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HomeMy WebLinkAbout0099 CROCKER ROAD - Health 99 Crocker Road West Barnstable A= 110 —015 ICI Commonwealth Of Massachusetts Executive Office Of Environmental Affairs °n Department Of Environmental Protection °`A- ?�A- TITLE 5 Official Inspection Form - Not For Voluntary Assessments Subsurface Sewage Disposal System Form Part A Certification �°mod .Property Address: 99 Crocker tM.West Barnstable Ma.02668 s Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker W.West Barnstable Ma.02668 --- Date of Inspection: 8/13/2007 ZozF,A J� Name of Inspector(please print)Sean M.Jones#SI4522 Company Name: S.M.Jones Title V Septic Inspection Mailing Address:74 Beldan Ln. - ; Centerville Ma.02632 N�� r ^ Telephone Number: 508-778-4597 C CERTIFICATION STATEMENT 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 15340 of Title 5(310 CMR 15.000).The system: X Passes Conditionally Passes Needs further evaluation by the Local Approving Authority Fails Inspectors Signature Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments: ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 1 r OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(cor u AAD) Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 Inspection Summary:Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B.System Conditionally Passes:N/A One or more system components as described in the"Conditional Pass"section need to be replaced or Repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the_for the following statements.If"not determined"please Explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally Unsound,exhibits substantial infiltration or exfiltration or the 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 structurally sound,not leaking and if a Certificate of Compliance Indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or Obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with Approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(S).The system will Pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 C.Further Evaluation is required by the Board of Health:N/A 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 310CMR 15.303(1)(b)that the System functioning in a manner that protects the public health,safety and the environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a Surface water supplyor 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 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 coliform Bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(corr wmD) Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of cesspool or privy is within Zone 1 of a public well. -T Any portion of cesspool or privy is within 50 feet of a private water supply well. X Any portion of 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pp,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] X (Yes/No)The system fails.I have determined that one or more of the above 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:N/A To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: 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 H of a public water supply well If you 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 CM15.304.The system owner should contact the appropriate regional office of the Department. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding SAS,located on site? _X_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tee,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No X _ Existing information.For example,a plan at the Board.of Health. X_ _ 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(3)(b)] L OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):-3— Number of bedrooms(actual):_3_ DESIGN flow based on 310 CMR 15.203 (for example): 110 gpd x#of bedrooms): 330 GPD Number of current residents: 2' Does residence have a garbage grinder(yes or no): no Is laundry on a separate sewage system(yes or no)_no [if yes separate report required] Laundry system inspected(yes or no):_n/a Seasonal use:(yes or no) no_ Water meter readings,if available(last 2 years usage(gpd): Sump pump(yes or no):—no Last date of occupancy/use: current COMMERCIAL/INDUSTRIAL:N/A Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping records Source of information: 7/2007 owner records Was system pumped as part of the inspection(yes or no): no If yes,volume pumped: gallons--How was this quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X 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 the system owner) Tight tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information:1978- records at BOH Were sewerage odors detected when arriving at the site(yes or no): No f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 TIGHT or HOLDING TANK: N/A (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_X (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:_0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of Leakage into or out of box,etc.): Box was level and in good condition.Box not leaking. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type X Leaching pits.Number:- 1-Leaching chambers,number: Leaching galleries,number: Leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternitave system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Soil was dry and vegetation was normal.No visible sib of ever having hydraulic failure.At time of inspection the leach pit had 3'of available leaching. 1 CESSPOOLS: N/A (cesspools 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: N/A (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.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION continued Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 10+ feet Please indicate(check)methods used to determine the high ground water elevation: I Obtained from system design plans on record-If checked,date of design plan reviewed: 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: High groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 99 Crocker Ln.West Barnstable Ma.02668 Owners Name:Joseph M.DeMartino Owners Address: 99 Crocker Ln.West Barnstable Ma.02668 Date of Inspection: 8/13/2007 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent referencelandmarks or Benchmarks.Locate all wells within 100 feet.Locate where water supply enters the building B A-1 8-1=24' A-2=2r C A s-2=.45' A--3=53' 1 C-3--6d' El 0 J "] D Town of Barnstable OF THE tp� Regulatory Services BS1A6LE Thomas F. Geiler, Director MASS.�$ 039. •0� Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. of �i�s Page: 1 of 1 CERTIFICATE OF ANALYSIS ;z ,.-V1 Barnstable County Health Laboratory (M-MA009) �9SSC �SF^i Report Prepared For: Report Dated: 9/20/2017 rQ Jeffrey Moore Order No.: G17103219 99 Crocker.Rd. W. Barnstable, MA 02668 t Laboratory ID#: 17103219-01 Description: Water-Drinking Water p',-.,Sample#: Sample Location: 99 Crocker Rd.,W.Barnstable Collected: 09/08/2017 Collected.by: Customer Received: 09/08/2017 Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as Nitrogen 3.2 mg/L 0.10 10 EPA 300.0 LAP 9/9/2017 Copper ND mg/L 0.10 1.3 EPA 200.8 LAP 9/11/2017 Iron ND mg/L 0.10 0.3 EPA 200.8 LAP 9/11/2017" pH 6.5 PH AT 25C NA 6.5-8.5 SM 4500-H-13 DCB 9/8/2017 i Sodium 21 mg/L 2.5. 20 EPA 200.8 LAP 9/11/2017 Total Coliform Present P/A 0 0 SM 9223E RG 9/8/2017 Conductance 220 umohs/cm 2.0 EPA 120.1 DCB 9/8/2017 The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria. Tested Negative for E.coli. Retesting is recommended. Sodium level is above the maxium contaminant level. Those on a low sodium diet may wish to consult a physician: t Afftached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE OF ANALYSIS Ufa i Barnstable County Health Laboratory (M-MA009) Recipient: Matrix: Water-Drinking Water Jeffrey Moore Sampled: 09/13/2017 11:15 99 Crocker Rd. Received: 09/13/2017 15:45 W. Barnstable, MA 02668 Collection Address: 99 Crocker Rd.,W.Barnstable Order#: G17103315 Sample Location: Description: . voc+TIC 1st Retest Lab ID: 17103315-01 Date Analyzed: 9/14/2017 @ 11:41 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Recommended maximum contamination level exceeded due to Coliform Bacteria.Tested Absent for E.coli.. EPA 524.2 - Volatile Organics by GC/MS Result MCL MDL Result MCL MDL Parameter ug/L ug/L. ug/L FParameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform 0.67 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Tfthloroethane ND 200 0.50 Ethlbenzene. ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2-Thchloroethane ND 5.0 0.50 Isopropylbenzene ND 0.50 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0' 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0.50 0.50 n-Pro 1,2,3-Tri��hloropropane ND pylbenzene ND 0.50 1,2,4-Thchlorobenzene ND 70 0.50 p-Isopropyltoluene ND. 0.50 1,2,4-Trimethylbenzene ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tent-Butyl benzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Tri methyl benzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND o.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 p-Bromofluorobenzene 910/0 70 1 130 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 98% 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND o.50 Attached please find the laboratory certified parameter list. Approved B (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maxi Conta ma it Lev mum 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 Page: of 1 CERTIFICATE OF ANALYSIS .: Barnstable County Health Laboratory (M-MA009) , i9sr'kCHl7 ^ Report Prepared For: Report Dated: 9/20/2017 Jeffrey Moore Order No.: G17103315 P%J 99 Crocker Rd. "Q W. Barnstable, MA 02668 -a Laboratory ID#: 17103315-01 Description: Water-Drinking Water 3 Sample#: Sample Location: 99 Crocker Rd.,W.Barnstable Collected: :,09%`13/2017 Nam. Collected by: Customer Received: 09/43/2017 Test Parameters ITEM RESULT UNITS RL MCL METHOD# .ANALYST TESTED NOTE Total Coliform Present P/A 0 0 SM9223 RG 9/13/2017 Recommended maximum contamination level exceeded due to Coliform Bacteria. Tested Absent for E.coli. Attached please find the laboratory certified parameter list. Approved B (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 +L/ iV/ iV V7 raci a.y: .)p roan JVp�V i,+v.a aaiaap Lo.uic �.is aaGpi LLIaPaJ ap.laap Lp.UiG aacai Laa �vv., vv� ?�`° CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laborator y tcHus Report Prepared For: Report Dated: 11/20/2009 Jeffrey W.Moore Old Cape SIR Order No.: G0955330 P 0 Box 2307 Orleans, MA 02653 Laboratory ID##: 0955330-01 Description: Water-Drinking Water Sample i!: Sampling Location: 99 Crocker Rd.West Barnstable,MA Collected: 11/18/2009 Collected by: Jeff Moore Map I10 Parcel 015-0-0 Received: 11/18/2009 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen 2.2 mg/L 0.10 10 EPA 300.0 11/18/2009 Copper 0.15 mg/L 0.10 1.3 SM 311 IB 11/20/2009 Iron ND mg/l. 0.10 0.3 SM3111B 11/20/2009 Sodium 14 mg/L 1.0 20 SM 3111B 11/20/2009 Total Coliform Present P/A 0 0 SM9223 11/18/2009 Conductance 170 umohs/cm 2.0 EPA 120.1 11/18/2009 pH 6.8 pH-units 0 SM 4500 H-B I t/18/2009 The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria Retesting is recommended 1 Attacbed please find the laboratory certified parameter list Approved By: (Lab Director) - 0 i ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 '~-Ig u A T 10 SEWA r� GE PERMIT N0. VILLAGE 1� 1(p ors INSTA LER'S M4NAME i ADDRESS 9 UlLDE RR OR NER DATE PERMIT ISSUED -3 I DATE COMPLIANCE ISSUED i a _f31Al a l:0- : AT110ff--/ y d VI EWAG E PERMIT N0. VILLAGE v0, �:INSTA LLER'S NAME i ADDRESS l ) a BUILDER OR AMMER DATE PERMIT ISSUED t DATE COMPLIANCE ISSUED l�`S 7� � � � 1 ` �, t ��.` �_ �� � _, -l� /�� � � ,_ �, �•� �� �. ,S'�s �f� 1 �� a � � — V �. No......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (®c --------------OF......................................----...-----......---------............._......._ jo _. Appliration for 11isposal Works Tonstrurtinn rjermit Application is hereby made for a Permit to Construct (✓f or Repair ( ) an Individual Sewage Disposal System at: hh �} ` Location-Address or Lot No. Owner •...............................Address Installer Address UType of Building Size Lot:. ` ;. �. .....Sq. feet ,. Dwelling—No. of Bedrooms......... ..............................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. . W Design Flow. ........... ..gallons per person per day. Total daily flow........s s ......................gallons. . WSeptic Tank--Liquid capacit .SWP..gallons Length................ Width..............:. Diameter---------------- Depth......... x Disposal Trench—No. .................... Wid ................. Total Length........ Total leaching area.._.....:..._.. sq. ft. Seepage Pit No.......t_____________ Diameter...IV.._....__ Depth below inlet........ ...:_. Total leaching area.J.��..sq. ft. Z Other Distribution box ( ) Dosing tank ( '-' �Percolation Test Results Performed by._A.L_r!xt............ s. l- SS�7_C........ Date...�`?._D Test Pit No. 1...._ ......minutes per inch Depth of Test Pit.................... Depth to ground water......................... fs, Test Pit. No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ ^ --------••--•-•••-.... •••-•---•.....................•-------------.......----..._......-----•----------•----•-------•------•--.....-------•----•----....-- Description of ----- . --�: ...9 .00.--- UWQ -ASS s:o�---------------------------------------------------------- Nature of Repairs or Alterations—Answer when applicable___________________________________________________•......__._.........._...................... ---•---•-•----•----•----••-•-•-•----.....-•---•-••----•----•-•-•••---•--•-•....................................••-•-••--•-•-•-••--••-•----•--•••--------••----•••••-••--•••----•---•--•............••-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha een issued by�he b rd of health. Si/ne ----- ------- -- . = � '�-9 - _ _ Date Application Approved B .... � ` PP PP Y ,rr ...... � . •�--------------- J T _.. . Date Application Disapproved for the following reasons-----------------•------------------•-------------------------------------------•----------------......-----•---- ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued..G....... _.......... Date � THE COMMONWEALTH OF MASSACHUSETTS Y' BOARD OF HEALTH O F....................................... ------............................................ Atipfiration for Bisplo ii al 18orkii Toutitrnrtinn rautit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: , t� S�c�Lc ...... C s:...1cQ `� ........................... ,. ..... ....................................•............................................................. Location-Add' ss or Lot No. ------------ ................................................................................................. Owner Address.........--••................... Installer Address d Type of Building Size Lot_._� :......Sq. feet U Dwelling No. of Bedrooms._.._.;3.................................Expansion Attic ( ) Garage Grinder ( ) aOther—Type of Building ............................ No. of persons__-.-____-__•-.•-.__-__-.___ Showers ( ) — Cafeteria ( ) Q' Other fiacttt>:es-.. W Design Flow,..............� ......_._.......___gallons per person per day. Total daily flow......3s.�.._.__........ --------------gallons. WSeptic Tank!-Liquid capacity/.S0.gallons Length---------------- Width................ Diameter................ Depth..._............ x Disposal Trench—No..................... Widyb................. Total Length...... ___... Total leaching area..__.___.____ff...sq. ft. Seepage Pit No......I-__._____. - Diameter.................... Depth below inlet........ Total leaching area-.k...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. 1____ __________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........................ RI' ......................................... ...... .................................................... 0 Description of Soil a m 'k rf - 4E4 -t..9 ? C r! —P t.. rat e l - tca� tO 5_c�.4_t__f ctr► cctf ._ '� �?_. ns . UNature of Repairs or Alterations—Answer when applicable._.............................................................................................. ---------------•---....----------------------------------------•-----------•---------------------------•--------------------------•............•-------------•-....................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITTIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h een issued b t bo rd of health. Signed. ; - A .�.------ ---------- ----------, -.-•---.-_-_-.. -----•--- :� Date Application Approved By....... L E /� L= 1= ------------•-------•- — � f c. ` Date Application Disapproved for the following reasons:---•-•--------•-----------------------------------------•---------------------.....-••--._...----•-•--•--..._... --•------•----------------••••-•------------------•------------•-•--------•------..•..---------•--•--•--.•--•--•-•-•---•------••---•-----•------...-•-••••--•••-•-•-•••---•--•------------••--•-•------- Date PermitNo......................................................... Issued-.................---------------...----------------.... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... ly................OF............. ::. Liz...-.............................. ...... r#ifirFatr limpriFana ThiJIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) b .--....... .. .....y k Installer at..................••......•. ' �� . •------- ------•-- -----------------------------------------------------------------------------------•----.•..._ has be i s l in 1�ccohda�wrtk �pr� i �5 of The State Sanitary Cod as descri ed in the applicatio or Disposal Works Construction Permit No........�) d S � - P.m' --- ------ dated ----------------------•......--••-•-• THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A UARANTEE THAT THE SYSTEM WILL FUNCTION eSATISFACTORY. DATE.. 7a -= 5.. Inspector . ...............-----•-- ................... - .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 07F t. -/� ..... ..........OF...... -•----............................ ............................... N0.... ................ .. FEE.::.:-•=�-•-.......... -.... ; ��d�t���a.� .kc /t'. ,� 4 Per issio ;hereby granted............. . •••_-=- to Con uc ) r Repair ( an ge Disposal System at NoT- :... f G`1 tion for Disposal Works Construction Permit ..._..- ed.......................................... �'S as shown on the application � �� , n. f B d f .............._ ✓r -- ---- - f DATE----.. oar o Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS X 4.7 ,r tam _ 2 - - . ,!',ir.•a� - - •. � • _ � ,1 _ . . yr- . ... _ r -Wid, -r► TJll 1 ' too I v� .� � ��..� �r'�r`• :=,� �tiF .-f ::��'r�r�:_ wl =s �'..-•max•,''=, �; r � - �3,2 p 2 i •:; ,, ��� �tom.�"*'`-�, l�f� E,�.���±-=-� �'-•IN t�'�:. I, � f !�pi �r!��. "rf.f 1 K• - p'�C PV'I t 4':f;'S ITT _ _ ! 1 GoD•�� �-�i Ff,c�• i,:' °I�j.�17 ti .;;y,_;;,� — ''� ^'•�i.;.t-s r•F��- ,'•�.�/ � ,��7 t7 t may/ Q--- �' ��r� __.� ..�.�... _--.:rs+�.lw-...._ � .... r j-J-/_ .. �rl�t��✓ 7V"�r'�'�' �✓• 1•�r"�L� i All- too I !�O�• I IH —' I�— I Ali FERIA MA fly,urn S:o pf y ;Tr 21 ff S14 TO I' �11�.GF lt�r{-S•�...7��1'C�?� s ��''• r.f,0� �+p4'�'Z. 1-7 N NaMaW I°IT7 99 CROCKER ROAD BCH RICK ROY JEFF MOORE CON S 'rRUCTION LLC www.RickRoyConstruction.com PROJECT INFORMATION CONTRACTOR/Y GER RICK OY CONSTRUICTION 3^ 123A QUEEN ANNE ROAD HARWICH�MA F � °»•' i�' 508-432-S840 ' PROJECT ADDRESS:99 CROCKER ROAD,WEST BARNSTABLE,MA R 32-4814 MCAST.NEr i PROPERTY OWNER:JEFF MOORE PROJECT DESCRIPTION:ADDITION TO AN EXISTING GARAGE ZONING INFORMATION:RF FRONT SETBACK: 30' SIDE SETBACK: 15' REAR SETBACK: 15' FLOOD INFORMATION:NOT IN FLOOD ZONE AUTHORITY HAVING JURISDICTIOWTOWN OF BARNSTABLE CODES:MSBC,7TH EDITION efi £ Sheet List Sheet Number Sheet Name No. Description Date A0.1 PROJECT INFORMATION A1.1 SITE PLAN A1.2 FLOOR PLAN A2.1 EXTERIOR ELEVATIONS A5.1 EXISTING PHOTOGRAPHS S1.1 FOUNDATION PLAN S1.2 I FRAMING SECTIONS VICINITY MAP LOCATION MAP ��� a \ JEFF MOORE ell' t © 99 CROCKER ROAD p q " PROJECT INFORMATION \ { f t All\ \ , ut \ E at tz WR qi;t v zk; i yak ex ���.' yt +` , �� aM { '� � a am $ a M,4 km \< W PERMIT SET �$ 3r w„ +' ` ` . . � ,x•a'\ � s� ga� 3\; Drawn by - AG '�', g ITO fa.* &`' ✓�' � Checked by AG 47 C t_ •'., + °: ._ 1..:., f;:.., a :.. o � (� f ((�� (''�4 cm»� :.. ,� ...�L1 �'1G� v a '�x "n$ cF ' " �\a� ` r'. �P e Scale RICK ROY CONSTRUCTION , _ _ — - - - - - - - - - - -� LLc � o www.RickRoyConstruction.com / 7 / CONTRACTOR/DESIGNER RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD HARWICH,MA 508-432-088 4 RROYCON@COMCAST.NEf EXISTING 2 STORY HOUSE / >S 0• EXISTING GARAGE HATCHED REGION / SHOWS AREA OF NEW WORK No. Description Date JEFFMOORE \ s o � 99 CROCKER ROAD SITE PLAN SITE PLAN BASED ON ATTCHED SURVEY PERMIT SET 1 Site Plan Draw by AG 1"=30'-0" ., Checked try AG A1 . 1 6i W Scale 1"=30'-0" Q Dc RICKROY 9-11 1/4" 24,-3• CONS T R U C 'T I ON L1,C Az.1 www.RickRoyConstrucbon.com 5 1 S12 GEgg� R/DESIGNER R CONSTRUCTION 123A QUEEN ANNE ROAD HARWICH,MA 508-432-6840 - - 508-432-4814 RROYCON@COMCAST.NET J. j. V . l+l n i(1 F -• - No. Deseiiplion Date Bo 2 S1.2 JEFF MOORE MEMO 99 CROCKER ROAD 2# 3" I, FLOOR PLAN 7 A2.1 n First Floor PERMIT SET Drawn by AG Checked by AG A1 .2 p W Scale 1/4"=1'-0" RCR EXISTING CEDAR ROOF RICK TO REMAIN ON EXISTING C 0 N S T x U C T I 0 N GARAGE ADDITION LLC www.Ric*RoyConstruction.com CONTRACTOR/DESIGNER _ — RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD EXISTING/DEMOLITION NORTH HARVOCH,MA 5 PROPOSED NORTH ELEVATION ELEVATION 508-432-4814 08-a32-4eao 1/8"=1'-0" 1 1/8"=1'-0" RROYCON@COMCAST.NET NEW ADDITION AND EXISTING MAIN ROOF TO RECIEVE NEW ARCHITECTURAL ASPHALT SHINGLES NEW DOUBLE HUNG WINDOW TO MATCH EXISTING — TW2646 rm 'Li Li SIDING TO OVERLAP — . --, -:-.,m. , MN CONCRETE FOUNDATION WALL.EXPOSED PORTION EXISTING/DEMOLITION EAST OF FOUNDATION WALL 6 PROP OSED EAST ELEVATION 2 ELEVATION NOT TO EXCEED 18" 118"=1'-0" 1/8"=T-0" REMOVE EXISTING SIDING TO OVERLAP TRIM AND RAFTER CONCRETE FOUNDATION ENDS WALL.EXPOSED PORTION OF FOUNDATION WALL NOT TO EXCEED 18" --------------- No. Description Date ® - - - I I-III -I I TO - EXISTING/DEMOLITION SOUTH n PROPOSED SOUTH ELEVATION ELEVATION JEFF MOORE 99 CROCKER ROAD NEW 9'X8'GARAGE DOOR EXTERIOR ELEVATIONS NEW 60"X 80"9 nnnn LITE DOUBLE DOOR PERMIT SET EXISTING/DEMOLITION WEST n PROPOSED WEST ELEVATION 4 ELEVATION Drawn by AG 1'-0" Checked by AG A2. 1 Scale 1/8"=T-0" Q 3l RICK ROY =, NEW ADDITION ON THIS SIDE OF EXISTING GARAGE CON STRUCTION LLC. `', •'' ""�, ',: ,, r> r,, ,� ... ,, www.RickRoyConstruction.com E CONTRACTOR/DESIGNER RICK ROY CONSTRUCTION a 123A QUEEN ANNE ROAD HARWICH,MA 508-432-6840 508-432.4814 u RROYCON@COMCAST.NET I s No. Description Date t JEFF MOORE 99 CROCKER ROAD EXISTING PHOTOGRAPHS g PERMIT SET Drawn by AG Checked by AG i a A5.1 0 . - Scale w RCRICK ROY CO3NS 'TRUCT' iON LLC www.RickRoyConstrucbon.com 9'-11 1/4" 24'-3" CONTRACTOR/DESIGNER RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD HARWICH,MA - _ 508-432�840 508-432 3814 RROYCON@COMCAST.NET EXISTING 3'9"FOUNDATION WALL WITH 16 X8 FOOTING bo NEW AND EXISTING 77 FOUNDATION TO ALIGN NEW AND EXISTING FOUNDATION TO ALIGN NEW 8"X 4'-3"FOUNDATION WALL WITH 16"X 8"FOOTING No. Description Date NEW 8"X 4'-3"FOUNDATION WALL WITH 16"X 8"FOOTING SEE S1.2 FOR MORE INFORMATION:' NEW 8"X 7'-9"FOUNDATION WALL WITH 16"X8"FOOTING NEW 4"CONCRETE SLAB SLOPED TO DOOR. JEFF MOORE 0. 99 CROCKER ROAD FOUNDATION PLAN 24'-3" - - 0 FOUNDATION PLAN 1/4"=1'-0" PERMIT SET Drawn by AG Checked by AG S1 . 1 o Scale 1/4" RICK CONSTRUCTJ0N NEW 2X4 WALL LLG Roof /1 NEW 2x10 @ 16"O.0 18'-0" www.RickRoyConstruction.com EXISTING 2X6 @ 16"O.C. NEW 2X8 @ 16"O.C. CONTRACTOR/DESIGNER EXISTING 2X8 @ 16"O.C. RICK ROY CONSTRUCTION 123A QUEEN ANNE ROAD 2 HARWICH,MA 508-432-6840 S1.2 ® 508-432-4814 RROYCON@COMCAST.NET i� o _ _ T.O.PLATE — — — 9'-9 1/2„ V EXISTING 2X4 @ 16"O.C. STUD WALL WITH CDX SHEATHING EXISTING 8"CONCRETE -s m 9 �-( W WALL, 3FOOT FOOTING POURWITH 6 X 8 U� nJ EXISTING 4"CONCRETE SLAB Lrju GRADE First Floor p _p — — T.O.Footing n -2'-9„—V B.O.Footin _3' S n Section 1 1 No. Description Date S1.2 T.O.PLATE JEFF MOORE F GRADE 99 CROCKER ROAD 1' FRAMING SECTIONS T.O_Footin _ -2'-9 B.O.Footin -3'-5" PERMIT SET Dram by AG ��Section 2 Checked by AG S1 .2 Scale 1/4"=T-0" CHOCKL.'H HVAV 273.37 < . 9g • v PARCEL A \9 S.0 Q O s, Q 74-f 5'���G�E 3 4 0,88 138.03 PARCEL e - � ���s`• � PLOT PLAN OF LAND /N EA RNS TA MASS PREPARED FOR YAWT SURVEY CONSUL rANrS 14/ ROUTE /49 JOSEPH DeMARrINC MARSTONS MILLS, MASS. O 40 BO /20 02648 SCALE /"= 40 feel November A,, 1987 RES. ZONE- RF FL OOD. ZONE: C PLA4V BOOK 39/- 97 /7 7D