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Home My WebLink About0195 ROUTE 149 - Health (5) 9' � +--ter /� n �Un p i (.1 n��-G I � 5�a�-�-�f �/ ,Da..�� a.. 1 1 �� Qg�BCDHE BAFwAEtE COUNTY DEPARimENT OF HEALTH AND ENVIRONMENT J-a"Mya •!~, PROMOTE-PROTECT-SUPPORT n !" . � YEARS OF SERVIC 1926-2016 October 26th, 2017 John and Mary Connor PO Box 812 Marstons Mills, MA 02648 RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 195-G Route 149 in the town of Barnstable. Dear John and Mary Connor, Our records indicate that the operation and maintenance contract with Bennett Environmental Associates, Inc. for your innovative/alternative wastewater treatment system may have expired or was canceled as of October 13th, 2017.To date we have not received evidence that you have entered into a new operation and maintenance contract. I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP)and the Town of Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at https://septic.barnstablecountyhealth.ora.You can access the list of wastewater operators of whom we are aware do business in Barnstable County. This septic database also provides further explanation about your I/A septic system, as well as any sample and inspection history for the performance of your system, as entered by previous service providers. My department oversees I/A septic system management and compliance efforts for the Board of Health in your town. We are authorized by your Board of Health to contact you to inform you of the above requirement and to request your compliance. Accordingly, please forward a copy of a signed contract via mail, fax, or e-mail within fifteen (15)days of receipt of this letter. For your convenience, I have enclosed a list of wastewater operators we are aware of that do business in Barnstable County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or vendor.. Please be advised that if you do not respond within fifteen (15)days of your receipt of this letter by forwarding a copy of a signed contract, you may be referred to the Barnstable Board of Health for further enforcement action. I can be reached at 508-375-6901; my fax number is (508)362-2603. 1 can also be reached via email at emilymichele.omsted@barnstablecounty.org. Thank you for your prompt attention to this matter. Sincerely, Emily Michele Olmsted CC: Barnstable Board of Health .Enclosures (2): Certified Wastewater Treatment System Operators List, Inspection and Testing Requirements BARNSTABLE COUNTY COMPLEX 3195 MAIN STREET/PO BOX 427 BARNSTABLE, MASSACHUSETTS 02630 Phone:(508)375-6613 1 Fax:(508)362-2603 1 TDD:(508)362-5885 Web:barnstablecountyhealth.org 1 Twitter:@BCHDCapeCod BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/24/14 BEA14-10704 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Connor Residence 195 Herring Run Place Unit G[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail X Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(March and September 2014) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(March and . September 2014) 1 9/22/14 Alpha Analytical Laboratory Report ' CD s For review and comment: ❑ For approval: ❑ As requested: ❑ For youi t se: REMARKS: r=` Please find enclosed the DEP Inspection and O&M Form,OMNI RSF Operation and Maintenance Inspection Checklist and laboratory analytical results for operation and maintenance conducted during the reporting period at the above referenced property. The inspection conducted in September 2014 is the first event completed for the new owners of the system. The Barnstable Board of Health approved a reduction in inspection frequency from quarterly to semi-annual in 2014. It is noted that inspection ports or cleanouts for the pressure dosed leach field laterals are not accessible for inspection. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health John and Mary Connor,Property Owners David C.Bennett,Principal [Internal] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip key. Mailing address of owner, if different: NA Street Address/PO Box: mean City State Zip ( ) - ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/6/14 12/31/13 Inspection Date Previous Inspection Date 6" Sludge, 1" Scum Sludge Depth(to be checked yearly) Pumping Recommended Yes No ® t5aiom.doc•rev. 11-07-05 Page 1 of 3 ' Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 5.0 mg/L Turbidity 2.35 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMa R 2.00. -z Operator Signature 14 Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31"of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 311h of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 3 t5aiom.doc•rev. 11-07-05 Page 3 of 3 -- Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When John and Mary Connor filling out forms Owner on the computer, use only the tab 195 Herring Run Place Unit G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip key. Mailing address of owner, if different: P.O. Box 812 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508) 951 -7914 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Finn 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/15/14 3/6/14 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.0 mg/L Turbidity 2.49 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ® Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: The system is operating correctly. Effluent quality passed field testing parameters. t5aiom.doe•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and ®&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. 44� Operator Signature ' Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 4 r� 0 � . .fin vrxonmer t Systems,lnce OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information { IN- \ R ~ G_ A Facility Street Address Date of ervice City Operator/O&M Firm Q, cove System Startup Date Weather Condition B. Septic Tank Sludge Pumping Required: Yes❑ Noo, 'Sludge Depth: ( T,Scum Depth: Effluent tee filter. MW Nd'0- If yes, inspec &clean at least yearly❑ If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler, if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank Li Check if sludge accumulating Pumping required: Yes❑ NoW Odor problems: Yes ❑ Nod, If yes,description Effluent tee filter: Yes❑ N6414 If yes, inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. 1� I ' D. Equalization Tank (if installed) Sludge Pumping Required: Yes❑ No❑ ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber 1 Vault(if Installed) Pump Inspections (all units) If problems,describe V,Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problems,describe Test pump alternator, or record hours Hours of operation Float switches �( Check all switches for operation tj�J Test alarm If non-functioning,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are functional, if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes❑ Nd W Q Clean bed: Yes❑ Not Distribution pipes Flush:Yes❑ No o Brush: Yes❑ Noo Any obstruction of airflow to filter modules: YesmfNo❑ If Yes, explain below(i.e. snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric-so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes❑ NoV If yes: ❑BOD ❑TSS ❑pH [:ITN ❑Other All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: OMNQ&� Environmentat Systems,Ine. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Address Da of Se ice wft- city Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required: Yes E] No% n Sludge Depth: ❑Scum Depth: Effluent tee filter: lft# Na' If yes,inspect El&clean at least yearly❑ If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank El Check if sludge accumulating Pumping required: Yes El N Odor problems: Yes E] No if yes,description Effluent tee filter Yes D NN" If yes, inspect El&clean at least yearly El If the sludge layer is greater than 4'request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules. Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank (if installed) Sludge Pumping Required: Yes El No 0 F1 Sludge Depth: El Scum Depth: Effluent tee filter. Yes 0 No F1 If yes, inspect El&clean at least yearly 0 Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) If problems,describe KFloat switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational Immediate corrective actions need to be taken. • e F. Pumps, Switches Floats Alarm System t.L�1 Pump Inspections(all units) "l If problems,describe Test pump alternator, or record hours Hours of operation R1 Float switches Check all switches for operation Test alarm V\ Yvon-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") � -t Inspect for ponding Ponding Present:Yes❑ No. Clean bed: Yes❑ NorA gAny Distributlon pipes Flush:Yes❑ No10 Brush: Yes El No obstruction of airflow to filter modules: Yes❑ No If Yes,explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes;�J No❑ If yes:�❑BCD ❑TSS ❑pH I1' (TN `D(Cther �-05 1 NO� All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: \ L1 mod✓ f! Svc-. i>J y�-�`7'`� i i I Serial No:09221409:07 HA A`JJ"A.L TICA L ANALYTICAL REPORT Lab Number: L1421315 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: CONNOR RESIDENCE Project Number: BEA14-10704 Report Date: 09/22/14 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com ' A Page 1 of 16 cl Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Alpha Sample Collection Sample ID Client ID Matrix Location Date/Time Receive Date L1421315-01 EFFLUENT WATER MARSTONS MILLS, MA 09/15/14 14:45 09/16/14 Page 2 of 16 I , Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 ' Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE';respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.All specific QC information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments, solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples(with the exception of Air canisters)free of charge for 21 calendar days from the date the project is completed.After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples.Air canisters will be disposed after 3 business days from the date the project is completed. Please contact Client Services at 800-624-9220 with any questions. q Page 3 of 16 � L--1— �. Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Case Narrative(continued) Nitrogen,Total Kjeldahl L1421315-01 has an elevated detection limit due to the dilution required by the sample matrix. I,the undersigned, attest under the pains and penalties of perjury that, to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report,such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. S-.t- Lura L TroV Authorized Signature: Title: Technical Director/Representative Date: 09/22/14 Page 4 of 16 'fclit,a Serial_No:09221409:07 i INORGANICS MISCELLANEOUS Page 5 of 16 Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 SAMPLE RESULTS Lab ID: L1421315-01 Date Collected: 09/15/14 14:45 Client ID: EFFLUENT Date Received: 09/16/14 Sample Location: MARSTONS MILLS,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst ;General Chemistry.=Westborodgh Lab Nitrogen,Nitrite 0.23 mg/1 0.050 — 1 - 09/17/14 04:01 44,353.2 DB Nitrogen,Nitrate 7.0 mg/1 0.10 — 1 - 09/17/14 05:07 44,353.2 DB .....-- ....... --.... _ _......_ _ _..._._ _... ._ ......-._ - . ...... _ ._....-..... Nitrogen,Total Kjeldahl ND mg/1 0.600 — 2 09/17/14 12:18 09/18/14 22:13 30,4500N-C AT Page 6 of 16 Serial No:09221409:07 .r Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Cheml try Westborough Lab.for sample(s): 01 Batch `WG722581 1W Nitrogen,Nitrate ND mg/1 0.10 1 09/17/14 01:49 44,353.2 DB General Chemistry Westborough Lab; for sample(s)h 01 Batch WG722584-1 . Nitrogen,Nitrite ND mg/1 0.050 1 09/17/14 01:52 44,353.2 DB General Chemistry Westborough Lfab for sa`mple(s) 01 Batch WG722791 1 .., _ _.. .� . Nitrogen,Total Kjeldahl ND mg/l 0.300 1 09/17/14 12:18 09/18/14 21:53 30,4500N-C AT Page 7 of 16 r Serial No:09221409:07 Lab Control Sample Analysis Batch Quality Control Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits . .M r A. . General Chemistry-:V1/estfjorouI.lab :Qssociate'd saniple(s): 01 R.,Batch:'WG722581 2< - Nitrogen,Nitrate " 100` 90-110 - a . t General;Chernlstry Westborough,Lab.rAssoclatedasamples) 0.1 Batch WG722584 2 Nitrogen,Nitrite :96 .' . 90-110 - 20 General Cliemistry:.`Vllestbo`rough EAb soclafed#s ple(s) Q1 Batch vWG7227,91 21-1 �. _. e Nitrogen,Total Kjeldahl 100:' - 78-122 - Page 8 of 16 ��. Serial No:09221409:07 Matrix Spike Analysis Project Name: CONNOR RESIDENCE Batch Quality Control Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits General,Chemistry,.-=;Westborough;:LabAssoclated:sample(s):Q1 >.QC;BatchslD.;rWG72258:1 4 QC Sample ,L142126.5 01- >Cherit ID MS'Sam'pI Nitrogen,Nitrate 0.32 4 4.3 99 - - 83-113 6 .. ._ .. ..s.. General Chemist Westborough'Lab.;Assoclated samples) 01 .. QC Batch"ID:UVG722584 4 'QC!Sam ple L.142129.6 01 `Client'ID 4MS=Sample Nitrogen,Nitrite ND 4 3.9 80-120 20 . .. ............... _ _... ............... .............. General Chemistry'„-Westborough!5L*ab Assoclatedaample(s):'!01. QC'Batch,ID:`WG72279.1 4 QC:Sample:rL'1"421281 01 ;Client ID MS,:Sam le • ._. r _, . _,�_,�.�,...-,my__. ,_..._ ,. p, Nitrogen,Total Kjeldahl 1.53 8 10.1 A07 - 77-111 - 24 Page 9 of 16 ��;,� Serial No:09221409:07 Lab Duplicate Analysis Project Name: CONNOR RESIDENCE Batch Quality Control Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General'Chemistry Westborough,Lab Associated•sample(s) 01. QC Batch'ID WG722581=3 QC Sample L`•1421265=01 Client ID " DUP Sample* Nitrogen,Nitrate 0.32 0.28 mg/1 13 Q 6 . _.. _..._ ; . F.� ._. 3rQCSample ..L142129601 CGeneral Chems tboroughA s 01; * QB lient D: DUPSam lMe.ahY w , Nitrogen,Nitrite ND ND mg/I ;NC 20 .. General Chemistry=Westboiough Labs Associated ample(s) 01 QC Batch"I_D WG722791'-3 , QC Sample L'1'421281=01 Glient.ID;>'DUP Sample ,Associate. .. _ . ..� _ G _ _.1'421 .81 _ Nitrogen,Total Kjeldahl 1.53 1.85 mg/I 19' 24 h Eir1 Page 10 of 16 =�, _ Serial No:09221409:07 ' Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1421315-01A Plastic 250m]H2SO4 preserved A <2 4.8 Y Absent TKN-4500(28) L1421315-01 B Plastic 250ml unpreserved A 7 4.8 Y Absent NO2-353(2),NO3-353(2) *Values in parentheses indicate holding time in days ! �;,� Page 11 of 16 ^ � Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Total:With respect to Organic analyses,a'Total'result is defined as the summation of results for individual isomers or Aroclors.If a'Total' result is requested,the results of its individual components will also be reported.This is applicable to'Total'results for methods 8260,8081 and 8082. Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit.For NJ-related projects(excluding Air),flag only applies to associated field samples that have detectable concentrations of the analyte,which was detected above the reporting limit in the associated method blank or above five times the reporting limit for common lab contaminants(Phthalates,Acetone,Methylene Chloride,2-Butanone). C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. Report Format: Data Usability Report AN, Page 12 of 16 Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 Data Qualifiers G -The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The lower value for the two columns has been reported due to obvious interference. M . Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for drs analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search. P The RPD between the results for the two columns exceeds the metbod-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. S Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report Page 13 of 16 Serial No:09221409:07 Project Name: CONNOR RESIDENCE Lab Number: L1421315 Project Number: BEA14-10704 Report Date: 09/22/14 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100, August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error, the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to, damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 14 of 16 Serial_No:09221409:07 Certification Information Last revised April 15,2014 The following analytes are not included in our NELAP Scope of Accreditation: Westborough Facility EPA 524.2: Acetone,2-Butanone(Methyl ethyl ketone (MEK)),Tert-butyl alcohol, 2-Hexanone,Tetrahydrofuran, 1,3,5-Trichlorobenzene,4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260C: 1,2,4,5-Tetramethylbenzene,4-Ethyltoluene, lodomethane(methyl iodide), Methyl methacrylate, Azobenzene. EPA 8330A/B: PETN, Picric Acid, Nitroglycerine, 2,6-DANT,2,4-DANT. EPA 8270D: 1-Methylnaphthalene, Dimethylnaphthalene,1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,4-Methylphenol. SM4500: Soil:Total Phosphorus,TKN, NO2, NO3. EPA 9071: Total Petroleum Hydrocarbons, Oil& Grease. Mansfield Facility EPA 8270D: Biphenyl. EPA 2540D: TSS EPA TO-15: Halothane, 2,4,4-Trimethyl-2-pentene, 2,4,4-Trimethyl-1-pentene, Thiophene, 2-Methylthiophene, 3-Methylthiophene, 2-Ethylthiophene, 1,2,3-Trimethylbenzene, Indan, Indene, 1,2,4,5-Tetra methyl benzene, Benzothiophene, 1-Methylnaphthalene. The following analytes are included in our Massachusetts DEP Scope of Accreditation,Westborough Facility: Drinking Water EPA 200.8: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI; EPA 200.7: Ba,Be,Ca,Cd,Cr,Cu,Na; EPA 245.1: Mercury; EPA 300.0: Nitrate-N, Fluoride, Sulfate; EPA 353.2: Nitrate-N, Nitrite-N; SM4500NO3-F: Nitrate-N, Nitrite-N; SM4500E-C, SM4500CN-CE, EPA 180.1, SM213013, SM4500C1-D, SM232013,SM2540C, SM4500H-B EPA 332: Perchlorate. Microbiology: SM921513; SM9223-P/A, SM9223B-Colilert-QT, Enterolert-QT. Non-Potable Water EPA 200.8:AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn; EPA 200.7:AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn; EPA 245.1, SM45001-1,6, EPA 120.1, SM251013,SM2540C, SM234013,SM232013, SM4500CL-E,SM4500E-BC, SM426C, SM4500NH3-BH, EPA 350.1: Ammonia-N, LACHAT 10-107-06-1-B:Ammonia-N, SM4500NO3-F, EPA 353.2: Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, SM4500P-B, E, SM52201), EPA 410.4, SM521013, SM5310C,SM4500CL-D, EPA 1664,SM14 510AC, EPA 420.1, SM4500-CN-CE,SM254013. EPA 624:Volatile Halocarbons&Aromatics, EPA 608: Chlordane, Toxaphene,Aldrin, alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT, Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs EPA 625: SVOC(Acid/Base/Neutral Extractables), EPA 600/4-81-045: PCB-Oil. Microbiology:SM9223B-Colilert-QT; Enterolert-QT, SM9222D-MF. For a complete listing of analytes and methods, please contact your Alpha Project Manager. Page 15 of 16 i Serial_No:09221409:07 Date • .<. CHAIN OF CUSTODY PAGE OF Recd � .:,�_ ct Information Report Information Data Deliverables Billing.Information 11 ❑ FAX ® EMAIL.. ® Same as cllentinfo PO#:10146.. _ Westborough,MA Mansfield,MA Project Name:Connor Residence TEL:50"98-9220 TEL:508-822-9300. ❑ ADEX ❑ Add'I Dellverables FAX:.508-898-9193 FAX:508-8223288 • project Location:Marstons Mills,MA State/Fed Pro ram criteria Client:Bennett Environmental Associates Project#:BEA14-10704 Address:1573 Main Street/P.O.Box 1743 Project Manager David C.Bennett Brewster,MA 02631 ALPHA Quote#:06 Phone:508-896-17 _ I'I ANALYSIS. E.H Fax:508-896-5109 ®Standard ❑'Rush(ONLY IF PRE-APPROVED) SAMPLANDLING Filtration Email:sfarrehkopf@bennett-ea:com ❑:Done ❑These samples have been Prevlously analyzed by Alpha Due Date:l Time: ® Not Needed ❑ Lab to do Other Project Specific Requirements/Comments/Detection imi Preservation • a❑ Lbt o do (Please specify below) EE ALPFIA:Lat ID< ; ?:. Sample ID Collection Sample Samplers Z11 {Lab:Uselt)niyji. Date Time Matrix Initials w z >- Comments ,;_ ,: Effluent:. \� 1� '- ww ® ® El ❑ ❑. ❑ .❑. El :❑ ❑ Z. w El El ISO El El El El 0 El El El 0 El 7 ;) k3AEl ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ El ❑ ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o ❑ ❑ ❑ ❑ ❑ a ❑ ❑ Container Type P P Preservative 0. . ° ;_ . fang complatefy:.Sariiples:,d, be_lg99�.dan Ref' ished Daterime Received y:/ Fie rqund;fuheploGkwlllrabtr� i� i tr'start: nliEenyam6igu1ti9s;ate l V ,rij�.olJed..:411;sarrple$ ::,: 1 %�< '{8iititrijttedyare.`:siabjedtitb.: ;�; FORM NO:Ot-010,W) % /�' .Pli�.wr �, �.� tiAlptia�s`,?ayiifept Tl3trliS•""""'`;�`-: (reV.2PAPR-0� '.' ,' r Page 16 of 16 BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/25/13 BEA09-10139 Attention:Title 5 Program I Winter Street-6th Floor Boston,MA 02108 REGARDING: Straubing and David Residence 195 Herring Run Place Unit G[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR ❑ COPIES DATE DESCRIPTION I DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(December 2012;March,June and September 2013) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(December 2012;March,June and September 2013) 1 9/17/13 Alpha Analytical Laboratory Report For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0 REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklists and laboratory test results for operation and maintenance conducted during the reporting period for the above referenced property. It is noted that inspection ports or cleanouts for the pressure dosed leach field laterals are not accessible for inspection. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Kim Straubing and Mr.Jeffrey David,Owners David C.Bennett,Principal[Internal] Matthew Costa-OMNI Environmental Systems,Inc. [via email] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DER Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 183.1 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/27/12 9/5/12 Inspection Date Previous Inspection Date sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ❑ no ® some pH 7.0 SU DO 4.0 mg/L Turbidity 10.74 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. t5aiom.doc•rev.11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massach=certi operator in accordance with 257 CMR 2.00. g�z5�r3 Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31t"of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information .3/6/13 12/27/12 Inspection Date Previous Inspection Date 7"sludge, 1"scum Pumping Recommended ® Yes ❑ No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: M no ❑ some pH 7.0 SU DO 3.0 mg/L Turbidity 11.49 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Replace the top riser section on the Recirculation Tank. Notes and Comments: Effluent quality passed field testing parameters. Recommend pumping of recirculation tank due to solids accumulation. t5aiom.doc•rev. 11-07-05 Page 2 of 3 Y Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Q,_��rLc-ja 0 Ct�7S�`) Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 315t of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip r� Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information ,9/.1-1/13� 6/5/13 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SLI DO 6.0 mg/L Turbidity 3.28 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ® Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ® TN ® Other(list below) NO2 NO3 TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. sis. Notes and Comments: Effluent quality passed field testing parameters. t5aiom.doc•rev. 11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 315t of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 301h of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aionn.doc•rev. 11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508) 896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6613 3/6/13 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 3.5 mg/L Turbidity 7.52 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. The owner had the septic tank and recirculation tank pumped out recently. t5aiom.doc•rev. 11-07-05 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certifi perator in accordance with 257 CMR 2.00. S '�\ A 'It'_*1 r; al P gkl Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 311h of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 OMNUMv �^ Fnviropmental Systems;Inc. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Address \\ Date df Servic \ City Operator/O&M Firm System Startup Date Weather Conditions -3k\-L\\-L o k\\-- \<'-x B. Septic Tank Sludge Pumping Required: Yes❑ N ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes[A No❑ If yes, inspect&clean at least yearly If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule X depending on how heavily the system is used. \ n j �v` �•� s � �,-5 `\y�..v`' Ova �`��'�\Z' �� `- �3�� C. Recirculation Tank ❑Check if sludge accumulating Pumping required: Yes❑ NN Odor problems: Yes ❑ N If yes,description Effluent tee filter: Yes❑ No If yes,inspect❑ &clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. ' D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) If problems,describe Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. I F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problerns de cri e G n (3�• Test pump alternator,or record hours , Hours of operation Float switches Check all switches for operation Test_alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. D a G. Filter Modules ("Sand Filters") s,��0•C ''L-G � � Inspect for ponding Ponding Present:Yes❑ NoA Clean bed: Yes❑ NA Distribution pipes Flush:Yes❑ NoN Brush: Yes El No ] Any obstruction of airflow to filter modules: Yes❑ No V If Yes,explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes❑ N If yes:❑BOD ❑TSS ❑pH ❑TN ❑Other All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, .laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: .S w cal•�,-, c�v� ��y�s.'!L..� C�V'iz OC� — l-(, no C, DO t OMN .& OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Address Date of Aervice City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank 11 1\ Sludge Pumping Required: Yes❑ NIA, Sludge Depth: I `Scum Depth: 1 Effluent tee filter: YesW INo❑ If yes, inspect&clean at least yearl�A If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. A j� C. Recirculation Tank �\ 5�� C �'`'�-11A44 �4 Check if sludge accumulating Pumping required: Yes No❑ Odor problems: Yes❑ No If yes,description Effluent tee filter: Yes ElNo If yes,inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) If problems,describe Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats,Alarm System Pump Inspections(all units) If problems,describe Test pump alternator,or record hours Hours of operation Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding. Ponding Present:Yes❑ No Clean bed: Yes❑ Nolp Distribution pipes Flush:Yes❑ No Brush: Yes❑ No Any obstruction of airflow to filter modules: Yes❑ No E If Yes,explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes❑ NCV If yes:❑BOD ❑TSS ❑pH ❑TN ❑Other All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: L -v0 UO _S"-d� �� "CCU f�5�✓ S .w. u\ \-T. 1� n Vc 170r !fM. E'nvzi-onmMI«I Systems,Me— OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Address V 1\ Date of Service City Operator/O&M Firm Svc System Startup Date Weather Conditions B. Septic Tank s``� "� � v�..,�� Sludge Pumping Required: Yes❑ No%6 ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes No❑ If yes,inspect% &clean at least yearly❑ If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank Y pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established with a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank ,�� I� El Checkifsludge accumulating umping required: Yes❑ No❑ Odor problems: Yes❑ No If yes,description Effluent tee filter: Yes❑ No If yes,inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes,inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) If problems,describe Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats,Alarm System � Pump Inspections(all units)�j P p V� If problems,describe Test pump alternator, or record hours 13" �"<, -�') Cs"- ,o\ e. Hours of operation Float switches Check all switches for operation *st alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. \ ` . , i5 1 C,C G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes❑ No Clean bed: Yes❑ Nov, istribution pipes Flush:Yes❑ Np(� Brush: Yes❑ NA Any obstruction of airflow to filter modules: Yes❑ NokO If Yes,explain below(i.e.snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes❑ No If yes:❑BOD ❑TSS ❑pH ❑TN ❑Other All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes: z 0MN Eri vrlwnfnent�d syste`f1s, I11C. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Address *Dat .f Se ice City OperatorlOWA Firm System Startup Date Weather Conditions B. Septic Tank At-,� '3�Q�0 Sludge Pumping Required: Yes❑ NcU4 ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes4 Nor, If yes,inspect&clean at least yearl f` If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank pumped,note the approximate scum layer thickness as well.Also,inquire if the homeowner has a pumping schedule established With a licensed septage hauler,if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank ❑Check if sludge accumulating Pumping required: Yes❑ No� Odor problems: Yes❑ No If yes,description Effluent tee filter: Yes❑ N. If yes,inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. 1 ' D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes,inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) If problems,describe Float switches V \ Check all switches for operation Make Sure the pump is.operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps,Switches, Floats,Alarm System Pump Inspections(all units) If problems,describe Test pump alternator,or record hours Hours of operation Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s),Float(s)and audible alarms)are functional,if not make a note so that corrective actions can be made. - r G. Filter Modules ("Sand Filters") Viyya/✓5041Ccc`F,.\Qz' nspect for ponding Ponding Present:Yes❑ NOOK Clean bed: Yes❑ NoO Distribution pipes Flush:Yes❑ N Brush: Yes❑ Nq,o Any obstruction of airflow to filter modules: Yes❑ N If Yes,explain below(i.e.snow,dirt) To inspect the condition of-the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection YesX No❑ If yes ❑BOD ❑TSS ❑pH (A I VA f All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile, laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained. Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves). System Notes:: \ `` —VQ �� U Serial_No:09171310:50 HA A N A L Y T I C A L ANALYTICAL REPORT Lab Number: L1317794 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: STRAUBING RESIDENCE Project Number: BEA09-10139 Report Date: 09/17/13 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193. 800-624-9220-www.alphalab.com Page 1 of 18 Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Alpha Sample Collection Sample ID Client ID Location Date/Time L1317794-01 EFFLUENT MARSTONS MILLS, MA 09/11/13 11:00 Page 2 of 18 Serial No:09171310:5O Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed along with any associated usability implications. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. HOLD POLICY For samples submitted on hold,Alpha's policy is to hold samples free of charge for 21 calendar days from the date the project is completed. After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service Representative and made arrangements for Alpha to continue to hold the samples. Please contact Client Services at 800-624-9220 with any questions. I, the undersigned, attest under the pains and penalties of perjury that, to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Cynthia McQueen Authorized Signature: Title: Technical Director/Representative Date: 09/17/13 HA Page 3 of 18 -= r Serial No:09171310:50 INORGANICS MISCELLANEOUS Page 4 of 18 Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 SAMPLE RESULTS Lab ID: L1317794-01 Date Collected: 09/11/13 11:00 Client ID: EFFLUENT Date Received: 09/11/13 Sample Location: MARSTONS MILLS,MA Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst 1 General.Cliemistry ;WestboroughLa6_�_ Nitrogen,Nitrite 0.30 mg/I 0.050 -- 1 - 09/12/13 01:07 44,353.2 DB Nitrogen,Nitrate 11. mg/I 0.50 — 5 - 09/12/13 01:59 44,353.2 DB _._._...__.-------------------.-.-.--------------..-...._. -._.... _.. -.._...----- —... _.. .._...-_... ---------- --------------------_------------._....................................-...-_...-. Nitrogen,Total Kjeldahl 5.17 mg/I 0.600 2 09/12/13 10:56 09/13/13 21:33 30,4500N-C AT HA Page 5 of 18 Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Che tsim ry •Westb ough Lab foraample(s'),01 '}Batch`. V1/G635443=1 k ,«�,....---.- . —_ ...-- ....,..w a..J.._ .�.ti«. - __.»,.«.. _ ......-.:r -. ate.. ,_- ,.>.�a....... .....,..�.....� ..ba. .- ._....._... r�. Nitrogen,Nitrate ND mg/I 0.10 -- 1 09/12/13 00:45 44,353.2 DB General Cfiem'istry-Westborough Lab for samples) 01{ Batch: WG635446.1 Nitrogen,Nitrite ND mg/I 0.050 1 09/12/13 00:48 44,353.2 DB ............ ......._ .... _....... . . .......... ......... ........ _._._.. _... _........ General.Chemistry.-Westborough Lab for'salriple(s): 61° Batch: WG6356271 _ _ _.w ._ _... _. Nitrogen,Total Kjeldahl ND mg/I 0.300 1 09/12/13 10:56 09/13/13 21:12 30,4500N-C AT Page 6 of 18 Serial No:09171310:50 Lab Control Sample Analysis Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits rY b. a.P � ) x,. 3 atc G63544 Ge eral Chemist ,Westborough,Lab, Associated sam le s 01 B h W &?�,�+�.u -.,.,,� .�.< :+� ,.�,e....,a�.,dmw�'�,.:a�.a .:e,......w_.u�.,»...w.«.-w..a4.; «�,...N.«�;��#.�.s�.r:..,,v..�. :t.,...-,+..,...�: �n�..:a...,"„iau�,�..,.,.M...+»...'.,�., ,�.a.�,pa.,,-.,.,,��,^+w.w.:."M..a�.�.a.:»„�:...�:.,,w�...,a.:�,-..•..,,�r,�,.—>.�,:...,.. .,.o.�Nitrogen,Nitrate z 102 . Nz - 90-110 - General Ch mist �V11es boron h�. A i T ry , g ab ssoclatedrsample(s) 0;1 Batch WG635446 2 e f �'"` -, Nitrogen,Nitrite w°7 A 01` - 90-110 - 20 General Chemistry Vl/estborough Lab Associated samples) `.01 Batch WG635627 2 �:a"wwae�.W'.. r_sfw`uu:8ti'®W �ravm.➢n..ywwmu.vu... n"x�'...waermrmam�5rn._.wr,w+fr.,ams..:._..mau.. ex.s....xmtib`r:a.v.m«a.0 ..e$'l£:aar3w.�F:...-,ieYs=.=.W...,w�m++murrmammaa..maM..twa aw..v+_..c...,.+e. .ram+�...i-rave+AWw"...w.+as.+re..namraM—'�*re..vwm—rowan. rss..a.>-o-�ws.+ar'.w_.�dmn-..mcaawv''� xa� Nitrogen,Total Kjeldahl 95 ,7 78-122 Page 7 of 18 sy�t�a Serial No:09171310:50 Matrix Spike Analysis Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits GeneraLChemistry-Westborough'°Lab Associatedaample(s):-01 QC Bafch.ID::WG635443-4. ' QC Sample: L1317:789 01 Client ID MS.Sampl.e Nitrogen,Nitrate 4.0 4 7.8 96 83-113 - 6 General Chemistry-Westborough Lab Associated sample(s); 01 QC,BatchdD.,:WGG635446-4 QC.Sample: L1317789=01 Chem ID. IVIS Sample Nitrogen,Nitrite 0.075 4 4.3 �7, 105`.�� - � � 80-120 20 ` �W General;Chemistry-Westborough.Lab Associated sarriple(s).:;01 QC Batch ID .VVG635627 4 - QC Sample.rL1:31.7.798 01,. Client]D. IVIS_Sample Nitrogen,Total Kjeldahl 41.6 8 50.8115.Y. Q - 77-111 24 _._..-.. . ........_ --._. .. _,.... - - _........ .. _._..... ... .___._. . Page 8 of 18 HA Serial No:09171310:50 Lab Duplicate Analysis Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Parameter Native Sample Duplicate Sample Units RPD Qua[ RPD Limits General Chemistry Westbyorough L'ab Associated samples) . 01 QC'Batch ID 'V1/G635443=3 QC Sample: L4317789701. Client ID: .DUP:Sample . Nitrogen,Nitrate 4.0 3.8 mg/I '4`� 6 General Chemistry Westborough Lab Assoclatedsample_(s): 01. QC BatchllD..:1/VG635:446-3 QC Sample: L1.317789=01. ClientllD. .DUP Sample Nitrogen,Nitrite 0.075 0.064 mg/1 16'.`` ' 20 . ._..... ro t. ..., .., �. ,.. ... GeneralaChemistry Westbougr-ab'•Associated-a 01. tQ&Batch ID �W.G635627-3 QG Sample .L131�7798-01. Cli._„ent ID:.: DIJP Sample. Nitrogen,Total Kjeldahl 41.6 44.8 mg/I y ;..,7a` 24 Page 9 of 18 PHA Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1317794-01A Plastic 250ml unpreserved A 7 4 Y Absent NO2-353(2),NO3-353(2) L1317794-01 B Plastic 250ml H2SO4 preserved A <2 4 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days Page 10 of 18 Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where.applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(I Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only.applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The lower value for the two columns has been reported due to obvious interference. Report Format: Data Usability Report �L1L�hA Page 11 of 18 Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 Data Qualifiers M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search. P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R Analytical results are from sample re-analysis. RE Analytical results are from sample re-extraction. S Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND Not detected at the reporting limit(RL)for the sample. Report Format: Data Usability Report / Page 12 of 18 Serial No:09171310:50 Project Name: STRAUBING RESIDENCE Lab Number: L1317794 Project Number: BEA09-10139 Report Date: 09/17/13 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100, August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,.damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling, containers,sampling procedures, holding time and splitting of samples in the field. Page 13 of 18 L-- Serial No:09171310:50 Certificate/Approval Program Summary Last revised August 29,2013 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water(Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Selenium, Silver, Sodium, Thallium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP)504.1, Ethylene Dibromide(EDB)504.1, 1,4- Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform - Colilert (SM9223, Enumeration and P/A), E. Coli. - Colilert (SM9223, Enumeration and PIA), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-EC Medium (SM 9221 E). Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics, TPH (HEM/SGT), CT- Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH. Microbiology Parameters:Total Coliform-MF mEndo (SM9222B), Total Coliform-MTF (SM9221 B), E. Coli -Colilert(SM9223 Enumeration), HPC-Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth(SM9221 E), Enterococcus-Enterolert. Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum, Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium; Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, CT-Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Dalapon, Volatile Organics (SW 8260), Acid Extractables (Phenols) (SW 8270), Benzidines (SW 8270), Phthalates (SW 8270), Nitrosamines (SW 8270), Nitroaromatics & Cyclic Ketones (SW 8270), PAHs (SW 8270), Haloethers (SW 8270), Chlorinated Hydrocarbons (SW 8270).) State of Illinois Certificate/Lab ID: 003155. NELAP Accredited. Drinking Water (Inorganic Parameters: SM21206, 2320B, 2510B, 2540C, SM4500CN-CE, 4500E-C, 4500H-B, 4500NO3-F, 5310C, EPA 200.7,200.8,245.1, 300.0. Organic Parameters: EPA 504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: SM2120B, 2310B, 2320B, 2340B, 2510B, 2540B, 2540C, 2540D, SM4500CL-E, 4500CN-E, 4500E-C, 4500H-B, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-E, 4500S-D, 4500S03-B, 5210B, 5220D, 5310C, 5540C, EPA 120.1, 1664A, 200.7, 200.8, 245.1, 300.0, 350.1, 351.1, 353.2, 410.4, 420.1.Organic Parameters: EPA 608, 624, 625.) Hazardous and Solid Waste (Inorganic Parameters: EPA 1010A, 1030, 1311, 1312, 6010C, 6020A, 7196A, 7470A, 7471 B, 9012B, 9014, 9038, 9040C, 9045D, 9050A, 9065, 9251. Organic Parameters: 8011 (NPW only), 8015C, 8081 B, 8082A, 8151A, 8260C,8270D, 8315A, 8330.) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM921513, 9222D, 9223B, EPA 180.1, 353.2, SM212013, 2130B, 2320B, 2510C, 2540C,4500CI-D, 4500CN-C,4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, 5310C, EPA 200.7, EPA 200.8, 245.1, EPA 300.0.Organic Parameters: 504.1, 524.2.) Wastewater/Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A, 300.0, 350.1, 351.1, 353.2, 410.4, 420.1, 8315A, 9010C, SM2120B, 2310B, 2320B, 2510B, 2540B, 2540C, 2540D, 426C, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-C, 4500NH3-B, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-B, 4500P-E, 4500S2-D, 4500S03-B, 5540C, 5210B, 5220D, 5310C, 9010B, 9030B, 9040C, 7470A, 7196A, 2340B, EPA 200.7, 6010C, 200.8, 6020A, 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 625, 8011, Page 1�of 1'88082A, 8330, 8151A, 8260C, 8270D,3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.) Serial No:09171310:50 Solid Waste/Soil (Inorganic Parameters: 9010B, 9012A, 9014, 9040B, 9045C, 6010C, 6020A, 7471 B, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B, 9038, 9251. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA- VPH, 8260C, 8270D, 8330, 8151A, 8081B, 8082A, 3540C, 3546,3580A,3620C,3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM2130B, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM9215B; ENZ. SUB. SM9223; ColilertQT SM9223B; MF-SM9222D.) Non-Potable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 for: AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1, SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM254013. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane,Toxaphene, Aldrin, alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT,Endosulfan I, Endosulfan II, Endosulfan sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables), 600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM9223B; Enterolert-QT:SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited. Drinking Water(Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 300.0, SM4500CN-E, 4500H+B, 4500NO3-F,2320B,2510B,2540C,4500E-C,5310C, 2120B, EPA 332.0. Organic Parameters:504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM92221), 9221B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, SW- 846 6010C, 6020A, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 426C, 1664A, SW-846 9010B, 9010C, 9030, 9040B, 9040C, SM2120B; 2310B, 2320B, 2340B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 4500S03-B, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D, 3060A. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082A, 8081 B, 8015C, 8151A, 8330, 8270D-SIM.) Solid& Chemical Materials (Inorganic Parameters: SW-846 6010C, 6020A, 7196A, 7471 B, 1010, 1010A, 1030, 9010C, 9012B, 9014, 9030B, 9040C, 9045C, 9045D, 9050, 9065, 9251, 1311, 1312, 3005A, 3050B, 3060A. Organic Parameters: SW-846 3540C, 3546, 3050B, 3580A, 36201), 3630C, 5030B, 5035, 8260C, 82701), 8270D-SIM, 8330, 8151A, 8015B, 8015C,8082A, 8081B.) New Hampshire Department of Environmental Services Certificate/Lab ID:2064. NELAP Accredited. Drinking Water(Organic Parameters: EPA 524.2: Di-isopropyl ether(DIPE), Ethyl-t-butyl ether(ETBE),Tert-amyl methyl ether(TAME)). Non-Potable Water(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene. EPA 8015C(M):TPH.) Solid&Chemical Materials(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.1, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, 2340B, SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F,4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM15 426C, 92221), 9221B, 9221C, 9221E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 7470A, 5540C, SM4500H-B, 4500S03-B, SM3500Cr-D, 4500CN-CE, EPA 245.1, SW-846 9040B, 9040C, 3005A, 3015, EPA 6010B, 6010C, 6020, 6020A, 7196A, 3060A, SW-846 9010C, 9030B. Organic Parameters: SW-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8011 8015C, 8081A,8081B,8082, 8082A, 8151A, 8330, 1,4-Dioxane by NJ Modified 8270,8015B, NJ EPH.) Page@li Chemical Materials(inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010, A, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D, Serial No:09171310:50 9050A, 9065, 9251. Organic Parameters: SW-846 8015B, 8015C, 8081A, 808113, 8082, 8082A, 8151A, 8330, 8260B, 8260C, 8270C, 8270D,8270C-SIM, 8270D-SIM, 3540C, 3546, 3580A, 3620C,3630C,50306, 5035L, 5035H, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited.- Drinking Water (Inorganic Parameters: SM9223B, 922213, 9215B, EPA 200.8, 200.7, 245.1, SM5310C, EPA 332.0, SM232013, EPA 300.0, SM21206, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 922213, 9215B, 5210B, 5310C, EPA 410.4, SM5220D, 2310B, 232013, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2340B, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010C, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 7470A, SM212013, 4500CN-CE, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 8315A, 3005A, 3015, 9010C, 9030B. Organic Parameters: EPA 624, 8260C, 8270D, 827013-SIM, 625, 608, 8081B, 8151A, 8330, 8082A, EPA 3510C, 5030B, 8015C, 8011.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010C, 6020A, 7196A, 7471 B, 8315A, 9012B, 9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 3050B, 9010C, 903013, 9040C, 9045D. Organic Parameters: EPA 8260C, 82701),8270D-SIM,8015C, 80816, 8151A, 8330, 8082A, 3540C, 3546, 3580A, 5035A-H,5035A-L.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID : 666. (Inorganic Parameters: SM231013, 2320B,4500CI-E,4500Cn-E, 9012B, 9014, Lachat 10-204-00-1-X, 1010A, 1030,4500NO3-F, 353.2,4500P-E,4500SO4-E,300.0,4500S-D, 5310B,5310C, 6010C, 6020A, 200.7, 200.8, 3500Cr-B, 7196A,245.1, 7470A, 7471B, 1311,1312. Organic Parameters:608,8081B, 8082A, 624, 8260B,625, 8270D,8151A, 8015C,504.1, MA-EPH, MA-VPH.) Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters: 524.2) Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited Drinking Water(Inorganic Parameters:200.7,200.8, 300.0, 332.0,2120B, 2320B,2510B, 2540C,4500-CN-CE, 4500E- C,4500H+-B,4500NO3-F,5310C. Organic Parameters: EPA 524.2,504.1) Non-Potable Water(inorganic Parameters: EPA 120.1, 1312,3005A,3015, 3060A, 200.7, 200.8,410.4, 1664A, SM2540D, 5210B, 5220D,4500-P,BE,245.1,300.0,350.1,350.2, 351.1, 353.2,420.1, 6010C,6020A, 7196A, 7470A, 9030B, 212013, 2310B,2320B, 2510B,254013, 2540C, 3500Cr-D,426C,4500CN-CE,4500CI-E,4500E-B,4500E-C, 4500H+-B,4500NH3-H,4500NO2-B,4500NO3-F, 4500S-D,4500S03-B,5310BCD, 5540C, 9010C,9040C. Organic Parameters: EPA 3510C, 3630C,5030B,625, 624, 608,8081 B, 8082A, 8151A, 8260C, 8270D, 8270D-SIM, 8330, 8015C, NJ-EPH.) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3005A, 305013, 3060A, 6010C, 6020A, 7196A, 7471B, 9010C, 9012B, 9014, 9040B, 9045D, 9050A, 9065, SM 4500NH3-13H, 9030B, 9038, 9251. _Organic Parameters:3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081B, 8082A, 8151A, 8260C, 8270D, 8270D- SIM,8330, NJ-EPH.) Rhode Island Department of Health Certificate/Lab ID: LA000065.NELAP Accredited via NJ-DEP. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476. NELAP Accredited Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7, 200.8,245.1,245.2, 300.0, 350.1,351.1, 353.2, 410.4,420.1, 6010, 6020, 7196, 7470, 9040, SM 212013,2310B,232013,2510B,254013, 2540C, 2540D,426C,4500CL- E,4500CN-E,4500E-C, 4500H+B,4500NH3-H, 4500NO2B,4500P-E,4500 S2 D, 510C,52106, 5220D,5310C, 5540C. Organic Parameters: EPA 608,624, 625, 8081, 8082, 8151,8260, 8270, 8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312, 9012, 9014, 9040,9045, 9050,9065.) Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited. Drinking Water(inorganic Parameters: EPA 200.7,200.8, 300.0,2510B, 2120B,2540C,4500CN-CE, 245.1,2320B, 4500E-C,4500NO3-F,4500H+B, 5310C.Organic Parameters: EPA 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A,200.7, 200.8,245.1, 300.0, 350.1, 351.1, 351.2, 3005A, 3015, 1312,6010B, 6010C,3060A, 353.2,420.1,23406, 6020, 6020A, SM4500S-D,SM4500-CN-CE, Lachat 10-204- 1- 7196A, 7470A,2310B, 23206, 25106, 2540B,.2540C,2540D, 3500Cr-D,426C,4500CI-E,4500E-B,4500E-C, Page M h3-H,4500NO2-B,4500NO3-F,4500 S03-B,4500H-B,4500PE, 510AC,5210B, 5310B 5310C,5540C, 9010Cm Serial No:09171310:50 9030B, 9040C. Organic Parameters: EPA 3510C, 3630C,50306,8260B, 608, 624, 625, 8011,8015C, 8081 A, 8081B, 8082, 8082A, 8151A, 8260C,8270C, 8270D,8270C-SIM, 8270D-SIM, 8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 3050B, 1311, 1312, 60106, 6010C, 6020, , 7196A, 7471A, 7471B, 6020A,9010C, 9012B, 9030B, 9014,9038, 9040C, 9045D, 9251, 9050A, 9065.Organic Parameters: EPA 50306,5035, 3540C, 3546, 3550B, 3580A, 3620C, 3630C, 6020A,826013, 8260C, 8015B,8015C, 8081A, 80816,8082, 8082A,8151A,8270C, 8270D, 8270C-SIM,8270D-SIM, 8330.) Department of Defense, L-A-B Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters: SM 4500H-B.Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: EPA 200.7, 200.8, 6010C, 6020A, 245.1, 7470A, 9040B, 9010B, 180.1, 300.0, 332.0, 6860, 351.1, 353.2, 9060, 1664A, SM 4500CN-E, 4500H-B, 4500Norg-C, 4500NO3-F, 5310C, 2130B, 232013, 2340B, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A, 8260C, 8270D, 8270D-SIM, 8330A, 8082A,8081 B,3510C,5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010C, 6020A, 7471A, 6860, 1311, 1312, 305013, 7196A, 9040B, 9045C, 9010C, 901213,9251,SM3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 8015C, 8151A, 8260C, 8270D, 8270D-SIM,8330A/B-prep,8082A, 8081 B, 3540C, 3546,3580A,5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAPITNI Scope of Accreditation: EPA 524.2: Acetone, 2-Butanone (Methyl ethyl ketone (MEK)), Tert-butyl alcohol, 2-Hexanone, Tetrahydrofuran, 1,3,5- Trichlorobenzene, 4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260B: 1,2,4,5- Tetra methyl benzene, 4-Ethyltoluene. EPA 8260 Non-potable water matrix: lodomethane (methyl iodide), Methyl methacrylate. EPA 8260 Soil matrix: Tert-amyl methyl ether (TAME), Diisopropyl ether (DIPE), Azobenzene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methylnapthalenes, Total Dimethylnaphthalenes, 1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline, 4-Methylphenol. Total Phosphorus in a soil matrix, TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix. EPA 9071: Total Petroleum Hydrocarbons, Oil&Grease. Page 17 of 18 Serial No:09171310:50 AGPHA:J:ob t..t CHAIN OF CUSTODY PAGE 10F1 .: Westborough,MA Mansfield,MA FAX ® EMAIL ® Same as Client info PO#:10139. TEl:508.898-9220 TEL:508-822-9300 Project Name:Straubing Residence ❑ ADEx ❑ Add'I Deliverables FAX:508-898-9193. FAX:508-e22-3288 Regulatory InformationClient Project Location:Marstons.Mills,NIA State/Fed Program . Criteria Client:Bennett Environmental Associates Project#:BEA09-10139 Address: 1673 Main Street!P.O.Box 1743 Project Manager David C.Bennett Brewster,MA 02631 ALPHA Quote#: Phone:508-896-1706 ANALYSIS Fax:508-896-5109 Standard Rush ONLY IF PRE-APPROVED) SAMPLE HANDLING ® ❑ ( Filtration Email:sfarrenko f bennett-ea-com P @ �� '� ❑ Done R ❑These samples have been Previously analyzed by Alpha Due Date: Time: 0 Not Needed a Lab to do Other Project Specific Requirements/Comments/Detection Limits: Preservatio n • C7 Lab to do (Please specify below) m A'LPHA.Lab.;ID: Sample ID Collection Sample Sampler's Z (Lab.lJse40nly) .<' Date Time Matrix Initials m :. ._.._... ..-:er...`,.:.'... Y Sample Spaeltle e� Z comments lfir� .�,'• >" , ' Effluent 1 3 1 c® ww S ® ® E1.1 ❑. ❑ E1.1 ❑ ❑ ❑ I El - ❑ .2 - El ❑ ❑ El ❑ El ❑ ❑ ❑ ❑ ❑ z Container Type P P - _ - 5nease;pnnt'claady,legibly;... Preservative 0 O "and ctiMpletely: ii&sor can', tiotiber logged in end;: Relinquished By. Date�me Received By: D e/Tlme tumarodhdume clock vrilli%ioC : stSd:Nnlh'8�rry:ambigultias I )<7 Z /�/ resolve il:_A1 _08-amples.^;..' :>'.1i _ sf� It dar6.9alectto'.'.`a! LIT- fi3t► (� f ilShasPeymentETe"FORNINOM S. 1 Qay.2•APRde) . Page 18 of 18 BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/23/11 BEA09-10139 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Straubing and David Residence 195 Herring Run Place Unit G[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ ® Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(Jan-Sept 2011) 1 9/22/11 Alpha Analytical Laboratory Report For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑x REMARKS: Please find enclosed the DEP Inspection and O&M Form,and laboratory test results of wastewater samples collected during this reporting period for the above referenced property. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc:Barnstable Board of Health Ms.Kim Straubing and Mr.Jeffrey David,Owners David C.Bennett,Principal[Internal] Matthew Costa-OMNI Environmental Systems,Inc. FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once . LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 1/4/11 9/8/10 Inspection Date Previous Inspection Date 10"of Sludge, and 0"Scum Layer Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc•rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: M no ❑ some pH 6.12 SU DO 26.12 mg/L Turbidity 0.79 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for'BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ®TN ® Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: General O&M visit for system functionality and conducted field testing. Notes and Comments: System is functional and passed field testing. t5aiom.doc•rev.11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operal1to—r in accordance with 257i1CMR 2.00. 91Z1�y Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use— by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental.Protection Attention: Title 5 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 r Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/9/11 1/4/11 Inspection Date Previous Inspection Date 7 of Sludge, and 1"Scum Layer Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) t5aiom.doc-rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown E clear ❑turbid ❑ Other(specify): Odor: E musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: E no ❑ some pH 6.60 SU DO 8.61 mg/L Turbidity 5.66 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: General O&M visit for system functionality and conducted field testing. Notes and Comments: System is functional and passed field testing. Left a notice for the homeowner to have the recirculation tank pumped out due to solids accumulation. t5alom.doc•rev.11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. 2_XI�QAICA ciI7��►t Operator Signature Datd '- System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 n of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc-rev.11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/10/11 3/9/11 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.08 mg/L Turbidity 5.63 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection&during this inspection: General O&M visit for system functionality and conducted field testing Notes and Comments: System is functional and effluent quality passed field testing. Homeowner had septic tank pumped out recently. t5aiom.doc•rev.11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection- Title 5 DEP Approved Inspection and O&M Form for Title 51/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention:.Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:when Kim Straubing filling out forms Owner on the computer, use only the tab Route 149 Unit 195-G key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip key. Mailing address of owner, if different: P.O. Box 863 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)428- 1831 ext. Telephone Number B. Authorized Service Provider BENNETT ENVIRONMENTAL ASSOCIATES, INC. O&M Firm 1573 Main Street/ PO Box 1743 Street Address Brewster MA 02631 City State Zip (508)896- 1706 ext. 129 Telephone Number Samantha Farrenkopf 13265 Certified Operator Name Certification Number C. Facility/System Information OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 8/25/03 8/25/03 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/14/11 6/10/11 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No j t5aiom.doc•rev.11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 3.28 mg/L Turbidity 6.92 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ® Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ®TN ® Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: General O&M visit for system functionality. Conducted field testing and collected effluent samples for laboratory analysis. Notes and Comments: System is functional and effluent quality passed field testing. t5aiom.doc•rev.11-07-05 Page 2 of 3 f Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31 st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30t"of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 Serial No:09221112:05 4LoA CAL ANALYTICAL REPORT Lab Number: L1114556 Client: Bennett Environmental Associates 1573 Main St. PO Box 1743 Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: STRALIBING Project Number: BEA09-10139 Report Date: 09/22/11 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY NELAC(11148),CT(PH-0574),NH(2003),NJ(MA935),RI(LA000065),ME(MA0086), PA(Registration#68-03671),USDA(Permit#S-72578),US Army Corps of Engineers,Naval FESC. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com Page 1 of 17 Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Alpha Sample Collection Sample ID Client ID Location Date/Time L1114556-01 EFFLUENT MARSTONS MILLS 09/14/11 11:35 Page 2 of 17 Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. For additional information,please contact Client Services at 800-624-9220. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any and all pages of this report. Authorized Signature: Elizabeth Simmons�^v�Y�'' Title: Technical Director/Representative Date: 09/22/11 Page 3 of 17 �''`` �� Serial No:09221112:05 INORGANICS MISCELLANEOUS Page 4 of 17 Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 SAMPLE RESULTS Lab ID: L1114556-01 Date Collected: 09/14/11 11:35 Client ID: EFFLUENT Date Received: 09/15/11 Sample Location: MARSTONS MILLS Field Prep: Not Specified Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemist�``Westbo�ou hL'ab _ . '`" ,' °}mow ,z _ .r r, — _ �yZ� _ 9 ., fit€:`.x s - m— a Nitrogen,Nitrite 0.18 mg/I 0.05 — 1 - 09/16/11 02:23 44,353.2 TH Nitrogen,Nitrate ND mg/I 0.10 1 - 09/16/11 02:23 44,353.2 TH Nitrogen,Total Kjeldahl 13 mg/I 0.30 — 1 09/16/11 13:50 09/20/11 20:11 30,4500N-C AT L�LL1L`?li� Page 5 of 17 Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Method Blank Analysis Batch Quality Control Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry,';,Westborougf Lab for,sample(s).x,01,'Batch: WG490293-2 TO 1 4 .-tn Nitrogen,Nitrate ND mg/I 0.10 1 09/16/11 00:38 44,353.2 TH General ChemstrydV1%estborough Lab for samples) 01 Batch: WG490295 20 r Nitrogen,Nitrite ND mg/I 0.05 - 1 09/16/11 00:46 44,353.2 TH ra at;rF-�a ;; ZA5,', - �- �:.: r- General Chemistry-Westborough Lab for sample("s): 01 Batch: WG490372-1 Nitrogen,Total Kjeldahl ND mg/I 0.30 - 1 09/16/11 13:50 09/20/11 20:02 30,4500N-C AT Page 6 of 17 Serial No:09221112:05 Lab Control Sample.Analysis Project Name: STRAUBING Batch Quality Control Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 LCS LCSD %Recovery - Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General'Chemist Westborou h=Lab.Associatedaam le s :'01`: :`Batch :WG490293 1 "` Nitrogen,Nitrate 102- 90-110 General Chemistry_ Westborough'Lab�`AssociatedT.sample(s):-,01 'Y�Batch`. W.G490295'1 Nitrogen,Nitrite 98" - 90-110 20 General Chemistry-'Westborough Lab iAssociat6d`sample(s):.Q1, "Batch%WG490372 2` n, Nitrogen,Total Kjeldahl 95• 85-110 Page 7 of 17 Akh,a` Serial No:09221112:05 Matrix Spike Analysis Project Name: STRALIBING Batch Quality Control Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits General Chemistry-Westborough�Lab Associated'sample(s):>01 QC Batch,[D:.WG490293-3 QC,Sample:'L1114553=01 ':Client ID:�,MS"Sample! Nitrogen,Nitrate 5.9 4 9.8 98 - 83-113 6 General Chemistry-Westborough Lab Associated sample(s): 01 QC Batch JD:'..WG490295-3 .QC Sample:-.L1114553-01. :ClientlD: M&Sample- Nitrogen,Nitrite 0.06 4 4.1 101 - 80-120 20 General Chemistry-"Westborough,Lab Associated sample(s): 01 QC:Batch ID:!WG490372=3 QC'Sample: L11.14558-01, -Client-ID:'MS'Zample, Nitrogen,Total Kjeldahl 1.8 8 9.7 99 - 77-111 24 Page 8 of 17 tia Serial No:09221112:05 Lab Duplicate Analysis Project Name: STRAUBING Batch Quality Control Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General;Chemistry-Westborough!Lab�Associated'sample(s)%01':'�QC Batch,ID ".WG490293-4 s QC-Sample.;C1'1:14553=01»'ClientlD: .DUP'Sample. - Nitrogen,Nitrate 5.9 6.0 mg/I 2: 6 General;Chemistry-,Westborough Lab-Associated Isample(s):=01'.::rQC�Batch".ID:?�WG490295=4� tQC,SampI6: L1;114553=01 Client'ID:`DUP_.:Sample Nitrogen,Nitrite 0.06 0.06 mg/I 'S' 20 GenerafChemistry-Westborough;Lab AAssociated'sample(s).•'01� QC]Batch1ID:MG490372=4 : QC Sample: L1-1.14507=03 FClient'ID: DUP;Samples. Nitrogen,Total Kjeldahl 0.38 0.35 mg/I V 24 Page 9 of 17 � ��• Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Sample Receipt and Container Information Were project specific reporting limits specified? YES Reagent H2O Preserved Vials Frozen on: NA Cooler Information Custody Seal Cooler A Absent Container Information Temp Container ID Container Type Cooler pH deg C Pres Seal Analysis(*) L1114556-01A Plastic 250ml unpreserved A 7 3.9 Y Absent NO3-353(2) L1114556-01 B Plastic 250ml unpreserved A 7 3.9 Y Absent NO2-353(2) L1114556-01C Plastic 250ml H2SO4 preserved A <2 3.9 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days h� Page 10 of 17 Serial No:O9221112:O5 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEAO9-10139 Report Date: 09/22/11 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(IOx) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G -The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H -The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I -The RPD between the results for the two columns exceeds the method-specified criteria;however,the lower value has been reported due to obvious interference. M -Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. NJ -Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where the identification is based on a mass spectral library search. Report Format: Data Usability Report Page 11 of 17 Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 Data Qualifiers P The RPD between the results for the two columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.Note:This flag is not applicable for matrix spike recoveries when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) R -Analytical results are from sample re-analysis. RE -Analytical results are from sample re-extraction. J -Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). ND -Not detected at the reporting limit(RQ for the sample. Report Format: Data Usability Report Page 12 of 17 Serial No:09221112:05 Project Name: STRAUBING Lab Number: L1114556 Project Number: BEA09-10139 Report Date: 09/22/11 REFERENCES 30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA- WPCF. 18th Edition. 1992. 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. LIMITATION OF LIABILITIES Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable for any incidental, consequential or special damages, including but not limited to,damages in any way connected with the use of, interpretation of, information or analysis provided by Alpha Analytical. We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation,cooling, containers, sampling procedures, holding time and splitting of samples in the field. Page 13 of 17 Serial No:09221112:05 Certificate/Approval Program Summary Last revised September 19,2011 -Westboro Facility The following list includes only those analytes/methods for which certification/approval is currently held. For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative. Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil. Drinking Water(Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine, Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Vanadium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP), Ethylene Dibromide (EDB), 1,4-Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform-Colilert(SM9223 P/A), E. Coli.-Colilert(SM9223 P/A), HPC-Pour Plate(SM9215B), Fecal Coliform- MF m-FC(SM9222D)) Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0- Phosphate, Total Phosphorus,Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt Copper, Iron Lead Magnesium, Manganese, Mercury, Nickel, Potassium Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents (MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane, Toxaphene, 2,4-D, 2,4,5-T, 214,5-TP(Silvex), Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines, Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile Organics,TPH (HEM/SGT), Extractable Petroleum Hydrocarbons(ETPH), MA-EPH, MA-VPH. Microbiology Parameters: Total Coliform - MF mEndo (SM9222B), Total Coliform - MTF (SM9221 B), HPC - Pour Plate (SM9215B), Fecal Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth(SM9221 E).) Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability, Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs, PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons (ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Volatile Organics, Acid Extractables (Phenols), 3.3'-Dichlorobenzidine, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated Hydrocarbons. ) Maine Department of Human Services Certificate/Lab ID:2009024. Drinking Water(Inorganic Parameters: SM92156, 9222D, 9223B, EPA 180.1, 353.2, SM2130B, 2320B, 2540C, 4500CI- D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic Parameters:504.1, 524.2.) Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1, SM2320B, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B, 4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NH3-H, 4500NO3-F, 4500P-B, 4500P-E, 5210B, 5220D, 5310C, 9010B, 9040B, 9030B, 7470A, 7196A, 2340B, EPA 200.7, 6010, 200.8, 6020, 245.1, 1311, 1312, 3005A, Enterolert, 9223D, 9222D. Organic Parameters: 608, 8081, 8082, 8330, 8151A, 624, 8260, 3510C, 3630C, 5030B, ME- DRO, ME-GRO, MA-EPH, MA-VPH.) Solid Waste/Soil (Inorganic Parameters: 9010B, 9012A, 9014A, 9040B, 9045C, 6010B, 7471A, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-VPH, 8260B, 8270C, 8330, 8151A, 8081A, 8082, 3540C,3546, 3580A,3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM2130B, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM92156; ENZ. SUB. SM9223; ColilertQT SM922313; MF-SM9222D.) N) n Jable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 Page f10-F:° al,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI, V,Zn); 245.1, SM4500H,B, EPA 120.1, Serial No:09221112:05 SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E; 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane,Aldrin, Dieldrin, DDD, DDE, DDT, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables),600/4-81-045-PCB-Oil. Microbiology Parameters:.(ColilertQT SM9223B;Enterolert-QT: SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited. Drinking Water (Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 245.2, 300.0, SM4500CN-E, 4500H+B,4500NO3-F,2320B,2510B, 2540C,4500E-C,5310C,2120B, EPA 332.0. Organic Parameters:504.1, 524.2.) Non-Potable Water (Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, 245.2, SW-846 6010B, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 1664A, SW-846 9010, 9030, 9040B, SM426C, SM2120B, 2310B, 2320B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260B,8270C, 8330, EPA 624,625,608, SW-846 8082, 8081A,8151A.) Solid & Chemical Materials (Inorganic Parameters: SW-846 6010B, 7196A, 7471A, 1010, 1030, 9010, 9012A, 9014, 9030B, 9040B, 9045C, 9050C, 9065,1311, 1312, 3005A, 3050B. Organic Parameters: SW-846 3540C, 3546, 3550B, 3580A, 3630C, 5030B, 5035, 8260B, 8270C, 8330,8151A,8015B, 8082,8081A.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935.NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.2, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1,524.2.) Non-Potable Water (Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, SM4500E-BC, EPA 200.7, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F, 4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM 15 426C, 9222D, 9221 B, 9221 C, 9221 E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2, SW-846 1312, 6020, 6020A, 7470A, 5540C, 4500H-B, EPA 200.8, SM3500Cr-D, 4500CN-CE, EPA 245.1, 245.2, SW- 846 9040B, 3005A, 3015, EPA 6010B, 6010C, 7196A, 3060A, SW-846 9010B, 9030B. Organic Parameters: SW-846 8260B, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 8081A, 8081B, 8082,8082A, 8151A, 8330, NJ OQA-QAM-025 Rev.7, NJ EPH.) Solid& Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 7196A, 3060A, 9010B, 9030B, 1010, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471B, 9014, 9012A, 9040B, 9045C, 9050A, 9065. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 8260B, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3540C, 3545,3546, 3550B, 3580A, 3630C, 5030B, 5035L, 5035H, NJ OQA-QAM-025 Rev.7, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0, SM2320B, EPA 300.0, SM2120B, 4500CN-E,4500E-C, 4500H-B, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4, SM5220D, 2310B-4a, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, LACHAT 10-107-04-1-C, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6020, EPA 7196A, SM3500Cr-D, EPA 245.1, 245.2, 7470A, SM2120B, LACHAT 10-204-00-1-A, EPA 9040B, SM4500-HB, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 3005A, 9010B, 9030B.. Organic Parameters: EPA 624, 8260B, 8270C, 625, 608, 8081A, 8151A, 8330, 8082, EPA 3510C, 5030B.) Solid&Hazardous Waste(Inorganic Parameters: 1010, 1030, EPA 6010B, 7196A, 7471A, 9012A, 9014, 9040B, 9045C, 9065,9050, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA 8260B, 8270C, 8015B, 8081A, 8151A, 8330, 8082, 3540C, 3545, 3546, 3580, 5030B, 5035.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID :666. Organic Parameters: MA-EPH, MA-VPH: Drinking Page Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0.. Organic Parameters: ��4�f2}17 Serial No:09221112:05 Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited. Drinking Water(Organic Parameters: EPA 524.2, 504.1) Non-Potable Water(Inorganic Parameters: EPA 1312,200.7,410.4, 1664A, SM25401), 5210B, 52201),4500-P,BE. Organic Parameters: EPA 3510C, 3005A, 3630C, 50306,625, 624, 608,8081A, 8082, 8151A, 826013, 8270C, 8330) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3050B, 6010B, 7196A, 7471A, 9010B, 9012A, 9014, 90406, 9045C, 9050, 9065, SM 4500NH3-H. Organic Parameters: 3540C, 3545, 3546, 355013, 3580A, 3630C, 5035, 8015B,8081A, 8082, 8151A, 8260B, 8270C,8330) Rhode Island Department of Health Certificate/Lab ID: LAO00065. NELAP Accredited via NY-DOH. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1. NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7,200.8, 245.1, 245.2, 300.0, 350.1, 351.1, 353.2, 376.2,410.4,420.1, 6010, 6020, 7196, 7470, 9040, SM 21206,2310B,232013,2510B,2540B, 2540C, 25401),426C, 4500CL-E,4500CN-E,4500E-C, 4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C,521013, 52201), 5310C, 5540C. Organic Parameters: EPA 608, 624, 625, 8081, 8082, 8151, 8260, 8270,8330.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012, 9014, 9040, 9045, 9050,9065.) Department of Defense Certificate/Lab ID: L2217. Drinking Water(Inorganic Parameters: SM 4500H-B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water(Inorganic Parameters: EPA 200.7, 200.8, 6010B, 6020,245.1,245.2,7470A, 9040B, 300.0, 332.0, 6860, 353.2,410.4, 9060, 1664A,SM 4500CN-E,45001-1-13,4500NO3-F, 5220D,5310C, 232013, 2540C, 3005A, 3015, 9010B, 9056. Organic Parameters: EPA 826013, 8270C, 8330A,625, 8082, 8081A, 3510C, 5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7,6010B, 7471A,9010,9012A, 6860, 1311, 1312, 30506, 7196A, 901013, 3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 826013, 8270C,8330A/B-prep, 8082, 8081A, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAP/TNI Scope of Accreditation: EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total Methyinapthalenes, Total Dimethyl naphthalenes, 1,4-Diphenylhydrazine (Azobenzene). EPA 625: 4-Chloroaniline, 4-Methylphenol. Total Phosphorus in a soil matrix, Chloride in a soil matrix,TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix, SO4 in a soil matrix. Page 16 of 17 OF CHAIN OF CUSTODY PAGE 3 -t Information-Data Deli -s Billing Information MANSFIELDi'.MA. Project Information Repoi verablL TEL: 508-898-9220 IEL 508-322-9300' Project Name: 130AX 04 EMAIL FAX: 508-89MI93 FAX: 6 XSame as Client Info 00 M: 0-822-3288 Project Location: 13 ADEx U Add'I DeliverablesClient Information Regulatory Requirements/Report Limits ClienT Proje�#r��,� .,PT State Fed Prp'g'r'a'ffi CH(iWa C, N.1 �� - Address: �\ Jr.0-10',op Project Manager: ALPHA Quote#: Time Phone: BOW TUrn-Around (L no% cr Fax: WLStandard C3 RUSH("WWF1wd1fPM4PPT9Vedn Email: Date Due: Time: SAMPLE HANDLING- U These samples have been previously analyzed by Alpha 0, Filtmdon_ Other Project Specific Requirements/Comments/Detection Limits: U Done ............. ............ ............. n'eed'ad L1 Lab to do PresintaUon 0 Lab to do: Collection Sample Sampler's (Plum speafy bokw). Sample ID Date . Matrix Initials s Sample Specific Comments Time W,rl, .�ggg• '*I M11 , ..... .......... ..... ....... In X MH NMI Conte n Iner Type. v r5ug's" ge Preservative -0.Noll r6o nil, 0"22@1hed 5yZ,0' DateMme Date/Tln�e 13y:_ r RM N0:.01-01(rev.14-=-07) Jin A— A '41 A ..........