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Home My WebLink About0279 HIGH STREET - Health i West Barnstable CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory N Report Prepared For: Report Dated: 12/14/2006 Joan K.Tompkins Order No.: G0639025 P O Box 568 West Barnstable, MA 02668 Laboratory ID#: 0639025-01 Description: Water-Drinking Water Sample#: Sampling Location 279 High St.W.Barnstable,MA Collected: 12/13/2006 Collected by: .J.Tompkins Map 111 Parcel 018 Received: 12/13/2006 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen 2.8 mg/L 0.10 10 EPA 300.0 12/13/2006 Copper 0.61 mg/L 0.10 1.3 SM 3111B 12/14/2006 Iron 0.11 mg/L 0.10 0.3 SM 3111B 12/14/20061 Sodium 16 mg/L 1.0 20 SM 311113 12/14/2006 Total Coliform Absent P/A 0 0 SM9223 12/13/2006 Conductance 140 umohs/cm 2.0 EPA 120.1 12/13/2006 pH 6.3 pH-units 0 EPA 150.1 12/13/2006 Water sample meets the recommended limits for drinking water of all the above tested parameters. Approved By: (La7D' or) a r-T1 C- Cn N ' �tr �A' a ® co W P' MCL=Maximum Contaminant Level RL = Reporting Limit Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 �FHAk3' :Lj IVE, 1 CERTIFICATE OF ANALYSIS �r trituS'�� Barnstable County Health Laboratory L Report Prepared For: Report Dated: 5/9/20033 �I- Order Number: Joan K.Tompkins MAP P O Box 508 PARCEL ' West Barnstable, MA 02668 LOT Laboratory ID#: 0319519-01 Description: Water-Drinldng Water Sample#: 19519 Sampling Location: 279 High Street,West Barnstable Collected 4/28/2003 Collected by: Joan K.Tom Received 4/28/2003 Routine. ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates 8.9 mg/L 10 EPA 300.0 4/29/2003 LAB: Metals Copper 0.5 mg/L 1.3 SM 3111B 5/2/2003 Iron 0.1 mg/L 0.3 SM 3111E 5/2/2003 Sodium 13 mg/L 20 SM 311113 5/2/2003 LAB: Microbiology Total Coliform Absent P/A Absent 309 4/28/2003 LAB: Physical Chemistry Conductance 187 umohs/cm EPA 120.1 4/28/2003 pH 6.4 pH-units EPA 150.1 4/28/2003 Note: Sample has higher than average levels of Nitrates.Monitoring is recommended(2-3 times per year)to establish any upward trends. +. Approved By: 4v L' (Lab Director) 1 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 TOWN OF BARNSTABLE LOCATION Vl-g SEWAGE # VILLAGE . %& SSESSOR'S MAP & LOT hif ,, 619 INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY ® ? LEACHING FACILITYAtype) (size) NO. OF BEDROOMS �RIVATiOR PUBLIC WATER BUILDER OR OWNER 10 DATE PERMIT ISSUED: 9,1 DATE COMPLIANCE ISSUED: _ -� VARIANCE GRANTED: Yes No b� TOWN OF BARNSTABLE LOCATIQN ' e4z ,u,, SEWAGE # VILLAGE �, �'�,�, f�f ASSESSOR'S MAP Q LOT d INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type (size) 2ti XlO�ob NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER c BUILDER OR OWNER v-- r DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� _ �° `� �� // / 4 I .r_�, THE COMMONWEALTH OF MASSACHUSETTS APPROVED Gam nble Cons®nr8*m ^ ,w BOARD OF HEALTH y_T7OWN OF BARNSTABLE "edlirat ? for Di-lipuual Work,5 Tomstrnrtiun Frrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .............................................. -•--•--••-•----------•...................•-----•-••-. ..........................--------------•- Location•Add�ess or Lot No. �� .................................... ..............................................................................................•... 'Owner ._ AddT ss Installer Address Ue of Building Size Lot............................Sq. feet �. Dwelling—No. of Bedrooms____________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter....------------ Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..-__-._--_-----.-_ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit..------------------ Depth to ground water....................... (i Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 9 -----------------------------•-•-••-••----•••••---•-•••--•-••-----•••-•----•-------•..........-••---......................................................... 0 Description of Soil......................................................................................................................................................................... V W --------------- ................................................. ............ ............................... ��-,� Nature of Repairs or Alterations—Answer when, applicable._-___ f Z'e-,'Co�-� .-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli t, e een ssued by t Ve boa•d of health. Sign .......- -- ............... .....'--------...-......... ............................................. Dare.................. Application Approved BY - tie ..a-:S------------------------------------------------------------ - t<- oa e- .. Application Disapproved for the following reasons: ....................... .................................... ...................................... ........................ ..............----------------`----------------------------------........_........----------...-----.......-..-------------------------------........._..........---........-----.......... ------ ...------Dare------- ..-------- Permit No. ..........f 3- -57+6................... Issued ......-- .................................... -- ------ Dare —————————————————————— ———————————————————— ------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE OlVdifi a e Df C�umpliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( N_--o) by .. ..... ............. \ --------...---------_.......-----------...-..-........-..-------...... --------------------------- .---- .---- --.... .....--------.....---------------- - qInsmller at ........... ----f 4_k-. .. - .... J T .....�.... Y..... ------------------------------------------------------- -------------------------------------------------------- has been installed in aYcordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. 6.-------------- dated .......__......................._...--..-_. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------------------------------------------ Inspector ....------...-------------------------..------------------------..-------------------------- NO - FEs... Z r................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 3TOWN OF BARNSTABLE Alr.pftrtt#intt for Mitip W Work,6 Tons#rur#inn Prruti# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -- .••--------------•------.-..--••..._..... .-•--•--------------•••-.-----•••-.--•__-•__ -•- •-......___••-___--•___....___-...__--__-- Location-Add or Lot No...•...................................... Ow r Add- ss Installer Address d CType of Building Size Lot............................Sq. feet U Dwelling— No. of Bedrooms-------- ______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- -----------------------------•-•-•-----•---------•----•----- W Design Flow............................________________gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width---------------- Diameter____--_-_____-__ Depth................ Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_______-_-_-.------ Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ a ,.a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-____-__-___________-_. Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------------------•-------------------------------•----•----••-----••••_--••••......................................................... Descriptionof Soil---------------•----------'----------------------------------------------------r-----------------------•--------•------•--•---•-----•---•---•---•--•--•-----------•-•--- x - V ........................•--...---------•----•-•--•--••-----•----•-------•---•---------•--•-----•---•-•-•-••--•-------•-•-•=r••--------...---•-------...•-•-•--•-..._..._.__......_...•-•._._.._._._...--- W _.._..._..-•----------------------------------•-----._......-.-.._-..._..........-------_-_...._.._•----_--- U Nature of Repairs or Alterations—Answer when applicable_ --- -__../t?'�4c f ______________ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia•ce� ssued by tk e board of health. Signe ............. ........... Dace Application Approved By ------------- ----.,-,,-...-........_ 'w,,�=v.<- I! -... .....-..,�'�--'` .. ----------...............................----.....----........--........ Dare Application Disapproved for the following reasons: ------------------------------------------------------_-------- ------------------------------------ ----------------------- ----- ---------------------------------- Dare PermitNo. ......... ..Z:- .... ------------------- Issued ........................................................ Dare _._——————————— ——--————————————————.—.——— THE COMMONWEALTH OF MASSACHUSETTS S BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Qlamplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repairedby ( ) ........................ f-.-. -. AN .rah ----------------------_-----. ---.-------------------------.----------.--------------- " mcraued� at 7 9 -W - , tk -,T \I ! h, ,.�,>0�-1 E ...._. ......... . ........................: ---------- -- -r - - -- - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. _. .- ---_�_V— ............... dated .-------._..........................._..._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---- -----------l.l -- K f -----------............------------------------- Inspector ..... ------------------`-------------------------...---------- --- ----------------------------- --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No..... - `� FEE........... Owpnoal Workv �nn> #rut~tinn rruti# Permission is hereby granted.........._ -4�.................................. to Construct (y) or Repair ( ) an Individual Sewage Disposal System at No S" i fr 1 1�1. --?--GOa, .._.... -----.•-•-•---•--•--------•--•-•-•----•-•--------- ---•------._... -------------------•--•-•---•----•--------- .................................. L Street as shown on the application for Disposal Works Construction Permit No------:____--______ Dated........................................... ti N ',� ••---....•-•-••--__---�---•• ------------------------------------- ........... i• '� Board of Health DATE = _ --------------•-•--•---------------•---- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS