HomeMy WebLinkAbout0195 ROUTE 149 - Health (8) � t t7c,-r� C
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BAP'$TARE CODMY DEPARTMENT OF HEALTH AND ENVIRONMENT
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PROMOTE-PROTECT-SUPPORT ;
• • YEARS
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October 26th, 2017
Stephen and Pamela Dane
PO Box 603
Marstons Mills, MA 02648
RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 195-D Route 149 in
the town of Barnstable.
Dear Stephen and Pamela Dane,
Our records indicate that the operation and maintenance contract with Bennett Environmental Associates, Inc. for your
innovative/alternative wastewater treatment system may have expired or was canceled as of October 13th, 2017.To date we
have not received evidence that you have entered into a new operation and maintenance contract.
I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP)and the Town of
Barnstable require you to keep an operation and maintenance (O&M) contract in effect at all times for your system.
Information about these requirements may be found at https://septic,barnstablecountyhealth.ora.You can access the list of
_wastewater operators of whom we are aware do business in Barnstable County. This septic database also provides further
.explanation about your I/A septic system, as well as any sample and inspection history for the performance of your system,
as entered by previous service providers.
My.department oversees I/A septic system management and compliance efforts for the Board of Health in your town. We are
authorized by your Board of Health to contact you to inform you of the above requirement and to request your compliance.
Accordingly, please forward a copy of a signed contract via mail, fax, or e-mail within fifteen (15)days of receipt of this
letter. For your convenience, I have enclosed a list of wastewater operators we are aware of that do business in Barnstable
County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or
vendor.
Please be advised that if you do not respond within fifteen (15)days of your receipt of this letter by forwarding a copy of a
signed contract, you may be referred to the Barnstable Board of Health for further enforcement action.
I can be reached at 508-375-6901; my fax number is (508)362-2603. I can also be reached via email at
emilymichele.omsted@barnstablecounty.org. Thank you for your'prompt attention to this matter.
Sincerely,
Emily Michele Olmsted
CC: Barnstable Board of Health
Enclosures (2): Certified Wastewater Treatment System Operators List, Inspection and Testing Requirements
BARNSTABLE COUNTY COMPLEX
3195 MAIN STREET/PO BOX 427
BARNSTABLE,MASSACHUSETTS 02630
Phone:(508)375-6613 1 Fax:(508)362-2603 1 TDD:(508)362-5885
Web:barnstablecountyhealth.org I Twitter:@BCHDCapeCod
Inspection report stored on Q drive:
Q:\IA Systems\I-A Inspection Reports
4
a
i
ENNETT ENVIRONMENTAL ASSOCIATES, INC.
LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS
1573 Main Street,P.O.Box 1743 (508)896-1706
Brewster,MA 02631 fax(508)896-5109
LETTER OF TRANSMITTAL
TO: DATE: JOB NUMBER:
Massachusetts Department of Environmental Protection 9/22/17 BEA09-10142
Attention:Title 5 Program
1 Winter Street-6th Floor
Boston,MA 02108 REGARDING: j
Dane Residence
195 Herring Run Place Unit D[Route 149] j
SHIPPING METHOD: Marstons Mills,MA
Regular Mail ❑ Pick Up ❑
Priority Mail ❑ Hand Deliver ❑
Express Mail ❑ Other ❑
e
Certified Mail Green Card/RR FX1 €
COPIES DATE DESCRIPTION
1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(March and
September 2017)
1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(March and
September 2017)
1 3/7/17 Alpha Analytical Laboratory Report
1 9/18/17 Alpha Analytical Laboratory Report
For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: 0
REMARKS:
Please find enclosed the DEP Inspection and O&M Forms,OMNI RSF Operation and Maintenance Inspection Checklists,and laboratory
analytical reports for operation and maintenance conducted during the reporting period at the above referenced property. It is noted that
ins peetiomports or cleanouts for the pressure dosed leach field laterals are not accessible for inspection. If you have any questions or
C r- @
require additional information,please contact us at your earliest convenience. Thank you. 1
cc: Barnstable Board of Health[via email]
Mr. Stephen Dane,Property Owner[via email]
w
1
FROM: Samantha Farrenkopf,Wastewater Program Manager
If enclosures are not as noted,kindly notify us at once
k
�tT Town of Barnstable Barnstable
Board of Health 1�Ce i
3 BA STABLE,
MASS, 200 Main Street, Hyannis MA 02601
*639. ♦0 2007
Office: 508-8624644 Wayne Miller,M.D.
FAX: 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
October 15, 2014
Mr. and Mrs. Dane
PO Box 603
Marstons Mills, MA 02648
RE: Correction to Sampling of Wastewater Effluent from your Innovative/Alternative:(OMNI)
System at:
195 Route 149 #D, Marstons Mills A= 078-018,40D.
Herring Run Place Condo
Dear Mr. and Mrs. Dane,
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, #D, 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:
v 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
QAlA systems\195 Rtl49\Final correction Dane unit#D 2014.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 9/25/14 BEA09-10142
Attention:Title 5 Program
1 Winter Street-6th Floor
Boston,MA 02108 REGARDING:
Dane Residence
195 Herring Run Place Unit D[Route 149]
SHIPPING METHOD: Marstons Mills,MA
Regular Mail ❑ Pick Up ❑
Priority Mail ❑ Hand Deliver ❑
Express Mail ❑ Other ❑
Certified Mail Green Card/RR ❑
COPIES DATE DESCRIPTION
1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(March and
September 2014)
1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(March
2014) ,,,-.) —4
01
_.Ra ,� •i.7 ��
For review and comment: ❑ For approval: ❑ As requested: ❑ For your us ❑x
rTI
REMARKS:
i�
Please find enclosed the DEP Inspection and O&M Forms and OMNI RSF Operation and Maintenance Inspection Checklist for operation
and maintenance conducted during the reporting period at the above referenced property. The Barnstable Board of Health approved a
reduction in inspection frequency from quarterly to semi-annual in 2013. During regularly schedule O&M in September 2014,it was
identified that the recirculation pump required replacement. The pump has been replaced and the completion of regular O&M including
effluent sampling is scheduled for early October. It is noted that inspection ports or cleanouts for the pressure dosed leach field laterals are
not accessible for inspection. If you have any questions or require additional information,please contact us at your earliest convenience.
Thank you.
cc:Barnstable Board of Health
Mr. Stephen Dane,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 Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/ PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508) 896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
3/7/14 9/12/13
Inspection Date Previous Inspection Date
1" 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
H 7.0 SU DO 4.0 mg/L Turbidity1.90 NTU
p 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:
Conducted 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.
&SX-zt gI`��JII��
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Pro ram
One Winter Street, 6t Floor
Boston, MA 02108
t5aiom.doc•rev. 11-07-05 Page 3 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:When Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider j
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/ PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508) 896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
9/16/14 3/7/14
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5aiom.doc•rev. 11-07-05 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
E. Field Testing
Field Inspection:
Color: ❑ gray ❑ brown ❑ clear ❑ turbid
❑ Other(specify):
Odor: ❑ musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ❑ no ❑ some
pH s to 9 SU DO 2 or greatermg/L Turbidity qo 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
C. 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 recirculation pumps have
failed. The system owner approved replacement of the pumps, which was conducted on 9/19/14.
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
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
r
t5aiom.doc•rev. 11-07-05 Page 3 of 3
i
E'�� �o�rr�E�t�l Systems,r�c�.
OMNI RSF Operation and Maintenance Inspection Checklist
A. Installation &Service Information
ILti� i`t� _D iLk C 10 3Q
Facility Street Address Date of Sdrvice
City Operator/O&M Firm
System Startup Date Weather Conditions
B. Septic Tank
t+ tl
Sludge Pumping Required: Yes❑ No'T� ,Sludge Depth: Scum Depth: I
Effluent tee filter: Yes❑ No%t 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 O '
Check if sludge accumulating Pumping required: Yes❑ NoVk
Odor problems: Yes❑ Ncko 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 I 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
AjFloat switches
�ATest
Check all switches for operation
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") �v�5v��` '
Inspect for ponding • Ponding Present: Yes❑ N�
Clean bed: Yes❑. N�
Distribution pipes Flush:Yes ❑ Nt4 Brush: Yes❑ No
Any obstruction of airflow to filter modules: Yesb No❑ If Yes, explain below(i.e. snow, dirt)
Sv\cYca
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❑ No4
If yes: ❑BOD ❑TSS ❑pH ❑TN ❑Other
All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile,
laboratory supplied containers. In order to prevent any cross-contamination from a previous sample rinse the
dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained.
Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves).
System Notes:
� e
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS
1573 Main Street,P.O.Box 1743 (508)896-1706
Brewster,MA 02631 fax(508)896-5109
LETTER OF TRANSMITTAL
TO: DATE: JOB NUMBER:
Massachusetts Department of Environmental Protection 9/25/13 BEA09-10142
Attention:Title 5 Program
1 Winter Street-6th Floor
Boston,MA 02108 REGARDING:
Dane Residence
195 Herring Run Place Unit D[Route 149]
SHIPPING METHOD: Marstons Mills,MA
Regular Mail ❑ Pick Up ❑
Priority Mail ❑ Hand Deliver ❑
Express Mail ❑ Other ❑
Certified Mail 0 Green Card/RR ❑
COPIES DATE DESCRIPTION
1 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(December
2012;March,June and September 2013)
1 OMNI Environmental Systems,Inc.RSF Operation and Maintenance Inspection Checklist(December
2012;March,June and September 2013)
1 9/18/13 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 analytical results for operation and maintenance conducted during the reporting period at 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
Mr.Stephen Dane,Owner
David C.Bennett,Principal[Internal]
Matthew Costa-OMNI Environmental Systems,Inc[via email]
FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529
If enclosures are not as noted,kindly notify us at once
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 Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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:
r� P.O. Box 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428 - 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/ PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
12/28/12 9/6/12
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5aiom.doc•rev. 11-07-05 Page 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 5.5 mg/L Turbidity 0.50 NTU
6 to 9 2 or greater 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
Conduct an operation and maintenance event. Collect effluent samples for field testing.
Notes and Comments:
Effluent quality passed field testing parameters.
t5aiom.doc•rev.11-07-05 Page 2 of 3
i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
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� g12�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 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, 6th Floor
Boston, MA 02108
t5aiorn.doc•rev. 11-07-05 Page 3 of 3
I
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:When Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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:
r� P.O. Box 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/ PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508) 896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
3/8/13 12/28/12
Inspection Date Previous Inspection Date
12" Sludge, 1"Scum Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5aiom.doc•rev.11-07-05 Page 1 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
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 3.0 mg/L Turbidity 1.60 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:
9Pd
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:
Conducted an operation and maintenance event. Collect effluent samples for field testing.
Notes and Comments:
Effluent quality passed field testing parameters.
t5aiom.doc•rev.11-07-05 Page 2 of 3
f
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 ce - �ed operator in accordance with 257 CMR 2.00.
ZS�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 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
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 Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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:
rab P.O. Box 603
�I Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/ PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508) 896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8125/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
6/5/13 3/8/13
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5aiom.doc•rev. 11-07-05 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
E. Field Testing
Field Inspection:
Color: ❑ gray ❑ brown M clear ❑turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: M no ❑ some
pH 7.0 SU DO 7.0 mg/L Turbidity 11.52 NTU
6 to 9 2 or greater 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
Conducted an operation and maintenance event. Collect effluent samples for field testing.
Notes and Comments:
Effluent quality passed field testing parameters.
t5aiom.doc•rev.11-07-05 Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
H. Certification
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��6", �S�Aac - - �75�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 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
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
A. Installation
Important:When Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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:
r� P.O. Box 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508) 896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
9/12/13 6/5/13
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
t5aiom.doc•rev. 11-07-05 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
E. Field Testing
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6.5 SU DO 6.0 mg/L Turbidity 2.37 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:
9pd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS M 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:
Conducted an operation and maintenance event. Collect effluent samples for field testing and
laboratory analysis.
Notes and Comments:
Effluent quality passed field testing parameters.
t5aiom.doc•rev. 11-07-05 Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted the required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
2)a QCj
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 31st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Pro ram
One Winter Street, 6t Floor
Boston, MA 02108
t5aiom.doc•rev.11-07-05 Page 3 of 3
. J
�\ J
0Mt N
En vironrngv!�R Sy,stems,Inc.
OMNI RSF Operation and Maintenance Inspection Checklist
A. Installation &Service Information
-Y �-f- `, `kl s I-L R = to
Facility Street Address ` ! Date f Service
City Operator/O&M Firm
Spa.
System Startup Date Weather Conditions
D. Septic Tank \v L
Sludge Pumping Required: Yes❑ NdA ❑ Sludge Depth: ❑ Scum Depth:
Effluent tee filter: Yes❑ Nk% 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 TankAI
El Check if sludge accumulating Pumping required: Yes❑ N4VO
e..
Odor problems: Yes ❑ Nox, If yes,description
Effluent tee filter: Yes ElNo0 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
�6"Pump Inspections(all units)
� If problems,describe t
WTest pump alternator, or record hours �y 3 (�G�� �c� C1 ��C�
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 ❑ NCM"
Clean bed: Yes❑ No1/
.Clean
pipes Flush:Yes❑ No�(] Brush: Yes❑ No&]
AAny obstruction of airflow to filter modules: Yes❑ No Of 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❑ Nom
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:
f
t
Emilrownental'systems,Inc.
OMNI RSF Operation and Maintenance Inspection Checklist
A. Installation &Service Information
Facility Street Address Date of Service _
City Operator/O&M Firm
--5yNo o
System Startup Date Weather Conditions
D. Septic Tank
Sludge Pumping Required: Yes❑ No. Sludge Depth: 6 iVLScum Depth: f
Effluent tee filter: Yes❑ N 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. 'I ' _
C. Recirculation Tank Q 0y,
Check if sludge accumulating Pumping required: Yes❑ No❑
Odor problems: Yes ❑ N If yes,description
Effluent tee filter: Yes ❑ N�K 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)
J 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
I ] Pump Inspections(all units)
If problems,describe
Test pump alternator, or record hours
Hours of operation
Float switches
Check all switches for operation
Test alarm
If non-functioning,corrective action(s)
Make sure pump(s), Float(s)and audible alarm(s)are functional, if not make a note so that corrective
actions can be made. , Q
G. Filter Modules ("Sand Filters") J
Inspect for ponding Ponding Present:Yes❑ No
Clean bed: Yes❑ NOA
,Distribution pipes Flush:Yes❑ No 000
Brush: Yes❑ No
Any obstruction of airflow to filter modules: Yes❑ If Yes, explain below(i.e. snow,dirt)
To inspect the condition of the filter modules remove the mulch layer at onne 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❑ NCO
If yes: ❑BOD OTSS ❑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:
-[tm OMN8RSF Operation and Maintenance Inspection Checklist
A. Installation & Service Information
Facility Street Address Date of Se7rvice
city Operator/U&M Firm
System Startup Date Weather Conditions
�36 ' ~��-�� Q k `J ^ -^
B. Septic Tank -
Sludge Pumping Required: Yes[] N6l& Fl Sludge Depth: Fl Scum Depth:
Effluent tee filter: Yes El N6l21 |f yes, inspect F7&clean at least yearly El
|f the sludge layer io 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 ioused.
C. Recirculation Tankw�r
F1 Check if sludge accumulating Pumping required: Yes El Nz~A
Odor problems: YaaFl N n yes,description
� Effluent tee filter: YeoFl Njo If yes, inopeutFl &n|oanut �oa��yeor|yF� �
^� . ^� ^~
|f the sludge layer io 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. E�0��;���y�� T�Ok ��������|Y��'�
^_ �r `
Sludge Pumping Required: Yes El No El El Sludge Depth: Scum Depth:
Effluent tee filter: Yes El No El |f yes, inspect Fl&clean ad least yearly El
.Same inspection criteria uo septic tank:
E. Pump Chamber/Vault(if Installed)
Vpump Inspections(all units) If problems,describe
VFloat switches
Make Sure the pump is operational by pulling up the float switch; if the pump is not operational immediate
corrective actions need hobotaken.
U
�
F. Pumps, Switches, Floats, Alarm System
[Pump Inspections(all units)
If problems,describe
Test pump alternator,or record hours 33 L� t (00\ C c_\. `ylko\- _C��
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❑ Nom
Clean bed: Yes❑ No+K
.Distribution pipes Flush:Yes❑ NoA Brush: Yes❑ No m
Any obstruction of airflow to filter modules: Yes❑ No kIf 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 o
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:
3�11a
C.
C\j&.3—
— .0
_ e
21
M1
Envrrontnewal Systeins, lice.
OMNI RSF Operation and Maintenance Inspection Checklist
A. Installation & Service Information
IUkck Irk'; - -9 �I i , 10
Facility Street Address \ Date of tervice
" S-yv\%"
City Operator/O&M Firm
51;V\
System Startup Date Weather Conditions
E. Se ticTank
p
Sludge Pumping Required: Yes ❑ Nob. ❑ Sludge Depth: ❑ Scum Depth:
Effluent tee filter: Yes❑ No If yes, inspect❑ &clean at least yearly❑
If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank
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❑ NkIA,
Odor problems: Yes❑ NogU If yes,description
Effluent tee filter: Yes❑ No If yes, inspect El &clean at least yearly El
If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to
prevent clogging of the filter modules. Note the characteristics of the effluent coming out of the manifold this
may indicate that the filter bed may need servicing.
NA 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
XPump Inspections(all units)
If problems,describe
Test pump alternator, or record hours
Hours of operation
Float switches
Check all switches for operation
Test alarm
If non-functioning,corrective action(s)
Make sure pump(s), Float(s)and audible alarm(s)are functional,if not make a note so that corrective
actions can be made. 1(�
G. Filter Modules ("Sand Filters )
Inspect for ponding ry Ponding Present:Yes El No
Clean bed: Yes❑ Nol
V \ ;,
Distribution pipes Flush:Yes❑ N Brush: Yes❑ No
[� 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
YeOK No❑
If yes: ❑BOD ❑TSS ❑pH �KJTN kJ10ther Vi`- )
All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile,
laboratory supplied containers. In order to prevent any cross-contamination from a previous sample rinse the
dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained.
Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves).
System Notes: \\
-'�S�`';,.^ Cis iC✓V� t��� (} m fA . .
, \ r
e
� - � � Jy 0 0
Serial No:09181317:41
J
1 HA
A-N A L Y T I C A L
ANALYTICAL REPORT
Lab Number: L1317961
Client: Bennett Environmental Associates
1573 Main Street
Brewster, MA 02631
ATTN: David Bennett
Phone: (508)896-1706
Project Name: DANE RESIDENCE
Project Number: BEA09-10142
Report Date: 09/18/13
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
%�FtiA
Page 1 of 18
Serial No:09181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
Alpha Sample Collection
Sample ID Client ID Location Date/Time
L1317961-01 EFFLUENT MARSTONS MILLS, MA 09/12/13 10:00
Page 2 of 18
Serial No:09181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
Case Narrative
The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation
or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report.
Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of
NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample
specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample,
followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a
required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is
designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the
associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific%
recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods
allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not
narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool
where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight
basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the
back of the report.
In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some
quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the
associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed
along with any associated usability implications.
Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical
Standards requested on the Chain of Custody.
HOLD POLICY
For samples submitted on hold,Alpha's policy is to hold samples free of charge for 21 calendar days from the date the project is completed.
After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service
Representative and made arrangements for Alpha to continue to hold the samples.
Please contact Client Services at 800-624-9220 with any questions.
I,the undersigned, attest under the pains and penalties of perjury that, to the best of my knowledge and
belief and based upon my personal inquiry of those responsible for providing the information contained
in this analytical report, such information is accurate and complete. This certificate of analysis is not
complete unless this page accompanies any and all pages of this report.
Authorized Signature: Michelle M,Morris
`�'"�M�'•`�.`'u"�r'''tT
Title: Technical Director/Representative Date: 09/18/13
Page 3 of 18
Serial No:09181317:41
INORGANICS
MISCELLANEOUS
Page 4 of 18
Serial No:O9181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEAO9-10142 Report Date: 09/18/13
SAMPLE RESULTS
Lab ID: L1317961-01 Date Collected: 09/12/13 10:00
Client ID: EFFLUENT Date Received: 09/12/13
Sample Location: MARSTONS MILLS,MA Field Prep: Not Specified
Matrix: Water
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
General Chemistry-Westborough Lab
Nitrogen,Nitrite ND mg/I. 0.050 -- 1 - 09/14/13 00:35 44,353.2 DB
Nitrogen,Nitrate 16. mg/I 0.50 -- 5 09/14/13 01:27 44,353.2 DB
...... 1. ......_ .. ......._ ........ ... _..... _ .. ...
Nitrogen,Total Kjeldahl ND mg/I_ 0.300 _ 1 09/13/13 12:20 09/17/13 19 18 30,4500N C _ AT
h6m'��
Page 5 of 18
Serial No:09181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
Method Blank Analysis
Batch Quality Control
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
General Chemistry,?Westborough Lab for sample(s). 01 Batch: WG635897 1';:
Nitrogen,Total Kieldahl ND mg/l 0.300 -- 1 09/13/13 12:20 09/17/13 18:58 30,4500N-C AT
General Chemistry`—Westborough Lab forsample(s) 01 Batch eWG636045 1
Nitrogen,Nitrate ND mg/I 0.10 1 09/14/13 00A7 44,353.2 DB
General Cliemist" We"sttiorou hi Lab for sam le s . 01 Batch: WG636046=1 a .
Nitrogen,Nitrite ND mgfl 0.050 1 09/14/13 00:18 44,353.2 DB
............ ......... ..........
Page 6 of 18
Serial No:09181317:41
Lab Control Sample Analysis
Project Name: DANE RESIDENCE Batch Quality Control Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
LCS LCSD %Recovery
Parameter %Recovery Qua[ %Recovery Qual Limits RPD Qual RPD Limits
a
General Chemistry-;Westborough'Lab Associated sample(s):,0I".,-Batch 1NG635897 2
1,.,.�..a.+.a...-..�.-..e...�:.:_._ ,«.,..,..n,....',jai..-.-.r•......e-�»-_.s._..:..w..;-.-...._...-.A-.,_ ".....-r+-.-..�.....wti`'`'.,,...x,.w......�;.«w.✓.w.._..._r.;i..'r:.a. ....._;.d..e« ..
Nitrogen,Total Kjeldahl :97-�'a. - 78_122 -
General Chemistry-;Westborough Lab ?Associated sample(s):,01 Batch WG636045 2
Nitrogen,Nitrate "'' `�"101 90-110 -
General Chemistry-.Westborough:Lab Associated samples) 01 Batch WG636046 2 ..
Nitrogen,Nitrite �.'104= - 90-110 20
Page 7 of 18
Serial No:09181317:41
Matrix Spike Analysis
Batch Quality Control
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
Native MS MS MS MSD MSD Recovery RPD
Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits
General,Chemistry-Westborough;Lab Associated sample(s.);:01 . <QC BatchtlD 1NG63589.7-4 QC Sam pie:,L13:17914,01 Client ID .MS Sample
Nitrogen,Total Kjeldahl 1.37 8 8.61 -''--90 - - 77-111_ - 24
GeneraPChemistry-Westborough L*ab:Associatedsample(s):_01 QC�Batch:ID -VVG636045 4 QC Sample L1317998 01 f;Client'ID. MS'Saniple
Nitrogen,Nitrate ND 4 4.2 "165, - - 83-113 - 6
General�Chemist Westkiorou hLabAssociated sam`le s :x01 QC.Batch- ;ID WG636046 4 QC Sample: L1317995 01 :'Client.ID MSSample
Nitrogen,Nitrite ND 4 4.0 ry-99 80-120 - 20
n
Page 8 of 18 LU?HA
Serial No:09181317:41
Lab Duplicate Analysis
Project Name: DANE RESIDENCE Batch Quality Control Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
Parameter Native Sample Duplicate Sample Units RPD Qua[ RPD Limits
GeneralaChemistry Westborough`La6'As oclat samples) ':01 QG`BatchilD 1NG635897-3 QG Sample 11317914=01 ClirentyID: �DUP,Sample:<
Nitrogen,Total Kjeldahl 1.37 1.36 mg/I _.""1. 24
General;Chemist W.estborou h.LabAssoclatedaample(s) 01a QGBatch'ID #WG636045-3 Q.CSample: "L1:317998=01Cllent;ID.:"..DUF,Sample=;"
Nitrogen,Nitrate ND ND mg/I 'NC" 6
General Chemistry-Westborough Lab. .Associated,sample(s) 01 . QC Batch+ID WG636046=3 QG Sample: ,11317995=01 }Client ID�-DUP. Sample..
Nitrogen,Nitrite ND ND mg/I i NC '; 20
Page 9 of 18 PhA
A 74
�..
Serial No:09181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
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(*)
L1317961-01A Plastic 250ml unpreserved A 7 4 Y Absent NO2-353(2),NO3-353(2)
L1317961-01B Plastic 250ml H2SO4 preserved A <2 4 Y Absent TKN-4500(28)
Container Comments
L1317961-01A
* 7
Values in parentheses indicate holding time in days a a Page 10 of 18
Serial No:O9181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
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 analyze list of the original
method.
Terms
Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is
shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum.
Data Qualifiers
A Spectra identified as"Aldol Condensation Product".
B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that
have detectable concentrations of the analyte at less than ten times(IOx)the concentration found in the blank.For MCP-related
projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)
the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable
concentrations of the analyte at less than ten times(IOx)the concentration found in the blank AND the analyte was detected above
one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ-
Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the
reporting limit.
C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted
analyses.
D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations
of the analyte.
E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument.
G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should
be considered estimated.
H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection.
I The lower value for the two columns has been reported due to obvious interference.
Report Format. Data Usability Report
Page 11 of 18
Serial No:09181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: 09/18/13
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
rrL\QN�i
Page 12 of 18
Serial_No:09181317:41
Project Name: DANE RESIDENCE Lab Number: L1317961
Project Number: BEA09-10142 Report Date: . 09/18/13
REFERENCES
30 Standard Methods for the Examination of Water and Wastewater. APHA-AWWA-
WPCF. 18th Edition. 1992.
44 Methods for the Determination of Inorganic Substances in Environmental Samples,
EPA/600/R-93/100,August 1993.
LIMITATION OF LIABILITIES
Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing
laboratory industry. In the event of an error, the sole and exclusive responsibility of Alpha Analytical
shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable
for any incidental, consequential or special damages, including but not limited to,damages in any way
connected with the use of,interpretation of, information or analysis provided by Alpha Analytical.
We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling,
containers, sampling procedures, holding time and splitting of samples in the field.
Page 13 of 18
Serial-No:09181317:41
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: SM212013, 2320B, 2510B, 2540C, SM4500CN-CE, 4500E-C, 45001-1-13,
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, 450017-C, 4500H-B, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-E, 4500S-D,
4500SO3-B, 5210B, 5220D, 5310C, 5540C, EPA 120.1, 1664A, 200.7, 200.8, 245.1, 300.0, 350.1, 351.1, 353.2, 410.4,
420.1. Organic Parameters: EPA 608,624,625.)
Hazardous and Solid Waste (Inorganic Parameters: EPA 1010A, 1030, 1311, 1312, 6010C, 6020A, 7196A, 7470A,
7471 B, 9012B, 9014, 9038, 9040C, 9045D, 9050A, 9065, 9251. Organic Parameters: 8011 (NPW only), 8015C, 8081 B,
8082A,8151A, 8260C, 8270D, 8315A, 8330.)
Maine Department of Human Services Certificate/Lab ID:2009024.
Drinking Water(Inorganic Parameters: SM921513, 9222D, 9223B, EPA 180.1, 353.2, SM212013, 2130B, 2320B, 2510C,
2540C, 4500CI-D,4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, 5310C, EPA 200.7, EPA 200.8, 245.1, EPA
300.0. Organic Parameters: 504.1, 524.2.)
Wastewater/Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A, 300.0, 350.1, 351.1, 353.2, 410.4, 420.1,
8315A, 9010C, SM2120B, 2310B, 2320B, 2510B, 2540B, 2540C, 2540D, 426C, 4500CI-E, 4500CN-C, 4500CN-E,
4500E-B, 4500E-C, 4500H+B, 4500Norg-C, 4500NH3-B, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-B, 4500P-E,
4500S2-D, 4500SO3-B, 5540C, 5210B, 5220D, 5310C, 9010B, 9030B, 9040C, 7470A, 7196A, 2340B, EPA 200.7,
66010eC, 200.8, 6020A, 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 625, 8011,
Page 7�o1 1'88082A, 8330, 8151A, 8260C,8270D, 3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.)
Serial No:09181317:41
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: SM92221), 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, SW-
846 6010C, 6020A, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4, 420.1, 426C,
1664A, SW-846 9010B, 9010C, 9030, 9040B, 9040C, SM2120B, 2310B, 2320B, 2340B, 2540B, 2540D, 4500H+B,
4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 4500S03-B, 5210B, 5220D,
2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D, 3060A. Organic
Parameters: SW-846 3510C, 3630C, 5030B, 8260C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082A, 8081 B, 8015C,
8151A, 8330, 8270D-SIM.)
Solid& Chemical Materials (Inorganic Parameters: SW-846 6010C, 6020A, 7196A, 7471B, 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, 362013, 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, SM522013, 4500CI-E, EPA 300.0, SM2120B, 2340B,
SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F,4500NO2-B, EPA 1664A,
SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B,
SM15 426C, 9222D, 9221B, 9221C, 9221E, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2,
SW-846 1312, 7470A, 5540C, SM4500H-B, 4500S03-B, SM3500Cr-D, 4500CN-CE, EPA 245.1, SW-846 9040B,
9040C, 3005A, 3015, EPA 6010B, 6010C, 6020, 6020A, 7196A, 3060A, SW-846 9010C, 9030B. Organic Parameters:
SW-846 8260B, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3510C, EPA 608, 624, 625, SW-846 3630C, 5030B,
8011, 8015C, 8081A,8081B, 8082, 8082A, 8151A,8330, 1,4-Dioxane by NJ Modified 8270,8015B, NJ EPH.)
Page li Chemical Materials(Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010,
81 A, 1030, 1311, 1312, 3005A, 3050B, 7471A, 7471B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D,
Serial No:09181317:41
9050A, 9065, 9251. Organic Parameters: SW7846 8015I3, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 82606,
8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 3540C, 3546, 3580A, 3620C, 3630C, 503013, 5035L, 5035H, NJ EPH.)
New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited.
Drinking Water (Inorganic Parameters: SM92236, 922213, 921513, EPA 200.8, 200.7, 245.1, SM5310C, EPA 332.0,
SM232013, EPA 300.0, SM212013, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA
524.2,504.1.)
Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 922113, 922213, 9215B, 5210B, 5310C, EPA 410.4,
SM522013, 2310B, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA
351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 234013, 2540C, 2540B, 2540D, EPA
200.8, EPA 6010C, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 7470A, SM212013, 4500CN-CE, EPA 1664A, EPA
420.1, SM14 510C, EPA 120.1, SM25106, 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, 9012B,
9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 30506, 9010C, 9030B, 9040C, 9045D. Organic Parameters:
EPA 8260C, 82701),8270D-SIM, 8015C, 808113, 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: SM2310B, 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, 82606, 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, 21206, 2310B, 232013,2510B,254013,2540C, 3500Cr-D,426C,4500CN-CE,4500CI-E,4500E-B,4500E-C,
4500H+-B,4500NH3-H,4500NO2-B,4500NO3-F,4500S-D,4500SO3-B, 5310BCD,5540C, 9010C, 9040C. Organic
Parameters: EPA 3510C, 3630C, 5030B,625, 624, 608, 808113, 8082A, 8151A,8260C, 8270D, 8270D-SIM, 8330,
8015C, NJ-EPH.)
Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3005A, 30506, 3060A, 6010C,
6020A, 7196A, 747113, 9010C, 90126, 9014, 904013, 9045D, 9050A, 9065, SM 4500NH3-BH, 903013, 9038, 9251.
Organic Parameters: 3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081B, 8082A, 8151A, 8260C, 8270D, 8270D-
SIM, 8330, NJ-EPH.)
Rhode Island Department of Health Certificate/Lab ID: LAO00065. 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,254013,2540C, 2540D,426C,4500CL-
E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C, 521013, 5220D,5310C,
5540C. Organic Parameters: EPA 608, 624,625, 8081, 8082,8151,8260, 8270,8330.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012,9014,9040, 9045, 9050, 9065.)
Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited.
Drinking Water(Inorganic Parameters: EPA 200.7,200.8, 300.0, 2510B,2120B,2540C,4500CN-CE, 245.1,232013,
4500E-C,4500NO3-F,4500H+B, 5310C. Organic Parameters: EPA 504.1, 524.2.)
Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664A,200.7,200.8, 245.1, 300.0, 350.1, 351.1,351.2, 3005A,
3015, 1312, 6010B,6010C, 3060A, 353.2,420.1, 2340B,6020, 6020A, SM4500S-D,SM4500-CN-CE, Lachat 10-204-
1- 7196A, 7470A, 2310B,2320B,2510B,25406,2540C,2540D,3500Cr-D,426C,4500CI-E,4500E-B,4500E-C,
Page A9 h3-H,4500NO2-B,4500NO3-F,4500 SO3-B, 4500H-B,4500PE, 510AC,521013,5310B 5310C, 5540C, 9010Cm
i
Serial No:09181317:41
903013, 9040C. Organic Parameters: EPA 3510C, 3630C,5030B,8260B,608,624, 625, 8011,8015C, 8081 A, 8081B,
8082, 8082A, 8151A,8260C,8270C, 8270D, 8270C-SIM,8270D-SIM, 8330, )
Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030,3060A, 3050B, 1311, 1312,6010B, 6010C, 6020, ,
7196A, 7471A, 7471B, 6020A, 9010C, 901213, 9030B, 9014, 9038, 9040C,9045D, 9251, 9050A, 9065. Organic
Parameters: EPA 50306, 5035, 3540C, 3546, 3550B,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, 21306,
23206, 234013, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A,
8260C,8270D, 8270D-SIM, 8330A, 8082A, 8081 B, 3510C, 503013, MassDEP EPH, MassDEP VPH.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010C,6020A, 7471A, 6860, 1311, 1312, 305013, 7196A,
904013, 9045C, 9010C, 9012B, 9251,SM3500-CR-D,4500CN-CE,2540G,Organic Parameters: EPA 8015C, 8151A,
8260C, 8270D, 8270D-SIM,8330A/B-prep, 8082A, 8081 B, 3540C, 3546, 3580A,5035A, MassDEP EPH, MassDEP
VPH.)
The following analytes are not included in our current NELAP/TNI Scope of Accreditation:
EPA 524.2: Acetone, 2-Butanone (Methyl ethyl ketone (MEK)), Tert-butyl alcohol, 2-Hexanone, Tetrahydrofuran, 1,3,5-
Trichlorobenzene, 4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260B: 1,2,4,5-
Tetramethylbenzene, 4-Ethyltoluene. EPA 8260 Non-potable water matrix: lodomethane (methyl iodide), Methyl
methacrylate. EPA 8260 Soil matrix: Tert-amyl methyl ether (TAME), Diisopropyl ether (DIPE), Azobenzene. EPA
8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl
naphthalene, Total Methylnapthalenes, Total Dimethylnaphthalenes, 1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,
4-Methylphenol. Total Phosphorus in a soil matrix, TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix. EPA
9071: Total Petroleum Hydrocarbons,Oil&Grease.
Page 17 of 18
Serial Nti:09181317:41
3
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L 'A Report Information Data Deliverables; Billing Information
❑ICA Project Information -4
FAX ® EMAIL. 1 ® Same as Client info PO#:10142 i
Westborough,MA Mansfield,MA
TEL 508-808-9220 TEL 508.822-9300 Project Name:Dane Residence ❑ ADEX ❑ Add'I Deliverables
FAX,50"98-9193 FAX:508-a22-3288
Regulatory . ••
Client Information Project Location:Marstons Mills,MA State/Fed Program, Criteria
Client:Bennett Environmental Associates Project#:BEA09-10142
Address:1573 Main Street/P.O.Box 1743 Project Mana er:David C.Bennett
Brewster,MA 02631 ALPHA Quote#:
Phone:508-896-1706. Turn-Around Time
ANALYSIS
Fax:508-896-5109 ®Standard ❑Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING
/
Email:sfarrenkopf@bennett-ea.com Pnrraue. --
❑ Done
❑These samples have been Previously analyzed by Alpha Due Date: Time: ® Not Needed
-'
Other Project Specific Requirements/Comments/Detection Limits: ❑ Lab to doPreservation •
❑ Lab to do
(Please specify
below)
ALPMA'L'at:ID' Sample ID Collection Sample Sampler's z
I. (Lati Use.'Oniy).I':LL Date Time Matrix Initials Z
Sample apecine
Comments
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Page 18 of 18
1
i
Town of Barnstable - Barnstable Water Watchers Program . . . ..... . Page.. _ of
Optical Brightener Data Sheet
Drainage Area: Collected by:
Pollution Sample Location Placed Pulled Number Volume O.B. +/- Total Rain Comments
Source# Number of Days test
v
LAOptical Brig htenerDataSheet.xls
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Stephen & Pamela Dane
PO Box 603
Rte 149 D Herring Run Place
Marstons Mills, MA 02648
September 16, 2013
Wayne Miller, MD
Chairman of the Board
Board of Health
Hyannis, MA 02601
I am writing to request a hearing on October 8, 2013 regarding the sampling and testing of
my OMNI 2000 Recirculation Sand Filtration System for my residence at 195-D Route 149,
Marstons Mills..
The system was installed in 2002-2003 and I moved into my home on June of 2003.
The installation of my system did not require a variance from any state or local regulations,
and my property is not located within any Well Protection (WP) Zones or any Groundwater
Protection (GP) Zones
In 2009 The Board of Heath.granted us permission to reduce sampling and monitoring of the
system to once per year.
We have now been in our home for over 10 years and each year we have had our system
tested and maintained on a quarterly basis.
Please see attached found on mass.Aov site—Sand Filter Approval Letter regarding Systems.
am at this time requesting that future maintenance of my RSF system be done on a yearly
basis. As in the past it will be performed by a Massachusetts certified operator for wastewater
management. We should also note that during the winter we are away 48 days and our
system every year has always passed with flying colors.
If at any time these regular inspections indicate my system is not in compliance, I will take the
necessary actions to resolve and correct any problem. We also have a monitoring device
inside our home that monitors the pumps and the tanks.
Thanking you in advance for your consideration.
Sincerely,
Page 1 of 2
McKean, Thomas
From: greatdaneproductions@comcast.net
Sent: Tuesday, September 17, 2013 8:45 AM
To: McKean, Thomas
Subject: Fwd: Sand Filter Approval from DEP & Hearing letter
Hi Tom,
It was nice talking with you once again.
Please see attached letter regarding hearing for Oct. 8th with our request to go
on
yearly maintenance of our RSF System.
Below is the forward on System Approval. Letter.
Let me know if it looks ok to submit and I have everything you need.
Bennett Environmental has been submitting our testing results since 2009
so, your office should have those results.
Thanks again for all your help.
Stephen Dane 508- 428- 1024
i
Sand Filter Approval Letter from DEP
ii. The operator must inspect, and maintain the System according to the following, and
anytime there is an alarm event.
a. For Systems in use year round: effluent from the System shall be monitored at
least once per calendar quarter. Any sample collected within 60 days or more than
90 days of a previous sample shall not be considered a required quarterly sample.
The following parameters shall be monitored: pH, effluent CBOD5, TSS,
alkalinity. and TN (TKN+NO3-N+NO2-N). Each time the System is monitored,
the water meter; if a water meter is installed,.shall be read and the water use
recorded. All monitoring data shall be submitted to the Department and the local
approving authority per Section IV, item .8 below. After two years of monitoring
and at the written request of the System owner, the local approving authority may
reduce the inspection and monitoring requirements for residential systems to two
inspections per year with field testing for pH, DO and turbidity and laboratory
testing for T1�T"
Filter Approval Letter from DEP
For Systems in use seasonally, where the facility is occupied fewer than six
months per year; effluent from the System shall be monitored twice per season;
9/17/2013
CarmodyTM Service History Page 1 of 1
Property History
Property Information
Property ID BAR49195RSF-D (Tracking Number)
Name Dane, Stephen
Site Address 195-D Route 149
Marstons Mills, MA
Service Statistics
Total Service Events (To Date) 52
Service History - 1 Year
Date Report Type
Entered Gallons Recorded By or Comments
Date Pumped Disposal Site
Serviced
9/20/2013 0 Bennett Sampling
11:58 AM ----Environmental----Report- -
9/12/2013 Associates, Inca
10:30 AM ' ------
Using: The Web Site
9/20/2013 0 Bennett "*Inspection" Conducted general O&M along with
11:57 AM Environmental effluent quality field testing, pulled
9/12/2013 Associates, Inc. effluent samples for lab analysis.
10:30 AM ------
Using: The Web Site
6/7/2013 0 Bennett "Inspection" Conducted O&M along with effluent
12:07 PM Environmental quality field testing.
6/5/2013 Associates, Inc.
12:30 PM ------
Using: The Web Site
3/13/2013 0 Bennett "*Inspection"* O&M visit along with effluent quality
7:43 AM Environmental field testing.
3/8/2013 Associates, Inc.
11:30 AM ------
Using: The Web Site
1/2/2013 System Generated No service No service event reported within service
-12:00 AM recorded schedule: 09/06/2012 to 01/01/2013.
1/2/2013
12:00 AM Notes:
No service event was recorded by the
system for this component: Sample
Report(Effluent)
1/2/2013 0 Bennett "*Inspection" System is operating correctly. Effluent
12:39 PM Environmental quality passed field testing parameters.
12/28/2012 Associates, Inc.
12:10 PM ------
Using: The Web Site
Total Gallons Pumped=0
httD:Hcarmodv.biz/-oumD/Service History.aSpX?pmode=l&permit id=254227&cidd=6351... 9/23/2013
CarmodyTM Service History Page 1 of 7
Property History
Property Information
Property ID BAR49195RSF-D (Tracking Number)
Name Dane, Stephen
Site Address 195-D Route 149
Marstons Mills, MA
Service Statistics
Total Service Events (To Date) 52
Service History-All
Date Report Type
Entered Gallons Recorded By or Comments
Date Pumped Disposal Site
Serviced
9/20/2013 0 Bennett Sampling
11:58 AM Environmental Report
9/12/2013 Associates, Inc.
1.0:30 AM ------
Using: The Web
Site
9/20/2013 0 Bennett "Inspection" Conducted general O&M along with effluent
11:57 AM Environmental quality field testing, pulled effluent samples
9/12/2013 Associates, Inc. for lab analysis.
10:30 AM ------
Using: The Web
Site
6/7/2013 0 Bennett "Inspection" Conducted O&M along with effluent quality
12:07 PM Environmental field testing.
6/5/2013 Associates, Inc.
12:30 PM ------
Using: The Web
Site - I
3/13/2013 0 Bennett "Inspection" O&M visit along with effluent quality field
7:43 AM Environmental testing.
3/8/2013 Associates, Inc.
11:30 AM ------
Using: The Web
Site
1/2/2013 System No service No service event reported within service
12:00 AM. Generated recorded schedule: 09/06/2012 to 01/01/2013.
1/2/2013
12:00 AM Notes:
No service event was recorded by the system
for this component: Sample Report(Effluent)
1/2/2013 0 Bennett "Inspection" System is operating correctly. Effluent quality
12:39 PM Environmental passed field testing parameters.
12/28/2012 Associates, Inc.
12:10 PM ------
http://carTnody.biz/pump/Service History.aspx?pmode=l&permit_id=254227&ha=10 9/23/2013
CannodyTM Service History Page 2 of 7
Using: The Web
Site
9/14/2012 0 Bennett Sampling System is operating correctly. Effluent quality
1:06 PM Environmental Report passed field testing parameters.
9l6/2012 Associates, Inc.
10:45 AM ------
Using: The Web
Site
9/14/2012 0 Bennett "Inspection" System operating correctly. Pulled effluent
1:04 PM Environmental samples for lab analysis. Effluent quality
9/6/2012 Associates, Inc. passed field testing parameters.
10:45 AM ------
Using: The Web
Site
6/11/2012 0 Bennett "Inspection" Conducted general O&M, effluent quality field
12:45 PM' Environmental testing.
6/8/2012 Associates, Inc.
1:30 PM ------
Using: The Web
Site
3/21/2012 0 Bennett "Inspection" Conducted O&M visit along with effluent
1:31 PM Environmental quality field testing. Requested that
3/13/2012 Associates, Inc. homeowner have recirculation tank pumped
3:00 PM ------ out due to solids accumulation.
Using: The Web
Site
1/2/2012 System No service No service event reported within service
12:00 AM Generated recorded schedule: 09/14/2011 to 01/01/2012.
1/2/2012
12:00 AM Notes:
No service event was recorded by the system
for this component: Sample Report(Effluent)
12/28/2011 0 Bennett "Inspection" System is not functioning correctly.
11:28 AM Environmental Recirculation tank pump is not functioning.
12/21/2011 Associates, Inc. Dosing pump is functioning properly. Notified
1:40 PM ------ homeowner of problem, granted verbal
Using: The Web authorization for repair. Effluent quality
Site passed field testing parameters.
9/27/2011 0 Bennett Sampling
8:44 AM Environmental Report
9/14/2011 Associates, Inc.
2:40 PM ------
Using: The Web
Site
9/27/2011 0 Bennett "Inspection" Conducted general system O&M, effluent
8:43 AM Environmental quality field testing, and pulled annual effluent
9/14/2011 Associates, Inc. samples for lab analysis.
2:40 PM ------
Using: The Web
Site
6/13/2011 0 Bennett "Inspection" Conducted general O&M and effluent quality
11:16 AM Environmental field testing.
6/10/2011 Associates, Inc.
1:00 PM ------
Using: The Web
Site
1-httri•//r.5irmnrly Nistnry a.cnx?mmndP=1 knermit 9/9.1/9.011
CarmodyTM Service History Page 3 of 7
3/14/2011 0 Bennett "Inspection" Conducted O&M and effluent quality field
1:11 PM Environmental testing.
3/8/2011 Associates, Inc.
1:00 PM ------
Using: The Web
Site
1/6/2011 0 Bennett "Inspection" Conducted O&M,field testing.
12:58 PM Environmental
1/412011 Associates, Inc.
10.15 AM ------
Using: The Web
Site
1/2/2011 System No service No service event reported within service
12:00 AM Generated recorded schedule: 09/08/2010 to 01/01/2011.
1/2/2011
12:00 AM Notes:
No service event was recorded by the system
for this component: RSF
1/2/2011 System No service No service event reported within service
12:00 AM Generated recorded schedule: 09/08/2010 to 01/01/2011.
1/2/2011
12:00 AM Notes:
No service event was recorded by the system
for this component: Sample Report(Effluent)
9/17/2010 0 Bennett Sampling.
9:00 AM Environmental Report
9/8/2010 Associates, Inc.
11:15 AM ------
Using: The Web
Site
9/17/2010 0 Bennett "Inspection" Conducted O&M,field testing, and pulled �
8:56 AM Environmental effluent sample for lab analysis
9/8/2010 Associates, Inc.
11:15 AM ------
Using: The Web
Site
6/22/2010 0 Bennett "Inspection*" O&M and Field Sampling Visit.
7:22 AM Environmental
6/9/2010 Associates, Inc.
4:00 PM ------
Using: The Web
Site
3/2212010 0 Bennett *'"Inspection" General O&M visit along with field testing
1:18 PM Environmental
3/16/2010 Associates, Inc.
11:00 AM ------
Using: The Web
Site
1/8/2010 0 Bennett "Inspection"
2:06 PM Environmental
1/6/2010 Associates, Inc.
11:30 AM ------
Using:.The Web
Site
1/2/2010 System. No service No service event reported within service
12:00 AM Generated recorded schedule: 08/26/2009 to 01/01/2010.
Notes:
httu://carmody.biz/pump/Service History.as-Dx?pmode=l&-oennit id=254227&ha=10 9/23/2013
CarmodyTM Service History Page 4 of 7
1/2/2010 No service event was recorded by the system
12:00 AM for this component: RSF
1/2/2010 System No service No service event reported within service
12:00 AM Generated recorded schedule: 07/01/2009 to 01/01/2010.
1/2/2010
12:00 AM Notes:
No service event was recorded by the system
for this component: Sample Report(Effluent)
9/15/2009 0 OMNI "*Inspection"
10:18 AM Environmental
8/26/2009 Systems, Inc.
10:00 AM ------
Using: The Web
Site
4/17/2009 0 OMNI Sampling
9:24 AM Environmental Report
4/8/2009 Systems, Inc.
11:45 AM ------
Using: The Web
Site
4/8/2009 0 OMNI "Inspection" O&M Conducted Effluent Sample Pulled
1:18 PM Environmental
4/8/2009 Systems, Inc:
11:45 AM -----
Using: The Web
Site
1/12/2009 0 OMNI Sampling
1:03 PM Environmental Report
12/17/2008 Systems, Inc.
2:00 PM ------
Using: The Web
Site
1/12/2009 0 OMNI "*Inspection"
1:02 PM- Environmental
1 2/1 712 0 0 8 Systems, Inc.
2:00 PM ---
Using: The Web
Site
12/11/2008 OMNI **Saved Sample 19 mg/L> 19 mg/L for Nitrate Amount : 22.51
.12:57 PM Environmental Message— mg/L> 19 mg/L for Total Nitrogen
Systems, Inc.
12/11/2008 0 OMNI Sampling Resubmit, sorry hit wrong button on last one
11:34 AM Environmental Report
8/4/2008 Systems, Inc.
1:30 PM ------
Using: The Web
Site
12/11/2008 0 OMNI Sampling
11:28 AM Environmental Report
8/4/2008 Systems, Inc.
1:30 PM ------
Using: The Web
Site
8/6/2008 0 OMNI "*Inspection"
8:58 AM Environmental
8/4'/2008 Systems, Inc.
1:00 PM -----
httn•//narmndv hi7/ntimn/Service T4istnrv.a.nx?mmode=l&nermit id=2.54227&ha=10 9/23/2013
CarmodyTM Service History Page 5 of 7
Using: The Web
Site
OMN4/23/2008 **Saved.Sample 19 mg/L> 19 mg/L for Nitrate Amount : 22
1:33 PM Environmental Systems, Inc. Message** mg/L> 19 mg/L for Total Nitrogen
3/24/2008 0 OMNI Sampling
1:30 PM Environmental Report
3/11/2008 Systems, Inc.
10:00 AM ------
Using: The Web
Site
3/11/2008 0 OMNI **Inspection**
1:29 PM Environmental
3/11/2008 Systems, Inc.
10:00 AM ------
Using: The Web Site
2/28/2008 OMNI **MESSAGE** Homeowner Current with testing contract as of
9:29 AM Environmental 2-14-08
2/28/2008 Systems, Inc.
9:27 AM
12/6/2007 0 OMNI Sampling
11:31 AM Environmental Report
11/9/2007 Systems, Inc.
12:20 PM ------
Using: The Web
Site
8/15/2007 0 OMNI **Inspection**
1:28 PM Environmental
8/13/2007 Systems, Inc.
10:20 AM ------
Using:The Web
Site
5/9/2007 0 OMNI **Inspection**
8:32 AM Environmental
5/3/2007 Systems, Inc.
3:00 PM ------
Using: The Web
Site
5/2/2007 OMNI **Saved Sample 21.2 mg/L> 19 mg/L for Total Nitrogen : 31
9:18 AM Environmental Message" mg/L> 30 mg/L for TSS Amount
Systems, Inc.
512/2007 OMNI **Saved Sample 23 mg/L> 19 mg/L for Nitrate Amount : 23.1
9:18 AM Environmental Message** mg/L> 19 mg/L for Total Nitrogen
Systems, Inc.
11M3/2006 0 OMNI **Inspection** Top Riser is damaged and cannot get cover to
8:45 AM Environmental secure properly
1.1/11/2006 Systems, Inc.
2:40 PM ----
Using: The Web
Site
8/16/2006 0 OMNI **Inspection** Replaced faulty pump in recirculation tank.
7:42 AM Environmental -
8/15/2006 Systems, Inc.
3:30 PM ------
Using: The Web
Site
httn•//narmnciv hip./nmmn/Service Histerv.asnx?nmode=l&hermit id=254227&ha=10 9/23/2013
CarmodyTM Service History Page 6 of 7
8/31/2007 OMNI **MESSAGE** Equipment needs service. ::: 08/31/07 -System
9:15 AM Environmental Came From operating properly at last inspection -CB
8/1/2006 Systems, Inc. Message Board
8:21 AM
8/1/2006 0 OMNI **Inspection**
8:21 AM Environmental
7/31/2006 Systems, Inc.
2:45 PM ------
Using: The Web
Site
5/8/2006 0 OMNI Sampling
1:26 PM Environmental Report
4/6/2006 Systems, Inc.
1:00 PM ------
Using: The Web
Site
4/11/2006 0 OMNI **Inspection**
12:44 PM Environmental
4/5/2006 Systems, Inc.
1:00 PM ------
Using: The Web
Site
4/24/2007 0 OMNI Sampling
3:03 PM Environmental Report
12/12/2005 Systems, Inc.
3:30 PM ------
Using: The Web
Site
2/21/2006 0 OMNI **Inspection**
3:51 PM Environmental
12/12/2005 Systems, Inc.
12:00 AM ------
Using: Data
Import
4/24/2007 0 OMNI Sampling
3:01 PM Environmental Report
8/9/2005 Systems, Inc.
3:00 PM ------
Using: The Web
Site
2/21/2006 0 OMNI **Inspection**
3:51. PM Environmental
8/9/2005 Systems, Inc.
12:00 AM ------
Using: Data
Import
4/24/2007 0 OMNI Sampling
3:00 PM Environmental Report
5/23/2005 Systems, Inc.
3:00 PM ------
Using: The Web
Site
2/21/2006 0 OMNI **Inspection**
3:51 PM Environmental
5/23/2005 Systems, Inc.
12:00 AM ------
http://carmody.biz/pump/Service_History.aspx?pmode=l&pe=it_id=254227&ha=10 9/23/2013
CarmodyTM Sergi ice History Page 7 of 7
Using: Data
Import
9/1/2005 OMNI **Saved Sample 5.4 mg/L exceeded the limit of 5 mg/L for
10:53 AM Environmental Message— Nitrite Amount : 19.5 mg/L exceeded the limit
Systems, Inc. of 19 mg/L for Total Nitrogen
4/24/2007 0 OMNI Sampling
2:58 PM Environmental Report
2/23/2005 Systems, Inc.
12:10 PM ------
Using: The Web
Site
2/21/2006 0 OMNI **Inspection**.
3:51 PM Environmental
2/23/2005 Systems, Inc.
12:00 AM ------
Using: Data
Import
5/2/2005 0 OMNI **Inspection**
10:13 AM Environmental
12/8/2004 Systems, Inc.
10:45 AM ------
Using: The Web
Site
4/22/2005 0 OMNI Sampling
2:49 PM Environmental Report
12/8/2004 Systems, Inc.
8:00 AM ------
Using: The Web
Site
2/21/2006 0 OMNI **Inspection**
3:51 PM Environmental
12/8/2004 Systems, Inc.
12:00 AM ------
Using: Data
Import
2/21/2006 0 OMNI **Inspection**
3:51 PM Environmental
5/26/2004 Systems, Inc.
12:00 AM ------
Using: Data
Import
2/21/2006 0 OMNI **Inspection**
3:5.1 PM Environmental
A 11/20/2003 Systems, Inc.
12:00 AM ------
Using: Data
Import
2/21/2006 0 OMNI **Inspection**
3:51 PM Environmental
9/16/2003 Systems, Inc.
12:00 AM ------
Using: Data
Import
Total Gallons Pumped=0
http://carmody.biz/pump/Service_History.aspx?pmode=l&permit_id=254227&ha=10 9/23/2013
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 9/23/11 BEA09-10142
Attention:Title 5 Program
1 Winter Street-6th Floor
Boston,MA 02108 REGARDING:
Dane Residence
195 Herring Run Place Unit D[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 VA Treatment and Disposal Systems(Jan-Sept
2011)
1 9/22/11 Alpha Analytical Laboratory Report
For review and comment: ❑ For approval: ❑ As requested: ❑ For your use:
REMARKS:
Please find enclosed the DEP Inspection and O&M Form,and laboratory test results of wastewater samples collected during this reporting
period for the above referenced property. If you have any questions or require additional information,please contact us at your earliest
convenience. Thank you.
cc:Barnstable Board of Health
Mr.Stephen Dane,Owner
David C.Bennett,Principal[Internal]
Matthew Costa-OMNI Environmental Systems,Inc
FROM: David C.Bennett,WWTO#6243/Samantha Farrenkopf,WWTO#13265/Joseph Smith,WWTO#12529
If enclosures are not as noted,kindly notify us at once
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
A. Installation
Important:When Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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:
r� P.O. Box 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
1/4/11 9/8/10
Inspection Date Previous Inspection Date
12"of Sludge, and 1"Scum Layer Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5aiom.doc•rev.11-07-05 Page 1 of 3
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 6.52 SU DO 12.23 mg/L Turbidity 15.5 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 functional and passed field testing
t5aiom.doc•rev.11-07-05 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted the required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordancewith 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, 6th 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 Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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:
VtLA P.O. Box 603
Street Address/PO Box:
ICI Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
3/8/11 1/4/11
Inspection Date Previous Inspection Date
11"of Sludge, and 1"Scum Layer Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5aiom.doc•rev.11-07-05 Page 1 of 3
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 6.37 SU DO 13.01 mg/L Turbidity 0.17 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 functional and passed field testing
t5aiom.doc•rev.11-07-05 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
H. Certification
certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted i and/or sample collection in accordance with Standard Methods o ducted the required Field Testing a /o p ,
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.
9171111
Operator Sign a ure 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, 6t5 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 Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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 603 .
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
6/10111 3/8/11
Inspection Date Previous Inspection Date
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: M musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 7.0 SU DO 6.97 mg/L Turbidity 0.82 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 functional, and passed field testing.Top riser section needs replacement on septic tank,
homeowner gave verbally authorization for work to be done.
t5aiom.doc•rev.11-07-05 Page 2 of 3
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
H. Certification
certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted the required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31 st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6th 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 UA
Treatment and Disposal Systems
A. Installation
Important:When Stephen Dane
filling out forms Owner
on the computer,
use only the tab Route 149 Unit 195-D
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 603
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1024 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/03 8/25/03
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
9/14/11 6/10/11
Inspection Date Previous Inspection Date
Sludge Depth(to be checked yearly) Pumping Recommended ❑ Yes ® No
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 6.80 mg/L Turbidity 0.17 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 testing. Riser installation was completed in July 2011.
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't 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
Serial_No:09221112:03
"' HA
A•N A.L'.Y.T I C A L
ANALYTICAL REPORT
Lab Number: L1114553
Client: Bennett Environmental Associates
1573 Main St.
PO Box 1743
Brewster, MA 02631
ATTN: David Bennett
Phone: (508)896-1706
Project Name: DANE
Project Number: BEA09-10142
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:09221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
Alpha Sample Collection
Sample ID Client ID Location Date/Time
L1114553-01 EFFLUENT MARSTONS MILLS 09/14/11 14:30
Page 2 of 17
Serial No:O9221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
Case Narrative
The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation
or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report.
Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of
NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample
specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample,
followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a
required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is
designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the
associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific%
recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Definitions of all data qualifiers and acronyms
used in this report are provided in the Glossary located at the back of the report.
Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical
Standards requested on the Chain of Custody.
For additional information,please contact Client Services at 800-624-9220.
I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and
belief and based upon my personal inquiry of those responsible for providing the information contained
in this analytical report, such information is accurate and complete. This certificate of analysis is not
complete unless this page accompanies any and all pages of this report.
Authorized Signature: u Elizabeth Simmons
Title: Technical Director/Representative Date: 09/22/11
Page 3 of 17 �°�
Serial No:09221112:03
INORGANICS
MISCELLANEOUS
Page 4 of 17
Serial No:09221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
SAMPLE RESULTS
Lab ID: L1114553-01 Date Collected: 09/14/11 14:30
Client ID: EFFLUENT Date Received: 09/15/11
Sample Location: MARSTONS MILLS Field Prep: Not Specified
Matrix: Water
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
General Chem stry�Westborougli Lab '
Nitrogen,Nitrite 0.06 mg/I 0.05 - 1 - 09/16/11 02:03 44,353.2 TH
Nitrogen,Nitrate 5.9 mg/I 0.10 -- 1 - 09/16/11 02:03 44,353.2 TH
Nitrogen,Total Kjeldahl 1.4 mg/I 0.30 — 1 09/16/11 13:50 09/20/11 20:05 30,4500N-C AT
E
/�L1L`r F;el
Page 5 of 17
S e ri a l_N o:09221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
Method Blank Analysis
Batch Quality Control
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
General,Chemistry NVestbo`rougFi Lab for,sample(s).f 01 ;Batch •WG490293-2;
...a xV ..,.►
Nitrogen,Nitrate ND mg/I 0.10 1 09/16/11 00:38 44,353.2 TH
General Chemistry Westbo' Lab for sample(s): 01 Batch:�„WG490295 2 } .. „
Nitrogen,Nitrite ND mg/I 0.05 - 1 09/16/11 00:46 44,353.2 TH
u� xs_...a.-,:...r..„_-arresc xs...�.- r-a c.�L ;.... _ -,_.._�.-
General Chemistry-Westborou6rLLab for sample(s): 01 Batch'�WG490372-1 "r-s
Nitrogen,Total Kjeldahl ND mg/I 0.30 - 1 09/16/11 13:50 09/20/11 20:02 30,4500N-C AT
w FiA
Page 6 of 17
Serial No:09221112:03
Lab Control Sample Analysis
Project Name: DANE Batch Quality Control
Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
LCS LCSD %Recovery
Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits
General;ChemistrytWestboroughSLab,,:Associateds 01 ample(s) �¢BatchWG490293 1
Nitrogen,Nitrate 102,,: . - 90-110
.y;..,. :...,r..,, .., ,v ..... - -.c ,;.s '*`.". >,:4"k h" y@. �y�+a';X +'C"Y„,,,,yy " ' "iS° 'q'"•' '.
GeneralChemistry=Westborough`LabAssoclated;sample(s);0,1t�Fi
Batch �WG490295
Nitrogen,Nitrite '98 90-110 20
—r � t
General Chemis try'-:Westborough;LabAssociatedsample(s).i01 :. Batch yWG490372
w
Nitrogen,Total Kjeldahl 95: = - 85-110 -
Page 7 of 17 �;,�
Serial No:09221112:03
Matrix Spike Analysis
Batch Quality Control
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
Native MS MS MS MSD MSD Recovery RPD
Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits
General Chemistry-Westborough,Lab Associated°sample(s):"01 QC:Batch:ID:,,WG490293`3 QC-Sample:'L:1,1"14553-01r , Client;ID:".,EFFLUENT
Nitrogen,Nitrate 5.9 4 9.8 98 83-113 6
General Chemistry--Westborough,Lab'Associated lsample(s):,01i- `W,Batch=lD:7WG490295-*3, QCiSample: L1,114553-01'� �Clientll) .:EFFLUENT';
Nitrogen,Nitrite 0.06 4 4.1 101 - 80-120 20
General Chemistry;-.Westborough`L'ab Associated,sample(s):-01; ;QCr Batch,ID:WG490372'3-,- 'QC,fSample ,L1.1�14558 01 :.,Client!ID:, MS?Sample.
Nitrogen,Total Kjeldahl 1.8 8 9.7 99 - 77-111 - 24
Page 8 of 17 hLt;a
Serial No:09221112:03
Lab Duplicate Analysis
Project Name: DANE Batch Quality Control Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
Parameter Native Sample Duplicate Sample Units RPD Qua[ RPD Limits
T w F .. ., ., {
General'Cfiemistry <Westborough,L'ab:'Associatedisample(s):'-0�1",?QC Batch ID :;1NG490293-4 QC;Sample L11r14553=0.1 Client°ID; EFFLUENT' ,
Nitrogen,Nitrate 5.9 6.0 mg/I 2a;. �, 6
mR -..,..:.. r.,-.,.--.. :-,. ,�_..., :..�,.:..,.. 7•.......«.-ten. a -, ..- ...-..-.,y.. - .. ,g .. •v. ..« ,,:. - r ,,,.�. -, .. .<
General,Chemistry Westborough,Lab Associated.samples) 01;g C BatcK,61, G490295-;4g y QC:Sample L11F14553-01,;.Client,ID74EFFLl1ENT = ,,^
, .. r . ,
Nitrogen,Nitrite 0.06 0.06 mg/I _`§5; 20
General Chemistry=WestboroughxLali Associated>sample(s): 01 �.QC.iBatch3ID _,WG49037ZW4 IQCISampie L1114507-03 ClientrlD "DUP Sample:=: T
r.x.
Nitrogen,Total Kjeldahl 0.38 0.35 mg/I ;-, i8` x 24
HA
Page 9 of 17
Serial No:09221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 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(*)
L1114553-01A Plastic 250ml unpreserved A 7 3.9 Y Absent NO3-353(2)
L1114553-01 B Plastic 250m]unpreserved A 7 3.9 Y Absent NO2-353(2)
L1114553-01C 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
i
Serial No:09221112:O3
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 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(Sx)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-clution: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
r?F;A
Page 11 of 17
Serial No:09221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 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
r
Al
iA
s
�
Page 12 of 17
Serial No:09221112:03
Project Name: DANE Lab Number: L1114553
Project Number: BEA09-10142 Report Date: 09/22/11
REFERENCES
30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA-
WPCF. 18th Edition. 1992.
44 Methods for the Determination of Inorganic Substances in Environmental Samples,
EPA/600/R-93/100,August 1993.
LIMITATION OF LIABILITIES
Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing
laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical
shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable
for any incidental,consequential or special damages, including but not limited to,damages in any way
connected with the use of, interpretation of, information or analysis provided by Alpha Analytical.
We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling,
containers,sampling procedures, holding time and splitting of samples in the field.
Page 13 of 17
Serial No:09221112:03
Certificate/Approval Program Summary
Last revised September 19,2011 -Westboro Facility
The following list includes only those analytes/methods for which certification/approval is currently held.
For a complete listing of analytes for the referenced methods,please contact your Alpha Customer Service Representative.
Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil.
Drinking Water (Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine,
Fluoride, Calcium Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium,
Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium, Selenium,
Silver, Sodium, Thallium, Vanadium, Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate.
Organic Parameters: Volatile Organics 524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP),
Ethylene Dibromide (EDB), 1,4-Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B),
Total Coliform-Colilert(SM9223 P/A), E. Coli.-Colilert(SM9223 P/A), HPC-Pour Plate (SM9215B), Fecal Coliform-
MF m-FC(SM9222D))
Wastewater/Non-Potable Water (Inorganic Parameters: Color, pH, Conductivity, Acidity, Alkalinity, Chloride, Total
Residual Chlorine, Fluoride, Total Hardness, Silica, Sulfate, Sulfide, Ammonia, Kjeldahl Nitrogen, Nitrate, Nitrite, 0-
Phosphate, Total Phosphorus, Aluminum, Antimony, Arsenic, Barium, Beryllium, Boron, Cadmium, Calcium, Chromium,
Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Molybdenum, Nickel, Potassium,
Selenium, Silver, Sodium, Strontium, Thallium, Tin, Titanium, Vanadium, Zinc, Total Residue (Solids), Total Dissolved
Solids, Total Suspended Solids (non-filterable), BOD, CBOD, COD, TOC, Total Cyanide, Phenolics, Foaming Agents
(MBAS), Bromide, Oil and Grease. Organic Parameters: PCBs, Organochlorine Pesticides, Technical Chlordane,
Toxaphene, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Acid Extractables (Phenols), Benzidines, Phthalate Esters, Nitrosamines,
Nitroaromatics & Isophorone, Polynuclear Aromatic Hydrocarbons, Haloethers, Chlorinated Hydrocarbons, Volatile
Organics,TPH(HEM/SGT), Extractable Petroleum Hydrocarbons(ETPH), MA-EPH, MA-VPH. Microbiology Parameters:
Total Coliform - MF mEndo (SM9222B), Total Coliform - MTF (SM9221 B), HPC - Pour Plate (SM9215B), Fecal
Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth (SM9221 E).)
Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium,
Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury,
Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability,
Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs,
PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons
(ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Volatile Organics, Acid Extractables (Phenols),
3.3'-Dichlorobenzidine, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated
Hydrocarbons. )
Maine Department of Human Services Certificate/Lab ID:2009024.
Drinking Water(Inorganic Parameters: SM9215B, 9222D, 9223B, EPA 180.1, 353.2, SM2130B, 2320B, 2540C, 4500CI-
D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, EPA 200.7, EPA 200.8, 245.1, EPA 300.0. Organic
Parameters: 504.1, 524.2.)
Wastewater/Non-Potable Water (Inorganic Parameters: EPA 120.1, 1664A, 350.1, 351.1, 353.2, 410.4, 420.1,
SM2320B, 2510B, 2540C, 2540D, 426C, 4500CI-D, 4500CI-E, 4500CN-C, 4500CN-E, 4500E-B, 4500E-C, 4500H+B,
4500Norg-B, 4500Norg-C, 4500NH3-B, 4500NH3-G, 4500NH3-H, 4500NO3-F, 4500P-B, 4500P-E, 5210B, 5220D,
5310C, 9010B, 9040B, 9030B, 7470A, 7196A, 2340B, EPA 200.7, 6010, 200.8, 6020, 245.1, 1311, 1312, 3005A,
Enterolert, 9223D, 9222D. Organic Parameters: 608, 8081, 8082, 8330, 8151A, 624, 8260, 3510C, 3630C, 5030B, ME-
DRO, ME-GRO, MA-EPH, MA-VPH.)
Solid Waste/Soil (Inorganic Parameters: 9010B, 9012A, 9014A, 9040B, 9045C, 6010B, 7471A, 7196A, 9050A, 1010,
1030, 9065, 1311, 1312, 3005A, 3050B. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-VPH, 8260B, 8270C,
8330,8151A, 8081A, 8082,3540C,3546, 3580A, 3630C,5030B, 5035.)
Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086.
Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for:
Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N);
(SM4500NO3-F for: Nitrate-N and Nitrite-N); 450017-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.)
Pa e NiofR 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
g f'o : F(I,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:09221112:03
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, 9221 E-EC, EPA 3005A, 200.7, 200.8, 245.1,
245.2, SW-846 6010B, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 350.2, 351.1, 353.2, 410.4,
420.1, 1664A, SW-846 9010, 9030, 9040B, SM426C, SM2120B, 2310B, 2320B, 2540B, 2540D, 4500H+B, 4500CL-E,
4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 5210B, 5220D, 2510B, 2540C, 4500E-C,
5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D. Organic Parameters: SW-846 3510C, 3630C, 5030B,
8260B,8270C, 8330, EPA 624,625, 608, SW-846 8082,8081A,8151A.)
Solid & Chemical Materials (Inorganic Parameters: SW-846 6010B, 7196A, 7471A, 1010, 1030, 9010, 9012A, 9014,
9030B, 9040B, 9045C, 9050C, 9065,1311, 1312, 3005A, 3050B. Organic Parameters: SW-846 3540C, 3546, 3550B,
3580A, 3630C, 5030B, 5035, 8260B, 8270C, 8330,8151A, 8015B, 8082, 8081A.)
New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited.
Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA
300.0, 200.7, 200.8, 245.2, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332,
504.1, 524.2.)
Non-Potable Water (Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B,
SM4500E-BC, EPA 200.7, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F, 4500NO2-B, EPA 1664A,
SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B,
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.)
New York Department of Health Certificate/Lab ID: 11148. NELAPAccredited.
Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 332.0,
SM2320B, EPA 300.0,SM2120B,4500CN-E,4500E-C, 4500H-B, 4500NO3-F, 2540C, SM 2510B. Organic Parameters:
EPA 524.2, 504.1.)
Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4,
SM5220D, 2310E-4a, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH,
EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, LACHAT 10-107-04-1-C, SM4500-NO3-F, 4500-NO2-B, 4500P-E,
2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6020, EPA 7196A, SM3500Cr-D, EPA 245.1, 245.2, 7470A, SM2120B,
LACHAT 10-204-00-1-A, EPA 9040B, SM4500-HB, EPA 1664A, EPA 420.1, SM14 510C, EPA 120.1, SM2510B,
SM4500S-D, SM5540C, EPA 3005A, 9010B, 9030B.. Organic Parameters: EPA 624, 8260B, 8270C, 625, 608, 8081A,
8151A, 8330, 8082, EPA 3510C, 5030B.)
Solid&Hazardous Waste(Inorganic Parameters: 1010, 1030, EPA 6010B, 7196A, 7471A, 9012A, 9014, 9040B, 9045C,
9065, 9050, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA 8260B, 8270C, 8015B, 8081A,
8151A, 8330, 8082, 3540C,3545,3546,3580, 5030B,5035.)
North Carolina Department of the Environment and Natural Resources Certificate/Lab ID: 666.Organic
Parameters: MA-EPH, MA-VPH.
Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters:
Page 6§�#2)17
Serial No:09221112:03
Pennsylvania Department of Environmental Protection Certificate/Lab ID : 68-03671. NELAP Accredited.
Drinking Water(Organic Parameters: EPA 524.2, 504.1)
Non-Potable Water(Inorganic Parameters: EPA 1312,200.7,410.4, 1664A, SM25401), 5210B,5220D,4500-P,BE.
Organic Parameters: EPA 3510C, 3005A,3630C, 5030B,625, 624, 608, 8081A, 8082, 8151A,8260B, 8270C, 8330)
Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 305013, 6010B, 7196A, 7471A,
9010B, 9012A, 9014, 9040B, 9045C, 9050, 9065, SM 4500NH3-H. Organic Parameters: 3540C, 3545, 3546, 3550B,
3580A, 3630C, 5035, 8015B, 8081A, 8082, 8151A, 8260B,8270C,8330)
Rhode Island Department of Health Certificate/Lab ID: LAO00065. NELAP Accredited via NY-DOH.
Refer to MA-DEP Certificate for Potable and Non-Potable Water.
Refer to NJ-DEP Certificate for Potable and Non-Potable Water.
Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476-09-1. NELAP Accredited.
Non-Potable Water(Inorganic Parameters: EPA 120.1, 1664,200.7,200.8,245.1, 245.2, 300.0, 350.1, 351.1, 353.2,
376.2,410.4, 420.1, 6010,6020, 7196, 7470, 9040, SM 2120B, 2310B,2320B, 2510B,254013, 2540C, 2540D,426C,
4500CL-E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E, 4500 S2 D,510C, 5210B, 5220D,
5310C, 5540C. Organic Parameters: EPA 608, 624, 625, 8081, 8082, 8151, 8260,8270,8330.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012,9014, 9040, 9045, 9050, 9065.)
Department of Defense Certificate/Lab ID: L2217.
Drinking Water(Inorganic Parameters: SM 4500H-B. Organic Parameters: EPA 524.2, 504.1.)
Non-Potable Water(Inorganic Parameters: EPA 200.7,200.8,6010B, 6020, 245.1,245.2,7470A, 9040B,300.0, 332.0,
6860, 353.2,410.4, 9060, 1664A, SM 4500CN-E,4500H-B,4500NO3-F, 52201),5310C, 2320B,2540C, 3005A, 3015,
9010B, 9056. Organic Parameters: EPA 8260B, 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, 9010B, 3500-CR-D,4500CN-CE,2540G, Organic Parameters: EPA 82606,8270C,8330A/B-prep,8082,
8081A, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP VPH.)
The following analytes are not included in our current NELAP/TNI Scope of Accreditation:
EPA 8260B: Freon-113, 1,2,4,5-Tetramethylbenzene, 4-Ethyltoluene. EPA 8330A: PETN, Picric Acid, Nitroglycerine,
2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl naphthalene, Total 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
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