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Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal.System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
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,
use only the tab 1. Inspector:
key to move your
cursor-do not Michael Kellett
use the return Name of Inspector
key.
Aardvark Environmental Inspections
Company Name
PO Box 896
Company Address
East Dennis MA 02641
Cityfrown State Zip Code
508-385-7608 S13742
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. l am a DEP approved system inspector pursuant to ction 15.340 of
Title 5(310 CMR,15.000).The system: `'> --i
.; T. C�)
® Passes ❑ Conditionally Passes ❑ Fails $
❑ Needs Further Evaluation by the Local Approving Authority
07/05/12 c J
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP.The original should be sent to the system owner
and copies sent to the buyer,if applicable,and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17
r
Commonwealth of Massachusetts
- Title 5 Official Inspection Fora
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'< 1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. Citylrown 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:
® 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:
❑ 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 Tihe 5Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. City/rown 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 mannerwhich 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
tSins•Vul^V i iue 50"lk- i iniSp�eGiOri Ft71m aLibsui ac6 Sefwadge Di3pmM Syalem•Page 3 ut 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
eys 1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. Cityrrown 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-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. City/Town State Zip Code Date of Inspection
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.
❑ ® 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 Form:Subsurface Sewage Disposal System•Page 5 of 17
I
Commonwealth of Massachusetts
N F Title 5 Official Inspection Form
s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. CitylTown 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
® ❑ information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5ins-11110 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
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. City[Town State Zip Code Date of Inspection.
D. System Information
Description'.
Number of current residents: 2
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
Water meter readings, if available last 2 ears usage d well
9 ( Y 9 (gP ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: current
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 5Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Fora
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is West Barnstable MA 02668 07/02/12
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:
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes,volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes,attach previous inspection records,if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)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):
t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
12/17/09 per BOH
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 1.7
feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints,venting,evidence of leakage,etc.):
Septic Tank(locate on site plan):
1.0
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑polyethylene ❑ other(explain)
If tank is metal,list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1,500 gal
3"
Sludge depth:
t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
a Title 5 official Inspection Form
Subsurtace Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
28"
Scum thickness
4"
Distance from top of scum to top of outlet tee or baffle
5"
Distance from bottom of scum to bottom of outlet tee or baffle
16"
How were dimensions determined? Measured
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,
liquid levels as related to outlet invert,evidence of leakage,etc.):
The tank was sound and tight with tees in place and liquid at outlet invert.
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
w 1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,
liquid levels as related to outlet invert,evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
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
f .
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert even
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.):
The box was level and tight with no sign of carryover.
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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
.r 1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 8
❑ 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.):
This system has a 6 infiltrators in a 22'x25'stone field.There was no sign of ponding or failure in the
stones.
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 Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Fora
ol Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
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-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
I
Commonwealth of Massachusetts
IFTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is West Barnstable MA 02668 07/02/12
required for every City/Town State Zip Code Date of Inspection
page-
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:
0 hand-sketch in the area below
❑ drawing attached separately
�ro
Tide 8 oftlal lnspeeaun Femt:SubsuRtce swage Disposal System•Page 15 of 17
t5ins•11110
7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
's Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every West Barnstable MA 02668 07/02/12
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
❑ Shallow wells
20.0
Estimated depth to high ground water: feet
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked,date of design plan reviewed: Date
❑ Obseved 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:
USGS maps show an elevation of over 20.0 feet.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•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
1610 Main Street
Property Address
Elizabeth Miller
Owner Owner's Name
information is required for every west Barnstable MA 02668 07/02/12
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
COMMONWEALTH OF MASSACHUSETTS
z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
a DEPARTMENT OF ENVIRONMENTAL PROTECTION
r
MAP�M Sye
FAILED INSPECTION PARCEL • ®2 3
Lot ;
TITLE 5
OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
t
Property Address: twoA
Owner's Name:
Owner's Address: 4 `t.
RECEIVED
Date of Inspection:
Name of Inspector: plea e p int) � Oolq JUL 4 2003
Company Name ,
' TOWN OF BARNSTABLE
Mailing Address: HEALTH DEPT.
A 0
Telephone Number: 9
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 15.340 of Title 5(310 CMR 15.000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's.Signature: Date: 64t-f03
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
r
****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.
Title 5 Inspection Form 6/15/20.00 page 1
1
Page 2 of l]
-4;
OFFICIAL INSPECTION FORM-NOT FOR.VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL`SYSTEM INSPECTION FORM
r PART A
CERTIFICATION (continued)
Property-Address:" 6
Own Jr:y
Date of Inspect' n:
Inspection`Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. .System Passes:
I have not found any information which indicates that any of the failure criteria described in 3 10 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,%.ill'pass.
Answer yes,no or not determined(Y,N;ND)in the for the following statements.If"not determined"please
explain.
The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or:tank failure is imminent:System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board.of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static^water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will 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:
2
t
' Page 3 of-1 I
OFFICIAL.INSPECTION FORM -.NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE.SEWAGE.DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:
Owner
Date of Inspe ion. ,/J(� a 3 ���
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.
I. 'System will pass urless Board of Health determines in accordance with.310�CMR 15.303(1)(b) that the
system is not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health (and Public Water Supplier, if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a,
surface water supply or tributary to a surface water supply,
The system.has a.septic rank 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 we11**. Method used to determine distance
**This system passes if the well water analysis,performed at a DEP certified,laboratory, for coliform
bacteria and volatile o,lganic 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 trigg-.red. A copy of the analysis must be attached to this form.
s
3. Other:
3
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:
�X/A
Owner:
Date of Inspect' U�
A System Failure Criteria applicable to all systems:
.You must indicate"yes"or"no"to each of the following for all inspections:
Y� 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
4/ Static liquid level in the distribution box above outlet invertdue to an overloaded or clogged SAS or
cesspool
Liquid depth in cesspool is less than 6"below invert or available volume is less than!/Z day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
of times pumped
_ Any portion of the SAS,cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feet of.a surface water supply or tributary to a surface
water supply.
i -J 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 coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and thepresence,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.]
(Yes/No)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 Y
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 facilitywith a design flow of.10;000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
the system i.s 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—I WPA)or a mapped
Zone 11 of 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.
4
t
Page 5 of 11.
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property.Address: /() / `n_,Q
P
Owner•
Date of Inspe on: '--Cj
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
_1Z 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?
-6Z1 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 availab.le note as N/A)
i� 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.
j _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition
oI`the baffles or tees, material of construction,dimensions, depth of liquid, depth.of sludge and depth of scum?
/_ Was.the facility owner(and occupants if different from owner)provided with information on the proper
mamtenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)or.the site has been determined based on:
Yes no
lZ — 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(3)(b)]
5
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: A
Owner
Date of Inspec"' n:
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):- Number of bedrooms(actual):
DESIGN'flow based on 310 CMR I S.M (for example: 110 gpd x#of bedrooms):
Number of current residentsdp q xe.6
Does residence have a garbage grinder(yes or no):
Is laundry on a separate sewage system (yes or'no)• L&.[if yes separate inspection required]
Laundry system inspected(yes or no
Seasonal use: (yes or no)/
• ry � 4
Watero (gpd)): l Gq1
meter readings, i of vailable(last 2 years usage
Sump pump(yes or no •
Last date of occupanc --
CO.MMERCIAL/INDUSTRIALjk&
Type of establishment.
Design flow(based on 310 CMR 15.2.03): 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:�z.e
Was system pumped as part of tU inspectiod(y6eor.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 froth system owner)
Tight tank _Attach a copy'of the DEP approval
Other'(describe):
A oximate age of all.components,date installed (if known)and source of information:
61
Were sewage odors detected when arriving at the site(yes or no):._
6 i
r
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM.INFORMATION(continued)
Property Address: Zo
Owner:
Date of Inspec 'on:
BUILDING SEWER(locate on site plan)/Xe-
Depth:below grade:
Materials of construction:_cast iron. _40 PVC_other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints, venting,evidence of leakage,etc.):
SEPTIC TANK: !:�-1610cate on site plan)
Depth below grade:
Material of construction: concrete_metal_fiberglass_polyethylene
_other(explain)
if tank is metal list age:_ is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of
certificate)
Dimensions:9,Ge
Sludge depth:_ �Ll
Distance from top of sludge to bottom of outlet tee.or baffle:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle: 6 eWf
Distance.from bottom of scum to bottom of outlet tee or baffle: 9 ,,5e O w Ire
How were dimensions determined:
Comments(on pumping recommen ations, nlet and outlet tee or baffle condition, structural integrity, liquid levels
related to outlet invert,a idence of leaka e,etc.)
/ a /
42
GREASE TRAP locate on site plan)
Depth below grade:_
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:
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels .
as related to outlet invert,evidence of leakage,etc.):
7
I
t ,
Page 8 of l 1
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property.Address: '.daci,
�.
Owner:
Date of lnspe on: 3
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 now: 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:jZ(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invertF �bequal,,Comments(note if box is level and distribution to outlets any evidence of solids carryover, any evidence of
kage into or oul of box,e c.):
PUMP CHAMBER(locate on site plan)
Pumps in working order(yes or no): s
Alarms in working order(yes or no): =.Y
Comments(note.condition of pump chamber,condition of pumps and appurtenances,etc.):
8
Page 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
HA
Owner:
Date of Inspe on:
SOIL ABSORPTION SYSTEM (SAS): locate on site plan,excavation not required)
If SAS not located.explain why:
Type
leaching pits,.number:
leaching chambers,number:
leaching galleries;number:, r
aching trenches,number,length:
leaching fields,number, dimensions:
overflow cesspool,number:
innovative/altemative system Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation,
etc
CESSPOOL (eesspool 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.Alocate 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.):-
9
Page 10 of 11
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: d
/ ;1-1A
Owner:
Date of Inspect an:
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate ail wells:within 100 feet.Locate where public water supply enters the building.
C:
9 '
o0 '
t -
10
Page l l of I 1
OFFICIAL.INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
Owner:
Date of Inspecti n: (j3
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please.indicate(check).all methods used to determine the high ground water elevation:
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:
11
Permit Number: ,may Date:
Completed by: i�
HIGH GROUND-WATER LEVEL COMPUTATION
Site Location: l�/`(/ /�✓( �� r �e45I.-A ,/C�Lot No.
Owner: Address:'
Contractor: Address: �JrAf �y ept �yAW_
r
" Notes:
STEP 1 Measure depth to water table "
to nearest 1/10 ft. .......................... Date
month/day/year
STEP 2 'Using Water-Level Range Zone
and Index Well'Map locate
site and deterrine:
® Appropriate index well......................... . / 27y7
OBWater-level range zone ................................................;:.....
STEP 3 Using mont-fly report "Current
Water Resources Conditions"
determine"current depth to
• water level or index well .......::..................
month/year
STEP 4 using Table of.Water-Ievel.Adjustments,
for index well (STEP 2A), current depth
to Water level for index.well (STEP 3).,
'and water-level zone (STEP 2B)
.......:.
determine water-level adjustment-............. 7....................................................................
STEP 5 . Estimate depth to high"water
by subtracting the water-
level adjustment (STEP 4)
from measured"depth to water
level at site (STEP 1)".:..................................:...... ....:..............::.....:... /. °�!
Figure 13.--Reproducible computation Iorm.
15 .
[ �� -.y LF
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1
BARNSTABLE COUNTY
WATER QUALITY LABORATORY DIVISION
DEPARTMENT OF HEALTH & ENVIRONMENT
SUPERIOR COURTHOUSE
P.O. BOX 427, BARNSTABLE, MA. 02630
Telephone #508-375-6605
FAX # 508-362-7103
FAX TRANSMITTAL
DATE: tq/ /U
TO: &aLsTA& E 67L—L—E
a cc'
FROM: ICU VV l L
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#Pages (including this cover sheet)
i
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Goo/1001Z geZg}ZeaH AID atg24suzeg £0TLZ9£805 RK3 Dt, :6 QHM 600Z/8T/TT
CERTIFICATE OF ANALYSIS�`� r• Page: 1
y Barnstable County Health Laboratory
yss�L�,tict^�I Report Prepared For: Report Dated: 10/23/2009
Shaun F.Harrington
All Cape Well Drilling Order No.: G0955060
P O Box 126
Brewster, MA 02631
Laboratory ID 4: 0955060-01 Description: Water-Drinking Water
Sample#; Sampling Location: 1610 Main St.West Barnstable,MA Collected: 10/22/2009
Collected by: Customer Received: 1 0/2 212 0 0 9
Routine -
ITEM RESULT UNITS RL MCL Method## Analyst Tested Note
Nitrate as Nitrogen ND mg/L 0.10 10 EPA 300.0 LAP 10/22/2009
Copper ND mg/L, 0.020 1.3 EPA 200.8 LAP 10/23/2009
Iron 17 m91L 0.50 0.3 EPA 200.8 LAP 10/23/2009
Sodium 12 mg/L 0.50 20 EPA 200.9 LAP 10/23/2009
Total Coliform Present P/A 0 0 SM9223 AF 10/22/2009
Conductance 120 umohs/cm 2.0 EPA 120.1 DCB 10/22/2009
pH 6,6 pH-units 0 SM 4500 H-B DCB 10/222009
,
Recommended maximum contamination level exceeded due to Colijorm Bacteria. Retesting is recommended. May present
aesthetic problems(taste,odor,staining)due to Iron.
__._........... --.._..__.... -- ....---... - ------------.----...........- -- -----•._._ - ---- ... ---
� 3
Attached please find the laboratory certified parameter list. Approved By:
b Manager)
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. ND=None Detected RL = Reporting Limit MCL-Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
S00/z0019 gt'1144Tnag AyD aTgn}suzeg £0TLZ9£805 XV.9 bb :6 GaM 600Z/8T/TT
3
CERTIFICATE OF ANALYSIS Page: 1
Report For: Barnstable County Health Laboratory
s,
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Olt,-Shaun F. Harrington Report Dated: 10/28/2009
All Cape Well Drilling Order No.: G0955060
P O Box 126
1 Brewster, MA 02631
Laboratory ID#: 0955060-01 Description: Water-Drinking Water
Samplc 4: Sampling Location: 1610 Main St.West Barnstable,MA Collected: 10/22/2009
Collected by: Customer
Received: ]0/12l2009
EPA 524.2- Volatile Organics by GUMS
ITEM RESULT UNITS RL MCL Method# Analyst Tested Note
Dichlorodifluoromethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Chloromethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Vinyl chloride ND ug/L 0.50 2.0 EPA 524.2 yn 10/23/2009
Bromomethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009,
1,1,1,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1,1,1-Trichloroethane ND ug/L 0.50 200 EPA 524.2 yn 10/23/2009
1,1,2,2-Tetrachloroethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
11 1,1,2-Trichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009.
l,l-Dichloroethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1,1-Dichloroethene ND ug/L 0.50 7.0 EPA 524.2 yn 10/23/2009
1,1-Dichloro ro ene ND ug/L 0.50 EPA 524.2
1 P P yn 10/23/2009
1 i 1,2,3-Trchlorobenzene ND ug/L 0.5o EPA 524.2
i yn 10/23/2009
1,2,3-Trichloropropane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
s 1,2,4-Trichlorobenzene ND ug/L 0.50 70 EPA 524.2 yn 10/23/2009
1,2,4-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
i I,2-Dibromo-3-chloropropane ND U91L 0.50 EPA 524.2 yn 10/23/2009 l
1,2-Dibromoethane(EDB) ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1,2-Dichlorobenzene ND ug/L 0.50 600 EPA 524.2 yn 10/23/2009
1,2-Dichloroethane ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009 F
"s
1,2-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 1 0/2 312 0 0 9
1
1,3,5-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1,3-Dichlorobenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1,3-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1,4-Dichlorobenzene ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009
2,2-Dichloropropane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
2-Chlorotoluene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
4-Chlorotoluene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Benzene ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009
Bromobenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Bromochloromethane ND ug/L 0.50 EPA 524.2 yn 10123/2009
Bromodichloromethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
- i
Bromofotm ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Carbon tetrachloride ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
9
500/E0012 4EZTj4TpaH AID aTg249u2e9 EOTLZ9E80S XVa b5 :6 Cam 600Z/8T/TT
CERTIFICATE OF ANALYSIS 7y; Page: 2
Report For: Barnstable County Health Laboratory
i9rr�_ct�t, / Shaun F.Harrington Report Dated: 1028/2009
All Cape Well Drilling Order No.: G0955060
P O Box 126
Brewster, MA 02631
Laboratory ID#: 0955060-01 Description: Water-Drinking Water
Sample#: Sampling Location: 1610 Main St.West Barnstable,MA Collected: 10/22/2009
Collected by: Customer Received: 1 012 2/2 0 0 9
EPA 524.2- Volatile Organics by GUMS
ITEM RESULT UNITS RL MCL Method# Analyst Tested Note
Chlorobenzene ND ug/L 0.50 100 EPA 524.2 yn 10/23/2009
Chloroethane ND ug/L 0.50 EPA 524.2 yn IO23/2009
Chloroform ND ug/L 0.50 80 EPA 524.2 yn 1023/2009
cis-1,2-Dichloroethene ND ug/L 0.50 70 EPA 524.2 yn 10/23/2009
cis-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
1 Dibromochloromethane ND ug/L 0.50 EPA 524.2 yn 102312009
Dibromomethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Etylbenzene ND ug/L 0.50 700 EPA 524.2 yn 10/23/2009
l Hexachlorobutadiene ND ug/L 0.50 EPA 524.2� yn 10/23/2009
j Isopropylbenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Methylene chloride ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009
Methyl-tert-butyl ether ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Naphthalene ND ug/L 0.50 EPA 524.2 yn 10/23/2009 I
n-Butylbenzene ND ug/L 0.50 - EPA 524.2 yn 10/23/2009
n-Propylbenzene ND ug/L 0.50 EPA.524.2 yn 10/23/2009
p-Isopropyltoluene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
sec-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009 1
a
Styrene ND ug/L 0.50 100 EPA 524.2 yn 10/23/2009
tert-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Tetrachloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 10232009
Toluene ND ug/L 0.50 1000 EPA 524.2 yn 10/23/2009
s Total xylenes ND ug/L 0.50 10000 EPA 524.2 yn 10/23/2009
trans-1,2-Dichloroethene ND ug/L 0.50 100 EPA 524.2 yn 10/23/2009
trans-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 10/23/2009
Trichloroethene ND ug/L 0.50 5.0 EPA 524.2 yn 10/23/2009
Trichlorofluoromethane ND ug/L 0.50 EPA 524.2 yn 10/23/2009 I
Recommended maximum contamination level exceeded due to Colijorm Bacteria. Retesting is recommended. May present
aesthetic problems(taste,odor,staining)due to Iron.
Attached lease find the laboratory certified parameter list.
P rY P Approved By: ..- - �'?... .-- --
(Lab Director)i
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ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level i
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605
900/b000 gez144j1P26 AyD 2jg2}suavu E0TLZ9E805 XVdl SV :6 Gam 600Z/8T/TT
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'1 CERTIFICATE OF ANALYSIS Page: 1
Barnstable County Health Laboratory
Report Prepared For: Report Dated: 10/30/2009
Shaun F.Harrington
All Cape Well Drilling Order NO.: G0955116
P O Box 126
Brewster,:-MA 02631
Laboratory ID#: 0955116-01 Description: Water-Drinking Water
Sample#: Sampling Location: 1610 West Barnstable,MA Collected: 10/29/2009
Collected by: Customer Received: 1 012 9/2 0 0 9
Test Parameters
ITEM RESULT UNITS RL MCL Method# Analyst Tested Note
Total Coliform Absent P/A 0 0 SM9223 RG 10/29/2009
Attached please find the laboratory certified parameter list. Approved By:
(Lab Manager)
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ND=None Defected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605
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McKean, Thomas
From: Gatewood, Rob
Sent: Thursday, March 12, 2009 3:14 PM
To: McKean, Thomas
Subject: RE: 1610 Main St, West Barnstable-Septic Report
Hi Tom.
No.
-----Original Message-----
From: McKean,Thomas
Sent: Thursday, March 12,2009 2:09 PM
To: Gatewood, Rob
Subject: FW: 1610 Main St,West Barnstable-Septic Report
Was the waster table artificially raised there? (see below e-mail)
-----Original Message-----
From: Crocker, Sharon
Sent: Thursday, March 12, 2009 2:03 PM
To: McKean, Thomas
Subject: 1610 Main St, West Barnstable-Septic Report
We received a call from Elizabeth Miller, owner, 1610 Main St, W B. She just received a Final Order to fix septic in
60 Days. Report had showed failed 6/30/03.
She does not believe the system to be in failure. There was only one year where the water table was (artificially)
raised due to work we did on the Bridge Creek and that was when the septic report was done. That was the only time
there was ever a water and all the neighbors experienced it.
Background: She was thinking of selling her house in 2003 so she had the inspector come in and look at septic
system. He told her she needed a new one if she sold the house and it would be approx. $45,000. Unfortunately, she
was also told by him that she did not have to replace it unless she decided to sell the house. (Of course we know, they
are required to file the report with us)
She was totally surprised and upset to receive this letter after not hearing anything apparently since inspection.
She is a geologist and does not believe the system to be in failure. She has never seen any signs around the
system and never any sluggishness or backup in the house. She has always used a yeast additive to her system and
it works perfectly. She stated that at the time the inspection was done, the town was working on the Bridge Creek and
this caused the water table to rise.
Please give her a call. She is very concerned. Her.cell #508-360-5200
1
TOWN OF BARNSTABLE
LOCATION IL 1�1�,.n 5� �� SEWAGE#
�ILLAGE bj) /34 9A) ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. j- M&PI N
SEPTIC TANK CAPACITY /�a
LEACHING FACILITY.(type) f j� � �_ (size) x !S
'NO.OF BEDROOMS "
OWNER
PERMIT DATE: (� . �'(� COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
33,
TOWN OF BARNSTABLE
O
01_ D INSPECTI 30 03
LOCATION �/� EWAGE #
� ,
VILLAGE LT�Aft252 ASSESSOR'S MAP & LOT )���_613
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS RIVATE WELL = R PUBLIC WATER JC&Vl
BUILDER OR OWNER CZ
DATE PERMIT ISSUED:
a
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
i
,�
�,
31y�� i
i
F
..--�
� --
No. 2 / T Ou
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2ppIication for IN posal 6pstem Construction J)ermit
Application for a Permit to Construct( ) Repair(''grade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. 1(p/& /n4 t;C� S4- Q+(,k Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 19 3Q-�5 l"1 I (/el(°
Installer's Name,Address,and Tel.No. 9cR-a O`728 Designer's Name Address,and Tel.No.
P ftil v2)tN $ A w � (2 4
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 30 gpd Design flow provided_ �,� gpd
Plan Date —�°� — O�/' Number of sheets Revision Date
Title
Size of Septic Tank / ay q" l Type of S.A.S. _ !O G )r�/,V-14
Description of Soil
aturEoof Repairs or Alterations(Answer when applicable) k/ecy
Date last inspected:
cat Co
uAgreenlent: R
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with thl irovisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
a w
1-romplrance has been issued by this Board eHealt'.Signed /� '>�! Date_�D —a C,
Application Approved by /w. Date
Application Disapproved by Date
for the following reasons
Permit No. Q0 6 d 0) 3 Date Issued
No.\, 2 U / r _.r:'� ,x Fee 6U
THE COMMONWEALTH OF MASSACHUSETTS Entered in comjl,,
F4UBLIC_HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
r�
01ptlflcation for Mispo$af 6pstem Construction Permit
Application for a Permit to Construct( ) Repair(grade( ) Abandon( ) nCompleteSystem ❑IndividuaLComponents
r Location Address or Lot No. 16.10 1XM t O S4 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 1'j '7— d ? �Q� SY /'� I (fey
Installer's Name,Address,and Tel.No. c,�i%% Irv- �`C�Q Designer's Name Address,and Tel.No.
i'VI�(ZIA) �.2w� /� G�f to14'u2ue� 4�
' Type of Building: 1
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ):
Other - Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) '�?3U gpd Design flow provided 5'!% gpd
Plan Date �'J - ,�� _ o j Number of sheets Revision Date
Title
Size of Septic Tank 1,;yu (;A� Type of S.A.S. /0
r
Description of Soil
LNature of Repairs or Alterations(Answer when applicable) k/e 61 (,L�2�ay7 .'��J✓1 r 2''
C .
Date last inspected:
t r_
E f Agreement:
G 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 Certificate of j j 1
G s .�...
1""Compliance has been issued by this Board`of Healt . 6
/ Signedn T7" Date /Q- - 's
Application Approved by Q;V.4v Date /� f _ �j
�
! T -a
Application Disapproved by Date
for the following reasons _
Permit No. a 6,)0) 3 7 Date Issued
y THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(L) Upgraded( )
t
Abandoned( )by (M e)4, 4J P! , <
r
at 1416 M-a.A) <4 (e.) 13ZAA has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.2 Uu dated
Installer Designer- � l 0,P I l e- SQ
r, �
#bedrooms a Approved design flow -3 gpd
The issuance of this permit shall not be construed as a guarantee that the system will functidnas designed.
Date a i I 1 I A 0 Inspector /U A/V
No. 0 07 y Fee
r THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION,BARNSTABLE,MASSACHUSETTS
Misposaf *pstem Construction permit
Permission is hereby granted to Construct( ) Repair(c---) Upgrade Abandon( )
System located at 14 /U X A F,4,ely
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Constructio must be completed within three years of the date of this permit.
Date y/OGI Approved by �' ��
No.-- Fee---L(-,S--------
130ARD OF HEALTH
TOWN OF BARNSTABLE
Application-*rlftl Con!5truct ion Permit
Application is hereby made for a permit to Co st t -�, Alter or Repair ( )an individual Well at:
Ad
Location Address Assessors Map—and—Parcel
Owner Address
—Bpjl
Installer Driller Address
Type of Building
Dwelling- ----------------------------------------------
Other - Type of Building —----------------- No. of Persons----------------------___—__—____________
Type of Well —--------------- Capacity--------------------
Purpose of Well---------
Agreement:
The undersigned agrees to install the aforidescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.
S LEI— d
Application Approved - 7L
date
Application Disapproved for the following reasons:---—-----------------------------------------------------------
------------- ------------------------------
Permit No. --------------- Issued-------A date——-----------
date
- - - - -------------------- -- - - - - - - --- --------------------------- - -- ---
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate (Of Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed (Altered ( ), or Repaired
by-AiL --------------------------------------------------- ------I------------------------------------------------------------
Installer
at ----------—-----------------—-—-——-—--------——---------———-------—--has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
RegulatikI as described in the application for Well Construction Permit No. -------------------------Dated-----------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCT ON SATISFACTORY.
DATE--------- Inspector--------------------------------------------------------------------------
dam"I 0219.
4 ,
No.-------------------- ,�- Fee------- - --------
f s BOARD OF HEALTH
TOWN OF BARNSTABLE ,
Application for Velt Cootruction Permit
Application is hereby made for a permit to Co st uct Alter ( ), or Repair ( )an individual Well at:
Location - Address Assessors Map and Parcel
i
Owner Address
I
Installer— Driller Address
{ Type of Building \
Dwelling - - -
fOther - Type of Building-------------------------- No. of
fp — �=-- - ------- --- Person—s--------------------------------
TYPe of Well
� Capacity -----
,
- -
Purpose of Well----------------------------------—------
i
jAgreement:
I The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
' place the well in operation until a Certificate .of Compliance has been issued by the Board of Health.
Si
Application Approved - --— ------ - -- -- ---- -— ---- ---
date
I
Application Disapproved for the following reasons:-----------_-_----------------------______—____________—___—___—_________
— —-- -- --------- — ----- - — ------ — — - ----------------------
i date
I
- --------- Issued--- = _Permit No. --------------------- - -----�----------------------
I date -
•-------------------------------------------------------------------------------------------------------�
I
i
BOARD OF HEALTH
i
TOWN OF BARNSTABLE
(Certificate ®f (Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed (Altered ( ), or Repaired ( )
by-------- - ------------- --———- —i�5�aiier - -- - - - - --
I at- -t2�6—..... !��a i — ---� � - ------------------------
------— -
----------------------------------------
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
IRegulation as described in the application for Well Construction Permit No. -------------------------Dated-------------- z-------
I .,
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
/U l _ ----------------------------------------------------------
� DATE------------------�- ------------
--------------------- Inspector-------------
-----------------------------------------------------------------------------------------------®-------
BOARD OF HEALTH
TOWN OF BARNSTABLE
lVell Congtruct ion Permit
No.1�- --------
Permission is hereby grantedFee---------------
I
-----_---------------------
� `�t�"`
I
to Construct (L-� Alter ( ), or Repair ( ) an ndividua,�I ell t:
No. --- ---------
Street
as shown on the application for a Well Construction Permit
/ 1-- -
�(/ 15 _ Board of Health
DATE------------ ----- ----f------ �.
EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES 9/08/09:
I. Hearing — Septic:
John Morin, representing Betsy Miller, owner=�,1-610 Main_Street;Wes�
CBarnstable,request for an extension on deadline of repair.
No one was present.
Mr. Dan Ojala spoke stating that the owner's contractors were working on it and had
recently called to get assistance on the property lines.
Upon a motion duly made by Ms. Rask, seconded by Mr. Sawayanagi, the Board
voted to extend the deadline for an additional 60 Days. (Unanimously, voted in
favor.)
p�oft Teti Town of Barnstable
Barnstable
Board of Health
M a
+ aABNSTABLE, • AUU
nedcaCity
v MASS. 200 Main Street,Hyannis MA 02601 1
039.
prf i a,
D MA
2007
Office: 508-862-4644 Wayne Miller,M.D.
FAX: 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
June 16, 2009
Ms. Elizabeth Miller, Trustee
1610 Main Street
West Barnstable, MA 02668
Dear Ms. Miller:
You are granted a 60-Day extension of the repair deadline until August 16, 2009
to replace your failed onsite sewage disposal system component(s) located at
1610 Main Street, West Barnstable.
The septic system originally failed during an inspection conducted by Robert
Bortolotti on June 30, 2003. Backup of sewage into facility or system component
due to overloaded or clogged SAS or cesspool existed at the time of inspection
according to Mr. Bortolotti's report.
The extension of the repair deadline is granted with the following condition: (1)
the septic system must be fixed, or.(2) provide the Board of Health with definite
proof that the septic system is not in failure and the owner will appear at the
August 4, 2009 Board of Health meeting. -
The extension is granted until August 16, 2009 to complete the work. Financial
assistance is available through the Town's homeowner septic loan program,
administered by Mr. Kendall Ayers. His telephone number is (508) 375-6610.
Sincerel 'yours,
f; �
Way �e Mi er, M.D., Chairman
Board of ealth
Q:\WPFILES\SepticRepairExt 1'610 Main St WB 2009.doe
THE Town of Barnstable Barnstable
AgA
Regulatory Services Department "' 'caC'
Public Health Division
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,-Director
FAX: 508-790-6304 Thomas A.McKean,CHO
03/13/09
Elizabeth Miller
KYA Realty Trust
1610 Main Street n
West Barnstable MA v D
p
Dear Elizabeth Miller,
-Thank you for discussing the status of your septic system with me today on the phone.
Enclosed is the copy of the inspection report filed with us in 2003. The inspection
indicates that your septic system failed "due to back up of sewage into your facility or
system component due to overload or clogged SAS." The report does not indieate high
ground water as a cause or issue as you mentioned on the phone.
The Board of Health requires a deadline of 60 days for repairing a septic system in
hydraulic failure. Please make arrangements within 60 days to either 1)have your
system repaired 2) have a re-inspection conducted to confirm the status of your system.
There are loans available from Barnstable County and the State that are very helpful if
you need to repair a failed system. We would be glad to assist you in finding these
ser!vices.
You may request easing before the Board of Health, a written petition requesting a
hearing on the matter, within seven(7) days-after the day this order was received.
Thomas McKean, R.S., CHO
Agent-of the Board of Health
r
Karen Malkus
Costal Health Resource Coordinator
r _
Town of Barnstable Barnstable
a
Regulatory Services Department j Mca j
, ' Public Health Division m
200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Geiler,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
May 8, 2009
Elizabeth Miller
KYA Realty Trust
1610 Main Street
West Barnstable, MA 02630
Re: 1610 Main Street, West Barnstable,MA
You are scheduled to appear before the Board of Health at their public
meeting scheduled on June 16, 2009 at 3:00, to show-cause why your
property or dwelling should not be condemned to continued use of a failed
septic system. According to our records, your septic system failed on
0613012003 and you were notified by certified mail to repair or replace your
failed septic system on 03/09/09 and 03/13/09. However, to date, the system
has not been repaired or replaced. The purpose of the hearing is to provide
you the opportunity to provide testimony, documentary evidence, and/or
witnesses pertaining to the repair or replacement of your septic system.
The meeting will be held on June 16, 2009 at 3:00 PM at the Town Hall,
367Main Street, Hyannis in the second floor conference room.
PER ORDER OF THE BOARD OF HEALTH
Thomas McKean, R.S., CHO
Agent of the Board of Health
ti
Town of Barnstable Barnstable
Regulittory Services Department ;�'ca j
6 9 � Public Health Division
200 Main Street Hyannis MA 02601 2007
Office: 508-862-4644 Thomas F.Gei(er,Director
r
FAX: 508-NO-6304 Thomas A.McKean,CHO
P 03/09/09 O �
Elizabeth Miller
KYA Realty Trust
1610 Main Street
West Barnstable, MA
FINAL ORDER
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at, 1610 Main Street, West Barnstable, was last inspected on
06/30/2003, by Robert Bortolotti a certified septic inspector for the State of
Massachusetts.
The inspection of the septic system'showed that the system "Failed" under the guidelines
of 1995 TITLE 5 (310 CMR 15.00) due to the following:
"Backup of sewage into facility or system component due to overloaded or
clogged.SAS or cesspool"
The deadline for repair has past. We, The Department of the Board of Health, have not
been informed that you have taken any steps to bring.your failed system into compliance.
Therefore, you are ordered to repair or replace the septic system within 60 days from the
date you receive this notification.
You may request a hearing before the Board of Healt'i, a written petition requesting a
hearing on the matter, within seven(7) days after the day this order was received.
Failure to repair/replace the septic system within.the deadline period will result in future
enforcement action.
PER ORDER OF THE BOARD OF HEALTH
omas cKean, R.S., CHO
Agent of the Board.of Health
5 b���?' 3b��
Excerpt from Minutes on 6/16/09 Board of.Health
D. Elizabeth Miller, owner— 1610 Main St, West Barnstable, septic issue.
No one was present for the owner. Karen Malkus, Coastal Resources-Public
Health Division, spoke of her communications with Elizabeth Miller.
Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Miller, the Board
voted to allow an extension of 60 Days from today, June 16, 2009, to (1) fix the
septic system, or (2) provide the Board of Health with proof definite that it is not in
failure and owner will appear at the August 4 Board of Health Meeting.
(Unanimously, voted in favor)
McKean, Thomas
From: McKean, Thomas
Sent: Friday, March 13, 2009 8:11 AM
To: Malkus, Karen; Crocker, Sharon
Subject: FW: 1610 Main St, West Barnstable-Septic Report
This property is about 1,700 feet away from the water.
-----Original Message-----
From: Gatewood, Rob
Sent: Thursday, March 12, 2009 3:14 PM
To: McKean, Thomas
Subject: RE: 1610 Main St, West Barnstable-Septic Report
Hi Tom.
No.
-----Original Message-----
From: McKean,Thomas
Sent: Thursday, March 12, 2009 2:09 PM
To: Gatewood, Rob
Subject: FW: 1610 Main St,West Barnstable-Septic Report
Was thewaster I artificially -aste table art cially raised there? (see below e-mail)
-----Original Message-----
From: Crocker, Sharon
Sent: Thursday, March 12, 2009 2:03 PM
To: McKean, Thomas
Subject: 1610 Main St, West Barnstable-Septic Report
We received a call from Elizabeth Miller, owner, 1610 Main St, WB. She just received a Final Order to fix septic in
60 Days. Report had showed failed 6/30/03.
She does not believe the system to be in failure. There was only one year where the water table was (artificially)
raised due to work we did on the Bridge Creek and that was when the septic report was done. That was the only time
there was ever a water and all the neighbors experienced it.
Background: She was thinking of selling her house in 2003 so she had the inspector come in and look at septic
system. He told her she needed a new one if she sold the house and it would be approx. $45,000. Unfortunately, she
was also told by him that she did not have to replace it unless she decided to sell the house. (Of course we know, they
are required to file the report with us)
She was totally surprised and upset to receive this letter after not hearing anything apparently since inspection.
She is a geologist and does not believe the system to be in failure. She has never seen any signs around the
system and never any sluggishness or backup in the house. She has always used a yeast additive to her system and
it works perfectly. She stated that at the time the inspection was done, the town was working on the Bridge Creek and
this caused the water table to rise.
1
I