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HomeMy WebLinkAbout0051 PERCIVAL DRIVE - Health ME-F 51 Percival Drive A_ 111.06 TOWN d�BA�NST1siB ! 3ACi4'FiQI'i SEYWA . ll `As�sESSORI taro SSP'i'LC TiK CAFACtf'y—; LEACEtIINalfP I �t'SC•V fit0 Y}FB (�DD &dp o l `Rmc�Bdvfr n: to• b�ax�mum�' shed foun�wa mlMU,Bottomaf�eaafi��.MW �iaatea�cupF �illell aq� g Facilt4yan��at #s mac: oasst�ar min?•OQ fiat a�.SearMi�t��'l Feet. $die o�'V�ld and,I.react►nb y�saiy Qvct}�s exist ' wittafin�QU=kat o�teactu�bg!' ) � � : Feet o ® Q `f r 11PL Commonwealth of Massachusetts Title 5 Official Inspection Form � ws bl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is Barnstable ✓ MA 02668 8-18-20 required for every ' page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information 51 o L44q-45i Shawn Mcelroy Name of Inspector Wiper Cape Septic Services Company Name P.O. Box 73 Company Address East Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 8-18-20 Ins- ors Ignature 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth'ofMassachusetts ,w. Title 5 Official Inspection Form �rl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes:. ® I have not found 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: System is in good working order with no sign of failure. 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 i Commonwealth of Massachusetts ,,, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments >" 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ' ❑N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts ra 3 Title 5 Official Inspection Form w.� i-1l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a �:: 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No - ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 i Commonwealth of Massachusetts �� fw Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8718-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310,CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large S stems:To be considered a large system the system must serve a facility with a design 9 Y 9 Y Y Y 9 flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ . ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts 0 Title 5 Official Inspection Form 'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments uc/ 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® 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 components,system onents excluding the SAS, located on site? Y p 9 ® ❑ 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? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora i i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is W. Barnstable MA 02668 8-18-20 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Well 9 ( Y g (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 8-2020 Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form w ! tit Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-26 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner---pumped 2-3 yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc-rev.7/26J2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts ,µ Title 5 Official Inspection Form ! Ibi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments n _ `s'• 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1992 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 12"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.): Good condition. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts 03 Title 5 Official Inspection Form w_ .i Subsurface Sewage Disposal System Form =Not for Voluntary Assessments Fz, ,lfi! 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 6"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: 1000 gal Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 1" 6„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc•rev.7/26/2018 Tite 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 ` Commonwealth of Massachusetts r� , Title 5 Official Inspection Form ► Subsurface Sewage Disposal System Form Not for Voluntary Assessments > %e 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Ci Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from pit. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form "it' ,�A �IMI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑' Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1-1000 gal � ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts 1, Title 5 Official Inspection Form ,i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System SAS cont. Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit in good condition and holding 18" of water with stain line at 18" below inlet invert. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form w ICI Subsurface Sewage Disposal System Form Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts a� 3 Title 5 Official Inspection Form C�M Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately iz Ll n Gdy' .s7 .. r. 1 3 A "3:'. . t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 111 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20'+ 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 ® 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: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev,7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ail Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •- T,;;r�" 51 Percival Dr Property Address Stephen Lamachia Owner Owner's Name information is required for every W. Barnstable MA 02668 8-18-20 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate .4 (Failure Criteria) and 6 (Checklist) completed ® D. System information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18'of 18 ff TOWN OF/B'A�ItNSTABLE �� f LOCATION 4 V ��Ct y (Z , SEWAGE # 7— 1 7 VILLAGE teJP 6y� �jGdC ASSESSOR'S MAP & LOT :-6/ p/ INSTALLER'S NAME PHONE NO.In / JD<F64_qj 7� %EPTIC TANK CAPACITY /6VQ C-)4] �LEACHING FACILITY:(type) /�/ 7- (size)17 CSC ZNO. OF BEDROOMS PRIVATE WELL R P491CRIEWNIFER ,BUILDER OR OWNER CLI SAkuDwi Cljl i DATE PERMIT ISSUED: * ff/-3z g z- IF DATE COMPLIANCE ISSUED: *3 VARIANCE GRANTED: Yes No �� 9� ;� 3� No.1......�_�... ...��...��/ - Fps.. ...�.�....�...�..� . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ®-W.0.---.OF.......l8AIRA1.4:i.-rA, ,.-_G...................... _-1-51 Appliratiun for Disposal Varks Tonstrnrtiun frrmit Application is hereby made for a Permit to Construct (y) or Repair ( ) an Individual Sewage Disposal System at: � ............ _... ..� .�......... ........................ •-- ...-•••--.......La..::T .----....-----.....------..........------ y �L cat n- ddressLLot.... ..1_�f.... .'r ..d... t Al .......A9.: T� -- 7/¢ �g Owner Address ,Wa C.. ../ t lf1! ............................... .......................SA.N.P...................................................... Installer Address AA Type of Building Size Lot..`T4y.. 1.1..Sq. feet Dwelling—No. of Bedrooms............................... ........Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type T e of Building No. of persons............................ Showers P� YP g --------•-•---------------•- P — Cafeteria ( ) daOther fixtures ----------_------------ ----------------•-----------......--•----•-•--. ----------------------•----------(....)---•-•......----•.... ...--.-- W Design Flow...................................5: -gallons per person per day, Total daily flow.............................��Q_ lions. � WSeptic Tank—Liquid capacity/&0d.gallons Length_,S..._4n... Width..`.-=/-.®. Diameter-_."-"..... Depth. _" x Disposal Trench—No..................... Width................. Total Length.................... Total leaching area....................sq. ft, Seepage Pit No........../-------- Diameter./Z_-®_. Depth below inlet6.. —.0."'. Total leaching area..................sq. ft. Z Other Distribution box ($6 Dosing tank ( ) Percolation Test Result Z Performed by...Do--- /e.....67A jRe........................... Date.._9.'� ......... a Test Pit No. l................minutes per inch Dep of Test Pit..../,61a_.`.�. Depth to ground water../f_0_967.._.. f= Test Pit No. 2...... .minutes per inch Depth of Test Pit----/_�`��a._��_ Depth to ground water.-Wave. ..__. G4O --•-------._._�.��_.._..---•------ ----------•------------••; 3T---•---•-�.. it-------• � �. Description of Soil"" ,.......2�_._..1.0 :01..�.�s���s�i-`---2¢---�'--,1-----�-•--------�1.CF�xI-....._..IC�Sa--- U .lt!l ennf_.tJ1N-. " ► -.------•----------•-----•----------------------------•--------•---------------------------------------------------------------•------ W ---•-•••--••----...•---•-•--------------••----•-----•-••-•••-••••••-•••-••-••--••••••••--•-•-•--•••-----•••••••••-------•-------••••-•••-•--•--••-••-•-••-•--•-•----•---•-----•......••••-•..._------... VNature 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 Environmental Code—The undersigned further agrees not to place the ,system in operation until a Certificate of Compliance has been issued by t board of health. Signed ...... " .-. ...-- .... ..........Q_N ...--------- .. ' 1� Date Application Approved B PP PP Y :--.... .. ' ... Date Application Disapproved for the following reasons: ..................................... .. ................................................................... .................. .............. .. ............ ..... ..................... ....................---...----..... ------------------- ................................................................ .............................. ' � ,,,,� Permit No. . ----- �� . C Issued .... �p1.jH 4F�YjA3' .� Dace • No._%.................... FEB.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - •---........ °. .tJ.....OF......�n. .` ......................... Appliration for Disposal Works Tonstrnrtion rumit Application is hereby made for a Permit to Construct (y) or Repair ( ) an Individual Sewage Disposal System at: .,fie >�, -r ......... .`Z....... .--•--•......•----.... -------------------------------- --------------- rLocahon-Address ��»•""+� � Lot Ow,nser ` Address ........ Installer Address Type of Building Size Lot_` 4,_._ L' ..Sq. feet Dwelling—No. of Bedrooms................................ ........Expansion Attic ( ) Garbage Grinder ( ) 4 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ....................................................................................................................................................... Design Flow....................................-?.gallons per person.per day,., Total daily flow.............................: ~�10..gallons. WSeptic Tank—Liquid*capacity,86V .gallons Length-_ -.''�__"4.. Width �:� Diameter---""""`:.... Depth.S..' 4 x Disposal Trench—No..................... Width................. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........../-------- Diameter.,/. `-__--,ew"°e•-.. Depth below inlet x._ ..... Total leaching area..................sq. ft. z Other Distribution box ( Dosing tank .- Percolation Test Results_ Performed by .mod + _ ¢ ®"� Date... .:. *4 Test Pit No. 1.......... per inch Depth of Test Pit Depth to ground water q aMf -_--- f1 Test Pit No. 2.......f!".minutes per inch Depth of Test Pit....!! Depth to ground water---Al 041 FBI --------• --------------- --- -- O Description of Soil � .. f ,r P r /a� .� /` .6--------�rTe orb- F�e_. W UNature of Repairs or Alterations—Answer when applicable..................................................................................._._........_. -•-------------------------------------------------------•-•--------•-----......._......----------------•-------------------------------------•----•---•--------............--••--•--•----......•--•---• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed - ................. �.'• .'1 j f ".................................................... .... �v...................................„ Dace Application Approved By - - � . --'--.....-..-=Dace-----'--------- Application Disapproved for the following reasons- ...................................................................................................................................... J ...................................................................................................................... ...-......-- --......-- ---........................................ ........--- ............".. �, � .� .•.. Dace Permit No f,? -" '-• 'l Issued Dace a� ,l114 OF lSj4.,P 9 WILLIAMc'�C THE COMMONWEALTH OF MASSACHUSETTS F. $ MORAN BOARD OF HEALTH .,1� 13899 ... " OF ---- t � ` f f+ L .'.............................................. 1. � $TE Tezttftcate of Contylian ie NA` "G THIS ISTO CERTIFY, Tbitt the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ...........,...'.f -----------I.................... 'r.°5 =s=` % ------------------------------------ ---- ------------------------- ................................................ Installer, - �"' ���'---------- ..r -/ ��. �'a .",g �i /�i f"'�l,//7, ,t l�j��.�i / 4 at ------A--------- -� ----------- -----_ :----- f r . .:. ----- ." ". �... .... .............. .1...... ,. ....... F f _: cr 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. ""_r"""" . ..-.-"' "---X----- dated .....-i............................-- ' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-----------------_---... ---- ...................................... Inspector ............ -- ------------------......---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ No...:... --------- FEE.:..................... Disposal,Works T-14anstrnrtuan pumit Permission is hereby granted..........:.......................... to Construct ( '-)�or Repair ( ) an Individual Sewage Disposal System r. -.' :s' { Street _ 1 as shown on the application for Disposal Works Construction Permit No_______________~_--Aated..........._......._........... ...... " ........................•----•--------------------------------------...-----••••--------------.....--•-- Board of Health DATE..................................... .......................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No.-{� -- - ---- Fee-- `'�- ------ BOARD OF HEALTH TOWN OF BARNSTABLE Applitation construction Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( an individual Well at: n�� lJ� Location — Address Assessors Map and Parcel --Cliff--- erry---auiLdar - ---------—--- --- - - Junlr Ian.__E. Sandwich '__—Ma.� — Owner Address ean_Jcde11_nri i i i n JInlr� _ �$___l�oute-130__Unitl _.Sane.�ici^.,—Ma. Installer — Driller Address Type of Building Dwelling ------------ Other - Type of Building --------- No. of Persons-------------------------------------------------- Typeof Well ------------------------------------------ Capacity--------------------------------___ --- ----- — Purpose of Well Agreement: 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 rtificate of Compliance has been issued by the Board of Health. Cg� Signe — - — = - '- -- Q - '-- aec_ datee Application Approved By - - --- - — — -—- —-- - -------- date Application Disapproved for the following reasons.----------------------- ------------- - -- -- --- ------------------__—_----------- date kR Permit No.- - - --- ------------ Issued------—------ -=- -- - �✓— —-------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TQ gF,Y t e Individual Well Constructed ( ), Altered ( ), or Repaired ( ) bY- - - ---------------------------------------------------------------------------------------------------------------------------------------------- r/ ]� —Installer_ r � ) has been installed in accordance with the provisions of the Town of Barnstable Bard of Healt Private Well P t on Regulation 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 FUNCTION SATISFACTORY. DATE-------------------------------------------------------------------------------------- Inspector--------------------------------------- ------------------------------------------- No. "�-----9/- -------- Fee--------------------- BOARD OF HEALTH TOWN OF BARNSTABLE 0 02 Application-*rVell Cootruction permit , C� �,o i herb made for permit to Construct Alter or Repair an individual Well at: Applications e y a p ( ), ( ), p ( �) T-,ot# 44 Percival Dr. � Location — Address Assessors Map and Parcel C_Liff_Per- —Builders------------------------------ ------Junb_Ln.---E. Sandwich-= - Ma. — -- - Owner Address --ael an -ice?_Drill?xg_____ 338�-Routa--130Un t#1 Sandwich, Ma. ------ Installer — Driller Address Type of Building Dwelling --Aaaider tia _-------------------------- Other - Type of Building ------------ No. of Persons------------------------------------------------------ Type of Well— 4"_Well ------------------- - - Capacity Purpose of Well---Drinking__Water __-_------- Agreement: 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. Signed---- ....:---_—_____�=---- ------ .-..�-�------- � —�--�----�--�- date Application Approved By � --- PP PP rove J--------------- -- —date---------- Application Disapproved for the following reasons:----=----1------------------------____�________ ___—_—_________—_ ---------------------------------------- - - -- - - ------------------------------------_---------------— —`' date Permit No.-- -. - - ------ Issued - i -� r-I ------- -------------------- //V � -- _-- -- -f F--; t- — date I( 4 - BOARD OF,HEALTH­ 'TOWN OF BARNSTABLE Certificate ®f (Compliance THIS IS TO CERTIF,Yt, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by--------�\---�---,r--� ---------------------------------------------------------------------------------------- - -- 1�- J f��+ Installer } / 1 J at --j VA -11 1021 4 has been installed in accordance with the provisions of the Town of Barnstable Board of Healthh,Private Well Protecti'an Regulation as described in the application for Well Construction Permit No-1 -T-�� ----;-Dated--r�--+�t!�—T-:Z;; C THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-- ----------- - - Inspector----------------------— - — -------------------------------- BOARD OF HEALTH + TOWN OF BARN'STABLE • Vern Congtructionvermit �. No. /_Y r-- Fee---- --, 2 ---- / 1 Permission is hereby granted-- r!-" ---- -- -_ - ------------------------------------------------------------ '� n . 0 to Construct Alter LAlter.�(/ ), or F e�Pair ( k an Individual-Well at / / 1 ,�?�(Crl ANo. /`�1 ------ k � 7 s �' � {% v! IQ �/�!!1` 1 ;l -- - T- - - - - -- --- Street / ° r as shown on the application for a Well Construction Permit No.-- - C -------------------------------------- Dated�----------------------------- - - Board of Health DATE----------------r----�r------�"------------------ f ' f -/ / / � 2� •' ' i — I ` Jam. ��0 .. . ..r ... ..� l� ISO Alp 00 coo a 00 ,O f,e,tom z� v � — - _ -� '- - -94-- � �i�ro��i �p�0 �•� !b��50 �.9�:0 � , _,.�'''_ 'qb •Zr • / � oo .... .: o� R E ? � N r i Ia i � �ri.� / _ _ / ` i o0 E�C1LiT. CoNTOU[Z 50 I r r •.� ; tiii_ �. .. : . %. �oYbhr'D Gc N-ro 4 ,b�0 � ®,���- �- , 2=51'-24�'� Z�•��.�fz157 G►`�P 11, .• �` S`'R"��'..--= . � Lam. �-�ss SUS ®� .� L� , • N D V4 u LD ��40' Department of Envirdnmental Management/Division of Water Resources WATER WELL COMPLETION REPORT WELL LOCATION GEOGRAPHIC DESCRIPTION Address 4 yy PEP N S E W of (feet) (circle) City/Town �7J Well owner t ;�_F ;- r�� (roads Address !r' r0� �?C, N S E W of 4— L ev r YI (mi.in tenths) (circle) Board of Health permit: yes'©-''ono intersect. w/ (road) WELL USE WELL DATA Domestic lia Public❑ Industrial ❑ Total well depth— l� ft. Monitoring❑ Other Depth to bedrock ft. Water-bearing rock/unconsolidated material: Method drilled A,,... Date drilled Description CASING Water-bearing zones: LQ-ai1L- 11 From. To lG1.�i Type 2) From To Length ?fir ft. Dia(1.D.)_�i` in.. 3) From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: � Screen: dia. Grout-0 Other Slot* /1_length from/421 to, WELL TEST i Static water level below land surface V(--s ff. Date -1-/- �l2 Drawdown �^ ft. after,pumpi.ng"4/-_hr, min,at aQ gpm How measured C-41��1 e o ery ft. after—hr.—min. 0 LOG of FORMATIONS COMMENTS a Materials From I o - o 0 Driller a� !law 1 Mass. Registration Firm Address ! t t f . . City/Town ervisin registered well driller lease print retry BOARD OF HEALTH COPY BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULTS Client: CLIFF• PERRY Collection Date: 07/21/92 Mailing Address:P 0 BOX 309 Date of Analysis:07/23/92 EAST SANDWICH MA 02537 Type of Supply: WELL Well Depth (FT) : 105 Telephone: 888-5458 Sample Location: PERCIVAL LANE LAT. (DDMMSS) : Not Given WEST BARNSTABLE LONG. (DDMMSS) : Not Given Collector: C STIEFEL Map/Parcel: Affiliation: BCHD Analytical Method: 502.1=1 , 502 .2=2 , 503 .1=3 , 504=4 , 524 .1=5, 524.2=6 , 502.1/503=7 --------------------------------=------------------------------------ --------------------------------------------------------------------- Contaminants Anal . Result MCL Detection Detected Meth. ug/1 ug/l Limits (ug/1) --------------------------------------------------------------------- Chloroform 2 22 . 0 0 . 5 Only those compounds listed above were detected. Attached is a list of compounds for which this sample was analyzed. NOTE: Contaminant levels equal to or exceeding the Detection Limits are reported. MCL means Maximum Contaminant Level for EPA-regulated compounds . (ug/1 = micrograms per liter = Parts Per Billion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5.0 * level not exceeded * Carbon Tetrachloride 5. 0 * level not exceeded * 1 , 2-Dichloroethane 5.0 * level not exceeded * 1, 1-Dichloroethene 7 .0 * level not exceeded * 1, 4-Dichlorobenzene 75 * level not exceeded * 1 , 1 ,1-Trichloroethane 200 * level not exceeded * Trichloroethene 5.0 * level not exceeded * Vinyl Chloride 2 .0 * level not exceeded * Comments or additional compounds found: LOT 44 o p g 4- ��Gc + Bern d E. rtels, Ph.D. Laboratory Director BAMSTABLE COUN rY HEALTH AND ENVIROIJNI1=111AL- UEPAHTMENT 7 SuCEnlon count IIouSE p ' � BARNSTABLE, MASSACHUSE1TS 02630 �'7 J� TABLE 1. Compounds Detectable by EPA Method 502.1* PHONr_: 162-2511 FXT. 330 LAB 337 COMPOUND D.L . COMPOUND D.L. CLINIC Sao Benzene 0.5 1 ,1-Dichloroethane 0.5 Carbontetrachloride 0.5 1 ,1-Dichloropropene 0.5 , ,I-Dichloroethylene 0.5 1 ,3-Dichloropropene 0.5 1 ,2-Dichloroethane 0.5 1 ,2-Dichloropropane 0.5 para Dichlorobenzene 0.5 1 ,3-Dichloropropane 0.5 Trichloroethylene 0.5 2,2-Dichloropropane 0.5 1 ,1 ,1-Trichloroethane 0.5 Ethylbenzene 0.5 'Vinyl Chloride 0.5 Styrene 0.5 3romobenzene 0.5 1 ,1 ,2-Trichloroethane 0.5 3romodichloromethane 0.5 1 ,1 ,1 ,2-Tetrachloroethane 0.5 Bromoform 0.5 1 ,1 ,2,2-Tetrachloroethane 0.5 Bromomethane 0.5 Tetrachloroethylene 0.5 Chlorobenzene 0.5 1 ,2 ,3-Trichloropropane 0.5 Chlorodibromomethane 0.5 Toluene 0.5 Chloroethane 0.5 - para Xylene 0.5 Chloroform 0.5 ortho Xylene 0.5 Chloromethane 0.5 meta Xylene 0.5 ortho Chlorotoluene 0.5 Bromochloromethane 0.5 para Chlorotoluene 0.5 . Dichlorodifluoromethane 0.5 Dibromomethane 0.5 Fluorotrichloromethane 0.5 meta Dichlorobenzene 0.5 Hexachlorobutadiene 0.5 ortho Dichlorobenzene 0.5 Isopropylbenzene 0.5 trans-1 ,2 Dichloroethylene 0.5 n-Propylbenzene 0.5 cis-1 ,2 Dichloroethylene 0.5 Sec-butylbenzene 0.5 Dichloromethane 0.5 Tert-butylbenzene 0.5 I D.L. is Detection Limit in micrograms, per liter or parts per billion (ppb) . This table lists. our normal limits of detection. If Are report a smaller amount, then our detection limit was lower for that analysis . *A photoionization detector is used in series with the electroconductivity detector, thus allowing for the analysis of most of the compounds listed in EPA' Method 503.1 as well . TABLE 2. Compounds which have Maximum Contaminant Levels (I.1CLs) set by the Environmental Protection Agency. COMPOUND MCL ( in ppb) Benzene 5.0 Carbontetrachloride 5.0 1 ,2-Dichloroethane 5.0 1 ,1-Dichloroethylene 7.0 para Dichlorobenzene 75 1 ,1 ,1-Trichloroethane 200 Trichloroethylene 5.0 Vinyl Chloride 2.0 Total Trihalomethanes 100 Chloroform, Bromodichloromethane , Chlorodibromomethane, and Bromoform comprise the total trihalomethanes. 1 Log Number: Bottle # M727 ` Date:' 7/30/92 OF SAIp� BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT �+ SUPERIOR COURT HOUSE p BARNSTABLE., MASSACHUSETTS'02630 A1A55 DRINKING WATER LABORATORY ANALYSIS PHONE:362.2511 '_Ext. 337 Client: Cliff Perry Collector: C Stief�l' Mailing Address: P 0 Box 3097 Affiliation: 4tCN[l East Sandwich; MA 02537 Tfine`& Date .of Telephone. ' Fs88=5458 Type of Supply 1tt5' Sample ;Location:' ':' Lot'44"Percival. Lane Well Depth: W Barnstable, MA' Date of Analysis:' 7jMW 9.90 PARAMETER SAMPLE RESULT RECOMMENDED LIMITS. Total Coliform Bacteria/100 .ml 0 O 7777 H .7: . Conductivity (micromhos/cm) 70 500.0. Iron m) <.1 0,.3. .. Nitrate-Nitro en (ppm) 1:2. . 10`X Sodium m) 9 20.0 Copper .(pPm) <.1 1.3 I. . X .. Water sample meets the recommended limits for drinking of all above tested parameters. II . Based only on results of the parameters tested for this sample, the water is suitable for drinking but may present the problems checked below: A. . ,Water sample has higher than average levels of. Nitrate. Future .monitoring is recommended (2-3 times per year) to establish any upward trends. " B. "`The'l ow pH -of the `water may shorten the useful 'life of they house's- pl'umbi leg. C. Water may present aesthetic problems (taste, odor, staining) due to D. Water sample 'has hfgk evels of sodium: Persons `on low sodium diets should consult ` their doctor. III. Due to one or more of the reasons. checked below, this water sample exceeds the recommended maximum contamination level for drinking water: A. High Bacteria B. Hi.gh Nitrates76 . REMARKS: CC: BarrEtabl e BOH CC: 1 /7/851 Laboratory Director .. ,. i..�.1.:.14 . . f ,, . . - '7 . c,L: .. - .. i:`. :�i ._. .art .r`f- • ` • li{;�iiRYd x'y,.,r, ,., _ � +hr,, �., �11•�-tA � •- .- , � f+ i'*' ,11 1 .. I Explanatier.of Test Results + Total Culiform Bacteria Coliform•hacteria-are an indicator of the ;sanitary quality-of"a water supply. Water supplies may hecnr.P contaminated from malfunctioning septic systems,,,cesspruil-,°'and''stirface,runoff. A total coliform count of 7cn- indicates that your water supply is safe and approved-for human'consumption.A total coliform count of greater than zero is most often the result of accidental cortar,inatior: of the'samnle bottle through improper sampling me-h;('s. For this reason. it would be advisable ;i rctv5t.ar,y well U•acer that is not approved: pH is the measure of acidity oralkaliniiyof the water. On the pli scale,the number 7 is neutral,less than " is acidic and more than 7 is alkaline. The pH of water on Cape Cod tends to be acidic in the range of 5.0 to 6.5. Conductivity Conductivity is a measure of the dissolved salts in s;)l fit ion.-Amounts in excess of 500".micromhos/cm are ,generally considered--unacceptable and may have a laxative t-f`ect upon users. v ., - Iron • - - _,. _ _. .__. The presence of iron in water in-concentration of .3 ppm or-greater may: give the water a bittersweet astringent taste. cause an unpleasant odor, often gives the water a ihrownish color and cause staining of laundry and porcelain. The average-concentration of iron in Cape Cod's water is .2- .h ppm'. Although the presence of iron in water may Cause the problems listed above, it is not cor,siderec', deleterious to health.•Iron may be removed bv,use of an iron removal system. Nitrate-nitrogen The Massachusetts Drinking Water Reaulatiom'hnvc set;'a Triaxitntim contaminant level for nitrates at 10 pprn. Excessive concentrations may cause'methemoglobinemia ian infant disease) and have been suggested to form potentialiy carcinogenic.nifrosamines. Contamination sources include fertilizers, cesspools and industrial wastes. i Copper Due,to the acidic nature of the water on Cape Cod„copper tends to'leach from pipes..This-normally does not ' present a health hazard: however, concentrations in.ercess of 1.0 ppm may cause a metallic taste. and/or a bluish-green stain on porcelain.fixtures. . ' Sodium' A concentration of sodium over 20 ppm is only of supply >�> people who are on a low sodium diet. lf•the water supply has more than 20 ppm sodium. it is up to the.people who are on such a diet to find another source of drinking water or contact their doctor to determine if consuming the water is advisable. Concentrations exceeding 50 ppm ind .:ate that there may be ocean water or road salt runoff water getting into the well. BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPAR'PM1:,N'].' 1_,A1i0RA'1'ORY REPORT VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULT'S Client : CLIFF PERRY Collection Date : 07/21/92 Mailing Address : P 0 BOX 309 Date of Analysis : 07/23/92 EAST SANDWICH MA 02537 Type of Supply: WELL Well Dopth (FT) . 105 Telephone: 888-5458 Sample Location: PERCIVAL LANE LAT. (DDMMSS) : Not Given WEST BARNSTABLE LONG . (DDMM.SS) : Not, Given Collector : C STIEFEL Map/Parcel. : Affiliation: BCHD Analytical Method: 502 . 1=1 , 502 . 2=2., 503 . 1=3 , 504=4 , 524 . '1 =5 , 524 . 2=6 , 502 . 1/503=7 --------------------------------------------------------------------- Contaminants Anal . Result MCL 1)ete. ,tic>r, Detected Meth . ug/l tig/1_ L_i.m=i.L.s (ug/l ) ------=-------------------------------------------------------------- Chloroform . 2 22. . 0 0 . 5 Only those compounds _listed above were detected . At tacla(--�cl i a list of compounds for which th:i-s sample was analyzed . NOTE: Contaminant - levels equal. to or exceeding the Detection Limits are reported. MCL means Max-1111U111 Coritamina'nt Level Fo:r EPA--rngul a t.c!d compounds . (ug/1 = micrograms per liter = Parts Pet-, Bill .i.c)n) The Environmental Protection Agency has set Maximum Coi'itaivinant Levels (MCL) for the following compounds . This sample compares as; COMPOUND MCL (in PPB) Benzene 5 . 0cd(,d . Carbon Tetrachloride 5 . 0 level. n 1, c';:ceeded 1 , 2-Dichloroethane 5 . 0 * level rtot exceeded 1 , 1-Dichloroethene 7 . 0 * level not exceeded y 1, 4-Dichlorobenzene 75 y level not exceeded 1 , 1 , 1-Trichloroethan'e 200 * level not exceeded Trichloroethene 5 . 0 * Level. not exceeded Vinyl Chloride 2 . 0 1 e V e I n()l. r-:xcee(Ied y Comments or additional compounds found : LOT 44 + Bern d E . P - reels , Ph.D . Laboratory Director L