation, etc.): Privy(locate on site plan): , Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of po•nding,condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts o- r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments rM 140 PINELEIGH PATH" Property Address ' SMALL Owner Owner's Name ; information is required for OSTERVILLE f MA 7-20-15 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 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 ' 140 PINELEIGH PATH Property Address SMALL Owner Owner's Name information is required for OSTERVILLE MA 7-20-15 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ; ® Surface water ; Check cellar II r ® Shallow wells Estimated depth to high round water:' . 9 P 9 9 reater than 5 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: pate ❑ Observed site(abutting property/observation hole within 150 feet of SAS). ❑ Checked with local Board of Health-explain: ' r ❑ Checked with local excavators, installers-(attach documentation) ❑_ Accessed USGS database explain: You must describe how you established the high ground water elevation: augered in bottom of dry pit no g.w encountered Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Y Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 PINELEIGH PATH . Property Address SMALL Owner Owner's Name information is required for OSTERVILLE MA `'7-20-15 every page. City/Town • 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 Assessing As-Built Cards Page 1 of 2 J . TOWN OF BARNSTABLE LOCATIONLUr I6 7 WQ,if-L:�i�PASEWAGE&--t)Oq VILLAGE Q ASSESSOR'S MAP&LOT INSTALLER'S NAME& PHONE NO.�? Q(/2 C.6 • SEPTIC TANK CAPACITY' /.S LEACHING FACILITY(type) a X I©' '(size) NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WAW Q BUILDEROROWNER 4 DATE PERMIT ISSUED: DATE COIJPLIANCE ISSUED; �r F ' VARIANCE GRANTED: Yes 6 http://www.toW.nofbamn table.us/Assessing/HMdisplay.asp?mappar=071004006&seq=1 8/11/2015 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■�■f®®®NAME s■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■eeea■■■■■■■■■■■e■■■■■e■■e■eN■■■■■■■Mee■■■■ AM ■■ ��■■■■: e■■■MMMM■■MMM■Me■e■■■■■■■■■ ee ■■■■■■■■■■■e■■■■■■■e■se■■ ■�■■■E■■■■ ®■e■■■e■■■■■■■■■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■■MEN ■■ ■■■■■■■■■■■■■■■■■■■e■■■e■ ■■■ �■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■NN■N■■■■■■■■MEN e■■■■■■■N■■■■■■■■■■■■e■■■■■■■■■e■■■■■■■■■ ■■■; M■■ ■■■■■■■■■■■■■■■■■■■NOON■Me■■■e■�■■■■■ee ■� ee��■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ NOON■■■ ■■■Ora ■e■ ■e■■■■■■■■■■■■■®■■■■■■■■■.■® ��ws�■■■■e ■■■ ■■■■■■■■■■■■■■ MOVIE■■■■■■ M■■e■■N■■■■■■■■■ eM■■■■M■■■■M■■■■M■■■M■■■M■■■■■■■■■■e M■■■■■e■■■■, ■■■■■■■■■■■■■ €€€€€■■■■■■■■■One■e■■■■■■see MEN eM■M■M■N■NONE' ■■■■■■e■■■■■■■■■■■M■e®■ NONE■ ■■■ NEON NEON ■OMEN■M■M■Me■■■■■■■■■■■ EMME MEN eM■■M■M■■■■es. ■■■■■e■■■■■■■■■■■■■MOM ON ■■e NOMM■M■■■n ■M■■M■■M■e ° :::::: . ._ . . . ®■■■■■■■■e�■ MEN■■■■SEEM■NONE M■■■■e■■ ■■M■N■M■■■ SM ®eM ■■■e■■■■■■■■■■■■■■■■■■e :;::::fie■■■■■■■■. ■MM■M■M■N ■ ■■■■■M■■■■■■■■■■■■■■M■■M ■■■■MNN■N■ ■■ ■M■® ■EMMEM■M■ .. .._ . ■■MOM .....■■■■■M®■e . ■■■■■■M ■■■■■M■■■■■■■■eee ■■NOON NOON■.■■Nee ■ e■■nee®■■■e■■ 1 .. ... NOON■ :::::■■■■■■■■■n e■■Nee■■S .� •- •- • • -• - • . t 11 •• • / • •. -••. ■■■■■■e■■■■■■eM■■ N■■■■ � ■ ■■ e■■e , NEON■■■Me- ■■■es■■■■■ ■e■■■■■ � NOON■■■ ■M■■■■■■■M■■■■■■■ NOON■■1 ... . ONION■ a ■■■■■■■■e■■■■■■Me■■■■■■■e`€i€€MEM■■■M 1 .. ... OMEN■■ ■■■■■■■■■■■■■■■■■ ■■e■■1 .. ... . NOON■ ■ ■® ■e■■■■■■■■■e■■■■■■■■■■■■■ N■e■■■■ 1 .. NOON■■■Ms■ ■M■■e■■eee■■■Mee■ NOON■■1 •• •• . ® • ■■ M■■■■■■■■■■■■■ ■■■■■■::::::■■■N■■e 1 •• ■■■■■M■ ■ a o m• firlIlA9�Jil" iTdnF11fi1C� ■■NEEMEMEN■N moo I a■■■■I■■■■■■see■e■■Nee • • ■ Me■�■■■e■■■■■■■e■ ■■■■■®M■M■M■■ :. ■ M ■■■■■■■■■■■■■■■■ ■■■■Nee■■■■■Nee■■■■■■e ■s ■ ■eN■ �. Me®eM■■■■■■■■■■■■■®■■■■M■■e■■Nee■■■■■■■■■■■■■■■ _ miEWI ie■® ::®:iiiiiMEi ®MsiiM■■ii®®Mi�■®sM®®i®i■iiiiME■■®®®■ ■M®®®:®M® ai ®ice ®�®■■■•®®�■®■■■■�® ��■■■i■ ■■■■M■■■Me■■■■M■■■■■■■■■■■■■■N■■■s■■■S�M■e■s■e•1 .. ... M■N■■■ . Ens ■►■■ ■■ t� ■■ ■■■e■■■■■ss■MOM■■■ „ . ■■■M .,. NOON■ .. ■ ■■■■■■■■ _ ■ ■MEM e■■■ ■■ :■■■■■■■ _ .................. e■sse■■e■■M■■■Mee■ ■■■ ■■■■eeee■■eE ■■e■■■■■ ■s■ ■ � .. .• NOON ■■eM■■■■■■■ �■ M■M■ M■Ne eeM■N■M M■■■ ■■■ M■ ■■n■M ■M■M■■ME ■■MMM■■MM ■MN■ 1 • -... . s■M ■v -. . es■■sMe■■■■■■■■■■NONE . - M■M■ ■■e ■ ■■n Nee■■■■■�■■■■ - .- . NONE MEN ■eeM11 .. ... . ■M ■®tee►■■■■sNe■®■■eNee■MNee■®® NEON ■ ■■■■■■■■■■e■■■■ . . ■ e ■■■■■■■■■■ - ■■ ONE al •. ■■■■■■■�■■■■■■■e�ev■M ■■MMse■eeM■Nee .. • .. ■MM■■N■■ ■■■ .. ._ - ■e■■■■■■■■■■e■■■■■■■■■■■ee■M M■eM I l .. ■■■■Nee■■ �M ■v■■ Ie ■■■■M■e■■N .. .. - Nees Me 1 ... ■■■l ... ■■NO■ ■■■ ,, ■■■� .ram■■S M■■e ®■ W ■■ ■e■■ ■e�Me■eM■■■■M •' e■■e■■' '■■ ■e■° •■■■■■M■■ ■■�■■r ■■■■■��■■■■ ENE e■■NEEM■M■■■■e ■ ° ■■■s NOON■■eee■■■■■■■■S■■®■■■N .1 .. ■ ■■e . .. NOON■NE ! ■■ ■■■■■■■S■■■■■■■ ■■e■■■■■Me■■■■■■■■ • . . ■■■■ ■■■M■■■M■■■■■■■sees■■■ . ■M■■■■■■e ■ e■■■■■■■■■■■■■■■■■■�■�■■■■■s■■■■■■■■ M■■■■■■■■■M■■■■■■N ■EN■■■ M■■■ee■■es■ ,. ■■e■ Nee■■■■■■■■■■ ■■■ ■■es■e■■■eeee■■■■: ■ , N■EMEN , MEN■■■■■■■■■ sM■■■■®ere ■■■■■■■■■■■ear M■■Orr . M■■■■■■■■■■■e■■e Mv = s►e■e■■ ■■■■■■■e■■■■e■■■■■■■■■ NEON . eee■■■■■■■■■■■ ■■■■■■■■■■■■■■■■e ■■■■■■■wee■M■M■NES■■M■■■■M■■se■■NM■ ee■■N■■N■ee■■e■■eM■Nee■ ■■M■■■■■■■■■■■■■M ■■■■■�. ■■■■s■■■■■■■■■■s■■■ � ■N■■e■■e■e■M■■■■■■e■■■e Me■M■■■e■■■■e■■s■■■■■■■ �► ■■■■■■:::: ; cam■ ■■N■■■■■■■■■■■■■■■■■N■■■■■■M■M■M■■N■Nee■■s■■e■■■e■■■e Me■■■EM■■■■M■M■■M■M■■■M ■■ ■■■■i ■■■e■■■■■sees■■■■■■■■■e■■■■■e■■■■■e■■■■■■■■e■■Nee■eee ■■■■s■■■■s■■�■■e■■■■■■ ■ . ■ ■M■■■es■■Se■sM■■N■■■■■See■■■■es■s■■■■■■�■■■■e■■MeM MM■■M■M■■■MM • - . . ■ ■v • _ ■■■■■�■■ ■® ■■■■■■■■■e■■MNe■■eNee■e■■■■■■■■■■■M .. .._ . NOON■ M■■■■■N■■M M■■■■■ ■ ■■N■■■■■M■■■M ENE ■■■■e■■■■■Nee■eM■■iee■e■■M■M®■■e■■■.11 .. ... a■eM M■■■■■■■M■■■ _CEMEEMEEME ■ ■■ NOON • ■■■■■■■■■■M■®■■es■■■MN■M■■■■■e■■■■eM■e■ •° '• • ■■■e■e■e ■Me■■■■Nee■■ ... ■■Mee■■e ■ ■e :- NOON■■ ■■Me■■■■■M■e■■■■■■■■M■■Nee■■M■■Me■■■■■e l : .. ■M■■e■■®Nee■■■■■■e■■. .. _ NOON■■ ■Ne ■■■ ■■■ ■■ M■■eeee■■eNee■■■■■■e■eNM■■M■■■■■M■■■■■e " e■■MeM■■■■■e■■■■■■■€€ €�■M■NNEN MEN MM■■■■■■■■■M■■e■e■■■■■■■■■■e■■■■eNee■e■ 11 -. . .. ■e■■®■■■■®■■■■e■ MEMO ■■Me■■■■e■■■■■■■■■■■■se■■eee■s■M■eee■■eM■■■■■■Se■■e■■M■■■■■■eM■®■ so ■e■ ■■■M■■■■■M■ ■■■■■■■se■■■■■■■Me■e■e■■�.�:I�������■■■■■eee■MNee■e■■ ; -„ -. •■■■■■■e■Nee■M■sM■■■■■M■ee■■■■■■■■ ■■N■■■■■■■■ ■■■Se■Nee■e■■■SeM■■MeMe■ ■■■■e ■es■■■S■■■■ ■■■■Ms■■s■®M■■■■■■®■■S■e■■■■■■■■■ ■■■■■■N■■■■■ ■■e■■■■■Nee■■■■■■■eee■e■ .. ... ■■■e M■NOMO EE .. . ■■■■■■■■e■M■■■■■■■e■■■■MM■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■e■■N■■■■■Me■e■■e■• 1 .. ■■=M■■■M MEN■MMMM■M■ ME MEN ■■■■■■e■■■■e■■■e■■■■■■■■■■e■■eM■e■■■M■■ .. ■■ ■■MEN M■MMOM■■■■■ . ■■■■■M■e■■■®■■■ENE ■ ■■■■■■■■■■M■■■■■■OMB■■■■■■■■■e■■■■■e■■■ ME MEN N■EM■MM■■■■■ - ■■■■■■■■M■■e■. ■M■■MM■■■■■■■■MEN ■ ■■■■■■e■e■■■■■■■■■M■■■■■■■■■■■■■■Nee■■■■■■■■■■■■e■■■e ■MM■M■■■■■N■■. .. . . . . . .. ■M■M■N■■■■e■■■SEEN ■■■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■See■■e■ . . .. e■M■M M■M■M■■eM■N■ - .. . . . . . •• M®■■■e■■M■■M■M■■■■M■M■■■■M■■ ■■■S■■■■■■■e■■■■Nee■Me■■■■e■■■■■■Nee■s■tee■M■■■M■M ■■eMEN■■M■■ .. . ■■M■■■e■■■■■■■M®■E■■■■e■■ ■■■SS■M■■■■■■■■■■■■e■■■■■■■■■■■■Nee■■■■ ._ ■■■SM■M ■■MENE■■Me■■ ■■■■■■■■a■M■■■�®■■■■M■■■■■■■i■■■ a ■■■■■■■■■■■■■■■■■■■■■■s■■■■■■M■N■■■M■M■•• .. ••• . • SM■M ■■■Me■ ■ M■■■ ■■M■■■■■■■■■■■■■■■■■■■■■■■■■S■■M■■■M■MM l •. ■■■■■■■S ■■■■■e M■N■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■e■MEN■M■■N 1 : .. MEN■M■M■■■■MEN al■a■IM■■■M■ ■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■MM■ee■Me11 ■e■■Me N■■■N■ e ME■■M■ ■■■■e■■NNE■■e■Nee■■■■■■■■■■■■■■■NONE■■■ ll . -. .. ■M■■ ■MO■■ ■E M■iM■■M■■■■ ■■■■■�►►►►►�►►►�►►►■NOON■■NM■e■■NEE■■N■ NONE■Me■M■SEE Elm MENNEN ■■■MM►►►■M 0 a m■a■►►►■■■■M■■■M■■MM ENE Ne■■ ' ■■■■M■■MN■■e■Se■■■■e■■■e■e■■■■■S®■n■■■■■■■■■■OMEN M■eM■MN■■ M■■■■■.•.•.•.• .•.•.•.•.•.•■■■■■■■■■■■■■■■NN■N■eee■■SM■■M■MENeeENE M■■■■N■■M■M■■■■■N■■N ■M■■■■■■■■■■■ems■■■■■■■■■■■■■■■■M■■EM eee■■s■eeM■■eM eNEE■■M■■■N■■■■N■■■■■N■IVENM■e■■■■■■■■M■MM■■■■■■■■■ ■e■■■■■■■■■■■■MM■■■■■■■■■■■■■■■■■MEN■MeN■eS■■NIeM■N■SM■MN■se M■■■■M■■■MEN■■■■■MEN ■e■■e■■■■■■■■e■S■■■■■■e■■■s■■■■■■■■M■EMNM■■■■■■■■■■■■ .s■■■■■■■■■■■s■■■■■■■■■��■■■■■N■■N■■■■■■■■■NONE■MEN ■eee■■■■■ee■■■■■■■■■■■■■■■■e■■■e■MeeN■■®■ ®■■■M■■NM■■N■■■■NONE■ENE ■■■■■■■■■■■■■■■■■ ■■■■■IM■■■■■■■■■■■■■ ■■'• - ■■■ ■■■■■■ ■■ ■■■■■■■■■■■■■■■■■ ■M■EM■■E■■Me■■■■■■■ o■■ ■■■ ■E ■■■■■■■■■eE■■■■■■ ■■■■■MEM■M■eMEM■■EMs ■■■ ■■■ ■■ ■■■■■■■■■■■■■■■■■ ■■■■ ■■■■■■e■■■■■■■■■0■ ■ 1 •. ■■ . - . ■■ E■■■■■■■■E■■■■■■■ ■■■ ■■■■■■■ ■�■■■EOM■■■ 1 .. -M■■ M■ E■■M■■■■■EM■EM■■■ ■■■M • ■■MEM■ ■M ■ 1 - ■■ ■E ■■■■■■■M■■MEE■■■■ ■ .. ... . ■■ .. ■■ ■■ ■ .. ■ e■ MEMEMME■■EE■EME■■ IN=s■■■►■■ / . - . MIME■MMEME■■■■■■ 8 a s. -••. • i MENEEMEMEMENEEM MEN ■■■■■■■■■■s■■■■■■ MEM.MI ..::.:..:.:.:.::���� E �.............::.:..:. ..:.:..............� ....... IM■ M■E■■M■■■■■■■■■■■ ............................................................................ .................................................................. :........... ................................................................................ .......................................................... ................... ..............................................:::::::::::::::::::::::::::::::::: ............................ .................................. .................... ............................. .................... .................... .. ■s■■■■IM■■■M■■■■■■■ ■® ■ .................... . . - . . ■■E■■s■■M■■s■■■■■■ ■■��IM ■ ■■ ........................................... . :::::::::::::::::::::::::::::::::::::::::: iii�■iiiiiii�iiiii iiio:i:iiii iiiIM■■i �� .... ii ■■■■E■■s■Ee■■E■■IM■ EM■■■■M■■■e ■■■■■ME ■ s■■ME■■M■■■s■M■■■■■■M■M■ ■EMEE■■ME■EM■■■ M■ MMMME■■■■■■■■■M■M■ s■■■■■■■■■■■■■ ■■■M■■ ■■■■■■■■■■■■■■IM ■ ■■■■■�r■M■■■■EMEM■■E■EEM■■■E■■■■M■ ■ ■■■EEM■■■E■■■■■■ ■■■■■■■■■■■■■■■■■E■■■■■■M■s■■■■■■■■■EIMIM■■■■■■■■■■■■■■■M■■■■■■■IM■■■■M■■■■■■ ■■■■■■■■■■■■IM■■M■■■■■■■■■■EEEME■M■■■■E■■■■■■■■■■■■■■■E■■■■■■ ■■■■■■■MIME■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■s■■■■■■■■■■■■■s■■■■ ■■ ■■■■■■■■E■■■ ■■M■■■■■■MM■■IMM■■■■E ■■M■■■■■■■M■■■■■■■■■■■■■■■IM■■■■■■■■■s ■■■■■■■■E■■■■■ ■■ ■ Wes■■■■ ME■■E■ IM■■■■■■■■■■M■M■M■■■■ ■■■■M■■■■■■■■■■■■■M■■■■■■■E■■■■■■■■■■ ■■■■■cam■■■■■ ■IM ■ ■■■■■■■■■■■■MIM■MM■■■ ■■■E■MEM■■■■ ■■■■■■■■■■■■■■■E■■■■■■■■ ® ►■■s■ ■■ 1 ■■■■■■■s■■E■■■M■IM■M■ M■■■■■E■■M■ . :. - ■■■■■■■■■■M■■s■■■ �IIII �� M■ ■■■MM■■■■■■■■■■M■■■■ M■■■■■■E■■■■ _ ■■■■■■■■■■■■■■■■■■■■■■ M■ M��■■ ■■■■■■E■■■■■■■■E■■M■ OM ii iM ■■■■■■■■■■MMM■MME ■■■■M■■■■■■Muz�u�■■■■■■■■■■■■■■■■■E■■■ ■ NJ - ME MENNEN ME ■■■M■ ■■■■E■EE■■E■ ■■■■■■■■■■■■■ ■ ■■ ■■ ■■■■■M■■■■■■■■■M■■ME ■■MEEE■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■ ■M .. - ■ ■■■■■■E■■■E■■■■■ME■M E■■■■■■■■■■■■M■■IMM■sIM■■■■■■■■■■■■M■■■ ■■ ■ ■■■■■■■■■■■■■MEM■■■M EME■■■eM■■■■■M■■■■M■■■■■■■■■■■■■■■■■■ ■■ ■ ■ ■■■■■■■■■■ME■M■■■E■■ ■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■ ■■■■■ ■■■■_ ■■ ■■■■■■■■■■■ME■■■■■■■ ■■■■■■■■■■s■■■■■■■■■■■■■■■■M■■■■■■■■■■■■IMMIMIM■■■■■■■IM■■■■■■■■ ■■■■■■■■■■■■MIME■■s■■ ■■■■■■■■■■■■■■■■■■■■■■■■M■■■■■■■■■■■■■■■■IMIMIMM■■■■■■■■■■■■■■■ ■■■■M■■■■■■■E■■M■■■■ MENEMOOOOOLEM E■■■■..00k'.LZUM. - NOMMEMEMEMEMMEMEEM .. ..■■■■■■■■■■■■■■■■■■IM■■■M■■■■■■■■■■■■M■■■■■■■■■■■IM■■■IM■EIM■■■■■■■■IM■■■■■■■■■■MIM■■■■IM■■■■ EIM■■■■■■■■■■■■■E■■■■■■■■■■■■■■■IM■■M■■■■■■■■■IM■M■■■IM■■■■■■■■■IM■■■■■M■MEIM■■■■■■■e■■s■■■■■■■■■■M■■E■■■IM■■■■ ■■■■■■■■E■■■■ .. No MEN M■■E■M■ME■■■■ ■■■■s■■■■M■M■■■MM■M■■M■■■■■■■■M■■■■■M■■MM■■■■■■■■■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■