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0195 ROUTE 149 - Health (6)
Ur" 4c (ZSBCDHE BAWSTAB.E COUMT DEPAPTu1ENT OF HEALTH ANO EwRoNMENT e,yNr • ` PROMOTE-PROTECT-SUPPORT tiH •0 YEARS OF SERVIC?71 1926-2016 October 26th, 2017 Suzanne Neal P.O. Box 253 Marstons Mills, MA 02648 RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 195-C Route 149 in the town of Barnstable. Dear Suzanne Neal, 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:Hseptic.barnstablecountyhealth.org. 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 Operatorslist, Inspection and Testing Requirements BARNSTABLE COUNTY COMPLEX 3195 MAIN STREET/PO BOX 427 i BARNSTABLE,MASSACHUSETTS 02630 °4 Phone:(508)375-6613 1 Fax:(508)362-2603 I TDD:(508)362-5885 P Web:barnstablecountyhealth.org I Twitter:@BCHDCapeCod i Inspection report stored on Q drive : Q:\IA Systems\I-A Inspection Reports } ENNETT 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 i LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: % Massachusetts Department of Environmental Protection 9/25/17 BEA14-10736 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Neal Residence 195 Herring Run Place Unit C[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR 0 COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(March and September 2017) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(March and September 2017) 1 3/7/17 Alpha Analytical Laboratory Report , 1 9/18/17 Alpha Analytical Laboratory Report e , For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI RSF Operation and Maintenance Inspection Checklists,and laboratory analytical reports for operation and maintenance conducted during the reporting period at 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[via email] Suzanne Neal,Property Owner i i FROM: Samantha Farrenkopf,Wastewater Program Manager If enclosures are not as noted,kindly notify us at once e ' 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 9/23/14 BEA09-10147 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Tangusso Residence 195 Herring Run Place Unit C [Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail Green Card/RR 1-1 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 For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0 REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI RSF Operation and Maintenance Inspection Checklists and laboratory test results for operation and maintenance conducted during the reporting period for the above referenced property. The Barnstable Board of Health approved for a reduction from quarterly inspections to semi-annual inspections in 2013. 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 Mr.Paul Tangusso,Owner David C.Bennett,Principal[Internal] .FROM: David C.Bennett,WWTO 46243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once A- ra 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip �1 Mailing address of owner, if different: 29 Cedarview Circle V� Street Address/P.O Box: Milford MA 01757 City State Zip (508) 381 -3747 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 4/30/02 5/9/02 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 9/11/13 Inspection Date Previous Inspection Date 0" Sludge , 0" Scum Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 4 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 6.0 mg/L Turbidity 0.10 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 r r Massachusetts 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 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"'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, 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip key. r� Mailing address of owner, if different: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508) 381 -3747 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 4/30/02 5/9/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial i 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 a i A 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 Y❑ earth ❑ moldy Eloffensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 5.0 mg/L Turbidity 2.07 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) NO3 NO2 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.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 Massachusetts certified operator in accordance with 257 CMR 2.00. 9�241q 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 Program One Winter Street, 6t Floor Boston, MA 02108 t t5aiom:doc•rev. 11-07-05 Page 3 of 3 OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information L� t��� � a Q- -3� (� P 3- Facility Street Address Date of Service City Operatod0&M Firm $, CAQ vow System Startup Date Weather Condition B. Septic Tank Sludge Pumping Required: Yes❑ NoM %Sludge Depth: aScum Depth: 0 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 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 C. Recirculation Tank lQJA,Check if sludge accumulating Pumping required: Yes❑ NoVk Odor problems: Yes❑ No 11 XI 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) 1 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. _• �y F. Pumps, Switches, Floats, Alarm System WPump 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") NL t4 Inspect for ponding Ponding Present: Yes❑ Nd W1 Clean bed: Yes❑ NdZ Distribution pipes Flush:Yes❑ Nov Brush: Yes❑ Nd% Any obstruction of airflow to filter modules: Yes No❑ If Yes, explain below(i.e.snow, dirt) Sh6u.. 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❑ NPO 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: \ er`,� fik U Envir omnewal Systems, Inc OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information Facility Street Address \\ Date.of Service city Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank �� Sludge Pumping Required: Yes❑ No, ❑Sludge Depth: ❑Scum Depth: Effluent tee filter. Ye3A 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 depending on how heavily the system is used. C. Recirculation Tank i ❑ Check if sludge accumulating Pumping required: Yes❑ NoIX) Odor problems: Yes❑ N If yes,description Effluent tee filter: Yes❑ No1' If yes, inspect❑ &clean at feast 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. LL�� rY J it F. Pumps, Switches, Floats, Alarm System `Pump Inspections(all units) If problems,describe �q Test pump alternator,or record hours c�c�,_.kn5 �� �.�v t Hours of operation Float switches Check all switches for operation XTest alarm If non-functioning,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are funcfional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") Inspect for ponding Ponding Present:Yes❑ NoX' Clean bed: Yes❑ Nod Distribution pipes Flush:Yes❑ No Brush: Yes❑ No' Any obstruction of airflow to filter modules: Yes❑ Noglf 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 YeSA No❑ If yes: ❑BOD ❑TSS ❑pH V'J`�TN O§Other W,3 ,Nr-=Z, 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: (` a S Serial_No:09221409:10 H A.N A,L_Y_T 1 C A L ANALYTICAL REPORT O T Lab Number: L1421314 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: TANGUSSO RESIDENCE Project Number: BEA09-10147 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 Page 1 of 15 Serial No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 Report Date: 09/22/14 Alpha Sample Collection Sample ID Client ID Matrix Location Date/Time Receive Date L1421314-01 EFFLUENT WATER MARSTONS MILLS, MA 09/15/14 15:30 09/16/14 Page 2 of 15 Serial No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 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. 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. Q"--``-�� Lura L Troy Authorized Signature: Title: Technical Director/Representative Date: 09/22/14 'Page 3 of 15 = -�'� Serial No:09221409:10 INORGANICS MISCELLANEOUS Ica; , Page 4 of 15 Seria l_No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 Report Date: 09/22/14 SAMPLE RESULTS Lab ID: L1421314-01 Date Collected: 09/15/14 15:30 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-,Westborough Lab, k Nitrogen,Nitrite 0.24 mg/I 0.050 - 1 09/17/14 04:00 44,353.2 DB -- .. ------- - ._ ---. - __._.. . .._........_ -- - __._..__... -- - _... Nitrogen,Nitrate 9.2 mg/I 0.20 — 2 - 09/17/14 05:06 44,353.2 DB __ _....-.. _..._. .._. .. ........__ Nitrogen,Total Kjeldahl 2.22 mg/I 0.600 -- 2 09/17/14 12:18 09/18/14 22:09 30,4500N-C AT AA?HA Page 5 of 16 Serial No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 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 Gral Chemis roene e uhLb f 1 Bach:'WG722581ga :1 Nitrogen,Nitrate ND mg/I 0.10 -- 1 - 09/17/14 01:49 44,353.2 DB General Chemistry Westborough Lab fo m r,saple(s) 01:"Batch:`WG722584-,1, Nitrogen,Nitrite ND mg/l 0.050 1 09/17/14 01:52 44,353.2 DB _r-e General Chemistry-'Westborough"Lab for sample(s):' OT Batch: �WG722791=1. Nitrogen,Total Kjeldahl ND mg/I 0.300 1 09/17/14 12:18 09/18/14 21:53 30,4500N-C AT -- Page 6 of 15 Serial No:09221409:10 Lab Control Sample Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1421314 Project Number: BEA09-10147 Report Date: 09/22/14 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry Westborough'Lab Assoc atedsample(s): 01 Batch:-- G722581 2 .... Nitrogen,Nitrate 100 90-110 .... _ .. __._.. _:...__ _.... _....._. General Chemistry Westborough Lab _Associated samples) 01 Batch WG722584-2 Nitrogen,Nitrite -96 90-110 20 General Chemistry V1lestborough;Lab Associated sample(s); 01 Batch:':WG722791 2 Nitrogen,Total Kjeldahl '100. 78-122 Page 7 of 15 �s\ t Serial No:09221409:10 Matrix Spike Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1421314 Project Number: BEA09-10147 Report Date: 09/22/14 Native IVIS 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 ID`WG722581-4 QC.Sample: L1421265-01 Client ID: MS Sample Nitrogen,Nitrate 0.32 4 4.3 99 - 83-113 6 General'Chemistry: Westborough'L•ab-Associated sample(s):01 QC Batch ID:'VVG7225844-- _QC Sample: L-1421296-01 Client ID: MS.Sample Nitrogen,Nitrite ND 4 3.9 :99 - 80-120 20 General Chemistry'-,Westborough'Lab-Associated'sample(s):-01 QC BatchsiD: WG722791 4:: :QC`Sample:1142128.1=0.1 ClientlD:"MS,Sample Nitrogen,Total Kjeldahl 1.53 8 10.1 107, 77-111 24 a Page 8 of 15 '%PEA Serial-No:09221409:1 0 Lab Duplicate Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1421314 Project Number: BEA09-10147 Report Date: 09/22/14 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits Westborough " ener ernistrv-mi sociated- �'-QC,8atch ID: WG722581'r �sarrlpe:�3):AV 3, - QC Sample L1421265-01 Client ID: :DUP-'Sa'mple'..: , Nitrogen, Nitrate 0.32 0.28 Mg/1 '11: Q 6 ,G6n'era]'Chemist'ry'=-W(§stbor6-ugfi,,L6b* Associated:sample(s):.�Ol QC:Batch ID:-W.G722584-3 ...QC Sample- L1421296,-'01-..Client-ID:.DUP-,Sa-MOle- Nitrogen,Nitrite ND ND Mg/l 20 ..... .................... .............. ............ Lab Associated sarnple(s):! 01. -[D:-�WG72279 1-01 Client ID- DUP"Sam Sa mple e General Chemistry��LWestbor6udh"L`b'A'' td' :--Qd Batch, !,-�3- OC.Saniple- 11421�8 Nitrogen,Total Kjeldahl 1.53 1.85 Mg/1 A 9 24 Page 9 of 15 Allle Seri al_No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 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(*) L1421314-01A Plastic 250ml H2SO4 preserved A <2 4.8 Y Absent TKN-4500(28) L1421314-01 B Plastic 250ml unpreserved A 7 4.8 Y Absent NO2-353(2),NO3-353(2) *Values in parentheses indicate holding time in days � -HA Page 10 of 15 Serial—No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEAO9-10147 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(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(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 Page 11 of 15 Seri al_No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 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 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 i� HA Page 12 of 15 Serial No:09221409:10 Project Name: TANGUSSO RESIDENCE Lab Number: L1421314 Project Number: BEA09-10147 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 tore-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 15 Serial No:09221409:10 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-Methyl naphthalene, 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 254OD: 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-Tetramethylbenzene, Benzothiophene, 1-Methylnaphthalene. The followinganalytes are included in our Massachusetts DEP Scope of Accreditation Westborough Facility: Yt p � 9 Y Drinking Wafer 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,SM2130B, SM4500C1-D, SM232013,SM2540C, SM450OH-B EPA 332: Perchlorate. Microbiology: SM92156; SM9223-P/A, SM9223B-Colilert-QT, Enterolert-QT. Non-Potable Wafer 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, SM4500H,B, EPA 120.1,SM251013,SM2540C, SM23406,SM2320B, 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, SM5220D,EPA 410.4, SM5210B, SM5310C,SM4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE, SM2540D. 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 14 of 15 Serial No:09221409:10 r: gate'Re .f'. a . . CHAIN OF CUSTODY PAGE, DF 1 ;.:...: /�:. - _-- :: Project Information Report Information Data Deliverables Billing Information �] FAX ® EMAIL.. ® Same as Client info PO#:10147 Westborough,MA Mansfield,Ma Project Name:Tangusso Residence TEL:50U98-9220 TEL:508-822-9300 ❑ ADEx ❑ Add'[Deliverables FAX:.508.898.9193 : FAX:808-822-0288 Regulatory Requirements/Report Client InformationProject Locaflon:Marstons.Mills,MA State/Fed.Pro rare Criteria Client:Bennett Environmental Associates Project*BEA09-10147 Address:1 M Main Street/P.O.Box 1743 ProjectManager:David C.Bennett Brewster,MA'02631 ALPHA Quote#: Phone:508-896A 706 • ANALYSIS . Fax:508-89645109 ®Standard 0 Rush(ONLY IF'PRE-APPROVED) SAMPLE HANDLING Filtration Email:sfarrenkopf@bennett-ea.com ❑ Done ❑These samples have been Previously analyzed by Alpha Due Date: :Time: 0 Not Needed.. ❑ Lab to do Other Project Specific Requirements/Comments/Detection Umi : Preservation • ❑ Lab to do (Please specify below) Collection Sample Sampler's Z. ALF�HALali ID:.i Sample ID p -atiitlSe:Onl Date Time Matrix )teals z;:'.:....:.r :........... .......j_ specific Initials Z Comments €� Effluent 1� L 13=5Z WUV ... ® ® El ❑ El ❑ ❑ .❑ El ❑ z 4 ❑ ❑ El. ❑ ❑ ❑ a ❑ ❑ ❑ o ❑ 0 El El ': F ' El El El ❑ ❑ ❑ ❑ 17 ❑ ❑lt4;t. ?ka El El L1 Container Type P P 0 D pnease prtnl:dleariy legibly Preservative andscomplslely::195in sis;cah;; Re!! fished By DateMme Receiv Date ime. ine�ounil.tifhe,blocli?will not': '� �/•�© .'tare;E`lhtil,8rly)eiilblgultles�sten."• _ resol4'9d.:AILsa.inples:':. ;;. :y f v t s. initted.Bre subject FORM rro:01�g1(utJ) .i' 't? '°�""- gt ,Q�Pft�a`s Payment•Tercnss' y Page 15 of'15 of BAA,� BARNSTABLE COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT O BARNSTABLE COUNTY COMPLEX * * 3195 MAIN STREET/PO BOX 427 Phone: (508) 375-6613 BARNSTABLE, MASSACHUSETTS 02630 FAX (508) 362-2603 TDD (508) 362-5885 December 23rd, 2014 Paul Tangusso 195-C Route 149 Marstons Mills, MA 02648 RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 195-C Route 149 in the town of Barnstable. Dear Paul Tangusso, Our records indicate that the operation and maintenance contract with A&B Canco for your innovative/alternative wastewater treatment system may have expired or was cancelled as of 12/31/69.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.org. 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 you 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 Iwright@barnstablecounty.org.Thank you for your prompt attention to this matter. Sincerely, Lindsey Wright CC: Barnstable Board of Health Enclosures (1): Certified Wastewater Treatment System Operators List ��► j Town of Barnstable Barnstable Board of Health 1'adCeCi + BARNSPABLE MASS. g 200 Main Street, Hyannis MA 02601 t639. �1 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Mr. and Mrs. Tangusso October 15, 2014 29 Cedarview Circle Milford, MA 01757 RE Correction to Sampling of Wastewater Effluent from'your Innovative/Alternative (OMNI) System at: 195 Route 149 #C, Marstons Mills A= 078=018-40C Herring Run Place Condo Dear Mr. and Mrs. Tangusso, You are granted permission to reduce the frequency that you monitor your system consisting of innovative/alternative technology (OMNI 2000 Recirculating Sand Filter system) at 195 Route 149, #C, to twice„a year. The following requirements are an update from the November 12, 2013 Board of Health letter. Permission is granted for the I/A system at your property with the following conditions: •'• The wastewater effluent shall be tested for Total Nitrogen twice per year. ❖ Operation and Maintenance Inspections can be reduced to twice a year, but shall include field testing for pH, DO, and turbidity. Sincerely, Wayne Miller, M.D., Chairman BOARD OF HEALTH Q:\lA systems\195 11049\Final correction unit#C 2014.doc F• Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Joseph R. Smith use the return Name of Inspector key. Bennett Environmental Associates, Inc. r� Company Name 1573 Main Street/ P.O. Box 1743 Company Address Brewster MA 02631 Cityrrown State Zip Code 508-896-1706 S14994 Telephone Number License Number B. Certification certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes' ❑ Conditionally Passes ❑ Fails ❑ Needs Furt r Evaluation by the Local Approving Authority 5-15-14 pector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °wM Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: None of the failure criteria described in 310 CMR 15.303- 15.304 existed at the time of inspection. The system appeared to be working as designed and functioning adequately under current use. 13) System Conditionally Passes: ❑ one or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy'is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts w Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day.flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments � M Route 149 - 195 Unit C (Herring Run Place) Property Address PaulTangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Route 149 - 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information Description: Omni Recirculating Sand Filter System with engineered design plan By Christopher Costa & Associates of East Falmouth, MA dated 4-9-02. The system is comprised of a 1,500 gallon septic tank, a 1,000 gallon recirculation tank, 2 OMNI filtration modules, 250 gallon pump chamber, and 1 leaching trench that is 27W x 651 x 2' D . Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d See Details 9 ( Y g (gpd)): Detail: 2012: 40,000 gallons= 110 gpd 2013: 45,000 gallons= 123 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Currently in use Seasonally Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: No Records on file at Town Board of Health Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ® Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): Pump Chamber to Leaching Trench t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Route 149 - 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2002: Design Plan By Christopher Costa &Associates of East Falmouth, MA dated 4-9-02. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3.5' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10'+Town water line feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints and venting were inspected and are in working order, no evidence of leakage encountered while inspecting main sewer line. System vented through roof. Septic Tank(locate on site plan): Depth below grade: 3.0' feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1,500 gallon septic tank with outlet riser to final grade. Schedule 40 PVC inlet and outlet tees functioning correctly. Septic tank outlet tee is fashioned with an effluent filter. If tank is metal, List age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1,500 gallons Sludge depth: 0" t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 17 v , Commonwealth of Massachusetts ti W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments M Route 149 - 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 41" Scum thickness 0" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Tape Measure, Sludge Judge, Probe. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not recommended at time of inspection. Inlet and outlet tees are functioning properly, septic tank is structurally sound. Liquid levels as related to the outlet invert was at a normal height. No evidence of leakage or backup observed while inspecting septic tank. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments cM Route 149 - 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins-3/13 . Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): No D-Box Present-Pump Chamber to Leaching Trench Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 250 gallon pump chamber is operating correctly. Riser and cover to final grade. Pumping not recommended at time of inspection. Pump, on/off float switch, and alarm float switch are functioning properly. Audible/Visual alarm operating properly and is located in basement. *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: (1)27W x 651 x 2' D ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil is sandy, there are no signs of hydraulic failure now or in the past, vegetation normal. Design Plan indicates 330.26 gpd provided, 330 gpd required. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c�M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ® drawing attached separately G 5,� U (D 9- 3 13 �a t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 5' + feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 4-9-02 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater determination was accomplished using percolation test data from the Design Plan By Christopher Costa&Associates dated 4-9-02 and revised. Soil Testing was conducted on 3-24-98 Taken By: Bruce Murphy and Observed By: Jerry Dunning. Soil test logs indicated that no groundwater was encountered at elevation 50.7, the bottom of the leaching trench is at elevation of 55.7 which leaves a 5'+estimated seperation to high groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Route 149- 195 Unit C (Herring Run Place) Property Address Paul Tangusso Owner Owner's Name information is required for every Marstons Mills MA 02648 5-7-14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems) completed E System Information— Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 195 Route 149#C (Herring Run Place) Property Address Normand Barclou Owner Owner's Name information is required for Marstons Mills Ma. 02648 9/15/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately 04 t .3 V_ Cq t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 15 of 17 BENNETTENVIRONMENTALAssOCIATES, INC* LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS & GEOLOGISTS & ENGINEERS 1573 Main Street- P.O. Box 1743, Brewster, MA 02631 508-896-1706 & Fax 508-896-5109 www.bennett-ea.com BEA09-10147 November 30, 2011 Mr. &Mrs.Paul Tangusso 29 Cedarview Circle "'';4 Milford,MA 01757 RE: OPERATION AND MAINTENANCE CONTRACT 2012 AND 2013 Innovative/Alternative Wastewater Treatment System: OMNI RSF Unit 195-C Herring Run Place—Marstons Mills, MA Dear Mr. &Mrs. Tangusso, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA),is pleased to provide a proposal for the continuation of professional services for the operation,maintenance and environmental monitoring of the innovative/alternative wastewater treatment system for you and your neighbors as described in accordance with the governing regulations under 310 CMR 15.00 as regulated under the Barnstable Health Department. These services include quarterly inspections for standard operation and maintenance of the treatment system, as well as annual effluent sampling for total nitrogen. The costs for such services are presented below as annual costs for the first and second year of this contract reflecting standard laboratory fees and reporting requirements. This contract and the quoted annual costs are good for a period of two years.subsequent to the date.of the next operation and maintenance event scheduled for December 2011. This proposal replaces the previous renewal contract proposal dated November 18, 2011. QUARTERLY INSPECTION/MAINTENANCE/SAMPLING:Inspect UA system and take field measurements of dissolved oxygen,pH and turbidity on a quarterly basis. Collect treated effluent wastewater samples on an annual basis under a proper chain-of-custody for analysis by a MA certified laboratory for nitrite/nitrate/TKN for total nitrogen. At the time of sampling events the conditions of the system will be inspected and documented with regards to the blower units,sludge level and associated piping. REPORTING/FILING: ..Review laboratory results relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal.forms on a quarterly basis. File inspection reports on the Barnstable County online database quarterly. File sampling reports on the Barnstable County online database annually for effluent sampling. Submit laboratory report, DEP transmittal forms to MA DEP, Barnstable County Department of Health and Environment,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Fees Operation/Maintenance and Reporting[Dec 2011-Sept 2012] $ 475.00 Professional Fees Operation/Maintenance and Reporting[Dec 2012-Sept 2013] $ 600.00 Laboratory Analysis [Total Nitrogen(NO2,NO3,TKN)] $ 47.73 Barnstable County Data Base Fee $ 50.00* 1 EMERGENCY SPILL RESPONSE WASTE SITE CLEANUP 0 SITE ASSESSMENT 0 PERMITTING SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 0 WASTEWATER TREATMENT,OPERATION&MAINTENANCE NOVEMBER 30,2011 TANGUSSOBEA09-10147 PAGE 2 OF 2 UNIT 195C HERRING RUN PLACE,MARSTONS MILLS,MA * Noted: I/A systems located in Barnstable County are required to report inspection and sampling results on the Mass Septic online database for use by the Barnstable County Department of Health and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filings on this required database of$50 per year. At the time of inspections the wastewater treatment equipment will be inspected to ensure that the system is working as designed. Should repair or replacement of equipment or sludge pumping be necessary beyond standard maintenance, such material and additional time beyond that of a normal inspection will be billed at time and expense. We are proceeding with the work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign the authorization below and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES,INC. Samantha Farrenkopf,ES WWTO,PWSO Wastewater Program Coordinator cc: Kara Risk,Business Manager encl. Terms&Conditions (2009)/Fee Schedule (2010) AUTHORIZATION: .� , DATE: a BENNE'Tu,l ENViffRONMENTALAssocii,,TES LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS 0 GEOLOGISTS Q ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 508-896-1706 0 Fax 508-896-5109 www.bennett-ea.com BEA09-10147 October 23,2013 Mr. &Mrs. Paul Tangusso 29 Cedarview Circle f Milford, MA 01757 RE: OPERATION AND MAINTENANCE CONTRACT 2014 and 2015 Innovative/Alternative Wastewater Treatment System: OMNI RSF Unit 195-C Herring Run Place—Marston Mills,MA Dear Mr. and Mrs. Tangusso, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with a budget estimate for the continuation of professional services relative to the operation and maintenance of the Innovative/Alternative Wastewater Treatment System located at the above referenced property. The collection and laboratory analysis of samples collected from the effluent of the septic treatment system is a required condition of the system, as set forth by the Barnstable Health Department to qualify treatment capacity on a quarterly basis. As such, work proposed by BEA includes the standard operation and maintenance of the treatment system, as well as annual effluent sampling for total nitrogen, and the preparation of the required forms for distribution to the appropriate town and state offices. Additionally,at the time of such sampling,blowers,filters and associated piping will be inspected to assure working condition and regularly scheduled maintenance performed on a fixed cost basis will be invoiced quarterly. Should any repair or treatment system components replacement be required,or additional sampling beyond the quarterly requirements necessary,you will be notified to authorize the additional work and expenses. This work will be billed at time and expense,portal to portal. The following budget represents estimated annual costs through one year of service to include four sampling and inspection events. These annual costs are valid for two years subsequent to the date of the first inspection. Please note that this contract runs with the property. As such,it is your responsibility to notify our office in writing of any sale of the subject property so that there is no disruption of services. Furthermore, you are required to notify any buyer of the transfer of this contract. EMERGENCY SPILL RESPONSE WASTE SITE CLEANUP SITE ASSESSMENT PERMITTING A SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE A WASTEWATER TREATMENT,OPERATION&MAINTENANCE OCTOBER 23,2013 TANGUSSOBEA09-10147 PAGE 2 OF 2 UNIT 195C HERRING RUN PLACE,MARSTONS MILLS,MA QUARTERLY INSPECTION/MAINTENANCE/SAMPLING Inspect UA system and take field measurements of dissolved oxygen, pH, and turbidity. Collect treated effluent wastewater samples on an annual basis under a proper chain-of-custody for MA certified laboratory analysis of nitrite/nitrate/TKN for total nitrogen. At the time of sampling events the conditions of the system will be inspected and documented with regards to the blower units,sludge level and associated piping. REPORTING/FILING Review inspection,field-testing,and laboratory analytical report relative to conditional requirements of the system under the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms and submit inspection and sampling reports on the Barnstable County Department of Health and Environment online database on a quarterly basis. Submit laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as appropriate,on an annual basis. Professional Services $ 680.00 Laboratory Analysis [lx nitrate/nitrite/TKN] $ 47.73 TOTAL ANNUAL EXPENSE: $727.73* TOTAL COST PER EVENT: $181.93 *Noted: I/A systems located in Barnstable County are required to report inspection and sampling results on the Mass Septic online database for use by the Barnstable County Department ofHealth and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary to institute annual user fees for filings on this required database of$50 per year. At the time of inspections the wastewater treatment equipment will be inspected to ensure that the system is working as designed. Should repair or replacement of equipment or sludge pumping be necessary beyond standard maintenance, such material and additional time beyond that of a normal inspection will be billed at time and expense. We are proceeding with the work as outlined. Immediate notification in writing is required if you do not wish to proceed. Otherwise, please sign the authorization below and return one copy of this proposal to our office. Should you have any questions or need additional information,please contact me directly at our office Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES,INC. Samantha Farrenkopf,ES WWTO,PUO Wastewater Program Coordinator cc: Kara Risk,Business Manager encl. Terms&Conditions (2009)/Fee Schedule(2010) AUTHORIZATION: ,DATE: p�IKE TOJy� Barnstable o Town of Barnstable BARtJSfABL�, " Board of Health �lilt� MA83. Arlt16 6 200 Main Street, Hyannis MA 02601 Office: 508-862.4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi November 13, 2013 Mr. Paul and Mrs.Maria-Tangusso 195 Route 149,Unit C Marstons Mills,MA 02648 RB' O. ertiori and'Ivlairitei�aice. 0&M:of. our Yrirzovativ /Alteimtive f.. :p.: .�.:..: Route.149 #C M stops M.i1is::' A .078=018'=40C;"''; 195. ,. n e Condo:.:.,,, >.r n l"c e i 7? . ... g Ru a. Dear Mr. and Mrs. Tangusso, You are granted permission to reduce operation and maintenance of your innovative/alternative technology (OMNI 2000 Recirculating Sand Filter system) at 195 Route 149,#C to two times per year. A public hearing was held before the Board of Health on November 12,2013. The Board reviewed your previous years of service records in regards to the operation and maintenance of your innovative system as well as the testing results of the effluent wastewater, The system has been functioning very well with the median total nitrogen level at or below 19 mg/liter,which meets the discharge limits, Permission is granted to reduce the frequency of operation and maintenance of your I/A system at your property will the following conditions: ❖ The wastewater effluent shall be tested for Total Nitrogen once per year. ❖ Operation and Maintenance Inspections shall be conducted twice per year in accordance with MA DEP Regulations. Since ly, ayne iller, M.D., Chairman BOAR OF HEALTH Q:1W PFILES1TangussolAOperotion&Mai nteiience2013.doc OQ OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street Address ` Da e o Service \ t city Operator/O&M Firm f. UQ k) N System Startup Date Weather Condition B. Septic Tank Sludge Pumping Required: Yes❑ Noq, Sludge Depth: Scum Depth: 0 Effluent tee filter: YesX 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 depending on how heavily the system is us d. C. Recirculation Tank ' Q,Check if sludge accumulating Pumping required: Yes❑ NcA Odor problems: Yes❑ No V If yes,description Effluent tee filter: Yes❑ No m 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. { }a 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 ��I=1oat 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 Nest 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 pond ing Ponding Present: Yes❑ Nd W] Clean bed: Yes ElNo� Distribution pipes Flush:Yes❑ No�6 Brush: Yes❑ NdX Any 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❑ N�\Kl 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: \ —e BENNETTENVIRONMENTAL Assocuns9 INC. 1573 Main St.,P.O.Box 1743 Brewster;MA 02631 \� 508-896-1.706®www.bennett-ea.com Date&time of visit: -31 � Q� 3=0Q A site visit was conducted today for: O&M 4YES ❑ NO Testing ❑YES �XIN0 Repair ❑YES NO Alarm Call ❑YES NO Your system is operating correctly YES ❑ NO Tank(s) in need of pumping ❑YES NO Further maintenance required ❑YES NO Repairs needed ❑YES Q(NO Please contact our office ❑YES QZfNO Contract renewal required ❑YES 04 NO Field testing CAPass ❑ Fail Sample pulled ❑YES % NO Laboratory sampling conducted ❑YES NO w' )3ENt!JET:T ENVIRONMENTAL 'i[`-ASSOCIATEs.INC. SSESSMENT Now �.gEMEDIATION% i %„=RSO_ Serial No:09171316:19 J,T# HA ANALYTICAL REPORT Lab Number: L1317799 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: TANGUSSO RESIDENCE Project Number: BEA09-10147 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 �i L\PHA Page 1 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 Alpha Sample Collection Sample ID Client ID Location Date/Time L1317799-01 EFFLUENT MARSTONS MILLS, MA 09/11/13 12:40 Page 2 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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. Authorized Signature: 4S.@00=4, Lisa Westerlind Title: Technical Director/Representative Date: 09/17/13 Page 3 of 18 �' Serial No:09171316:19 INORGANICS MISCELLANEOUS ,—AL., �a Page 4 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 SAMPLE RESULTS Lab ID: L1317799-01 Date Collected: 09/11/13 12:40 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 General Chemistry-Westborough Lab " Nitrogen,Nitrite 0.15 mg/I 0.050 - 1 - 09/12/13 01:10 44,353.2 DB Nitrogen,Nitrate 7.7 mg/I 0.10 -- 1 - 09/12/13 01:10 44,353.2 DB Nitrogen,Total Kjeldahl 2.32 mg/I 0.600 — 2 09/12/13 10:56 09/13/13 21:30 30,4500N-C AT 1 aiA Page 5 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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 Chemistry Westborough Lab.for'sample(s) 01 .Batch °WG635443 1 Nitrogen,Nitrate ND mg/I 0.10 -- 1 - 09/12/13 00:45 44,353.2 DB Generd:Chemistry'=Westborough Lab for sample(s). 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 sample(s): 01 Batch..WG635627 1 Nitrogen,Total Kieldahl 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:09171316:19 Lab Control Sample Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry--Westborough":Lab rAssociatedsample(s) 01 Batch.WG635443-2 Nitrogen,Nitrate �102 , 90-110 General Chemistry 1estborough"Lab Associated.sample(s):=01 Batch:WG635446-2 Nitrogen,Nitrite 101`. 90-110 20 General ChemistryUVestborough.Lab Associated sample(s): 01 4Batch.WG635627 2 Nitrogen,Total Kjeldahl 95"'' 78-122 _ .......... Page 7 of 18 fvtia Serial No:09171316:19 Matrix Spike Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1317799 Project Number: BEA09-10147 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 General Chemist -Westborough:Lab Associated sample(s)::01 QC Batch ID:,WG635443-4 QC Sample: L1317789-01 Client-[D.:. MS.Sample Nitrogen,Nitrate 4.0 4 7.8 96 - 83-113 6 General Chemistry-Westborough Lab Associated sample(s): 0-1 —Q__C Batch ID: WG635446-4 DC Sample: L1317789-01 Client ID: MS Sample Nitrogen,Nitrite 0.075 4 4.3 A __ 105 80-120 20 General Chemistry-Westborough lab Associated,sample(-s)-01 QC Batch"ID: WG635627-4. QC Sample: L1 31 7798- 11 Client ID.:'-MS Sample Nitrogen,Total Kjeldahl 41.6 8 50.8 115 Q - - 77-111 24 Page 8 of 18 /! �a Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Duplicate Analysis Lab Number: L1317799 J Batch Quality Control Project Number: BEA09-10147 Report Date: 09/17/13 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General Chemistry-Westborough Lab Associated sample(s):, 01—QC Batch ID. W.G635443-3 QC Sample; L1317789-01 Clie P Sample Nitrogen,Nitrate 4.0 3.8 mg/I 4" 6 General'Chemistry 1Nestborough;Lab Associated sample(s): 01` QC BatchAD. WG635446-3 QC Sample:.L1317789=01 Client ID ;DUP Sampler Nitrogen,Nitrite 0.075 0.064 mg/I 16 _a 20 GeneralzChemistrym-Westborough Lab Assoc lot,ed`sample(s): 0;1 QC'BatchAD: WG635627-3 QC Sample L1317798-01 Client ID:. DU Sample - __ . ..: Nitrogen,Total Kjeldahl 41.6 44.8 mg/I 7 24 Page 9 of 18 A�h� Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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(*) L1317799-01A Plastic 250ml unpreserved A 7 4 Y Absent NO2-353(2),NO3-353(2) L1317799-01 B Plastic 250ml H2SO4 preserved A <2 4 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days ,i PWA �w.vlrcw Page 10 of 18 Serial No:O9171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEAO9-10147 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: Tenn 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(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 lower value for the two columns has been reported due to obvious interference. Report Format. Data Usability Report Page 11 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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 �/L�L�FiFI Page 12 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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 Serial No:09171316:19 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: SM212013, 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, 4500SO3-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: SM9215B, 9222D, 9223B, EPA 180.1, 353.2, SM2120B, 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, 4500SO3-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, JRPage 01-B 8082A, 8330, 8151A, 8260C, 8270D, 3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.) Serial No:09171316:19 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, 8081 B, 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, SM2540D. 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: SM9222D, 9221 B, 9222B, 9221 E-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, 3620D, 3630C, 5030B, 5035, 8260C, 82701), 8270D-SIM, 8330, 8151A, 8015B, 8015C, 8082A, 8081 B.) New Hampshire Department of Environmental Services Certificate/Lab ID: 2064. NELAP Accredited. Drinking Water(Organic Parameters: EPA 524.2: Di-isopropyl ether(DIPS), 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, 9222D, 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 f8Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010, �1 A, 1030, 1311, 1312, 3005A, 3050B, 7471 A, 7471 B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D, i Serial No:09171316:19 9050A, 9065, 9251. Organic Parameters: SW-846 801513, 8015C, 8081A, 808113, 8082, 8082A, 8151A, 8330, 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3540C, 3546, 3580A, 3620C, 3630C, 5030B, 5035L, 5035H, NJ EPH.) New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 92.15B, EPA 200.8, 200.7, 245.1, SM5310C, EPA 332.0, SM23206, 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, 922113, 922213, 9215B, 521013, 5310C, EPA 410.4, SM5220D, 2310B, 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, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 23406, 2540C, 254013, 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, SM251013, SM4500S-D, SM5540C, EPA 8315A, 3005A, 3015, 9010C, 9030B. Organic Parameters: EPA 624, 8260C, 8270D, 8270D-SIM, 625, 608, 808113, 8151A, 8330, 8082A, EPA 3510C, 5030B, 8015C, 8011.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010C, 6020A, 7196A, 747113, 8315A, 901213, 9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 305013, 9010C, 9030B, 9040C, 9045D. Organic Parameters: EPA 8260C, 8270D, 8270D-SIM,8015C, 8081 B, 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: SM231013,232013,4500CI-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, 7471 B, 1311,1312. Organic Parameters: 608,8081 B, 8082A, 624, 826013, 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, 232013, 251013,2540C,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, 52106, 5220D,4500-P,BE, 245.1, 300.0, 350.1, 350.2, 351.1, 353.2,420.1, 6010C, 6020A, 7196A, 7470A, 903013,2120B,2310B,2320B, 25106, 2540B, 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, 8081B, 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, 901213, 9014, 9040B, 9045D, 9050A, 9065, SM 4500NH3-131-1, 9030B, 9038, 9251. Organic Parameters: 3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081 B, 8082A, 8151A, 8260C, 8270D, 8270D- SIM, 8330, NJ-EPH.) Rhode Island Department of Health Certificate/Lab ID: LA000065. NELAPAccredited 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, 231013, 2320B, 251013, 254013, 2540C,2540D,426C,4500CL- E, 4500CN-E,4500E-C,4500H+B, 4500NH3-H,4500NO213,4500P-E,4500 S2 D, 510C, 521013, 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, 300.0,251013,.212013, 2540C,4500CN-CE, 245.1, 232013, 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, 601013, 6010C, 3060A,.353.2,420.1, 2340B, 6020, 6020A, SM4500S-D, SM4500-CN-CE, Lachat 10-204- 1- 7196A, 7470A, 2310B, 2320B,2510B, 2540B,2540C, 2540D, 3500Cr-D, 426C,4500CI-E,4500E-B,4500E-C, Page 29 h3-H, 4500NO2-B, 4500NO3-F,4500 S03-13,45001-1-13, 4500PE, 510AC, 5210B, 5310E 5310C,5540C, 9010Cm Serial No:09171316:19 903013, 9040C. Organic Parameters: EPA 3510C, 3630C, 503013, 826013,608,624, 625,8011, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 3050B, 1311, 1312, 6010B, 6010C, 6020, , 7196A, 7471A, 7471B, 6020A, 9010C, 901213, 9030B, 9014, 9038, 9040C, 9045D, 9251, 9050A, 9065. Organic Parameters: EPA 5030B, 5035, 3540C, 3546, 355013, 3580A, 3620C, 3630C, 6020A, 8260B, 8260C, 8015B, 8015C, 8081A, 8081B, 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, 904013, 90108, 180.1, 300.0, 332.0, 6860, 351.1, 353.2, 9060, 1664A, SM 4500CN-E, 4500H-B, 4500Norg-C, 4500NO3-F, 531OC, 2130B, 232013, 2340B, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A, 8260C, 8270D, 8270D-SIM, 8330A, 8082A, 8081B, 3510C, 5030B, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010C, 6020A, 7471A, 6860, 1311, 1312, 3050B, 7196A, 9040B,9045C, 9010C, 9012B, 9251, SM3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 8015C, 8151A, 8260C, 8270D, 8270D-SIM, 8330A/B-prep, 8082A, 8081B, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAP/TNI 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- Tetramethyl 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 J Serial_No:09171316:19 :i ate=Re6'd in:'La6' i4:J` b#'t o LPM o A CHAIN OF CUSTODY _.��� . � •'� 7�7 r. V l PAGE 1 OF 1 •.::,... y' HA •ject Int•rmatton a e a • D- D'' e ❑ FAX EMAIL. ® Same as Client info PO#:10147 Westborough,MA Mansfield,MA Protect Name:Tangusso Residence J TEL:508-898-9220 TEL:508-822-9300 ❑ ADEx ❑ Add-1 Deliverables FAX:508-898-9193 FAX 608-822.3288 Regulatory • •• InformationClient Project Location:Marstons Mills,MA Stare/Fed Program 7..l Criteria Client:Bennett Environmental Associates Protect#:BEA09-10147 Address: 1573 Main Street/P.O.Box 1743 Protect Manager:David C.Bennett Brewster,MA 02631 ALPHA Quote#; Phone:508-896-1706 Turn-Around Tinne • ANALYSIS Fax:508-696-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Filtration Email:sfarrenkopf@bennett-ea,com l f� ❑ Done Not Needed El TheseThese samples have been Previously analyzed by Alpha Due Date: Time: l Lab to do Other Project Specific Requirements/Comments/Detection Limits: Preservation ❑ Lab to do (Please specify below) N ;'ALPHA Lab ID Sample ID Collection Sample Sampler's Z (LatiUseOnlyj _'; Date Time Matrix Initials Sample Speeinc �_...... ..b Ea F- Comments Effluent �t �3 Z:.vp wW. ' ® ® ❑ ❑ ❑ ❑. ❑ ❑ ❑ ❑ ❑ ❑ . Z _ 0 El ;. v..SAY: ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ _ j:� ❑ ❑ ❑ El ❑ ❑ ❑ ❑ ❑ ❑ ❑ i5` ❑ ❑ ❑ ❑ ❑ ❑ El ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ I .. .. ❑ ❑ 0 M El. ❑ ❑ ❑ ❑ ❑ ❑ z Container Type P P _ _ _ _ _ _ _ ;:�F[ease►irint;cleaily;,fegfi(y.:;"• Preservative O D :and'conipletelvi;Sairipl093celi i hbt-belogged'inserid: i R wish Datefrime Received By: DatefTime turnsroCtnditime;Flock-will;not,,. 1 st'aR until"any smbiguilies'aie; yg '[esolved All.samples i // / �n hied are sublecfto jI FDRLLND:01.01(t•NJ) S�/ 143o t a;s.Paymen1 erms. I (tev.2e-APR J{J= Page 18 of 18 - �i 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 9/24/13 BEA09-10147 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Tangusso Residence 195 Herring Run Place Unit C[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail 0 Green Card/RR ❑ COPIES DATE DESCRIPTION 1 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:Bamsiable Board of Health Mr.Paul Tangusso,Owner 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 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:when Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508)381 -3747 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 4/30/02 5/9/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 12/28/12 9/6/12 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 11 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: M no ❑ some pH 6.5 SU DO y 4.0 mg/L Turbidity 0.54 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 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. 1 am a Massachusetts certified operator in accordance with 257 CMR 2.00. � 41 dl� 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: rab 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508)381 -3747 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 4/30/02 5/9/02 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. 12/28/12 Inspection Date Previous Inspection Date 0"sludge, 0"scum 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 DERApproved 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 6.5 SU DO 4.0 mg/L Turbidity 0.36 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 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 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 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 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508) 381 -3747 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 4/30/02 5/9/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/5/13 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 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 6.5 SU DO 8.0 mg/L Turbidity 1.01 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 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 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 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 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508) 381 -3747 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 4/30/02 5/9/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial ./ ar: Seasonal Residence—used less than 6 mo ye ® Yes ❑ No D. Operating Information 9111/13 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 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: ® no ❑ some pH 7.0 SU DO 7.0 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. Notes and Comments: Effluent quality passed field testing parameters. The pump chamber risers are receiving damage from roots from a pine tree that is in close proximity to the pump chamber. The risers will need replacement soon and the tree roots may need to be cut back in order to protect the septic system component from further damage. 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 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 Program One Winter Street, 6th Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3.of 3 N1 . �r�urr�Qn���tcz�`Syst�rns,In4; OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information tu`ck ` v "C.. IZ C, 1 = 00 Facility Street Address Date f Servi e ` -i-S\0'& Y As IvH Vie. Sv�'�,�f ��' mac. City Operator/O&M Firm �— I IVN System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required: Yes❑ No� ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes No El If yes, inspect&clean at least yearly❑ If the sludge layer is within 12"of a 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 ElNo If yes,inspect❑ &clean at least yearly ElIf the sludge layer is greater than 4"request at 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. PumpChamber/Vault(if Installed) ) Pump Inspections(all units) If problems,describe 5 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 1 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❑ Nk Clean bed: Yes❑ NoK Distribution pipes Flush:Yes❑ No Brush: Yes❑ No ❑Any obstruction of airflow to filter modules: Yes ElN 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: ' v E,rzvx��4nmentul Syst,��ns,Ixtc OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information U 3 (10 Facility Street Address Date of Se ice City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required: Yes❑ No KSludge Depth: 0 Scum Depth: 0 Effluent tee filter: Yes X No ElIf 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 depending on how heavily the system is used. _ r_ C. Recirculation Tank 5�\► ' Check if sludge accumulating Pumping required: Yes❑ No[� Odor problems: Yes❑ No p If yes,description Effluent tee filter: Yes❑ No� 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❑ 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 f 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❑ N Distribution pipes Flush:Yes❑ NC Brush: Yes El Any obstruction of airflow to filter modules: Yes❑ No kf 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: n I �t� �-.�:L..�S �4z �,�,.. .,� �I�w�\ �• fir;� ��.s,�,t,t, ;e.. . < "DO — ,\.j,?F9J 0t3 (o 0M 1 Environmental Systems,Inc. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information �-Ac- �kA�\ � (A-��I V-�' Facility Street Address Date of Se ice City Operator/O&M Firm 5y\-N System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required: Yes❑ Nd\pg ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yesm No❑ If yes,inspect tk&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 ❑ Check if sludge accumulating Pumping required: Yes❑ NdAj Odor problems: Yes❑ NdZ, If yes,description Effluent tee filter: Yes❑ Nog 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 —AFloat 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 PO PCs s kG C.,Am\ 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❑ NOVI Clean bed: Yes❑ NC(O Distribution pipes Flush`.Yes❑ Nc0] Brush: Yes❑ No4 ❑Any obstruction of airflow to filter modules: Yes❑ Noa.lf 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&A 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: En viruninefnta!Systems, Inn. OIL NI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information ff� is- - C' `k 11 3 Facility Street Address i Date f Service , ff City Operator/O&M Firm 5yjy' System Startup Date Weather Conditions ` . B. Septic Tank 5`� � � A (A Sludge Pumping Required: Yes❑ N ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Ye No❑ If yes,inspec ]&clean at least year) If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank 9 Y p 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 (s�j U�F� � '^ ��" � �' ❑Check if sludge accumulating Pumping required: Yes❑ N&A Odor problems: Yes❑ No❑ If yes,description Effluent tee filter: Yes❑ N4 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) Q;��,� �,�,.�-• °�. �c�5 is 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 ElN Clean bed: Yes ElNc� Distribution pipes Flush:Yes❑ No Brush: Yes❑ No Any obstruction of airflow to filter modules: Yes❑ Nol 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 Ye� No❑ If yes:❑BOD ❑TSS ❑pH tqTN 40ther J,�t j 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: 4 T �QIN, A 046 L Serial_No:09171316:19 HA ANA L-aY T1 CAL ANALYTICAL REPORT Lab Number: L1317799 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: TANGUSSO RESIDENCE Project Number: BEA09-10147 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)508-898-9.193 800-624-9220-www.alphalab.com Page 1 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 Alpha Sample Collection Sample ID Client ID Location Date/Time L1317799-01 EFFLUENT MARSTONS MILLS, MA 09/11/13 12:40 Page 2 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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. Authorized Signature: • Lisa Westerlind Title: Technical Director/Representative Date: 09/17/13 Page 3 of 18 '� Serial No:09171316:19 INORGANICS MISCELLANEOUS Page 4 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 SAMPLE RESULTS Lab ID: L1317799-01 Date Collected: 09/11/13 12:40 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 General Chemistry Westborough Lab _ y Nitrogen,Nitrite 0.15 mg/I 0.050 - 1 09/12/13 01:10 44,353.2 DB Nitrogen,Nitrate 7.7 mg/I 0.10 -- 1 ' - 09/12/13 01:10 44,353.2 DB - ........ ......_..... ............. ......-- _..__: _------ . ...._....-_...... ._. ...... .........-..._- .. . .._.....__.. ._.... --..... _ Nitrogen,Total Kjeldahl 2.32 mg/I 0.600 2 09/12/13 10:56 09/13/13 21:30 30,4500N-C AT Page 5 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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 Chemistry-Westborough Lab for-sample(s),01 Batch: WG635443-1. Nitrogen,Nitrate ND mg/1 0.10 1 09/12/13 00:45 44,353.2 DB General Chemistry-Westborough Lab for sample(s):•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 sainple(s): 01 Batch: WG6 5562711 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:09171316:19 Lab Control Sample Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qua[ Limits RPD Qual RPD Limits Cherris ry IW General estborougi- Lat aAssociated`sample(s):01 Batcli:WG635443-2 _ rip Nitrogen,Nitrate ` "'102` 90-110 General Chemistry Westborough°Lab Associated sample(s).01 Batch.1[VG635446-2 - Nitrogen,Nitrite m" 101- 90-110 20 ..�-,.-�•. -•--,n.�,�-,-�---_. �,.�,m.�,�.-�...,� �.�....,-.,x._.,...-�- mow..-_.--.._.__.,,�.... �.t_ v.. �__�_� .. 4�,.�. . � .._ .,..,,.,� Genera],Chemistry..-Westborough Lab ;Associ6ted;sample(s):`01 ` Batch:WG635627-2 e Nitrogen,Total Kjeldahl '.95' ` '' 78-122 Page 7 of 18 y�ti� Serial No:09171316:19 Matrix Spike Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1317799 Project Number: BEA09-10147 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 General_Chemistry-Westborough Lab,Ass cci6ted;s mmple(sy 01 QG Batch ID: WG635443=4 QC Sample: L1317789-01 Client ID: MS Sample Nitrogen,Nitrate 4.0 4 7.8 96 - 83-113 - 6 General Chemist Westborou h L'ab Associated'sam le s 01 QC Batch ID 1NG635446-4 QC Sa v ' �' ___ _ - - ry �_� Triple L-1317789-01 Client ID: MS�.Sample Nitrogen,Nitrite 0.075 4 4.3 " 105r� - 80-120 - 20 General Chemistry^Westborough Lab Associated sample(s): 01 QC Batch ID:WG635627-4 QC:Sample: 1-1317798-01 Client lb—MS Sample Nitrogen,Total Kieldahl 41.6 8 50.8 � 115: Q y- 77-111 24 Page 8 of 18 ANA. o.. Serial No:09171316:19 Lab Duplicate Analysis Project Name: TANGUSSO RESIDENCE Batch Quality Control Lab Number: L1317799 Project Number: BEA09-10147 Report Date: 09/17/13 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits �Clemistryt Westborough Lab Associated-sample(s): 01° QC-Batch-ID: WG635443-3 QC Sample: L1317789-01 Client ID: DUP Sample General ,. <. _. _..._ .. �. . _ _ _ Nitrogen,Nitrate 4.0 3.8 mg/I 4 6 _._.__...._ --. - ...... � a 1QC BatchID G6354463QC SampelGenerall,Chem ist Wesboough Lb, Associated samples) 0 _. _l�ent D wD.U..P Sampezz ta ' Nitrogen,Nitrite 0.075 0.064 mg/I 7 --16` 20 General�Chemistry ,1estborough Labb Associated�sample(s) F01 '"QCBatch`ID WG635627=3' QC Sample: L1317798=01m'Client ID."—DO P Sample= m Nitrogen,Total Kjeldahl 41.6 44.8 mg/I 7 24 HA Page 9 of 18 _ a. Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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(*) L1317799-01A Plastic 250ml unpreserved A 7 4 Y Absent NO2-353(2),NO3-353(2) L1317799-01 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:O9171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEAO9-10147 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 analyzes. 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(IOx)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(IOx)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 Page 11 of 18 Serial No:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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:09171316:19 Project Name: TANGUSSO RESIDENCE Lab Number: L1317799 Project Number: BEA09-10147 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. I 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. AT ' ��• Page 13 of 18 Serial No:09171316:19 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 P/A), 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: SM2120B, 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, SM2120B, 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, g6o0110C, 200.8, 6020A, 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 625, 8011, Page f�4 0R, 8082A, 83301 8151A,8260C, 8270D, 3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.) Serial No:09171316:19 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, 8081 B,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, SM25401). 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 ll, 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:SM9222D, 9221 B, 9222B, 9221 E-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, 3620D, 3630C, 5030B, 5035, 8260C, 8270D, 8270D-SIM, 8330, 8151A,8015B,8015C, 8082A, 8081 B.) 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, 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, 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.) li Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010, Page NA, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D, Serial No:09171316:19 9050A, 9065, 9251. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 82606, 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: SM922313, 9222B, 9215B, EPA 200.8, 200.7, 245.1, SM5310C, EPA 332.0, SM23206, EPA 300.0, SM212013, 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, 9222B, 9215B, 521013, 5310C, EPA 410.4, SM52201), 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, 234013, 2540C, 254013, 2540D, EPA 200.8, EPA 6010C, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 7470A, SM21206, 4500CN-CE, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM25106, SM4500S-D, SM5540C, EPA 8315A, 3005A, 3015, 9010C, 9030B. Organic Parameters: EPA 624, 8260C, 8270D, 8270D-SIM, 625, 608, 8081B, 8151A, 8330, 8082A, EPA 3510C, 50306, 8015C, 8011.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010C,6020A, 7196A, 747113,8315A, 9012B, 9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 3050B, 9010C, 903013, 9040C, 9045D. Organic Parameters: EPA 8260C, 8270D, 8270D-SIM,8015C, 8081 B,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: SM23106, 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, 232013,251013, 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, SM25401), 5210B,5220D,4500-P,BE, 245.1, 300.0, 350.1, 350.2, 351.1, 353.2,420.1, 6010C, 6020A, 7196A, 7470A, 9030B,2120B,231013, 232013,2510B,2540B,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,50306,625, 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, 3050B, 3060A, 6010C, 6020A, 7196A, 747113, 9010C, 9012B, 9014, 9040B, 9045D, 9050A, 9065, SM 4500NH3-BH, 903013, 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 2120B,2310B, 232013,2510B,254013,2540C,2540D,426C,4500CL- E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C, 5210B, 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, 300.0,251013, 21206,2540C,4500CN-CE, 245.1,232013, 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- Pagel1- 7196A, 7470A, 23106,2320B,2510B,2540B,2540C,2540D,3500Cr-D,426C,4500CI-E,4500E-B,4500E-C, r 143-1-1,4500NO2-B,4500NO3-F,4500 S03-B,45001-1-13,4500PE, 510AC, 521013,5310E 5310C, 5540C,9010Cm Serial No:09171316:19 9030B, 9040C. Organic Parameters: EPA 3510C, 3630C,5030B,8260B, 608,624, 625,8011,8015C,8081 A, 8081 B, 8082,8082A, 8151A,8260C,8270C, 8270D, 8270C-SIM,8270D-SIM,8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 30506, 1311, 1312,601013,6010C, 6020, , 7196A, 7471A,7471 B, 6020A, 9010C,90126, 90306, 9014,9038, 9040C, 9045D,9251,9050A, 9065. Organic Parameters: EPA 5030B,5035,3540C, 3546, 355013, 3580A, 3620C, 3630C,6020A,8260B, 8260C, 801513,8015C, 8081A,8081B,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, 901013, 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, 23406, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A, 8260C, 8270D,8270D-SIM, 8330A, 8082A, 8081 B, 3510C, 503013, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7,6010C,6020A, 7471A, 6860, 1311, 1312, 3050B, 7196A, 9040B, 9045C,9010C,9012B, 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 NELAP/TNI 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- Tetramethylbenzene, 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:091713'16:19 • i f- Datt3 Rec'd(n:Lab'> '�ALI?M;4:Jo�CHAIN OF CUSTODY PAGE 1 OF 1 r.. HA Report Information Data Deliverables Billing Information roject Information ❑ FAX ® EMAIL. ® Same as Client into PO#:10147 Westborough,MA Mansfield,MA TEL 508-898-9220 TEL:508-822-9300 Project Name:Tangusso Residence ❑ ADEx ❑ Add'i Deliverables 1 I FAX,508-898-9193 FAX:608.922�3288 Regulatory Requirements/Report7 Client Information Project Location:Marstons Mills,MA State/Fed Pro ram Criteria Client:Bennett Environmental Associates Project#:BEA09-10147 Address:1573 Main Street/P.O.Box 1743 Project Manager David C.Bennett Brewster,MA 02631 ALPHA Quote#: i I Phone:508-896-1706 • I ANALYSIS ; Fax:508-896-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING Email:sfarrenkopf bennett-ea:com / f Filtration t/t � 1� Done ❑These samples have been Previously analyzed by Alphe Due Date: Time: l l�� ❑ one ® Not Needed ❑ Lab to do c Other Project Specific Requirements/Comments/Detection Limits: Preservation • ❑ Lab to do (Preese specify below) .0 -ALPHA Lab ID Sample ID Collection Sample Samplers z Use Onlyj Date I Time Matrix Initials m m Sample speerne _...... >.. Z comments -.:. " �::'`. Effluent 1NW- ® ® ❑ ❑ ❑ ❑. ❑ ❑ ❑ ❑ ❑ 0 2 - ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 7. li� ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ El f ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑I _ ii': - � : .. .. El [I El ❑. ❑ ❑ ❑ z Container Type P P i 0 D - _ _ _ ;.Pl'ease pant Eleady leglb�y'. , Preservative 4:antl�comtitetely;<;Sairiplesicarr l not:be 19f19ed:(nTanu•ni�"i: . _; R uishe DatenIme Received Daterrime turiiaroUnd�time'iolocle{v�(i,nob,. f ctatt:iiri(If'sny tirobiguitlet#'aie�': i �� •� Z. g tesolvep.All:e®i�plas::';.' _ �nhied are sutijecFto: FORM N0:01-0tpd)J) b t'( a',s.Payiitient"femis. J7{� Page 18 of 18 . �TKWE TOy, Barnstable 04 Town of Barnstable OftedcaCf Ba sTQ Board of Health �F9. Arfar�a�°' 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junibhi Sawayanagi November 13, 2013 Mr. Paul and Mrs. Maria Tangusso 195 Route 149, Unit C Marstons Mills, MA.02648 RE Operation and IVlamtenan (O&M) of your Irinovahve/Alternative (OMNI) Sysfem at 195 Route 149 #C, Marstons Mills' ; *A 078 018 40C„ Herring Run Place Condo Dear Mr. and Mrs. Tangusso; _ You are granted permission to reduce operation and maintenance of your innovative/alternative technology.(OMNI 2000 Recirculating Sand Filter system) at 195 Route 149, #C to two times per year. A public hearing was held before the Board of Health on November 12, 2013. The Board reviewed your previous years of service records in regards to the operation and maintenance of your innovative system as well as the testing results of the effluent wastewater. The system has been functioning very well with the median total nitrogen level at or below 19 mg/liter, which meets the discharge limits.. Permission is granted to reduce the frequency of operation and maintenance of your I/A system at your property will the following conditions: ❖ The wastewater effluent shall be tested for Total Nitrogen once per year. ❖ Operation and Maintenance Inspections shall be conducted twice per year in accordance with MA.DEP Regulations. Since ly, Wayne i ller, M.D., Chairman B HEALTH Q:\WPFILES\TangussoIAOperaoon&Maintenence2013.doc Herring Run Place S 195 Route-149,',Unit# C, , ' R Marstons Mills ean, Thomas From: Paul Tangusso [tangussop@gmail.com] Sent: Monday, October 14, 2013 6:11 PM V6,1 02013 To: Health Subject: Meeting Agenda Request 11/12 - Septic System Maintenance Inspection Reduction October 14, 2013 Wayne Miller, M.D. , Chairman, Board of Health Barnstable, MA Dear Dr. Miller: I am writing to request a reservation on the next available Health Dept meeting agenda (11/12 if possible) . The purpose of the reservation is to request a reduction in the `maintenance' inspection interval associated with our I/A Recirculating Sand Filtration system located at 195C Herring Run in Marstons Mills. The current `maintenance' inspection interval is 4x per year and we would like to request a reduction to 2x per year. This request is similar to previous requests recently reviewed and approved for some of our neighbors. We spoke briefly a few weeks ago regarding this subject. At that time you mentioned that we may be listed as being a seasonal' user. I believe the term `seasonal' was used by the inspection company (Bennett Environmental) since this is a secondary residence for us. That being said, however, the term `seasonal' does not appear to apply from a Board of Health definition since we use the home, and the IA system, year round. This is possible since our primary residence is located only about lhr and 20mins off Cape. We are on the Cape almost every weekend as well as during summer vacation. Please note that we do not rent the residence at any time during the calendar year (renting is also restricted by our association' s rules and regulations) . In addition to my wife and me the only other individuals who use the residence are our daughter and her husband who may visit several times during the year. We would appreciate consideration by the Board of Health regarding this request. Sincerely, Paul & Maria Tangusso 195C Herring Run Marstons Mills, MA 02648, ]'7-233-4923 29 Cedarview Circle Milford, MA 01757 tangussop@gmail_com 1 )Yr/ � Town of Barnstable arn ble 7 Board of Health 23,7 1 8dcac I °"R'S1�'MASS. 200 Main Street, Hyannis MA 02601 y �, 2007 OFFICE: 508-862-4644. Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Paul &Maria Tan usso, 1 oute 4 , ni , Marstons Mills, MA 02648 ACKNOWLEDGEMENT Or RECEIPT: October 21, 2013 We have received your submission"to the Board of,fealth 12e: 195 route 149,— G 9V arstons �W iffs fora hearing to reduce your-monitoring requirements for your 11A septic system. y 2hankyou. Your item will be heard at the Board of Health Meeting on the: Date of: Tuesday,November 12, 2013 You, or a representative for you, is expected to.be present to answer questions the Board may have. Meeting Location: Town Hall, 367 Main St, Hyannis Hearing Room, Second Floor Time: 3:00— 6:00 P.M. Approximately three days prior to meeting, an agenda will be sent out to you— once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to ,..`Boards.& Committees > Board of Health - or- Go to, Official Agendas QAAGENDAS BOH\let Receipt of BOH Submission 2013.doc BENNETT ENVIRONMENTAL ASSOCIATES, INC. y 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 9/22/11 BEA09-10147 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Tangusso Residence 195 Herring Run Place Unit C[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: 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 Mr.Paul Tangusso,Owner 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508)381 -3747 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 I OMNI Environmental Systems OMNI RSF DEP ID Manufacturer ID Model Number 4/30/02 5/9/02 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 1"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 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: ® no ❑ some pH 6.49 SU DO 15.23 mg/L Turbidity 3.56 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 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 hgram 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508)381 -3747 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 4/30/02 5/9/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 3/8/11 1/4/11 Inspection Date Previous Inspection Date 3"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 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 6.17 SU DO 16.43 mg/L Turbidity 0.20 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 ' 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. ?-Yb �Xkp�" KO\�- — I9�z��%1 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, 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508)381 -3747 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 4/30/02 5/9/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ® Yes ❑ No D. Operating Information 6/13/11 3/8/11 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 6.0 SU DO 13.45 mg/L Turbidity 0.27 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 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. "Cl — 9wzu 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 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 hgram 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 Paul Tangusso filling out forms Owner on the computer, use only the tab Route 149 Unit 195-C 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: 29 Cedarview Circle Street Address/PO Box: Milford MA 01757 City State Zip (508)381 -3747 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 4/30/02 5/9/02 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 6/13/11 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 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 6.5 SU DO 12.90 mg/L Turbidity 0.73 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 M 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 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 operator in accordance with 257 CMR 2.00. ["\Ilf Opera or 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, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 r Serial No:09221112:06 HA Z-'L'NAL*Y,,,A ' ICAL ANALYTICAL REPORT Lab Number: L1114554 Client: Bennett Environmental Associates 1573 Main St. PO Box 1743 Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: TANGUSSO Project Number: BEA09-10147 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:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEA09-10147 Report Date: 09/22/11 Alpha Sample Collection Sample ID Client ID Location Date/Time L1114554-01 EFFLUENT MARSTONS MILLS 09/14/11 13:30 Page 2 of 17 Serial No:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEA09-10147 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 speck 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. Nitrogen, Nitrate L1114554-01 has an elevated detection limit due to the dilution required to quantitate the result within the calibration range. 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 Title: Technical Director/Representative Date: 09/22/11 Page 3 of 17 �� Serial No:09221112:06 INORGANICS MISCELLANEOUS Page 4 of 17 Serial No:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEA09-10147 Report Date: 09/22/11 SAMPLE RESULTS Lab ID: L1114554-01 Date Collected: 09/14/11 13:30 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 Chemistry_.Westborough Lab Nitrogen,Nitrite 0.07 mg/I 0.05 — 1 09/16/11 00:55 44,353.2 TH Nitrogen,Nitrate 8.6 mg/I 0.50 — 5 - 09/16/11 02:05 44,353.2 TH Nitrogen,Total Kjeldahl 1.4 mg/I 0.30 — 1 09/16/11 13:50 09/20/11 20:06 30,4500N-C AT ti LPL HA Page 5 of 17 Serial No:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEA09-10147 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 Chemist -VY ry e,-l ro g Lab for samples)01 Batch: WG490293 2 Nitrogen,Nitrate ND mg/I 0.10 — 1 09/16/11 00:38 44,353.2 TH General)Chemistry' VVestborough Lab for samples) 01 a Batch WG490295 2 - Nitrogen,Nitrite ND mg/I 0.05 — 1 09/16/11 00:46 44,353.2 TH • _�. ..,-.«w,�..,,„..-.,.V. �ataa:r*v:..,ar.��a..-.. ^.4�;,e;�. ,.-•'�.;s - _ -... _ _.�.,.«- a-irsS+.. ..'s.r C" g"*1::ssF-, General Chemistry=Westborough Lab for samples)_ 01•°°Batch:'WG490372-1 m _ �• - •'' Nitrogen,Total IQeldahl 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:09221112:06 Lab Control Sample Analysis Project Name: TANGUSSO Batch Quality Control Lab Number: L1114554 Project Number: BEA09-10147 Report Date: 09/22/11 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery (,dual Limits RPD Qual RPD Limits r se—ne [I ++s-wa^w,arso. 9 — c�r^•_'�,1. ',�,..a..--r., General:Chemistry-Westborough LabAssoclatedasarnple(s) 01 Batch: .,A,,. ew,:aaz�..a?,..:,..,+.iP»., ar.i�&A'-A..wv c ns....-.... ..a..,.,--Patch �.. .�-t e...�.a:.. ..;.�«.t �...x.. .. ., '� .,k,. ._ ...>.....,:....:,,.�.�.?,�•...n _°�-.i;;.k-.•,.;,.. Nitrogen,Nitrate 102 - 90-110 w...�.«- 'w`""•',Tr'w.^•w-t+r++-�--'^:w -....�y �...-.+ ....- _. w ,7.w,...... .. :;... a "»�%t---^�r'4^sr. �•p,,:r 'i::,'--Y s'"-""•"+ GeneralKChemistWestborou hLab Associatedtsam le s0,1 BatchWG490295=1�; - f Ca.,.a.��.:av _ •• ,. ..... _..r....4�- _•t..z<.. t_ _.. .._. _ .. -..__.. r..1..:_ .... Nitrogen,Nitrite 98""=,`m' - 90-110 20 a. Gral" he C mistry )Vestborough-LabeAssoclatedf as mple(s): 01'- e e -°g�`Bat -61711VG490972'2°r s ...._ _,z. . .,.-«.' ..ua'..K.. ..:.. . _x... ._x::.--a.' r..: �.;'.._4: vu ,.x.,....-.,r.S.d_:;••a, . .. Kr. _.. .... •.,... :3.> «, .m._"' .3x';..a _.: ...r.»..-.. :''�'.s.,''»t :,a..« `. Nitrogen,Total Kjeldahl '"°=95 - u - 85-110 - Page 7 of 17 tia Serial No:09221112:06 Matrix Spike Analysis Project Name: TANGUSSO Batch Quality Control Lab Number: L1114554 Project Number: BEA09-10147 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 LabiAssociatedssample(s):;01x.�:QCTBatchj1D 'VVG490293=3' 4QC;,Sample `L1',114553=01 =.ClientxlD: MS^Sample : Nitrogen,Nitrate 5.9 4 9.8 ;98 - - 83-113 - 6 General,Cherrnstry='�Westb6rough'}L`• Associated sample(s):z01r�,QC.,`BatchtIC:cWG490295-S� :'YQC:;Sample L11:14553417 ientrlD: MSsSample ' Nitrogen,Nitrite 0.06 4 4.1 101t - - 80-120 - 20 General Chemistry, Westborough LabrAssociated?sample(s): 01 ,QC:,Batch ID WG49037,2-3F„ QC,Sample L11x14558 01 .; Client lD MS Sample M Nitrogen,Total Kjeldah) 1.8 8 9.7 "~.997 -_- - 77-111 24 Page 8 of 17 HA Serial No:09221112:06 Lab Duplicate Analysis Project Name: TANGUSSO Batch Quality Control Lab Number: L1114554 Project Number: BEA09-10147 Report Date: 09/22/11 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits _ �,,,.--ay,,,,;,•,...ram-u.,•..- ...-,er- �+va �-�-�+.��cr'a-tr�-r 1 .a...w ._..r ..,._.�.a..• _..,�z- +�-w+�- �,raew � _^Q,.t_ ry+" Y,o,f Y. "'i Tk'�a'+^ General Chemist Westborou h;LabAssoclatedsam le s 01 =QC;Batch'€ID, WG490293-4 QG;Sam le €L*1:114553=01t ClientrlD: DUPrSam le , . . Nitrogen,Nitrate 5.9 6.0 mg/I 6 General Chemist=1Nestfjotou h Lab, As os ciated'sample(s) 01'. iQC4.Batch ID WG490295-4'aQC Sample L1r 14553=01 Client=lD DUP S pled R �.A Nitrogen,Nitrite 0.06 0.06 mg/l 5 ;-;y? 20 General,.Chemistry'-Westborough L t at ebAssoaesampe(s) <01 W aar �L11�1�4 50.7_03 CIIent�ID, gDUP Samples W*. Nitrogen,Total Kjeldahl 0.38 0.35 mg/I _ 8 '": 24 Page 9 of 17 �;a. Serial No:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEA09-10147 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(*) L1114554-01A Plastic 250ml unpreserved A 7 3.9 Y Absent NO3-353(2) L1114554-01 B Plastic 250ml unpreserved A 7 3.9 Y Absent NO2-353(2) L1114554-01 C Plastic 250ml H2SO4 preserved A <2 3.9 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days Page 10 of 17 Serial No:O9221112:O6 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEAO9-10147 Report Date: 09/22/11 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analyzes 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 analyze 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"Aldo]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:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 Project Number: BEA09-10147 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(RL)for the sample. Report Format: Data Usability Report YX FF a'�• Page 12 of 17 Serial_No:09221112:06 Project Name: TANGUSSO Lab Number: L1114554 • Project Number: BEA09-10147 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:09221112:06 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, 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, 2,4-D, 2,4,5-T, 2,4,5-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: SM9215B, 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.) NQQn fP able 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 fo-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:09221112:06 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, SM2540D,5210B,5220D,4500-P,BE. Organic Parameters: EPA 3510C,3005A,3630C, 5030B,625, 624, 608,8081A, 8082, 8151A,8260B,8270C,8330) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3050B, 6010B, 7196A, 7471 A, 9010B, 9012A, 9014, 9040B, 9045C, 9050, 9065, SM 4500NH3-H. Organic Parameters: 3540C, 3545, 3546, 3550B, 3580A, 3630C, 5035, 8015B, 8081A, 8082, 8151A, 8260B,8270C,8330) Rhode Island Department of Health Certificate/Lab ID: LA000065. 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 2120B,2310B,2320B, 2510B,2540B,2540C,2540D,426C, 4500CL-E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C, 5210B, 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,4500H-B,4500NO3-F, 5220D, 5310C, 2320B,2540C, 3005A,3015, 9010B, 9056. Organic Parameters: EPA 8260B,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, 1312,3050B, 7196A, 9010B,3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 8260B,8270C, 8330A/B-prep,8082, 8081A, 3540C, 3546,3580A, 5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current NELAPITNI 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 Methylnapthalenes, Total Dimethylnaphthalenes, 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 Serial No:09221112:06 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.NELAPAccredited. Drinking Water (Inorganic Parameters: SM9222B, 9221E, 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, SM15 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. NELAPAccredited. 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, 2310E-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. Drinkin Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters: Page 6§44o 1 CHAIN OF CUSTODY PAGE�OF� DateRec'dlnLab: ALPHA Job#: WESTBORO,MA MANSFIELD,MA Project Information E1 Report Information -Data Deliverables Billing Information TEL: 508.89E-MO TEL:505.522.9300 FAX 508.898-9193 FAX 508-822a28e Project Name: Uss(7 ❑FAX CkEMAIL Same as Client Info PO#: Client Information Project Location: ` s O ADEx ❑Add'I Deliverables ��C$�ws W' Client: '� '•�� Project#:�j ('� — �Q j.�� � � Regulatory .� � Requirements/Report - - jl Address: 63 Pro'ect Mana er: State/Fed Program Criteria ALPHA Quote#: Phone:"E53T"l{j V143"Q CL Cr Fax:73cri-c6 (o�J`v Standard ❑RUSH(o*wmInw rrpe-umv+n Email:" �� `` � �Y�_e-% Date Due: Time: y SAMPLE HANDLING • ❑ These samples have been previously analyzed by Alpha Other Project Specific Requirements/Comments/Detection Lim ❑Done its: Fr7tr ne ...$� , 4 Mf Not needed ❑Lab to do Preservation ❑Lab to do 14rPFiA Lab ID Collection Sample Samplers /� (PW7°'ptdybelow) / (Lab.Use Only) Sample ID Date Time Matrix Initials Sample Specific Comments Y'!,<. f .;3.. Container Type ... . . . :..: .. .,...,.:.. ... Plea m.print.ciaarliJogitily grid com- P I?Preservative pletely. Sarnplesscap be logged•, in.and turnaround tim''not e clock will not:: alin uishe Dateffime Rec By: DateTme start until gny,ambig;Uities are:resoly. ZD AII`samples su6ikistl`are subject to ;:,Alptia'S.Temts and Conditions:::;;'..'.:. l .� ee Csversa side. FORM NO:01-01(rev 14-OCT-01) i .r r / NOT TO SCALE 6 5 ® } 2 - ^ NOTE: RISERS AND COVERS TO WITHIN 6' OF FINISH GRADE , 1 6" PINE BARK MULCH OMNI 2000 RE-CIRCULATING SAND FILTER FILTER FABRIC COVER 2 MODULES REQUIRED (NO SUBSTITUTION) FINISH GRADE=59.1 AIRATION HOODS (3) COVERS TO GRADE - O� F.FL=61.0 1.5"PRESSURIZED LINE SEPTIC 3" PVC RETURN UNE I1 , ❑ - EFFLUENT FILTER & TANK=58.8 59.4 TOP OF _ �1V11 GAS BAFFLE RECIRG. Acme Precast Model PL122 TANK=59.9 R.S.F. FINISH GRADE 59.3 ®° 9 SLOPE R.S.F. 55.18 _ - i1zv �`•d�_r:' MODULE r[AICFLOW 3'PEASTONE. KEY MAP ^� HO USE #2 O 5 NV. 1U" SPUTTER _ _ - --- wv. 55.48 14" 55.23 - '56.23 3• 4.0• GAS 54.93 .:. .•.. ,e , LIQUID BAFFLE - AC :.� `' �.�...•: ry 24 HR. RES. 57.7 PUMP ON / ,Q _�2 "HIGH WATER ALARM" 9 3 aaT 1.1 CRUSHEQ 55.21 ! WASHfdr STONE<.'� .�., :i• ' 1500 GALLON SEPTIC TANK "LOW WATER SHUT OFF" , i PUMP OFF SET LEVEL 1000 GALLON "OMNI 2000' ' s EFFLUENT FILTER RECIRCULATION TANK OMNI 2000 PUMP CHAMBER eorroM By. •Zoeller" (NO SUBSTITUTION) 250 GALPUMP CHAMBER' S57 SOIL ABSO PTION SYSTEM "BY-PASS ORIFACE" - DESIGNED BY OTHERS "CHECK VALVE" NOTE:TIMER AND EVENT COUNTER SHOULD BE MONITORED FROM 2/30' LONG, 1.00" DIA. PVC LATERALS DESIGN SPECIFICATIONS CONTROL PANEL EACH WITH TEN 1/4" DIA. HOLES SPACED 3" O.C. ALONG PIPE INVERT. Sand Filter Media . . . . . . . . . . . 24" min. depth <1% #200 sieve, 2mm to 4mm size AVERAGE DAILY FLOW . . . . . . . . 55 gpd/per person/per bedroom TRENCH IS 65' LONG, 2.7' WIDE WITH Wastewater strength-BOD5 . . . . . 230 mg/liter/residential DESIGN CRITERIA 2' EFFECTIVE DEPTH. Re-Circulation Ratio . . . . . . . . . 4:1 NUMBER OF BEDROOMS 3 Re-Circulation Tank Size . 150%of design Flow (Use a 1000 gal. tank) PERSONS PER BEDROOM 2 F- DAILY FLOW PER PERSON 55 q Sand Filter Loading Rate(ReSldential) Loading Rote(gpd/sf)=1150/BOD5=5 gpd/sf TOTAL DAILY FLOW 330 w Sand Filter Surface Area SA=Flow gpd/Loading Rate gpd/ft2 LEACHING AREA REQUIRED 445.9 sq.R.(330 gal. ®0.74 gal./s.f.) SOIL EVALUATOR'S LOG 330 d 5 d sf = 66 S.F. REQ. 69.3 S.F. PROVIDED LEACHING AREA PROVIDED 445.3 sq.R Depth from son Boll sole son other 0_ 9p / 9p / ( ) Surtace Hm Texture Color Matt Relative LEACHING CAPACITY PROVIDED 330.26 g.p.d.(446.3)(0.74) (Ind,es) . (USDA) (Munsel) Factors m OMNI 2000 RE-CIRCULATING SAND FILTER (2 MODULES REQ.) Re-Circulation pump Size [330 + (4x330)] x 103% = 1,650 gpd CALCULATIONS DEEP OBSERVATION HOLE F-1 c0. ONE MODULE PIPED BACK TO 68.75 gals./60 min. cycle BOTTOM CD RE-CIRCULATION TANK 2.7' x65' x0.74 = 129.\ 3 Use Myers Model #ME40 or equal (65 gals. @ 12 TH) gpd 0"-8" A SAL 2B 87 N ONE MODULE PIPED BACK TO xs• ^°J\^o \\��P Sand Filter Setbacks Some as Title V septic tank SIDEWALL 8"-30' B L/S SEPTIC TANK so 135.4 If x 2' x 0.74 = 200.39 g.p.d. - o _ 30"-132" C M/S OMNI 2000 RE-CIRCULATION TANK 6 - ;r\p / GENERAL NOTES 330.26 g.p.d./O.74 = 446.3 s.f. 1500 GALLON SEPTIC TANK _- `• o / ., 1. ALL ELEVATIONS SHOWN ARE "9'P-sr,�. B • ,y p o,• ASSUMED. rn PUMP CHAMBER 2. ALL PIPES IN THE SYSTEM TO BE DEEP OBSERVATION HOLE #E-2 3 o,_ b o �\ 62.2 i I P o � q�. G'r ry 0 CAST IRON OR SCHEDULE 40 P.V.C. 75 sv.s se. 6 ui - -- 59�a 3. REMOVE ALL UNSUITABLE MATERIAL OA SAL A i 2 BENEATH THE INVERT ELEVATION ti NOTE: �O @J' ,f"Poq xo FOR A RADIUS OF 5' AS PER 310CMR 15.255(5) �-� 6"-24' B L/S >_ - - AND BACKFILL W/ CLEAN COARSE < PARTIAL STRIP-OUT REQUIRED %.'g O�• q�b rq GRANULAR MATERIAL 602 24•-138" C M S W DOWN TO MEDIUM SAND - `� --58 / LAYER AND 5' ALL AROUND ai N SOIL ABSORPTION SYSTEM - 4 5,9-0 nos 'o TP F-1 4. ALL BACKFlLL SHALL A CLEAN j s�zx COARSE GRANULAR MATERIAL FREE �, 4, FROM DEBRIS & LARGE STONES. RS 4% 5. CHRISTOPHER COSTA &Assoc. 9' MUST BE NOTIFIED WHEN THE 50.7 •�4 / SYSTEM IS INSTALLED PRIOR TO PERCOLATION RATE _ <5 MIN./INCH 3P ass BACKFILLING FOR INSPECTION. ' DEPTH TO GROUNDWATER =NONE ENCOUI o , �.� ' JERRY DUNNING 6. UNLESS OTHERWISE NOTED ALL SYSTEM COMPONENTS SHALL BE OBSERVATIONS BY: ON INSTALLED IN ACCORDANCE WITH TAKEN BY: BRUCE G. MURPHY CURB STOP M1 MASSACHUSETTS TITLE V SANITARY 3/24/98 Li SEWER CODE AND LOCAL RULES DATE TESTED: WHICH MAY BE APPLICABLE IN A WORKMAN-LIKE MANNER. n 7. THIS LOT IS NOT IN THE FLOOD PLAIN. �° NOTE TO INSTALLERS" 8. A GARBAGE GRINDER WILL NOT BE INSTALLED ON THE SYSTEM. YOU/ / �e CERTIFIEDT BE AN INSTALLERMNIYOUVIRONMENTAL CAN BECOMESYSTEMS CERTIF CERTIFIED 9. NO CHANGES SHALL BE MADE TO THIS PLAN Li �' WITHOUT PRIOR APPROVAL FROM CHRISTOPHER � ti 9'y AT THE TIME OF INSTALLATION. PLEASE CONTACT COSTA& Assoc. >- OMNI AT 1-888-450-OMNI FOR DETAILS 10. DIG-SAFE SHALL BE NOTIFIED FOR THE PROPER APPLICANT: BAYSIDE BUILDING CO., INC. < LOCATION OF EXISTING UTILITIES PRIOR TO ANY of R7 EXCAVATION, 4J�SN PROPOSED DWELLING LOCATION ru F- 11 OMNI ENVIRONMENTAL SYSTEMSOMNI 2000 PRODUCTS LAT THROUGH CHRISTOPHER�CtUt6TOPl-ER}C, PROPOSED SEWAGE SYSTEM LOCATII COSTA Z 12. OMNI 2000 CONTROL PANEL TO BE LOCATED `�' No.31305 - �I 14.ION Y OMVNNII 20 ONSIDE DLLINGIBIO-FILTER OMPONENTSLOCATION. ty LOT 18 - UNIT 2 - ROUTE F NO SUBSTITUTIONS stfi 0 REVISIONS PLAN VIEW BARNSTABLE (MARSToNs mms), MASSACHUF w SCALE:AS NOTED DATE:4/9/02 SCALE 1'= 20' o LEGEND CERTIFIED PLOT PLAN & TOPOGRAPHY DRAWN BY:JAB ICHECKED BYi C,C. JOB NO.: PROP. SPOT ELEV. = X60.5 DONE BY.' EXIST. SPOT ELEV. = x56.04 CHRISTOPHER COSTA & assoc. o PROP. CONTOUR =v 46 me site is situated in Flood Zone "e- BSS DESIGN P.O. BOX 128/465 E. FALMOUTH HWY. EXIST. CONTOUR =� 46 ASSESSORS MAP #78_ LOT 18 NO. DATE DESCRIP77ON BY EAST FALMOUTH, MASSACHUSETTS j i I' J