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HomeMy WebLinkAbout0195 ROUTE 149 - Health (9) �-�' "'� 1 (Z&BCDHE BARVSTme COUNrY Dspmu w OF HEALTHANO ENViRONMENr PROMOTE-PROTECT-SUPPORT '- .0 YEARS 1926-2016 October 26th, 2017 Carolyn Keating PO Box 1492 Marstons Mills, MA 02648 RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 195-1 Route 149 in the town of Barnstable. Dear Carolyn Keating, Our records indicate that the operation and maintenance contract with Bennett Environmental Associates, Inc.for your innovative/alternative wastewater treatment system may have expired or was canceled as of October 13th, 2017.To date we have not received evidence that you have entered into a new operation and maintenance contract. I"am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and the Town of Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at https://septic.barnstablecountyhealth.ora. You can access the list of wastewater operators of whom we are aware do business in Barnstable County. This septic database also provides further explanation about your I/A septic system, as well as any sample and inspection history for the performance of your system, as entered by previous service providers. My department oversees I/A septic system management and compliance efforts for the Board of Health in your town. We are authorized by your Board of Health to contact you to inform you of the above requirement and to request your compliance. Accordingly, please forward a copy of a signed contract via mail, fax, or e-mail within fifteen (15)days of receipt of this letter. For your convenience, I have enclosed a list of wastewater operators we are aware of that do business in Barnstable County. The firms listed operate multiple types of VA 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, I Emily Michele Olmsted CC: Barnstable Board of Health Enclosures (2): Certified Wastewater Treatment System Operators List, Inspection and Testing Requirements BARNSTABLE COUNTY COMPLEX 3195 MAIN STREET/PO BOX 427 BARNSTABLE,MASSACHUSETTS 02630 Phone:(508)375-6613 1 Fax:(508)362-2603 1 TDD:(508)362-5885 Web:barnstablecountyhealth.org I Twitter:@BCHDCapeCod BENNETT ENVIRONMENTAL, ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: I Massachusetts Department of Environmental Protection 9/25/17 BEAO9-11136 Attention:Title 5 Program 1 Winter Street-6thFloor Boston,MA 02108 REGARDING: Keating Residence 195 Herring Run Place Unit I[Route 149] SHIPPING METHOD: - Matstons Mills,MA I i Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑K Green Card/RR ❑K COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 51/A Treatment and Disposal Systems(March and September 2017) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(March and September 2017) - 1 317/17 Alpha Analytical Laboratory report - 1 9/18/17 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 Forms,OMNI RSF Operation and Maintenance Inspection Checklists,and laboratory analytical reports for operation and maintenance conducted during the reporting period for the above referenced property.--It is notedthat-& `inspection ports or_cleanouts for the Tressure dosed le edlield laterals-ire-hot accessible for inspection.If you have any questions or iJ require additional information,please contact us at your earliest convenience.Thank you. cc:Barnstable Board of Health[via email] f Ms.Carolyn Keating,Owner[via email] FROM: Samantha Farrenkopf,Wastewater Program Manager If enclosures are not as noted,kindly notify us at once • T 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip . key. m Mailing address of owner,if different: P.O.Box 1492 Street Address/PO Box Marstohs Mills MA 02648 city State Zip , (508)420-3768 ext. Telephone Number B.Authorized Service Provider Bennett Environmental Associates Inc. 08M 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 9/12102 9112102 Installation Date Start of Operation Approval Type: ® General ❑Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D.Operating Information 3/2/17 9/6/16 Inspection Date Previous Inspection Date _ 14''sludge,0.25"scum Pumping Recommended ❑ Yes ® No Sludge Depth(to be checked yearly) - t5alom.doc•rev.04-11-13 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑turbid ❑ Other(specify): Odor: M musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO y 5.0 mg/L Turbidity 1.27 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) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection&during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and laboratory analysis. The top riser on the final dosing pump chamber was replaced during the operation event. Notes and Comments: All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. t5alom.doc•rev.04-11-13 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 e =5 DEP Approved Inspection and O&M Form for Title 5 I/A ( � g�l. Treatm Sent and Disposal stems Ers�� z z; i H. Certification ifi p 1i d 01 o 9.1 1 certify:1 have inspected the sewage treatment and disposal system at the address above,have o v ❑ 0 ❑ S' < conducted the required Field Testing and/or sample collection in accordance with Standard Methods, o T have completed this report and the attached technology operation and maintenance checklist,and zi a �' ❑.Alp o g N the information reported is true,accurate,and complete as of the time of the inspection. I am a — �. g o ❑ Massachusetts certified operator in accordance with 257 CMR 2.00. rn _ .E N Operator Signature Date ❑ ❑ . . g o❑ o � Q El El ❑❑o i System owner must submit this report,technology O&M checklist,and any required sampling results i 5 Q ,.o to the local board of health as follows for each inspection performed: < �) Remedial Use—by January 31s'of each year for the previous calendar year o ® :❑ ❑ ❑ ❑ Piloting Use-within 45 days of inspection date ❑❑ ❑ ❑ ❑ ❑0❑P � \ Provisional Use—by March 311h of each year for the previous 12 months w E S a J - NNl ❑.❑❑71110310 General Use—by September 30'h of each year for the previous 12 months f ❑ " aaupN ale pN Send to: I Ink Department of Environmental Protection 6 4 Attention: Title 5 Program d_ — One Winter Street,51h Floor Boston,MA 02108 g R J U g 9 E ❑ H F m � � o � � o E '� a 7. U .a o -� o - jlm/ a � E ® E o m c E y {� 0 ryry 2 .!U °. .'Y 3 aPi c N d t5aiom.doc-rev.04-11-13 Page 3 of 3 Serial_No:09181716:55 _ Alpha Analytical,Inc. ID No.:17873 mr- Massachusetts Department of Environmental Protection Facility:Company-wide Revision 10 Bureau of Resource Protection-Title 5 Department:Quality Assurance Published Date:1116/201 7 1 1:00:05AM DEP Approved Inspection and O&M Form for Title 5 I/A Title:Certificate/Approval Program Summary Page 1 of 1 pp p Certification Information Treatment and Disposal Systems The following analytes are not included In our Primary NELAP Scope of Accreditation: A. Installation Westborough Facility Important:When Carolyn Keating EPA 624:m/p-xylene,o-xylene filling out fomts Owner EPA 8260C:NPW:1,2,4,5-Tetramethylbenzene;4-Ethyltoluene,Azobenzene;SCM:lodomethans(methyl Iodide),Methyl methacrylate,1,2,4,5- on the computer, Tetramethylbenzene;4-Ethyltoluene. use only the tab Route 149 Unit 195-1 EPA 827OD:NPW:DimethAnaphthalene,1,4-Diphenyihydrazlne;SCM;Dlmethylnaphthalene,1,4Dlphenylhydmzlne. key to move your Facility Street Address EPA 300:DW:Bromide cursor-do not EPA 6860:NPW and SCM:Perchlorate use the return Marstons Mills 02648 EPA 9010:NPW and SCM:Amenable Cyanide Distillation key city Zip EPA9012B:NPW:Total Cyanide EPA905OA:NPW:Specific Conductance Mailing address of owner,if different: SM3500:NPW;Ferrous Iron rd SM4500:NPW:Amenable Cyanide,Dissolved Oxygen;SCM;Total Phosphorus,TKN,NO2,NO3. P.O.Box 1492 SM531OC:ON,Dissolved Organic Carbon mm� Street Address/PO Box: Mansfield Facility Marstons Mills MA 02648 SM 254OD:TSS City State Zip EPA 3005A NPW (508)420-3766 ext. EPA 8082A:NPW:PCB:1,5,31,87,101,110,141,151,153,180,183,187. Telephone Number EPA TO-15:Halothane,2,4,4-Trimethyl-2-pentane,2,4,4-Trimethyl-l-pentene,Thlophene,2-Methyithlophene, 3-Methylthipphene,2-Ethylthlophene,1,2,3-Tdmethylbenzene,Indan,Indene,1,2,4,5-Tetramethylbenzene,Benzothlophene,1-Methylnaphthalens- Biological Tissue Matrix:EPA 3050B B.Authorized Service Provider The following analytes are Included In our Massachusetts DEP Scope of Accreditation Westborough Facility: Bennett Environmental Associates Inc. O&M Firm DrinkiEPA Water 1573 Main Street/PO Box 1743 EPA 300.0:Nitrate-N,Fluoride,Sulfate;EPA 353.2:Nitrate-N,Nitrite-N;SM4500NO3-F:Nitrate-N,Nltrite�N;SM4500E-C,SM4500CN-CE,EPA 180.1, SM2130B,SM4500Ci-D,SM2320B,SM2540C,SM450OH-B Street Address EPA 332:Perchlorate;EPA 524.2:THMs and VOCa;EPA 504.1:EDB,DBCP. Brewster MA 02631 Microbiology:SM92158;SM9223-PIA,SM9223B-Colllert-QT,SM9222D, City Slate Zip Non-Potable Water (508)896-1706 ext.129 SM4500H,B,EPA 120.1,SM2510B,SM2540C,SM2320B,SM4500CL-E,SM4500E-BC,SM4500NH3-BH,EPA350.1;Ammonle-N,LACHAT 10-107- Telephone Number 06.1-B:Ammonia-N,SM45001,103-F,EPA 353.2:Nitrate-N,EPA 351.1,SM4500P-E,SM4500P-8,E,SM4500SO4-E,SM5220D,EPA 410A ' SM521013,SM5310C,SM4500CL-D,EPA 1664,EPA420.1,SM4500-CN-CE,SM2540D. Samantha Farrenkopf 13265 EPA 624:Volatile Halocarbons 8 Aromatics, Certified Operator Name Certification Number EPA 608:Chlardane,Toxaphene,Alddn,alpha-BHC,beta-BHC,gamma-BHC,delta-BHC,Dieldrin,DDD,DOE,DDT,Endosulfan 1,Endosulfan 11, , Endosulfan sulfate,Enddn,Endrin Aldehyde,Heptachlor,Heptachlor Epoxide,PCBs EPA 625:SVOC(Acid/Base/Neutral Extractables),EPA 600/4-81-045:PCB-Oil. Microbiology:SM9223B-Colllert-QT;Enterolert-QT,SM9221E. C. Facility/System Information Mansfield Facility: - OMNI Environmental Systems OMNI RSF Drinking Water DEP ID Manufacturer ID Model Number EPA 200.7:Ba,Be,Cd,Cr,Cu,Ni,Na,Ca,EPA 200.8:Sb,As,Be,Be,Cd,Cr,Cu,Pb,NI,Se,TL.EPA 245.1 Hg. - 9112/02 9/12/02 Non-Potable Wafer Installation Date Start of Operation EPA 200.7:AI,Sb,A.Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Me,NI,K,Se,Ag,Na,Sr,TL,T1,V,Zn. EPA 200.8:Al,Sb,As,Be,Cd,Cr,Cu,Pb,Ma,Ni,Se,Ag,TL,Zn. Approval Type: ® General ❑Provisional ❑ Piloting ❑ Remedial EPA 245.1 Hg. SM23408 Seasonal Residence—used less than 6 mo.lyear: ❑ Yes No For a complete listing of analytes and methods,please contact your Alpha Project Manager. D. Operating Information 9111/17 3/2/17 Inspection Date Previous Inspection Date ❑ ® Sludge Depth(to he checked yearly) Pumping Recommended Yes No i Document Type: Form Pre-Qualtrax Document ID:08-113 Page-1 4 of 15 t5alom.doc•rev.04-11-13 Page 1 of 3 i Seria l_No:09181716:55 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 Project Name: KEATING RESIDENCE Lab Number: L1732170 DEP Approved Inspection and O&M Form for Title 5 I/A Project Number: BEA09-10136 Report Date: 09/18117 Treatment and Disposal Systems REFERENCES E. Field Testing Field Inspection: 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. Color: ❑ gray ❑ brown ® clear ❑turbid 121 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA-WEF. Standard Methods Online. ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 6.5 SU DO 6.0 mq/L Turbidity 1.11 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. j F. Sampling Information Samples Taken: ❑ Influent ® Effluent Commercial systems or systems with a design flow of 2000 gpd and greater,and General Use nitrogen reducing systems: gpd Parameters sampled:❑pH❑BOD❑CBOD ❑ TSS❑TN®Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection&during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing and j laboratory analysis. j i I LIMITATION OF LIABILITIES Notes and Comments: Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. laboratory industry. In the event of an error,the sale 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, j containers,sampling procedures,holding time and splitting of samples in the field. ' I tbaiom.doc•rev.04-11-13 Page 2 of 3 Page 13 of 15 Serial_No:09181716:55 _ Massachusetts Department of Environmental Protection Project Name: KEATING RESIDENCE Lab Number: L1732170 Bureau of Resource Protection-Title 5 Project Number: BEA09-10136 Report Date: 09/18/17 DEP Approved Inspection and O&M Form for Title 5 I/A Data QuafJRers Treatment and Disposal Systems projects,flag only applies to associated field samples that have detectable concentrations of the analyte at lrss than ten times(lox) the coneeamithm found in the blank.For DOD-mlated projects,Dag only applies to associated field samples that have detectable concentrations of the snalyte at less than ten tunes(lox)the concentration fond in the blank AND the analyze was detected above H. Certification one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related pmjects,flag only applies to associated field samples that have detectable concentrations of the=style above the I certify:I have inspected the sewage treatment and disposal system at the address above,have reporting limit.For NJ-related projects(excluding Air),flag only applies to associated field samples that have detectable conontmtinnsofthe analyze,which was detected above the reporting limit in the associated method blank or above five times the conducted the required Field Testing and/or sample collection in accordance with Standard Methods, reporting limit for common lab contaminants(Phoralates,Acetone,Methylem Chloride,2-Dut=one). have completed this report and the attached technology operation and maintenance checklist,and C -C—lution:Thetargetarelyteco-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)forco- ractod the information reported is true,accurate,and complete as of the time of the inspection. I am a analyses. Massachusetts certified operator in accordance with 257 CMR 2.00. D -Concentration ofaaalyte was quantified from diluted=alysis.Flag only applies to field samples that have delectable cencentratious of the analyze. C1 R -Coocneatin of=alyin exceeds the range fthe calibrnzien curve and/or linearr=ge ofdm instrument. -'25`t'l O -Thee entration may be biased high due to matrix interferences(i.e, o-Oution)withrem-target compound(s).The result should Operator Signature C� Date be considered estimated. H -The analysis cfpH was performed beyond the regulatory-required holding time of 15 minutes from the time ofsa rple collection. - I .The lower value for the two columns has been reported due to obvious interference. M RepmrngLimit(RQ exceeds the MCP CAM Reporting Limit f rthisanalyte. to them own boarder of health sfoll follows each i technology 0&M checklist,and any required sampling results to the local board of health as follows for each inspection performed: NJ -presumptive evidence ofcompound.This represents=estimated concentration for Tentatively Identified Compounds MCs),where the identdlcadon is based on a mass spectral library search. Remedial Use—by January 31 ss of each year for the previous calendar year P -The RPD between the results for the we columns exceeds the method-specified criteria. Q The quality control sample exceeds the associated acceptance criteria.For DOD-=Wcd projects,LCS and/or Continuing Calibration Piloting Use-within 45 days of inspection date Standard execcd=ces 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.) Provisional Use—by March 31lh of each year for the previous 12 months R -Analytical results are from sample re-analysis. RR Analytical results are fromsample re-extraction. General Use—by September 301h of each year for the previous 12 months s -Analytical results are from modified screening analysis. J Estimated value.This represents an estimated concentration for Tntaively Identified Compounds(TICS). Send to: ND Not detected at the reporting limit(RL)for the sample. Department of Environmental Protection Attention: Title 5 Program One Winter Street,511 Floor Boston,MA 02108 Report Format: Data Usability ReportHA ' C Page 12 Of 15 l5aiom.doc•rev.04-11-13 Page 3 of 3 Serial N o:09181716:55 Project Name: KEATING RESIDENCE Lab Number: L1732170 _. y�/��Tg=t W'— Project Number: BEA09-10136 Report Date: 09/18/17 l�%iN -_ — GLOSSARY Envil7%OTbmental Systems,Inc. Acronyms EDL -Estimated Detection Limit:This value represents die level to which target analyte concentrations are reported as estimated OMNI RSF Operation and Maintenance inspection Checklist values,when those target analyte concentrations arc quantified below the reporting limit(RL).The EDL includes any adjustments tram dilutions,concentrations or moisture content,where applicable.The use ofBDLs is specific to the analysis ofPAHs using Solid-Phase Microextraction(SPME). A. Installation&Service Information EPA Envimnmcatel Protection Agency. 1'- LCS -Laboratory Control Sample:A sample matrix,free from the snalytes of iotcrest,spiked with verified known amounts of rfl:f�n� analytw orematerial containing known andve�cd amounts ofeenlyms, f T Date of Service ,C {- LCSD -Laboratory Control Sample Duplicate:Refer to LCS, Fae011y Street Address t g r1 - LFB -Laboratory Fortified Blank:Asample matrix,free from the analytes ofinteresq spiked with verified known amounts of 4f5T00YIs C G 6/+ ,[.7-�1,C � (C,yJJV� analytworamaterialconminingknommdverifiedemounuofanalytes., city Operator/O&M Firm MDL -Method Detection Limit:This value represents ate level to which target analyte concentrations are reported as estimated 5 url n y L� values,when those target analyte concentrations am quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. System Startup Date Weather Conditions MS -Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount ofmatrix sample for - which an independent estimate of target analyte eoncentrstion is available, MSD -Matrix Spike Sample Duplicate Ref to MS. NA Not Applicable. B. Septic Tank NC -Not Calculated:Term is utilized when one or more ofthc results utilized in the calculation are non-detect at the pamareter's r r/ reporting unit. Sludge Pumping Required: Yes❑ No ❑Sludge Depth:/ Scum Depth: •2S NDPA/DPA -N-Nitrosodiphenylaminc/Diphenylamine. - Effluent tee filter: Yes❑ No If yes,Inspect❑&clean at least yearly El Ni Not Ignitable. NP -Non-Plastic:To=is utilized for the analysis ofAtterberg Limits in sail. p the sludge no layer Is within 12'ate of the outlet Invert,recommend that the homeowner have the septic tank RL -Reporting Limit:The value at which an instrument can accurately measure an analyte at a specific conceatartion.The RL pumped,note the approximate scum layer thickness ehauler,as well.Also,inquire If the homeowner has a pumping includes any adjustments from dilutions,concentrations or moisture contort,where applicable. schedule established with a licensed septage hauler,If not recommend a two to taus year pumping schedule depending on how heavily the system Is used. and RPD Relative PercentDiffereaee:The results from matrix miller matrix spike duplicates are primarily designed to assess the precision of ennlyticai results in a given matrix and ere expressed as rotative percent difference(RPD).Values which ere less earn five tunes the reporting limit for any individual parameter ere evaluated by utilizing the absolute difference between the C. Recirculation Tank values;although the RPD value will be provided in the report. y// s�ur� �w•� SRM -Standard Reference Material:A reference sample ofa known or certified value that is ofthe same or similar matrixes the r-� / associated field samples. heckifsludgeaceumulating Pumping required: Yes❑ No(_t-f STLP Semi-dynamic Tank Leaching Procedure per EPA Method1315. TIC -Tentatively Identified Compound:A compound that has been identified to be present and is not part of the target compound Odor problems: Yes❑ No o list(TCL)for the method and/or program.All TICS me qualitatively identified and reported as estimated conccntraums. If yes,dewdplton Effluent tee filter. Yes❑ No If yes,Inspect❑&clean at least yearly❑ Footnotes If the sludge layer Is greater than 4'request that the homeowner pump out the recirculation tank In order to 1 - .The reference,for this analyte should be considered modified since this analyte is absent from the target analyte list ofthe prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this original method. may Indicate that the filler bed may need servicing. Terms D. Equalization Tank(if Installed) Analytical Method:Both the document from which the method originates and the analytical mf mace method.(Example:EPA 8260E is I� shown as 1,8260B.)The codes for the reference method documents sre provided in the References section of the Addendum. �1n Sludge Pumping Required: Yes No ❑Slud Sludge the SCUM Depth: Final pH:As it pension to Sample Receipt&Container Information station of the report,Final PH reflects pH of container determined after 9 p ❑ p adjustment at the laboratory,if applicable.lfoo adjustrnort required,value reflects Initial pH. Effluent fee fifer: Yes❑ No❑ If yes,Inspect❑&clean at least yearly❑ Frozen Date/1'ime:With respect to Volatile Organics in soil,Frozen Date/rime reflects the date/limt at which associated Reagent Water- y Served vials were initially frozen.Note:Iffirezen date/time is beyond 48 hours from sample collection,valuewia be reflected in'bold'. Same Inspection criteria as septic tank; Initial pH:As it pertains to Sample Receipt&Container lntarmetion section ofthe report,Initial pH reflects pH of container determined upon receipt,if applicable. E. Pura Chamber/Vault If installed NS uwr Total:With respect to Organic analyses,aTotal'rrsult is defined az the summation ofresults for individual isomers or Atrocious.IfafotaP p ( ) sw� resultis requested thc resultsofits individual compocentswill alsobereported.This isappkicableto'Totnl'results for methods 8260,8081 � / and 8082. ❑Pump Inspections(all units) If problems,describe Data 4ua!!f/ers Float switches A -Spector identified as"Aldal Condensation Product". Check all sWltchea for operation B -The ennlyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that Make Sure the pump Is operational by pulling up the float switch;If the pump Is not operational Immediate have detectable comentmtims ofthe analyte a less than ten amen(lox)the concentration found in the blank.For MCP-related corrective actions need to be taken. Report Format Data Usability Report / - Fvi Page 11 of 15 Serial_No:09181716:55 Project Name: KEATING RESIDENCE Lab Number:L1732170 Project Number: BEA09-10136 Report Date; 09/18/17 Sample Receipt and Container Information Were project specific reporting limits specified? YES Cooler Information Cooler Custody Seal A Absent Container Information Initial Final Temp Frozen e ContainerlD Container Type Cooler pH pH deg Pres Seal Date/Time Analysis(*) L1732170-01A Plastic 250ml unpre ewsd A 7 7 5.0 Y Absent _ NO2-353(2),NO3-353(2) L1732170-01B Plastic 250ml H2804 preserved A <2 12 5.0 Y Absent TKN-4500(28) Page 10 of 15 *Values in parentheses indicate holding time in days 1cR, s� Y. C _ oQ c> G Cl) m�t = moo_" o G) o� n om m3-^sc cCO ❑ Q U ' c a .� m m m iu"rmo c C o '� mmae m n 9. = N G m O 3a m CO 117� _ (n acorn Q oZ O 3—m a•vn a n� 3 3 v v m o — ono a m U+� v...ms ❑ ❑ n a3m�m= .moo— { y mo m m n �S 3 r•rrD � m^3�' m � =B m,�T� m ❑'= co Vl m $ ^m N ❑ cmam q�°o•3m' Q o. SM 3 O _ �m ❑ p 3 a o m a � = � p N C� J mama O cmm��w m ❑ N a m o ] � vm m ❑ =mo==� aN � m to aywm4c m ❑ o O Z ro 0 0 p 0am c� omm Z rLo�L -U r6 a to j� o m C S m Et m 5 m m o O v�so m o maa_�� Q❑ o c m 3 0 m �m m n r v C GS' S QMN Envt>tonrnentrd!'SXstesns,Inc. ^ OMNI RSF Operation and Maintenance Inspection Checklist °° o I .a AL A v o A. Installation&Service Information z e ? ;W Facility Street Address t Date of Service E NvYI25 nniY1C -toi�a l,^l�. 4�Pr . z o city oper WO&M Flrm °1 J W U U U System Startup Date We Coq'tlone� IL o !o to K r2 B. Septic Tank s l e E Sludge Pumping Required: Yes❑ No ❑Sludge Depth: ❑Scum Depth: y E e E ,E Effluent tee filter. Yes❑ No >,— :in W .in If yes,Inspect❑&clean et least yearly❑ G i If the sludge layer Is vAlhin 12°of the outlet Invert,recommend that the homeowner have the se tle lank IU: U. 0 i P C c ° !a Sc7. Cf pumped,note the approximate scum layer thickness es well.Also,Inquire If the homeowner has a pumping o schedule established with a licensed seplage hauler,if not recommend a two to four year pumping schedule Q a m 'm:: iC; �`'�: depending on how heavily the system is used. C�1 C. Recirculation Tank t1d Check If sludge accumulating Pumping required: Yes❑ Nod' ( m Odor problems: Yes❑ No oyes,description p : w Effluent tee filter: Yes❑ No� If yes,inspect❑&clean at least yearly❑ I .m; m lU. I If the sludge layer Is greater than 4'request ihalthe homeowner pump out the recirculation tank in order to E ,,U: prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this y - may indlcate that the.filler bed may need servicing. oo .o D. Equalization Tank(if Installed) z ! N N m.. Sludge Pumping Required:Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: E. E E Effluent tee filter: Yes❑ No❑ If yes,Inspect❑&clean at least yearly❑ w m Same Inspection criteria as septic tank: z °,'. W Iy: iy. y': E. Pump Chamber/Vault(if Installed) v, a ��// �V Pump Inspections(all units) c9 0 ro / If problems,describe D3 Float switches Check all switches for operation Make Sure the pump Is operational by pulling up the float switch:Ifthe pump Is not operational Immediate corrective actions need to be taken. •• E E ;:Z z d l z _L: O •O .Q N iV.. :U-: :U � E i`m: a 'iu. :w: m a c7a I:(?:. :c7:: Serial'No:09181716:55 Matrix Spike Analysis Batch Quality Control Project Name: KEATING RESIDENCE Lab Number. C1732170- Project Number: BEA09-10136 Report Date: 09/18/17 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Quay Limits General Chemist . ry-:Westborough'Lab Associated sample(s);01 QC Batch ID:WG1040950-4 QC Sal Client ID: MS S.ample Nitrogen,Nitrate 0.94 4 5.0 - 1D2` - - 83-113 6 General Chemistry Westborough Lab Associated sample(s)i 01 QC Batch ID:WG1040951-4 QC Sample:1-1732045-01 Client ID: MS Sample Nitrogen,NiMte 0.12 4 3.8 92 80-120 20 General Chemistry-Westborough Lab Associated sample(s):01 QC Batch.ID:WG1040970-4 QC Sample:L1732033-63 Client ID- MS Sample Nitrogen,Total Keldahl 1.49 B 8.70 90 _ _ 77-111 - 24 Page 8 of 15 E a r � a N .0 9 2'F S m o�'s m-- �+ m m �, '< Ul a m en s— ❑"411 O_ fmv_ ❑ O o9cmm� vain 0 3 m m v v fn n.m (� `S r°m` = c. m o O 3',o m F. 3 Cn a m m O O O 3rsm syc o 3 a t my 3 v v >> m en a o o a m y„m ❑. ❑ CD a�v300 3 { N 3 _ - m3.�m~ 0) 3 =3mm,01m m m en C%f m o m y m �'m�3 .a-,.' r S ❑ m om8m3, � -am m3 = �.ao 0 0 2.m' a�m m \ CD — Q" gg o v a m>>m EJ `\ y U) mom m�acam 0 z Z41 ^'m 0 9m S �jT ❑ i9 m —m m vo m m _ =mN o� zEl o m-^m mca �- 3 0 q a•mm 6� o m me � Z 10 Q S Serial No:03071719:16 P, m o m N o � � J I N ZI J O a .0 e) ANALYTICAL REPORT. a I. E ❑ z o I m I " N.Lab Number: L1706700 L�+ E Client: Bennett Environmental Associates m 1573 Main Street Q Brewster,MA 02631 d o m CCU ATTN: David Bennett tam o. :No. Phone: (508)896-1706 O C r ❑ > Project Name: KEATING RESIDENCE ` ° to C m Project Number. BEA09-10136 U m Report Date: 03/07/17co I m • to > `E ;E 8 IX Z w q. 1 The original project report/data package is held by Alpha Analytical.This reportidate package is paginated and should be reproduced only In Its ❑ L�r <;o p entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. w Certifications&Approvals:MA(M-MA086),NH NELAP(2064),NJ NELAP(MA935),CT(PH-0574),IL(200077),ME(MA00086),MD(348).NY (11148),NC(25700/666),PA(68-03671),RI(LA000065),TX(1`104704476),VT(V7-0936),VA(460195),USDA(Permit NP330-14-00197). _ Z ro :o o` F o a o o uQ] :9 Eight Walkup Drive,Westborough,MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com ` m M:: E a E z z z s r ,... Z Page 1 of 15 a a m IL ;c7. 0:i c7:: a Serlal_No:09181716:55 Project Name: KEATING RESIDENCE Lab Number L1732170 Project Number: BEA09-10136 Report Date: 09/18/17 Method Blank Analysis Batch Quality Control ai \_r- O Dilution Date Date Analytical zl Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst m " ai `m ,a General Chemistry-Westborough Lab for sample(s): 01 Batch: WG1040950-1 W E 13 m o Nitrogen,Nitrate _ No .m911 0.10 - 1 09/12/17 23:41 44,353.2 MR ; a 0 General Chemistry-Westborough Lab for sample(s): 01 Batch: WG1040951-1 Nitrogen,Nitrite ND mgll 0.050 - 1 - 0911211723:44 44,353.2 MR General Chemistry-Westborough Lab for sarrlple(s): 01 Batch: WG1040970-1 Nitrogen,Total Kleldahl ND rrg/I 0.300 - 1 09/1311700:15 09/15/1719:47 121,4500NH3-H AT 1n J J_ Z Z C Q N O F- E9 U]J x W c t- W U Z W 0 W O 0 Q� Q� Z W W �_ W Ld Y m LL U W .. d m a E E M z' o ,� g d O O m a m N E rn Page 6of15 ay -1 a J Serial No:03071719:16 Serial No:09181716:55 Project Name: KEATING RESIDENCE Lab Number: L1706700 Project Name: KEATING RESIDENCE Lab Number: L1732170 Project Number: BEA09A0136 Report Date: 03/07/17 Project Number: BEA09-10136 Report Date: 09/18/17 Case Narrative SAMPLE RESULTS The samples were received In accordance with the Chain of Custody and no significant deviations were encountered during the preparation Lab ID: L1732170-01 Date Collected: 09/11/17 10:15 or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of custody are located at the back of the report. Client ID: EFFLUENT Date Received: 09/12/17 Sample Location: MARSTONS MILLS,MA Field Prep: Not Specified Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet NELAP requirements for all Matrix: Water NELAP accredited parameters unless otherwise noted In the following narrative.The date 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 Dilution Date Date Analytical for each Individual sample,followed by the Laboratory Batch Quality Control at tho and of each parameter.TentatIvely Identified Compounds Parameter Result Qualifier Unite RL MDL Factor Prepared Analyzed Method Analyst (TICS),If requested,are reported for compounds Identified to be present and are not part of the method/program Target Compound List, even if only a subset of the TCL are being reported.If a sample was re-analyzed or re-extracted due to a required quality control corrective General Chemistry Westborough Lab 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", Nitrogen,Nitrite 0.17 mgA 0.050 — 1 - 09/13/17 00:20 44,353.2 MR respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element Nitrogen.Nitrate 8.5 mgA 0.50 — 5 - (19/13/17 02:26 44,353.2 MR are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific k recovery or RPD value that is outside Nitrogen,Total Kjeldahi 2.30 mgA 0,300 — 1 09/13M7 00:15 09/15/17 20:06 121,4500NH3-H AT 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 (RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some I U 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 formal 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. Authorized Signature: al� Kelly Stenstrdni icli HA Title: Technical Director/Representative Date: 03/07/17 Page 3 of 15 " ti a' Page 5 of 15 Serial_No:09161716:55 Serial_No:03071719:16 INORGANICS INORGANICS MISCELLANEOUS MISCELLANEOUS Page 4 of 15 Page 4 of 15 Serial_No:03071719:16 Serial_No:09181716:55 Project Name: KEATING RESIDENCE Lab Number: L1706700 Project Name: KEATING RESIDENCE Lab Number: L1732170. Project Number: BEA09-10136 Report Date: 03/07/17 Project Number: BEA09-10136 Report Date: 09/18/17 SAMPLE RESULTS Case Narrative Lab ID: L1706700-01 Date Collected: 03/02/17 10:45 Client ID: EFFLUENT Date Received: 03/03117 The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation Sample Location: MARSTONS MILLS,MA Field Prep: Not Specified or analysis unless otherwise noted.Sample Recelpt,Container Information,and the Chain of Custody are located at the back of the report, Matrix: Water Results contained within This report relate only to the samples submitted under this Alpha Lab Number and meet NELAP requirements for all I NELAP accredited parameters unless otherwise noted in the following narrative:The data presented In this report Is organized by parameter Dllutlan Date Data Analytical Factor Prepared Anal y (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 Parameter Result Qualifier Units RL MDL p Analyzed Method Analyst for each Individual sample,followed by the Laboratory Batch Quality Control at the end of each parameter.Tentatively Identified Compounds ,General Cheinlstry-WestborOUgh Lab (TIC,),If requested,are reported for compounds identlfled to be present end are not part of the method/program Target Compound List, Nitrogen,Nitrite 0.33 ri 0.050 -- 1 03/03/17 22 00 44,353.2 MR even if only a subset ofthe TCL are being reported.Its sample was re-analyzed or re-extracted due to a required quality control corrective Nitrogen,Nitrate 18. m/I . 0.50 - 5 - 03103/17 23:10 44,353.2 MR action and if both sets of data are reported,the Laboratory ID of the m-analysis or re-extraction is designated with an"R"or"RE"; '-'---'-- --- -----9-- ------- ------ ------------- respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element Nitrogen,Total Kjeldahl 1.72 mg/I 1.50 -- 5 03/107:15 03/06/1715:09 121,4500NH3-H JO y _— 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 assoclated usablllty impilcations.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. i i In reference to questions H(CAM)or (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 spachic 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 j from the date the project is completed.After 21 calendar days,we will dispose of ail 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. i Please contact Client Services at 600-624-9220 with any questions. • i i I I I. I I I I 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. I Amite-Naik Authorized Signature: %r1i. t;a Title: Technical Director/Representative Date: 09/18/17 Page 5 of 15 Page 3 of 15 1. Serial No:09181716:55 Project Name: KEATING RESIDENCE Lab Number: L173217D Project Number: BEA09-10136 Report Date: 09/18/17 Alpha Sample Collection Sample ID Client ID Matra Location Date/Time Receive Date L1732170-01 EFFLUENT WATER MARSTONS MILLS,MA 09/11/17 10:15 09/12/17 Page 2 of 15 1 /cTC.Fa m m. ao:m m � S '❑ m m 0 y: C N Er C y o: o.- �:o: m mm z :o z ;o; z >o' D D "c or U. A w ;0 m m u: Ei m o. m d; z 3 "3 .;3;: O v: ,a_ C m C �S ;U S Q Q D N 'N a 03 W O O N 'm O a A Cr v D o a � c O cr y m a� D Z m o e o r_ o J rp6 . i3 9zz y r o 0 ;y z . a y o x 1 i w Serial No:03071719:16 Lab Control Sample Analysis Project Name: KEATING RESIDENCE Batch Quality Control 1 Lab Number: L1706700 Project Number: BEA09-10136 Report Date: 03/07/17 LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General Chemistry Westborough Lab Associated sample(s)'0� BatchW 982825'2 „ ;::; N@mgen,Nitrate ':`;98�_- - 90-110 General Chemisf y Westborough Lab Associated samples),'01 Batch:VJG98282&2 NHmgen,Nitrite :.d06 - 90-110 - 20 .. .._ _-.. .. ,. General Chemistry Westborough Lab'AgsoGated'sBmple(s) 01 Batch.>WG98287542 Nitrogen,Total Keidahl '.T."92T .' - 78-122 - Page 7 of 15 'LFiA m Cn m ;Z o D S t• N N> -.1 or sa m Da m o 0 m> o o' m Z z - w c azi o D Om O oD oD N T 0' - A m N o X m' CO m o m rn �° D o m yZ a m D D w < £ w D >z m m z W m ^ m 'o rn m �o iv > 5F w ;o v 'm Co '< n In w D m S w 'aIn w m IT z o 0 m ° B �v H � �= o g . D� g.w ai pv m N No _d 0 m fn 9 O m mm _ �� m a m Iz wo a o 0 0 o ro 60 o vz � Serial No:03071719:16 CHAIN OF CUSTODY PAGE 6.Reed is Lab: ' toF'1 _ � � -'ALPHA Jotr;#:' ' HA - l]FAX ®ENWL ®sameas CGenti ro: '10136 . wa:m rough MA ri.;i:nad,MA' 77 project Name:Keating Residence TEL sosaesa2m Ta-eosausi6p 0 aDFx :Q�Heel OeiWerablea. FAX 5DB8999193. FAx:5pe832 88. .. .., .. .. • Piojecttocatim:-Marston M_iS,.MA stefvFed:Pm - ClentBerinett EnVUbnMental Assodiates: AddrL,s:i5-73Ma7i6 SGeet1P.o;sdx:l.743 Proect.Manager DaA'd.0.Bennett :Brewster,-MA 02531 AIPH.A:4Uote$, -- ... ... .._. • - Phbhe:;50:8.096=170E - '. .. ..... .. .. ;. . ANALYSIS Fax:;508-896-5109 M Standard '[3 RUSh P 1&Y)F PREa PRo E14 :snr.7PrF Hauor.wG - Emailrstaerenkopf@tiennett-ea:com. f1%benan [] -mmpran"s—PreHwzN enepaad nyao8c., Dde,Dele: Time: OtherProect.5 q - `.. D—fad. .j per�cRe irirements{Commentsf.Deteetion.limits:J - . Pmseivedort b6a,.)escenN - - - befaw- ACPHA._hab ID SamplelD - Covectim Semple ..SamplePs, Z'. (Lab.Uss only) - W6 : Tene M.M. ifefials: - ea.mmb oa ❑ ❑ ooa ❑ o ❑ .o EI ❑1❑ .- Li a ❑ U. ME] ❑: a ❑: -❑ ❑ ❑ o o ❑ ❑ oETa ❑ ❑ o _ 1. z -L Cpntalner Type P P _ - Prese T,7-- 0, .. ° ?lease Pdd d�N.kamy. .. - -.e d.'bt'eN.:Bemplas,an ed tie.lvpgad In ReGnAe�ned6r oeTude RectiVaitay; oateTjna nmmedcdemasmekwmare R -f dd.aleuo6p�n nme VL ZkphaSFW...T.�.; 1 w . Page 15 of 15 Serial No:03071719:16 Matrix Spike Analysis Project Name: KEATING RESIDENCE Batch Quality Control Lab Number: L1706700 Project Number: BEA09-10136 Report Date: 03/07/17 Native MS MS MS MSD MSD Recovery RPD Parameter Sample Added Found %Recovery Qual Found %Recove Qual Limits RPD Qual Limits __... Geneal Chemistry-Westborough Lab Associated samples),01 QC Batch ID WG98282 4 ''QC Sample:L1706726-01 Client;ID,:MS Sarnple Nitrogen,Nitrate 7.0 4 11 �`700 - - 83-113 - 6 General Chemistry Westborough Lab Assoaated sample(s);01 QC Batch ID WG982826 4':'`QC Sample:L1706726-01 'Client ID.MSSample Nitrogen,Nitrite 0.37 4 4.4 <:101 - 8D120 20 General Chemistry Westborough Lab Associated samples) 41 QC Batch ID WG982875 4 QC Sample'L1706418-01 ClienT ID: MS Sample Nitrogen,Total Keldahl 8 28.295- - - 77 111 24 Page 8 of 15 j 1;A Serial No:03071719:16 Lab Duplicate Analysis Project Name: KEATING RESIDENCE Batch Quality Control Lab Number: L1706700 Project Number: BEA09-10136 Report Date: 03/07/17 Parameter Native sample Duplicate Sample Units RPD Qual RPD Limits General Chemist y,;Westborough Lab As so latedsarnple(s) 017 QC Batch ID WG9828253 :'QC Sarnples L1706726-04 ClieOt ID DUPSample Nitrogen,Nitrate 7.0 ... 70 mg/I .. 6 General:Chemistry-,Westborough Lab Assoaated sainale(s):01`: QC Batch ID WG982826-3 :QC Sample- L-T 6726-01 Cllent1l) DUP:Sample Nitrogen,Nitrite 0.37 0.37 mg/I 20 General_Chemist y Westbordugh Lab Assoaated samples) 01 QC Batch ID WG982876 3:.:QC Sample: L17064`18-D1 Chen't:ID DUP Sample ----.... _ . ........ ........... -- ---- .-.....---'- - - -- - - — -- Nitrogen,TotalKeldahl 20.6 22.4 mg/I 24 Page 9 of 15ti� v N 0 o wmmmz m 0 g gmmfnmw8w2 gmwm0 :E -+ mq+m mm wg wwwmmmmmmlmm:� -r 10-n A u>DD� DS -C Do DDugi+ate ^yr3oD5 0 °�DDD z'a ogiauDDDDDDm D Dw O C A Not cX m aNc cm�mot Q.�y'w;. a ^-imwu� +oommm w m•- G maw _s _ u o 8 m+ o, orp n ..`mAWDSv oNmorCOmm�m no otmii+Qo o.Ni�mA� W to _ m•yQ y 0w-s<- 3- a m- ro _T:. mon z E 3 D ro DDm m��4' m <c aw�m� mw•'m ysurDD•• O�ZDm... O�Qf?3s 3 Ze C17 o ..0-o o a n •5 a z^ �• w m z �n li_I,<�,�.. I� 001 m, = m0miim -9� mao�� -^ mo rzvw= I vv vr+� -n n``3 .-I I� .,� o3-nl I ��m� �mn m mJ0'o y H n m a m`2 o o`e m O a Na�- r)wo' �m oz o a�'{nn3 o_m='_ = o m m w O mm m°'Rm wpm mmwo �.gom nQm-o wwm3AA o� D f _ Om- o m mop w 3 3 nn �Znmu 2rN� apum - Vo t- (2, 0,�'t! -^-im m C N Cry R'o-n0V - D'o-I 'Do qm' .�°. < w m ? `ar rwo Ni�ow c wm''� -� H. �,2 _ o� D-DDDC mno. . 23 3 c� m yma o.3 mmw 'Dxwm n to p � co m mocl�-oo DDrgu E. 3 NNo 0 0 N n r_&x�- mwn �a0. i�o o, m a °c 3 cn ax mZ3 m0E' ^oA o A DQ a maog DdN omoZ sN� - - 3 BAN m =Zm z>x� N w _ n w Nm3 bwmZ m 'm3w m SDI y'� z ii �m w nr a,mo m m � v u'ro .No 20 v w n Z m ..m 3 0'rD- u m -'z, w g S u v I� 'w' d o A-' o z w -T. n nx°1 Zwm OO w v m O m G o m n mnx mA3 n g -°, s 3 4 7 bp 0 C) a D m m m _ m D n mD - -fin w$o o - - z Er i, a mm ? g d 3 m O u Z 3 O - 3 0 0 v- fe m _ z _ < 'mZ Z 5^ O A N 'm9 S m Z. Z D o 3m p O A S Z m m O om w m� in 'o a N x O OD a - f� rn N m i1 st 1 m w.. stm w 3D 5 m I X w3 3 Z 333 A O O c) 3 inv Z z $ ,z o CD - >a n D W o m z rn m D T.,OD _ N O V oy?m Serial No:03071719:16 Serial No:03071719:16 Project Name: KEATING RESIDENCE Lab Number: L1706700 Project Name: KEATING RESIDENCE Lab Number: L1706700 Project Number: BEA09-10136 Report Date: 03/07/17 Project Number: BEA09-10136 Report Date: 03/07/17 Sample Receipt and Container Information REFERENCES Were project specific reporting limits specified? YES 44 Methods for the Determination of Inorganic Substances in Environmental Samples, EPA/600/R-93/100,August 1993. Cooler Information Custody Seal Cooler 121 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA-WEF. A Absent Standard Methods Online. Container Information Tamp Container ID Container Type Cooler pH deg C Pres Seal Analysis(`) L170fi700-01A Plastic 250ml unpresewed A 7 6.0 Y Absent NO2-353(2),NO3-353(2) L1706700-018 Plastic 250ml H2SO4 preserved A 12 6.0 Y Absent TKN-4500(28) 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. IiA 'Values in parentheses indicate holding time in days Y t A Page 13 of 15 Page 10 of 15 Serial No:03071719;16 Serial_No:03071719:16 Project Name: KEATING RESIDENCE Lab Number: L1706700 Project Name: KEATING RESIDENCE Lab Number: L1706700 Project Number: BEA09-10136 Report Date: 03/07/17 Project Number: BEA09-10136 Report Date: 03/07/17 GLOSSARY Data Quallffers Acronyms reporting limit for common lab contaminants(Phthalates,Acetone,Methylene Chloride,2-Butanone). BDL -Estimated Detection Limit:This value represents the level to which target analyte concentrations am reported as estimated C -Co-elution:The target acolyte coclmes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted values,when those target analyte emarentmtioco are quantified below the reporting limit(RL).The EDL includes any, analyses. adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis I) .Concentration of mmlyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations ofPAH.using Solid-Phase Micmextmetion(SPME). of the analyte. EPA -Environmental Protection Agency. E -Concentration ofmalyte exceeds the range of the calibration curve and/or liner range ofthe instrument. LCS -Laboratory Control Sample:A sample matrix,free from the analyses of interest,spiked with verified known amounts of G The concentration may be biased high due to matrix interferences(he,co-elution)with non-target comp rand(s).The result should ,,styles or a material containing known and verified amounts ofanalytes. be considered estimated. LCSD -Laboratory Control Sample Duplicate:Refer to LCS. H -The analysis ofpH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. LED -Laboratory Fortified Blank:A sample matrix,free from the snalytes of interest,spiked with verified known amounts of I The lower value for the two columns has been reported due to obvious interference. madytes or a material containing known and verified amounts of acolytes. M -Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte. MDL Method Detection Limit:This value represents the level to which target snulyle concentrations are reported as estimated NJ -Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where values,when those target analyte eoneentimlons em quantified below the reporting limit(RL).The MDL includes soy the identification is based on a mass spectral library search. adjustments from dilutions,concentrimarts or moisture content,where applicable. P The RPD between thee onits for the burn columns exceeds the method-specified criteria. MS -Matrix Spike Sample:A sample prepared by adding a known mass of target snaky[,to a specified amount of matrix sample for which an independent estimate of target.malyte concentration is available. Q -The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration MSD -Matrix Spike Sample Duplicate:Roger to MS. Standard excel dences are also qualified on all associated sarmple results.Note:This flag is not applicable for matrix spike recoveries NA -Not Applicable, when the sample concentration is greater than 4x the spire added or for batch duplicate RPD when the sample concentrations are less than 5x the RL.(Metals only.) NC -Not Calculated:Term is utilized when one or more of the results utilized in the calculation are non-detest at the parametcr s R -Analytical results are from sample re-analysis. reportingunit. RE -Analytical results are from sample re-extraction. NDPA/DPA -N-Nitrmodiphenylamine/Dipbenylamim. S -Analytical results are from modified screening analysis. NI -Not Ignitable. ' NP -Non-Plastic:Term is utilized for the analysis ofAtterberg Limits in soil. .J -Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICS). RL -Reporting Limit:The value at which an instrument can eccummly measure an analyte at a specific concenhaOon.The RL ND Not detected at the reporting limit(RL)for the sample. includes any adjustments from dilutions,concentrations or moisture content,whom applicable. RFD -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 RFD 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 sawriated field samples. STLP -Semi-dynamic Tank Leaching Procedureper EPA Method 1315. TIC -Tentatively Identified Compound:A compound that has been identified to be present and is not pan of the target compound list(TCL)for the method and/or program.All TICS are qualitatively identified and reported as estimated concentrations. ' Footnotes ' 1 -The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the migi-I mathmd. Terms �K Total:With respect to Organic analyses,.'Total'resmh is defined as the summation ofreaults for individual isomers or Aroclms.If a'Totar reach is requested,the results of its individual components will also be reported.This is applicable to'Totai'results for methods 8260,8081 and 8082. Analytical Method:Both the document from which the method originates and the malytical 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. ay - Data Quall/fers A -Spectra identified as"Aldal 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-J tad projects,flag only applies to associated field samples that have detcclablc concentrations of the analyte at less than ten times(1 Ox) the concentration found in the blank ForDOD-related project.,flag only applies to associated field samples that have detectable concentrations of the analyte at less than tea 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 camciated 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.ForNLrelated 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 Report Format: Data Usablllty Report Report Formal: Data Usability Report LPL HA �L�L Hrl Page 11 of 15 Page 12 of 15 Town of Barnstable Barnstable F THE 1p� �.i iiii ~� Board of Health 1` cacft V 200 Main Street, Hyannis MA 02601 111 039 10 2007 prfD MA'S� Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Carolyn Keating October 15, 2014 P.O. Box 1492 Marstons Mills, MA 02648 RE: Correction to Sampling of Wastewater Effluent from your In (OMNI) System at: 195 Route 149 #I, Marstons Mills A= 078-018-40I Herring Run Place Condo Dear Carolyn Keating, 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, #I, to twice a year. The following requirements are an update from the January 28, 2009 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:\IA systems\195 Rt149\Final correction unit#12014.doc 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 BEA09-10136 Attention:Title 5 Program I Winter Street-6th Floor Boston,MA 02108 REGARDING: Keating Residence 195 Herring Run Place Unit I[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑X Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(March and September 2014) 1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(March and September 2014) f r> —4 . For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: REMARKS: Please find enclosed the DEP Inspection and O&M Forms and OMNI RSF Operation and Maintenance Inspection Checklists for operai i and maintenance conducted during the reporting period for the above referenced property. The Barnstable Board of lealth approved a � reduction in inspection frequency from quarterly to semi-annual in 2013. During regularly schedule O&M in September 2014,it has 63 identified that the dosing and recirculation pumps required replacement. The pumps have been replaced and the completion of regglar O&M including effluent sampling is scheduled for early October. It is noted that inspection ports or cleanouts for theipressure do&ed 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. a cc:Barnstable Board of Health Ms.Carolyn Keating,Owner David C.Bennett,Principal [Internal] FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529 If enclosures are not as noted,kindly notify us at once Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip key. Mailing address of owner, if different: P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12102 9/12/02 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 j 10" Sludge , 1" 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 DEP Approved Inspection and ®&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 8.0 mg/L Turbidity 0.18 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 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. ' q')rt-I 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 301h of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 1 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return City Zip key. Mailing address of owner, if different: P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 9/15/14 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 ,l 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: M no ❑ some pH 6 to 9 SU DO 2 or greatermg/L Turbidity NTU 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: Attempt to conduct an operation and maintenance event. Identify that the dosing and recirculation pumps have failed and no alarm was triggered because the main circuit breaker tripped. The system owner approved replacement of the pumps which was conducted on 9/16/14. Notes and Comments: Completion of the semi-annual operation and maintenance event including effluent sampling is scheduled for early October 2014. 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. ';��a CX�t A Z�'6 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 t5aiom.doc•rev. 11-07-05 Page 3 of 3 A �l OMNUOr OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information I'k-5-d� A Facility Street Address Dat6 of Service City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank �I 1� Sludge Pumping Required: Yes El No Sludge Depth: V Scum Depth: Effluent tee filter: Yes❑ Nol, 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 Check if sludge accumulating Pumping required: Yes❑ No❑ Odor problems: Yes❑ WIN If yes,description Effluent tee filter: Yes❑ No7A1 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 1 Vault (if Installed) Pump Inspections(all units). If problems,describe Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problems,describe Test pump alternator, or record hours Hours of operation Float switches_ Check all switches for operation West 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") �t4 Inspect for ponding Ponding Present: Yes❑ Now `L,Clean bed: Yes❑ NoW Distribution pipes Flush:Yes❑ No4• Brush: Yes❑ Noll. q&Any obstruction of airflow to filter modules: Yes$9- 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❑ No�4. If yes: ❑BOD ❑TSS ❑pH E]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: I w a� i a -envirownentnt Systems, Ins: OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information I Facility Street Address Dale of Se 'ce City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank Sludge Pumping Required: Yes❑ Nc ❑Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yes No El yes, inspect &clean at least yearly El 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❑ Nd Odor problems: Yes❑ N1 If yes,description Effluent tee filter: Yes❑ Nb 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,descr't .Float switches z' € 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 treed to be taken. i F. Pumps, Switches, Floats,Alarm System Pump Inspections(all units) If problems,describe Test pump alternator,or record hours Hours of operation `d] Float switches v\ Check all switches for operation Test alarm If non-functioning,corrective action(s) i 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") j ',Inspect for ponding Ponding Present:Yes❑ Nd Clean bed: Yes❑ NdA j Distribution pipes Flush:Yes❑ NQ� Brush: Yes❑ N+ ] ❑Any obstruction of airflow to filter modules: Yes❑ Nolf 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 10 �uOA If yes: ❑BOD ❑TSS ❑pH �'$TN {MOther ; , PO Nj 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: { t j McKean, Thomas From: Carolyn Keating [cckeating@comcast.net] Sent: Thursday, September 26, 2013 11:41 AM To: Health Subject: Request Permission for Test.Frequency Reduction ATT: WAYNE MILLER, MD, CHAIRMAN, BOARD OF HEALTH MR. TOM MCKEAN Dear Dr. Miller: I am requesting permission to reduce the FREQUENCY OF TESTING of my septic system, located at 195-I HERRING RUN PLACE. 195-I Route 149, MARSTONS MILLS, Massachusetts. I believe you and Mr. Tom McKean are familiar with this system, as there are nine homes in all in this complex. We are currently. being tested by Bennett Environmental Services, who have served us carefully and well for a number of years. Presently we are tested four (4) times a year, and would like to have this number reduced. May I please be placed on your agenda for October 8? Thank you very much for your help. Sincerely,. Carolyn C. Keating 508 420-3768 P. O. Box 1492 Marstons Mills MA 02648 - i C Y CarmodyTM Service History Page 1 of 2 carmodyTM Environmental Management Services rkdy BARNSTABLE County, Massachusetts—Thomas McKean 9/30/2013 Main Menu Service History Home Log Out How To:All Tutorials ;Print Service History) Apply for Passwords Support Phone/Fax Report Tech Problem Property Information Change/Request Form Change Password Property ID BAR49195RSF-1 (Tracking Number) Carmody Training Links Map Register Event File a Service Event Name Keating, Carolyn How To:File Event Site Address 195-1 Route 149 Data Resources Marstons Mills, MA Search for a Property Service Activity Create a Report Service Statistics Create an Excel File Statistics Report Total Service Events (To Date) 51 Split Parcels Setup Review Questions - Send Payment ❑ View Onsite Service History: 1 2 3 All Years r Include Inactive Show All Reports Service History - 1 Year Date Report Type Entered Gallons Recorded By or Comments Date Pumped Disposal Site Serviced 9/17/2013 0 Bennett Sampling a v+ 1:13 PM Environmental Report Prm4; ?R 9/11/2013 Associates, Inc. 9:00 AM ------ Using: The Web Site 9/17/2013 0 Bennett "Inspection" Conducted general t _lfiew'.w 1:12 PM Environmental O&M along with N -- Print`:- 9/11/2013 Associates, Inc. effluent quality.field 9:00 AM ------ testing and Using: The Web collected effluent Site samples for lab analysis 6/7/2013 0 Bennett "Inspection'" Conducted O&M 1:22 PM Environmental along with effluent k>"'Print: 6/5/2013 Associates, Inc. quality field 9:00 AM ------ testing. Using: The Web Site 3/7/2013 0 Bennett "Inspection" System is operating =_ View.' 9:34 AM Environmental correctly. Effluent FNP Rfifif-`�5-� 3/6/2013 Associates, Inc. quality passed Feld 9:00 AM ------ testing parameters. Using: The Web Observed system Site cycle while on Site. 1/2/2013 System No service No service event 12:00 AM Generated recorded reported within l ttp://carmody.biz/pump/Service_History.aspx?permit_id=254242&cidd=6351612295963... 9/30/2013 CarmodyTM Service History Page 2 of 2 c� 1/2/2013 service schedule: 12:00 AM 09/05/2012 to 01101/2013. Notes: No service event was recorded by the system for this component: Sample Report(Effluent) 1/2/2013 0 Bennett "Inspection" System is operating ta�wv _. •_ 2:11 PM Environmental correctly. Effluent Print 12/27/2012 Associates, Inc. quality pass field 9:15 PM ------ testing parameters. Using: The Web Site Total Gallons Pumped=0 This is a privately operated web site. Sponsorship does not constitute an endorsement from any participating regulatory agency. Copyright©2013 Carmody®.All rights reserved. Legal I Privacy http://carmody.biz/pump/Service_History.aspx?permit_id=254242&cidd=63 51612295 963... 9/30/2013 CarmodyTM Service History Page 1 of 3 i carmodyTM Environmental Management Services ot#y, BARNSTABLE County, Massachusetts —Thomas McKean 9/30/2013 Main Menu Service History Home Log Out _ How To:All Tutorials. ,Print Service History, Apply for Passwords Support Phone/Fax Report Tech Problem Property Information Change/Request Form Change Password Property ID BAR49195RSF-I (Tracking Numberl Carmod Trainin Links Map Register Event File a Service Event Name Keating, Carolyn How To:File Event Site Address 195-1 Route 149 Data Resources Marstons Mills, MA Search for a Property Service Activity Create a Report Service Statistics Create an Excel File Statistics Report Total Service Events (To Date) 51 Split Parcels Setup y !Review Questions Send Payment History: ❑ View Onsite Service 1 2 3 All Years Cl Include Inactive Show All Reports �F:.:. i Service History -2 Years Date Report Type Entered Gallons Recorded By or Comments Date Pumped Disposal Serviced Site 9/17/2013 0 Bennett Sampling .= 1:13 PM Environmental Report Prin4;fi 9/11/2013 Associates, Inc. 9:00 AM ------ Using: The Web Site 9/17/2013 0 Bennett "*Inspection" Conducted general � lfiew°,� •; 1:12 PM Environmental O&M along with Print Y __ 9/11/2013 Associates, Inc. effluent quality field 9:00 AM ----- testing and Using:The Web collected effluent Site samples for lab analysis 6/7/2013 0 Bennett —Inspection*" Conducted O&M ', lfiew 1:22 PM Environmental along with effluent 6/5/2013 Associates, Inc. quality field testing. 9:00 AM ------ Using:The Web Site 3/7/2013 0 Bennett **Inspection** System is operating *N Miew< 9:34 AM Environmental correctly. Effluent 3/6/2013 Associates, Inc. quality passed field 9:00 AM ------ testing parameters. Using: The Web Observed system r Site cycle while on Site. 1/2/2013 System No service No service event 12:00 AM Generated recorded. reported within http://carmody.biz/pump/Service_History.aspx?permit_id=254242 9/30/2013 CarmodyTM Service History Page 2 of 3 1/2/2013 service schedule: 12:00 AM 09/05/2012 to 01/01/2013. Notes: No service event was recorded by the system for this component: Sample Report(Effluent) 1/2/2013 0 Bennett '"Inspection" System is operating a�� 2:11 PM Environmental correctly. Effluent Pant 12/27/2012 Associates, Inc. quality pass field 9:15 PM ------ testing parameters. Using:The Web Site 9/14/2012 0 Bennett —Inspection" Conducted general Mx_t View 1:44 PM Environmental O&M along with Pant. 9/5/2012 Associates, Inc. effluent quality field 9:30 AM ------ testing and pulled Using: The Web effluent samples for Site lab analysis. 9/14/2012 0 Bennett Sampling ► ti = 1:41 PM Environmental Report Pant 9/5/2012 Associates, Inc. 9:30 AM ------ Using: The Web Site 6/11/2012 0 Bennett 'Inspection*" Conducted O&M Viewr66 11:38 AM Environmental visit along with Pant av }- 6/7/2012 Associates, Inc. effluent quality field 3:25 PM ------ testing. Using: The Web Site 3/20/2012 0 Bennett "Inspection'* Conducted general -= View 4 =u 1:14 PM Environmental O&M, effluent 3/12/2012 Associates, Inc. quality field testing, 11:00 AM ------ and replaced top Using: The Web polylok riser Site sections on septic tank and on recirculation tank. 1/2/2012 System No service No service event 12:00 AM Generated recorded reported within 1/2/2012 service schedule: 12:00 AM 09/14/2011 to 01/01/2012. Notes: No service event was recorded by the system for this component: Sample Report(Effluent) 12/30/2011 0 Bennett "Inspection" Conducted general 1:21 PM Environmental O&M visit.Effluent f_ Pant:_:; %�- 12/21/2011 Associates, Inc. quality passed field 9:45 AM ------ testing parameters. Using: The Web Site Total Gallons Pumped=0 http://carmody.biz/pump/Service—History.aspx?pennit—id=254242 9/30/2013 CarmodyTM Service History Page 1 of 2 carmodyTM Environmental Management Services ody BARNSTABLE County, Massachusetts-•Thomas McKean -•9/30/2013 Main Menu Sampling Report Home Question Color Key: (Sample)=Required Question Log Out How To:All Tutorials Tracking Number: BAR49195RSF-I . Apply for Passwords Name: Carolyn Keating Support Phone/Fax Report Tech Problem Site Address: 195-I Route 149 Change/Request Form Marstons Mills,MA Changesword Mail Address: 195-1 Route 149 Carmody Training Marstons Mills, MA Register Event Assigned Provider: Bennett Environmental Associates, Inc. File a Service Event From Property Profile How To:File Event Management Level: General with Nitrogen Requirements Data Resources Search fora Property Selected Service Provider ID: 12580 Service Activi Selected Service Provider: Bennett Environmental Associates, Inc. Create a Report Create an Excel File Report Filed By: David C Bennett Statistics Report Split Parcels Components that were sampled: Setup 1: RSF Review Questions Send Payment Last Report Dates Lid Depth Inspection: 9/11/2013 Septic Tank: Maintenance: None Filed Lift Tank/Siphon Chamber: Pump: None Filed Aeration Unit: Date&Time Serviced: 9 -/ 2013- @ 9F 00_ __ AM _ Month /Day /Year Notes/Comments/Message None Recorded or Other Observations: (Viewable by Regulators and Service Providers ONLY!) Laboratory Alpha Analytical s. ; Sampling Report Sampler Name Joseph Smith Data Quality 1990 Sample Type I�-gr-ab Effluent (Leave item blank if not tested) BOD5 Amount(mg/L) Nitrate Amount(mg/L) 6.6 Nitrite Amount(mg/L) 0.22 pH Amount(mg/L) TKN Amount(mg/L) 2,33 Total Nitrogen (mg/L). 9 15 TSS Amount(mg/L) This report only describes the conditions at the time of service and under the conditions of use at that time.This report does not address how the system will perform in the future under the same or different conditions of use.Carmody,Compass and Septic Search are independent business entities and are not associated with business practices or liabilities assumed by the inspection,inspectors and or their business entities. —This is a copy of an electronic document generated from Carmody. ©Copyright 2013 CDS Holding,Inc.All tights reserved. http://carmody.biz/Pump/Service_Reports.aspx?ha=1&hi=1&id=1075540&permit_id=254... 9/30/2013 CarmodyTM Service History Page 1 of 2 f Carmody TM Environmental Management Services ody, BARNSTABLE County, Massachusetts-Thomas McKean~9/30/2013 Main Menu Sampling Report Home Question Color Key: (Sample)=Required Question Log Out How To:All Tutorials Tracking Number: BAR49195RSF-I Apply for Passwords . Name: Carolyn Keating ISl uphone/Fax ;Report Tech Problem Site Address: 195-1 Route 149 'Chan eiRequest Form Marstons Mills, MA 1Change Password Mail Address: 195-1 Route 149 Carmocl Trainin Marstons Mills, MA Register Event Assigned Provider: Bennett Environmental Associates, Inc. File a Service Event From Property Profile How To:File Event Management Level: General with Nitrogen Requirements Data Resources Search for a Property Selected Service Provider ID: 12580 [service Activity Selected Service Provider: Bennett Environmental Associates, Inc. Create a Report Create an Excel File Report Filed By: David C Bennett 'Statistics Report ISplit Parcels Components that were sampled: Setup 1: RSF Review Questions Send Payment Last Report Dates Lid Depth Inspection: 9/11/2013 Septic Tank: Maintenance:I None Filed Lift Tank/Siphon Chamber: Pump: I None Filed Aeration Unit: Date 8r Time Serviced: 1' ! / 2012 @ : 30 _ AM Month /Day /Year Notes/Comments/Message None Recorded or Other Observations: (Viewable by Regulators and Service Providers ONLYI) Laboratory Alpha Analytical Sampling Report Sampler Name Joseph Smith Data Quality Good Sample Type Effluent (Leave item blank if not tested) BOD5"Amount(mg/L) Nitrate Amount,(mg/L) 3 7 _._ Nitrite Amount(mg/L) 0.14 pH Amount(mg/L) .....- TKN Amount(mg/L) Total Nitrogen(mg/L) 5.14 TSS Amount(mg/L): This report only describes the conditions at the time of service and under the conditions of use at that time.This report does not address how the system.will perform in the future under the same or different conditions of use.Carmody,Compass and Septic Search are independent business entities and are not associated'with business practices or liabilities assumed by the inspection,inspectors and or their business entities. --This is a copy of an electronic document generated from Carmody. ©Copyright 2013 CDS Holding,Inc.All fights reserved. http:Hcannody.biz/Pump/Service_Reports.aspx?ha=2&hi=1&id=970069&permit_id=2542... 9/30/2013 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 9/18/13 BEA09-10136 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Keating Residence 195 Herring Run Place Unit I[Route 149] SHIPPING METHOD: Marstons Mills,MA Regular Mail ❑ Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑X Green Card/RR ❑ COPIES DATE DESCRIPTION 1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(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: REMARKS: Please find enclosed the DEP Inspection and O&M Forms,OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklists and laboratory test results for operation and maintenance conducted during the reporting period for the above referenced property. It is noted that inspection ports or cleanouts for the pressure dosed leach field laterals are not accessible for inspection. If you have any questions or require additional information,please contact us at your earliest convenience. Thank you. cc Barnstable Board of Health- Ms.Carolyn Keating,Owner David C.Bennett,Principal [Internal] Matthew Costa-OMNI Environmental Systems,Inc. FROM: David C.Bennett,WWTO 46243/SamanthaFarrenkopf,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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 1492 Street Address/PO Box: Rna-M Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 12/27/12 9/5/12 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev. 11-07-05 Page 1 of 3 F LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 4.5 mg/L Turbidity 1.15 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. The system is operating correctly. t5aiom.doc-rev. 11-OM5 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. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 315t of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General.Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom:doc•rev.11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 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 12/27/12 Inspection Date Previous Inspection Date 8"sludge, 2"scum Sludge Depth(to be checked yearly) Pumping Recommended El 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 6.0 mg/L Turbidity 1.31 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. The system is operating correctly. 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 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 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: tab P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 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 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 1.11 NTU . 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ❑ Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below) Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: Conduct an operation and maintenance event. Collect effluent samples for field testing. Notes and Comments: Effluent quality passed field testing parameters. The system is operating correctly. 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. S' a��' 4c"Q�- 9IA 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 t5aionn.doc•rev.11-07-05 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important:When Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 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: L P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 Installation Date Start.of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. O Operating Information p 9 9/11/13 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 0.68 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 system is operating correctly. t5aiom.doc•rev.11-07-05 Page 2 of 3 f Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems H. Certification certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January 31st of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 311h of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev. 11-07-05 Page 3 of 3 f 7 4Unuaz'M*"1yseras, OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information VL Facility Street Address Date of Se ce City Operator/O&M Firm System Startup Date Weather Conditions B. Septic Tank 5c.c)irh L-�Z (Iv, -3�12)t v Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Ye4 No❑ If yes, inspe4&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❑ No❑ Odor problems: Yes❑ No9 If yes,description Effluent tee filter: Yes❑ Nd4 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. i , D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes,inspect❑&clean at least yearly❑ I' Same inspection criteria as septic tank: I E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) fZ( 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 QVZ ( 9 ""N) Hours of operation Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) I 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❑ Noko Distribution pipes Flush:Yes❑ NO% Brush: Yes❑ Nc�] Any obstruction of airflow to filter modules: Yes❑ N If Yes, explain below(i.e. snow,dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration.If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection 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: CO- -I (Do t f vtrpnmeawsSystems,.Ind, OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information ik`k \�`J -3 6 1 1-3 e �.- 0 Facility Street Address Date of S rvice City Operator/O&M Firm It System Startup Date Weather Conditions B. Septic Tank �'1 r (i Sludge Pumping Required: Yes❑ No Sludge Depth. � ASCum Depth: Effluent tee filter: Yes No❑ If yes,inspect&clean at least yearly If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank 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 A Check if sludge accumulating Pumping required: Yes❑ No Odor problems: Yes❑ No If yes,description Effluent tee filter: Yes No If es inspect &clean at least earl ❑ � yes, p ❑ yearly If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank.in order to prevent clogging of the filter modules.Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Pump Inspections(all units) If problems,describe Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problems,descri Test pump alternator,or record hours d S e CC, 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❑ Nq►�J Clean bed: Yes❑ N v � Distribution pipes Flush:Yes❑ Nov...'Brush: Yes❑ NcN Any obstruction of airflow to filter modules: Yes❑ Nolf 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❑ Nog 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: =UQ Q,\) ns Z,G o Z"v DO - �O yr 131 OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information Facility Street A dress Date of Se ice City Operator/O&M Firm System Startup Date Weather Conditions -A(Av3 B. Septic Tank Sludge Pumping Required: Yes❑ No\-R9� ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: YekM No❑ If yes,inspecZK&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 s�J� -��s " 3\Q&\ ❑Check if sludge accumulating Pumping required: Yes❑ NotA 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) 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 � tt 2.� e w•j Test pump alternator,or record hours �!oo�O (,t,�,� TIJ 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 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 j Clean bed: Yes El NOV Distribution pipes Flush:Yes❑ No Brush: Yes❑ No9 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❑ Nou If yes:❑BOD ❑TSS ❑pH ❑TN ❑O.ther 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: 1� vim\ c4Q uD 01Vtl r i _ Efrvironmentul Systems, Inc. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation &Service Information C�\ 73 Ck to 0 C) Facility Street Address DaT61of Se ice City OperatouOM,Firm System Startup Date Weather Conditions B. Septic Tank `�� ��'� " `'�'� 0,, -3� h� t 5 Sludge Pumping Required Yes❑ NcLK ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yesiw No❑ If yes,inspect[V&clean at least yearly❑ 'za' ' 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❑ 071 Odor problems: Yes❑ N if yes,description Effluent tee filter: Yes❑ No If yes, inspect❑&clean at least yearly❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules. Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank(if installed) Sludge Pumping Required: Yes❑ No❑ ❑Sludge Depth: ❑Scum Depth: Effluent tee filter: Yes❑ No❑ If yes, inspect❑&clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault(if Installed) Xpump Inspections(all units) If problems,describe Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch;if the pump is not operational immediate corrective actions need to be taken. i F. Pumps, Switches, Floats,Alarm System Pump Inspections(all units) If problems,describe WTest pump alternator,or record hours Hours of operation Float switches Check all switches for operation r 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") 4Inspect for ponding Ponding Present:Yes❑ N99 ` Clean bed: Yes❑ No V v Distribution pipes Flush:Yes❑ No[,� Brush: Yes❑ NOV Any obstruction of airflow to filter modules: Yes❑ No p 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 40ther 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: oo ci i' \ -- \C Serial No:09171310:10 1HA ,Y T I C A L ANALYTICAL REPORT Lab Number: L1317796 Client: Bennett Environmental Associates 1573 Main Street Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: KEATING RESIDENCE Project Number: BEA09-10136 Report Date: 09/17/13 The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its entirety.Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications&Approvals: MA(M-MA086),NY (11148),CT(PH-0574),NH(2003),NJ NELAP(MA935),RI(LA000065),ME(MA00086), PA(68-03671),USDA(Permit #P-330-11-00240),NC(666),TX(T104704476),DOD(1-2217),US Army Corps of Engineers. Eight Walkup Drive,Westborough, MA 01581-1019 508-898-9220 (Fax)508-898-9193 800-624-9220-www.alphalab.com Page 1 of 18 Serial No:09171310:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 Report Date: 09/17/13 Alpha Sample Collection Sample ID Client ID Location Date/Time L1317796-01 EFFLUENT MARSTONS MILLS, MA 09/11/13 08:40 f\PHA Page 2 of 18 Serial No:09171310:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 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(ie.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 i i 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. r Cynthia McQueen Authorized Signatures Title: Technical Director/Representative Date: 09/17/13 E Page 3 of 18 �� �`�` 1 Serial No:09171310:10 INORGANICS MISCELLANEOUS kFiA Page 4 of 18 Serial No:0917131O:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 Report Date: 09/17/13 SAMPLE RESULTS Lab ID: L1317796-01 Date Collected: 09/11/13 08:40 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 _e --_-_ Nitrogen,Nitrite 0.22 mg/I 0.050 -- 1 09/12/13 01:07 44,353.2 DB _.. ......._._. .,- ...... _._._—.. ......_ .,..------ _--- Nitrogen,Nitrate 6.6 mg/I 0.10 - 1 09/12/13 02:00 44,353.2 DB Nitrogen,Total Kjeldahl 2.33 mg/I 0.300 1 09/12/13 10:56 09/13/13 21:28 30,4500N-C AT i I Page 5 of 18 Serial No:09171310:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 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,- ampie(s):0 Batch: WG635443-1 Y Nitrogen,Nitrate ND mg/I 0.10 — 1 - 09/12/13 00:45 44,353.2 DB General Chemistry-Westborough Lab fWsample(s).;01'-Batch: WG635446-1-1 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 Kjeldahl ND mg/I 0.300 — 1 09/12/13 10:56 09/13/13 21:12 30,4500N-C AT Page 6 of 18 Serial No:09171310:10 Lab Control Sample Analysis Project Name: KEATING RESIDENCE Batch Quality Control Lab Number: L1317796 Project Number: BEA09-10136 Report Date: 09/17/13 LCS LCSD /oRecovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General.Cherhistry-�Wesfborough.Lab Associated•sample(s): 01 at h:WG635443-2 Nitrogen,Nitrate 102 90-110 - General Chemistry Westborough Lab Associated sample(s).,01 Batch:.WG635446-2 _._ Nitrogen,Nitrite ` ,._.�101'� ._.' 90-110 20 General-Chemistry-Westborough borough Lab Associated;sample(s): 01- Batch:WG635627-2 ` ' .. _ Nitrogen,Total Kjeldahl -95, 78-122 - Page 7 of 18 AA t�,a Serial_No:09171310:10 Matrix Spike Analysis p Y Project Name: KEATING RESIDENCE Batch Quality Control Lab Number: L1317796 Project Number: BEA09-10136 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 . ...�. il- -. _.�... .�..._.�. _ at—e - ..-)-6._--TC ._--tc-._,.��.,,,_—�, „ �._ �, ,a.. _... 1.. �! -_.,._ �-. General Chemistry=Westborough Lab Associatedsample(s): 01.: QC,Batch>ID: WG635443-4° QG�Sample:,L?317-789-01 Client ID: MS-:Sample Nitrogen,Nitrate 4.0 4 7.8 96` - - 83-113 6 �- _ T 01 QC:Batch ID.WG635446-4 QC Sample: L1317789-01 Client ID: MS Sample Nitrogen,Nitrite 0.075 4 4.3 105 80-120 - 20 General,Cliemistry-Westborough Lab Associated sample(s): 01 QC Batch_ID: WG635627.4 QC`SampleL1'3'17798=01- Client ID: MS.Sample Nitrogen,Total Kjeldahl 41.6 8 50.8 115' — Q - 77-111 24 `G\ Page 8 of 18 Serial No:09171310:10 Lab ®uplicate.Analysis Project Name: KEATING RESIDENCE Batch Quality Control Lab Number: L1317796 Project Number: BEA09-10136 Report Date: 09/17/13 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits General Chemistry=MestborougFL-ab Associatbaisample(s): 01 QC Batch,ID: WG635443-3 QC Sample: L1317789=01 -ClientrlD: D.UPISampl( ` Nitrogen,Nitrate 4.0 3.8 mg/1 -4- 6 General Chemistry Westborough Lab Associated sample(s): 01 QC Batch ID- WG635446-3 QC Sample: L1317789-01 Client,ID: DUP Sample Nitrogen,Nitrite 0.075 0.064 mg/I a 16� 20 General Chemistry-Westborough Lab Associated samples) 01 QC Batch ID: WG635627-3 QC Sample Y L1317798-01 Client ID: DUP Sample Nitrogen,Total Kjeldahl 41.6 44.8 mg/I 7 24 _. __. .... - -----.....- --- -- - . .... — -- ----- _. --. -- -- —.._. ---.. ------- Page 9 of 18 A&PHA Serial No:09171310:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 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(*) L1317796-01A Plastic 250ml unpreserved A 7 4 Y Absent NO2-353(2),NO3-353(2) L1317796-01 B Plastic 250ml H2SO4 preserved A <2 4 Y Absent TKN-4500(28) *Values in parentheses indicate holding time in days AA Page 10 of 18 Serial No:09171310:1O Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 Report Date: 09/17/13 GLOSSARY Acronyms EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of PAHs using Solid-Phase Microextraction(SPME). EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The'value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"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 ten times(1 Ox)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(10x) the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(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 E �L�L`i?NA Page 11 of 18 i Serial No:09171310:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 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 LLL�HA Page 12 of 18 Serial No:09171310:10 Project Name: KEATING RESIDENCE Lab Number: L1317796 Project Number: BEA09-10136 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 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. t i Page 13 of 18 Serial No:09171310:10 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: 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, 4500S03-B, 5540C, 5210B, 5220D, 5310C, 9010B, 9030B, 9040C, 7470A, 7196A, 2340B, EPA 200.7, g6010C, 200.8, 6020A, 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 625, 8011, Page 1i o1f 1,88082A,8330,8151A, 8260C, 8270D, 3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.) Serial No:09171310:10 Solid Waste/Soil(Inorganic Parameters: 9010B, 9012A, 9014, 9040B, 9045C, 6010C, 6020A, 7471 B, 7196A, 9050A, 1010, 1030, 9065, 1311, 1312, 3005A, 3050B, 9038, 9251. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA- VPH,8260C, 8270D,8330, 8151A, 8081B, 8082A,3540C, 3546, 3580A, 3620C,3630C, 5030B, 5035.) Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086. Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for: Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N); (SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM2130B, SM4500CI-D, 2320B, SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2- Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM9215B; ENZ. SUB. SM9223; ColilertQT SM9223B; MF,-SM9222D.) Non-Potable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7 for: AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1, SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE,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 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, 8081B.) New Hampshire Department of Environmental Services Certificate/Lab ID:2064. NELAP Accredited. Drinking Water(Organic Parameters: EPA 524.2: Di-isopropyl ether(DIPE), Ethyl-t-butyl ether(ETBE),Tert-amyl methyl ether(TAME)). Non-Potable Water(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene. EPA 8015C(M): TPH.) Solid&Chemical Materials(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.1, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, 2340B, SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F,4500NO2-B, EPA 1664A, SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM15 426C, 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: LPage'j' W-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B, 011,8015C, 8081A, 8081B, 8082, 8082A,8151A, 8330, 1,4-Dioxane by NJ Modified 8270,8015B, NJ EPH.) li sf8Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A,.7196A, 3060A, 9030B, 1010, A, 1030, 1311, 131'2, 3005A, 3050B, 7471A, 7471B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D, Serial No:09171310:10 9050A, 9065, 9251. Organic Parameters: SW-846 801513, 8015C, 8081A, 808113, 8082, 8082A, 8151A, 8330, 82606, 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: SM922313, 922213, 92156, 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, 5210B, 5310C, EPA 410.4, .SM5220D, 2310B, 23206, 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, SM2120B, 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, 503013, 8015C, 8011.) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010C,6020A, 7196A, 747113,8315A, 90126, 9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 30506, 9010C, 903013, 9040C, 9045D. Organic Parameters: EPA 8260C, 8270D, 8270D-SIM,8015C, 8081B,8151A, 8330, 8082A,3540C, 3546, 3580A,5035A-H, 5035A-L.) North Carolina Department of the Environment and Natural Resources Certificate/Lab ID:666. (Inorganic Parameters: SM231013,2320B, 4500CI-E,4500Cn-E,9012B, 9014, Lachat 10-204-00-1-X, 1010A, 1030,4500NO3-F, 353.2,4500P-E,4500SO4-E, 300.0,4500S-D, 5310B, 5310C,6010C, 6020A,200.7,200.8,3500Cr-B, 7196A, 245.1, 7470A, 7471B, 1311,1312. Organic Parameters:608,8081B,8082A,624, 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, 2320B,2510B, 2540C,4500-CN-CE,4500E- C,4500H+-B,4500NO3-F,5310C. Organic Parameters: EPA 524.2, 504.1) Non-Potable Water(inorganic Parameters: EPA 120.1, 1312, 3005A,3015, 3060A, 200.7, 200.8, 410.4, 1664A, SM2540D, 5210B, 5220D,4500-P,BE,245.1, 300.0, 350.1, 350.2, 351.1, 353.2,420.1,6010C, 6020A, 7196A, 7470A, 9030B,2120B, 23106, 232013,251013,25406, 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, 3050B, 3060A, 6010C, 6020A, 7196A, 7471 B, 9010C, 9012B, 9014, 9040B, 9045D, 9050A, 9065, SM 4500NH3-BH, 9030B, 9038, 9251. Organic Parameters: 3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081B, 8082A, 8151A, 8260C, 8270D, 8270D- SIM, 8330, NJ-EPH.) Rhode Island Department of Health Certificate/Lab ID: LA000065. NELAP Accredited via NJ-DEP. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476. NELAP Accredited. Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7, 200.8,245.1,245.2, 300.0, 350.1, 351.1, 353.2, 410.4,420.1, 6010,6020, 7196, 7470, 9040, SM 212013, 2310B,23206,2510B,25406, 2540C, 2540D,426C,4500CL- E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500N026,4500P-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, 2510B, 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, 1312,60106,6010C, 3060A, 353.2,420.1,2340B, 6020, 6020A, SM4500S-D, SM4500-CN-CE, Lachat 10-204- 1-Page%1- 7196A, 7470A, 2310B,2320B, 2510B,2540B, 2540C, 2540D,3500Cr-D,426C,4500CI-E,4500E-B,4500E-C, fr A3-H,4500NO2-B,4500NO3-F,4500 S03-B,4500H-B,4500PE,510AC,5210B,5310B 5310C, 5540C, 9010Cm Serial No:09171310:10 9030B, 9040C. Organic Parameters: EPA 3510C, 3630C, 50306,82606, 608,624, 625, 8011, 8015C, 8081 A,808113, 8082,8082A, 8151A,8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM,8330, ) Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 305013, 1311, 1312, 601013, 6010C, 6020, , 7196A, 7471A, 74716, 6020A, 9010C, 901213, 9030B, 9014, 9038, 9040C,9045D,9251,9050A, 9065. Organic Parameters: EPA 503013,5035, 3540C, 3546, 355013, 3580A, 3620C, 3630C,6020A,8260B, 8260C,8015B,8015C, 8081A,8081 B,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, 2320B, 23406, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A, 8260C, 8270D, 8270D-SIM,8330A, 8082A,8081 B,3510C, 50306, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010C, 6020A, 7471A, 6860, 1311, 1312, 3050B, 7196A, 904013, 9045C,9010C, 901213, 9251, SM3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 8015C,8151A, 8260C, 8270D,8270D-SIM, 8330A/B-prep, 8082A, 8081 B, 3540C, 3546,3580A,5035A, MassDEP EPH, MassDEP VPH.) The following analytes are not included in our current 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 Dimethyl naphthalenes, 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 0 131 S •al N :0917 0:10 Date Rec'dnn Lab:` C Z ,h .t0• '�??:.?�8��fi"'RHA: cb'#`' r ar•, .t CHAIN OF CUSTODY G 1OF1 Report Information Data Deliverables Billing Information ❑:FAX.. ® EMAIL ® Same as.Client info Po M.1613,6 Westborough,MA Mansfield,ma Project Name:Keating Residence TEL:608-999-9220 TEL:SPM22-9300 ❑ ADEx'. ❑ Add']Deliverables - FAX:.508-898-9193 FAX:506-8223288 Regulatory • •• :Project Loaatlon:Marstons:Mills,MA StareiFed.Program Criteria Client:Bennett Environmental Associates Pro-ect.#:BEA09.-10136 Address:1573 Main Street/P.O.Box 1743 Project Manager:David C.Bennett' No" MIN- Brewster,MA 02631 ALPHA Quote#: Phone:508-896-1706Turn-Around Time ANALYSIS.. Fax:548-896=5109 ®Standard:* ❑Rush(ONLY IF PRE-APPROVEDt " SAMPLE HANDLING Email:sfarrenkopf@bennett-es.com Fllraaan i l j Q.t Done ❑These samples have been Previously analyzed by Alpha Due Date: Time: 0 Not Needed ❑ Lab.todo Other Project Specific Requirements/Comments/Detection.Limits: Preservation • ... ❑ Lab to do (Please specify below) Sample ID collection Sample : Samplers z. .. Date Time Matrix Initials at �:• :« �e Sample SPeci Z. H Comments ;;�>:=ems Effluent � j�:. ��� WW• ,� E . l `'P �':-�'k.i�•'1'rSS t '"i4�y;:C. .. .. ❑ ❑ ❑ ❑ ❑., :.. .. ti ❑ ❑ ❑ El El El ❑ ❑ ❑ ❑ ❑ ❑ ... ..'... :..a,. Elay.. .. - 1.2 I; .. Container Type P P PIeservative 0.. 0 erid co Fie I 'g'I IDS,bl 1 - . : , - nol'Ge�lo9 ed mantl.;+3 .0 R ishe DateMme Received By: Dat mme . turns'ounditime.cla k"6W1it:nor.: u ,/► �' .�,�•. i �istaAvetileny.ambi_ge(lles ale;.' 1 "i [esalved All>samPles:' _ s ` rti ed.'a'tesubjectto rOftMN0:e1.O7(I-N.e J$Aj�'fu�yarj{. aynienl:Te' .Page 18 of 18 BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1706 Brewster,MA 02631 fax(508)896-5109 LETTER OF TRANSMITTAL TO: DATE: JOB NUMBER: Massachusetts Department of Environmental Protection 9/22/11 BEA09-10136 Attention:Title 5 Program 1 Winter Street-6th Floor Boston,MA 02108 REGARDING: Keating Residence 195 Herring Run Place Unit I[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 UA 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 Ms.Carolyn Keating,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 i 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 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: d� P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 city State Zip (508)420-3768 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 r 9/12/02 9/12/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 1/5/11 9/9/10 Inspection Date Previous Inspection Date 2"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 6.47 SU DO 15.55 mg/L Turbidity 2.38 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 sampling. t5ai6m.doo•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 accordancewith 257 CMR 2.00. 'C\%N coo qV7 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 3/9/11 1/5/11 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 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 15.71 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 ❑ 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 sampling. I t5aiom.doe•rev.11-07-05 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and 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 n of each year for the previous calendar year Piloting Use-within 45 days of inspection date Provisional Use—by March 31th of each year for the previous 12 months General Use—by September 30th of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Pro ram One Winter Street, 6t Floor Boston, MA 02108 t5aiom.doc•rev.11-07-05 Page 3 of 3 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip Mailing address of owner, if different: P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip (508)420-3768 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 9/12/02 9/12/02 Installation Date Start of Operation Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No D. Operating Information 6/9/11 3/9/11 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No t5aiom.doc•rev.11-07-05 Page 1 of 3 I LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 DEP Approved Inspection and OW Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown M clear ❑turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 10.46 mg/L Turbidity 1.75 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 sampling. 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. c g6l 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, 6th Floor Boston, MA 02108 r 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 Carolyn Keating filling out forms Owner on the computer, use only the tab Route 149 Unit 195-1 key to move your Facility Street Address cursor-do not Marstons Mills 02648 use the return key. City Zip �I1 Mailing address of owner, if different: V� P.O. Box 1492 Street Address/PO Box: Marstons Mills MA 02648 City State Zip Ll (508)420-3768 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 9/12/02 9/12/02 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 6/9/11 Inspection Date Previous Inspection Date Sludge Depth(to be checked yearly) Pumping Recommended El Yes ® No i t5aiom.doc-rev.11-07-05 Page 1 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other(specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.0 SU DO 11.49 mg/L Turbidity 1.96 NTU 6 to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent ® Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: gpd Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ®TN ® Other(list below) Nitrate Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection &during this inspection: General O&M visit for system functionality. Conducted field testing and collected effluent samples for laboratory analysis. Notes and Comments: System is functional and passed field sampling. i 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. C112�I11 Operator Signature Datef 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 r t5aiom.doc•rev.11-07-05 Page 3 of 3 Serial No:09221112:08 AHA �,A;","-Y.T I C A L ANALYTICAL REPORT Lab Number: L1114557 Client: Bennett Environmental Associates 1573 Main St. PO Box 1743 Brewster, MA 02631 ATTN: David Bennett Phone: (508)896-1706 Project Name: KEATING Project Number: BEA09-10136 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:09221112:08 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 Report Date: 09/22/11 Alpha Sample Collection Sample ID Client ID Location Date/Time L1114557-01 EFFLUENT MARSTONS MILLS 09/14/11 09:15 Page 2 of 17 Serial No:O9221112:08 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 Report Date: 09/22/11 Case Narrative The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report. Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample, followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific% recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the back of the report. Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical Standards requested on the Chain of Custody. For additional information,please contact Client Services at 800-624-9220. I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and belief and based upon my personal inquiry of those responsible for providing the information contained in this analytical report, such information is accurate and complete. This certificate of analysis is not complete unless this page accompanies any andall pages of this report. Authorized Signature: S�l�riyvre Elizabeth Simmons Title: Technical Director/Representative Date: 09/22/11 Page 3 of 17 �`�` Serial No:09221112:08 INORGANICS MISCELLANEOUS Page 4 of 17 Serial No:09221112:O8 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 Report Date: 09/22/11 SAMPLE RESULTS Lab ID: L1114557-01 Date Collected: 09/14/11 09:15 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 V 2stporough Lab,_ Nitrogen,Nitrite 0.16 mg/I 0.05 — 1 - 09/16/11 00:57 44,353.2 TH Nitrogen,Nitrate 5.4 mg/I 0.10 - 1 - 09/16/11 00:57 44,353.2 TH Nitrogen,Total Kjeldahl 2.8 rt mg/I 0.30 — 1 09/16/11 13:50 09/20/11 20:12 30,4500N-C AT L1L`?HA Page 5 of 17 Serial No:09221112:08 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 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 GeneraChemistryWestboroughYLab fors mple(s) 01TO- eBatchWG490293-2 ,�ti Nitrogen,Nitrate ND mg/I 0.10 — 1 09/16/11 00:38 44,353.2 TH j R d`.General Cher istVlweX-rf.-•o.^y...Y La for sa me 01 -Ba WG 49 02 2"ry `�'.�-' .. .-.e ....�,...,.......��... ....�.....,..y:y.-.,.�....'�'wl Nitrogen,Nitrite ND mg/I 0.05 — 1 09/16/11 00:46 44,353.2 TH „ _ -�✓4`xir. fir.--. '��'=.e-tr r7`2aw'� wr yc:t :.,"r"s. ,. o, f..... _.} * 711f '°[`_"vl i'2` General Chemist d�'� „' ry 1Nestborough.Lab for sample(s): 01 Batch: WG490372-1 ;. Nitrogen,Total Kjeldahl ND mg/I 0.30 1 09/16/11 13:50 09/20/11 20:02 30,4500N-C AT Page 6 of 17 Serial No:09221112:08 Lab Control Sample Analysis Project Name: KEATING Batch Quality Control Lab Number: L1114557 Project Number: BEA09-10136 Report Date: 09/22/11 -- —^ LCS LCSD %Recovery Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits General"Chemist Westborou h, —0a ,Associated sam le s 01 Batch 1NG490293'1 y6 } r..r aimsxR,.- � s.;?'-«es,,4+:-ii++.lr g-as-"k.-„+s+o,.?- a+.+eke,'v;..:Apt ku'..::.x.�.;xo-r✓..»,..^,c*'' . t i Nitrogen,Nitrate 90-110 . ' �r • _ �+ �' _ _x . .abAssoc dsGeneraffChem �t WesboughLeam °, s. Nitrogen,Nitrite k :e98i ' - 90-110 - 20 ..,.. ,__' ,...„-. ..g,,..:,,.:-.,,.. .,..,,,,y......... ..--.r.,..y#--.".-. ^•o'er..-..� .._�_ -. �,.+,r." -„a-�" "w.-;,s 'F9e"`°.,sa" `.`y ",s"'"°"�"".+f GeneraliChemistry ,WestboroughL`ab Associated;sample(s)., ,1f-,tBatch I:WG490372 2 k0 .. ,..,..... max -..Lxxar- ++ .,a»e.'+n•:"`":m"a. ,.n,:c -£>,M... .,.t. :-<.::....rr ...x,. ,.....fir -,:, ... »..,ms.X�:. a Nitrogen,Total Kjeldahl 95t' "':` - 85-110 Page 7 of 17 Serial No:09221112:08 Matrix Spike Analysis Project Name: KEATING Batch Quality Control Lab Number: L1114557 Project Number: BEA09-10136 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'ChemistWestborou hLatYAss mociatedsa le s `.;01. : QC;BatchID.WG490293_ _3 , .l:QCSa.m le .Lfl'fl;l46537- en ,, .77,MS'Sam le - Y' Nitrogen,Nitrate 5.9 4 9.8 498 - 83-113 6 General'Chemistry,=.Westborough LatifAssociated:sarpple(s):jO QClBatch ID: ING'490295 3 �'QCtSample 'L11k14553`-01;jChent;ID: MS Sa plea n - ' Nitrogen,Nitrite 0.06 4 4.1 `101'' - - 80-120 20 Gen eral?Cliemistry Westboroughic &Associatedrsample(s). 01k QG;BatchflD:r.WG490372 3 QC Sample 1211�14558-01 rCllent ID: MS Sample k Nitrogen,Total Kjeldahl 1.8 8 9.7 �,�199F—. - 77-111 24 Page 8 of 17 ti?�, Serial No:09221112:08 Lab Duplicate Analysis Project Name: KEATING Batch Quality Control Lab Number: L1114557 Project Number: BEA09-10136 Report Date: 09/22/11 Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits .. +:nuW.-'�"`.tin.'# rn•.M"."iy"R`a^btlro^"'.�.w.v�t�r ...,.. .,,. .�.�.g�r» �..,... ...�,....�,.,,,---�,,,wr •.�yprs;M•...q,..o.�....�.,.- General Chemistry Westborough L'ab yAssoclatetl sample(s).�01 „QC Batch ID VVG490293=4��;QC Sample iL�1i1t1�4553I CllenVID S€DUP Sample � " r -3 Nitrogen,Nitrate 5.9 6.0 mg/I -2 ''' 6 v-wra.ngr'. -k . %�^9-r..p.�r.c-..,M,..�w....-�« .r --�n...'r,^ro�c_re-.. .; `M,. .... .. -�,a._... -r r— �,.,,,.., ,. ......-e...,.... -sue.,.. General Chemistry-Westborough La 15rMssoclated,,sample(s) 01t�<QC Batch ID. kWG490295 4� �;QC Sample L1114553 M101?,CIie tiID' DURSa ple b" Nitrogen,Nitrite 0.06 0.06 mg/I W5, _*' 20 General Chemist<Westborough Lab A ss oclated s mple(s) t01`- QC:pBatch ID'AWG49037244�.-;QC,,S p e sL 114507=03�Client;ID�DUR Sample 1 , m.:.,...s.. .-_���x-s..:..z..•.orou sd`:,.,e- . ',,: s w.:_+...-..e�.......».a l .: ---,-t_ ...r. 5..-s.. .._.rm..-'r -..._-+•a-_ :. .. smLm.._....,.....�`n:`......v� r�... m. Nitrogen,Total Kjeldahl 0.38 0.35 mg/I 24 Page 9 of 17 •�;� Serial No:09221112:08 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 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(*) L1114557-01A Plastic 250ml unpreserved A 7 3.9 Y Absent NO3-353(2) L1114557-01 B Plastic 250ml unpreserved A 7 3.9 Y Absent NO2-353(2) L1114557-01C 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:09221112:08 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 Report Date: 09/22/11 GLOSSARY Acronyms EPA Environmental Protection Agency. LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. LCSD Laboratory Control Sample Duplicate:Refer to LCS. LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes or a material containing known and verified amounts of analytes. MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values, when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from dilutions,concentrations or moisture content,where applicable. MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for which an independent estimate of target analyte concentration is available. MSD Matrix Spike Sample Duplicate:Refer to MS. NA Not Applicable. NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's reporting unit. NI Not Ignitable. RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL includes any adjustments from dilutions,concentrations or moisture content,where applicable. RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values; although the RPD value will be provided in the report. SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the associated field samples. Footnotes 1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original method. Terms Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum. Data Qualifiers A Spectra identified as"Aldol Condensation Product". B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(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(10x)the concentration found in the blank AND the analyte was detected above one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ- Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the reporting limit. C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted analyses. D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations of the analyte. E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument. G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should be considered estimated. H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection. I The 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 F�A Page 11 of 17 Serial No:09221112:08 - Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 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 Page 12 of 17 Serial No:09221112:08 Project Name: KEATING Lab Number: L1114557 Project Number: BEA09-10136 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-N o:09221112:08 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/IVon-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: SM921513, 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, SM232013, 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: SM921513; ENZ. SUB. SM9223; ColilertQT SM922313; MF-SM9222D.) N n 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 Pageflo)° 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:09221112:08 SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N), LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1, SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1, SM4500-CN-CE,SM2540D. Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane,Aldrin, Dieldrin, DDD, DDE, DDT, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables and SVOC Base/Neutral Extractables),600/4-81-045-PCB-Oil. Microbiology Parameters:(ColilertQT SM9223B;Enterolert-QT: SM9222D-MF.) New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited. Drinking Water (Inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 245.2, 300.0, SM4500CN-E, 4500H+B,4500NO3-F,2320B,2510B, 2540C,4500E-C, 5310C,2120B, EPA 332.0. Organic Parameters:504.1,524.2.) Non-Potable Water (Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, 245.2, SW-846 6010B, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 1664A, SW-846 9010, 9030, 9040B, SM426C, SM2120B, 2310B, 2320B, 2540B, 2540D, 4500H+B, 4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 5210B, 5220D, 2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D. Organic Parameters: SW-846 3510C, 3630C, 5030B, 8260B,8270C,8330, EPA 624,625, 608,SW-846 8082,8081A,8151A.) Solid & Chemical Materials (Inorganic Parameters: SW-846 6010B, 7196A, 7471A, 1010, 1030, 9010, 9012A, 9014, 9030B, 9040B, 9045C, 9050C, 9065,1311, 1312, 3005A, 3050B. Organic Parameters: SW-846 3540C, 3546, 3550B, 3580A, 3630C, 5030B, 5035, 8260B, 8270C,8330,8151A,8015B, 8082, 8081A.) New Jersey Department of Environmental Protection Certificate/Lab ID: MA935.NELAP Accredited. Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA 300.0, 200.7, 200.8, 245.2, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332, 504.1, 524.2.) Non-Potable Water (Inorganic Parameters: SM5210B, EPA 410.4, SM52201), 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, i 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, 7471 B, 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.) i New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited. Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0, SM2320B, EPA 300.0, SM2120B,4500CN-E,4500E-C,4500H-B, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA 524.2, 504.1.) Non-Potable Water (inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4, SM5220D, 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. Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters:Chloride EPA 300.0. Organic Parameters: Page 6§,ofl7 �I Serial_No:09221112:08 - Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAPAccredited. Drinking Water(Organic Parameters: EPA 524.2, 504.1) Non-Potable Water(Inorganic Parameters: EPA 1312,200.7,410.4, 1664A, SM254013,5210B, 52201),4500-P,BE. Organic Parameters: EPA 3510C, 3005A, 3630C,50306, 625, 624,608, 8081A, 8082,8151A, 826013, 8270C,8330) Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 30506, 601013, 7196A, 7471A, 901013, 9012A, 9014, 904013, 9045C, 9050, 9065, SM 4500NH3-H. Organic Parameters: 3540C, 3545, 3546, 3550B, 3580A, 3630C, 5035,80156, 8081A, 8082, 8151A, 826013,8270C, 8330) Rhode Island Department of Health Certificate/Lab ID: LAO00065. NELAP Accredited via NY-DOH. Refer to MA-DEP Certificate for Potable and Non-Potable Water. Refer to NJ-DEP Certificate for Potable and Non-Potable Water. Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1. NELAPAccredited. 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 212013,2310B,232013, 2510B,2540B, 2540C,25401),426C, 4500CL-E,4500CN-E,4500E-C, 4500H+B,4500NH3-H,4500NO213,4500P-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, 904013, 300.0, 332.0, 6860, 353.2,410.4,9060, 1664A,SM 4500CN-E,4500H-B,4500NO3-F, 52201), 5310C,23206,2540C, 3005A, 3015, 901013, 9056. Organic Parameters: EPA 82606,8270C, 8330A,625,8082,8081A,3510C, 503013, MassDEP EPH, MassDEP VPH.) Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010B, 7471A, 9010,9012A,6860, 1311, 1312, 3050B, 7196A, 90106,3500-CR-D,4500CN-CE,2540G,Organic Parameters: EPA 826013, 8270C,8330A/B-prep,8082, '4 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 :J:$; z r.�,:, ....fr: r�, .y. :�r'. �z1_: :> ,s.aljr,.,• a>,,. `yAXri �`�l:< ,V�•, %tl'"iY.r �7r.✓+{'.:...a [� L.. 'cV:.y .�y t!•Y., !..�1T�: ... .I. S;' !✓'.+F - •i� - 'y Sr TO DY� PAOE � of 1 -CHAIN �.� CUSTODY fil'D .�'.,e;W. a _. 'T�t�tY•� Y3:.':5,' 4e p�LL ad erf •>Y3i„r::�+'s<z: �" - �f��" '7, , ?�:' y ic1-�"Zi9.,h �'�. �.,�„-.tS:�•.>S ��.., `G, (r�:i!' y G •�,?;±73�s"r�:.�rlSq Uta�,a'�'": :=>:7f .� :Y.n ..-`r:.� a�....• �(�.'�to r"� �34. �` d. •'_kdSy :`•. Deliverables Billing Information ct Information Report Information-Data WESTeOR9. . ..TEL.-508.698.9m- - T.EL'.50 22-9300 - Project Name: ' Q FAX EMAIL Same as Client info .PO:#.!C�3 b: .• .'_.;.... '. ' 'FAX; 508-898.9193 ...FW.-509.922-3288Client Informati - .. 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El Done Note: All CAM methods for inorganic analyses require MS eve 20avll samples Not needed.". . .. ( r9 Ys q every ):..: CI Lab to'dd' .: .. Y ]• Preservation Cl Lab to do ALP 1 Lak 1D ;` Collection' Sample Sampler's / Mom"`P°uj below) a.Ilse Oil } Sample ID Date- Time Matrix Initials Sample Spwific-Comments N. *Y.,i:.•1;k7 r ,4S`l•`yj(f Y:rV J �. S �i n, 5 elf:'nNv��r:: I Container Type �+•5. ''.ei`:r:�;73�, PLEASE ANSWER QUESTIONS ABOVEI yPe <Pleast3piiitkCle;3rl",t rr Preservative `plptely:>'!'Serr pleS Car i 09,012oO,e N-. IS YOUR P . rr, , .9 k' ROJECT ;:in':aridtumarour3d ti iie.4 kffilriknat;Y' i Relinqui 'ed 8y: Datelllme ved By: Datelltme <star[until,agramigufes�are res'o[ved: MA MCP Of CT RCP samplesstilienitpQiliar`a`sUbje`ejtor?j Alpha'S:.Teims andoji�tfor$� s„4fi1 AA; e3 ORM NO:01-01(rev.18 Jen-20f0) f "� & OMNI 2000 CI. CULATING SAND FIL TER PRO FIL. DETAILS, - -p SEWAGE SYSTEM NOT TO SCALE - 6 5 4 3 2 , NOTE: RISERS AND COVERS TO WITHIN 6" OF FINISH GRADE s 6" PINE BARK MULCH * OMNI 2000 RE-CIRCULATING SAND FILTER 2 MODULES REQUIRED FILTER FABRIC COVER -- (NO SUBSTITUTION) • s� . '. AIRATION HOODS 0 _ , v- FINISH GRADE=59.7 s / fir. ` r (3) COVERS TO GRADE f s F.FL.=62.6 1.5" PRESSURIZED LINE ? ' SEPTIC » a 7 `; 3 PVC RETURN LINE EFFLUENT FILTER & TANK= 59.0 i 58.5 TOP OF GAS BAFFLE - RECIRC. 4° R.S.F. FINISH GRADE 57.0-57.5 Acme Precast -Model PL122 TANK= 60.0 ' _ SLOPE O __I W11 ' k .l •.t' •w<. A' ,j.. •:i••err' " R.S.F. tL-r T 54.7 � 1 '.�� �' ;•,� MODULE AC FLOW - „Q .......... 3" PEASTONE + HOUSE _ _EY MAP ^� #9 . 55.15 13-10" SPLITTER --` '_ a L "=60' INV. 55.0 I 14" 55.33 I' 54.75 _ t ` 1-1/2" PVC 4 r " 54.4�t " 3 LIQUID AG I Q d a o d d 4 . { i I' I^ PUMP ON 54.2 _ t <. . ° ' +' LEVEL �� 24 HR. RES. I I d .. { 9 + ; HIC:1 WATER ALARM � - d e � 3,�4a T� 1-1/2"'CRUSHED, I ! co -' WASHED' STONt s o I _ 54.35 o I I w e 4 _ . .. 1500 GALLON SEPTIC TANK _ "LT)' • WATER SHUT OFF" _ ! PUMP OFF a -�- - _ .CCT " 20J0" , Lr r s� ! j� _ _ ,- - __. L..vEk_ 1000 GALLON OMNI � � .� .. 022 J I �;i�-�; FILTER RECIRCULATION TANK t I ���c4 j -.. ... ..._. :.; - - - r ►'�r . . ...._ EFFLUENT FIr By. Zoeller NO SUBSTITUTION) OMNI 2000 P�,MF CHA,. .,, Ra lOM � t k ` SYS . f ( A SORP 0I �T 250 GAL.PUMP CHAMBER 1 V w "BY-PASS ORIFACE" �" I DESGED .�Y OTHERS 6 y0T�.TIMER ,.._JD EVENT COUNTER i / 6 "CHECK VALVE" SHOlill-`.`?3E MONITORED FROM 4/1 5' LONG, 1 .00" DIA. PVC LATERALS / CONTFr�, PANEL » , Z "' EACH WITH FIVE 1 / 4 DIA. HOLES SPACED -_ _-- -- . s4.e / o��� � • . 3' O.C. ALONG. PIPE INVERT. DESIGN SPECIFICATIONS ,.. TWO TRENCHES: 32.5 LONG, ,ft'' . . . DESIGN CRITERIA 2.7' WIDE WITH 6° '� Sand Filter Media 24 min.-depth <1% 200 sieve, 2mm to 4mm size 2 EFFECTIVE DEPTH. 8.1 APART "j NUER OF BEDROOMS 3 CURB � AVERAGE DAILY FLOW . . . . . . . 55 gpd/per person/per bedroom PE'rONS PER BEDROOM 2 �-� , stop Wastewater strength-BOD5 . . . . 230 mg/liter/residential DAI,Y I=LOW PER PERSON 55 54.7 a Re-Circulation Ratio . . . . . . . 4: 1 TO ,`yL DAILY FLOW 330 �S Re-Circulation Tank Size . . . . . . . 150% of design flow (Use a 1000 gal. tank) LE! THING AREA REQUIRED 445.9 sq. ft.(330 gal. ® 0.74 gal./s.f.) SOIL EVALUATOR'S LOG • l- 457.1 s ft. Surface ceram Hor. Texture Color MoSoil Soil Soil tt. Relative � Othe 6 � � � LEi:�•HING AREA PROVIDED q• 5fl.2 Sand Filter Loading Rote(Residential) Loading Rate(gpd/sf)=1150/BOD5=.5 gpd/sf T 338.25 d. 446.3 0.74 LE:JHING CAPACI iY PROVIDED _9 P ( )( ) (Inches) (USDA) (Munse►) Factors I °�° / Q Sand Filter Surface Area . . . . . SA=Flow gpd/Loading Rate gpd/ft2 I � � f,._..' � { CALCULATIONS 56.7 DEEP OBSERVATION HOLE #C-1 o Q� 55.9 330 9pd/5 tapd/sf = 66 S.F. REQ. (69.3 S.F. PROVIDED) / t I� DO TP D- 8 . BC`, i OM I 53:e a pump . . . . . . . ( )� - gp 2.7�x 65' x 0.74 = 129.87 d. 7 A Loamy o i' r ry Re-Circulation um Size 330 + 4x330 x 103% r r w '°P 1 650 d , 9 p 56.1 f 55.0 Q �D f sFo 68.75 gals./GO min. cycle SlC'WALL - 7"-30" B Loamy o �/ �� 3X y��s Myers Model ME40 or equal 65 gals. 12 TH 14C;' 3 If x 2 x 0.74 - 208.38 g.p.d. o 6o F Use Mye # G ( 9 ) 54.2 Sand ru f 1 5xa Sand Filter Setbacks . . . . . . . . . Same as Ti`"-Ie V septic tank - 338.25 g.p.d./O.74 - 457.1 s.f. o j�5.€i� s9.sic__-____ of GENERAL NOTES 30"-144" C M ed. �� Sand 0 7.30 �� 1. ALL ELEVATIONS SHOWN ARE M �p 56.7 ASSUMED. 44.7 `��` 54.7 Cn rn ` 2. ALL PIPES IN THE SYSTEM T BE - . ,P 56.5 - DEEP OBSERVATION: HOLE #C-2 CAST IRON OR SCHEDULE hi P.V.C. w X60�-"'" TP \ 3. REMOVE ALL UNSUITABLE l.�� ERIAL 10"-7" A Sandy Q 57.0 `` BENEATH THE INVERT ELEV ON GgR,gCE \ 55.9 Loam 55.g FOR A RADIUS OF' 5' AS F` s'. 310CMR 15.255(5) AND BACKFILL W/ CLEAN`'.1 ARSE 7"-30" B Loam Q PR�OSEO 54.0 Sand m 3 GRANULAR MATERIAL. 57.12 DEOiQpOM 4\�`` ! yo�sE 4. ALL BACKFILL SHALL BE CL tt�l 30"-144" C M ed. 58.91ELEK 6, TP C-2 \, i- FREE Sand z zhrr COARSE GRANULAR MATERI ( S. _ FROM DEBRIS & LARGE ST y^,.�.� 0 oE�K 5. CHRISTOPHER, COSTA & Asp c, ��� ,, -� . i e ''!,`�� 44.�5 .- Co 57.o x s5s MUST BE NOTIFIED WHEN T' '"' = ' �i,*gar .©OUL AS d 1ON 5:'"? GALLON SEPTIC TANK ' SYSTEM IS INSTALLED PRIG' �Ox,x, . �' -"'�R m PERCOLATION RATE _ <5 MIN. INCH Civil BACKFILLING FOR INSPEGTi ,� . a .,r�l i+ �^ -' „ . ,e: �. Ncc DEPTH TO GROUNDWATER NONE ENCOUNTER_a ,a� ...,_t. PIPED �.�,C' TO > _ w +o , E U • _ p..I..b.• Ir'. •. r 6. UNLESS OTHERWISE NOTED . _� JERRY DU�NIN� N c ^ �F � "� OBSERVATiOIvS BY. cr • t I . : __ ,.,,.t ., _ _ . . _. ., _,. SYSTEM COMPONENT. SH�'�. _;.�� r +r+ �.04 s�,.� Ur�� _ . 2000 RE-t,IK(,ULH I l Oiv TANK t , F, By 6RJG_ M�nPHY ?a, INSTALLED IIJ ACCORDANT; '-VTH W = 11Jv T^K'�Iv u , 0!v'ii`I 2000 RE-CIRCULATING MASSACHUSETTS TITLE V S,h` TARY ��' !/�/ ; �0'�. DATE TrSTcD: �3 20.98 - .... .............................:........".... t. SAr0 FILTER (2. MODULES REQ.) SE LOCAL + }!ES � u SEWER CODE AND RESERVEAREA ON WHICH MAY BE AI'PLICA�? ' ! A MODULE PIIPED BACK TO 65.0' WORKMAN-LIKE NANNEP ` o z1 TP c- RE CIRCULATIOlN TANK ry 7. THIS LOT IS NOT IN TI1E FL OD PLAIN. PUh P CHAMBER 8. A GARBf\GE CRINGER WILLX I` � BE INSTALLED ON THE SYSTE'v`; NOTE TO INSTALLERS 9. NO CHANGES SHALL BE A,A E TO THIS PLAN w Q WITHOUT.: PRIOR APPROVAL ;1"'OM CHRISTOPHER YOU MUST BE AN OMNI ENVIRONMENTAL SYSTEMS COSTA & Assoc: CAN BECOME C.=RTIFIED 10. DIG-SAFE SHALL BE NOTIFIED; FOR THE PROPER APPLICANT: BAYSIDE BUILDING CO., INC. CERTIFIED INSTALLER. YOU LOCATION OF EXIShNG UTILI.:IES PRIOR TO ANY OF PROPOSED DWELLING LOCATION AT THE TIME OF INSTALLATION. PLEASE CONTACT EXCAVATION. �P�s Ssy OMNI AT 1-888-450-OMNI FOR DETAILS 11. OMNI 2000 PRODU^TS AVA!,ABLE THROUGH o� otic OMNI ENVIRONMENTAL SYS T'MS AT 1-888-450-OMNI CHRISTOPHER PROPOSED SEWAGE SYSTEM LOCATION Z STA 12. OMNI 2000 CONTROL PANT I�:TO BE LOCATED , . 313 � No. 31305 INSIDE DWELLING IN A VISIP, ,& AUDIBLE LOCATION. q f o �� 0T . N UNI' ROU"'T140 00 14. ONLY OMNI 2000 l310-FI�T� , COMPONENTS SURv� ij 0 NO SUBSTITUTIONS REVISIONS 1 MASSACHUSETTS;, � � BARNSTABLE (MAxsTorrs MrLr�s), W PLAN VIEW SCALE: 1„= 20' SCALE: AS NOTED DATE: 10/1 /02 ZD a LEGEND CERTIFIED PLOT PLAN �' TOP 0GF,,IPHY�� DRAWN BY: JAB CHECKED BY: C.C. JOB NO.: PROP. SPOT ELEV. = X60.5 DONE BY.' I, � EXIST. SPOT ELEV. = x56.04 The site is situated n Flood Zone "C" r CHRISTOPHE`R COSTA & assoc. i PROP. CONTOUR = +�.�46 _BSS DESIGN P.O. BOX 128/465 E. FALMOUTH HWY. es EXIST. CONTOUR = -.46 ASSESSORS MAP #78 LOT 18 ` NO. DATE DESCRIPnON BY EAST FALMOUTH, MASSACHUSETTS