HomeMy WebLinkAbout0138 LAKESIDE DRIVE - Health 138 LAKESIDE DRIVE
MARSTONS MILLS
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Fax Send Report OCT-03-201610:45 MON
Fax Number . 915088624713
Name BARNST HEALTH
Name/Number 915083622603
Page 4
Start Time OCT-03-2016 10:44 MON
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Results - [O.K]
TOWN OF BARNSTABLE w
Health)Division-200 kdain Street-Hyannis,MA.02601
•FAX CS
Number o£pages inctuding cover sheet: y
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Phone:( j$ 3S 0 Phone: 508-867.-4644 _
Fax hone• `S)'-s 2—z Fax phone: 508-790-6304
CC:
REMARKS! ❑ Urgent For your ❑ Rep1yASAP ❑ ?lease comment
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TOWN OF BARNSTAB LE
Health Division—200 Main Street - Hyannis, MA 02601
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Date:XAM
Number of pages including.cover sheet: y
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TO: FROM:
iYl i N �'C.h �- Town of Barnstable
Health Division'
Phone: ) •3-- 5-- GIN/ q Phone: 508-862-4644
Fax phoneLL,-6-,) Fax phone: 508-790-6304
CC:
REMARKS: ❑ Urgent For your ❑ Reply ASAP ❑ Please comment
review
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New I/A System Permit Summary Sheet s
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Site Information
Town: bA(WSTA F_'-,�. Town Permit# 2-0O t —CDO 3
Assessor Map/Parcel: I oz - Gro Unique Town ID#
Site Address: 13 S L cA ice Si a_Q__
Owner Name: �"1 c�-1- f-h e �, (� . ( ( (3v✓1+
Alternate Name:
Home Phone: Mailing Address: P1 U . FtC> x 9 5
Work Phone: (Y1 rM O 2. G`( K
Title 5 Information ( 4-sk) aq I — H V9
Building Type/Use: nc� -Gr,-M I Design Flow: Z 2-0 (gpd)
Seasonal Use? Yes❑ No ❑ Unknown ❑ Bedrooms: 2
Title V N.S.A.? Yes's No ❑ Unknown ❑ Lot Size: 2
2�^C ZT �Al�raom L:
Non-standard components:
Please list all components e.g. 1/A treatment unit,pump chamber,pre-and post equalization tanks,pressure distribution
SAS, effluent inter, UV unit, etc., and maintenance schedule for each component e.g. quarterly, 2x/yr, annual, etc.
< 5-00 zf>-_P�'� -+u r _JP i o-j� Se-. S -2--2- L--T-
I/A Treatment Unit
Make and Model# MI G.ry DEP Permit Type: ❑ General
Board Approval Date: oon P COC Date: t 2 b I _Provisional
O & M Contract Entity: w T S ❑ Remedial
Contract Start Date: I► 1 -6 o t Contract Duration: 2 ❑ Pilot
Unit Installation Date: Unit Startup Date: tt c-6 o to l DEP Permit ID#: ::2- gam"
Influent/Effluent Monitoring Requirements and Water Quality Limits
Please indicate water quality parameters that must be monitored and any town mandated water quality limits;if no limits
are shown, we will assume parameters and effluent limits specified in the system's DEP approval will apply.
O / UYl
Effluent
pH BOD5 CBOD ElTSS E TN [-INitrate97- Nitrite Organic N El `Ammonia _ TKN �
Fecal Coliform El Total P� Organic P ❑ TDS ❑ Oil/Grease ❑
Conductance ❑ Alkalinity ❑ Water Usage ❑ Temp. ❑
Monitoring Schedule: 2/�.,�„ Other Applicable Limits:
Influent
pH ❑ BOD5 ❑ CBOD ❑ TSS ❑ TN ❑
Nitrate ❑ Nitrite ❑ Organic N ❑ Ammonia ❑ TKN ❑
Fecal Coliform ❑ . Total P ❑ Organic P ❑ TDS ❑ Oil/Grease ❑
Conductance ❑ Alkalinity ❑ Water Usage ❑ Temp. ❑
Monitoring Schedule: Other Applicable Limits:
BCDHE Tracking# Please return this sheet to: FAX: 508-362-2603 Email: bciatech@cape.com
PDT,; 1 t 'Zc:)(D/
RECEIVED
NOV 3 200Z
A.M.Wilson Associates Inc. TOWN OF BARNSTABLE
HEALTH DEPT.
November 8,2002
Tom McKean,Director
Health Dept.
Town of Barnstable
200 Main Street
Hyannis, MA 02601
RE: 138 Lakeside Drive, Marstons Mills
(Our File No. 2.1009.01)
Dear Mr. McKean:
In response to our telephone discussion of 11/07/02,I believe the sections of Title 5 relevant to
system design at the above captioned site are 310 CMR 15.214(1)and 310 CMR 15.217. These
are not part of the "transition regulations" but rather are regulations which apply-to the design of
septic systems generally.
310 CMR 15.214(1)limits flow for systems serving new construction in Nitrogen Sensitive
Areas to not more than 440 gallons per acre per day EXCEPT under conditions set forth at 310
CMR 15.216 or 15.217.
The subject site is in a Zone H and therefore is within a Nitrogen Sensitive Area under 310 CMR
15.212 and is subject to the provisions of.214(1).
Our office,therefore,proposed that the design conform with 310 CMR 15.217(1)which states in
pertinent part that nitrogen loading limitations set forth at 310 CMR 15.215 "SHALL NOT
APPLY TO DISCHARGE OF AN EFFLUENT MEETING THE FEDERAL SAFE DRINKING
WATER ACT NITRATE STANDARD OF 10 PPM" through the use of an approved alternative
system.
As you are aware, our plan provided nitrogen loading calculations using the widely accepted
Cape Cod Commission formula. The calculations assumed the use of a"Microfast"
denitrification system which was also part of our system design.
We did in fact utilize the land area for in front of the property to the centerline of the road in the
area calculations. When the Smallfields acquired the lot,it was our understanding this section of
road was a private way. In such cases,the lot owner owns the land to the center of the way.
P.O.Box 486 508 375 0327
3261 Main Street
Barnstable, MA 02630 FAX 375 0329
t
Our calculations showed an equilibrium concentration of 9.41 PPM NO3. This is below the
Federal SDW standard of 10 PPM. Title 5 does not require a variance to be issued when Section
310 CMR 10.217(1)is utilized.
Apparently after review,you agreed with our analysis. Based on that analysis,you issued your
letter of 7/12/00 stating that the plans conformed with Title 5. You also required,through that
letter which was provided to Mr. Chapman and his attorney attendant to his acquisition of the
site;monitoring,signing of a maintenance agreement; and recording of a restriction limiting the
site to two bedrooms.
I am aware that the restriction was drawn up. Although I was not involved,I must assume that
since the installation permit was issued,the maintenance contract was completed and provided to
your office. I have also not seen any of the testing data from the site. You indicated during our
telephone discussion that the NO3 concentration was less than 4 PPM. This would indicate that
the system is functioning somewhat better than anticipated.
In summary,then,the site was not permitted under the Transition Regulations,but,rather,under
the regular Title 5 regulations. No Variance was required because the system met required
regulations.
Please don't hesitate to call if you have any additional questions.
Yours,
A. M. WILSON ASSOCIATES, INC.
Arlene M. Wilson,PWS
Principal Environmental Planner
cc: Steve Cour,DEP, Boston
1102AW 14/csp
'44 Commercial Street
Raynham, MA
02767
Tel: (508) 880.0233
INSPECTION AND TESTING AGREEMENT Fax; (508)880.7232
Agreement entered into by and between Wastewater Treatment Services,Inc, (herein called WTS)and the
FAST'System OWNER(herein called OWNER) for the inspection by WTS of certain equipment of OWNER
which is described below.
Upon acceptance of this agreement at WTS's office, WTS will render the following services only:
Equip en will be inspected at least 2 times per year with the first inspections beginning
Jr 1 1 These inspections will include:
1) Testing of thesludge depth in the septic tank.
2) Inspection,power testing and clean replace intake filter of the air blower.
3) Inspection of the alarm system.
4) Inspect overall condition of FAST®System.
J
5), Notify OWNER of any problems encountered.
6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts.
WTS shall notify the local Board of Health and Department of Environmental Protection in`writing within 24
hours of a system failure or alarm event including corrective measures that have been taken.
OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor
time will be billed to the OWNER at current labor rates of$78.00 per hour.
Emergency service between regular inspections will be provided at standard labor rates during normal business
hours; at time and one-half after 5:00 PM and on Saturdays;and at double time on Sundays and holidays.
Emergency service charges will include a minimum four(4) hours of labor, plus standard WTS charges for parts,
plus mileage and travel charges. The annual rate includes routine maintenance,but does not include repairs
required for damages caused by abuse, accident, theft,acts of third persons,forces of nature, or alterations made to
the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes,labor
disputes, non-cooperation by OWNER, or other factors beyond the control of WTS.
OWNER understands:.and agrees that WTS is not responsible for special,incidental or consequential damages,
including but not limited to loss of time, injury to person or property, or equipment failure."`
OWNER agrees that'WTS may enter OWNER's property and have acceptable access to all dreas deemed by
WTS to be necessary or appropriate for WTS to perform its duties hereunder.
Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current
contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS
must receive the payment before expiration of the current contract year to assure continuous contract coverage.
' 1 _
1
Failure to return payment may result in suspension of service, cancellation of the contract and/or nullification of
warranties, at the election of WTS. OWNER may not assign this contract without the prior written consent of
WTS. It will remain in'force until a party cancels by written notice to the other at the address;given herein.
F,N _
MANUFACTURER .-`�MODEL.NO. SERIAL NO. LOCATION ANNUAL RATE PERMIT _
gio-Microbics MicroFAST 2N85 Marstons Mills,MA $410.00 General
Includes(2)Field Tests
EOUIPMENT OWNER Wastewater Treatment Services,Inc.
*Signed by OWNER::
Matthew Balboni Signed. ✓ - !jr/
*Address:
138 Lakeside Drive 44 Commercial Street
Raynham,MA 02767
Tele: (508) 880-0233
*City; .'State: Zip: Fax: (508) 880-7232
Marstons Mills MA 02648 i
;d
Telephone 781-29111188 Effective Date of Agreement
E-mail address:
OWNER understands that(1)ANNUAL RATE payment is for one year only commencing on the effective date set
forth above and is non-refundable; and(2) Current DEP Regulations require OWNER.to maintain a service
agreement for the life of the FAST®System. I HAVE READ AND UNDERSTAND THE FOREGOING.
*Signed by OWNER:
Field Testing
Onsite testing performed twice per year will be used to demonstrate that the systems are operating at a secondary
treatment standard of 30 mg/L of BOD5 and TSS. The following will be performed: _
1) Visual examination of the effluent for color, turbidity and effluent solids.
2) Effluent pH to determine if the wastewater is between 6 and 9 standard units.
3) Dissolved Oxygen,2mg/L or more,to ensure that the system is operating.
4) Turbidity, less than or equal to 40 NTU.
If the effluent does not meet effluent quality standards, a grab sample will be collected for laboratory analysis.
Results sent to state and'local Agencies as well as the OWNER. OWNER is responsible for.. oviding acceptable
access to effluent for field testing and/or to enable a grab sample to be taken for laboratory testing performed. If
such laboratory sample is required, OWNER will be responsible for charges incurred. IF REQUIRED,THE
COST FOR THIS ADDITIONAL TESTING WILL BE$190.00/VISIT.
Effluent Testing
State requirements are two (2)grab samples per year for Nitrate,Nitrite, and TKN at a cost of$205.00/test. Water
meter reading.
*Approval for Testing
Owner's Signature
Operator assigned: 'Michael Moreau
Telephone: 4508) 989-2744
1
Failure to return payment may result in suspension of service, cancellation of the contract and/or nullification of
warranties,at the election of WTS. OWNER may not assign this contract without the prior written consent of
WTS. It will remain in force until a party cancels by written notice to the other at the address given herein.
MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE PERMIT
Bio-Microbics MicroFAST 2N85 Marstons Mills,MA $410.00 General
Includes(2)Field Tests
EQUIPMENT OWNER Wastewater Treatment Services,k
*Signed by OWNER:'',, Ae
Matthew Balboni Signed: 10
*Address:
.138 Lakeside Drive 44 Commercial Street
Raynham,MA 02767
Tele: (508)880-0233
*City: State:_Zip: Fax: (508) 880-7232
Marstons Mills MA 02648 _
Telephone 781-291:.4188 Effective Date of Agreement
L�
E-mail address: _
OWNER understands that(1)ANNUAL RATE payment is for one year only commencing on the effective date set
forth above and is non-refundable; and(2)Current DEP Regulations require OWNER.to maintain a service
agreement for the life of.the FASTI System. I HAVE READ AND UNDERSTAND THE FOREGOING.
*Signed by OWNER: :
Field Testing
Onsite testing performed twice per year will be used to demonstrate that the systems are operating at a secondary =
treatment standard of 30.mg/L of BOD5 and TSS. The following will be performed:
1) Visual examination of the effluent for color,turbidity and effluent solids.
2) Effluent pH,to determine if the waste water is between 6 and 9 standard units. -
3) Dissolved Oxygen,2mg/L or more,to ensure that the system is operating.
4) Turbidity, less than or equal to 40 NTU.
If the effluent does not meet effluent quality standards, a grab sample will be collected for laboratory analysis.
Results sent to state and'local Agencies as well as the OWNER. OWNER is responsible for providing acceptable
access to effluent for field testing and/or to enable a grab sample to be taken for laboratory testing performed. If
such laboratory sample is required, OWNER will be responsible for charges incurred. IF REQUIRED,THE
COST FOR THIS ADDITIONAL TESTING WILL BE$190.00/VISIT.
Ef6ent Testing fit.
State requirements are two (2)grab samples per year for Nitrate,Nitrite, and TKN at a cost of$205.00/test. Water
meter reading.
*Approval for Testing
Owner's Signature
Operator assigned: 'Uchael Moreau
Telephone: ',(508) 989-2744989-2744
)39'
� 1
Message Page I of 1
Crocker, Sharon
From: Crocker, Sharon
Sent: Tuesday, September 03, 2013 4:34 PM
To: 'Iwright@barnstableccunty.org'
Subject: FW: scan
Hi Lindsey,
Wanted to make sure you received this information. I was aware you sent the letter out to the owner
requesting it.
- Sharon Crocker
Administrative Assistant
Town of Barnstable - Healtl-
508-862-4739
-----Original Message-=:=--
From: Sharon Foster'[mai Ito:sfoster@wwtsinc.com]
Sent: Tuesday, September 03, 2013 1:45 PM
To: Crocker, Sharon
Subject: Fwd: scan
Hello Sharon,
Attached please find'the signed Operations &Maintenance Agreement from Mr. Balboni.
Let me know if you need anything else.
Best regards, t
Sharon @ WWTS, Inc.
5r
t•. I
I 9/3/2013
oF_B �� BARNSTABLE COUNTY
DEPARTMENT OF HEALTH AND ENVIRONMENT
v R"` ' BARNSTABLE COUNTY COMPLEX
3195 MAIN STREET/ PO BOX 427 Phone: (508) 375-6613
CIS BARNSTABLE, MASSACHUSETTS 02630 FAX (508) 362-2603
TDD (508) 362-5885
July 18th, 2013
Matthew Balboni
PO Box 951
Marston Mills, MA 02648
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 138 Lakeside Drive _Y
in the town of Barnstable.
Dear Matthew Balboni,
Our records indicate that the operation and maintenance contract with Unknown for your innovative/alternative
wastewater treatment system may have expired or cancelled as of July 18th, 2013. To date we have not received evidence
that you have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of,Environmental Protection (MA DEP)and the Town of
Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system.
Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees I/A septic system management and compliance efforts for the Board of Health in your town.We
are authorized by your Board of Health to contact you to inform you of the above requirement and to request your
compliance.Accordingly, please forward a copy of a signed contract via mail, fax or e-mail within fifteen (15)days of
receipt of this letter.
For your convenience, I am enclosing a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you do not respond within fifteen (15) days of your receipt of this letter by forwarding a copy of
a signed contract, I may refer you to the Barnstable Board of Health for further enforcement action. Y.:o may be,required to
appear before the Barnstable Board of Health to show cause as to why you have not maintained the (uired contract.
I can be reached at (508)375-6901; my Fax number is (508)362-2603. 1 can also be ached via-email) at
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter. _71
Sincerely,
Lindsey Wright °M .
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
' E FB BARN TA GOON
E.PARTMENT OF HEALTH AND ENVIRONMENT74
''
a BARNSTABLE COUNTY COMPLEX
3195 MAIN STREET/ PO BOX 427 Phone: (508) 375-66.13
9S�ACHVS���S 4 BARNSTABLE, MASSACHUSETTS 02630 FAX (5.08) 362-2603
TDD (508) 362-5885.
August 15th, 2013
U
Matthew Balboni
PO Box 951 -oO4,2` -73
Marston Mills, MA 02648no
� y- - 01'(/J
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 138 Lakeside Drive,
in the town of Barnstable. n ��� tso
Dear Matthew Balboni, � �c! ��
Our records indicate that the operation and maintenance contract with Unknown for your innovative/a erna ive
wastewater treatment system may have expired or cancelled as of August 15th, 2013. To date we have not received
evidence that you have entered into.a new operation and maintenance contract. «,
s
1 am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and the Town of
Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system.
Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide.
My department oversees I/A septic system management and compliance efforts for the Board of Health in your town. We
are authorized by your Board of Health to contact you to inform you of the above requirement and to request your
compliance. Accordingly, please forward a copy of a signed contract via mail, fax or e-mail within fifteen (15) days of
receipt of this letter.
For your convenience, I am enclosing a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you ado not respond within fifteen (15) days of your receipt of this letter by forwarding a
copy of a signed contract, i may refer you to the Barnstable Board of Health for further enforcement action.You may
be required to appear before the Barnstable Board of Health to show cause as to why you have not maintained the
required contract.
I can be reached at (508)375-6901; my Fax number is (508)362-2603. 1 can also be reached via email at
Iwright@barnstablecounty.org. Thank you for your prompt attention to this matter.
Sincere)
ind Wrig
Enclosures: Certified Wastewater Operators List
CC: Barnstable Board of Health
Certified Mail Number: 70123050000035218258
G«'
3 �2: �0 '�' !s s 1( ,4- F
V1 Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
required for 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.Please see completeness checklist at the end of the form.
Important:When A. General Information
filling out forms
on the computer, ' I SC)
use only the tab 1. Inspector:
key to move your
cursor-do not Joshua M. Bows _
use the return Name of Inspector
key.
Merrill Associates, Inc.
r� Company Name
427 Columbia Road
Company Address
Hanover MA 02339
City/Town State Zip Code
781.953.2705 8765
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ N ed Further Evaluation by the Local Approving Authority
Inspe r' Signature Date
The s tem 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 fird& be sent to the system owner
and copies sent to the buyer, if applicable, and`#he 600fdGlr g atatfStt�it M.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not addrpss.howahe;systet'neji perform in the future under
the same or different conditions of use.
a a�3 l•.I. � `i l.�V 1� I'ilotV
t5ins•11/10 Title 5 Official Inspection Form:Subsurface y
Sewa9j oisa
s YPdg�1 of 17
� U
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is g09 Hidden Ridge Drive Irving TX 75038 6-25-12
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
A) System Passes:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•11/10 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
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman -
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive Irving TX 75038 6-25-12
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes(cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is TX 75038 6-25-12
required for every 909 Hidden Ridge Drive, Irving
page. Cityffown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health(and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well"*.
Method used to determine distance:
"*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than 1/2 day flow
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
required for every
State Zip Code Date of Inspection
page. Cityrrown
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17
' f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
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
® El Was
on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 2 Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220
l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
The system consists of a building sewer, 1500 gallon septic tank with a residential FAST treatment
unit within it a distribution box with flow levelers and a chamber leaching field.
0
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonaluse? ❑ Yes ® No
N/A
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
The house has not been occupied for 4 years.
Sump pump? ❑ Yes ® No
2008
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.):
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-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is g09 Hidden Ridge Drive, Irving TX 75038 6-25-12
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
No records were available at the Board of Health or
Source of information: from owner
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system(yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
l5ins•11110 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
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
11 Years, system was installed around year 2001 based on Certificate of Compliance
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
1.7±
Depth below grade: feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line:. 100'+
feet
Comments (on condition of joints,venting, evidence of leakage, etc.):
Building Sewer is in good condition with no evidence of leakage or failing joints.
Septic Tank(locate on site plan):
Depth below grade: 0.5' (w/cast iron cover to grade)
e
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: approximately 5.5'x 9'
0
Sludge depth:
t5ins•11/10 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
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is 909 Hidden Ridge Drive, Irvin TX 75038 6-25-12
required for every g g
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 N/A-no sludge-FAST unit installed
Scum thickness 0
Distance from top of scum to top of outlet tee or baffle N/A-no scum-FAST unit installed
Distance from bottom of scum to bottom of outlet tee or baffle N/A-no scum-FAST unit installed
How were dimensions determined? N/A-no scum/sludge FAST unit
installed
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
System had not been used in 4 years. A cast iron cover to grade exists over the inlet side of the tank.
Effluent in tank was all liquid. Pumping prior to placing system back in operation is recommended.
Concrete tank, and concrete baffle in good condition. A FAST residential treatment unit is installed in
the outlet side of the tank. Separate inspection and start-up of FAST system is recommended prior to
placing septic system back in operation.
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•11/10 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
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is 909 Hidden Ridge Drive, Irvin TX 75038 6-25-12
required for every g
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•11/10 Title 5 Official Inspection Form: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 138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is 909 Hidden Ridge Drive, Irvin TX 75038 6-25-12
required for every 9 g
page. CityrTown IState 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 0-only residual liquid in D-box. System unused
for four years.
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 level, flow levelers are installed in D-box. No evidence of carryover, nor blockage observed
in D-box.
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.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17
S
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive Irving TX 75038 6-25-12
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number:
2
❑ 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.):
Based on original design plans of 2000, favorable soil conditions exist and no groundwater was
encountered There were no signs of hydraulic failure or ponding on site.
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•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owners Name
information is required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
i
j Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
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
15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: . 30
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: 1-3-01
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:
ESHGW was estimated using the original design plan and soil encountered during soil testing in the
year 2000. Gravelly coarse sand was encountered on the property in 2000,with no groundwater
encountered 10'deep during soil testing. Given the coarse parent material, and the pond 400'±
away, I estimate the groundwater to approximate the pond water elevation, but certainly well below
the existing septic leaching field. Further evidence is provided by the abutting property owner,who
recently excavated a hole 10'deep with no sign of water.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
15ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
• Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 138 Lakeside Drive, Marstons Mills, MA 02648
Property Address
Susan Chapman
Owner Owner's Name
information is
required for every 909 Hidden Ridge Drive, Irving TX 75038 6-25-12
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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
TOWN,ISTABLE £
ATION ..� 0 SEWAGE # �Cl�
Q LAGE— w S .t;t 15 ASSESSOR'S MAP & LOT h �O
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY I
LEACHING FACILITY: (typo) 1 aCV size 0- .� 1 O
NO. OF BE
DROOMS OOMS
BUILDER OR OWNER a6
P oRMITDATE: 36 cT COMPLIANCE DATE:
Separation Distance Between the: _
ivoximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Faciliiy (If any wells exist
on site or within 200 feet of leaching facility) _ Feet
.Edge of Wetland and Leaching Facility (If any wetland's exist -' - -- -
within 300 feet of leaching facility) T Feet
Furnished b.y .
371V`1 - -
�y
e. 't 4M0 1
D-DQ F21 4,
-he12
�4j 01
S1`Dd
VV
� 5- rif
ICA
0%
-
-
"*-7
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233 `!
Fax: (508) 880-7232
January 28, 2009
Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Re: Suzanne Wi-llia:ns-Chap.rnan 1.38 Lakerade.'Dr., .Mars!,)*ic ;vrills, MA
Serial No. 2N85
ATTN: Health Agent
We at Wastewater Treatment Services have been reviewing some of our old files and
found a number of service contract cancellations of our FAST units in your town.
We are trying to do some follow-up with each of our former customers and would ask for
your help. Referenced above are customers and addresses along with unit serial numbers.
We would like to ask you to check and see if each unit has a service provider as required
and who that person might be, as the manufacturer has only certified a small number of
people to service their units. The concern is that their units are being serviced and tested
properly and that these service providers are reporting these results back to the
manufacturer-as required.
Wastewater Treatment Services is the factory service representative of all FAST units in
New England and ask that this information be sent to our office as we will be reporting
`back to the manufacturer.
Your help is needed and we thank you in advance for your cooperation.
Sincerely,
Ww kwatm g wat7wd Svaiceo
Wastewater,Treatment Services, Inc:
Service Department
OF BAA, BARNSTABLE COUNTY
DEPARTMENT OF HEALTH AND ENVIRONMENT
U - by
BARNSTABLE SUPERIOR COURT HOUSE Phone(508)375-6613
3195 MAIN STREET P.O. BOX 427 FAX(508)362-2603
�SSACHVs BARNSTABLE, MASSACHUSETTS 02630 TDD(508)362-5885
October 27, 2008
Thomas McKean
Barnstable Health Department
200 Main Street
Hyannis, MA 02601
RE: I/A septic system operation and maintenance contract letters to owner
Dear Thomas McKean,
I have enclosed a copy of a letter to Suzanne Williams-Chapman, the owner of a FAST
innovative/alternative septic system at 138 Lakeside Drive in the Town of Barnstable. This letter is in
regards to the cancellation of the O&M contract for this system.
If you have any questions I can be reached on my desk phone at(508) 375-6888 or by fax at
(508) 375-6880. I can also be reached via email at bbaumgaertel@barrnstablecounty.org. Thank you for
your time.
Sincerely,
Brian Baumgaertel
Information Specialist
Enclosure(s): 1
F
r1
r�
BARNSTABLE COUNTY
o 7 DEPARTMENT OF HEALTH AND ENVIRONMENT
BARNSTABLE SUPERIOR COURT HOUSE Phone(508)375-6613
3195 MAIN STREET P.O. BOX 427
�y FAX(508)362-2603
SSACHUsti� BARNSTABLE, MASSACHUSETTS 02630 TDD(508)362-5885
October 27, 2008
Suzanne Williams-Chapman
P.O. Box 1093
Marstons Mills, MA 02648-5093
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 138
Lakeside Drive in the town of Barnstable.
Dear Suzanne Williams-Chapman,
On October 23, 2008, I attempted to reach you by telephone regarding your FAST'
Innovative/Alternative (I/A)septic system. I was unable to reach you because you have no listed phone
number.
We have been informed by Wastewater Treatment Services, your last service provider of record,
that your operation and maintenance contract with them for your FAST system expired or was cancelled
on March 14, 2007.
I am writing to remind you that the Massachusetts Department of Environmental Protection
(MA DEP) and the Town of Barnstable require you to keep an operation and maintenance (0&M)
contract in effect at all times for your system. These requirements may be found on the MA DEP
website at:
http://www.mass.gov/dep/water/wastewater/iatechs.htm
My department oversees I/A septic system management and compliance efforts for the Board of
`I Health in your town. We are authorized by your Board of Health to contact you to inform you of the
f above requirement and to request your compliance. Accordingly, please forward a copy of a signed
contract via mail, fax or e-mail within fifteen (15) days of receipt of this letter. For your
convenience, I am enclosing a list of wastewater operators we are aware of that do business in
Barnstable County. The firms listed operate multiple types of I/A technologies and are not associated
with any particular technology or vendor.
Please be advised that if you do not respond within 15 days of your receipt of this letter, I will
refer your property to the Board of Health for further enforcement action.
I can be reached at (508) 375-6888; my Fax number is (508) 375-6880. 1 can also be reached via
email at bbaumgaertel@bamstablecounty.org. Thank you for your prompt attention to this matter.
Sincerely,
Brian Baumgaertel
Information Specialist
Enclosure
CC: Barnstable Board of Health
CERTIFIED MAIL NUMBER: 7007-1490-0002-5249-4402
Vl ST,va.69zent selyN�",
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233
Fax: (508) 880-7232
March 14, 2007
Ms. Suzanne Williams-Chapman
P.O. Box 1093
Marston's Mills,MA 02648-5093
Re: Serial Number: 2N85
Location: ,138 Lakeside Drive, Marston's Mills,MA
Dear Ms. Williams-Chapman:
We understand you do not wish to continue your maintenance contract with our
company. Please be advised the Massachusetts Department of Environmental Protection
requires a maintenance contract be in place for the life of the alternative septic system.
Also,we are required to inform both the state and local agency of your decision.
If you have any questions or'rieed additional information please call our office at
(508) 880-0233:._
Sincerely,
Donna L. Callahan
Copy to: Massachusetts DEP "
,Barnstable Board of Health cryE.
200 Main Street
Hyannis,MA 02601 I t
Barnstable County Dept. of Health & Environment
-:;Barnstable Superior Court House
i 31951VIain Street;P.O::Box`427
Barnstable, MA 02630
R�
CF/�/ D 44 Commercial Street
Raynham, MA
SFP l o27s7
4.20 ,�
T owe'' " � 45 Tel: (508) 880-0233
N�A�T N D`pT' Fax: (508) 880-7232
August 24, 2005
Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report for se
0 jhe property of Suzanne Williams-Chapman locate at 138 Lakeside Drive
LMarston'sls,^
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Suzanne Williams-Chapman
Massachusetts DEP
Coma=
tNC0RP0RATE0
8450 Cole Parkway Shawnee, KS 66227 Phone 913-422-0707 m Fax: 912-422-0808 4905
e-mail: onsite -biomicrobics com m www.biomicrobics.com w 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST®% System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams-Chapman Street
Mail Address: Mail Address 44 Commercial Street
P.O.Box 1093 Raynham, MA 02767
Marston's Mills,MA 02648-5093 City State Zip
508-880-0233 508-880-7232
Phone 508-420-8840 Fax e-mail Phone Fax e-mail
INSTALLATION INFQRMATI.ON r
Model No. Serial No. Date of Installation j Date of last pump out
MicroFAST.5 2N85 11/13/2001
EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS
Electrical Panel s
Visual Alarm eratin X
Audio Alarm Operating X
if resent
Blower s
Air Inlet Filter Clean X
Blower Hood Vents Clear X
Excessive Noise X
Excessive Vibration X
Treatment unit(s)
Unusual Odor
Pum out Re wired: X
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT o tional LIMIT RESULT
Estimated Dail Flow 2 Bedrooms
H Standard Units
Color N/A
Temperature
Odor None
Comments:
TECHNICIAN SERVICE DATE
Joan Peterson 08/10/2005
` Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
E. Sampling Information 4905
Samples Taken:_ Influent _Effluent
Parameters sampled:_pH_BOD_TSS_TN_Other(list below)
Other 1 Other 2
Other 3
Description of any maintenance performed since previous inspection &during this inspection:
Cleaned Filter,,,Splash Recycle,
Notes and Comments:
Also tested:
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
Joan Peterson 08/10/2005
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use - General Use-by September
31 of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
DEPMicroFASTnew.doc•8124/05 Page 2 of 2
�'/i �//`E'C7t72e/1t �Pi`CJGCe6i, Y2G.
f;E' 44 Commercial Street
�''� :',f;Rgyg!,i q�, A
02767'°�~
TeL (9*j880-0233
Fax: (508) 880-7232
September 2, 2004 Di IV13fOw�''-
Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Attention: Health Agent `
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report(as required) for services
performed on 06/30/2004 at the property of Suzanne Williams-Chapman located at 138
Lakeside Drive-Marston's Mills, MA.
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Suzanne Williams-Chapman
Massachusetts DEP
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection -TR 5
DEP Approved Inspection'and 0&M Form for Title 5 I/A
Treatment and Disposal Systems
-2988 . _:_:
A. Installation -
Important: Suzanne Williams-Chapman
When filling out Owner
forms on the
computer,use 138 Lakeside Drive
only the tab key Facility Street Address
to move your Marston's Mills 02648
cursor-do not
use the return city Zip
key. Mailing address of owner, if different:
138 Lakeside Drive
Street Address/PO Box:
Marston's Mills MA 02648
City State
Zip
(ext.
Telephone Number
B. Authorized Service Provider
Wastewater Treatment Services, Inc.
O&M Firm
44 Commercial Street
Street Address
Raynham MA 02767
City State Zip
(508)—880-0223 ext.
Telephone Number
Joan Peterson 9166
Certified Operator Name Certification Number
C. Facility/System Information
2N85 Bio-Microbics, Inc. MicroFAST.5
DEP ID Manufacturer's Name&ID Model Name&Number
11/13/2001
Installation Date Start of Operation
Approval Type:—General X Provisional _Piloting _Remedial
Seasonal Residence—used less than 6 mo./year:_Yes X No
D. Operating Information
06/30/2004
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No
Color: N/A Odor: None
Effluent Description
DEPMicroFASTnew.doc-9i2/04 Page t of 2
l
I "
LlMassachusetts Department of Environmental Protection
Bureau '6.
of Resource Protection - I" T tle,.5�
DEP Approved Inspectionand 0&M Form for Title 5 I/A
Treatment and Disposal Systems
2988
E. Sampling Information
Samples Taken:_Influent _Effluent
Parameters sampled:_pH_BOD_TSS_TN_Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
Cleaned Filter,,,Splash Recycle,
Notes and Comments:
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technologyoperation and maintenance checklist,
Pand the i
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
Joan Peterson 06/30/2004
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting &Provisional Use- General Use—by September
31 st of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6`h Floor
Boston. MA 02108
DEPMicroFASTnew.doc•9i2iO4 Page 2 of 2
MWIMCORPORATED
8450 Cole Parkway Shawnee, KS 66227 w Phone 913-422-0707 m Fax: 912-422-0808 2988
e-mail: onsite cbbiomicrobics.com m www.biomicrobics.com w 800-753-FAST(3278)
FIELD INSPECTION & E S RVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams-Chap—man Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
INSTALLATION INFORMATION
Model No. Serial No. Date of Installation Date of last pump out
MicroFAST.5 2N85 11/13/2001
EQUIPMENT YES '' `NO MAINTENANCE PERFORMED AND'COMMENTS'
Electrical Panel(s)
Visual Alarm Operating X
Audio Alarm Operating X
if resent
Blower(s)
Air Inlet Filter Clean X
Blower Hood Vents Clear X
Excessive Noise X
Excessive Vibration X
Treatment unit(s)
Unusual Odor
Pum out Required: X
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LIMIT RESULT
Estimated Daily Flow 2 Bedrooms
H Standard Units
Color N/A
-Temperature
Odor None
Comments:
TECHNICIAN SERVICE DATE
Joan Peterson 06/30/2004
r
iY
i
44 Commercial Street
Raynham, MA
02767
I
Tel: (508) 880-0233
Fax: (508) 880-7232
September 29, 2004
Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST° Treatment System
Serial Number: 2N85
Attached please find the Field Inspection & Service Report (as required)for services
performed on 09/15/2004 at the property of Suzanne Williams-Chapman located at 138
Lakeside Drive -Marston's Mills, MA.
Please call if you have any questions or require additional information. �
Sincerely, sq `
Wastewater Treatment Services, Inc.
Service Department `
CO
Enclosures
Copy to: Suzanne Williams-Chapman
Massachusetts DEP
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
2988
A. Installation
Important: Suzanne Williams-Chapman
When filling out Owner
forms on the
computer,use 138 Lakeside Drive
only the tab key Facility Street Address
to move your Marston's Mills 02648
cursor-do not
use the return city Zip
key. Mailing address of owner, if different:
138 Lakeside Drive
Street Address/PO Box:
Marston's Mills MA 02648
City State
Zip
(ext.
Telephone Number
B. Authorized Service Provider
Wastewater Treatment Services, Inc.
O&M Firm
44 Commercial Street
Street Address
Raynham MA 02767
City State Zip
(508)—880-0223 ext.
Telephone Number
Joan Peterson 9166
Certified Operator Name Certification Number
C. Facility/System Information
2N85 Bio-Microbics, Inc. MicroFAST.5
DEP ID Manufacturer's Name&ID Model Name&Number
11/13/2001
Installation Date Start of Operation
Approval Type:_General X Provisional _Piloting _Remedial
Seasonal Residence—used less than 6 mo./year:_Yes X No
D. Operating Information
09/15/2004
Inspection Date Previous Inspection Date
20.0"
Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No
Color: N/A Odor: None
Effluent Description
DEPMicroFASTnew.doc•9/29/04 Page 1 of 2
i
I
'r 1
i
1
a
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
2988
E. Sampling Information
Samples Taken:_Influent _Effluent
Parameters sampled:_pH_BOD_TSS_TN_Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
Cleaned Filter,,,Splash Recycle,
Notes and Comments:
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist,and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
Joan Peterson 09/15/2004
Operator Signature Date
System owner must submit this report, technology O&M checklist,and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Photing &Provisional Use- General Use—by September
31s`of each year for the within 30 days of inspection 30th of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6`h Floor
Boston. MA 02108
DEPMicroFASTnew.doc-9/29/04 Page 2 of 2
f
1
INCORPORATED
8450 Cole Parkway m Shawnee, KS 66227 m Phone 913-422-0707 w Fax: 912-422-0808 2988
e-mail: onsite(cDDbiomicrobics.com m www.biomicrobics.com m 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marstoes Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams-Chapman Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marstoes Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
INSTALLATION:INFORMATION
Model No. Serial No. Date of Installation Date of last pump out
MicroFAST.5 2N85 11/13/2001
EQUIPMENT EYES n NO =h1AINTENANCE PERFORMED AND COMMENTS
Electrical Panel(s)
Visual Alarm Operating X
Audio Alarm Operating X
if resent
Blower(s)
Air Inlet Filter Clean X
Blower Hood Vents Clear X
Excessive Noise X
Excessive Vibration X
Treatment unit(s)
Unusual Odor
Pum out Required: X
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(opt onall LIMIT RESULT
Estimated Daily Flow 2 Bedrooms
-
pH Standard Units
Color N/A
Temperature
Odor None
Comments:
TECHNICIAN SERVICE DATE
Joan Peterson 09/15/2004
l
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233
" ;r 11 `'� Fax: (508) 880-7232
December 15, 2003r- 2; 2003
Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST' Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report (as required)for services
performed on 12/02/2003 at the property of Suzanne Williams-Chapman located at 138
Lakeside Drive -Marstods Mills, MA.
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Suzanne Williams-Chapman
Massachusetts DEP
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
1698
A. Installation
Important: Suzanne Williams-Chapman
When filling out Owner
forms on the
computer,use 138 Lakeside Drive
only the tab key Facility Street Address
to move your Marston's Mills 02648
cursor-do not
use the return city Zip
key. Mailing address of owner, if different:
VQ 138 Lakeside Drive
Street Address/PO Box:
Marston's Mills MA 02648
City State
Zip
(ext.
Telephone Number
B. Authorized Service Provider
Wastewater Treatment Services, Inc.
0&M Firm
44 Commercial Street
Street Address
Raynham MA 02767
City State Zip
(508)—880-0223 ext.
Telephone Number
Joan Peterson 9166
Certified Operator Name Certification Number
C. Facility/System Information
2N85 Bio-Microbics, Inc. MicroFAST .5
DEP ID Manufacturer's Name&ID Model Name&Number
11/13/2001
Installation Date Start of Operation
Approval Type: _General X Provisional _Piloting _Remedial
Seasonal Residence—used less than 6 mo./year:_Yes X No
D. Operating Information
12/02/2003
Inspection Date Previous Inspection Date
11
Sludge Depth(to be checked yearly) Pumping Recommended _Yes X No
Color: N/A Odor: None
Effluent Description
DEPMicroFASTnew.doc-12/15/03 Page 1 of 2
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
1698
E. Sampling Information
Samples Taken: _Influent _Effluent
Parameters sampled:_pH_BOD_TSS_TN_Other(list below)
Other 1 Other 2 Other 3
Description of any maintenance performed since previous inspection &during this inspection:
Cleaned Filter,,,Splash Recycle
Notes and Comments:
F. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
completed this report and the attached technology operation and maintenance checklist, and the
information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
Joan Peterson 12/02/2003
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January Piloting & Provisional Use - General Use—by September
31 st of each year for the within 30 days of inspection 301h of each year for the
previous calendar year date previous 12 months
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th Floor
Boston. MA 02108
DEPMicroFASTnew.doc•12/15/03 Page 2 of 2
� t'
MNCORPORATE0
I
8450 Cole Parkway m Shawnee, KS 66227 Phone 913-422-0707 n Fax: 912-422-0808 1698
e-mail: onsite(5�biomicrobics.com a www.biomicrobics.com m 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's MillsMA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams-Chapman Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
INSTALLATION INFORMATION
Model No. Serial No. Date of Installation Date of last pump out
MicroFAST.5 2N85 11/13/2001
EQUIPMENT YES NO MAINTENANCE PERFORMED AND COMMENTS
Electrical Panel(s)
Visual Alarm Operating X
Audio Alarm Operating X
if resent
Blower(s)
Air Inlet Filter Clean X
Blower Hood Vents Clear X
Excessive Noise X
Excessive Vibration X
Treatment unit(s)
Unusual Odor
Pum out Required: X
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LIMIT RESULT
Estimated Daily Flow 2 Bedrooms
H Standard Units
Color N/A
Temperature
Odor None
Comments:
TECHNICIAN SERVICE DATE
Joan Peterson 12/02/2003
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233
Fax: (508) 880-7232
LIGEO
K 1,-DDecember 1, 2003
2 2 2003f:CoF L_L\RNSTASLE
HEALTH DEPT.
Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report(as required)for services
performed on 09/18/2003 at the property of Suzanne Williams-Chapman located at 138
Lakeside Drive-Marston's Mills, MA.
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Suzanne Williams-Chapman
Massachusetts DEP
.Y
_ COMMONWEALTH OF MASSACHUSETTS
f EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 01108 617.291.5500
DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems
Installation Authorized Service Provider
Installation.�1Jdress: 0&NI Firm: I'
138 Lakeside Drive
Marston's Mills, MA Wastewater Treatment Services, Inc.
Owner Name: Mail AJdress:
Suzanne Williams 44 Commercial Street
[Mail Address: 138 Lakeside Drive Raynham, MA 02767
Marston's Mills, MA 02648 Tole hone No.: (508)880-0233
Certified Operator Name: }� ,
Telephone No.:
DEP No.:
Mfr.No.: ZN'85 Cert.No.:
Model No.:
Installation Date: Stan of Operation:
MicroFAST 11/13/01
Approval e) Season Bence-used less than 6 moJyear: (Circle)
General Provisional Piloting Remedial Yes No I
Operating Information
Previous Inspection Date: Inspection Dat Sludge Depth:(to be checked yearly) TY%
mping commended(Circle)
s No
Effluent Description: Attach copy of certified lab results.
Check all that are required
Samples:Influent Effluent
Parameters: pH BOD TSS TN
Other Other Other
Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection
and During this Inspection:
Notes and Comments: OL '
I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the
attached manufacturer's operation and maintenance checklist,and the information reported is true, accurate, and complete as
of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CNIR 2.00.
Operator Signature a e
System owner must submit Remedial Use-by lanuary 3l"of Department of Environmentl
this report, manufacturer's each year for the previous calendar Protection
O&M checklist,and any year Attn: Title 5 Program
required sampling results Piloting& Provisional Use . within �n
3O days of inspection date One Winter Street, 6 Floor
to the local Board of Health Boston, AMA 02108
and DEP as follows for General Use-by September 30 of
each inspection performed: each year for the previous 1' months
511i01
e f
r � Q
1
I N C 0 R P 0 R A T E 0
8450 Cole Parkway• Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808
e-mail: onsiteft-biomicrobics.com ■www.biomicrobics.com■800-753-FAST(3278)
i
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST& System
INSTALLATION AUTHORIZED SERVICE PROVIDER
... ._....., - ._.:.: .-...__.. ..::: L { ""•.G thy,... -i- •
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
INSTALLATION INFORMATION
'�
Model No. Serial No. Date of Installation Date of last pumpout
MicroFAST 2N85 11/13/01
EQUIPMENT YES.J- MAWENANCE PFRFORMEU A_ND QOMNIE?NTS
Electrical Panel(s)
Visual Alarm Operating
Audio Alarm Operating
if resent
Blower(s)
Air Inlet Filter Clean l/
Blower Hood Vents Clear
Excessive Noise
Excessive Vibration i
Treatment unit(s)
Unusual Odor
Pum out R uired:
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) L rfW RESULT
Estimated Daily Flow 2 Bedrooms
H Standard Units)
Color
Temperatureko fa
Odor
TECHNICT SIGNATURE SERVICE DATE
. � l
TOWN OF BARNSTABLE
LOCATION ���L�k �' --�� � S SEWAGE # ��f
VILLAGE Q ��S ���S _ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY l 57a) 64-1 i ca FA-3 4"
LEACHING FACILITY: (type) ) 7'GOsize)
NO.OF BEDROOMS
BUILDER OR OWNER NO
PERMIT DATE: 3 d - O COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
oc
L�l Ic r3� '
U1 �
TOWIvPr gARNSTABLE
16c_
LOCATION �3 L�t��.sh��� ' SEWAGE #
VII.LAGE IOU ` ASSESSOR'S MAP &LOT`jk-5 �0
INSTALLER'S NAME&PHONE NO.
'jSEPTIC TANK CAPACITY ,
c
LEACHING FACILITY: (type) �� f p(size)
\NO.OF BEDROOMS
QBUILDER OR OWNER Q6
JJ
PERMTTDATE: 6 v COMPLIANCE DATE:
Separation Distance Between the: I
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility
Private Water Supply Well and Leaching FacilityFeet
on site or within 200 feet of leaching facility) �any wells exist
Edge of Wetland and Leaching Facility(If any wetlands exist Feet
within 300 eet of leachin facility)
Feet
Furnished by
A
Ft
6c 1 S'1 0 ii I
i
i
44 Commercial Street
Raynham, MA
02767
x r Tel: (508)88070233
Fax: (508) 880-7232
�..
March 5 2003 , pq�y@��p/'p; y9
FV
MAR 1 2 2003
TOWN OF BARNSTABLE
Barnstable Board of Health HEALTH DEPT.
PO Box 534
Hyannis, MA 02601
..rw ,..y "I'+t ;, 6 I'`4'a"r7 y. r ._d:. ns ..au.Ti.'3. -�.:y.Y �'..+' •. w,.�,...a^^" * _,
`Attention. 'Health"Agedf
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report (as required) for services
performed on 02/12/2003 at the property of Suzanne Williams-Chapman located at 138
Lakeside Drive -Marston's Mills, MA.
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures
Copy to: Suzanne Williams-Chapman
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION J•
ONE WINTER STREET, BOSTON, MA 03108 617•392.5300
DEP Approved Inspection and O&M Form for Title 5 Ua Treatment and Disposal Systems
Installation Authorized Service Provider
Installation Address: O&M Firm:
138 Lakeside Drive
Marston's Mills, MA Wastewater Treatment Services, Inc.
Owner Name: Mail Address:
Suzanne Williams 44 Commercial Street
Mail Address: 138 Lakeside Drive Raynham, MA 02767
Marston's Mills, MA 02648 Telephone No.:' (508)880-0233
Certified Operator Name;
Telephone No.: Certi � ���:�sc��--•
DEP No.: Mfr.No.: 2N85 Cert.No.: �`
Model No.: Installation Date: Start of Operation:
MicroFAST 11/13/01
Approval e) Season 'dence—used less than 6 moJyear:(Circle)
General Provisional PilotingRemedial Yes No
Operating Information
Previous Inspection Date: Inspection ate: Sludge Depth:(to be checked yearly) Pumping commended(Circle)
221 fit-. Yes No
Effluent Description: Attach copy of certified tab results.
Check all that are required
Samples:lnfluent Effluent
Parameters: pH BOD TSS TN
Other Other Other
Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection
and During this Inspection:
Notes and Comments:
'J
[ certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the
attached manufacturer's operation and maintenance checklist, and the information reported is true, accurate, and complete as
of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CNIR 2.00.
AL9 i
Operator Signature ace
System owner must submit Remedial Use-by January 3 l"of Department of Environmental
this report, manufacturer's each year for the previous calendar protection
O&M checklist. and any year A"n: Title S Program
required sampling results Piloting & Provisional Use - within One Winter Street, 6'" Floor
3Q days to the local Board of Health of inspection date
Boston, ivIA 02108
and DEP as follows for General Use -by September 30 of
each inspection performed:
each year for the previous 12 months
511i01
• 1
AW
INCORPORATED
8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808
e-mail: onsit biomicrobics.com ■www.biomicrobics.com■ 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
...'-.-INSTALLATION INFORMATION e;`;��
Model No. Serial No. Date of Installation Date of last pumpout
MicroFAST 2N85 11/13/01
E UIPMENT t
'A
Electrical Panel(s)
Visual Alarm Operatin
Audio Alarm Operating
if resent
Blower(s)
Air Inlet Filter Clean V
Blower Hood Vents Clear
Excessive Noise
Excessive Vibration L/ —
Treatment unit(s)
Unusual Odor L✓
Pum oat Required:
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LIlN1T RESULT
Estimated Daily Flow 2 Bedrooms
H Standard Units)
Color
Tem erature
Odor
TECHNICIAN§IGNATURE SERVICE DATE
GAL urwt/� �/3 h I CO 4
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233
♦ .' -
Fax:,•.- • 508 -72 0 3 88 2 pp
r
'October 30, 2002 q'
Barnstable Board of Health
PO Box 534
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report (as required) for services
performed on 09/19/2002 at the property of Suzanne Williams located at 138 Lakeside
Drive -Marston's Mills, MA.
Please call if you have any questions or require additional information.
Sincerely,
Wastewater Treatment Services, Inc.
Service Department
Enclosures Y
Copy to: Suzanne Williams
"`
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, SOSTON, MA 01 I08 6 L7•191.S300
DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems
Installation Authorized Service Provider
Installation Address: U&til Firm:
138 Lakeside Drive
Marston's Mills, MA Wastewater Treatment Services, Inc.
Owner Name: Mail Address:
Suzanne Williams 44 Commercial Street
Nlail Address: 138 Lakeside Drive Raynham, MA 02767
Marston's Mills, MA 02648 Telephone No.: 097tw�o�x--)
)
Certified Operator Name:
Telephone No.:DEP No.: Mfr IY 2N85 Cen•No.: f�
Model No.: /
Installation Date: Start of Operation:
MicroFAST 11/13/01
Approval?�P�rovi
Season Bence—used less than 6 moJyear: (Circle) i General Piloting Remedial Yes No
Operating Information
Previous Inspection Date: Inspe ate Sludge Depth:(to be checked yearly) Pum tnQ Y) p' ommended(Circle) i
Yes
Effluent Description: Attach copy of certified lab results.
Check all that are required
Samples:Influent Effluent
Parameters: pH BOD TSS TN
Other Other Other
Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection
and During this Inspection:
Notes and Comae *s:
mq w -71
[ certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the
attached manufacturer's operation and maintenance checklist, and the information reported is true,accurate, and complete as
of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00.
Operator Signature Da e
System owner must submit Remedial Use-by January 3l"of Department of Environmental
this report, manufacturer's each year for the previous calendar Protection
O&NCI checklist, and an year
Y
required sampling results Piloting & Provisional Use - within Attn: Title 5 Program,,,
3O days of inspection date One Winter Street, 6 Floor
to the local Board of Health �, Boston, NIA 02108
and DEP as follows for General Use -by September 30 of
each inspection performed: each year for the previous 12 months
511i01
f
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1
INCORPORATE D
8450 Cole Parkway■ Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808
e-mail: onsite biomicrobics m ■www.biomicrobics.com■ 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name . Suzanne Williams Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508480-7232
Phone Fax e-mail Phone Fax e-mail
;.INSTALLATION INFORMATION
;r •.: r
Model No. Serial No. Date of Installation Date of last pumpout
MicroFAST 2N85 11/13/O1
EQUIPMENT YES': NO MAIi!TIENANCE PERFORMED AND COIMI1b61HNNfS
` x
r
Electrical Panel s
Visual Alarm Operating
Audio Alarm Operating
if resent
Blower(s)
Air Inlet Filter Clean
Blower Hood Vents Clear
Excessive Noise
Excessive Vibration
Treatment unit(s)
Unusual Odor
Pum oat Re aired:
rEFFLUENT
SettlingZone
Treatment Zone
(optional) j, T RESULT
ail Flow 2 Bedrooms
Units)
Temperature
Odor
J� CHNICIAN,§JGYATURE SERVICE DATE
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233
Fax: (508) 880-7232
March 21, 2002
Barnstable Board of Health
PO Box 534
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report (as required) for services
performed on 2/20/2002 at the home of Suzanne Williams located at 138 Lakeside Drive
-Marston's Mills, MA. The unit was not tested as the home had only been occupied for
five days.
Please call if you have any questions or require additional information.
Si rely,
APR 0 1 200Z
et M. Whitman
TOWN OF BARNSTABLE
Enclosures HEALTH DEPT.
Copy to-.Suzanne Williams
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 01108 t)17•193-S300
DEP Approved Inspection and O&M Form for Title 5 UA Treatment and Disposal Systems
Installation Authorized Service Provider
F(nstallafiondress: 0&tit Firm:
138 Lakeside Drive
Marston's Mills, MA Wastewater Treatment Services, Inc.
Owner Name: Mail Address:
Suzanne Williams 44 Commercial Street
iv(ail Address: 138 Lakeside Drive Raynham, MA 02767
Marston's Mills, MA 02648 Tele hone No.: ( 08)880-023
Tele hone No.: Certified Operator Name:
DEP No.: Mfr.No.: Cert.No.:
2N85 l�
Model No.: Installation Date:
MicroFAST Start of Operation:
11/13/O1
Approval e) Season 'dence-used less than 6 moJyear: (Circle)
General Provisional Piloting Remedial Yes No
Operating Information f
Previous Inspection Date: Inspection D Date: t
�P Sludge Depth:(to be checked yearly) Pumping Fecommended(Circle)
Effluent Description: Yes o
Attach copy of certified lab results.
Check all that are required
Samples:Influent Effluent
etta�,
Dq)
Parameters: pH BOD TSS TN
Other Other Other
Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection
and During this Inspection:
Z
exx-c,� ax�
Notes and Comments: __ -031
I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the
attached manufacturer's operation and maintenance checklist,and the information reported is true, accurate, and complete as
of the time off the inspection. I am a Massachusetts certified operator in accordance with 257 CNIR 2.00.
:�h-P/;/�,�
Operator Signature ace
System owner must submit Remedial Use-by January 3 1"of Department of Environmental
this report, manufacturer's each year for the previous calendar Protection
O&M checklist, and any year .Attn: Title S Program
required sampling results Piloting & Provisional Use - within ,,,
to the local Board of Health 3O days of inspection date One Winter Street, 6 Floor
and DEP as follows for General Use-by September 30"of Boston, �LNI.A 02108
each inspection performed: each year for the previous 1' months
�/li0l
91=1 OR PO RATE 0
8450 Cole Parkway a Shawnee, KS 66227■Phone 913-422-0707 a Fax: 912-422-0808
e-mail: onsite(Mbiorn1crobiCICOM■www.biomicrobics com a 800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
:INSTALLATION R1 EORMAITON :,::r
Model No. Serial No. Date of Installation Date of last pumpout
MicroFAST 2N85 11/13/01
EQL)IPMElectrical�Panel(s) J`NO 14 �1TrI1 1 y�lE�P�ERFUR "A
I (3p �
Visual Alarm Operatina
Audio Alarm Operating
ifpresent)
Blower(s)
Air Inlet Filter Clean
Blower Hood Vents Clear
Excessive Noise V
Excessive Vibration 1z/
Treatment unit(s)
Unusual Odor t�
Pumpout R aired:
Primary Settling Zone
Aerobic Treatment Zone
EFFLUENT(optional) LEVW RESULT
Estimated Daily Flow 2 Bedrooms
H Standard Units)
Color
Tem erature
Odor
][#CFMCIANSjGNATURE SERVICE DATE
�� 7P
3oL
f
10-21-2002 03:08PM FROM A.M. WILSON ASSOC. TO 5087906304 P.01
Q
PU NUMBER
A.M.-Wilson Associates Inc. (5 08) 3 7 5-0 3 2 9
DATE:
Tp; %B6+9 Ale ee A
COMPANYI DE2ARTMENT:
Tp 4! O� sf1Sre 3C�
Number of pages (including title page) :
COMMENTS
i
'Se 2A
i
7�
T® Sx/D dJ c
FROM:
IF COMPLETE DOCUMENTATION IS .NOT RECEIVED, PLEASE CONTACT US AT
I
(508) 375-.032.7.
doc:FAXFORM
P.O.Box 486 508 375 0327
3261 Main Street
Barnstable,MA 02630 FAX 375 0329
44 Commercial Street
Raynham, MA
02767
RECEIVED
TeL (508) 880-0233
JUL 0 2 2002 Fax: (508) 880-7232
June 25, 2002 TOWN OF BARNSTABLE
HEALTH DEPT.
Barnstable Board of Health
P.O. Box 534
Hyannis, MA 02601
Attention: Health Agent
Reference: Single Home FAST® Treatment System
Serial Number: 2N85
Attached please find the Field Inspection& Service Report and test results (as required)
for services performed on 5/23/2002 at the home of Suzanne Williams located at 138
Lakesid-6Drive -Marstods Mills, MA.
Please call if you have any questions or require additional information.
Sin ely,
net M. Whitman
Enclosures
Copy to: Suzanne Williams
w y. COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, SOSTON, MA 01108 617•291.S300
DEP Approved Inspection and O&NI Form for Title 5 UA Treatment and Disposal Systems
Installation Authorized Service Provider
Installation Address: O&M Firm:
138 Lakeside Drive
Marston's Mills, MA Wastewater Treatment Services, Inc.
Owner Name: ��fail Address:
Suzanne Williams 44 Commercial Street
iNlail Address: 138 Lakeside Drive Raynham, MA 02767
Marston's Mills, MA 02648 Telephone No.:, _ (50 )880-0233
Telephone No.:
Certified Operator Name:
DEP No.: Mfr.No.: 2N85 Cert.No.:
Model No.: Installation Date: Start of Operation:
MicroFAST 11/13/01
Approval e) Season 'dence-used less than 6 mo./year: (Circle)
General Provisional Piloting Remedial Yes No
Operating Information
Previous Inspection Date: Inspection Qate: Sludge De the(to be checked p yearly) PumpinnNo
mmended(Circle)
Yes I Effluent Description: Attach copy-of certified lab results. !
Cheek all that are required j
Samples:Influent Effluent
J �� 1 Parameters: CPS TS �'J
Other 0 er Other
Description of Overall System Condition: Description of any Maintenance Performed since Previous Inspection
and During this Inspection:
t
Notes and Comments:
I certify: I have inspected the sewage treatment and disposal system at the address above, have completed this report and the
attached manufacturer's operation and maintenance checklist,and the information reported is true, accurate, and complete as
of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CNIR 2.00.
LL� ,
Operator Signature ate
System owner must submit Remedial Use-by January 3 I"of Department of Environmental
this report, manufacturer's each year for the previous calendar protection
O&M checklist,and an year Y Attn: Title S Program
required sampling results Piloting Provisional Use - within One Winter Street, 6'" Floor
to the local Board of Health 30 days off inspection date
General Use-by September 30"of Boston, ��[.� 02108
and DEP as follows for each inspection performed: each year for the previous I: months
511i01
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INCORPORATED
8450 Cole Parkway. Shawnee, KS 66227■Phone 913-422-0707■ Fax: 912-422-0808
e-mail: "n te(Mbiomicrobics com■www.biomicrobics com ■800-753-FAST(3278)
FIELD INSPECTION & SERVICE REPORT
For Bio-Microbics Single Home FAST® System
INSTALLATION AUTHORIZED SERVICE PROVIDER
138 Lakeside Drive
Installation Address Marston's Mills,MA 02648 Name Wastewater Treatment Services,Inc.
Owner Name Suzanne Williams Street
Mail Address: Mail Address 44 Commercial Street
138 Lakeside Drive Raynham, MA 02767
Marston's Mills,MA 02648 City State Zip
508-880-0233 508-880-7232
Phone Fax e-mail Phone Fax e-mail
'INS
IALLATION Il�iFORMAION �
A.Y ro-
Model No. Serial No. Date of Installation Date of last pumpout
MicroFAST 2N85 11/13/01
EQUIPMENT
Electrical Panels..
Visual Alarm Operating
Audio Alarm Operating
if resent
Blower(s)
Air Inlet Filter Clean
Blower Hood Vents Clear L/
Excessive Noise i
Excessive Vibration
Treatment unit(s) _
Unusual Odor
Pum oat Required:
Primary Settling Zone
Aerobic Treatment Zone v
EFFLUENT(options]) LEWr RESULT
—
[Estimated Dail Flow 2 Bedrooms
H Standard Units)
Color
Tem ature
Odor
CHNICIAN SIGNATURE SERVI E DATE
GROUNDWATER
ANALYTICAL
Inorganic Chemistry
Field ID: Marstons Mills Matrix: Aqueous
Project: Williams/21485 Sampled: 05-23-02
Client: Wastewater Treatment Services Received: 05-24-02
Lab ID: 51166-03 Container: 1 L Plastic Preservation: Cool
='y Analyte b *$�� ;:, , Result r Umts' Repo lyied rting Ana QC Batch f Method
ti,r,::r. rx ,ga ?i: x� t fir.• �r }Llinit *' .,c FF.• z . ,1`_ *a ,{a. t x a
Biochemical Oxygen Demand BRL mg/L 10 05-24-02 13:30 BOD-1126-W SM 5210 B
pH 7.3 pH N/A 05-24-02 09:45 PH-1258-W SM 4500-H+ B
Solids,Total Suspended 81 mg/L 10 05-24-02 TSS-0696-W SM 2540 D
Lab ID: 51166-01 Container: 250 ml Plastic Preservation: Cool
aY'x Ana��fieRepOrting s.
�,az yt ;� p esu t Urnts 5 . . Analyied�^ QC Batches , hMethodv ?
iYa..k,:!.>R ,°'�..�,,�.rh�t>is„>:fw ;�'�a':�.�a� v .`i'i". '�".:.4,`•bi�;`.,.-°'.�T?�i ;�,�'i"�. 'S Lllnit44f .^.�za'�^;:^.,.&`�.sv.,-°�'r, �r f1.xf�..�f.:,d: „gym s..<ty✓y�1 ,s'`P�
Nitrate(as Nitrogen) 13 mg/L 0.2 05-24-02 18:27 NI-1442-W SM 4500-NO3 F
Nitrite(as Nitrogen) 0.14 mg/L 0.02 05-24-02 17:33 NI-1442-W SM 4500-NO3 F
Lab ID: 51166-02 Container: 250 mL Plastic Preservation: H2SO4/Cool
� {7a '�� -^ ,.YI-".v '`!�c'��`k'e':� .i .•�,P3 ,+r'`�'x<a�h. 't c"%i"r� ,,.� - :' +.d e x a-..r a� ,.
Un
; ��.:Reporting .r,„�zs �".�r$ � ��€,��.� ��. �5 �k��-•fir, ;. �_ i
f tz Analyte, yr # Results itsAnal, ed �A CrBatch Method
LIItt_It r..;k.,is'?,." rE, n 't'a
Ammonia(as Nitrogen) 0.9 mg/L.I 0.2_ 05-29-02 AM-0952-W SM 4500-NH3 BH f
Nitrogen,Total Kjeldahl (TKN) 3.9 mg/L 0.5 06-03-02 TKN-0866-W EPA 351.2
Method References: Methods for Chemical Analysis of Water and Wastes, US EPA,EPA-600/4-790-020,Revised(1983),and
Methods for-the Determination of Inorganic Substances in Environmental Samples,US EPA,
EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater,
APHA,Eighteenth Edition(1992).
Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is the lowest
value that can be reliably quantified under routine laboratory operating conditions.
Reporting limits are adjusted for sample dilution and sample size.
Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532
10-21-2002 03:09PM FROM A.M. WILSON ASSOC. TO 5087906304 P.04
see
No.— Batted in conlp9Cr:�—
THE COMMONWEALTH-OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION-TOWN OF
BARUTASCE,
MASSACHUSETTS
application for Diopogal opgtem Congtruttion hermit
Application for a Permit to Construct(R )Repair( )Upgrade( )Abandon( ) C7 Complete System El Individual Components
I oration Addasa or!of No.13S Lakeside Drive Ou ner's Nstne Addles and Tel.No.
Mills Richard & Shirley Smallfield
Aesessor'sMsp/Paszel 102/ZO 117 Harding St., Medfield, MA 02052
Installers Name.Addies9.and Tel,No.
Designer's Name.Addms and Tel.No.
A. M. Wilson Associates, Inc.
P.o. Box 486, Barnstable, MA 02630
Type of Building: 2 Lot Siac, 12 0 q.2 ()arbage Grinder( )
Dwelling No.'of Bedrooms 0s )
Other Type of Building No.of Persons , Showers( ) Cafeteria(
Other Fixtures
Design Flow 257 gallons per day. Calculated daily now 220 gallons.
Fran Date Number of sheets
1 Revision Date_, 6/20/00
Title
Size of Septic Tank 1`�OlLgel Type of S.A.S.
Description of Soil—q
#1•A 2"-10" fine loamy sated/B-1 "-36" Bi�tY c - med.
4E2:A-3"-8" fine tomy sand/B1&2 8'-36n 4] lAatrsil
Nature of Repair9 or Alterations(Answer when applicable)
Date last inspected:
Agseernent•.
The undersigned agmes to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation undl a Certifi-
cate of Compliance has been issued by this Board of Health.
Date
Signed
Application Approved by ate
ApplicationDisa roved'for the following
reasons PP
Permit No: Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CHRTIFY.that the On-site Sewage Disposal System Constructed( X)Repaired( )Upgraded( )
Abandoned( )by
at_ IIR 612-nd T*jyR1�" W13 -eras been constructed in accordance
with the provisions of fide 5 and the for Disposal System Construction Permit No. dared
Installer Designer A Nilson Associates. Inc. _
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.'
Date Inspector
-------------
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
jawpogat �bpgtem QConotruction'3permit
Permission is hereby granted to Construct($ )Repair( )Upgrade( )Abandon( )
system located at 138side rive raters Mills
and as described in the above Application for Disposal System Construcdon 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 tbis'permit.
Date: Approved by
10-21-2002 03:09PM FROM A.M. WILSON ASSOC. TO 5087906304 P.05
.17
J1 i
OP,
7
T
\Mi 7 TAN U H 3, main S(roet
30r,-.staole, MA
i!N:"::
AU
j C)IN C
C ,HALL CD Z.
N 1!
"JONE" SHAILL FREE C.)F ALL
-tes
AND' s C),,-, r,c.
WATER LINES
;;0iNT'-*, OF
h.L\! L BlE CON- 5.
U8 -775 0,327 FAX 7,75 0329
S '07H
,,::'WER LINES. 8 - - , - L -r L- -I I PIPE AND ARE .0
OF A S S I PRES7):-jRc'
TNESS.
ASSURE WATERTIGH
�Z'o R;: TE: j'EL) TO AS�S
TiC- TANK, ETC
..;TR:BUTION 9� SHA; BE
Q EN T QUIVAI i T
-r: Ac7'Jktij L11 RCjjC)NEl0 OR AN
j! 17.4
vvT F ALI_ IAAIE-PiAl.. iN LEArH.IN(,
WI 7H NA.A R!AL AS DESCRi,c,El)
r.
Subsurfaqe
L0'lJi,-"!kAcC'NT SHALL NO, BE
-R�,TF (WER THE [jV:Lr-S OF THE SEWAGE DIS-
THE Oijp5E 7F CaON Sewage
0-4 Vol%
A L
k TO THE SF
WAGE CjjSP05 Diu oscl
m,"'D 1-r C All ON:.,, C.
rF KIHOLIT P
WRJT"'N
ENGINEER ANC) THE LOCAL
LTH
Des.Ign
Sy, TEIM SHALL BE INSPECIED A'---..REQUIRED By
F V.
\,C.-', ICATE. 0,L COMPUANICE AS REQUIRED BY
-W�
LE ',,' AND AN A-S-R-UiLT PLAN BY THE
THE SYSTEM MUST' BE OBTAINED
NIRACTOR UPON COMPLET!ON OF THE ABOVE WORK,
iS 17-STEM. iS' NOT DESIGNEE) FOR A GARBAGE
SAL uflill
N WERE COM
1's SHOW
T,,-) AVAILABLE RECORD PLANS
Te--71-o- 2000
T)0 n. 2C. owing No.
ONLY, 'SEE CHAPTER 70,
U ARE APPRO-YOMAIE GENERAL ljF'NERAL 'LAWS D c-siqr I M.O.
ASSIJV.E NO RESPONSIBil.-ITY FOR DAMAGES e C'k
UTILITIES OMMITTED 0
ClIRRED AS A RESULT OF JBUC Drown
ACCU'RATE.Li( �,SHOWN- THE :APPROPP KIATE --[) A S
C;EPARTWIEKIT SHALL BE CONTAC*Tz job. No.
ELI. AS Dll', SAfE (.pH NIJNIESER -t-888-DIG-S of
WG
AN)' r): TF.UrTION is, V. =LAKEBASF.D
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617-292-5500
JANE SWIFT
G BOB DURAND
Governor
Secretary
LAUREN A.LISS
_c Commissioner
\ ® June 4,2002
Richard Smallfield
138 Lakeside Drive
Marston Mills,MA 0264
Re: NON-BO-02-1006
138 Lakeside Drive,Marston Mills
MicroFAST System,Provisional Use Approval
NOTICE OF NONCOMPLIANCE
WARNING: THIS IS AN IMPORTANT NOTICE.FAILURE TO ADEQUATELY DEAL WITH THIS
NOTICE COULD RESULT IN SERIOUS LEGAL CONSEQUENCES.
Dear Mr.Smallfield:
It has come to the attention of the Department that the System noted above is being operated in
noncompliance with one or more laws,regulations,orders,licenses,permits,or approvals enforced by the
Department.
Attached hereto is a written description of(1)the activity referred to above,(2)the requirements violated,
(3)the action the Department now wants you to take,and(4)the deadline for taking such action. An Administrative
Penalty may be assessed for every day from the date of this notice that you are in noncompliance.
Notwithstanding this Notice of Noncompliance,the Department reserves the right to exercise the full extent
of its legal authority in order to obtain full compliance with all applicable requirements,including but not limited to
criminal prosecution,civil action,including court-imposed civil penalties,or administrative penalties assessed by the
Department.
If you have any questions,please contact John L.Ciccotelli at the DEPBoston Office at(617)292-5657.
Sincerely,
Glenn aas, irec or
Division of Watershed Management
cc: Barnstable Board of Health
DEP/SERO,Attn:Brian Dudley
This information is available in alternate format by calling our ADA Coordinator at(617)574-6872.
DEP on the World Wide Web: http://www.state.ma.us/dep
0 Printed on Recycled Paper
Notice of Noncompliance
R. Smallfield .
138 Lakeside Drive,Marston Mills
Page 2
NOTICE OF NONCOMPLIANCE
Noncompliance Summary
NAME OF ENTITY IN NONCOMPLIANCE:
Richard Smallfield, 138 Lakeside Drive,Marston Mills,MA,hereinafter the"Owner".
LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS OBSERVED:
138 Lakeside Drive,Marston Mills,W,
DATE(S)WHEN NONCOMPLIANCE OCCURRED OR WAS OBSERVED:
Noncompliance since October 5,2001,at 138 Lakeside Drive, Marston Mills.
DESCRIPTION OF NONCOMPLIANCE:
Noncompliance with Section IV(6)of the Department's September 16, 1998 MicroFAST Provisional
Use Approval applicable to the alternative system installed on your property:
1. System installation completed on or about October 5,2001.
Installation of an Alternative System(FAST), 138 Lakeside Drive,Marston Mills.
DESCRIPTION OF THE REQUIREMENTS NOT COMPLIED WITH:
310 CMR 15.024(1),"Violations of 310 CMR 15.000", states in relevant part that"It shall be a violation
of 310 CMR 15.000 for any person to: constructor use a system in any manner that is not in compliance
with an applicable Disposal System Construction Permit,Certificate of Compliance,other approval or
order".
310 CMR 15.287(7)states that "it is a violation of 310 CMR 15.000 to install,construct,or operate an
alternative system except in full compliance with the written approval and 310 CMR 15.287".
Section IV,"Conditions Applicable to the System Owner", item 6 of the MicroFAST Provisional Use
Approval issued by the Department on September 16, 1998, specifies that the owner must obtain written
approval from the Department as follows, "Prior to installation of the System,the owner/operator shall
submit to the Department the written approval of the local approving authority together with a copy of
the complete application that was submitted...".
The Owner failed to submit to the Department the written approval of the local approving authority and
obtain written approval from the Department.
f
Notice of Noncompliance
R. Smallfield
N 138 Lakeside Drive,Marston Mills
Page 3
DESCRIPTION OF THE ACTION TO BE TAKEN NOW,AND THE DEADLINE FOR TAKING
SUCH ACTION:
1. Within 30 days from the date of receipt of this notice,the Owner shall submit to the Department
the following information:
• Plans and specifications for the proposed systems,showing all relevant components,
stamped by a Massachusetts Registered Professional Engineer or,a Massachusetts
Registered Sanitarian.
• Written approval of the Barnstable Board of Health,together with a copy of the complete
application submitted to the Board of Health and all supporting information.
• A copy of the Disposal System Construction Permit for.the System.
Upon receipt of the requested information,the Department will conduct its review of the
submissions.
2. Should the Department issue a denial of approval for the System,within 30 days of receipt of the
denial,the Owner shall submit to the Barnstable Board of Health,with a copy to the Department,
a complete application for a system that complies with Title 5,310 CMR 15.000.
The above information shall be submitted to:
Steven H. Corr P.E.
Department of Environmental Protection
Division of Watershed Management
One Winter Street,Boston MA 02108
DATE: B _.
Glenn Haas,Director
Division of Watershed Management
CERTIFIED MAIL NO.: 7099 3400 0016 6074 9308
Effluent Test Results for Single Home MicroFast®Treatment Systems on 138 Lakeside Drive,Marstons Mills,MA
Provisional flag
138 Lakeside Drive, Marstons Mills,MA 102/020 1 &R Sales and Service, Inc.(Wastewater Treatment Services, Inc.)with Bio-microbics
Date BOD Kjeldahl, Nitrogen Nitrate, Nitrogen 4110E Nitrite, Nitrogen 4110E Ammonia,Nitrogen 350.1 pH Solids,Suspended Pass/Fail Comments
mg/L mg/L mg/L mg/L mg/L S.U. mg/L P or F
11/13/2001 NT NT NT NT NT NT NT First check on new system
2/20/2002 NT NT NT NT NT NT NT NT home had only been occupied for 5 days.(2/15/02)
5/23/2002 BRL 3.9 13 0.14 0.9 7.3 81 P
6/4/2002 DEP letter notice of noncompliance
9/19/20021 NT INT INT NT NT INT INT I Iserviced unit
Effluent Test Results for Single Home MicroFast®Treatment Systems on 138 Lakeside Drive,Marstons Mills,MA
Provisional
138 Lakeside Drive, Marstons Mills, MA 102/020 J&R Sales and Service, Inc. (Wastewater Treatment Services, Inc.)with Bio-microbics
Date BOD Kjeldahl, Nitrogen Nitrate, Nitrogen 4110E Nitrite, Nitrogen 4110B Ammonia, Nitrogen 350.1 pH Solids,Suspended Pass/Fail Comments
mg/L mg/L mg/L mg/L mg/L S.U. mg/L P or F
11/13/2001 NT NT NT NT NT NT NT First check on new system
2/20/2002 NT NT NT NT NT NT NT NT home had only been occupied for 5 days.(2/15/02)
t
��a n c aw&oe i, J.l
RED VVED 44 Commercial Street
Raynham, MA
� . N®�
`TOWN O,F BARNSTABLE i Tel.�(508) 880-0233
HEALTH DEPT.; Fax:'(508) 880-7232
November 14, 2001
Barnstable Board of Health
PO Box 534
Hyannis, MA 02601
Attention: Board of Health Agent
Reference: Home FAST Treatment
Serial Number: 2N85
Attached please find a copy of the Product Registration Report for the FAST Treatment
System for work performed on 11/13/01 at the home of Suzanne Williams located at 138
Lakeside Drive, Marston's Mills, MA. Also, attached is a copy of the fully executed
Inspection&Effluent Testing Agreement.
If you have any questions or require additional information please do not hesitate to call.
S' cerely,
anet M. Whitman
Enclosures
f
Sep-27-00 03: 24P J&R Engineered 15088807232 P.02
Piaaua oompbia oil iiaam marked•
inaluding th M suits um. Mni
SISMW ordinal ow+owt to:
Ma Salsa d Setwa.tnc.
14 CptgMMW Surat
Navnham.Mgt 03167
00)
J&R SALES A SERVICE, INC.
INSPECTION AND EFFLUENT TEEMS AGREEMENT
Agreement entered into by and between J&R Sales&Service, Inc.(herein called MR)and the FAS1'0
System OWNER(herein called OWNER)for the inspection by J&R of certain equipment of OWNER
which is described below.
Upon acceptance of this agreement at J&R's office.J&R will render the following services only:
Equipment will be inspected at ieast 4 time per year that this Agreement remains in ettect, with the first
inspections beginning &/ -6/ . These inspections will include:
1) Testing of the sludge depth in the septic tank.
l) Inspection, power testing and clean/replace intake filter of the air blower.
1) Inspection of the alarm system.
1) Inspect overall condition of FAST'System_
1) . Notification to OWNER of any problems encountered.
i) Service other than routine maintenance will be billed at an hourly rate, plus travel and parts.
J&R.shall notify.the:-16cal board of health and Department of Environmental Protection in writing within
24 hours of a system failure or alarm event including corrv.tive measures that have been taken.
OWNER will be billed standard J&R charges for any parts used in repairs or maintenance. any
additional labor time will be billed to the OWNER at standard labor rates of$69.00 per hour.
Emergency service between regular inspections will be provided at standard labor rates during normal
business hours.at time and one-half after 5:00 PM and on Saturdays;and at double time on Sundays and
holidays. Emergency service charges will include a minimum four(4)hours of labor, plus standard J&R
charges for parts,plus mileage and travel charges. The annual rate includes routine maintenance, but
does not include repairs'required for damages caused by abuse,accident,theft,acts of third persons.
forces of nature, or alterations made to the equipment.. J&R shall not be responsible for failure to render
the agreed services if caused by strikes, labor disputes, non-cooperation by OWNER or other factors
beyond the control of J&R.
OWNER understands and agrees that.1&R is not responsible for special, incidental or consequential
damages, including loss of time, injury to person or property, or equipment failure.
OWNER agree,~; that MR may enter OWNER's property and have ti"uptable access td all,wreris decrnvd
by J&R to be ne cussury or appropriate for J&R to perform its duties hcreundcr,
urc to ..
Sap-27-00 03: 24P J&R Enginaarad 16088807232 P.03
s
This is a two-year contract which will be billed annually. A11.payments arc nun-relindable. OW'NER's
tkilure to•hay invoices promptly or to otherwise comply with this contract may result in suspension of
service, canccliatii�ri 6fcontract and/oi nullification of"warrarit�es; at the else ticin of J&R.`"This
agreement is not ascignahle without the consent of.d&R,and will remain in forcc•until;canecled by either
parry through written notice,
MANUFACTURER M ODEL NO, SERIAL NO. LOCATION ANNUAL RATE_ .
Bio-Microbies MlcroFAST a/114r Marston's Mills, MA $370.66
EQUIPMENT OWNER J&R Salem&Serv' Me-
*Signed by OWNER% WI Q_i0w
Suzanne Williams Signed:
*Address:
138 Lakeside Drive 41 Commercial Street
Raynham, MA 02767
Tele:(508)823-9566
*City:1 ap§61, sState: �zip: Fax:(508)880-7232
Marston's MilLs MA 02648
*Telephone Effective Date of Agreement //—/3'0/
OWNER uhdo6istands that ANNUAL RATE payment is for one ycar_onlyaf this.two-year.agreemerl
�y .
and is norPVdfundable,and(2)Current law requires OWNER to maintain a service agrzeme.nt.,for,the life - R
of the•FAST"System. THAVE•READ AND,UNnFILVtAND.THE>FOREGOM.
' *Signed by OWNER: __..._. �_._ . _...._._.,. . _. . r
Effluent 1_'�gt g
Effluent sample taken 4 times per year and delivered to a qualified testing lab for evaluation. Results
sent to State and local Agencies as well as the OWNER OWNER is responsible for providing
acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed.
PERMIT:
*(PLEASE CHECK ONE) ( ).GENERAL ( }REMEDIAL (X )PROVISIONAI.
*SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH (Y)or(N) if YES, please attach cony of
peimit
( X ) BODs,TSS,pH,TKN,N0 3N,Ammonia O pH, ROD,TSS,Total Nitrogen ( ")Other:
*Cost for testing: $210.00/visit
Operator amignea: William Everett
Telephone: (509)400-386t3 *Kngineer: Arienc Wilson
,I • .... ... :. .. ....., i `.. .-,Prey .
'Approval for Effluent Testi
- ,.. l ton wner'S Signature
of , w
7,HAIN hV;,ryJ"y-
� � Q
� I �
1
I N C O R P O R A r E 0
8450 Cole Parkway a Shawnee, KS 88227■ Phone 913-422-0707 a..Fax: 912-422-0808 .
x
e-mail ontiteAbi6 I biClcomn www blomicrobics com ..800-753-FAST(3278)
`TRODUUCT REGISTRATION REPORT" .
Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty.
Date of Start-U //-/-?-6 i Date Shipped to End User 7/12/01 Serial QN85
OWNER
NAME Suzanne Williams
ADDRESS 138 Lakeside Drive
CITY/STATE/ZIP Marston's Mills, MA 02648
PHONE/FAX
BIO-MICROBICS DISTRIBUTOR
NAME J&R Sales and Service, Inc.
ADDRESS 44 Commercial Street
CITY/STATE/ZIP Raynham, MA 02767
PHONE/FAX 508-823-9566 FAX 508-880-7232
INSTALLER
NAME Chapman Bros Cleaning' Services
ADDRESS P.O. Box 3171
CITY/STATEfZIP Pocasset, MA 02559-3171
PHONE/FAX
CONSULTING:ENGINEER if applicable),-_`
y
NAME Arlene Wilson
ADDRESS
CITY/STATE/ZIP
PHONEIFAX 508-375-0327
Good Bad NA Good Bad NA
ELECTRICAL PANEL(S) TREATMENT UNIT(S)
Visual Alarm Operating Air vent Gear C9K ❑
Audio Alarm Operating Septic tank level ID/ ❑
BLOWER(S) Septic tank meets min. size 01 ❑
Wired for correct voltage 0111, ❑ Septic tank filled to ❑
Inlet/outlet i operating level
piped correctly L� ❑ Air Lift Operation [� ❑
Filter element installed � ❑ Recirculation tube in place (� ❑
Blower hood secure (� ❑ Fasteners tight � ❑
Blower works correctly [ ❑ WATER-TIGHT JOINTS
Blower located within 100' of ❑ ❑ Treatment unit to septic tank (� ❑
treatment unit
Air line clear _ •..,❑ _, 'Entrance tube to insert cover ❑ ` ❑
Air inlet screen clear Insert to insert cover ( ❑
Blower hood vents clear ❑ Discharge line connection ( ❑
Factory Authorized Personnel: Title:
Firm: J8R Sales and Service Inc Date:
Nov 14 01 02: 20p 508 880-7232 p. 1
i
s
dvCZ6.��°Gl�/` ✓/`t'�2l%7�/ZC cJP,i`U�,6�, �/Ll/.
44 Commercial Street
Raynham, MA
02767
Tel: (508) 880-0233
Fax: (508) 680-7232
November 14,2001
Barnstable Board of Health RECEI E
PO Box 534
Hyannis,MA 02601 NOV 2 0 2001
g
Attention: Board of Health Agent TOWN FL
HEALTH DEpTgBLE
Reference: Home FAST Treatment
Serial Number: 2N85
Attached please find a copy of the Product Registration Report for the FAST Treatment
System for work performcd on 11/13/01 at the home of Suzanne Williams located at 138
Lakeside Drive,Marston's Mills, MA. Also, attached is a copy of the fully executed
Inspection&Effluent Testing Agreement.
If you have any questions or requirc additional information please do not hesitate to call.
S' cerely, r
anet M. Whitman
Enclosures
Nov 14 01 02: 20p 508 880-7232 p. 2
• Q
•
I N C 0 R P 0 R A r E 0
8450 Cole Parkway■Shawnee,KS 66227■ Phone 913-422-0707 ■ Fax:912-422-0808
e-mail: onsiteftbiomicrobics.com■www.biamicrobics.com■ 800-753-FAST(3278)
PRODUCT REGISTRATION REPORT
Product Registration Report must be completed and returned to Bio-Microbics, Inc. in order to effect warranty.
Date of Start-U 1/12-01 Date Shipped to End User 7/12101 Serial#2N65
OWNER
NAME Suzanne Williams
ADDRESS 138 Lakeside Drive
CITY/STATEIZIP Marston's Mills, MA 02648
PHONEIFAX
81044ICROBICS DISTRIBUTOR
NAME J&R Sales and Service, Inc.
ADDRESS 44 Commercial Street
CITY/STATEIZIP Ra nham, MA 02767
PHONE/FAX 508-823-9666 FAX: 5084380-7232
INSTALLER
NAME Chapman Bros Cleaning Services
ADDRESS P.O. Box 3171
CITY/STATEIZIP Pocasset, MA 02559-3171
PHONEIFAX
CONSULTING ENGINEER if applicable)
NAME Arlene Wilson
ADDRESS
CITY/STATEIZIP
PHONEIFAX 508-375-0327
Good Bad NA Good Bad NA
ELECTRICAL PANEL(S) TREATMENT UNIT(S)
Visual Alarm Operating Air vent clear LZY ❑
Audio Alarm Operating ❑ ❑ Septic tank level W ❑
BLOWER(S) Septic tank meets min. size ❑
Wired for correct voltage ( ❑ Septic tank filled to ❑
operating level
Inlet/outlet piped correctly ❑ Air Lift Operation ( ❑
Filter element installed ❑/ ❑ Recirculation tube in place ❑
Blower hood secure ❑ Fasteners tight L ' ❑
Blower works correctly WATER-TIGHT JOINTS
Blower located within 100'of Treatment unit to septic tank (SY ❑
treatment unit
Air line clear ❑ Entrance tube to insert cover 91, ❑ ❑
Air inlet screen clear ❑ Insert to insert cover 1!Y ❑
Blower hood vents clear [�' ❑ Discharge line connection [ ❑
Factory Authorized Personnel: Title:
Firm: J&R Sales and Service, Inc. Date: /1 It to
Nov 14 01 02: 21p 508 880-7232 p. 3
Sep-27-00 03:24P J&R Engineered 15088807232 P.02
Please complae all items marked
including theft sigmWes. Mail
signOd original oonony to: WIN
MR sales't s,mice.Inc.
l/c�0 isl sy'M
itaynha `MAD276 J&R SALES At SERVICE, INC.
INSPECTION AND EFFLUENT TESTING AGREEMENT
Agreement entered into by and between J&R Sala&Service,Inc.(herein called J&R)and the FAST"
System OWNER(herein called OWNER)for the inspection by J&R of certain equipment of OWNER
which is described below.
Upon acceptance of this agreement at J&R'9 office,MR will render the following services only:
Equipment will be inspected at least 4 times per year that this Agreement remains in efFect, with the first
inspections beginning //--/3-0i _. These inspections will include:
1) Testing of the sludge depth in the septic tank.
t) Inspection, power testing and clean/replace intake filter of the air blower.
I) inspection of the alarm system.
1) Inspect overall condition of FAST'System.
I) Notification to OWNER of arty problems encountered.
I) Service other than routine maintenance will be billed at an hourly rate, plus travel and parts.
J&R shall notify the local board of health and Department of Environmental Protection in writing within
24 hours of a system failure or alarm event including correntive measures that have been taken.
OWNER will be billed standard J&R charges for any parts used in repairs or maintenance. Any
additional labor time will be billed to the OWNER at standard labor rates of S68.00 per hour.
Entergcocy service between regular inspections will be provided at standard labor rates during normal
business hours;at time and one-half after 5:00 PM and on Saturdays;and at double time on Sundays and
holidays. Emergency service charges will include a minimum four(4)hours of labor, plus standard J&R
charges for parts,plus mileage and travel charges. The annual rate includes routine maintenance, but
does not include repairs required for damages caused by abuse,accident,theft,acts of third persons.
forces of nature,or alterations made to the equipment. J&R shall not be responsible for failure to render
the agreed servites if caused by strikes,labor disputes, non-cooperation by OWNER_or other factors
beyond the control of.I&R.
OWNER understands and agrees that J&R is not responsible for special, incidental or consequential
damages, including loss of time, injury to person or property,or equipment failure.
OWNER agrct..s that MR may enter OWNER's property and have acceptublc access to 11*wre6s deemed
by J&R to be necessary or appropriate for MR.to perform its duties hereunder. """` """'
INov 14 01 02: 21p 508 880-7232 p. 4
Sep-27-00 03:24P ]&Ft E»gineered IS088SO7232 P.03
This is a two-year contract which will be billed annually. All payments are nun-refundable. OWNER's
failure to pay invoices promptly or to otherwise comply with this contract may result in suspension of
service,cancellation of contract and/or nullification of warranties,at the election ofJ&R. This
agreement is ncx assignable without the consent of I&R and will remain in force until canceled by either
party through written notice.
MANUFACTURER MODEL NO. SERIAL NO. 1,0C:ATION ANNUAL KATE
Bio-Microbicc MicroFAST o7/Y�� Marston's Mills, MA $370.00
EQUIPMENT OWNER J&R Salea&Serv- InC_
*Signed by OWNER: Q,6,a 7
S1128nne Williams Signed:
*Address: ``
138 Lakeside Drive 4 Commercial Street
Raynham, MA 02767
Tele:(508)823-9566
*City:1kau�5}aia&lState: 14A_Zip: Fax:(508)880-7232
Marston's Mills MA 02648
•Telephone _ _,_ Effective Dale of Agreement //—/3-
OWNER understands that(I)ANN(JAL RATE payment is for one year only of this two-year agreement
and is non-refundable;and(2)Current law requires OWNER to maintain a service agreement for the life
of the FAST"°System_ I HAVE READ AND UNDIPWSrAND THE FOREGOING.
"Signed by OWNFR: �
Effluent Testing
Effluent sample taken 4 times per year and delivered to a qualified testing lab for evaluation. Results
sent to State and local Agencies as well as the OWNED. OWNER is responsible for providing
acceptable:=ess to effluent to enable a grab sample to be taken for laboratory testing performed.
Pl✓It11ITT:
*(PLEASE CHECK ONE) ( )GENERAL ( ) REMEDIAL (X )PROV1SIONAI.
•SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(N) if YES,piwse attach aTy of
permit
( X )BOD5,TSS,pH,TKN,NO3N,Ammonia ( )pH, ROD,TSS,Total Nitrug" ( )Other:
"Cost for testing: $210.00/visit
Operator amigned: William Everett
Telephone: (SM)400-3MB *Engineer: Arlene Wilson
'Approval for Effluent Testi bVI IA AJ
Ilon wner's Signature
j Massachusetts Department of Environmental Protection
l Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation 4905
Important: Suzanne William s-Cha man
When filling out Owner
forms on the
computer,use 138 Lakeside Drive
only the tab key Facility Street Address
to move your Marston's Mills
cursor-do not 02648
use the return city Zip
key. Mailing address of owner, if different:
P.O. Box 1093
Street Address/P0 Box:
n's Mills MA
city 02648-5093
� City State Zip
508-420-8840 ext.
Telephone Number
B. Authorized Service Provider
Wastewater Treatment Services, Inc.
O&M Firm
44 Commercial Street
Street Address
Raynham MA 02767
city State
Zip
508 —880-022 3 ext.
Telephone Number
Joan Peterson 9166
certified Operator Name certification Number
C. Facility/System Information
2N85 Bio-Microbics, Inc. MicroFAST .5
DEP ID Manufacturer's Name&ID Model Name&Number
Installation Date 11/13/2001Start of Operation
Approval Type:_General X Provisional _Piloting _Remedial
Seasonal Residence-used less than 6 mo./year:_Yes X No
D. Operating Information
08/10/2005
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly)
Pumping Recommended _Yes X No
Color: N/A Odor: None
Effluent Description
DEPMicroFASTnew.doc-8/24/05 Page 1 of 2
.i' ..L.
RECE��ED
. . . . . . NOV 13 2002
A.M.Wilson Associates Inc. TOWN OF BARNSTABLE
HEALTH DEPT.
November 8, 2002
Tom McKean, Director.
Health Dept.
Town of Barnstable
200 Main Street
Hyannis, MA 02601
RE: 138 Lakeside Drive, Marstons Mills
(Our File No. 2.1009.01)
Dear Mr. McKean:
In response to our telephone discussion of 11/07/02, I believe the sections of Title 5 relevant to
system design at the above captioned site are 310 CMR 15.214(1) and 310 CMR 15.217. These
are not part of the "transition regulations" but rather are regulations which apply to the design of
septic systems generally.
310 CMR 15.214(1) limits flow for systems serving new construction in Nitrogen Sensitive
Areas to not more than 440 gallons per acre per day EXCEPT under conditions set forth at 310
CMR 15.216 or 15.217.
The subject site is in a Zone H and therefore is within a Nitrogen Sensitive Area under 310 CMR
15.212 and is subject to the provisions of.214(1).
Our office, therefore,proposed that the design conform with 310 CMR 15.217(1)which states in
pertinent part that nitrogen loading limitations set forth at 310 CMR 15.215 "SHALL NOT
APPLY TO DISCHARGE OF AN EFFLUENT MEETING THE FEDERAL SAFE DRINKING
WATER ACT NITRATE STANDARD OF 10 PPM" through the use of an approved alternative
system.
As you are aware, our plan provided nitrogen loading calculations using the widely accepted
Cape Cod Commission formula. The calculations assumed the use of a "Microfast"
denitrification system which was also part of our system design.
We did in fact utilize the land area for in front of the property to the centerline of the road in the
area calculations. When the Smallfields acquired the lot, it was our understanding this section of
road was a private way. In such cases,the lot owner owns the land to the center of the way.
P.O. Box 486 508 375 0327
3261 Main Street
Barnstable; MA 02630 FAX 375 0329
Our calculations showed an equilibrium concentration of 9.41 PPM NO3. This is below the
Federal SDW standard of 10 PPM. Title 5 does not require a variance to be issued when Section
310 CMR 10.217(1) is utilized.
Apparently after review,you agreed with our analysis. Based on that analysis,you issued your
letter of 7/12/00 stating that the plans conformed with Title 5. You also required,through that
letter which was provided to Mr. Chapman and his attorney attendant to his acquisition of the
site; monitoring, signing of a maintenance agreement; and recording of a restriction limiting the
site to two bedrooms.
I am aware that the restriction was drawn up. Although I was not involved, I must assume that
since the installation permit was issued,the maintenance contract was completed and provided to
your office. I have also not seen any of the testing data from the site. You indicated during our
telephone discussion that the NO3 concentration was less than 4 PPM. This would indicate that
the system is functioning somewhat better than anticipated.
In summary, then,the site was not permitted under the Transition Regulations, but, rather,under
the regular Title 5 regulations. No Variance was required because the system met required
regulations.
Please don't hesitate to call if you have any additional questions.
Yours,
A. M. WILSON ASSOCIATES, INC.
Arlene M. Wilson, PWS
Principal Environmental Planner
cc: Steve Cour, DEP,Boston
1102AW 14/csp
� — K
J,an-O -01 01 : 21P J&R Engineered 15088807232 P _ 03
' Sep-•27-00 03 = ?ap J&k Er g i nee.r-ed 15088807232 P_ 03
Phis is a two-,year contract which will be billed annually. All payrnonts arc nun-refundahle. OWNER'S
failure to pay invoices promptly or to otherwise comply with this euntract may result in suspension of
service, t hncellation of contract and/or nullification ot-warranties, at the election of J&R. T1,ic
atq•eemcni is nix assignable without the consent of,J&R and will remain in ford' until canceled by either
party through written notice,
1Ah NUFACTURL:k MODEL NO, SERIAL Nam).. LOCATION ANNUAL RATE
Bio-MicrobicR M;croFAS'f Marstun's Mills, MA $370 00
LOUIPME OWNE &Scrv• U,
'signed by OWNIER (1WI
Suzanne William, Signed:
'Address: ``
138 Lakeside Drive 41 Commercial Street "
Raynharn, MA 02767
Tele. (508)823-9566
'L hy. y"�aA36a.)NbState.PY $_zip.. Fax: (508)880-72:12
Marston'; Milh MA 02649
'Telephone _ Fft"ective Date of Agreement
OWNER understands that(1)ANNUAL RATE payment is for one year only of this two-year agftmeni.
and is non-refundable, and(21)Current law requires OWNER to maintain a service agreement tier the life
of the FAST'Sywrn_ I HAVE READ AND UNUFIU TAND THE K)REGOING,
*Signed by OWNER:t
Effluent 7:ejlwg
Effluent sample taken 4_ times per year and delivered too qualified testing lab for evaluation. Results
sent to State and local Agarwits as well as the OWNER. OVMR, is rvs.Portsihle for providing
a eptable asses:;to effluent to enable a grah sample to be taken for laboratory testing perRxmed.
*(PLEASE CHECK ONE) ( )GENERAL ( ) RrMFDIAL (X ) PIKOVISIONAI
•SPECIAL c o NUI'I IONS PF,R I.(VAL BOARD OF HEALTH (Y)or(N) if YES, please attach OTY M
permit
( X ) BOU5i TSS. pl-I.TKN. NO3N. Ammonia O pH, ROD,TSS,Tt)tal Nitrugcn ( ►t lther
'Cost for testittig: S210.Mvipi
Operatur timigned: Willittuo EvACttL
Telephode: (SQ 1)40"80 oEnginetr: Ariepe Wilson
''Approwul for F.Pluent Te,Ii
I ion wner's Signature I
No.
Fee l:
r THE,COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
Zipplication for MigO al *pgtem Construction Permit
Application for a Permit to Construct(X )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 138 Lakeside Drive Owner's Name,Address and Tel.No.'-!::�L,^ —%-4-
Ma.rstons Mills Richard & Shirley Smallfield--JP 5663I�rv6byr
Assessor's Map/Parcel 102/20 117 Harding St. , Medfield, MA 02052
Installer's Name,Address,and Tel.yo. J�2 Designer's Name,Address and Tel.No.
SD r gzv_' q z� � � A. M. Tiilson Associates, Inc.
j-p?- 6q?-- !Jj 6 P.O. Box 486, Barnstable, MA 02630
Type of Building: (508)375-0327
Dwelling No.of Bedrooms 2 Lot Size 12,000 sq. ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 257 gallons per day. Calculated daily flow 220 gallons.
Plan Date1/20/00 Number of sheets 1 Revision Date 9/2010D
Title 4tthciirf^ra Sewage Dispogal DP-91 }
Size of Septic Tank 1 500 gal Type of S.A.S. F18wDif;FA_3_sor-s
Description of Soil See P#9678, 2/03/00
#1:A-2"-10" fine loamy sand B-10"-36" silty clay loam Cl & 2 - 3 "- " gravelly roarge - med.
#2:A-3"-8" fine loany sand/B1&2 8"-36" silty loalrsil /C364W' vell curse sarid sand
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Bo Health.
Sig
ne Date 1 A,/d
Application Approved by _ LtL Date
Application Disapproved for the following reasol(/
Permit No. Date Issued
e ` ..-. 1 Wig 1.{•s"M .f - ..• •� `.; "' `.
l
(V
1 Fee
. ,' tee". ,.
'THE6COMMONWEALTH SACHUSETTS 1 ;Entered in computer:
OF MAS Yes
APUBLfC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTSN
t Application for IDipool 6petem Con6truction Permit
l r 1i
Application for a Permit to Construct(X. Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No. 138 Lakeside Drive Owner's Name,Address and Tel.No.
Marstons Mills Richard & Shi'�ley Smallfield
Assessor's Map/Parcel 117 Harding St. , Medfield, MA 02052
10,9/20
Installer's Name,Address,and Tel.No. Z� Designer's Name,Address and Tel.No.
LIT J� A. M. Wilson Associates, Inc.
J-U yY- �.w 6 P.O. Box 486, Barnstable, MA 02630
...,P! /rnn n nnn
Type of Building: J ,—V ,
Dwelling No.of Bedrooms 2 Lot Size 12,000 sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design°Flow 257 gallons per day. Calculated daily flow 220 gallons.
Plan Date Z LU U(1 Number of sheets 1 Revision Date 9/20 0D
,Title Sizb irface Sponge Di anneal Tkpci ga
' /rrSize of Septic Tank 1500'val. Type of S.A.S. Flow T)i ffrranrc
Description of Soil See -*678, 2/03/00
#1:A-2"-10" fine loamyYs6Pd;/1-10"-36" silty clay loam/91 & 2 - 36"-124" gravelly coarse - med.
`•''. #2:A-3"-8" fine loamy sand`/9M 8"-36" silty clay loan-silty clay/C36-lW'-gravely coarse sand _sand sand
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has bee issued by this Bo Health.
-Signs / •��r ' _ Date 3 G
Application Approved by Date 6)
Application Disapproved for the following reaso /
i
,I
Permit No. Date Issued f
_. .-- _.
——————————————————————————————————————
r, f / , THE COMMONWEALTH OF MASSACHUSETTS '
2 ZeI o/ , ,
61F/-* BARNSTABLE, MASSACHUSETTS
Certificate of-Compliance
THIS IS TO CEFY,that the n-site Sewage Disposal System Constructed( X)Repaired( )Upgraded( )
Abandoned( )by _1 4"� .-dv Z �-
at 138 1Bke9ide Ilrive; M�tcm R'lins has been constructs m ccordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 4/0 B6J dated 310
Installer Designer A. M. Wilson Associates, Inc.
The issuance of this permit s all nggt be construed as a guarantee that the syst�q m yll functi•n as designed.
Date �l� !u Inspector
�✓�1�� �� Vu {J�-C-'�/�j �t� J {�..��c�t � c->,�t �'�T�` p�� C c�-Q-� � U-c..,r� J���L�.
Fee
t
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
�Ois�po!5ar *p5tem Construction Permit.
Permission is hereby granted to Construct(X)Repair( )Upgrade( )Abandon( )
System located at 133 Lakeside Drive, Marstons Mills
i
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.
4 Provided:Construction must be completed within three years of the date of t =pefinit. 1
Date: 7 A roved;
ti w a, -i�,t �t cn t x a �,�, r s• ^r�„x^ns � ara.<. -:t
s�, TOWN,�) R_NSTABL>✓
.,'..3 ,Y T
SEWAGE #
LOCATION
v
YILLAGE l
�� s-E ��� . X ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO. S�Sw2e. C0�� 2C} QI�IZ , .
SEPTIC TANK CAPACITY 6rn 4"'1� A
LEACHING FACa ITY: (type) T'; (siie) 0Z 1 p
NO. OF BEDROOMS
BUILDER OR OWNER at
P)oRMIT DATE: 3 o c>r J COMPLIANCE DATE:
4
Separation Distance Between the. -
1Vzmum Adjusted Groundwater Tablet
o the Bottom of Leaching Facility Feet
"Private Water Supply Well and Leaching Facihiy. (If any wells exist
on site or-withih200 feet of leaching facility) Feet
Edge of Wetland and Leactung Facility (If any wetlands exist
within300'feet of leachin facility)
Furnished by`e\
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1
i sl
11 ✓J i�L.�
Health Complaints
17-Jul-01
Time: 9:27:00 AM Date: 7/17/2001 Complaint Number: 2948
Referred To: GLEN HARRINGTON Taken By: DANIELLE ST.PETER
Complaint Type: TITLE V SEWAGE
Article X Detail:
Business Name:
Number: 138 Street: LAKESIDE DR
Village: MARSTONS MILLS Assessors Map-Parcel:
Complaint Description: HER NEIGHBOR, JOHN CHAPMAN, HAD
CLEARED ABOUT 20 FEET ONTO HER
PROPERTY LINE DURING CONSTRUCITON
OF HIS HOME. SHE IS CONCERNED
BECAUSE A NEIGHBOR TOLD HER HE
TOLD THEM THAT HE WAS PLANNING TO
PUT IN A LEACH FEILD (ON HER
PROPERTY) SHE IS CONCERNED
Actions Taken/Results: GH RETURNED HER CALL. HE EXPLAINED
THAT HE WITNESSED THIS LEACH FEILD
AND IT IS LOCATED DIRECTLY NEXT TO
THE TANK, NOT NEAR THE PROPERTY
LINE. AS FOR THE CLEARING OF THE
LAND, IT IS A CIVIL MATTER.
Investigation Date: Investigation Time:
1
k
1
t
Town of Barnstable
N T
Department of Health Safe and Environmental e
P Services
inx►vsrnBc.E. t3'
9� 1MASS
659. ,0� Public Health Division
p'E0AA0�A P.O. Box 534, Hyannis MA 02601
Office: 508-790-6265 Thomas A.McKean,RS,CHO
FAX: 508-790-6304 Director of Public Health
RECORD OF VERBAL COMMUNICATION
04-j-
�-t :y �.-•�-� Jew �-�c a - o�
4ro'�'!Lc ,r , Gtc o� y- a,a�- �•�.1 r� .�.,,
• /olt �► Tom -,
C YfJ.v sow
verbcomm.doc
�oFIMHE' ti Town of Barnstable
Department of Health, Safety, and Environmental Services
' ,0� Public Health Division
�EDN'0�A P.O. Box 534, Hyannis MA 02601
Office: 508-790-6265 Thomas A.McKean,RS,CHO
FAX: 508-790-6304 Director of Public Health
1 :� Lame c�Pi C-z vl/1
RECORD OF VERBAL COMMUNICATION
w .l /` �
r
verbcomm.doc
PHNE CALL:
A.M.
DATE TIME P.M.
I s
PHONED
j'1 ECG) 1 Q RETURNED
E - 1 r / (J� `/ l!T' -YOUR CALL
AREA CODE NUMBER EXTENSION PLEASE CALL
'AGE
+' WILL CALL
AGA1N t
CAME TO
SEE YOU
WAN TO
SEE"YOU
E D 08hiversal- 48003
d
NOTES
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10-05-2001 04:28PM FROM A.M. WILSON ASSOC. TO 5087906304 P.01
Ben I ycnnmL P.E.
�:O��ttBd! D , 1�fA08 :
Odobw
S.2001
TQ�IIlJ OZC
R: A �A
TO wbn kmly
Pima be advised Sat I mWutW kqmdom Fohmmy 15,16.tad 209 2001 at the above
ratm dt Nd A8 of the ktw&te,dw cmvtdm and r ►a3 of wmdeable soft in
the YWMy ottm soli absospum system and nAmmd wig chm sand bad be=
ft"WIK ad the FAST tack.D4m and SAS had be®. d 111 1 ily,ad wai
rear for to .af die FAST tacit and bkmM
As a-rssatt of Wpacdow I bdim&e work ampkftd and 6902 ed above mt the
�gs�Ot of 3ti5 and ehe�tvtrod pin.
snow
Smoa�eiy',
i
TOTAL P.01
DEED RESTRICTIONS
WHEREAS, Suzanne Williams of 20 Drew Lane, Mashpee,
Massachusetts 02649 is the owner of 138 Lakeside Drive, Barnstable
(Marstons Mills) , Massachusetts 02648 being shown on a plan
entitled "Subdivision of Land of SAND SHORE, A Wooded Area in
Marstons Mills, Barnstable Mass, for Hia Pearl Corp. " dated
October 1957, Gerald A. Mercer & Co . , Engineers, recorded with the
Barnstable County Registry of Deeds on October 17, 1957 in Plan
Book 138 Page' 25 .
WHEREAS, Suzanne Williams as the owner of said lot has agreed with
the Town of Barnstable Board of Health to a restriction as to the
number of bedrooms which cam be included in any home built on said
lot as a pre-condition to obtaining a variance from the 310 CMR
15 .214 State Environmental Code, Title V, Minimum Requirements for
the Subsurface Disposal of Sanitary Sewage and to obtaining a
building permit for this lot .
WHEREAS, the Town of Barnstable Board of Health, as a pre-
condition to granting the variance from 310 CMR 15, 214, State
Environmental Code, Title V, Minimum Requirements for the
Subsurface Disposal fo Sanitary Sewage, and authorizing the
issuance of a building permit for the construction of a single
family home on this lot, is requiring that the agreement for the
restrict.ion 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, Suzanne Williams does hereby place the following
restrictio on her above referenced land in accordance with ,her
agreement with the Town of Barnstable Board of Health, which
restriction shall run with the land and be binding upon all
successors in title .
HAYES&HAYES
ATTORNEYS-AT-LAW,P.C.
23 EAST MAIN STREET 138 Lakeside Drive, Barnstable (Marstons Mills) , Barnstable
HYANNIS.MA 02601
County, Massachusetts may have constructed upon the lot a house
(508)77S-0080
containing no more than two (2) bedrooms .
Suzanne Williams agrees that this shall be permanent deed
restriction affecting property located at 138 Lakeside Drive,
i
Barnstable (Marstons Mills) , Barnstable County, Massachusetts adn
j being shown on the plan recorded in Plan Book 138 Page 25 .
i
For title of Suzanne Williams see the following deed: Book 13272
Page 114 .
II I
.Executed as .a sealed instrument this '7 ` day of October, 2000 .
PROPERT, �
"• .
v;si r'+-t .-' � n .•.-,�.--.,e.-+c -.-�, �: rx*-.�.an. - .r.e.-.s,�.ls.... - '...fs�, r e3�^ -' -`'MIMI - � -
.,._
Suzan Williams
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss . October ,i 2000
Then personally appeared the above named Suzanne Williams,
and acknowledged the foregoing instrument to be her free -act and
deed, before me,
�/ Not I ? Public
My commission expires :
l �pv 17, �ppa
.>t '/i'.-.fi'`,Ze�� 1f 3e.-.�•wF VS.wk�. 1. N. ._ — _ -
HAYES&HAYES
--%TTOP.NEYS-AT-LAVJ,P.C. .
23 EAST MAIN STREET
HYANNIS,MA 0260!
1
(508)775-0080
P � atr � r
Ja•n-0?-01 01 : 20P J&R Eng i neer-ed 15088807.232 P _ 02
Sop -27--00 0:3 = 24P ,)&,R Emig 1 neered 1 5088807 2 3 2 P . 02
Rmin,compl�a•rll�Nhn a�u1�oJ
iadrdhns ohm signowin. Mai:
ris"d arlonal wnvwa to:
c.
44 Ca 90P!5AW
Itar*ha� MA tr17Q7 J&R SALES t1 SERVICE, INC,
LNSPEMON AND EEML=TEa?MiG AGR�,,,aFE,�,M M
Agreement entered into by and between J&R Sales & Service. Inc. (herein called J&R)and the FAST'
System OWNER(herein .alled OWNER) for the inspection by J&R of certain equipment of OWNER
which is dcscnbed below,
Upon acceptance of this agreement at,I&R's office, J&R will render the following serviccs only:
Equipment will be inspected at least 4 times per year that this Agreement remains in effect, with the first
inspections beginning _-____- These Inspecdons will irwlude:
I) Testing of the sludge depth in the septic tank,
I) Inspection, power testing and clean/replace intake filter of the air blower.
I 1 Inspeti:tion of the alarm system-
I) Inspect overall condition of FAS"I'System.
I) Notification to OWNER of any probierrui encountered.
I) Ser-tice other than routine maintenance will be hilted at an hourly rate, plus travel and parts.
J&R shall notify the local board of health and Department of Environmental Protection In writing within
24 hours o1 a ,system failure or alarm event including correerive measures that have been takctl
OWNER will be hilled standard J&R charges for any parts used in repairs or maintenance. Any
additional labor time will be tilled to the OWNER at standard labor rates of$69.00 per linur.
Emergency service between regular inspections will be provided at standard labor rates during normal
business hours, at linte and one-half after 5;00 PM and on Saturdays; and at double time on Sundays and
holidays. Emergency service charges will include a rninimum four(4) hours of labor, plus standard J&R
charges for parts, plus mileage and travel charges, The annual rate includes routine maintentuxe, but
does not include repairs required for damages caused by abuse, accident, theft, acts of third persuns,
forces of nature, or alterations made to the equipment. J&R shall not be responsible for failure to render
the agreeJ servi;es if caused by strikers, labor disputes, non-cooperation by OWIVE R or ether factors
beyond the control of,J&R
OWNER under5iands and agrees that.I&LR is not responsible for special, incidental or cc-nsequential
damages, including loss of iime, injury to person Lnr property, or equipment failure.
OWNER a61NO thus J&R shay triter OWNER's property and have acccptablr access (d wfl,,N nie Jccmcd
by J&R it; be nucL�i:ary or appropriate for J&R to perform its dulics hurcunder, "" ''
10-21-2002 03:10PM FROM A.M. WILSON ASSOC. TO 5087906304 P.06
r
NP VAPiAPJC G?E;I!,!�'`j' 3J;='r'fif�??c •: iti'/7;4'O�E"v l,OAD�Nl9 /?,G T!C�11`�:
I cP[Vl U.coo sf_ L/A4/7%! TI::yN, �':'(.:+Gr~C:�/+12,(7 5F ANh "S/A/,;�.E
,HCWE Fly S,T„ P\1I 4A/JCEn TREA 441 N- F'PUPOSE0,
-30 CWM 4LZV
~4 Aelkrvl
mu.LA
4r m"t BrrYs►sra.G�•- p saSe e4^, 'N�a! -got.
/41s H j f! 'AjM
4' INVERT A; IDUILDIN/` -
i
4" INVERT AT 1500 GAL, TANK (Ifs)
I
4" INVERT AT 1500 GAL. TANI': (0UT) _9g.SC.
4" INVERT AT D!Sj. BOX ;!N)
4" INVERT AT MST. BOX (0;.!1')
!NVERTS AT I EACHING FA&_11i';
4"' WEPT AT BEG.
t.E.ACHING P ACktj :
4.' INVERT AT END
LEACHING FACILITY
ELEVATION Al, B01 TOM
,OF LEACHING f At`!UTY �U
02SERVEC- GIR01 NT IN=,T�.F' ELEVATiCil _-
c'
er
TOTAL P.06
10-21-2002 03:08PM FROM A.M. WILSON ASSOC. TO 5087906304 P.03
Part VM: ONSITE SEWAGE DISPOSAL.REGULATIONS
SECTION 12.00: Monitoring of Alternative Septic Technologies
Adopted 4/1/95, Revised 11/4/97. Effective 11/5/97
Town ®f Barnstable
BWAMAN _ Board of Health
.�.� P.O. Box 534, Hyannis MA 02601
Office: 508-790.6265 soMn 0.Raak RS.
FAX: 508-79M304 Ralph A.Murphy,M.D.
Summer KWAM
Monitoring of Alternative Septic Technologies
In considering permitting the'use of various alternative septic treatment technologies in the
Town of Barnstable, the Board of Health of the Town of Barnstable recognizes that there
may be specific local circumstances which warrant the Board to require more stringent
conditions for the installation and monitoring of these alternative systems than may be
required by the Massachusetts Department of Environmental Protection. As allowed
under M.G.L. ch. 11 sec 31 and as required by the revised 310 CMR 15.00 sections
15.285(2d), 15.286(5), 15.288(4) which became effective November 10, 1994, the Board
of Health\\of the Town of Barnstable hereby reserves the right to impose any additional
conditions ffluent water quality standards and/or monitoring requirements it views as
necessary to ensure the safe and effective performance of any alternative septic system
which the Board agrees to permit in the Town of Barnstable.
Effective Date of Regulation: November 5, 1997
1ti
usan G:Ras". Chairman
Sumner Kaufman
Board of Health
Town of Barnstable
monitor
07-13-2000 01:55PM FROM A.M. WILSON ASSOC. TO SILVIA F.1�2
Town of Barnstable
Reigulatory Services
Thomas F.Geller,Director
Public Health Division
ThomaS McKean,Director
367 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508790-6304 '
July 12,2000
Arlene M. Wilson
A. M. Wilson&Associates,Inc.
P.O.Box 486,3261 Main Street
Barnstable,MA 02630
Dear Ms. Wilson:
Pursuant to your request, the Town of Barnstable Health Division has reviewed the Title 'V design plan
for 138 Lakeside Drive, Marstons Mills. The Town of Barnstable Health Division has determined
that the design plan coziforms with Title V.
However,the following criteria must be met in order for the.submittal to be complete:
--• A monitoring plan for a Provisional Use Approval technology shall be approved by the Barnstable
Board of Health, in accordance with the attached regulation.
A maintenance agreement must be signed by the owner of the property.
• A registered deed restriction be placed on the property Iimiting use to two bedrooms.
Proposed floor plans must be submitted at time of building permit application sign-off
If you should have any questions,please do not hesitate to contact me.
Sincerely yours,
Thomas McKean,RZ, C.H.O. �
. l
f L60C
Town of Barnstable P u
Department of Health,Safety,and Environmental Services
Public Health Division Date
U
367 Main Street,Hyannis MA 02601
uaxeTear.e,
noes.
Date Scheduled ® Time ( � Fee Pd.
Soil Suitability Assessment for Sewage Disposal
Performed By: /SffZAIAeJ Yo Lov.,/y Witnessed By: 0:+/✓/VA /00 v 2ANInT
CATION &...::NE..
RAI, INFOR1 L X ION
Location Addr I v J �Ir s/D� DOA
j! Owner's Name
/ �
U (,� G L yC/U'� Address
Assessor's Map/Parcel: 10 Z/Z o Engineer's Name A m t.Ao/( L orJ A cSLX,
I NEW CONSTRUCTION —A— REPAIR Telephone 9 3 7 5— O 3_&�-37
I
Land Use ///afiA/"% Slopes(%) 4 -3 Surface Stones AA
Distances from: Open Water Body 7/CX3 R Possible Wet Area R ,Drinking Water Well A6110 ( 'V A,)
Drainage Way 7 7-S R Property Line "r IQ,, R Other WATu Ri;. R
P?' 147c6 GT1oY,,i
D ITT YestCr
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
1312o i o�f
S 'O'�
I l��►
6
n
►ate' ��w
Parent material(geologic)141j1%N!"ae / /r s fa AlRj^-� /
Depth to Bedrock Z 50
' IJvi'IGU��rS
Depth to Groundwater: Standing Water in Hole: ma's Weeping from Pit Face A/.)
Estimated Seasonal High Groundwater el, �� v �Q� t3�Z.u4J a zo pV
.......................
'TE NA�'Y�J►�1' 00'R EASO�ALMG T'V�AT TA LI ' :> ;`<<::<;:
.......
Method Used: ry ,F, '`_-%-0(s°3rii�i:✓�e?e9^� , - ... .... X. _
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment R.
Index Well N_.__.,._... Residing Date:.__..,_. Index Well level Adj.factor Adj.Groundwater Level
" >: PERC0 A- IOl�t TEST hate::::: <;:: :<:: "Tirae
Observation w
Hole N Af Time at 9" 1 41 f
H
Depth of Perc �d.g� $h Sy%61 Time at 6" 3:T qJr��
Start Pre-soak Time c@ V.�`► 0 J`� Time(9"-6") ' 0� � '7
End Pre-soak q
Rate Min./Inch 4 Z. Z., C I U C'w12,
Site Suitability Assessment: Site Passed I/ Site Failed: Additional Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back—�
Copy: Applicant
SEEP OBSIZVATIUN:IiOLE
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
ConajaLma_WGravel)
s,dty CIt,Ay a
10— 3G 13 oY t r �y (= lA41,
(�" �.Il COAASe ll,>y t, ) �I�vWe.e9 i9fa4,r, 1i0tl'
C" . Mj n. SAIA9
.E A GONHEL #DF. BS.:. VT
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.°
DEG'+r N'C)Nl, L8hU4
— 3 S PINS 60bLa
3— /� '��L/ �✓ "A ss/lJv' !re r AGL'd
S_ ZI3 CL,-y 0
y��w L,owv^
S1� 10 2 (� ► ssi�n3 8r��cu'
t Ju./ .T L/c
36� IZ� `_/ iCnv3�� 10 2 ��L L� 51"L,D GeAIA/) /.crasU
A b
.............................................. ....................... .................
................
Hole# .
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistencv.° Gravel)
DEE..P OBSER�ATIONHOLE LOG . Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,° Gravel)
1,
it
Flood lusuranec Pate AI:t 7 s G - — ,� S'�
Above 500 year flood boundary No_ Yes
Within 500 year boundary No x Yes
Within 100 year flood boundary No, Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? Yy� S
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and experience described in 310 CMR 15.017.
Signature Date
J�.........--
THE COMMONWEALTH OF MASSACHUSETTS
��� BOARD OF HEALTH
_.. ... _ .fA609�....OF...... ..................................
, pVtiratinn -for Bhipmat lVarkii Tomi#rurtion Vrrmit.
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
G ..Sb7.S:. i
Location-Address or Lot No.
'.r '1�1.�.---------�ei ?'�da ,rslP'1.It.E ? eGvs��f n'�P�d-l�O
Own Address
w ----- .•�.E � /� ----------------_ r am► , -e rr
a
Installer Address
QType of Building Size Lot___ ../. _Sq. feet
U Dwelling—No. of Bedrooms._-_-____--____. ----------------------Expansion Attic ( ) Garbage Grinder (c_.��
p., Other—Type of Building ____________________________ No. of persons----..__.._____.._._.__._.__ Showers ( ) — Cafeteria ( )
a' Other fixtures _________________________________
W Design Flow..................... 5145--------------gallons per person per day. Total daily flow.............j- ......_-------------gallons.
WSeptic Tank—Liquid capacity/M- gallons Length----- Width:.___ Diameter----......
Disposal Trench—No. .__. Width......$:o:...... Total Length---____ ._ otal leaching area........
3 Seepage Pit No------_------------ Diameter-------------------- Depth below inlet............_....... Total leaching -area-------.----------sq. ft..
z Other Distribution box ( ) Dosing tank ( ) (-
aPercolation Test Results¢ Performed bY-------- ------ Date----------------------------------------
a Test Pit No. 1_.c�t_.�___minutes per inch Depth of Test Pit.................... Depth to ground water---------------.........
(� Test Pit No. 2................minutes per inch Depth of Test Pit--_--_________----- Depth to ground water__._.._____-__._____.,..
-----------------------------------------------------------------------------------------------------------------------------------------------------
0 Description of Soil------------ —--------------------------------------------------------------------- ------------------------_
x
c, ---- -- - - ---- ---------- - -- _ ----- -----------
.............. P-------_l/E1--�- "---' is
/f �c, C� .•fl f.�O�9� -_�---- -�
V Nature of Repairs or Llteratio��� wer when applicable.._____ ��%.-----enGA.W/-/,---/#A�-------G�.........................
6,a uS -------------------------------------------
Agreement:
il r��' &rM. ------.. .......Z-A.1 ' 7-q------------ ------------------
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI 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 board of alth.
Signed......... -4— ,� /
A licatimi Approved B
G ate
Date' `
Application Disapproved for t ae following reasons-----------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Date
Permit No.------�-Q.)... .................................. Issued.....i--2--l- <_ --•---•--------•--
Date
------------------------------------------------
--------
No..-//d-.;�_'.--•--...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.. ... ..... f'arF............ ..... ---'--
Apphratiun -fur Diu outti Works Tunutrurtiun Vrrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual bf4g LDisposai
System at
Location'-Address a d e
` "i '� � a�' In �' or Lot No.
" yI'�!d._._.._.. ' `&.oMW_ . "---.ram.---------
Own Address
aL? '. .................... .. C,44eW& 4 '....�'.e�Y��!
p Installer Address
U Type of Building Size Lot..... Ae. _..Sq. feet
- Dwelling—No. of Bedrooms.................--____--_----_-_--Expansion Attic ( ) Garbage Grinder (&*+01"-
. : Other—Type of Building .............................No. of persons-------------
xCafeteria (- )
'.,
Otherfixtures ------------------------------------------------------ ----=----------------------------------------------------------- -- -•---------•-••••-••------
W Design Flow......................%;M..._.....__._gallons per person per day. Total Bail flow--_:-______•-JAM............._..__.gallons.
USeptic Tank—Liquid capacity/.gallons Length__....A-_ Width.. ..... Diameter--- ---_ De)th. __...
xDisposal Trench—No.j;;jjWV_ ..... Width..... .lwo.------ Total Length.... . otal leaching are _, t.4,p,,w Q
3 Seepage Pit No..................... Diameter.................... Depth below inlet-------- .......... Total leaching area-------
z Other Distribution box ( ) Dosing tank ( )
a Percolation Test Results Performed by.......................................................................... Date.......------------_-----------------
-,a Test Pit No. I..u..A -_minutes per inch Depth of Te,.tr,Pit....... ________ Depth to ground water..-------_-_-__._.-:....
f1 Test Pit No. 2................minutes per inch Depth 'of Test Pit----------_'_.......Depth to ground water__._--__-______--_____._
"O Description of Soil------- X19..44 10K 4MCIC............................. ------------------------ - --------------------------------
----------------------------------- - "
-: -- --/--------------------------- 6.................................................
U Nature of Repairs or Alterations—A wer when applicable._-__............. f'Y�6�• ______
-b
= •--•-•---- --•---
Agreement' LSh� /fly f`LS/ T
The -undekijne agrees to install- the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate tof Compliance has been issued by the`.ht rdp:.of} alth
^ to
Application Approved BY r/f - -•- ,stir "�= --...... ."- ...............
E Y 'wt Date
t. .n. -I...0
.-Application Disapproved fort ;t following reaso'n��.;--t ``�•-•--•...............:.....•----•--•---..� --..:-'--------•----...----••-...........................
.........•----•-•--------=----=`•---=_.._-•--•-_......--=-•--------------••---•----
Date
PermitNo:.............................-------------•----........... Issued.........................................................
Il'O J Date
E'COMMONWEALTH OF MASSACHUSETTS
ki u
, v
BOARD OF HEALTH
r,
•i �
..........................................OF............... .! '.!!.! .3. .......... L.+C,........:................... '
.. Trr#if ira#.e of f�oi tptianre
THIS IS TO CERr"1k µ Y, That the Individual Sewage Disposal System constructed--( ) or Repaired
by - ,: nstaller
•+/
F
at----------......... - --------X*.X ....� ---------------------- ------------•-•--•----------•-•-----------------
has been insta]Ted in accordmice with the provisions d Article XL of The State Sanitary Code as described in the \
application for Disposal Works`, 'An truction Permit No ". L _: �!°4`' ?dated----------
THE "ISSUANCE' OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE AT THE a
SYSTEM WILL FUNCTION SAT.fSFACTORY. <, . .
DATE_ : t�..X --- --- .•-/ ...................
7
rs d ` :. Inspector L;E �.
THE COMMONWEALTH OF MASSACHUSETTSs
�`= t BOARD .OF HEALTH
uQ ................. Gd ......OF..-a� l�t't sTl{Ji4.�,.: '�* � .
�`
FE
RnVviial Morkii (nonitrurtioll f rrmft
Permission is hereby granted....4 :d2 :" aai�
Q .:..............
to Construct (x ) or Repair ( ) an In divid al Sewageisposal System
-.
at No.... - �t J11`E�S - --- --------•-----
--- -----------
S reet - #
as shown on the application fotOis osal Works Cdkstructi n(je;mit No:___ 11I-------- Dated.....R •� ..7........
-
v Boa of ea _.
DATE:".I&.--- -------- r
�u.'
FORM 1255 HOBBS & WARREN. INC.. PUf}BLISHERS S
'i
V. w 4•: m^�i:+,��`�....N,.. �' '`...: � _._'�=i �•��y�',���`'�`'Sa."3w w:,Yrr =...,���*.aF� -
.3d ,,.3 �� ` sir :�;"`� •-'� ,°'<� ry ' �1+ y'� - ..... �4, ..
�ky,r
t.
" ,. 70oU Gi-1L
�i �..�s�JJ�o l�i�Ai/`�roAl �� �a0��'�QCH/ --� ais r'• M _ .>
34
7�1,gN sNocc�i�c/G .F-
iSNO(J�SL 10 c'�9 T/,7,11j` c
October 9, 1974
Town of Barnstable
Board of Health
397 ?'Fain Street
" Hyannis, I-4A 02601
Attn: John M. Kelly
Dear Mr. Kelly:
Y M
Enclosed you will find a copy of a plot plan with
the sewer system diagramed for Lot 5, Lakeside
Drive, Centerville.
I am sorry_I .did not Tail this to you sooner, but
I inadvertently forgot that I promised it to you.
I appreciated your help . h my obtaining the build—
ing permit,.which I needed.
41
I hope you will accept my sincere apology;/for the
delay.,.:.
Sincerely,
ff(Iff D WELOP1,1EENT C0'P.
�,4Nor`m"�n �rossman ,
t,
2,'�'}}ri
:mil
`I
1
e
n�
Its
12'-0'
I r- ----
------- ---------------------=-------------- I
4 I I I
24'-0" 1, 2'-6'
-------------- ---------- ----------- --
�- I � -- , I I � N
------------ --- ------ --- J PROVIDE FOR FIREPLACE I I I I m
d I 4 HEARTH ABOVE AS PER I I PROVIDE ALUM.SASH I I
UP TO 6A AGE I CONTRACTOR SPEC. O I VENT. WINDOWS A5 PER I I UJ
1 Q o v '^ I CODE REQ. F
I i A L 1 _I ° PROVIDE SOLID PROVIDE 2'x6'xl'DEEP I I I I W
I I ®. BLOCKING FOR CONCRETE PAD TO I' BEYOND
DROP WALLAS —————————————— I POINT LOAD LIMIT OF STAIR AS SHOWN. -I_-
-.. I I
REQUIRED. I �I O FROM ABOVE
PROVIDE 4"MIN. I O n - LOCATE COLUMN d
GA5 LIP(MIN) I I ryI 5V2" PIA. LALLY COL.ON v I FOR DE P10 NTSOLID LOAD FROMN4 I
— 2'x2'xl'GONG.PAD(TYP) * `q I ABOVE
f-- I I
f 1 --1 r
I -3-2x12 - I 3-2x12 3_2x12 5-2x12 3-2 12 —�B-2x12_I + 3=2x12 I Q
I I LTJ LT.J L -___ J LTJ L T LTJ I I
I I I I
5'-8' S'-5' 5'-10'
n I
I
&ARA 7E ; ' =I ° BASEMENT 10"CONCRETE o
Q ;o FOUNDATION WALL ON I I lfl
I I 4'GONGRETE SLAB ON I I A ® 4" GONGRETE SLAB OrF a I'-8'xO'-10' CONTINUOUS
I I 6°COMPACTED FILL I I IJ 6-COMPACTED FILL CONCRETE FOOTING I I Q
o (4'0" BELOW GRADE
I Q o MINIMUM). i I
`r I I
B-2x12 r 3-2x12 r 2x6 K.D.SILL PLATE ON I
x& P.T.SILL PLATE
I L J-—- J o_ ?LAYER SILL SEAL A/N I I
I I I I ctS ANCHOR BOLTS® 4'0' I I -
I I I uy LOCATE COLUMN 4 TAIRS O.G.(MAXIMUM). I I fj
I 4 I I I a PROVIDE SOLID 14 RISERS
I �------------------------ ----J I I L ..BLOGKINGFORPOINT r ------------ ------�
_5-2x12 3'2x12 u
I DROP FDN. DROP FDN. I I ,. L66 LOAD FROM ABOVE' i J�_L —J
-- -------=--------------- -- — I I-- ------- �_ --
I PROVIDE FOR I
------------- --� STOOP ABOVE AS '----------------- ILI
�• 9�" q�• I.q REQUIRED(CONTRACTOR
TO FIELD VERIFY) J
Q
v.0' 12'-0' 12'-0
24'-0' I'b' 98'O .roe Wo.
1639
P/wE�
A - 5
FOUNDATION PLAN
JAB
P
re
ROOF CONSTRUCTION TYPICAL FLOOR o
215# COMPOSITION 5HIN64E5 ON 3/4° T.bG. FIR PLYWOOD DECKING
2x12 RIDGE BEAM NV CONT. 15# BUILDING FELT OVER /2" GLUED AND RING NAILED TO
VENT STRIP PLYWOOD 5HEATHIN6 ON RAFTERS FLOOR J015T5 AS NOTED ON
R AS NOTED ON PLANS. PLANS. s o
/lq PLYWOOD SHEATHING TYPICAL SILL
'.a• 14'-0• �'-o• TYPICAL SOFFIT
2xIO.RAFTERS® ib'O.G. Ix6 PINE FASCIA W/ Ix3 FASCIA I - 2xb KILO DRIED SILL PLATE ON
I - 2xb TREATED SILL PLATE ON
TRIM W/ GONTINUQU5 METAL DRIP I- LAYER SILL SEAL W/ NON-
2xb GL6. JOISTS® Ib'O.G. EDGE. PROVIDE /2" A.G. PLYWOOD CORROSIVE METAL ANCHOR BOLTS
a' INSULATION(R30) OR Ixl2 PINE SOFFIT BOARD W/ ® 45" O.G. (MAXJ.
_ VAPOR BARRIER CONTINUOUS VENTING A5 PER p
WOOD STRAPPING SILL TO BE 8" ABOVE FINISH GRADE p
12 12 I/x3 2'6AB. ODE S' (MIN) N
12 s Ix3 FASCIA TRIM BOARD HAi-L CONSTRUCTION TYPICAL STAIR _n
Ixb FASCIA BOARD 1/2" T.W.HARDBOgRD SIDING ON 3- 2x12 STRIN6ER5 W/AO" TREADS Qr
3'q• SOFFIT W/GONTINUGS VENT. /b° ASPENITE OR I/2" PLYWOOD (MIN) (HARDWOOD 01 /4 PLYWOOD W
5HEATHING ON 2xb STUDS ® Ib" O.G. AS PER BLD. 5PEG.) 3/4 RISERS m
BOTTOM OF JOISTS MAX. W/ R-19 BATT INSULATION. EQUALLY PAGED AND NOT TO Lu
I'-O" OVERHAN6 PROVIDE 4 MIL POLY VAPOR EXCEED 1 /4" IN RISE, FFF R
TYPICAL BARRIER ON INTERIOR W/ 1/2" Lu
0
LINE OF RAFTERS 5HEETROGK OVER.
BEYOND . `.
TI 3/4" T86 PLYWOOD
B
:E lE I 15 BEDROOM L GLUED d RING NAILED
,I = 2XIO FLOOR JOISTS® 16"D.G.
rEin YrR DOA SG+EW .E NORCO GLAD 5PEG. T�T
L
f - SUBFLOORING 2ND FLOOR
—— _ MARK OTY NUMBER
x6 ® 16" O.G.vv.5�5'UD
Y2'&AD.(INTERIOR) A 5CDH-2528 2'IQI/8"x5'�516 DOUBLE HUNG �
a �Igi4'xu'/e"Lam- BED �° GATT INSULATION NtN.B. B 5GDH-2525-2 5 i "x5'4 �6" MULLION Z
/Z'SHEATHING „ , ��
G'- SGDH-2428-3 -14 /e x5 4 �6 TRIPLE
/"T46 PLYWOOD D. SGDH-2428-2 W/TR. 4'111/ "x- (o'P/I6'�« MULLION W/ DHESG 24-2L16 ABOVE
4 CPLUED a RING.NAILEa E 5GGA-2436-I 2'0 4"x5'0 " SINGLE CASEMENT Q
M. BATH MASTER BEDROOM 2x10 FLOOR JOISTS® I6"O.G. s " ' " P.
0 6" GATT. INSULATION
F FS 606 3'8 /4 x3 I� /e FIXED SKYLITE (VELUX SPEC.)
as Ix3 GRO55 BRIDGING G SGDH-2424-2 4'II I/2 8"x4' /-4," MULLION
H 5GDH-2424-2 W/TR. 4'1I I/2"xb'101 �b"09 MULLION W/ DHE5G 24-21-16 ABOVE
5USFLOORIN6 1ST FLOOR �J
TOP OF FOUNDATION .
i 1-2x6 K.D.SILL PLATE ON Dom . p
IL
1-2xb P.T.SILL PLATE ON xx
s SEALER VV NON CORROSIVE MARK OTY DOOR 51ZE TYPE / NOTE5 O ��
_ ANCHOR BOLTS® 4'0" O.G. _
BASEMENTell I 3'O"xb'8" EXTERIOR FRONT ENTRY vv/ 2-12" 51DELITE5 0
W � 3y2° VIA. LALLY COI. „ ,
ON 2'x2'xl'GONG.PAD 2 2 8 xb 8" 6 PANEL
g 3 2'b"xb'8" b PANEL W
4" THICK GONG.SLAB 4 2'4"xb'8" b PANEL -�
5 2'8"xb'8" EXTERIOR STEEL INSULATED
FINISHED SLAB (o 2'6"xb'5" EXTERIOR FULL VIEW GLASS
- - - -- - - - - -- --- -
_ '7 5'O"x6'8" EXTERIOR DOUBLE 2'6" FULL VIEW GLA55
8 2'O"xb'8" b PANEL
q 1'4"xbW. 3 PANEL 1638
10 5'O"xb'8" BI - FOLDS
II 2-2'0"x6b" DOUBLE 6 PANEL
SECTION A 12 910"x'1'0" OVERHEAD GARAGE DOOR A - b
13
14
15
TAD
: ...........
12'-0"
O
� 0
12 O
N
12 12 12 ry
a12 W
U
w
2x(2 GLG.JOISTS 2xb GLG.J015TS W
® 16" O.G.VV R30 IN5UL. ® 16"O.G. YV R50 IN5UL. J1
3: LOFT BONUS
= _ °; HALF WALL H/ UNFINISHED
WOOD GAP
IU'VPgi)
J F J
2x10 F.J.® 16"O.G. 2-I5/4 xlb'LVL BEAM = 0 2x10 F.J.® 16" O.G. Z
J W/RI9 INSUL. � 0
�GITC+EN &RZAT ROOM -j K &AR &E
o
2x10 F.J.® I6"OG. f
w
W/Rlq INSUI..
LINE OF MAIN FLOOR BEYOND
- 0
• • n
SST
J
JM uo,
1638
SECTION - B SECTION - G PA6E,A _ -,
' tAD
22'-8' 4'-4' 4'-b' b'b' 11'-6' 14'-0'
r r r HMI
I,
G 13- xl2 HDR. 3-2x12 HDRJ G 3-2x12 HDR.
SKYLITES ABOVE ��
(ALIGN NV OUTER EDGE
pb - - •-- - -OF WINDOWS BELOW)---- - --� --- O
SEE-THRU GA o A N
DOb FIREPLACE b EARTH
CONTRACTOR TO
I I 1 I I I P U TAIR VERIFY SIZE.
I I I I I I v 14 R15ER5 W
___ GREAT ROOM ___ MA5TE Of o
3-2x10 FLUSH F.J. DOS DII -2-13/4"xlb" L CATHEDRAL GLG. ABOVE � � M o `T lL(1
SLOPED CEILING FOR FLU5F1 BEAM
(H
STAIRS TO ABOVE �p _a LINE OF BALCONY AOVE
2-2' --ANG r .J�
2--0'
B
2- _- _ - _ - 2'-4• II'8•
F3-3,)'.
- Hxl -1 /axQ�4 D02 5'OARCH d_AY3_I9/4"xll'1/e" L L BEAMF USH FLU511 BEAM 2-2XIO HD FLUSH W/FL R ABO A
(HANG F.JJ. I DORE14 RISERS —--- — (HANG FJ)DI O 4'_4 II'-8' i3, O. b._O.v 2,_44-0. 2&A A&E B D03 Z
tlll 4" CONCRETE SLAB O - O
m b" COMPACTED FILL I ® I OPEN D04 DOq Y E
wr ,� I I I RAILING 4 08 r' 3 4 t�
SLOPE FLOOR 2".TO RDS I 'L I m L 5H e�
�j OVERHEAD DOORS i - - '�
005 Y
t�Xvr PROVIDE I LAYER OF e Q I �GIT N I LL O LL
tv FIRE-RATED SHEETR K Q
v
K ADJACENT TO ALL LI OPEN O Nb I '�
SURFACES ABOVE GL L _OSET �+ p
Lu-
�-2x10 F.J.®Ib'OG.YW RA R<r�UL. i(�-2x10 F J.®1 6'. OG.YU RM I -� "o E I o (H� 4 6'-4' V-2' `D S'- - -
° UPS IRS r 3-2 10 HDR. E
G I — O
VAULTE>�GL 14 R RS x z
r � I
"r (P1:2 D12 Q -1 4 I ' VAULTED it ct't 4 ��
3-2x12 HDR. 3-2x12 HDR. �^ I I In I POI m '^
, GLG.
2.10 RAF.6 If-OL IN/RW -2xl 2xl -
3-2x1 Q
HDR.
Lu
b'b' 9'-9' 3'-N' 6'-0' 6'-0' 2'-2' 4'-10' 4'10'
24'-0' l'-b' 17-0' W-O' 12'-O" NO,
1639
PhSC'.
)A
A
MAIN FLOOR PLAN B
NTE5 ,. 1 N-01
I.8'0'CEILING HEIGHT
2.ALL INTERIOR DOOR HEADERS
TO BE 2-2x8 UNLESS OTHERWISE
NOTED.
3.ALL EXTERIOR WINDOW 3 DOOR A D
HEADERS TO BE 5-2x8 UNLESS •...�.-"•
OTHERWISE NOTED.
12'-0' IT-6' 26'-0' 5'6' S'.6. ~
� B
--------------------- -----
I ——————'— 3-2x10 HDR. i Ci
� 0
�-----1 F- --� r----� r--- -� n
I I DOWN I LINE OF SLOPED I m
14 RI- F I I I I cQ CLG. I r
a — W
— -------------�------- L W
I OPEN TO GREAT ROOMi/1�/O
I ( HALF WALL i co BELOW 24'-4'
HALR^IALL W/WOO GAP
u P05
I I LINE OF SLOPED Q DO5 P DOWN
I CEILING(TYP) '^ OPEN RAILING A P
v I I r----- LOPT. 4 DO5 '! J
I I BONUS I m_
OPEN TO to 004
UNFINISHED i LINE CLG.(:A-'SLOPED: �c BELOWFOYER n ` !3fl 0
WV 4' T-6, g II'-8' 8'-10' b'-lo' 5'-4' I'_8• 4'-4'
4'-4' o
I I 4'0" KNEEWALL I(TYPICAL) 4'0° KNEEWALL o
I
I I
II I
G I 2xIO RAFTER$!2.6 61.6.JOISTS®16'OL!W/R80 INWfAL. 4
I II I I I � -L" I n
�-- --� —————————— —————
H I ------- - -- �------- ---�
- ---
w
12'-0' —L
Q
24'-0' �'b. 12 O' 14'-0' 12'-a
----------------
Joe)io.
1639
UPPM FLOOR PLAN a Pam'
NOTES
I.010' CEILING HEIGHT
2.ALL INTERIOR DOOR HEADERS
TO BE 2-2x8 UNLESS OTHERWISE
NOTED.
3.ALL EXTERIOR WINDOW
HEADE?25 TO BE 5-2x8 UNLE5
OTHERWISE NOTED.
JAD
��.� d�
rn. rrl a rs
-7-7
7
7
7; �_,,77
:Revisions
'Ve,
k
Mystic
OBSERVATION .' HOLE, � DATA ,—— OBSERVATION HOLE ' DAT-A
Lake'
P# 9678
-TEST PIT #1 .� GRD_El_.'� TEST By: A.M. WILSON ASSOCIATES TEST PIT #2 ORD. EL. 98.7 TEST a y: A.M. WILSON ASSOCIATES Z4
"NA WITNESSED By. DONNA MIORANDI
GW. EL NA WITNESSED By: DONNA MIORANDI
GW. EL ,
.7
EL.NA CERTIFIED By. BER ARD J. YOUNG T,. 02/03/00 MOTTLING EL.NA CERTIFIED BY: BERNARD J. YOUNG 6" MAX
DATE: 02/03/0 MOTTUNG DAIE. -
o
L c s
ELEV. SURFACE SOIL SOIL SOIL SOIL ELEV. SURFACE SOIL SOIL SOIL SOIL 9.50 1.00' MIN, 3.00' MAX
COLOR MOTTLING OTHER DEPTH HORIZON TEXTURE COLOR MOTTLING OTHER
DEPTH HORIZON 'TEXTURE kJwtslo
1DRI
LEAVES, TWOS SURFACE .3" SEEDED TOPSOIL, 2% SLOPE
NEEDLES DEPTH
2 0 ,'NONE 98.7 0-3 0 NONE
Middle
97.7 -2 PEASTONE
99.5 0- 1.25 0.17 MIN
LEVEL Pond
FINE SANDY MASSIVE, FINE SANDY MASSIVE, M
'MIN 99.7 AX
97. 96.60
-10
A 'LOAM 10YR 4/3 NONE FRIABLE , 98.45 3-8 A LOAM 10YR 4/4 NONE FRIABLE huba
9 9.33 2 C3
MASSIVE, 96.5C
C3 0 C3
SILTY CLAY MASSIVE, SILTY CLAY
96.25 96 0
-196.75 TO 1-1/2-WASHED Pond
4 2
JOYR 5/6 NONE' FRIABLE LOAM 10YR 5/6 NONE FRIABLE 96.
LOAM 98.03 8-23 Bwl TRIBUTION STONE
DIS BOX
FLINT STR
94.10 Har'nbtins
SINGLE GRAIN SILTY M ASS;I VE, DB-3 H-10
GRAVELLY CRS
Pond
96.5 36-88 Cl SAN 10YR 4/6 NONE LOOSE 96.78 23-36 Bw2 CLAY 10YR 6/3 NONE FRIABLE WATER TEST
SINGLE GRAIN, GRAVELLY CRSE_' SINGI F GRAIN 6 GRAVEL ON NATIVE SOIL OR 3.00 -6 16.00
MICROFAST" 5.40
10YR 5/6 LOOSE MECHANIC/1LY COMPACTED BASE
124 C2 SAND NONE LOOSE 36-120 . SAND NONE
92. 8
7
BOTTOM OF TEST HOLE 88.70
LOCUS: MAP
22x10
'BOTTOM ELEV 88.7
BOTTOM ELEV 89.17
PERC RATE:: NOT TO SCALE
PERC RATE:
TOP PER*C HOLE TOP PERC HOLE
1 01,
NO WATER OBSERVED 0124", 46* EL95.67 <2 NO WATER OBSERVED 0 2 0 54" EL 94.2 <2
MIN./INCH IMIN./iNCH
ANALYSIS ':
SYSTEM PROFILE
NOT TO SCALE
DESIGN FLOW:
SEPTIC TANK ':REQUIREMENTS:
ASSESSORS MAP.- 102 L 0 T,20 2 BR x 110 GALZ(BR-DAY) 220 GPD
FL OOD ZONE.- C
200% DAILY FLOW 400 ;GAL�
Pro
MIN 1500 GAL
Existing TANK REOD,
Rf' 40,000 SF , jec t Title . Z.I
ZONING.
welling
100xi
F/z
ell
FRON TA CE ................... 1,50
-REQUIREMENTS: 4�!
Lot 6 LEACHING FACILITY
FRONT,-YARD......................30 opo
SIDE & REA R YA RD........ 15
Y Pr sed
LOTIS LEGALLY PRE-EXISTINGINON-CONFORMING
10
C
152
LEACHING FACILITY PROVIDED . :
9�,Xg
7J'40"E de .
L kes
(10, X 22'� +_,2 10'+2 2') X �'21 X
§8x.9
q 40- 100.00'
0."74 GAL/(SF--�DAY) 257 .GPD
Lot r
__ 100 IV
(ASSESSORSMAP 120 LO' 20)
LOT AREA = 10,000 F RESERVE: SAME
99X9
OR
0.23 ACRES
Q)
-PLAN REF- "SUBDI WSION PL A N-OF SA NO SHORE '
LOT AREA PER 301CMR15 =:12000 SF
Mars 0 S,
;--?ARE-D FOR HIA PEARL CORP.
A WOODED-AREA IN MA RS TONS Y/L L 99xj INCLUDING AREA TO CL OF IRIVATE WAY
9 7x8
L r.L) OCTOBER 1957, PREPARED BY 24,00
GIE7�ALD A. MERCER & CO.
[11qUT
ES
G �j
OVERLA Y Z RIC T I Bosketball
1. UNLESS OTHERVASE
NOTED, ALL CONSTRUCTION
Hoop D R11 VE 0
-SHALL,�-CONFORM TO,
METHODS AND MATERIALS
LLJ
0
ENVIRONMENTAL' CODE�AND` .
>
98xj
TIONS.
0
TOWN OF BARNSTABLE, RULES AND REGULA
repare( .0
V) 2. GROUTTO BE USED AT ALL' POINTS WHERE PIPES ,� P J 'F
ST# I LLJ ENTER OR LEAVE ALL-,CONCRETE, STRUCTURES IN
98x5
<
99x5
ORDER TO PROVIDE A WATERTIGHT SEAL.
Qi 5 ASSESSORS MAP 120 LOT -219
99 . 5
�Su
4.00 3. ALL SHIPLAP JOINTS IN SEPTIC TANK SHALL BE, � SAN NE `V1LL1AMS"
SEALED WITH NEOPRENE CASKETS OR ASPHALT ,
0 CEMENT TO PROVIDE A,WATERTIGHT SEAL
O' M I N
4. PRECAST, SEPTIC, TANk,' biSTRIBUTION
CONCRETE
H-10
qqx� LEACHING FACILITY TO WITHISTAND
0
Cr-J 3261,Moin Street
LOADING 'UNLESS UNDER PAVEMENT, DRIVES ' R'
arn s MAI
tcble�
5. 50 4. 00/
�N Q) TRAVELLED WAYS ,WHEREIN H-20 LOADING ,SHIALL'
02630,�,�,
z 98x2
S99- % I/ /--�
3. 00 APPLY.
2�xi
z 97x"
-BE -
IZ: Q) L PVC PIPES IN THE .,SYSfEM SHALL
5. AL
.3 001,
SDR35
c- 8 . 7
'ALL�
-SHALL FREE,,OF
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