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0390 PLUM STREET - Health
390 PLUM STREET, A= 196 017 \ a i 19 V No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE ZIppYicatiou ifor Yell Cott.5truction Permit Application is hereby made for a permit to Construct( ), Alter( ), or Repair( /an individual well at: -� T / Location-Address � A rs Map and Parcelsses V0 A-M:&u / Owner � Address' bQ . ,cJ CP Cad / 7 Instal er-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well P'Vt)-Q— Capacity Purpose of Well Agreement: The undersigned agrees to install the afore described 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 o Co lia a has been issued by the Board of Health. Signed 9 9- 0 4D4ate Application Approved By b Application Disapproved for the following reasons: Date 5 Permit No. )kNe� 00 Issued /(?oo' ate ------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the in 'vidual well Constructed(Z<---'/Altered( ), or Repaired( ) by /Installer �,I at 390 E � v� `f✓ l�f�i�M/ has been installed In accordance with the provlslons of the Town of Barnsta e o r altorivate Well Protection 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 SATISFACTORILY. Date Inspector 0 No. Fee + BOARD OF HEALTH TOWN OF BARNSTABLE Zfpplication jfot Yell Construction Permit Application is hereby made for permit to Construct Alter or Repair( an individual well at: PP Y P ( ) ( ) P ( ) Location-Address + Assessors Map and Parcel Owner _ Address Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well (ffY)P,S /1 0-- Capacity Purpose of Well r Agreement: The undersigned agrees to install the afore described 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 oflCom, lia a has been issued by the Board of Health. Signed ( J Date Application Approved By v r Y /Date Application Disapproved for the following reasons: ` i Date � Permit No. r �_ Issued y Date' ----e—m>meoveoe_-- o.me--__e—___—. -----aaemvmsss_mm—ev—s—o.,__v------me___..--------_., BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(Altered( ), or Repaired( ) by l OAAW ()J-11( / Installer . at has been installed in accordance with the the provisions of the Town of Barnstab e/Board of Health-Private Well Protection I Regulation as described in the application for Well Construction Permit N ated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE Yell Cott�truction permit No. &2119005 Fee Permission is hereby granted to j,/ J Installer to Construct Alter ), //o-rs� Repair( an individual well at: No. Street as shown on t e appli ation for a Well Construction Permit No.0 Dated ,. t�l v Date /) Approved By ', Iu % � �'r �F,�-y 1� I ,��;d' 1,"•.,lm �t �.I , �ix,'��. �. ICI" '�.�„ 4�S.��e.Y. lie 11 4v, n. e ACCOMPLISHED LIST. a Muc ratify tha to-do ist, don' y u tl ? J - 6 (- ns i i ACCOMPLISHED LIST. Much ratifyi tha too 'st, on' fu t r 4 courtya d.comro fin , f c % 16AI I courtya d.com/ I„ !� `/!►� I�� 0 . p No. owe —C/ qg Fee VYes THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rpplication for his o�aY bpstem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System 21ndividual Components Location Address or Lot No. '3-+`O /c /i;Nl J,-A kAqW bwner's Name,Address,and Tel.No. p t f Co61 4y)o � °� a�k3 �l�S�I 1 Assessor's Ma /Parcel �� �� Installer's Name,AddrIV'snes-s,,and Tel.No. I`i11S j /�YPT Cron Designer's Name,Address, nd�J Tel.No. �(}S SU PoQei l r� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(ll f Other Type of Building aeo. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 30 gpd Design flow provided 3 q gpd Plan Date I '�—(� Number of sheets �_ Revision Date Title V\eAv L,e°t k; Size of Septic Tank Type of S.A.S. L-r 1V Xa,&1 Description of Soil �,{�. S j I o c v Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by:this Board of Healed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued t ` s No. l '✓ p Fee /5�V THE COMMONWEALTH OF MASSACHUSETTS Entered in '0 putet�i r PUBLIC HEALTH DIVISION--,jOWN OF BARNSTABLE,'MASSACHUSETTS Yesr Zipplicatlon for Mis Ais al 4pstem Construction Permit Application for a Permit to Construct( ) Repair de( ) Abandon( ) El Complete System ❑v'Individual Components V.Location Address or Lot No. - C?0 filLI'-1S / aS ° Owner's Name,Address,and Tel.No. S06 a-43 Li&I 1 Assessor's Map/Parcel t F fj b E 4 Y)GAr11" (_1V1((r ., Installer's Name,Address,and Tel.No. !�+ C4,? Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size 10 sq.ft. Garbage Grinder((i)C) Other Type of Building ���, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) V3C) gpd Design flow provided 3 q gpd Plan Date I — (fr Number of sheets Revision Date Title P 1 , Size of Septic Tank Type of S.A.S.. �,..,t'S�'q �'s-P CA Description of Soil s , C, Nature of Repairs or Alterations(Answer when applicable) th C /1 AP L. i, 4- s y Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health Si plied Date 1 Application Approved by Date ] Application Disapproved by Date for the following reasons Permit No. nPPTS 3�19 Date Issued ) " THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS `' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) -Repaired( ) Upgraded( ) Abandoned( )by at �(� U►'b1 } 1�P ..P A5'rrt 14 8,d4eep° qfitructed in accordance,, with the provisions ofTitle 5 and the for Disposal System Construction Permit No�/b 'f dated Installer ,'i t� ll/�1G1J4u.s cob' Designer lv.t-1,� A/'r L14 i #bedrooms Approved design flow gpd The issuance of this pettpI not be construed as a guarantee that the system w*11- n do as designed. Date F�' Inspector hJ. j _ ----------------------------------- ----------- ------------------- - - ------------------------------------------ -------- No. P Fee - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS J Misposal i ipstem Construction 3permit Permissionis hereby granted �yto Construct( ) Repair( ) U,.pgrade( ) ! Abandon( ) System located`at�3gr�!_ 1 In SA f-e� �Ae5� �';, `� t�-( 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:Construction must be comple d within three years of the date of this' permit. Date 3 Approved b Town of Barnstable ,o� ►ati Regulatory Services °�► Richard V. Scali, Director '"R'tom.AS& Public Health Division •9 i63 ,0� 1°rFn Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Date: Sewage Permit# Assessor's Map/ParceI Installer& Designer Certification Form Designer: Installer: LIS Address: ��� 7' Address Z✓? l �eV�►�'se l`C s 7 - 36a417 5?1�i—��2 z37 On �`��5 �vs was issued a permit to install a (date) (installer) septic system at S3- 2D 141, 6q S� ' G6'-' based on a design drawn by (address) c�r� yy rn dated /od9, ZIP (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box andlor septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certiA, that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructe si '�compl n e with the terms of the I/ a oval letters if applicable). ? BRAD (Iris ller's Signature40 1 1 t 9F QfST�R� 3`�AflTA�a�'� (Designer's Si tune (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- .BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice formsWesignercertification form.doc ELLIS BROTHERS C0NST . CO . 508-362r6237 w TOWN OWNERS NAME Ojgcr BUILDERS NAME 3 ti LOCATION 3 o P iU+"1 SEWAGE PERMIT NO.�Loi5- DATE Ln (0o6 COMPLIANCE ISSUED DATE uj - 79.9 FINAL INSPECTION BY • /' ui - 7 ,a • �AL'c NEW SYSTEM 0 REPA 2: WATER PUBLIC OR WELL SEPTIC TANK CAPACITY 1000 1500 2000 (� � 13, NEW OR `X =U F- LEACHING FACILITY TYPE '' _ 3 SIZE f fX (© � 3 `�� - - - - - ~► \i em I 3 �0 ` TOWN OF B�AR/N�S�TAB}L�E LOCATION �V051' l )/"��� bGE VILLAGE �-P ASSESSO/R�'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 3G�( � SEPTIC TANK CAPACITY LEACHING FACILITY:(type) fin�e I�� (size) i �G NO.OF BEDROOMS 3 OWNER 64 PERMIT DATE: i t I L'3 I Ly COMPLIANCE DATE: Separation Distance Between the: Maximwn 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 -�-- PLu14A 3 9 D ,r Plan,, '51 A � �►Jobd� f i Q6cK A - Z • too' f3-Z - Sr Pq - 3 _ a?,8 P r3-.-S- 76>3 .775 r (54- T1A3 r r r r f I , QSKE Tp� Town of Barnstable Barnstable � RegulatoryServices Department 1A AmecaCft1t RNSTAa� ��. Public Health Division i639 ,��� m �Fb"APB a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas A.McKean,CHO FAX: 508-790-6304 CERTIFIED MAIL#7015 1730 0001 4987 9293 November 7, 2018 BARR, ANDREW D & RUTHANNE 390 PLUM ST WEST BARNSTABLE, MA 02668 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 390 Plum Street, West Barnstable, MA was inspected on 10/23/2018 by James D. Sears, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\390 Plum Street West Barnstable.doc Town of Barnstable sa.�uvsrnsi.e. � . 9�0 . Regulatory Services Department lfD MP't� Public Health Division 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS - (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or,ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. o Backup of sewage into the house due to an overloaded or clogged SAS or cesspool O 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc L Commonwealth of Massachusetts. e Title 5 Official Inspection Form Vt - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 0 3 90 Plum Street Property Address Andrew Barr Owner Owner's Name ,_: information is : required for every West Barnstable MA 02668 10-23-18 page. City/Town State Zip Code Date of Inspection -hl' 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. `pAttuumurq,,,� Important:When A. Inspector Information SI'y- 13�1 filling out forms p on the computer, off,• �y use only the tab James D.Sears ?� JAMES N=key to move your Name of Inspector = SEARS use the return urn —{ cursor- not Ca ewide Enterprises ,. ,E key. Company Name '•.•RT I F` O �� 153 Commercial Street /�������5 INSPE�'���`���` ICI Company Address Inn Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Ce rtification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property 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 10-23-18 fifspector'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 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form y` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information isequired or every West Barnstable MA 02668 10-23-18 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: Failed system- Leaching The system is a 1500 Gal Tank D Box and field 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 Commonwealth of Massachusetts Title 5 Official Inspection Form .0 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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 ❑ 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): 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: Lt5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form F; Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 390 Plum Street �LJ Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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 f Commonwealth of Massachusetts p Title 5 Official Inspection Form le Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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 4932M is less than 6" below invert or available volume is less than %day flow 1,EAC1W,1,,t ❑ ® 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 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 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 I ❑ ❑ 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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 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)) I I 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 Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �L ,• 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is West Barnstable required for every MA 02668 10-23-18 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): NA Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Description: 1500 Gal. Tank D Box and Field. Number of current residents: 2 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 information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Well Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts R Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name infgormation is every West Barnstable re wired for eve MA 02668 10-23-18 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 15.203): 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: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts (P Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,u 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is every West Barnstable required for eve MA 02668 10-23-18 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: 1996 Permit # 96-301. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 28" 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.): Pipeing is 4" PVC SCH -40. i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 F c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 18" 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: 1500 Gal.Precast H-10 Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-Plan-Tape Sludge Jusge 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 at working level. Tank and covers at 18" below grade. In and outlet tee's. No sign of leakage. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;V 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is every West Barnstable required for eve MA 02668 10-23-18 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 El 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 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 page. City/Town Stat e 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 Over outlet's Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): _ D Box is 16"x16"-3' below grade w/two lines out. D Box is full over outlet's 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 <e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 39'x12' ❑ 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 c Commonwealth of Massachusetts Title 5 Official Inspection Form / Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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.): Leaching is a 39'x12' field. Ck D Box and camera of box and field full. Not leaching need to replace system. 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 c Commonwealth of Massachusetts Title 5 Official Inspection Form '10 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 • i Commonwealth of Massachusetts Title 5 Official Inspection Form <� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 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 I t5insp.doc rev.7I261201 B Title 5 Official P l Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 • r c aa%. ♦aaa.s t.Aarfi% I i ,/ r y `LEACHING FACIL[TY:(t ) �, -c (s ) - NO. OF B£D,ROOMS _ PRIVATE WELL R PUBLIC WATER_ ,BUILDER OR OWNER DATE PERMIT ISSUED: / � f �� l �l T_ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 0 • ti � I 9'd LL60-LLb-909 sesiadjelu3 ep medeo eZL 90'9 6L 100 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is required for every West Barnstable MA 02668 10-23-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells P© 10, Estimated depth to high ground water: 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: 4-18-96 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: T.H. on Design plan 4-18-96 10' no G.W.. Bottom of leaching at 4'-5" below grade. Bottom of leaching at 5'-T above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 a � 1 n I a '� �✓-� r" Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 390 Plum Street Property Address Andrew Barr Owner Owner's Name information is West Barnstable MA 02668 10-23-18 required for every 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 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 .L£AcNiNk ,t 3---`7 t5insp..doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 { ?:;Wedcite meeting Page 1 of 2 Miorandi, Donna From: George Heufelder[gheufelder@barnstablecounty.org] Sent: Monday, March 25, 2013 4:47 PM To: Miorandi, Donna Subject: Sorry From: Ronald R Beaty [mailto:rbeaty@umassd.edu] Sent: Sunday, March 24, 2013 4:32 PM To: George Heufelder; Gongmin Lei Cc: Mark Zielinski; Maggie Downey; Mary Pat Flynn; Bill Doherty; Sheila Lyons; Patrick Princi; Justyna Marczak Subject: County Lab -Water Quality Testing Services Available to West Barnstable Residents Importance: High Barnstable County Department of Health and Environment 3195 Main Street P.O. Box 427 Barnstable, MA 02630 Attention: Barnstable County Department of Health and Environment RE: County Lab - Water Quality Testing Services Available to West Barnstable Residents Please be advised that the West Barnstable Fire District, Board of Water Commissioners is holding an important meeting on Wednesday, March 27, 2013 at 7:00 PM. It will be located at the West Barnstable Fire Station on Meetinghouse Way - Route 149. We have many residents in West Barnstable who are experiencing various issues of concern regarding the water quality coming from their household drinking water wells. They are extremely interested in learning some specific information about the respective water quality testing services offered by the County Lab. If at all possible, it would be greatly appreciated if someone from the County Lab and/or the Barnstable County Department of Health and Environment could please stop by the meeting and briefly provide some details regarding the water quality testing lab and its various services, during public comment. We have West Barnstable residents and business owners attending the meeting specifically seeking information about the aforementioned services offered by our regional government and it is imperative that they receive accurate and up-to-date information... West Barnstable Fire District, Board of Water Commissioners,Meeting Agenda & Notice, 7.00 PM, Wednesday,March 27, 2013 httl2://www.town.bamstable.ma.us/meetingnotices/WEST%20BARNSTABLE%20FIRE% 20DISTRICT%20WATER%2000MMISSIONERS%203-27.12df LOCATION: West Barnstable Fire District & Station 2160 Meetinghouse Way (Route 149) 3/26/2013 Wedwite meeting Page 2 of 2 West Barnstable, MA 02668 Thank you very much for any assistance you may be able to provide regarding this important matter. Sincerely yours, Ron Beaty From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Monday, March 25, 2013 4:43 PM To: George Heufelder Subject: Wed nite meeting Hi George: Are you sending me an email re: Wed nite meeting? Donna 3/26/2013 i M; Barnstable County Health Laboratory ANALYTICAL REPORT FOR West Barnstable Petroleum Study Report Prepared for: West Barnstable Petroleum Study Donna Miorandi 200 Main Street Hyannis, MA 02601 Order#: G 1372876 No. of Samples: 5 Dade Received: r 3/26/2013 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 03/27/2013 7; CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) Recipient: Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum Study Sampled: 03/26/2013 10:34 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 390 Plum Street,West Barnstable Sample Location: 196 017 Order#: G1372876 Description: voc Lab ID: 1372876-01 Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Andrew&Ruthanne Barr,390 Plum St EPA 524.2- Volatile Organics by GC/MS Resuft MCL MDL Result MCL NMDDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2-Trichloroethane ND 5.0 0.50 Isopropylbenzene ND 0.50 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 o.so 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 n-Propylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 0.50 sec-Bu 1,2,4-Trimethylbenzene ND tylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0. 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Trimethylbenzene ND 0.50 trans-1,2-Dichlaroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND 0.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2 Chlorotoluene ND 0.50 p-Bromofluorobenzene 1000/0 70 1 130 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 980/0 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND-None Detected Reporting RL - Re ortin Limit MC L=Maximum Cont minant Level Superior Court House, P0. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 5 0 9M, CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) i Recipient: Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum Study Sampled: 03/26/2013 10:43 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 1611 Main St/Rt 6A,West Barnstable Order#• G1372876 Sample Location: 191-043 i Description: voc Lab ID: 1372876 02 Date Analyzed: 3/26/2013 @ 10:28 Sample#:. Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Jeremie&Diane Mailloux, 1611 Main St � I EPA 524.2- Volatile Organics by GC/MS Result MCL MDL Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2-Tdchloroethane ND 5.0 0.50 Isopropylbenzene ND 0.50 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 n-P'ropylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 1,2,4-Trimethyl benzene ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND loon 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Trimethylbenzene ND 0.50 trans-1,2-Dich loroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethehe ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND 0.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered °g QC Limits(/o) 2-Chlorotoluene ND 0,50 p-Bromofluorobenzene 1000/c 70 130 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 1010/0 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.so Chloroethane ND 0.50 A&&7-6414-� -LQ-n Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 2 of 5 IL CERTIFICATE OF ANALYSIS �V iat Barnstable County Health Laboratory (M-MA009) "tAClIU,r'.� Recipient: Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum Study Sampled: 03/26/2013 9:53 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 388 Plum Street,West Barnstable Order#: G1372876 Sample Location: 196-018 Description: voc Lab ID: 1372876-03 Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Catherine Marie Kurra,388 Plum St EPA 524.2- Volatile Organics by GC/MS Result MCL MDL, Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Tdchloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachioroethane ND 0.50 Hexachlorobutadiene ND 0.50 s.0. 0.50 Iso py 1,1,2-Trichtoroethane ND pro (benzene ND 0.50 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.5o Methyl-t:ert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 n-Propylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 0.50 sec-Bu 1,2,4-Trimethylbenzene ND tylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 050 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Trimethylbenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 0.50 trans-1 1,3-Dichlorobenzene � ND trans -Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND' 0.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 p-Bromofluorobenzene 100% 70 130 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 101% 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 3 of 5 CERTIFICATE TIFI ATE OF ANALYSIS Barnstable County Health Laboratory (M-MA009) ''•,,g, /jai Recipient: Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum_Study Sampled: 03/26/2013 10:07 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 374 Plum Street,West Barnstable Order#: G1372876 Sample Location: 196-019 Lab ID: 1372876-04 Description: voc Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Karen,Allen_&Carl Wirtanen,P 0 Box 5 EPA 524.2- Volatile Organics by GC/MS Result MCL MDL Result MCL MQL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichlompropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Tdchloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachioroethane ND 0.50 Ffexachlorobutadiene ND 0.50 1,1,2-Trichloroethane ND 5.0 0.50 Isopropylbenzene ND 0.50 1,1-Dichlo methane ND 0.50 Methylene chloride ND 5.0 0.50 7.0 0.50 Meth I ty 1,1-Dichloroethene ND y-tert-bu I ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND o.so 0.50 n-Bu Ibe 0.50 1,2,3-Trichlorobenzene ND ty nzene ND 1,2,3-Tdchloropropane ND 0.50 n-Propylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 0.50 sec-Bu 1,2,4-Trimethylbenzene ND tylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butyl benzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylene5 ND 10000 0.50 1,3,5-Trimethylbenzene ND 0,50 trans-1,2-Dichloroethene ND 100 0.5o 0.50 trans-1 p p 1,3-Dichlorobenzene ND ,3-Dichloro ro ene ND 0.50 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND 0.50 2,2 Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2 Chlorotoluene ND 0.50 p-Bromofluorobenzene 10211/o 70 130 4 Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 1030/a 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Attached please find the laboratory certified parameter list, Approved By: . (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, P0. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 4 of 5 OF H ;osaJY, CERTIFICATE OF ANALYSIS m' Barnstable County Health Laboratory (M-MA009) Recipient: Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum Study Sampled: 03/26/2013 10:14 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 404 Plum Street,West Barnstable Order#: G1372876 Sample Location: 196-016 Description: voc Lab ID: 1372876-05 Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Edward 8L Tracie Crowley,404 Plum St EPA 524.2 - Volatile Organics by GC/MS ' Result MCL MD Result MCL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND so 0.50 j Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 I Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1;1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Ethlbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 j 1,1,2-Trichloroethane ND 5.0 0.50 Isopropylbenzene ND 0.50 j 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0.50 1,2,3-Trichloropropane ND 0.50 n-Propylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 1,2,4-Tdmethylbenzene ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0- 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 j 1,3,5-Tdmethylbenzene ND 0.50 trans-1,2-Dichloroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 i 1,3-Dichloropropane ND 0.50 Trichloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND 0.50 2,2-Dichloropropane ND 0.50 Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 4-Chlorotoluene ND o.50 p-Bromofluorobenzene 92% 70 130 1,2-Dichlorobenzene-d4 92% 70 130 Beniene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0so Chlorobenzene ND 100 0.50 Chloroethane ND 0.50 Attached please find the laboratory certified parameter list. Approved By: (Lab Director) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, P0. Box 427, Barnstable, MA 02630 Ph: 508-375-6606 Page 5 of 5 BARNSTABLE COUNTY DEPARTMENT OF HEALTH&ENVIRONMENT of sz WATER QUALITY LABORATORY' BARNSTABLE SUPERIOR COURTHOUSE; o r 3195 MAIN STREET/P.O.Box 427 •BARNSTABLE,MA 02630 `z PHONE: 508-375-6605 •FAX:508-362-7103 $�ssACHUs��� BOTTLE IDENTIFICATION NUMBER DRINKING WATER ANALYSIS (lab Use only) (PLEASE FOLLOW ALL INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS FORM) REPORT GOES TO: WPM kkvfi1ANV BAIX SAMPLING DATE: IN_ IME: M. A M ci4e a ne COMPANY NAME: G SAMPLE COLLECTED BY: MAILING ADDRESS: C� SAMPLE LOCATION: v �r/� W65-rIIARNS�" JM kS tr t) PHONE#:`�/]—, r�` 'FAX: MAP&PARCEL# O 0-Lj E-MAIL: � r t@ Come ® �I OWN WATER T WELL WATER�X WELL DEPTH FINANCIALLY RESPONSIBLE PARTY: CONTACT NUMBER: BILLING ADDRESS: IF REQUIRED BY MA DEP,PLEASE PROVIDE THE FOLLOWING INFORMATION: PWS ID: PWS NAME: DEP LOCATION(LOC)ID# DEP LOCATION NAME: PWS CLASS: COM NTNC TNC SAMPLE ACEDIFIED:YES SAMPLE INFORMATION: (1)(M)ULTIPLE (S)INGLE (2)(R)AW (F)INISHED (3)ROUTINE SAMPLE(RS) SPECIAL SAMPLE(SS) (4) RESAMPLED:YES : NO CUSTODY TRANSO+ER 0 DATE TIME Relinquished By: y•3 2o r✓ 10 Received By: 2Y� 2b 4110 .. COMMENT: ANALYSIS REQUESTED: —Lab Use Only— CHECK ANALYTE PRESERVATION RESULT UNIT ANALYSIS ENTERED BY REVIEWED DATE &DATE BY&DATE Copper mg/L Iron y s03 No mg/L Sodium mg/L Conductance umols/cm Nitrate HNO3 No mg/L. Yes—PH — Total Coliform THIO:Yes No VOC(524.2) HC1:Yes No ug/L Ammonia H2SO4:.Yes No mg/L Other COMMENT: BARNSTABLE COUNTY DEPARTMENT OF HEALTH & ENVIRONMENT BARNSTABLE SUPERIOR COURTHOUSE OF BJ 3195 MAIN STREET/P.O. BOX 427 BARNSTABLE,MASSACHUSETTS 02630 ''gssAcsti��� PHONE: 508-375-6605 •FAX: 508-362-7103 SAMPLING INSTRUCTIONS FOR PRIVATE WELLS 1. Obtain the sampling bottle(s)from the County Lab or Town Health Department. A 100 mL sterile bottle is for bacteria analysis. If water is chlorinated or smells strong chlorine, a 100 mL sterile bottle with preservative of sodium thiosulfate must be used. 2. It is recommended to use a straight faucet preferably NOT swing-type. 3. Turn on the cold water and let it run for five (5)minutes. 4. Fill the bacteria bottle to well above the 100 mL line. This is critical to ensure that there is enough water to perform the test. Do not place the cap on any surfaces or allow anything(i.. e. faucet,hands, etc.)to touch the inside of the bottle. a. When filling the larger of the two bottles, do not fill the bottle to the very top. Be careful not to touch the inside of the bottle or cap with the faucet,your hands, or anything else. b. Sample must be kept cold after drawing the water. 5. Fill out the reverse side of this form and the labels on all bottles. The laboratory requires accurate and complete information. The lab is not held responsible for damages resulting from lack of or incorrect information given,including phones#'s. Please check off all tests being requested. 6. The charge for a routine well analysis (coliform bacteria,pH,conductivity,iron,nitrate, sodium, and copper) is $30.00. Checks should be made out to Barnstable County.Exact change is required if paying in cash. Additional tests require additional fees. Consult the lab for more information. 7. Samples are accepted Monday—Thursday from 8:00 AM to 4:00 PM. They must be delivered to the lab within 6 hours of collection or 24 hours if refrigerated. NOTES: • Samples for bacteria are not accepted on Friday. • Whirlpool,hot tub and pool samples are accepted ONLY Monday and Tuesday. 8. Completion of tests and results takes 10 business days. Results will be sent in the mail. 9. Special requests, such as results in less than 10 business days, are available for an additional charge. Contact the laboratory for pricing. NOTICE: WATER FROM THE SAME SOURCE CAN PRODUCE CONTRARY RESULTS IF TESTED AT DIFFERENT TIMES AND/OR DIFFERENT LOCATIONS. THE COUNTY OF BARNSTABLE SHALL NOT BE LIABLE FOR DAMAGES RESULTING FROM THE RELIANCE ON RESULTS OF WATER TESTS INACCURATELY PERFORMED. PLEASE COMPLETE REVERSE SIDE OF FORM { . 7 Miorandi, Donna From: Hutcheson, Julie (DEP) Oulie.hutcheson@state.ma.us] Sent: Friday, April 05, 2013 4:44 PM To: Miorandi, Donna Subject: RE: Message from "RNP0026734A2A86" Hi Donna I agree that based on the lab results, the best course of action for the Barr's is to put in a deeper well. The initial concentrations they reported do not exceed the acceptable levels. Please let me know haw they are taking the recommendation. Thank you Julie Julie J. Hutcheson Branch Chief MassDEP Emergency Response Southeast Region 20 Riverside Dr. , Lakeville MA 508-946-2852 julie.hutcheson@state.ma.us -----Original Message----- From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Wednesday, April 03, 2013 8:41 AM To: Hutcheson, Julie (DEP) Subject: FW: Message from "RNP0026734A2A86" Good Morning Julie: Here are the results of the VOC samples that I collected. The county Lab processed them. They are all ND. The only thing I can say and I have relayed this to Andrew Barr is that he should definitely put in a new deeper well. Any thoughts are greatly appreciated. Thanks! Donna Miorandi -----Original Message----- From: Gongmin Lei [mailto:gmlei@barnstablecounty.org] Sent: Friday, March 29, 2013 2:24 PM To: Miorandi, Donna Subject: FW: Message from "RNP0026734A2A86" Donna: Attached please find the reports you were looking for. Best, Gongmin 508-375-6606 FAX: 508-362-7103 -----Original Message----- From: Lab Scans Sent: Friday, March 29, 2013 2:17 PM To: Gongmin Lei Subject: Message from "RNP0026734A2A86" This E-mail was sent from "RNP0)26734A2A86" (Aficio MP 4002) . Scan Date: 03 .29.2013 14:17:12 ,(-0400) Queries to: labscans@barnstablecounty.org 1 Please "i46 not reply to this email. For question and information, contact the Barnstable County Health Lab (508) 375-6605 gmlei@barnstablecounty.org 2 No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01pplicatiou jf or Vern Cougtructtou Permit Application is hereby made for a permit to Construct( Alter( ), or Repair( ) an individual well at: Location-Address Assessors Map and Parcel Owner Address `fie-s wur�o W CA `dJ ry 9 S &A Installer-Driller Address Type of Building Dwelling Other-Type of Building No. of Persons Type of Well `� �S�C S C -,10 Capacity 10 = YIA Purpose of Well De-s Yea.-CS'lx L Agreement: The undersigned agrees to install the afore described 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 Certifi pliancpbas been issued by e oard of Health. Signed712(411,3 Date Application Approved By (U5 Date Application Disapproved for the following reasons: Date Permit No. `�" ®�I Issued _ GI Date ---------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(Altered( ), or Repaired( ) by i) ,� Installer at 3�0 �lU � cy has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. W,901-5— 67 I Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector E No. W�0 Fee BOARD OF HEALTH TOWN OF BARNSTABLE 01ppricatiou _for Veft Cougtructiou Permit Application is hereby made for a permit to Construct(v�,r Alter( ), or Repair( ) an individual well at: 9 O (AAvs S+. UJ I ?)A r t J Location-Address Assessors Map and Parcel A N Ax-b-,3 Q o,*-R_ Owner Address �e s WNA f•j o W b r- M 9 C)HtA,j S Installer-Driller �- Address Type of Building Dwelling "'` Other-Type of Building No. of Persons Type of Well Z c-%1N-,,e STl C d,L10 Capacity /D -t 9 p n-t Purpose of Well OU wt-eS tA C_ . r Agreement: The undersigned agrees to install the afore described 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 Complianc as been issued by e Board of Health. Signed - 2 y r Date Application Approved By Date Application Disapproved for the following reasons: Ii I J Date Permit No. "" �Ld O�I Issued G(_ Date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed(Altered( ), or Repaired( ) by Installer at 3�0 �� L) has been installed in accordance with the,provisions of the Town of Barnstable Board,of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. W 20 Dated ol- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH TOWN OF BARNSTABLE 13 , �� Well �tCougtruction Permit No. "� Fee Permission is hereby granted to 0 e5 VhA,,j k) W CJl.i1 b41 t N 1 Installer to Construct(a), Alter(( ), or Repair( ) an individual well at: No. 3c1 U P u4^.. 5` - w 6L l Street as shown on the application for a Well Construction Permit No. w d o o by ' Dalrd Date a Approved By U ' z i 0/1 J f 44 Y i� CIO � V 41 /"Oio �• 1 • J 2 S y COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION Certified Parameter List as of:01 Dec 2009 M-MA009 BARNSTABLE COUNTY HEALTH&ENV DEPT, BARNSTABLE,MA Anal es Methods for NON-Potable Water Methods for Potable Water ALUMINUM EPA 200.8 ANTIMONY EPA 200.8 EPA 200.8 ARSENIC EPA 200.8 EPA 200.8 BARIUM EPA 200.8 BERYLLIUM EPA 200.8 EPA 200.8 CADMIUM EPA 200.8 EPA 200.8 CHROMIUM EPA 200.8 EPA 200.8 COBALT EPA 200.8 COPPER EPA 200.8;SM 3111 B EPA 200.8;SM 3111 B IRON SM 3111B LEAD EPA 200.8 EPA 200.8 MANGANESE EPA 200.8; SM 3111 B MERCURY EPA 200.8 NICKEL EPA 200.8;SM 3111 B EPA 200.8;SM 3111 B SELENIUM EPA 200.8 EPA 200.8 SILVER EPA 200.8 EPA 200.8 THALLIUM EPA 200.8 EPA 200.8 VANADIUM EPA 200.8 ZINC EPA 200.8;SM 3111 B PH SM 4500-H-B SM 4500-H-B SPECIFIC CONDUCTIVITY EPA 120.1; SM 2510B HARDNESS(CACO3),TOTAL SM 2340B CALCIUM SM 3111 B SM 3111 B MAGNESIUM SM 3111B SODIUM SM 3111 B SM 3111 B POTASSIUM SM 3111 B ALKANILITY,TOAL SM 2320B SM 2320B CHLORIDE EPA 300.0 FLUORIDE EPA 300.0 SULFATE EPA 300.0 EPA 300.0 NITRATE-N EPA 300.0 EPA 300.0 NITRITE-N EPA 300.0 TURBIDITY EPA 180.1 TOTAL DISSOLVED SOLIDS SM 2540C SM 2540C NON-FILTERABLE RESIDUE(TSS) SM 2540D TOTAL ORGANIC CARBON SM 5310B CHEMICAL OXYGEN DEMAND HACH METHOD 8000 BIOCHEMICAL OXYGEN DEMAND SM 5210B TRIHALOMETHANES EPA 524.2 VOLATILE HALOCARBONS EPA 624 VOLATILE AROMATICS EPA 624 VOLATILE ORGANIC COMPOUNDS EPA 524.2 1,2-DIBROMOETHANE EPA 504.1 1,2-DIBROMO-3-CHLOROPROPANE EPA 504.1 PERCHLORATE EPA 314.0 HETEROTROPHIC PLATE COUNT SM 9215B TOTAL COLIFORM MF-SM 9222B TOTAL COLIFORM EPA 1604 TOTAL COLIFORM ENZ.SUB.SM 9223 FECAL COLIFORM MF-SM 9222D MF-SM 9222D E.COLI EPA 1603 EPA 1604 E.COLI EPA 1103.1 NA-MUG-SM9222G E.COLI MF-SM 9213D ENZ.SUB.SM 9223 ENTEROCOCCI EPA 1600 EPA 1600 Effective Date:01 July 2012_Expiration Date:30 Jun 2013 COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION ' Certified Parameter List as of:01 Dec 2009 M-MA009 BARNSTABLE COUNTY HEALTH&ENV DEPT, BARNSTABLE,MA Analvtes Methods for.NON:-Potable Water Methods for Potable Watei ALUMINUM EPA 200.8 ANTIMONY EPA 200.8 EPA 200.8 ARSENIC EPA 200.8 EPA 200.8 BARIUM EPA 200.8 BERYLLIUM EPA 200.8 EPA 200.8 CADMIUM EPA:20M EPA 200.8 CHROMIUM EPA 200.8. EPA 200.8 COBALT EPA'200.8,, A COPPER EPA 200.8;SM 311-1;B EPA 200,&SM 3111E m _ IRON SM 3111B LEAD EPA 200.8 EPA 200.8 MANGANESE EPA 200.8;SM 31116 MERCURY EPA 200.,8 NICKEL =. EPA 200.8;,SM 3111 B EPA 200.8;SM 3111 B .; a . SELENiilM - - =y ';:' tPA 200 8 1 -cam EPA SILVER EPA4200$ ,, + r '.EPA 200 8 a �� * „� 3 . ' THALLIUM C EPA 200 8 = EPA 200 8 " VANADIUM - r EPA 2008 �� �,`t 3= rP ; r� ZING EPA 200.8;SM 3111B" PH SM*4500-H-8 SM 4500-H-Bu SPECIFIC CONDUCTIVITY EPA 120 1 SM 2510B5 'e} HARDNESS(CAC03),TOTAL .' �,SM 2340E iY : Pix .CALCIUM:-" SM31118 :SM3111B pig• - MAGNESIUM _ . SM'3111B " SODIUM SM 3111Bw $M 3111-6 „ a� POTASSIUM SM 31118 ALKANILITY,TOAL SM.2320B. , ` .SM 2320B :- -� : �A m3 ` CHLORIDE EPA 300.0 FLUORIDE EPA 3000 SULFATE EPA 300.0 EPA 300.0 NITRATE-N EPA 300.0 K - ` EPA 300:0 .. _�._ . _. NITk_IT_E-N__. .__.... EPA 300.0 TURBIDITY EPA 180,1 TOTAL DISSOLVED SOLIDS SM 2540C SM 2540C NON-FILTERABLE RESIDUE(TSS) SM 2540D g" TOTAL ORGANIC CARBON SM 53106 w s 3 CHEMICAL OXYGEN DEMAND HAC! METHOD 800C 3M.. . (a, - 'BIOCHEMICAL OXYGEN DEMAND''**SM 5210E TR{HALOMETHANES +i�*,•EPA 524.2 re y i : VOLATILE HALOCARBONS EPA 624 _VOLATILE AROMATICS EPA 624 0 .•R: -gip VOLATILE ORGANIC COMPOUNDS PA 524;2 1,2-DISROMOETHANE ,EPEA504'.1 " k ` . - 1 2-DIBROMO-3 CHLOROPROPANE 'EPA 504.1 � c` ,. PERCHLORATE EPA 314.0., ,:HETEROTROPHIC PLATE_COUNT ,;. SM 9215B TOTAL COLIFOM MF-SM 92226 R TOTAL COLIFORM EPA 1604 ��. - TOTAL COLIFORM , ENZ.SUB.SM 9223 . ,FECAL COLIFORM MF-SM 9222D ; _ ~� MF-SM 92220 E. COLI EPA1603 EPA.1604, E.COLT EPA 1103.1 Y NA-MUG-SM9222G ` y y E:COLT MF-SM 9213D ENZ:SU'B.SM 9223 ENTEROCOCCI EPA 1600 EPA 1600 Effective Date:01 July 2012;Expiration Date:30 Jun 2013 t - CERTIFICATE, OF ANALYSIS Pager 1 of 1 Barnstable County Health Laboratory.(M-MA009) y°! Report Prepared For: Report Dated: 3/1/2013 K Andrew Barr Order No.: G1372559 393 Plum St. W Barnstable, MA 02668 i Laboratory ID#: 1372559-01 Description: Water-Drinking Water Sample#: Sample Location: 390 Plum St.W.'Barnstable,,MA, Collected:,, 02/25/2013 Collected by: A. Barr Received: 02/25/2013 i Routine t ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE Nitrate as NitroCen 0.44 mg/L 0.10_ 10 EPA 300.0 LAP 2/25/2013 CO PP @r. ND - mg/L. 0.101.3 . SM'31118 LAP, 2/27/2013 _ Iron b � 5 � �ND mg/L �.s�r0 lfl ' � 0.3 SM'31118" LAP 2t27/2013 ' - t i.� , x r* a 4- t._4a e s p(-I 6.1 PH ATa25C NA 6 b-8.5 SM 4500-H-B y DCB I2126/20131 SOdIU"m 6 7,. gm9lLna 2 5 20 i SM 31116 LAP„ 2/2712013 TOtdl C$liform" Absent P/A, , 0 GSM 9223 RG� �2/2512013 � e� :c A COndUCfBnCe. 71. umohs/cm' 2 0 r EPA 120 1 DCB 2/26/2013, k Water sample meets the recommended l mats' r drinking water of all;the above tested parameters Approved ,By Attached please find the laboratory certified parameter list. w 9 } (Lab Manager) n t "3 ` r V -w g x+ 'SC }*, x.�J rig rc < m . r ND Noie Detected Y y' RL Reporting Limit MCL=Maximum Contaminant Level �i Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 CERTIFICATE,. OF ANALYSIS:. `•. .k T Barnstable County Health Laboratory. (M MA009) { Recipient: Matrix: Water-,Drinking Water { Andrew Barr Sampled: 02/25/2013 `9:40 �. 390 Plum St. _'' Received: 02/25/2013 10:00 ' W.Barnstable,,MA 02668 Collection Address: 390 Plum St.W.Barnstable,MA , Order#: G1372559 Sample Location: Lab`ID: 1372559 Ol Description: Rkt Date Analyzed: 2/27/2013 r@ 15:54 Sample#: . Analyst:_ yn Method: EPA 524.2 Dilution Factor 1 ; Comment: Water sample meets the recommendedlimits for drinking water o`f all the above tested"pa'rameters. EPA 524.2- Volatile Organics by GC/MS T Result M L MDL Result MCL MD^ Parameter Parameter u :u L„ �u L �g/L ug/L u9/L 9/ 9! 9/ z A t Dichiorodifluoromethane _.. , ND ' -, ..,, o.50,a. Chioroform M050 Chioro0 50 „ ds-1,2=Dichlortethene „' ND 70Vinyl chloride t,o Oso ias1,3-Dichloropnopene ht0Bromomethane ,0 ND � 50 ,{ Dibrom&hlaoif 1;1,1,2-Tetrachloroethane•. AND 0 506 �= Dibroiomethane ND1;1,1-Trictsloroethane - ND �00 050 Ethylbenozene . �' END 7001,1,2,2 Tetrachloroethane ND�, � � 0 50 Hexachl robutadiene �� N;2-Trichioroethaner ND ` 50 -050 Isopropylbenzene ND1,1 Dichloroethane. °} ND Ov50 Methjrlene chloride " - '° '° � ND 5 —=1= 1,1 Dichloroethene 'A ND .. ' :7 0 0 5o Methyl-tert-butyl ether. ND , 0.50y. 1,10ichloropropene ND l 0.5o , Naphthalene `ND 0.50 1,2,3 Trichlorobenzene { ND �, 0.50, y. n-Butylbenzene y f ND {„ 1,2,3 Tnchloropropane ND i 0 50 n-Propylbenzene ND' '• 0.50 -��— ._ .1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND ; 0:50 .p ,4�rrrrrrtet en ,,, --32 0 50 sec-Butylbenzene ND 1;2 Dibromo 3-Chloropropane — ND 0 50 Styrene �,, ND i00 0 50 1,2 Dibromoethane(E06) :�--ND .__ O50 tert 6utvlbenzene " 4-•ND - ` L 0-�0 1i,2-Dichiorobenzene —-- ND 1 600 j 0.50 jTetrachloroethene i ND 5.0 0:50 II1,2-Dichloroethane ND 5.11) I 0.50 Toluene N0 1000 0.50 I1,2-Dichlor6propane _ 1 ND 0.50 i Total xylenes ND 10000 0.50 5=Trimeth benzene 3.0 0.50 trans-l;2-0ichloroethene ND ioo 0.50 (��(' - ichlorobenzene = .s ND � 0.50 . trans-1,3 Dichloropropene � ND �, �0.59 r: {1,3,Dichioropropane ,,� ��� AND„ �" O 50 richloroethene N0 5 0 or50 1;4-Dichiorobenzene �. ��ND nchtorofluoromethane, t ,2 DlchlOrOprppane-- -� * rd�ND ` 0 5�� r��,2D Of�iteS .( _ _ / Rcovered . ts 2 Chforotoluene - ND 0 50 � �� fluorobenzene �119010 70 r�130 4-Chlorotoluene { ND 0.50 loHie niene-d4: b i20�lo .70.,._ 130._, Benzene ND 5 0 Bromobenzene° ND,:., 0.50 Bromochioromethane _ND 0 50 Bromodichloromethane ;! _ND 0 50 Bromoform ND i 0.50 . {`- Carbon tetrachloride _ T ,ND= k 5 0 0.50, - Chiorobenzene: —ND 100 _ 0 50`` `- - Chloroethane ' ND— -I i 0.50 i ' e 1� � Approved;,By f Attached please find the laboratory certified parameter list (Lab Director) - 3 % .� ND=None Detected RL = Reporting Limit Mc Maximum.Contamrna vel- Superior Court House, PO. Box 427, Barnstable, MA 02630, Ph 608-375-6606 Page 1 of 1. M i `OF yq�tis` 9M, Barnstable County Health Laboratory .yss^cHusw/ ' ANALYTICAL REPORT FOR i West Barnstable Petroleum Study Report Prepared for: West Barnstable Petroleum Study Donna Miorandi 200 Main Street Hyannis, MA 02601 Order#: G 1372876 No. of Samples: 5 Date Received: 3/26/2013 i i Superior Court House, P0.Box 427, Barnstable, MA 02630 Ph:508-375-6606 03/27/2013 �YpE HAT CERTIFICATE OF ANALYSIS iq� 79; Barnstable County Health Laboratory (M-MA009) Recipient: Donna Miorandi Matrix: Water-Drinking Water West Barnstable Petroleum Study Sampled: 03/26/2013 10:34 200 Main Street Received: 03/26/2013 11:34 Hyannis, MA 02601 Collection Address: 390 Plum Street,West Barnstable Order#: G1372876 Sample Location: 196-017 Description: voc Lab ID: 1372876-01 Date Analyzed: 3/26/2013 @ 10:28 Sample#: Analyst: yn Method: EPA 524.2 Dilution Factor: 1 Comment: Mail to Andrew&Ruthanne Barr,390 Plum St I EPA 524.2- Volatile Organics by GC/MS Result M L MD Result M IL MDL Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroform ND 80 0.50 Chloromethane ND 0.50 cis-1,2-Dichloroethene ND 70 0.50 Vinyl chloride ND 2.0 0.50 cis-1,3-Dichloropropene ND 0.50 Bromomethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromomethane ND 0.50 1,1,1-Tdchloroethane ND 200 0.50 Ethylbenzene ND 700 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Hexachlorobutadiene ND 0.50 1,1,2-Trichloroethane ND 5.0 0.50 Isopropylbenzene ND 0.50 1,1-Dichloroethane ND 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloroethene ND 7.0 0.50 Methyl-tert-butyl ether ND 0.50 1,1-Dichloropropene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichlorobenzene ND 0.50 n-Butylbenzene ND 0,50 1,2,3-Trichloropropane ND 0.50 n-Propylbenzene ND 0.5a 1,2,4-Trichlorobenzene ND 70 0.50 p-Isopropyltoluene ND 0.50 1,2,4-Trimethylbenzene ND 0.50 sec-Butylbenzene ND o.so 1,2-Dibromo-3-chloropropane ND 0.50 Styrene ND 100 0.50 1,2-Dibromoethane(EDB) ND 0.50 tert-Butylbenzene ND 0.50 1,2-Dichlorobenzene ND 600 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloroethane ND 5.0 0.50 Toluene ND 1000 0.50 1,2-Dichloropropane ND 0.50 Total xylenes ND 10000 0.50 1,3,5-Trimethylbenzene ND 0.50 trans-1,2-Di chloroethene ND 100 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,3-Dichloropropane ND 0.50 Trcchloroethene ND 5.0 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichlorofluoromethane ND 0.50 2,2 Dichloropropane ND 0.50 t Surrogates %Recovered QC Limits(%) 2-Chlorotoluene ND 0.50 p-Bromofluorobenzene 1 100% 70 130 4 Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 1 980/0 70 130 Benzene ND 5.0 0.50 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND l00 0.50 Chloroethane ND 0.50 Attached please find the laboratory certified parameter list. Approved By:(Lab Director) ND=None Detected RL Reporting Limit MCL=Maximum Cont minant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 5 Miorandi, Donna From: Hutcheson, Julie (DEP) Oulie.hutcheson@state.ma.us] Sent: Monday, April 08, 2013 3:10 PM To: Miorandi, Donna Subject: RE: Message from "RNP0026734A2A86" Hi Donna According to your email, it sounds like the proper actions have been taken. We'll see if Mr. Barr does subsequent sampling. Hopefully he does decide to install a new well. Thank you Julie J. Hutcheson Branch Chief MassDEP Emergency Response Southeast Region 20 Riverside Dr. , Lakeville MA 508-946-2852 julie.hutcheson@state.ma.us ----- ri i O g nal Message----- From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Monday, April 08, 2013 9:45 AM To: Hutcheson, Julie (DEP) Subject: RE: Message from "RNP0026734A2A86" Hi Julie: Just talked to Andrew Barr and he states that he is going to test again with g 5 g another laboratory. Sounds like he doesn't trust the County Lab by him doing this although he didn't state that. Told him you were following up and that you agreed with me on a new well. Right now he says he is inundated with taxes and is not even thinking about this problem. He is still on bottled water and if putting in a new well it would be towards the summer time. He states he will call me in a week or so. His phone number in case you don't have it is 508-243-4891. Thanks so much! Donna Miorandi Health Department -----Original Message----- From: Hutcheson, Julie (DEP) [mailto:julie.hutcheson@state.ma.us] Sent: Friday, April 05, 2013 4:44 PM To: Miorandi, Donna Subject: RE: Message from "RNP0026734A2A86" Hi Donna I agree that based on the lab results, the best course of action for the Barr's is to put in a deeper well. The initial concentrations they reported do not exceed the acceptable levels. Please let me know how they are taking the recommendation. Thank you Julie Julie J. Hutcheson Branch Chief MassDEP Emergency Response Southeast Region 20 Riverside Dr. , Lakeville MA 508-946-2852 julie.hutcheson@state.ma.us -----Original Message----- From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] 1 Sent: Wednesday, April 03, 2013 8:41 AM To: Hutcheson, Julie (DEP) Subject: FW: Message from "RNP0026734A2A86" Good Morning Julie: Here are the results of the VOC samples that I collected. The county Lab processed them. They are all ND. The only thing I can say and I have relayed this to Andrew Barr is that he should definitely put in a new deeper well. Any thoughts are greatly appreciated. Thanks! Donna Miorandi -----Original message----- From: Gongmin Lei [mailto:gmlei@barnstablecounty.org] Sent: Friday, March 29, 2013 2:24 PM To: Miorandi, Donna Subject: FW: Message from "RNP0026734A2A86" Donna: Attached please find the reports you were looking for. Best, Gongmin 508-375-6606 FAX: 508-362-7103 -----Original Message----- From: Lab Scans Sent: Friday, March 29, 2013 2:17 PM To: Gongmin Lei Subject: Message from "RNP0026734A2A86" This E-mail was sent from "RNP0026734A2A86" (Aficio MP 4002) . Scan Date: 03 .29.2013 14:17:12 (-0400) Queries to: labscans@barnstablecounty.org Please do not reply to this email. For question and information, contact the Barnstable County Health Lab (508) 375-6605 gmlei@barnstablecounty.org 2 Page: 1 CERTIFICATE OF ANALYSIS ` . Barnstable County Health Laboratory � rsrACFtusw�, Report Dated: 5/18/2004 Report Prepared For: Ruthanne Barr Order No.: G0425141 Barr,Ruthanne,&Andrew D 141 Rumford Ave. Mansfield, MA 02048 Laboratory ID#: 0425141-01 Description: Water-Drinking Water Sample 4: 25141 Sampiing Location 390 Plum St West Barnstable ,NIA Collected: 5/14/2004 Collected by: R Barr Received: 5/14/2004 I ,Routine +Ammonia ITEM RESULT UNITS RL MCL Method# Analvst Tested Note LAB: IC Lab - i Ammonia BRL m--/L 0.1 EPA 350.1 LAP 5/14/2004 Nitrates 0.9 mg/L 0.1 10 EPA 300.0 LAP 5/14/2004 i LAB: Metals Copper 0.2 mg/L 0.1 1.3 SM 3111B LAP 5/14/2004 Iron BRL mg/L 0.1 0.3 SM3111B LAP 5/14/2004 t Sodium 12 mg/L 1.0 20 SM 3111B, LAP 5/14/2004 LAB: Microbiology I i Total Coliform Absent P/A 0 Absent 369 D 5/14/2004 LAB: Physical Chemistry Conductance 130 umohs/cm 1 EPA 120.1 MHS 5/14/2004 pH 6,8 pH-units 0 EPA 150.1 MHS 5/14/2004 I EPA 524.2- Volatile Organics by GC/MS ITEM RESULT UNITS RL MCL Method# Analvst Tested Note LAB: GUMS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 TFB 5/17/2004 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 TFB 5/17/2004 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,2,3-Trichlo ropro pane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 'r Page: 2 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 5/18/2004 Report Prepared For: Ruthanne Barr Order No.: G0425141 Barr Ruthanne &Andrew D 141 Rumford Ave. Mansfield, MA 02048 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 TFB 5/17/2004 I 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,2-Dibromo-3-chloropropa BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 I 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 TFB 5/17/2004 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 I 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 i 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 I 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 4-Chlorotoluene BRL ug/L 0•5 EPA 524.2 TFB 5/17/2004 I Benzene BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 jBromobenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Bromochloromethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 I iBromodichloromethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Bromoform BRL ug/L 0.5 EPA D-24.2 TFB M 7/2004 I Bromomethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 i Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 TFB 5/17/2004 Chloroethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Chloroform BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 i Chloromethane BRL ug/L 0.5- EPA 524.2 TFB 5/17/2004 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 TFB 5/17/2004 cis-1,3-Dichlo ropropene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 i Dibromomethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 /i pF HAq�S'. ;o CERTIFICATE OF ANALYSIS Page: 3 3s > Barnstable County Health Laboratory -rACHt;st', Report Dated: 5/18/2004 Report Prepared For: Ruthanne Barr Order No.: G0425141 Barr,Ruthanne,&Andrew D 141 Rumford Ave. Mansfield, MA 02048 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 TFB 5/17/2004 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 i Isopropylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Methyl-tert-butyl ether BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 I i Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 I n-Butylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 I Naphthalene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Styrene BRL ug/L 0.5 100 EPA 524.2 TFB 5/17/2004 I tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 Toluene BRL ug/L 0.5 1000 EPA 524.2 TFB 5/17/2004 I Total xylenes BRL ug/L 0.5 10000 EPA 524.2 TFB 5/17/2004 I trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 TFB 5/17/2004 I trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 I I I richloroethene BRL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004. i Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 TFB 5/17/2004 Water sample meets the recommended limits for drinking water of all the above tested parameters. ( irector) Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 I NI CERTIFICATE IS Page OF ANALYS g, Barnstable County Health Laboratory Report'Dated: 5/18/2004 € Report Prepared For: Ruthanne Barr Order No.: G0425141 'Barr,Ruthanne,&Andrew D 141`Rumford Ave: : - Mans eld, MA 02048 . Ethvlbenzene BRL ug/L 0.5 700 EPA 524.2 TFB. 5/11/1004 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 IsoF=ropylbenzene BRL ugn. 0.5 EPA 524.2 TFB 511712004 ' r ,- % 5 P-t S2BL7 42a..=�h., za,TFB 5/17/20y0 4NEtFy -buty ether - a �. q TFB 0 11�Ahylene chloride BRL u� 0 5 5 0 EPA 524 2 5/17/z 04 yes , n-$atylbenzene `'BRL- ap�L 0 5° EPA 524.2,' :,:�FFB 5/17/2004? " , . n-Propylbenzene BRLP ug/1 0.5, EPA 5241 TF8, 5/17/2004' - - u • 4 ""naphthalene' BRL p ug/L 0.5 EPA 524..2' TFB 5/17/2004 p-Isopropyltoluene , BRL ug/L ti `0.5 a EPA 524.2 TFB 5/1712004 sec BUtylberi�erie BRL ug/L '0.5 TFB M7/2004 EPA 524.2 2c yreae BRL ug/L 0.5 100 EPA 524:2 TFB ` 5/17/2004 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5l17/2004 Te#rachlOCOethene BRL- ug/L 0.5 5.0 EPA 524.2 TFB 5/17[2004 Y T_ ttene BRL ug/L 0.5 1000 EPA 524.2. TFB 5/17/2004 5 Total xylenes BRL ug/L '0.5 10000 EPA 52422 TFB 5/17/2004 'trans-1.2-DichlOroethene BRL ug/L. 0:5 1,00 EPA 524.2- TFB 5/17/2004 trims=l;3-DichloroprOperie BRL ug/I 0.5 EPA 524.2 ` TFB' 5/17/2004 i Trichloroethe;ne BRL ugJL 0. 5.0 EPA 524.2 TFB 5/17/2004 Trichlorofluo.romethane BRL ug/L 0.5 EPA 524.2 TFs 5/17/2004 EPA 524 2 TFB / Vinyl chloride BRL ug/L . 0.5 2 0 � ,� .� 5n7/2voa rYl r samplemeets the recommended limits for drmktn'g water of all the above tested pAria ieters: y � Approved' Sy C2� `oX� :• ,� d , hector) a 6 °-k& Aw" a Superior Court House,' POAox 427, Barnstable, MA 02630, Ph:508-375-6605 .8L 'Nc n u , b» nx 71 �of a,tal� CERTIFICATE OF ANALYSIS Page: , «� '$ } Barnstable'County Health Laboratory CHU4 .Report Dated: 5/1.8/2004 Reoort Prepared For: Ruthann Barr Order No.: G0425141 Barr,Ruthanne,&Andrew D 141.Rumford Ave. Mansfield, MA: 02048 "E r Laboratory ID#: 0425141-01 Description:. water Drinking water (' 1 Sample#: 251A1 Sampling Location 390 Plum St west Barnstable MA Collected:_ 5/14/2004 1 S a Collected by: R Barr Received:. V14/2004 } Routine+Ammonia °ITEM, RESULT . UNITS RL MCL* Method# `�Analyst vTesed Note , .,� i':,' - LAB ICLab F �A><ntnoniaBRL mg ;0`1 EPA 350 1 LA P s/l.a/looa ; aNitrates 0 9 :% mg/L" 1?U I j, 10 4 "z `EPA 300.0 LAP 5/14/2004 + LAB: :Metals ,. Copper 0.2 mg/L 0.1 1:3 " '°,�SM 3111E .UAP 5/14/2004 �$�, .� mg/1 0.1 0.3 SM 3111 B LAP 5/14/2004 Iron 12 14/mg/L 1.0 20 SM 311 I�B LAP 5/ 2004 Sodium LAB: Microbiology Total Coliform Y y Absent P/a o Absent309 D. 5/14/2004 " i k LAB: Physical Chemistry Conductance 130 ;umohs/cm 1 EPA 120 1 MHS 5/14/2004, E pH 6.8 pH-units � 0 -EPA 150.1 MHS�- 5/14/2004 F r SPA 524.2- Volatile Organics by GUMS ITEM x RESULT $ ; " UNITS " "RL� "MCL d Method#nAnalystTe t diNote 3 ; w,... ��• �+�A,�O _ ,i.raB: �ll./drli7 # .� g s ay 1,1,1,2-Tetrachloroethane5Er`.A 524.2 TFB s/17rzooa 1,1,1=Trichloroethane, BRL ug/L� 0.5 200 EPA524.2 TFB= SIl712-004 ` 1,1,2,2-Tetrachlor6ethane. � BRL ug/L - �0.5 EPA524.2 TFB `-5/1712004 ,ems _ 1,2-TrichlOroethaue ug/L 0.5 5.0 EPA 524 2 TFB: 5/17/2004 BRI. �, Dichloroethane . BRL ug/L 0.5 EPA 524.2'>x TFB 5/17/2004. . J 1 1`Dichloroethene "BRL urn o.s 7.0 EPA sea z,- L TFB sn it2oaa 1,1=Dichloropropene BRL` ug/1 o.s EpA s2a.z ?FB sn i2oo4 ° 1,2,3-Trichlorobenzene BRL u� o. ' EPAsia.z TFB sn7i2ooa ,1,2,3-Trichloropropane BRL u o.s EPA 524.2 TFB s/17nooa - : Superior Court House; P0.`Boi.427, Barnstable, MA 02630 Ph:508-375-6605 €: tea' Page: 2 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Dated: 5/18/2004 Report•Prepared For: Order-�No.- G0425141 a Ruthanne Barr Barr,Ruthanne,&Andrew D 01 141 Rumford Ave: 'Mansfield, 'NA. 02048 - ...................... 1,2,4-Trichlorobenzene BRL ug/I. 0.5 70 EPA 524.2 TFB 5/17/2004 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 TFB 5/17/2004 1,2-Dibromo-3--chloropropa BUL ug/L 0.5 EPA 524.2 TFB 5/1.7/2004 !', 1,2-Dibromoethane fEDB) " BRL'° f ugno sEPA 5242 TFs t�sn7no04L Dichlorobenz `_ ug$jtj, /i 05 a 600 EPA 52414,� TFB ene S/17/2004 1,2-DichlOroethane BRLF '_ ugn 0:5 S 0 EPA".52a2 `` TFB5/17/2004 2e im r � �1,2 DichloroprCpane' �$RL� `r u� 0.5 `� EPA.5242 ' TFB 5117/2004" , 1,3,�-Trimethylben'e' Bjtj, ug/L'` 0.5 EPAY524 2 TFB 5/17/2004 .1,3-Dichlorohenzene' ..BRL ug/L �o s EPA s24.i TFB` silal2ooa ro P 1,3-Diahloro rop ane - BRL ug/L - os EPA 524.2 ,, TFB:°: ,sn 7/2004 �= 1,4-Dichlorobenzene $RL ug/L 0.5 5.0 EPA 524.2 TFB 5/17/2004 2,2-Dichloropropane BRL ug/L.' 0.5 EPA 5241 TFB• 5/17/2004' 2-Chlorotoluene BRL' ug/L 0.5 EPA 524.2 TFB 5/17/2004 4-Ch[Ol'otoluene BRL . ug/L 0.5 EPA 524.2 TFB 5/17/2004 , Benzene BRL ug/L 0.5 5:0 EPA 524.2. TFB . 5/17/2004 I Bromobenzene BRL ug/L 0.5 EPA 524.2 TFB' 5/17/20,04 I` Bromochloromethane BRL ug/L 0.5 EPA 524.2 TFB 5/17i2004 Bromodichlorom ethane BRL ug/L 0.5 EPA 524.1 TFB 5/17/2,004 e 1 Bromoform BRL ug/1:, 0.5 EPA 524.2 TFB 5/17/29,04 Bromomethane .BRL,n, ug/t 0 5 - � hPA 524 2 TFB �5/1712004 � " w a *�a �.... Carbon tetrachloride BRL yK# a g" ug/t `' O 5 a* 5 0�A,7 � #EPA 524-2 a TFB 'R 5/17/2004 $RL - ug/L 4-0 5 100� EPA 524 2 TFB' 5/17I2Q04 � Chlotobenzene , $ju, ug/L� 0 5 - EP.A 524 2 4 TFB ,` 5/17/2004 r Chloroethane II w ., Chloroform BRL ug/L O 5 EPA 524.2- F TFB 5/I7%2004 a M. F Ch10rOmethane "BRL. ug/L 0 5 EPA 524.2= TFB 5/17/2004 , cis 1,2=D><chloroethene BRL ugJL 0.5 70% EPA 524,2 TFB 5/17/2004 '* el F 4 cis-1,3-Dichlo'ropropene BRL ugh 0.5 EPA 524.2 TFB 5/17(2004 , Dibramochloromethane BRL ui/ o.s EPA 52a:2 TFB' 5/1712004' �- ' 0.5 'EPA k4.2 TFB 5/1.7/2004 Dtbromomethane BRL a ;. `Dichi'Oodlfluoromethane BRL ug/L 0.5 EPA 524;2 TFB s/17/2004 10. +' Y superior Court.House, PO.Box 427, Barnstable, MA 02630 Ph:508-375-6605 ri yr ui.�rvaHL Ur UN1lrtfbKUUNll S:UELL STUHAU?; TANK' tE AND ADDRESS MR, WC OF XWE --..._ 'PROVED TANK YARDr -- APPROVED TANK YARD NO. o Tank Yard Ledger 502 CMR 3.03(4) Number; _a i I certify under Penalty of law I have personally examined the underground s s age c delivered' to this "approved tank yard" by firm, corporation or paztnershi L and accepted,same in conformance with Massachusetts Prevention Regulation 502 CMR 3.00 Provisions for Approving [hxiergrOUnd Steel Storage Tank dismantling yards. A valid permit was issued by LOCAL Head of Fire Department FDm# totransport. this tank to this yard. Name and off' ial title of app yard owner or owners authorpil representative: ' SIGNN_ Ti= DATE SI,NED s sit pf disposal moist be returned to the local head of the fire department FDID# ursuant to 502`CMR 3:00. (EACdi TALC.MUST HAVE A RECEIPT OF DISPOSAL) �/ FORM F.P. 291 `/j L1C (OVER) :MASSACHUSM7S STATE FIRE MARSHAL S CIFFIC E. RECEIPT OF DISPOSAL OF UNDERGROUND 'STEEL STORAGE TANK ) - •,<�,�� ra.. F4 �* �+ '`i. �> �-+�°� �arts* � m 1'vo 4 u , �.�''�;°`=' ... e NAME AND ADDRESS APPROVED TANK YARD` «g }g �p JIM _ APPROVED TANK YARD NO. eauw 4 . Tank Yard Ledger 502 CMR 3.03(4)' NumberC' I certify under penalty'of"law I have personally examined the undesgro:u;d s' for tank delivered to this "approved tank yard" by firm, corporation or partnership and accepted same in c0nf0nMnce with Massachutetts Fire Prevention Regulation 502 CMR 3.00 Provisions for Approving Underground Steel Storage dismantling yards. A valid permit was issued by LOCAL. Head of Fire Department FDID#�,�,�j(3to transport this tank to this yard. ( if N aryl official title of app yard owner or owners authorized representative: / SIGNATUEM. TIMEDATE SIGNEDl This siclried pt of disposal must.be returned to the local head of the fire department FDID# � pursuant tc 502 CMR 3:00. (EACH TANK DUST HAVE A RDCEIPT OF DISPOSAL) FORM F.P. 291 (oyER) MASSAMSEPlS STATE FIRE MARSHAL'S OFFICE RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK NAME AND ADDRESS „ S1 e ' OF &E16f010.�E1lR - APPROVED TANK YARD NEW gt, yg APPROVED TANK YARD NO. 7711A� All, Tank, Yard Ledger 5>02. CMR 3.03(4) Number.: fv ' I certify under penalty of.law I have personally ecamifi d the underground s m9tar delivered to this "approved tank yard" by from, corporation or Partnership S (/// Lrjjly and accepted same in conforntiance with Mas- chUsetts Fire Prevention* � Regulation 502 CI�2 3.00 Provisions foiiAPpmvin- Und�sground Stee'l'S qr� tli.ng yes, (� A valid pennit was issued by LOCI, .Head of Fire Department FDID# to transport { amthie and:tank to this yard. � � �`j) . tle of app yard owner or owners authorized representative: SI ✓� I TITLE DATE SIMM1 This S'' f disposal must be returned to the local heart of the fire departrrnnt FDID#CJ L 19;=ant to 502 01R 3 s 00. (EACH TAM MST HAVE A RECEIPT OF DISPOSAL) l/ FORM F.P. 291 ((7VF32) MASSACHUSETTS STATE FIRE KkPZHAL'S OFFICE L .. � o Zo 3 4 COMMONWEALTH OF MASSACHUSEM L' ECUTIVE OFFICE OF ENVIRONMENTAL AFF DEPARTURIFT OF AIRS ENVIROI NTAI. PROTECTION v1AP PARCEL . Z) .,�.. TITLES �'-,- OFFICIAL INSPECTION FORM_ SUBSURFACE SEWAGE FOR DISPPOVSAI,SY ARY ASSESSM T3 PART A STEM FORM Pm"Addr6sc �O MTWCATION owner:Name; c/, Owner'sAddre n o RECEIVED specttos. ell MAY Date of In / 0 6 2004 COmpiu�y pj�es of r:(pj 0 ) TOWN OF BARNSTABLE NaftAddm ; p��� o C HEALTH DEPT. /ot Telephone Number; Sam h d' 6 Cs� �f CERIMCATION STATEMENT I certify that I have personally the below is that accurate disP�l system at this e as oP the time of the' o�Trod �8 expari m in the pauper timctioa and boa The b3pewon approved system levector Pant to��1S ofon sibs sewage d1�sal�'�ema.I am a DEp tle S(310 CMR 110pp� The syst m. Ll-passes °Wally Pa.Ss Fags t padw Evainatim by the LOW Appv bg Aut>xrity Inspector's Signature: TU _ Date: 9 Orf Within 3 days shall subnnt a�'of�won�rt to tlx i;ld or �mpdebng this inspecaoa ff the system is a Ong Authority(Board of Health or DEP The on ' for and the system owner p subirnit the �d system or has a des go flow of 10,000 ty guoal should be sent to the system ow�r and�es s Wto the buyer,the appro�e o�°ice of duo and the appm i g Notes and a ""'This report only d escribes conditions at the time ' time Thb 0D does not address how the system conditions of use: w�won and under the conditions of use at that perform In the ire under the same or ditterent I i Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM • PART A CERTIMCA/TION(continued) Property Addma a 912 '1•� l✓PJ Tvv�J���� ,�Owner. o+ .s o,- Date of bspedimn 0.2 c 937 Summary. Check A AC,D or E/AL—�eomPlefia afi d Seedon D A. S I Nava found any ikon which in�cates that�,of the>a�afteda gybed in 310 CUR 15.303 or in 3 10 10 CA�IIt 13.304 exist Any Aulma criteria not evaluated are indicated below. Comments: B. Sydem Comndonagy Paseesr e /One or more system components as described m the"ConMond Pase sechoa need to be replaced or repaired.The sYM,upon completion of the replacement or repw,as wed by the Board of Health,will Pass• Answer yea,no or not determined(Y,N,ND)in the for the following eta If"not detominecr plow The septic tank is metal and over 20 years old'or the septic tank(whethw metal or ant)is sbruchnally existing tank with infiltration or exfiltration or tank f lure is imminent Sys will pm inspection if the a complying septic tank as approved by the Board of Hearth. mdimetal septic tank will that the tank is l�than inspectim if it is��not leaking and if a Certificate of� years old is available ND explain: observation of sewage backup or break out or high static water level in the distribution box tine to broken of obstructed pipe(s)or due to a broken,settled of uneven distrbitim box.System will pass inWao r if(with approval of Board of Health): broken pipes)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required puffing amne than 4 times a year doe to broken or obstructed pass won if(with approval of the Board of Health): 1 s)•T system will broken pipes)are replaced obstruction is removed ND explain: Pere 3 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSE SUBSURFACE SEWAGE DISPOSAL SYSTEM INSpE SLATS PART APrQ CTION FORM q CERTMCATTON(contiar pet ti►Addr+eas; �/ /91N v y ,S - �J Owner. Li/oy-r 'D� �� r �� �? Date ofinspettw,n; O C Further,xvahwMMis Required by the Board of gqM: Conditions eadst which require fnrt>rer evaluates by the 8 to Pfft t public health,�y or the Board of Health in ardor to detamm If Me system L syskm Is pass unless Board of Health d is ateordance L a manner pu with 3I0 System wff Protect!whicb� t blk health,safety and 00�1�� — C�oa1 or Pm+Y�within SO feet of a woe aster boddo8 vWtated wetland or a sah marsh � System will fall nntess the Ili system 1ng is a mamw tl�p Pebik WW 3a dY an if any)d � publk health,safety,and wlrunmenf: that sulficID water stq)*or Septic lank and seal absorptioar system(SAS)aat the y to a surface water SAS is within I00 feet of a — TIM system has a septic tarok and&S and the SAS is within a ZMW I o,fa public water— The system has a septic tank and SAS sap*. toe SAS is watbaa 50& t of a private water su .-_ TU system has a septic tank and SM ad the PpIY we11. private water supply well**.mod used to ��I00 feet but SO feet or more from a "This system Passes if the well bacteria and Passes water Permed st a DEP c'Wfi the presem�� oryp� � that the well is� ��0 ',�'oo801ity and liform faahM cntum erne triMfedumnia A�of e�ga It to or less tlmn 5 ppm,Po�OW no other adached to this fond, 3. Other. Pogo 4 of 11 OFFICIAL INSPECTION FORM— SUBSURFACE SEWAGE DISPOSAL,Sy VOLUNTARY ASSESSMENTS STEM INSPECTION FORM PART A CERTIFICATION(conoinued) Property Address (.f9,V Owners (-✓ .� `��j /��` O�-.�6� Date of Inspe�om D. System Fohm Criteria aPPlinble to an systems;YOU so Ind `fires'or`ne to each at6e following f �� ens: Yea IVo/� of sewage jab acilttY or system ,' '""�'SAS or to the su" the c'surface watm dae gednor cerlopde — S the n box overloaded or tat:c leveel is /asapoal �o�'e o art doe to an overloaded or clogged SAS or de V&m a WGI Is less than 6"below' Requ'redwag more than 4 limes in the last 3'ear_due to cl Of available ogged or�ob than��9sw, Mportiona[the S idPe() Number Any Peron of cesspool or privy �is below f a elevation, ►' supply to —_ — portion of a cesspool tr'�3► a Portion of a cesspool ar l�Y is within a Zone 1 of a public well, otaor privy a SO fat of aOvate water sumly WdL supply well with�jWs lea than 100 feet greater them 50 fed;from a Pn+ate Performed it a9ca1riy analysis,[ water wen indicates that the weii *on pow'forte orm bacteria vola�ge organic water analysis, nitroga and nitrate nitrogen b equal to or few than S tacllhy and the presence at am COMpounda tr erect.A copy d the analysis mast be attached to this 04 form.] . oar taa°n e ria (Yes/No)The system ta&I have determined that one or more of the above failure described in 310 t�15.303,thcrerm the Criteria eldst as Health to determine what will be newmaq,to COMM me hilumUsteni owner should oonkt the Board of & Large Systems; To be considered a large system the system must,serve a t gYou mug Pd indicate �t9 with a design flow of 10,000 gpd to 15,000 (Z'he Wowin cri ether"yes"01"no"to each of the following; g criteria apply to large systems in addition to the cateria�,e) Yes the system is within 400 feet of a surface drinking w�supply — the system is within 200 feet of a tributary to a sine Ong water supply — the system is located in a nitro6011 sensitive area(Interim Wellhead proms �_IWPA Zone 11 of a public waW well or a mapped "Yes"in Section D above If you have answered"yes"to m,question in Section E �>a>det Se�osystem ��tad�°�or the"M m of�anya significant ih��answered 15.304.The �pMiau D shall �sY�m°0�dered a system owner should contact the a ul�de��'�m sCeondanee with 310 C11dlt 14onal office of the Department. Pagesofil OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTg SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CRECIMIST erty Prop AAddress: /�r 4 07 s7�' Owner. �G -$ (q nm oElnspe�om � Check if the following have ban dons You most indicate es"or"no"as to each of the fottowin y iafoonmtioa was F vided by the owner,ocaupaK or BwdefHaft Were any of tthe system camponents puaWed out in the prey kw two we" the system received normal Bows in ft I)MVIOU two week period Have UW volnmea of water been w1roduced to the reoentty or as part of this Ere / wens as bosh puns of the system obtained and examined?(If they were not=afth nose as N/A) v — was tha fa a4 ar&wetting inspected for goa of sea►agp b®ck up -7/ was the site inspected for sips of break out Were all system componeuK exchWWS the&AS located on site 7bwere the sepiisc tank manholes=WveW4 qxnc4 and the interior of the tank the condition affies as teen material of oq ��Gf H�4�of slu*and�of� makftiance of Owner cif different from 0WW)PWWedwAm&=Uft=0n&ePMPer Yes The size and tocat m of the SO Absorption system(SAS)on the site has been dammed based on: n4 ExWWg n forramon.For v ampk a plan at the Board of Heattb, Deftnfmd in the field(if auy of the faihn is unacceptable)[310 CUR 15.302c3xb)l cntena related to Part C is at issue app wdmati n of distance Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECnON FORM PART C SYSTEM FORMATION Owner. o Date of ftspecdon: $NTUL FLo COMMONS Number of bedrooms(depen). Number of bedrooms(max.3 DESIGN flow bawd on 310 CM 15.203(for w ampk 110 gpd a#of badvooms): ��C� Numbs of Qwent=dells:_� Does residence have a image grinder 6=a nod/(_A0 Is I=m&y on a separate sewage system or no)� Cif yes I �y system inspected brit or W)C O Seasonal use:(y a or noy. //_l�/UO WSW metes if avaL/dek(Ift 2 years„np(t*)e �ppumplyes orno}i Last dde,of occ up wW. CONM USTRTAL Type of estab ishment: Design flow(based an 310 Clldlt 15.203x Basis of design flaw(ftd5*rsws/sglle0c.): Grease trap present on or no}:— Industriat waste holding tm*psrseot(yea or noy_ NOwsanituY Waste discharged to the rldc S system(yes or no): Last daft of oecapancy/bsa: OTHER(desmfta Aunp%ng Records 1404 �� ImoTION Souxme�i�ormaEmn: /f/� ✓`1 L--;—! �� Q s [9 war/ was system pumped as part of tt� bes = if yes,voh�me pumpedt _How was quantity pumped wed? Reason for pomph* 1'Y se OB SYSTEM l/Sept la*won box,salt absorption Wstam _Single crospool - -f --Shared system(Yes or no)(if Yes,attach previoas ink m wrds,ifs,) o�cs'W technology.Attach a capq Of the current opem(m� zwe cDntw(10 be -- ystem owner) Titk tank —Attach a copy of the DEP approval _Other(desca'be): Appt+oadmate age of all components,daft wed(if town)and t'hmm°a 96 - �V/ were seww odors defected when wiv ng at the site(yes or no Page 7 of!1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTAR SUBSURFACE SEWAGE DISPOUL SYSTEM]NSPECTI PART C ON FOgM SYSTEM INFORMATION(continue Lf Owner; o elf Dm at o� O BMDJNG SEWER(Iacft Dpth bebw grade: Materials otemshucfwa.t,;nm (anat fim Pnift wow MR*WA ojr �°the`( x SEPTIC T - ntprh below gam: . Mhwd otco m: �- ft_ If M) atQq*"x(yeS Orno): (attach a copy of Sh dge DOP to bottom at mtiet too ar baft- Di"w top of scram to tap atop t tee or baffir Hsbnw dates toe or How w�ene COMMOW(m p nm ingas seoommeadatiau� collet v� to ouatet Mot �� bagle condition,dal fisegrax hgWd keels �- �•f 7�i vs `o. ']'' GREASE TRAP.-il on sk plan) Depth below grade.matedd _ ( )of oonon,_concr+ete metal— _poly_other teams: DWa Oe fim tap of to WP of oudlet tee or bate: bottom of ram to boaom f outW tee ar battle: comnaft(°II as retaW to �g�00oons,inlet o invert;evidence of leakage,et�o�rtlet bade coalition,dal .hquid levels Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSIM32T3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contnu4 290 /(,f s1- Oweex: o. o -Vl / Date of Iospectim- q TIGHT or HOLDING TANK: 'L ltadc most be pumped at time of )fit m an sits Plan) Depth below Stada MaterialofoOustcoctian: concrete metal fiberglass-_poly,et Wkm odmx( ): CapacitT. eaHom Design Flow: ~diy Almm present(yes ar nor Alarm leek Ala m in wvddng order(yea or no): �. Date aflastpompmg Comments(candhian afdtsrm and fiost switches,etc.): DISTRIBUITON BONG �afpse most be opmed)brae on site plan) Depth af liquid Ind above outlet invert ►I?Q/,', 7 O / Comments(note dbom is teed and won to outlets equal any evulmm of sands canyovM any evidenoo of lea into or out at eimx �/O � ((' o Cam, , Al0 PUW CHAMBER; �on site Plan) Pumps m working order(yes or nor Alarms in wmwng mfer(yes or nor Commema(note conftan a(pump,chamber,condition of pumps and q*ummancc%etc.): t , ,• Page 9 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSES SWEM SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION INFORMATION PART C FORM (c=dnx ) tZ � o%� ,z Owner.Date of p SOIL ABSORPTION SYSTEM(SAS):_[locate on site Plan,erGcavadon no t X SAS not boated exphda why: -------------- leWJ&9pits;manbw "aching : Sftwchcl�Ember, . : ai �of COj�(Ante canditian of soil,signs ofbyy�,� � 0 cl a 1 C 1,condition afvegewc, o,�� c? CESSPOOL4 IA/(cessP001 most be pumped as part of inspectioaxlocate on site plan) Number and confin; Depth—top afl*dd to inlet iavett: Depth of scum laycr Dime�ons atcesspool; Materials of oons�octian: won of groondwater iuflo�r,(yes or no): Comments(note coaftes � of f Vs of hylia_ fft e,leas!Of pondWS condition of vegeW11, PRIVY:/��ocate as site per) Materials Dimensions:� � Depth of solids: Comments(note con&m of s,signs why&aWic Wwle,level of podi.S condition of vegcW etc.): 9 page to d l l r•. . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Addnew o �"/v!o 5-1— owner. �t !y o 117 Date d Inspa'tbecc g7ZZ109c( SKETCH OF SEWAGE D>WCSAL MTEM Provide a dmt&tithe sewage dls wd system including ties to at least tm permanent relb x=lam or bend t all welts within loo fact.Lxate wheme public water supply anteers the bmU&S Nm Lds� r Page 11 of 11 F' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS `r • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(cow Property Addre= 90 AV"'l ��- s 0"mr. Date of Inspection 9 0 UZI EXAM SIC" Surface water ON&cellar Shal w wells F.st mWd ft&to Voaod water -, )6 feet Phrase indip6a(check)AN meftft used to determine am bo lid water elevation: Obtainedfmm system desip Pku on m cmd-If chadmd date of dedp phn nviewe& C,bmxn with site(abdft P�yfoWavation bole within 150 feet ofmclm SA3) C'hected wi&local excavators,installers-(A one) Accessed USCS dauhm-e�- Yon t desc�e hoar ou �g ma water a ati on. o lJ d O ti r..w a . A O . 0 l �vU �� cr-o, �� Page. CERTIFICATE OF ANALYSIS �C Barnstable County Health Laboratory Report Prepared For: Report Dated: 04/12/2001 Order Number: G0109391 Shayne Watson 390 Plum Street West Barnstable, MA 02668 Laboratory ID#: 0109391-01 Description: Water-Drinking Water Sample#: F648 649 650 Sampling Location: 390 Plum Street West Barnstable MA Collected: 03/28/2001 Collected by: S Watson Received: 03/28/2001 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB- GC/MS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 04/10/2001 1,1,1-Trichloroethane BRL ug/L 0.5 206' EPA 524.2 04/10/2001 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 04/10/2001 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 04/10/2001 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 04/10/2001 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 04/10/2001 1.,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 04/10/2001 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 04/10/2001 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 04/10/2001 1,2,4-Trimethylbenzene 15 ug/L 0.5 EPA 524.2 04/10/2001 1,2-Dibromo-3-chloropropan BRL ug/L 0.5 EPA 524.2 04/10/2001 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 04/10/2001 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 04/10/2001 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 04/10/2001 1,3,5-Trimethylbenzene 6.7 ug/L 0.5 EPA 524.2 04/10/2001 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 04/10/2001 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 04/10/2001 1,4-Dichlorobenzene BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 04/10/2001 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 04/10/2001 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 04/10/2001 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 2 CERTIFICATE OF ANALYSIS A� Barnstable County Health Laboratory Report Prepared For: Report Dated: 04/12/2001 Order Number: G0109391 Shayne Watson 390 Plum Street West Bamstable, MA 02668 Laboratory ID#: 0109391-01 Description: Water-Drinking Water Sample#: F648 649 650 Sampling Location: 390 Plum Street West Barnstable MA Collected: 03/28/2001 Collected by: S Watson Received: 03/28/2001 Benzene BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 Bromobenzene BRL ug/L 0.5 EPA 524.2 04/10/2001 Bromochloromethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Bromodichloromethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Bromoform BRL ug/L 0.5 EPA 524.2 04/10/2001 Bromomethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 04/10/2001 Chloroethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Chloroform BRL ug/L 0.5 EPA 524.2 04/10/2001 Chloromethane BRL ug/L 0.5 EPA 524.2 04/10/2001 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 04/10/2001 cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 04/10/2001 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Dibromomethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Ethylbenzene 1.3 ug/L 0.5 700 EPA 524.2 04/10/2001 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 04/10/2001 Isopropylbenzene 1.4 ug/L 0.5 EPA 524.2 04/10/2001 Methyl-tert-butyl ether BRL ug/L 2.0 EPA 524.2 04/10/2001 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 n-Butylbenzene BRL ug/L 0.5 EPA 524.2 04/10/2001 n-Propylbenzene 1.6 ug/L 0.5 EPA 524.2 04/10/2001 Naphthalene 0.8 ug/L 0.5 EPA 524.2 04/10/2001 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 04/10/2001 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 04/10/2001 Styrene BRL ug/L 0.5 100 EPA 524.2 04/10/2001 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 I CERTIFICATE OF ANALYSIS Page. 3 4;a y1i Barnstable County Health Laboratory Report Prepared For: Report Dated: 04/12/2001 Order Number: G0109391 Shayne Watson 390 Plum Street West Barnstable, MA 02668 Laboratory ID#: 0109391-01 Description: Water-Drinking Water Sample M F648 649 650 Sampling Location: 390 Plum Street West Barnstable MA Collected: 03/28/2001 Collected by: S Watson Received: 03/28/2001 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 04/10/2001 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 Toluene BRL ug/L 0.5 200 EPA 524.2 04/10/2001 Total xylenes 10 ug/L 0.5 10000 EPA 524.2 04/10/2001 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 04/10/2001 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 04/10/2001 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 04/10/2001 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 04/10/2001 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 04/10/2001 Approved By: (Lab Director) Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 r o Barnstable County Health Laboratory Barnstable Superior Court House, 3195 Main Street Barnstable, MA 02630 508-375-6605 Fax: 508-362-2603 SPECIFIC SER VICES. ILE E a ® The County Lab is certified by MA DEP for analyses of drinking water, surface water, groundwater and wastewater. Major customers include local residents, public water supplies, and any others on Cape Cod. ® Private Well Water Analysis for Local Residents: Analysis Price "Routine" pH, Conductance, Total Coliform, Nitrate, $30.00 Sodium, Copper, Iron "Re Kit" pH, Conductance, Total Coliform, Nitrate, $105.00 Sodium, Copper, Iron Volatile Organic Compounds (VOC) 1. Please contact us for any other testing; 2. Turnaround time (TAT): 10 business days. We do provide quick TAT service. 3. Free containers are provided. �����h' rea�nr,D�" t ► VOLATILE ORGANIC COMPOUNDS (VOCs) SW-846 Method 8260 Table IA. Summary of Holding Times and Preservation for Volatile Organic Compounds by Gas Chromatography/Mass Spectrometry Analytical Technical and Contract Preservation Parameter a Holding Times Volatile Organic Technical: 7 days from Cool to 4•C ±2•C; Compounds (VOCs) collection; in Water Contract: 5 days from receipt at laboratory VOCs in Water Technical: 14 days from HC1 to pH <2; collection; Cool to 4•C ±2•C Contract: 10 days from receipt at laboratory VOCs in Soil Technical: 48 hours Cool to 4•C ±2•C; sealed Contract: 48 hours zero headspace containers; freezing can extend the holding time b VOCs in Soil Technical: 14 days from Preserved samples: in collection; methanol ° or sodium Contract: 10 days from bisulfate d receipt at laboratory a Individual target compounds are listed in Table 1B. b Freezing the sample can extend the holding time; however, 48 hours unfrozen holding time will be considered cumulative. Use Method 5030 for purge and trap. d Use Method 5035 for purge and trap. Data Calculations and Reporting Units: Calculate the response factor (RF) and the concentration of individual analytes according to the equations specified in Sections 7.3.4 of Method 8260. Report water sample results in concentration units of micrograms per liter (• g/L) . Report soil sample results on a dry-weight basis in micrograms per kilogram (• g/kg) . Report percent solid and percent moisture to the nearest whole percentage point. For rounding results, adhere to the following rules: a)If the number following those to be retained is less than 5, round down; b)If the number following those to be retained is greater than 5, round up; or c)If the number following the last digit to be retained is equal to 5, round down if the digit is even, or round up if the digit is odd. All records of analysis and calculations must be legible and sufficient to recalculate all sample concentrations and QC results. Include an example calculation in the data package. 8260CRF 1 of 5 Revision 12/03/1999 Table 1B. Target Compound List, CAS Numbers, and Contract Required Quantitation Limits for Volatile Organic Compounds by Method 8260 Analyte CAS Number CROL •a/La CROL • cf/Kcr b Benzene 71-43-2 1 5 Bromobenzene 108-86-1 1 5 Bromochloromethane 74-97-5 1 5 Bromodichloromethane 75-27-4 1 5 Bromoform 75-25-2 1 5 Bromomethane 74-83-9 1 5 n-Butylbenzene 104-51-8 1 5 sec-Butylbenzene 135-98-8 1 5 tert-Butylbenzene 98-06-6 1 5 Carbon tetrachloride 56-23-5 1 5 Chlorobenzene 108-90-7 1 5 Chlorodibromomethane 124-48-1 1 5 Chloroethane 75-00-3 1 5 Chloroform 67-66-3 1 5 Chloromethane 74-87-3 1 5 2-Chlorotoluene 95-49-8 1 5 4-Chlorotoluene 106-43-4 1 5 1,2-Dibromo-3-chloropropane 96-12-8 1 5 1,2-Dibromoethane 106-93-4 1 5 Dibromomethane 74-95-3 1 5 1,2-Dichlorobenzene 95-50-1 1 5 1,3-Dichlorobenzene 541-73-1 1 5 1,4-Dichlorobenzene 106-46-7 1 5 Dichlorodifluoromethane 75-71-8 1 5 1,1-Dichloroethane 75-34-3 1 5 1,2-Dichloroethane 107-06-2 1 5 1,1-Dichloroethene 75-35-4 1 5 cis-1,2-Dichloroethene 156-59-2 1 5 trans-1,2-Dichloroethene 156-60-5 1 5 8260CRF 2 of 5 Revision 12/03/1999 I 1,2-Dichloropropane 78-87-5 1 5 2,2-Dichloropropane 594-20-7 1 5 1,3-Dichloropropane 142-28-9 1 5 1,1-Dichloroprope-ie 563-58-6 1 5 Ethylbenzene 100-41-4 1 5 Hexachlorobutadiene 87-68-3 1 5 Isopropylbenzene 98-82-8 1 5 p-Isopropyltoluene: 99-87-8 1 5 Methylene chloride 75-09-2 1 5 Naphthalene 91-20-3 1 5 n-Propylbenzene 103-65-1 1 5 Styrene 100-42-5 1 5 1, 1, 1,2-Tetrachloroethane 630-20-6 1 5 1,1,2,2-Tetrachloroethane 79-34-5 1 5 Tetrachloroethene 127-18-4 1 5 Toluene 108-88-3 1 5 1,2,4-Trichlorobenzene 120-82-1 1 5 1,2,3-Trichlorobenz,ene 87-61-6 1 5 1,1,1-Trichloroethane 71-55-6 1 5 1, 1,2-Trichloroetha_ae 79-00-5 1 5 Trichloroethene 79-01-6 1 5 Trichlorofluoromethane 75-69-4 1 5 1,2,3-Trichloropropane 96-18-4 1 5 1,2,4-Trimethylbenzene 95-63-6 1 5 1,3, 5-Trimethylbenzene 108-67-8 1 5 Vinyl chloride 75-01-4 1 5 o-Xylene 95-47-6 1 5 m-Xylene 108-38-3 1 5 p-Xylene 106-42-3 1 5 Methyl-t-butyl ether 163-40-44 1 5 Dichlorofluoromethane 75-43-4 1 5 ' Based on 25 mL water purge. b Based on wet weight 8260CRF 3 of 5 Revision 12/03/1999 Table 2. Summary of Calibration Procedures for VOCs by SW-846 Method 8260 Calibration Element Frequency Acceptance Criteria Corrective Action GC/MS Tuning with BFB Beginning of each 12 Ion abundance criteria in 1. Identify the problem. hour period during Table 4 of Method 8260 2. MS tune criteria must be which standards met before any calibration samples are analyzed standards, samples, blanks, or QC samples are analyzed Initial Calibration Initially; whenever RSD for RFs • 20%; 1. Terminate analysis (minimum blank + 5 required, due to 2. Recalibrate and verify points for each failure of CCV before sample analysis analyte) (ICAL)a, b, continuing Following ICV, every %D between RF of CCV and 1. Recalibrate and verify Calibration 12-hour, and end of avg RFs from ICAL • 15% 2. Reanalyze samples back to Verification (CCV) run last good CCV System Performance With ICAL or CCV RF for chloromethane, 1. Terminate analysis Check Compound (SPCC) 1,1-dichloroethane, 2. Recalibrate and verify bromoform, • 0.10; before sample analysis chlorobenzene, 1,1,2,2- tetrachloroethane, • 0.30 Calibration Check With ICAL or CCV RSD for RFs • 30% 1. Terminate analysis Compounds (CCC) 2. Recalibrate and verify before sample analysis Internal Standards Each analysis of CCV -50 to +100% 1. Re-analyze all samples analyzed while system was out- of-control Retention time Each analysis of CCV ±3 x the SD of the avg 1. Re-calibrate and verify evaluation of CCV standard ICAL RT for each analyte 2. Re-analyze samples back to standards last good CCV a The ICAL low standard must be above but near the CRQL. The low ICAL standard must have a signal to noise ratio • 5:1. If this requirement cannot be met, the laboratory must submit a MDL study as part of the data package. b ICAL and continuing CAL standards must contain all target analytes listed in Table 1B. Report the retention time window for each analyte. Determine retention time windows as ±3 x the standard deviation of the average initial calibration retention time for each analyte. 8260cRF 4 of 5 Revision 12/03/1999 Table 3. Summary of Internal Quality Control Procedures for VOCs by SW-846 Method 8260 QC Element Frequency Acceptance Criteria Corrective Action Method Blank Each 12-hour time < CRQL for each compound 1. Investigate the source of (MB) period, minimum of contamination and document. one per SDG a 2. Reanalyze all samples processed with a blank that is out of control. Matrix Spike One MS/MSD set per Water Sample: 65-135% of 1. Report in case narrative and Matrix batch or SDG (1 expected value; • 30% RPD Spike Duplicate MS/MSD set per 20 between MS and MSD (MS/MSD) samples minimum) Soil Sample: 50-150% of expected value; • 50% RPD between MS and MSD Surrogate Every sample, Water Sample: 85-11596 except 1. Reanalyze all samples with Spikes:b standard and for 1,2-dichloroethane (75- non-compliant surrogate method blank 115%) of expected value recoveries Soil Sample: 70-125% of expected value Laboratory One per SDG Water Sample: 70-130% of 1. Investigate the source of Control Sample expected value problem and document. (LCS) 2. Reanalyze all samples Soil Sample: processed with a LCS that is out 65-135% of expected value of control. a SDG - Sample Delivery Group - each case of field samples received; or each 20 field samples within a case; or each 14 calendar day period during which field samples in a case are received. b Toluene-da, BFB, 1,2-dichloroethane-d„ and Dibromofluoromethane Dilute and reanalyze samples which contain one or more target analytes at concentrations above the initial calibration range. Results for such reanalyses should fall within the mid-range of the calibration curve. 8260CRF 5 of 5 Revision 12/03/1999 Report results and submit documentation for both analyses. 8260CRF 6 of 5 Revision 12/03/1999 Commonwealth of Massachusetts Executive Office of Environmental Affairs < Department of � � 1998 Environmental Protection 's William F.Weld e Governor retry Argeo Paul Celiucci . Struhs U.Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A _ CERTIFICATION Property Address �d Pwf '/'/�/�` 6 �%' ��j�%` Address of Owner- Date of Inspection: j1/,,,/1 ic� (If different) Name of Inspector. ' )A/d� Company N e, dd s e e-phone Number. &YL CERTIFICATION STAT �NT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: l/" �'� t /V�/L./ Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. BI SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined(Y,N, or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal, cracked,structurally unsound, shows substantial infiltration or exfiltration,.or tank failure is i ;nent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston, Massachusetts 02108 a FAX(617)556-1049 • Telephone(617)292-5500 i� Primed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �{ / CERTIFICATION (continued) Property Ad )�V i Lu� Owner, f�J�l, Date of Inspectio B)SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) OTHER (revised 11/03/95) 2 f • 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 3 / C} �`�!` ` ' Owner. Date of Inspection: D) SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an 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. 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.. (revised 11/03/95) 3 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOAM PART B CHECKLIST Property Address: 1"3c v rL'Vm Owner. L&,or e Date of Inspection: � jC�//9 Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. VNone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. ,./The facility or dwelling was inspected for signs of sewage back-up. V The system does not receive non-sanitary or industrial waste flow v The site was inspected for signs of breakout. V All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or /tees, material of construction,dimensions, depth of liquid, depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C D SYSTEM INFORMATION Property Address: 6 3�0 / 7 Owner. L K Date of Inspection: FLOW CONDITIONS RESIDENTIAL- Design flow: gallons Number of bedrooms: Number of current residents: Garbage grinder(yes or n Laundry connected to system,(yes r no):_ Seasonal use(yes o no)_ y Water meter readings, if available: w Last date of occupancy: I 1 COMMERCIAL/INDUSTRIAL, Type of establishment: Design flow:_gallons/day 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: OTHER(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes o o) f If yes,volume pumped: gallons Reason for pumping: TYkE 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) Other(explain) APPROXIMATE AGE of all components, date installed(if known)and source of information: Sewage odors detected when arriving at the site: (yes o rio _ (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C q SYSTEM INFORMATION (continued) Property Addree /0 ?`��/" e 5 7- Owner. K Date of Inspection: SEPTIC TANK (locate on site plan) Depth below grade: /?/ Material of construction: concrete_metal_FRP—other(explain) Dimensions: 4 YJ „X �i L x /f' Sludge depth:_ / Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Z u i Distance from top of scum to top of outlet tee or baffle: Z Z �� Distance from bottom of scum to bottom of outlet tee or bafTle:�_ Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction:_concrete_metal_FRP_other(expkdn) 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: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage, etc.) (revised 11/03/95) 6 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner. Date of Inspection: TIGHT OR HOLDING TANK_ (locate on site plan) Depth below grade: Material of construction:_concrete_metal_FItP other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX._ (locate on site plan) ) �i Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of boa, etc.) PUMP CHAMBER:_ (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: V Owner. Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: l leaching fields, number, dimensions: T, x overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation etc.) 2— CESSPOOLS:_ (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(cesspool must be pumped as part of inspection) 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.) (revised 11/03/95) 8 i� r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner. �-A f Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' i , 2J DEPTH TO GROUNDWATER Depth to giroundwater: .L,tfeetf method cA determination or proxitnatio 1 4CZ- Y' (revised 11/03/95) 9 r EIJI - _- r- MI - - - Ft _ _ - -- ---- --- -- - - NO. , DATE E of THE T� TOWN OF BARNSTABLE FEE O � OFFICE F • RECEIVED BYE' i DAIRTSTABLL 'o SIu& BOARD OF HEALTH N gga1639. # {rfry� t F uAI�,. 367 MAIN STREET � �/vA, t HYANNIS, MASS.02601 ° 4 � VARIAN '996CE REQUEST FORM r` .� � All variances must be submitted FIFTEEN (15) days prior to the scheduled<B.o. of Heal 44/ meeting. 9 NAME OF ,APPLICANT Sv-� GzvI TEL. NO. 57-+8 - 3 1 o ADDRESS OF APPLICANT 34e .4 fe—D, �4LmocJ _n-1 NAME OF OWNER OF PROPERTY ,t� e,s3--d etc- Lc_�T1- a: C��-. .! SUBDIVISION NAME DATE APPROVED ASSESSORS MAP AND PARCEL NUMBER jla \ -7 LOCATION OF REQUEST n�- i"� Pr-uV,-� �j't, W SIZE 'OF LOT tI Z�,o SQ. FT. WETLANDS WITHIN 200 FT. OF PROPERTY: Yes No x VARIANCE FROM REGULATION(List Regulation) WeLc. ,Oar REASON FOR VARIANCE(May attach letter if more space is needed) '512-6 OF 4� PLAN four COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPROVAL Susan G. Rask Chairman Joseph C. Snow, ;•i.D. Brian R. Grady BOARD OF HEALTH TOWN OF BARNSTABLE TOWN OF BARNSTABLE y0f THE Tp� bvP �♦� OFFICE OF = EAUST"L BOARD OF HEALTH MAR& p, t639- `em 367 MAIN STREET 0 MAY k HYANNIS, MASS. 02601 July 8, 1996 Brian Laak 36 Alma Road Falmouth, MA 02540 Dear Mr. Laak: You are granted a variance to install an onsite sewage disposal system leaching facility 105 feet away from an existing onsite well, in lieu of the required 150 feet separation distance at Lot 17 Plum Street, West Barnstable. The variance is granted with the following conditions: (1) The septic system shall be installed in strict accordance with the submitted plans dated May 26, 1996. (2) The health inspector shall inspect the installation of the onsite sewage disposal system and certify in writing the system was installed in the location shown on the submitted plans dated May 26, 1996. If the system is not installed in the location as designed, the health inspector shall notify the licensed installer to submit a revised plan or order the installer to relocate the system in accordance with the engineered plan. (3) The existing cesspool shall be disconnected and filled in with soil or destroyed. (4) The onsite well water shall be tested for nitrate-nitrogen, sodium, coliform bacteria, VOC's and all the other parameters as required by the Board of Health Private Well Protection Regulation. Ink The variance is granted because there is an existing building with a private well and two cesspools on this lot. The small size of this lot precludes the ability to place a new leaching facility the required separation distance of 150 feet away from the septic system. Also, the new septic system will meet all the provisions of the State Environmental Code, Title 5 and all the other local health regulations. Sincerely yours, Susan G. Rask, R.S. Chairman Board of Health Town of Barnstable SGR/bcs cc: Edward Barry laak �l AASSESSORSMAPN �'� r Z' 6r -- G�'z PARCEL NO. .- Q ! . No.---------� -- Fee-------------------_..-- BOARD OF HEALTH TOWN OF BARNSTABLE Applicat ion Ar Vell Cootruct ion Permit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair (c-•an individual Well at: -Q� "—� - -- - — ------------------------------- --------------------------------------------------- Location — Address Assessors Map and Parcel ---' Z`' K ----------------------- _S r • /1-1 0. --- - -- - -- - -- -- ---------------------------------------------------- Owner Address ------------------------------- -------------- -- ---------------------------------------- 0.--------------------------------------- Installer — Driller Address Type of Building t Dwelling--- - --------------------------------------------------------- Other - Type of Building ------------- No. of Persons------------------------------------------------------ Type of Well__-2 -—- ------------------------- ----- 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 Certificate .of Compliance has been issued by the Board of Health. 6 Signed-�"-- -- —------------------------------------------ 1111 ---� -------------- - ------------ date Application Approved B -- - -� � - -- date Application Disapproved for the following reasons:----------------------------------------------------------------------------—------ --------- -- - ----------- --- ------------------------------------ - ------------------- date Permit No. - - ---------------- Issued nZ----------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate ®f Comphance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( bY----------Q_A 3C6k^)-4-fl- - - ----------------------------------------------------------------------------------------------- -------------------------- Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection 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------------------------------------------------------------------------- v 1._----— --- Fee------------------ BOARD OF HEALTH TOWN OF BARNSTABLE ' pplitation for IV ell Construct ion pertnit Application is hereby ma a-fora permit to Constru t r� Alter,( ), of Repair (man individual Well at: _gig�----n��-�=4------- ---��-�-------------------- - --------------------------------------------------------- ---- ---:-:, -------- - Locatio — Address Assessors-Map and Parcel" (A -JLcK 3yF/ ni� 7— , 6g- - ----- - ..r �.-a----------- wner Address' c--�---�- '---- or Driller dres - 'Type of Building O Dwelling --- Other - Type of uildin ---------- - No. of Persons---------------------------------------------------- Typeof Well— ------------------------------------- - t Capacity-'__'`, ---------------------------------------------- Purpose of Well-_,Obi 'T, - `' ` --------- 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 Regalation - The undersigned further agrees not to ~ place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. ' ate Application Approved B PP PP date #` Y .2 Application Disapproved for the following reasons:--------------------------------- ------ ---- --------------= --_----------—-----—---—----—......._____--------- _____: t date n.I — i► Permit No.-� 1 -=— ----- Issued - - date © ` S'ePT�`f D �r� BOARD OF HEALTH TOWN OF BARNSTABLElk Certificate Of CoM phance THIS IS TO CERTIFY, That the Individual Well Constructed Altered or Repaired (rl by-------- A ------------- --------------------------------------------------------------------—--------- Installer at —---------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit Dated-,f THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY'. DATE-------------- Inspector—-------------------------------------------------------------------------- BOARD OF HEALTH B TOWN' O'F ' AFMSTABLE Vell Congtructionpermit No. Fee Permission is hereby granted ------——---- to Construct Alter or Repair an Individual Well at: No. ---------—----------------------------------—--------------------—----------------------------------- Street as shown on the P a lication for a Well Construction Permit No. Dated-------- -------------------------------- ----- ---------- oar o. ealt it He alth DATE-Af \A1 ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich, MA 02563 (508)888-6460 . 1-800-339-6460 FAX(508)888-6446 . CLIENT: Brian Lack LOCATION: 390 Plumb St. ADDRESS: W. Barnstable, MA SAMPLE DATE: 8-14-96 COLLECTED BY: D. Pennini/ DA Scannell DATE RECEIVED: 8-14-96 TIME: 4_:;OOPM LAB I.D. #: E8-283 JOB TYPE: G'New Well „ 4 SAMPLE I.D. #: ES-283 WELL SPECS. : 16' RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100ml (MF Method) 0 0 pH pH units 6.0-8.5 6.36 Conductance umhos/cm 500 104 Sodium mg/L 28.0 8.1 Nitrate-N/Nitrite-N mg/L 10.0 0.17 Iron mg/L 0.3 0.05 Manganese mg/L 0.05 0.011 COMMENTS: Yes WATER IS SUITABLE FOR DRINKING PURPOSES OR PARAMETERS TE X}IX � Date o ld J. 0ari Laboratory irector IT =. Less Than Assessing As-Built Cards Page 1 of 1 v/'1 rU W f4 Ur k$ARNSTABLE y O' LOCATION ��� �y ���rn J J SEWAGE " : `3 i VILLAGE_L�'••J !./'.r�y� )/ ASSESSOR'S MAP & LOT/ /�^ 017 �24STALLER'S NAME & PHONE NO. 11v" f 1 K ASEPTIC TANK CAPACITY LEACHING FACILITY:(type) Ir7-� ;-%1 (size) " NO. OF BED,-DOOMS PRIVATE WE L R PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: f �� DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r� • http://www.town.bamstable.ma.us/Assessing/HMdisplay.asp?mappar=196017&seq=1 3/14/2013 TOWN OF BARNSTABLEEES$CR$ N�' moo,THE rot PARCEL NO' /7 ;< b.Q��♦� OFFICE OF 3AMST"L BOARD OF HEALTH 1MpY.rAee. A F'RECj �y d0 367 MAIN STREET ���( Io/ HYANNIS, MASS.02601 �/ U- �,61 JUL 12 1996 ��NTH DCPT. BJIRAIai E July 8, 1996 Brian Laak 36 Alma Road Falmouth, MA 02540 Dear Mr. Laak: You are granted a variance to install an onsite sewage disposal system leaching facility 105 feet away from an existing onsite well, in lieu of the required 150 feet separation distance at Lot 17 Plum Street, West Barnstable. The variance is granted with the following conditions: (1) The septic system shall be installed in strict accordance with the submitted plans dated May 26, 1996. (2) The health inspector shall inspect the installation of the onsite sewage disposal system and certify in writing the system was installed in the location shown on the submitted plans dated May 26, 1996. If the system is not installed in the location as designed, the health inspector shall notify the licensed installer to submit a revised plan or order the installer to relocate the system in accordance with the engineered plan. (3) The existing cesspool shall be disconnected and filled in with soil or destroyed. (4) . The onsite well water shall be tested for nitrate-nitrogen; sodium, coliform bacteria, VOC's and all the other parameters as required by the Board of Health Private Well Protection Regulation. Ink The variance is granted because there is an existing building with a private well and two cesspools on this lot. The small size of this lot precludes the ability to place a new leaching facility the required separation distance of 150 feet away from the septic system. Also, the new septic system will meet all the provisions of the State Environmental Code, Title 5 and all the other local health regulations. Sincerely yours, . Susan G. Rask, R.S. Chairman Board of Health Town of Barnstable SGR/bcs cc: Edward Barry lack TOWN OF BARNSTABLE !s , a f �, LOCATION ?�) I SEWAGE # t;r.3,�" VILLAGE ,f5* ��� ,� ASSESSOR'S MAP & LOT/'/X*^ 61.7 INSTALLER'S NAME &PHONE NO. �.C �/� a`SEPTIC TANK CAPACITY .y�LEACHING FACILITY:(type) 'I/��—d/1!�J � 1 (size) X x �<l NO. OF BEDROOMS PRIVATE WELL R PUBLIC WATER BUILDER OR OWNER ,)417q (� � T1ATE PERMIT ISSUED: / — DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes f� No ... ,,� .7 ��� r "-' "'' w � �y r�-'', �,� � .� _ I � l .�;- �"Z ��.__ � _l TOWN OF BARNSTABLE LOCATION �1 U M SE SEWAGE #)—D -' 36 VILLAGE �sl1=S'T E$"ZCA- 8l6-ASSESSOR'S MAP& LOTAEdLg6-+ 9 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY We i-m _577'aa C J, Pu m P c q 4m o gg LEACHING FACILITY: (type) (size) lZ6"VI-1711L, NO. OF BEDROOMS BUILDER OR!`� .-� o PERMTTDATE: �z�16 COMPLIANCE DATE: 6 y Separation Distance Between the: I Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist c 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-EM6-1 N 1EU L 146- S/.kQe jKs r F, WEI Ja _ lv� b 0 q7 io f p, I No. - Fee (� d �] 7 q THE COMMONWEALTH OF MASSACHf1SET'TS 1 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppricatiou for ]Dizpaaf *pgtem Corie;tructton Verna Application is hereby made for a Permit to Construct(A-)or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 190 PLkk S Ir We0- -ts4b(e 1-) 4),# L A,4 r Installer's Name,Address,and Tel.No. D si ner's Name,Address and Tel.Pio. CIV 111� . We bbey- a" CAP' �►� ir�gr,�s q39 yin/H 57— Y,4 r My i M Type of Building: Dwelling No.of Bedrooms Garbage Grinder(/) Other Type of Building Ire5i0 fib,( No. of Persons Showers Cafeteria( ) Other Fixtures Design Flow Q&-Q gallons per day. Calculated daily flow gallons. Plan Date 12 I A t/ Number of sheets Revision Date Title Description of Soil Nature of Repairs or Alterations(Answer when applicable) COn S f� In a e �6'*L ' desltoH F I l ;h I5ttr c cess Boa Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environm pntal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board o �Heal -7 3 1/ Signed /�/� Date I y Application Approved by %X44,e6q _ LM4 — Application Disapproved forte following reasons Permit No. / e 30 Date Issued `° �� No. Fee d f $�� -7� ,�� THE COMMONWEALTH OF MASSACH T,S - PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE.,MASSACHUSETTS Ofpplication for rjizpo.5a1 bpgtem Construction Permit Application is hereby made for a Permit to Construct(k)or Repair(- )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 3q0 PLUM s' Ir West &-o4b1e �r1 ak L 44 r ' Installer's Name,Address,and Tel.No. D signer's Name,Address and Tel.No. , INe bher CAP, q39 r4411:4 5 yArmv►M Type of Building: Dwelling h4o.of Bedrooms A- Garbage Grinder(1)ip Other Type of Building yesiPft h a,.( No.of Persons Showers Cafeteria( ) Other Fixtures Design Flow 0 0- gallons per day. Calculated daily flow gallons. Plan Date fl Number of sheets Revision Date Title " r Description of Soil - Nature of Repairs or Alterations(Answer when applicable) Coh S ff de-3'Yro j F it Gef3 Poo .0 tct st n Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envir �/onm ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board o,�jeal 3 / Signed 4.� V` Date ( Cv Application Approved by_ �, ) J,&J, Application Disapproved for the following reasons r Permit No. 3G Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTAB*LE- MASSACHUSETTS Certificate of-Comuliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed OK or repaired/replaced( )on by 1301 We}-6e;r for $r►Rn Loalc as deSetiben O,%,% ,e l st-x i has been construc d i accordance. with the provisions of Title 5 and the for Disposal System Construction Permit No. . - o dated Use of this system is conditioned on compliance with the provisions set forth,+elow: 101, ley CDP No. O Fee �'✓�''' Ci THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 30i.5po.5af *pgt`em Congtruction Permit Permission is hereby granted to hl to construct(tK )repair( )an On-site Sewage System located at 390 P S 7-1 W 5-MA!- - and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. r Date: r �'� % Approve y 1 Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection 'Southeast Regional Office William F. Weld Govemor � Qr Daniel S.Green"b_�urim t Commissi erc February 25, -1992 William W. Durrell RE: BARNSTABLE- WSC/SA-4-0545 P.O. Box 251 Crane Duplicating Co. West Barnstable, Massachusetts 02668 Route 6A & Plum Street, ppproof • ` _ -, _.,� ,._,��w - fl eaD m port T�r .- easur esig z f... r 21E, ,310 CMR40�,000-11' ; o, : p i Dear' Mr. Durrell• - The Department-of Environmental Protection, Bureau of.Waste Site Cleanup (the "Department"') , has reviewed a design or -a, 'Short 'Term 'Measure{ (the 'STMD") at and .near the grounds of the Crane Duplicating Company on Route 6A . 1 and Plum Street in West Barnstable, Massachusetts (the "'Site") , submitted on your behalf' by IEP, Inc. , in the following document: SHORT TERM MEASURE ASSESSMENT DURRELL PROPERTY 1611 MAIN STREET WEST BARNSTABLE, MASSACHUSETTS (WSC/SA-4-0545) DECEMBER, 1991 • " The STMD includes the following tasks: (1) the excavation and disposal of surficial soils contaminated l withyghydrocarbonsfromtwoil locationsat the Site, and _ _- _ a a (2) the implementation of a groundwater qualrty monitoringpl°an 7, The Department approves the STMD with the following 'provisioris ti A k(1} You "shall meet all',the provisions relative to 'thee Short Term Measure (STM) previously required by the Department, (2) , Excavation and disposal of the contaminated surficial soils -shall . comply with M.G.L. c.21C or c.21E, and. shall be I completed within sixty (60) days of receipt of this letter, Lakeville Hospital • Route log • Lakeville,Massachusetts 02347 • FAX(508)947-6557 • Telephone (508)946-2700 -2 (3) The groundwater monitoring program must include field screening for dissolved oxygen and laboratory testing for hydrocarbon aromatics with practical quantitation limits sufficient to determine compliance with drinking water standards and guidelines. Sampling must be quarterly and comprehensive (all monitoring wells, private water supply wells at 424 Plum Street, 1610, 1630, 1633 and 1636 Main Street) . Each quarterly sampling round will be accompanied by gauging of all monitoring wells. Quarterly groundwater monitoring rounds will begin within thirty (30) days of receipt of this letter, and will be reported to the Department_4 - .. withnsixty ;(,>6.0) daysofsampling andgauging,. „,Grofiundwater, 1 monitoring activities°.,w11 be-dscontnued,`onlyg,upon written Departmentapprovapl; and �u (4)' If = during] the implementation of they` proposed work a -. determination is made that addi`tiorial,work9plans ar.e needed to, `? complete the STM, a supplemental plan, and schedule shall. be submitted to the Department for approval. The Department requires a written response within fourteen (14) days of receipt of this letter 'indicating whether you intend to take the actions outlined above. i Your cooperation in this matter is appreciated. Should you have any ' further questions regarding site WSC/SA-4-0545, please contact Marcel V. Boelitz of this office at (508) 947-2868. Very truly yours, obert E. Donovan, Regional jineer -•r.;, "'-';` . .- - c ^; .`,". -�:„ ,'.' � " 'F''.-Or' Waste $ite cleanup- 4' ir...<' i� . r ./ / CERTIFIED MAIL,<#P2�3 ".147 829 a ' RETURN "RECEIPT; REQUESTED` M W } EV cc: DEP. - Boston BWSC DEP SERO ATTN: Ellie Grillo DEP- - SERO - Data Entry i i 01 1 -3- cc: Town Council Town of Barnstable 367 Main Street Hyannis, MA 02601 ATTN: Warren J. Rutherford Town Manager (508) 790-6205- Board of Health Town of Barnstable P.O. Box 534 Hyannis,, MA 02601y 'm .ATTN. ;Thomas -McKean Ri . p � � tit; .. Dire Qtor;,m.. _ (508): 790 6265 � a u _ �rx o Conservation Commission Comriission Town of Barnstable ' 367 Main Street Hyannis, MA 02601, ATTN: Robert G'atewood` Chairman (508) 790-6245 West Barnstable Fire District Route 6A West Barnstable, MA 02668 ATTN: Chief John Jenkins (508) 362-3241 Information Repository Whelden Public Library Meeting House Way West Barnstable, MA +02668 ATTN Jane Merritt " Pi " , ., }'' '`, a = a.- -''40.: i"y:.'i ".ktr,na'W .,fro. W *a A Crane Duplicating Service; Inc v 10 Main Street P.O. Box= 481. Barnstable, MA 02�630 ATTN: Richard l Price _President 4 IEP, Inc. P.O. Box 1840 ` 90 Route 6A/Sextant Hill Sandwich, MA 02563 ATTN: Joseph S. Hobin (508) 888-6689 I Ike Gommmtffir1alfl of ` z5sttcl�use�tg Department of Public Safety—Division of F)re Prevention APPLICATION FOR PERMIT FOR REMOVAL AND TRANSPORTATION TO APPROVED TANK YARD j - AUGUST 23, 1988 C.82 S.40 M.G.L. To: HEAD OF FIRE DEPARTMENT DIG SAFE NUMBER WEST BARNSTABLE `'"" '°'" 88 3 3 _ 364 0 Slort Dote AUGUST 23, 1988 In accordance with the provisions of Chapter 148, G.L. as provided. in i Section 38A Application is hereby made by TANKS UNLIMITED Name of Person,F irm or orpora .ion) ROUTE 28A; P.0 BOX; 477 FAL•MOUTHMA 025564 ress,. _ For permtss'ion to remove and .transpora underground steel storage tanks) from, ; i .[THREE (3)ry TANKS:`. 1611 MAIN STREET,' WES1 BARNSTABLt 1'1A 02• 2,'C00 GALLONS EACH] ; Street address city or town FD1D° 0 1 9 2 3 to approved Tank Yard'i 201-01 (A.W. >MARTIN, NEW BEDFORD) State clearly type of inert gas used in DRY ICE (CO2) steel storage tank Type of inert gas use Name of Person, Firm, Corporation disposing tank TANKS UNLIMITED Date issued - rejected 8-23— 1988 By: � �✓ Date of expiration $_2819 paid/due igna ure ot Ap iCant - - — — — — — — —— — — — - - — — — — — — — — — — — — — — — — — — — — — — — — — — V)e Commonixtaltb of oa�ncbuf�ettn; DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION > ® E Mt6`4 AUGUST 23, 8 ,,.: F. ETA-` �°FOR REMOALANDTRANSFORTATIOPPROVED TANK YARD OtG, saFf' t+uMBER In ,accordance with the 1'provt saons of Chapter �148, G I asp provI ed`'I n ~8 `8 3 3'� 3'6 4 0 Sect.ion �36A'thi s perm, i`s lgranted,eto - � siur�'oa;�. 3^� Name:, TANKS,UNLIMITED m� u -,=name of person, f t rm or or_pora r:o'n / To transport 'underg'round steel sto"rage' tank(s) I G y 201-01 ( to Approved tank ard# S dl�r y type of �e�ttt" gas used i n steel storage tank steel tank: .DRY ICE (CO2.) method, FDIC# 0 1 9 2 3 Name and address of contractor disposing tank TANKS UNLIMITED NORTH 'FALMOUTH, MA. Fee paid $ 5.00 Location to which tank—w7FTT— be transported IL NO1-0 This permit will expire 8-26— 1488 ppr v r _ SI na Ot Ott icIa I g ant tng permit(T'iTL'E) (He� of Fire Dept.) OkYN JENKINS, CHIEF OF DEPARTMENT I FORM ]] - SUiI, RVAI ATOR FORM ' AS;;ESSOE].SMAP11� ^� Page 1 of 3 PARCEL N0: a Date: No. 72D Commonwealth of Massachusetts Massachusetts al Oil Suilabili Assessment or O - t e e Performed By: .. � .......��t:t_ oJ��-.......................................... ._ - � ........ ............. ........... IFrP Witnessed BY: ............ . T.aohenc Addmil Cc lIJ S)W � 5`"��li; LvM ^nr► 026 6$ ew Construction ❑ Repair� Office Review Published Soil Survey Available: No Yes ❑ Soil Map Unit • Year Published Publication Scale ................................................ ... . ....... Soil Limitations Drainage Class. fa�f 1-zx • . ❑ Yes Surficial Geologic Report Available: No Scale !c�-� Publication Year Published Gc,. ............CAi�Jtfi ...`.°°"...... ..... ............................ Geologic Material (Map Unit) ._.......... Landform ............................. ............................................... Flood Insurance Rate Map: year flood boundary No El Yes Above 500 y ❑ -- Within 500 year flood boundary No ❑Yes Within 100 year flood boundary No ❑Yes ❑ Wetland Area: ma unit) ...................................................................................................... Map (map National Wetland Inventory ...... .. ........................................ unit) .............................. . Wetlands Conservancy Program Map(map Month Current Water Resource Carr Frans (USGS)' Range :ALove Normal y;Normal ❑Belc'.I Normal ❑ Other References Reviewed: Dk:P A.P�RoiF!}FORM-ilt9;:94 l I FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 A Location Address o Lot 140. AA? Olt-site Review Time: j Q'co A M weather ��°F'� �'.,r► Deep Hole Number Date:. y . . . . ... .:.:.:...:. ... lent ....:.�..:,,..::,.,..:.:..:.. Location (identify on site p Slope M -3 0 Surface Stones /j0•Nr Land Use Vegetation _... Landform - Position on landscape !sketch on the back) feet Distances from. feet Drainage way � � � feet Open Wete, Body feet Property Line Possible Wet Area Other Drinking Water Well .I Z� feet DEEP OBSERVATION HOLE LOGS other Soil Color Soil Soil Texture (Munselll Mottling (structure,Stones,G Gravel) Consistency, lj Depth from (USDA) Horizon (USDA) Surface(Inches) � S LoA/,, 7511�3�3 — 2 Ss�N '2- 1. 5A b 5ANrD W DeptMoBedrock: from Pit Face'. Weeping parent material(g Standing water in the Hole: e th to Groundwater: Ebtimated Seasonal High Ground Water: UEp APPROYEr1 F01 1'12107/95 i FORM 11 - SOIL FVALUATOR DORM • rage 2 of 3 . Location Address or Lot 140• 0j -site Review �1 9 ft"11 6 Time: o,GU AIA Weather G;O#F Deep Hole Number TTJ� Date:. :.... .. Location (identify on site pion) Siope (96) "3 Surface Stones po..NG Land Use Vegetation Landform .. pe (sketch on the back) Position on landsca Distances from: feet `Drainage Way feet 5 , Open Water Body feet Property Line feet Possible Wet Area Other Drinking Water Well .�ZO feet DE EP OBSERVATION HOLE LOGS Other - Coto Soil Soil Horizon Soil Texture (Aunseli) Mottling (Structure,Stones,G Boulders, Consistency. Depth from (USDA) surface(Inches) O — 2 1kA)-� 10 tL 4A _ 2 — 12 3 Lo^0.^ - 2,� MED/F v N 5' 117/N 5AII �AI III c- T a 1�LO n No UA OeDtMoBedrock: eotogic) Weeping from Pit Face: Parent Materiel Ig Standing Water in the Hole: - e th to Groundwater: Estimated Seasonal High Ground Water:_ UEP AppRoYE11 FOP-"•Ii101145 f i u-E FORM ll l - SoiL LsVALUATOR )NORM Page 3 of 3 Location Address or Lot No. MF )0 �A-7 Determirtatl'o�l or Seasonal Hi h Water Table Method Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole . inches ❑ Depth to soil mottles inches ❑ Ground water adjustment .... ......... .. feet Index Well Number ....... ....... Reading Date .................. Index well level .... Adjustment factor ..... ...... Adjusted groundwater level ..... ................... ... _. Dept of Natura11 Occurrin Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? — If not, what is the depth of naturally occurring pervious material? Certification I certify that on NOV 115 (date) I have passed the soil evaluator examination approved by the Department of Environmental Pttrainin ection anexpertised that ea above experience was performed by me consistent with the requiredg described in 310 CMR 15.017. 1 G U 2 q 6 Signature Date UEP APPROVED FORA)-12/07/95 FORM 12 - PERCOLATION TEST Location Address or Lot No. A5 -'q (`,& lo I- COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test` - Date: .:. l fig 116 Time:, 0AM Observation Hole # 7- t Depth of Perc H. Start Pre-soak End Pre-soak Time at 12" Time at 9" Time at 6" 5 If I N M)N 0 Time (9"-6") Rate Min./Inch AA 'J I N Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ....................................................................................................................................._._......_......._ . Performed By: oz,q L_/� (mowN cgpF Witnessed By: T=T> Comments: DEP APPROVED FORM-12107/95 y `v(s ! AVvmP le% ALL o 1-4 We I{ ! 1i I 3 1 � P v i i f gg! 7 a r { q' 1 j R I 9 LOCUS DATA 6A °F .� Locus CURRENT OWNER ANDREW & EDWARD �,� RUTHANNE BARR - / / A N ; STON 0.2 Aa ��� PLAN REFERENCE PB 74-9-2 132 DEED REFERENCE 18768-299 / 44.1 ZONING DISTRICT RF / ^,o / 6 CIV FLOOD ZONE "X" / L 0 T LOCUS MAP ~ 10,841f S.F. NOT TO SCALE: ASSESSORS MAP 196 _ _ _ �� S 130' TO WELL PARCEL 017 / o �� spas, 18-0120 OVERLAY DISTRICT NEIGHBORHOOD WELLS --/ co Q / WELL � 45.1 I �)s BENCHMARK PCOF ARK LOT AREA 10,841 f S.F. / / X 45.1 pp. CONCRETE BOUND ELEVATION 45.25 SITE & SEWAGE 448 X / 33.3' 23.3' 44.6 X \ REPAIR PLAN / #390 \ VACANT LOT Z EXISTING 45.4 ;3390 DWELLING PROPOSED • 13.4' 9 TO WELL �- "D" BOX" PL UM S TREE T DECK N X 45.4 X 45.1 r 45.5 � W. BARNSTABLE, MASS EXISTING 1,500 10 5.8 GALLON DATE: NOV. 9, 2018 N REMAIN TANK TO ,0' \ s sp.� 19 / s OWNER/APPLICANT: 41 x 45.3 / ANDREW BARRco >>Soo• 390 PLUM STREET WEST BARNSTABLE WELL „3' TO WELL � 10' PROPOSED SAS M A 02668 EXISTING / A N BE 22' 3 LEACHING FIELD EXISTING NG REMOVED / ABANDONED 18'x26' IN ACCORDANCE WITH / o SHEET 1 OF 2 DWELLING TITLE 5 FOR 5' AROUND SHED N PROPOSED SYSTEM . WHERE POSSIBLE PROPOSED PREPARED BY: l' OBSERVATION VARIANCES REQUESTED 150 TO WELL PORT EAS SURVEY, INC. TITLE V P . O. BOX 1729 NONE ' 44.1 SANDWICH , MA 02563 TOWN OF BARNSTABLE 0 20 30 40 PH. (508) 888-3619 TO ALLOW THE PROPOSED LEACHING AREA TO BE 113' FROM AN ABUTTERS WELL (#388). A VARIANCE OF 37' IS REQUESTED. CELL (508) 527-3600 TO ALLOW THE PROPOSED LEACHING AREA TO BE 130' FROM AN GRAPHIC SCALE: EAS.SURVEY©YAHOO.COM ABUTTERS WELL (#404). A VARIANCE OF 20' IS REQUESTED. 1 INCH = 20 FEET SYSTEM DESIGN RAISE COVERS TO WITHIN 6" OF FINISH GRADE OBSERVATION PORT TO EXISTING APPROVED DESIGN FLOW TCF = 47.79 FINISH GRADE GRADE / SCREW ON CAP 3 BEDROOMS AT 110 GPB/D 3-3-2 GPD GRADE 45.9 ELEV. 45.1 FINISH GRADE ' ELEV. - //�� �� ELEV. 44.9 GROUND ELEVATION 44.8 REQUIRED`SEPTIC TANK TOP = //ate /�� a ///��� `\/ a� � �� _v,• 330 x_2 _ _ 660 GAL. N TOP ELEV 42.0 N SEPTIC TANK PROVIDED = _1 500_GAL. a' EXISTING 4" PVC 20' ®S=0.02 ,...;•�.•::�.;.;:�::•r..;. ' • SCH 40 2 MIN-3 MAX 4e PVC SCH 40 7' ®S= 0.01 :•:•'r:•:••�••::•: :;:•°••.•.•.;�;:�::;:•:::.:•:•. : . INV.= SIZE OF LEACHING FACILITY REQUIRED I�IV.= EXISTING " ° �°o e o°° ° ° •°°e e e ° °°°°°°oo e° °e o 0 0 0° N � 42.56 10"TEE 14 TEE INV.= ° ° ° ° ° °°°° ° ° ° ° ° ° ° DESIGN PERC RATE _« __MIN./INCH � '� 00 0°0°0°0°°°0°°°o°oo°o°o°o°o°o°e°o°00000 00 op o°e°o°o°e t0 �' INSTALL 42.39 6" ° ° o o°e °o°e°o 0 o e e o 0 0° o °o o ° o 0 0 GAS BAFFLE 3 n 18' x 26' LEACHING FIELD LONG TERM APPL. RATE_9•_74_GPD/S.F. 4'-1" LIQUID LEVEL H- INV. INV.=41.63 ELEV.41.50 L41.0 SIZE OF LEACHING SYSTEM PROVIDED: DATUM: IN 26• _I a 330 _ 0.74 SF/GPD = 446 S.F. MIN. REQ. VERTICAL DATUM: ° ° EXISTING 1,500 GALLON (3) 4" PIPES 6' ON CENTER 'n 0 USING A 18' x 26' LEACHING FIELD MSLt / BARNSTABLE GIS SEPTIC TANK TO REMAIN I ELEV.35'9 WITH A MINIMUM OF 6" STONE UNDERNEATH BENCH MARK USED: 4 OBSERVATION PORT TO DH#2 ADJ. G.WATER GRADE / SCREW ON CAP TOP OF CONCRETE BOUND 18' ELEVATION 45.25 CONSTRUCTION NOTES: 46 x 20. 4 /S S.F. 18-0120 FILTER FABRIC 468 x 0.74 G/SF = 346 GPD 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ° ° ° o 0 0$e°e ° ee eo, 346 GPD PROV > 330 GPD REQ.= 16 GPD RES. ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING ° ° ° ° ° ° ° ° ° '°°°°°°°°°°°°°°° ooeoo$o°ogogOoOooeo 0 o000oeo ° e e ° ° ° ° ° °e ° ° e e ee ° ° ° ° ° ° o NO (GARBAGE DISPOSAL GRINDER ALLOWED) SITE 8c SEWAGE WORK ON THE SITE. ° ° ° ° ° ° O ° eee '0 NO 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE °e°e°° °o o"o°o°° °°o°a o o ° ° REPAIR PLAN WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 1 3' 1 6' 3' 1P#8679 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. r(��QO 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING / , MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND I-- 18.0' D.T.H. #1 D.T.H.PL UM S TREET S.A.S. AREA IS PROHIBITED END VIEW GROUND ELLEV6 /45.0 GROUNDELEV.645.1 GENERAL NOTES: DAN OJALA, PLS, PE, SE #1805 IS CURRENTLY NO GROUNDWATER NO GROUNDWATER IN 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. APPROVED BY THE DEPARTMENT OF ENVIRONMENTAL W. BARNSTABLE MASS TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS PROTECTION TO CONDUCT SOIL EVALUATIONS AND THE A A FOR SUBSURFACE DISPOSAL OF SEWERAGE. RESULTS OF HIS SOIL EVALUATION ARE IN ACCORDANCE SANDY LOAM SANDY LOAM 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE DATE: NOV. 9, 2018 ACCESSIBLE WITHIN 3" OF FINISH GRADE, WITH ANY REMAINING WITH 310 CMR 15.100 THROUGH 15.107. 7.5YR 7/3 2e 7.5YR 7/3 2. ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. B-1 B-1 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SANDY LOAM SANDY LOAM OWNER APPLICANT: CAPABLE OF WITHSTANDING H-10 LOADING UNLESS 1OYR 4/4 10YR 4/4 OTHERWISE SPECIFIED. DATE OF WELL: 4/96 12" 12" A N D R E W B A R R 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION INDEX WELL: SDW 252 DTH #1 B-2 B-2 OF ALL UTILITIES PRIOR TO ANY EXCAVATION. WELL ZONE: A INDICATES DEEP MED. SAND MED. SAND 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE WELL ADJUSTMENT: 0.8 TEST HOLE 2.5YR 6/8 " 2.5YR 6/8 390 PLUM STREET OR WITHIN 6 OF GRADE SHALL BE MORTARED IN PLACE. PER APPROVED PLAN 5/25/96 EL. = 43.0 24 EL. = 43.1 24' WEST BARNSTABLE 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. INDICATES MA 02668 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF 46" PERC TEST 46„ SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE P_1 C-1 C-1 SHEET 2 OF 2 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND NO MOTTLING FINE/MED. SAND FINE/MED. SAND LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. TMOF NO WEEPING 5YR 7/4 5YR 7/4 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN PREPARED BY: 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT �� DAVID ELEVATION OF THE OUTLET PIPE. DAMP DAMP E A S SURVEY, INC. 9• THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES FLA E TY R EL. = 34.5 126" EL. = 35.1 120" 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS N 1 P. BOX 1729 11. BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC �� �� 120" INDICATES ADJ. GROUNDWATER B.O.H. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND E. BARRY SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE �T NO OBS. GROUNDWATER SOIL EVALUATOR SANDWICH , MA 02563 FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL D. OJALA S.E. #1805 BE LEVEL PH. (508) 888-3619 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION NO OBSERVED GROUNDWATER SOIL TYPE: TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW PERC RATE: <2 MIN. PER INCH DEPTH TO BOTTOM OF HOLE 10.0' LOADING RATE: 0_7 CELL (508) 527-3600 AND APPROVAL. 4 GAL/SF/MIN EAS.SURVEY@YAHOO.COM 13. 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G i/A)E Y _ ACCr��c COWR (WATr'anc► TO €'NGINCEi� , w m OPnDr`iT 1/ A` OF FIN. . 1'Al�I Wk1 .75' OF CO.1- R OVER PRECAST RE't?UIRED f}VF , . TF M ! _, t �.. 7v _.� . 2t SLC>PE y N _ ra _ �__ -, -...__---..Y, ..._-.Y.....f.. ._. ..._.... _..._ ._.. ...__...._..__. .._. .:III r WIT T' �7U�1 PINT: Lfvtt l! ��� - ��_.�.^� ,' 'T Jl��f '�� .�_, ?�� � -� i :.... . r4 J . r , df r0. Pr-RC. .� TANK r+ ."!'_. _) �_ p�.�rcG ��t-; 1 �.� •� !•1!R - " ;1 .�:,, .. C LASS SOILS >r ' � s (Zx SLOP() �G" CRUSH0 STONE OR MECHANICAL _ f)EPT+ or rLC+"r _ COMPACTION. (15.221 (z)) - TF E C SII S. 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( ... ... r>~t Hti:"; ,f..., . ...; .(.t!a'; .. a s} �4.,a:;. ,µ'me tlq!:`F , ,. , ft,:. 4 t t_ q _ ,.•r ebl, .. r �� 1 I' .r� ! l�l�T. s � ' _ i1. , `sA q s �aIr,IMUM F IF`E t ITCH 1 I T /f3" E :CAN 1 f)InOPOOMrt IT J�-• .. _ (.� r I llilF T r!r•I S TO 'OF AAS H • -� a )E"Slrr t.o T) Nc, FOP 1�I_t- :.COS KP� (?l ° �tST" A GP l� f:.�IGN. !'LOW .., S. ('Ir`r JOINTS 70 lE. MAC E �•`nTT�RTIGI�T N tt:f7TIC TANK: ��.!? clrn J� ) r-lcCs O tC:fiLi ONS r^ I _,_ T ..__ ___ { ___ f. ONSTrUCTION Dr All-S Tr? F IN /�.CCOROANCE WITH MASS. A t ,. FNVIRONVrlQTAL CODE, Tltl.l Y'. A '=v G ti l ON .;Ef'fIC TANK ti r- w i 7. r►-Il_, t t AN, S FOR PROr�OS ) WORN, 17P3I_Y rrin NOT TO BE Cl�ti1G;_ t.i�f.'D FOR LOT UNE r;TAKIN(t / I ril)ES 8. rtIPF FOR SFf�TIr ,YST>-rw 'T;. SCI4• 40--4" t OT'fOM: . .1 ry -. w (.�..�._.) 9. (,OMPr)NF_-NTS NOT TO BF FT ,t_.K ILL.EC1 OR CO' CEALED itHOU7 -'��J ►t4SPE.CTION by f3OARD OF' iIrALTH Arin PFRMISSION 013TAINED h. FROM 130ARD OF HEAI_TH 10, E xIST � O �� 'r71� YT ICE "1JMPE_D AND fLED WITH CLE AN ►! �� N _ aO SAND OR Pit i,i AS i.'•11_ s�• 1 z;,; f p l c j v,l e e 1 1•, , I y.0 rtl �j Lj A c ` -T k ,0 Y-- `f•.11 6-^G e, ry g P,/�'�i'«�•^-I f'•.�(,•,a' � I • o OK .i 1 ,,d�••,,r*-!t- .,� �'" -�,d-�..�i� ►^/tt..J'`�'� C,7 r: �'J�-�1,�rf EC� fv� i'l�:t-� l�1+•�l I.a Or 'a M �4►J�'x�.1"��: �/l.Q�dr-►c-:� 6' 2p r �,� '%' - ' 'I , � OF f t : AND S � E 13 LA N ! �t✓'''"` ar11"'• -Jh I(Y ll-,,..1�.' e�f-„a,_,.r,..R.�_..•,,•-.�-�-�r-..++t+r-+ram.•.,.-r»--`�"`rd`-�--��,. �'eM' F t a , i F IN THF, TOWN OF: " T'Ftt.rlARED FOR:MA V11<• :` A.t PFW1 , F,*! r' - • F .� � • � -- { � , ' r.� CALF: �_f�'_2�;,» bA'►`i�:: �.:_1 _1��,���_.��i'�(: i '',down Xa'» Il'7 f' I'll ; '. 1 C 'A , sVAiA "ag Il V i e +" r « , i' i ,: fir..,,' f' `"'� ,�. t• tvr �9 �1 sx / ) t71 ;> �.S , ,y 771rjo!711101�14771: _77114�7 � W11- WN, all. q.e'.." ti�ii, -�At: if FIT, W-0 tin 'A SANTA "%� Xp T AM 7"i :A,11 nha 1 0% -2400,44 1 *��,",�,--,-,�,e,,� , R _ HOLK EST" PTJ C��,� 'tT 1. CPA: (NOT TO Ali! WT '0111*0 0 F"Al" ELI 'At MESS,, JO IN A low TM ,COVER W"' �A GHY) TO v AC&§S COWR IWATER'Dom OF FW GWOr 1 �0A Q J tMINIMW .75,?OF -COVE t A S�OPE REQUIPfD OVER 0 6VF_R PPE(��-'L'ij ,�` 7 TN 7' �A, %4, DATE-, "llLofql,Sirm >b's wa A 7 4�)10 'J, tm�7D J FLO�': _4L 7" [)E�1714 71tompA"o�4. �51 TEE ZE1 "IS Ift ? L LOCATION OUTLET DEPT got TOW no' A SAW ILAP PAR A 4 It %4SS p Ton 77 ES50RS:MA y S�EP'nq TANK Box t, ,7 V e Q4 777 FAC I L�T`Y _00n,7ONE, LINDA �,,�O TIPN tt.: 1z 140 e Ef t1>1 861LDIN joy Vv V , J 0 t t, �R NT WIN& SIDE All REA slow,Q: t 1114 NOTES.-" 7�, titI 7t7 I�72 t Z § 77 � 2,., MUNIC,1 AWL,, N: ,i- A(WSAGt DISPOS 04 140, 1 ky� T, ER,it SINBC DES' MJNIMUM-,PIPE,'0ITcWT PER� rOOT. �ALC' Sl ' NITS'J,� 8E� AASVllA4.16_- 1 v TLOW GPp 41.- ot PRECA 0 -Plpf AIR QS:Tp;BIT V t JEMC TANK, -,��2Lo'�,GPD i-GALLONS CON STOOdlION',OETAILS PGPOIRDANCE WITH_,iMASS��. A n Vol VOL U�,;E A�' L��God DAN% MADE )�ATFRTIG�4�' TO IN 'E ': 'MIS PLAN,JS QR: PROPOSEDWORK ONLY AND -7. N0T'-JO:"bE ENVIRONMr`.NTAL .CqDF I ITLE:, LIFE A' U��p �,ALLbN`:ic, PTJqJA�K, ,, A A n 1, -7' iplpr,��FOR 4 �PSED Q OR ,-LO.T 1INE �STAKJING;. A ., _LE 'EA b'.'WITHOUT' '9 COkIPONEN'TS, N OT, E aW F)LLt oR '�GONC D '�QN 13Y BOARD OF 146ALTH AND PERMISSION OBIMNED '0 T� ICTAL. A74" S 7&0 OWNS:: rROM ]BOARD :OF; HF!QLTI;4VQ1 W 7Y-Q !p�i,f� � 4 41 MEAN t INKI r_LW-ir-9 ..... 1_0_-EX15TWO" CESSPOOLS- Tb' er PUMPED AND rJLLE6"W t OR�REpqpfp AS NECESSARY, yl&i Y� SAND 7'� 4. 7 A: Ak >�VIA "Lilly W wq!T0xn,:, Z A6 ......... \4 YA LAN St' KKK . W i _A own YnA, 0 To 3 top 'his ly IN THE,T6WN,' 0F, . 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