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Commonwealth of Massachusetts
W Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
I
Route 149- 195 Unit G (Herring Run Place)
Property Address
j; Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. General Information 1
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not Joseph R. Smith
use the return Name of Inspector
key.
Bennett Environmental Associates, Inc.
Company Name
1573 Main Street/ P.O. Box 1743
Company Address
Brewster MA 02631
City/Town State Zip Code
508'-896-1706 S14994
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Need/Furt Evaluation by the ocal Approving Authority
5-15-14
ectors Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
5/2� �I
t5ins•3/13 Title 5 Official Ins ct Form:Subsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
ac°M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
None of the failure criteria described in 310 CMR 15.303- 15.304 existed at the time of inspection.
The system appeared to be working as designed and functioning adequately under current use.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
,M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed. ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing_to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
W Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. CitylTown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/day flow
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
f Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Route 149 - 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 5 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
;M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Omni Recirculating Sand Filter System with engineered design plan By Christopher Costa &
Associates of East Falmouth, MA dated 10-1-02, and Revised 6-30-03: Comprised of a 1,500 gallon
septic tank, a 1,000 gallon recirculation tank, 3 OMNI filtration modules, 250 gallon pump chamber,
and 1 leaching trench that is 4'W x 931 x 2' D .
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ® Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d See Details
9 ( Y 9 (gpd)):
Detail:
2012: 139,000 gallons = 381 gpd 2013: 139,000 gallons= 381 gpd
Sump pump? ❑ Yes ® No
Last date of occupancy: Currently
Occupied
Commercial/Industrial Flow Conditions:
Type of Establishment:
'Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ElYes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
1 t
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M Route 149 - 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: No Records on file at Town Board of Health
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
❑ Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
® Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
® Other(describe):
Pump Chamber to Leaching Trench
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
} t
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
7-9-03: Town of Barnstable Certificate of Compliance Dated 7-9-03. Ref. Disposal works construction
permit number 2003-296
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 3.0'
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: 20'+Town water line
feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Joints and venting were inspected and are in working order, no evidence of leakage encountered
while inspecting main sewer line.
Septic Tank(locate on site plan):
Depth below grade: 2.5
feet
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
1,500 gallon septic tank with outlet riser to within 6"of final grade. Schedule 40 PVC inlet and outlet
tees functioning correctly.
If tank is metal, List age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1,500 gallons
Sludge depth:
6"
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is Marstons Mills MA 02648 5-8-14
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 35"
Scum thickness
1"
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
13"
How were dimensions determined? Tape Measure, Sludge Judge,
Probe.
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Pumping not recommended at time of inspection. Inlet and outlet tees are functioning properly, septic
tank is structurally sound. Liquid levels as related to the outlet invert was at a normal height. No
evidence of leakage or backup observed while inspecting septic tank.
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
w Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M Route 149 - 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches,etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
;M Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
0"
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
No D-Box Present- Pump Chamber to Leaching Trench
Pump Chamber(locate on site plan):
Pumps in working order: ® Yes ❑ No*
Alarms in working order: ® Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
250 gallon pump chamber is operating correctly. Riser and cover to final grade. Pumping not
recommended at time of inspection. Pump, on/off float switch, and alarm float switch are functioning
properly. Audible/Visual alarm operating properly and is located in basement utility room.
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length: (1)4'W x 931 x 2'
D
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Soil is sandy, there are no signs of hydraulic failure now or in the past, vegetation normal. Design
Plan indicates 562 gpd provided, 550 gpd required.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
wM , Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8-14
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
wM Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
® drawing attached separately
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t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Route 149 - 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is required for every Marstons Mills MA 02648 5-8-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: +
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 10-1-02 , Revised 6-30-03Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Groundwater determination was accomplished using percolation test data from the Design Plan By
Christopher Costa &Associates dated 10-1-02 and revised 6-30-03. Soil Testing was conducted on
3-20-98 Taken By: Bruce Murphy and Observed By: Jerry Dunning. Soil test logs indicated that no
groundwater was encountered at elevation 44.5, the bottom of the leaching trench is at elevation of
52.2 which leaves a T+estimated seperation to high groundwater.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
Route 149- 195 Unit G (Herring Run Place)
Property Address
Kim Straubing
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 5-8=14
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information —Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
1.
TOWN OF-BARNSTABLE
LOCATION �,/ ��/t T .�F • kT> y 9 SEWAGE
VIL.LAGE__A PV�C_/OGt 11 4»!1IL ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY -_ACT '/D BC v�C1 rVr'1 �LEACHING FACIL=4 (type) �G' /4 (size)
j NO. OF BEDROOMS
I
BUILDER OR OWNER GC 5/lJ/
PERMITDATE: Z� 2 COMPLIANCE DATE: 3 19 03
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or.within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
i
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7 1 f/7
M i
.. -
a 1
1
1f
No. -2q)o3-29(I Qj j M
FEE 00
C®MA ONWIA1111 01 MASSACHUSETTS /—
Board of Health, '�z M-A.
APPLICATION FOP, DISPOSAB��COAfWTION PERMIT
Application for a Permit to Construct( Repair( Upgrade(,4 bandon( - ❑Complete System ❑Individual Components
Location 't y �p
Owner's Name
Map/Parcel# Address P� Gl �zsu (w Cp
Lot# Telephone# SO g-
Installer's Name . � Designer's Name C Yv:s�
Address 5)(D Address %f[�r l a S 4 _6
Telephone# O _ 7 /Q Telephone# <j�8 - rp St
Type of Building sJ/ <-�' Lot Size sq.ft.
Dwelling-No.of Bedrooms `3 r Garbage grinder( )
Other-Type of Building A A No.ofpersons o{ Showers( ),Cafeteria( )
Other Fixtures AIA
Design Flow(min.required) .�d gpd Calculated design flow Design flow providedr6' —gpd
Plan: Date 03 Number of sheets d Revision Date
Title
i
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF,RREPAIRS ORALTERATI S
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to place thplystem in operation until a Certificate of C0-pyance has been issued by the Board of Health.
Signed
Date
S `7 ? d3
�rove�.
Inspections
No. cO3-z �
C® ®N TM OF MASSACHUSETTS `
Board of Health, MA.
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) ❑Complete System 1
The under,7signed/eereby certify the Sewage Disposal System; Construdted( ),Repaired( ),Upgraded( ),Abandoned(
by: �e-�
at L -At
has been installed in accordance with the pro Jo s of 310 CMR 15.00(Title 5)and the approved design plans/as-built plans relating to
application No. 2�3-29� dated rl 1'7 Approved Design Flow (gpd)
Installer
Designer: f�L. Inspector: Date: 7)9 ,�3
The issuance of this permit shall not be,construed as a guarantee that the system will function as designed.
FEE
COMMONWEALTH Of MASSACHUSETTS
Board of Health, o/ l"�`, MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( )an individual sewage disposal system
J / as described in the application for
Disposal System Construction Permit No. 246- dated /1'7/�� .
Provided: Construction shall be completed `thi three years of the date of this per )ICV tn s must be met.
Form 9255 Hev.5f96 A.M.SuIMn Co.Boston,MADate 7 � �3 Board of Health _ r; 4% �
BENNEEw-r EN�jLRON MZ`,' N'TALAs'wcffA-rFs, INCO
LICENSED SITE PROFESSIONALS 0 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS A ENGINEERS
1573 Main Street-P.O. Box 1143, Brewster, MA 02631 0 508-896-1706 Fax 508-896-5109 O www.benneft-ea.com
BEA09-10139
October 23, 2013
Mr. Jeffrey David&Ms. Kim Straubing
P.O. Box 863
Marstons Mills,MA 02648
7-
RE: OPERATION AND MAINTENANCE CONi"CT 20:14 and 2015
Innovative/Alternative Wastewater Treatment System: OMNI RSF
Unit 195-G Herring Run Place—Marstons Mills,MA
Dear Mr. David and Ms. Straubing,
BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA)is pleased to provide you with
a budget estimate for the continuation of professional services relative to the operation and
maintenance of the Innovative/Alternative Wastewater Treatment System located at the above
referenced property. The collection and laboratory analysis of samples collected from the effluent of
the septic treatment system is a required condition of the.system, as set forth by the Barnstable
Health Department to qualify treatment capacity on a quarterly basis.
As such, work proposed.by BEA includes the standard operation and maintenance of the
treatment system, as well as annual effluent sampling for total nitrogen, and the preparation of the
required forms for distribution to the appropriate town and state offices. Additionally,at the time of
such sampling,blowers,filters and associated piping will be inspected to assure working condition
and regularly scheduled maintenance performed on a fixed cost basis will be invoiced quarterly.
Should any repair or treatment system components replacement be required,or additional sampling
beyond the quarterly requirements necessary,you will be notified to authorize the additional work
and expenses. This work will be billed at time and expense,portal to portal.
The following budget represents estimated annual costs through one year of service to include
four sampling and inspection events. These annual costs are valid for.two years subsequent to the
date of the first inspection. Please note that this contract runs with the property. As such,it is your
responsibility to notify our office in writing of any sale of the subject property so that there is no
disruption of services. Furthermore, you are required to notify any buyer of the transfer of this
contract.
EMERGENCY SPILL RESPONSE Q WASTE SITE CLEANUP A SITE ASSESSMENT A PERMITTING 6 SEPTIC DESIGN&INSPECTION
WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 0 WASTEWATER TREATMENT,OPERATION&MAINTENANCE
OCTOBER 23,2013 STRAUBINGBEA09-10139
PAGE 2 OF 2 UNIT 195G HERRING RUN PLACE,MARSTONS MILLS,MA
QUARTERLY INSPECTION/MAINTENANCE/SAMPLING
Inspect I/A system and take field measurements of dissolved oxygen, pH, and turbidity. Collect treated effluent
wastewater samples on an annual basis under a proper chain-of-custody for MA certified laboratory analysis of
nitrite/nitrate/TKN for total nitrogen. At the time of sampling events the conditions of the system will be inspected and
documented with regards to the blower units,sludge level and associated piping.
REPORTING/FILING
Review inspection,field-testing,and laboratory analytical report relative to conditional requirements of the system under
the MA DEP and local Board of Health approvals. Prepare DEP transmittal forms and submit inspection and sampling
reports on the Barnstable County Department of Health and Environment online database on a quarterly basis. Submit
laboratory report and DEP transmittal forms to MA DEP,local Board of Health,and associated vendors/contractors,as
appropriate,on an annual basis.
Professional Services $ 680.00
Laboratory Analysis[Ix nitrate/nitrite/TKN] $ 47.73
TOTAL ANNUAL EXPENSE: $727.73*
TOTAL COST PER EVENT: $181.93
*Noted: I/A systems located in Barnstable County are required to report inspection and sampling
results on the Mass Septic online database for use by the Barnstable County Department of Health and
Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary
to institute annual user fees for filings on this required database of$50 per year.
At the time of inspections the wastewater treatment equipment will be inspected to ensure that the
system is working as designed. Should repair or replacement of equipment or sludge pumping be
necessary beyond standard maintenance, such material and additional time beyond that of a normal
inspection will be billed at time and expense.
We are proceeding with the work as outlined. Immediate notification in writing is required if you
do not wish to proceed. Otherwise, please sign the authorization below and return one copy of this
proposal to our office. Should you have any questions or need additional information,please contact me
directly at our office
Very truly yours,
BENNETT ENVIRO TAL ASSOCIATES,INC.
A
Samantha Farrenkopf,ES WWTO,P S
Wastewater Program Coordinator
cc: Kara Risk,Business Manager
encl. Terms& Conditions (2009)/Fee Schedule(2010)
AUTHORIZATION: ,DATE:
EN®TNETT ENVIRONMEN'TAE Ass CIATES, INC.
LICENSED SITE PROFESSIONALS & ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS & ENGINEERS
1573 Main Street-P.O. Box 1743, Brewster, MA 02631 A 508-896-1706 A Fax 508-896-5109 t www.bennett-ea.com
BEA09-10139
November 30,2011
Mr.JeffreyDavid&Ms.Kim Straubin ��
g r
P.O.Box 863
Marstons Mills,MA 02648
RE: OPERATION AND MAINTENANCE CONTRACT 2012 AND 2013
Innovative/Alternative Wastewater Treatment System: OMNI RSF
Unit 195-G Herring Run Place—Marston Mills,MA
Dear Mr. David&Ms. Straubing,
BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA),is pleased to provide a proposal
for the continuation of professional services for the operation,maintenance and environmental monitoring
of the innovative/alternative wastewater treatment system for you and your neighbors as described in
accordance with the governing regulations under 310 CMR 15.00 as regulated under the Barnstable
Health Department. These services include quarterly inspections for standard operation and maintenance
of the treatment system, as well as annual effluent sampling for total nitrogen.. The costs for such
services are presented below as annual costs for the first and second year of.this contract reflecting
standard laboratory fees and reporting requirements. This contract and the quoted annual costs are good
.for a period of two years subsequent.to the.date of the next operation and.maintenance event scheduled
for December 2011. This proposal replaces the previous renewal contract proposal dated November 18,
2011.
QUARTERLY INSPECTION/MAINTENANCE/SAMPLING:Inspect I/A system and take field measurements of
dissolved oxygen,pH and turbidity on a quarterly basis. Collect treated effluent wastewater samples on an annual basis
under a proper chain-of-custody for analysis by a MA certified laboratory for nitrite/nitrate/TKN for total nitrogen. At
the time of sampling events the conditions of the system will be inspected and documented with regards to the blower
units,sludge level and associated piping.
REPORTING/FILING: Review laboratory results relative to conditional requirements of the system under the MA
DEP and local Board of Health approvals. Prepare DEP transmittal forms on a quarterly basis. File inspection reports on
the Barnstable County online database quarterly. File sampling reports on the Barnstable County online database
annually for effluent sampling. Submit laboratory report, DEP transmittal forms to MA DEP, Barnstable County
Department of Health and Environment,local Board of Health,and associated vendors/contractors,as appropriate,on an
annual basis.
Professional Fees Operation/Maintenance and Reporting[Dec 2011-Sept 2012] $ 475.00
Professional Fees Operation/Maintenance and Reporting[Dec 2012-Sept 2013] $ 600.00
Laboratory Analysis[Total Nitrogen(NO2,NO3,TKN)] $ 47.73
Barnstable County Data Base Fee $ 50.00*
1
EMERGENCY SPILL RESPONSE A WASTE SITE CLEANUP 6 SITE ASSESSMENT & PERMITTING & SEPTIC DESIGN&INSPECTION
WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE
1
NOVEMBER 30,2011 DAVID-STRAUBINGBEA09-10139
PAGE 2 OF 2 UNIT 195G HERRING RUN PLACE,MARSTONS MILLS,MA
* Noted: I/A systems located in Barnstable County are required to report inspection and sampling
results on the Mass Septic online database for use by the Barnstable County Department of Health and
Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found it necessary
to institute annual user fees for filings on this required database of$50 per year.
At the time of inspections the wastewater treatment equipment will be inspected to ensure that the
system is working as designed. Should repair or replacement of equipment or sludge pumping be
necessary beyond standard maintenance, such material and additional time beyond that of a normal
inspection will be billed at time and expense.
We are proceeding with the work as outlined. Immediate notification in writing is required if you
do not wish to proceed. Otherwise, please sign the authorization below and return one copy of this
proposal to our office. Should you have any questions or need additional information,please contact me
directly at our office
Very truly yours,
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
Samantha Farrenkopf,ES WWTO,PWSO
Wastewater Program Coordinator
cc: Kara Risk,Business Manager
encl. Terms&Conditions(2009)/Fee Schedule(2010)
AUTHORIZATION: / ,DATE:
Env eatR*tems,.Inc
OMNI RSF Operation and Maintenance Inspection Checklist
A. Installation & Service Information
Facility Street Address Date of 8ervice
Y1( &-s —5k
City Operator/O&M Firm
System Startup Date Weather Condition
B. Septic Tank
Sludge Pumping Required: Yes❑ Noo, V Sludge Depth: ( q,Scum Depth:
Effluent tee filter: MW NCN-O If yes, inspe &clean at least yearly❑ CCN—wUe�--
If the sludge layer is within 12"of the outlet invert,recommend that the homeowner have the septic tank �►?�\�`r'
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 an how heavily the system is used.
C. Recirculation Tank
Check if sludge accumulating Pumping required: Yes❑ NOW
Odor problems: Yes ❑ Nod, If yes,description
Effluent tee filter: Yes❑ NAS If yes, inspect❑&clean at least yearly❑
If the sludge layer is greater than A"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
t may indicate that the filter bed may need servicing.
1 ' D. Equalization Tank (if installed)
Sludge Pumping Required: Yes❑ No❑ ❑ Sludge Depth: ❑ Scum Depth:
Effluent tee filter: Yes❑ No❑ If yes, inspect❑ &clean at least yearly❑
Same inspection criteria as septic tank:
E. Pump Chamber!Vault(if Installed)
�.Pump inspections(all units)
If problems,describe
V,Float switches
Check all switches for operation
Make Sure the puinp 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
NY
Pump Inspections(all units)
If problems,describe
Test pump alternator, or record hours
Hours of operation
Float switches
*est
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") ,�����l F�c A- "�� �,j W\U�v\k�s
Inspect for ponding Ponding Present:Yes❑ Nc�
Q Clean bed: Yes❑ No-
Distribution pipes Flush:Yes ❑ No Vj Brush: Yes❑ Not4
Any obstruction of airflow to filter modules: Yes� No El If Yes, explain below(i.e. snow, dirt)
JS hC1l,
To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area,
then lift the filter fabric so that the media can be inspected through the end of the contactor. The media
should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface
of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to
completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with
a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found.
H. Sample Collection
Yes❑ No\
If yes: ❑BOD ❑TSS ❑pH ❑TN ❑Other
All samples are to be taken from the manifold located in the recirculation tank,and are to be stored in sterile,
laboratory supplied containers.In order to prevent any cross-contamination from a previous sample rinse the
dip cup into the effluent stream at the manifold three times so that a representative sample can be obtained.
Make sure to wear proper safety equipment while pulling samples(i.e.rubber gloves).
System Notes: \\
CAW f�-cra
v- � a.\ S
ENNETr ENviRoNmFNTAL
.Ass®cwEs, Inc.
1573 Main St.,P.O.Box 1743
Brewster,MA 02631
508-896-1706 a www.bennett-ea.com
Date&time of visit: }�
A site visit was conducted today for:
O&M �ffi,YES ❑ NO
Testing El YES ,—qNO
Repair ❑YES (p(NO
Alarm Call ❑YES q6 NO
Your system is operating correctly OYES ❑ NO
Tanks) in need of pumping ❑YES 94 NO
Further maintenance required ❑YES 14 NO
Repairs needed ❑YES e14 NO
Please contact our office ❑YES (ONO
Contract renewal required ❑YES (16 NO
Field testing Pass ❑ Fail
Sample pulled ❑YES Cal NO
Laboratory_sampling conducted ❑YES UdNO
AM
�: s=.
� EIVNETTEN VIRONMENTAI.'(.
r%��;:u%"AS$OCIATES MC. '-
'ASSESSMENT
-.- '= .REMEDIATION
r
ESOURC..... AGEMENT=:a
Serial No:09171310:50
H
YTICAL
ANALYTICAL REPORT
Lab Number: L1317794
Client: Bennett Environmental Associates
1573 Main Street
Brewster, MA 02631
ATTN: David Bennett
Phone: (508)896-1706
Project Name: STRAUBING RESIDENCE
Project Number: BEA09-10139
Report Date: 09/17/13
The original project report/data package is held by Alpha Analytical.This report/data package is paginated and should be reproduced only in its
entirety.Alpha Analytical holds no responsibility for results and/ordata 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(68703671),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
C
Page 1 of 18
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Alpha Sample Collection
Sample ID Client ID Location Date/Time
L1317794-01 EFFLUENT MARSTONS MILLS, MA 09/11/13 11:00
' BHA
Page 2 of 18
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Case Narrative
The samples were received in accordance with the Chain of Custody and no significant deviations were encountered during the preparation
or analysis unless otherwise noted.Sample Receipt,Container Information,and the Chain of Custody are located at the back of the report.
Results contained within this report relate only to the samples submitted under this Alpha Lab Number and meet all of the requirements of
NELAC,for all NELAC accredited parameters.The data presented in this report is organized by parameter(i.e.VOC,SVOC,etc.).Sample
specific Quality Control data(i.e.Surrogate Spike Recovery)is reported at the end of the target analyte list for each individual sample,
followed by the Laboratory Batch Quality Control at the end of each parameter.If a sample was re-analyzed or re-extracted due to a
required quality control corrective action and if both sets of data are reported,the Laboratory ID of the re-analysis or re-extraction is
designated with an"R"or"RE",respectively.When multiple Batch Quality Control elements are reported(e.g.more than one LCS),the
associated samples for each element are noted in the grey shaded header line of each data table.Any Laboratory Batch,Sample Specific%
recovery or RPD value that is outside the listed Acceptance Criteria is bolded in the report.Performance criteria for CAM and RCP methods
allow for some LCS compound failures to occur and still be within method compliance.In these instances,the specific failures are not
narrated but are noted in the associated QC table.This information is also incorporated in the Data Usability format for our Data Merger tool
where it can be reviewed along with any associated usability implications.Soil/sediments,solids and tissues are reported on a dry weight
basis unless otherwise noted.Definitions of all data qualifiers and acronyms used in this report are provided in the Glossary located at the
back of the report.
In reference to questions H(CAM)or 4(RCP)when"NO"is checked,the performance criteria for CAM and RCP methods allow for some
quality control failures to occur and still be within method compliance. In these instances the specific failure is not narrated but noted in the
associated QC table.The information is also incorporated in the Data Usability format of our Data Merger tool where it can be reviewed
along with any associated usability implications.
Please see the associated ADEx data file for a comparison of laboratory reporting limits that were achieved with the regulatory Numerical
Standards requested on the Chain of Custody.
HOLD POLICY
For samples submitted on hold,Alpha's policy is to hold samples free of charge for 21 calendar days from the date the project is completed.
After 21 calendar days,we will dispose of all samples submitted including those put on hold unless you have contacted your Client Service
Representative and made arrangements for Alpha to continue to hold.the samples.
Please contact Client Services at 800-624-9220 with any questions.
I,the undersigned, attest under the pains and penalties of perjury that,to the best of my knowledge and
belief and based upon my personal inquiry of those responsible for providing the information contained
in this analytical report, such information is accurate and complete. This certificate of analysis is not
complete unless this page accompanies any and all pages of this report.
Cy _ Cynthia McQueen
Authorized Signature:
Title: Technical Director/Representative Date: 09/17/13
�ia
Page 3 of 18L
Serial No:09171310:50
INORGANICS
MISCELLANEOUS
,� �.�
Page 4 of 18
Serial No:O9171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
SAMPLE RESULTS
Lab ID: L1317794-01 Date Collected: 09/11/13 11:00
Client ID: EFFLUENT Date Received: 09/11/13
Sample Location: MARSTONS MILLS,MA Field Prep: Not Specified
Matrix: Water
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
General Chemistry-Westborough Lab
Nitrogen,Nitrite 0.30 mg/I 0.050 -- 1 09/12/13 01:07 44,353.2 DB
Nitrogen,Nitrate 11. mg/1 0.50 - 5 09/12/13 01:59 44,353.2 DB
----- ---— -.. ---.._— _,.. —._ _...-_. _----..
Nitrogen,Total Kjeldahl 5.17 mg/I 0.600 - 2 09/12/13 10:56 09/13/13 21:33 30,4500N-C AT
e-\
i L91-iA
Page 5 of 18
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Method Blank Analysis
Batch Quality Control
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
General Chemistry-Westborough Lab for sample(s)`. 01 Batch: WG635443-1
Nitrogen,Nitrate ND mg/I 0.10 1 09/12/13 00:45 44,353.2 DB
General Chemistry-Westborough Lab for sample(s): 01 Batch: WG635446-1
Nitrogen,Nitrite ND mg/I 0.050 -- 1 09/12/13 00:48 44,353.2 DB
General Chemistry-Westborough Lab for sample(s): 01 Batch: WG635627-1
Nitrogen,Total Kjeldahl ND mg/I 0.300 1 09/12/13 10:56 09/13/13 21:12 30,4500N-C AT
Page 6 of 18
Serial No:09171310:50
Lab Control Sample Analysis
Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
LCS LCSD %Recovery
Parameter %Recovery Qual %Recovery Qual Limits RPD Qual RPD Limits
General Chemistry-Westborough Lab Associated sample(s): 01 Batch:WG635443-2
Nitrogen,Nitrate 102 90-110
General Chemistry—Westborough Lab Associated sample(s): 01 Batch:WG635446-2
Nitrogen,Nitrite 101 90-110 20
General Chemistry-Westborough Lab.Associated.sample(s): 01 Batch:WG635627-2
Nitrogen,Total Kjeldahl 95 78-122
---------
Page 7 of 18 x �
Serial No:09171310:50
Matrix Spike Analysis
Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Native MS MS MS MSD MSD Recovery RPD
Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits
General Chemistry-Westborough Lab Associated sample(s): 01 QC Batch ID:WG635443-4 QC Sample: L1317789-01 Client ID: MS Sample
Nitrogen,Nitrate 4.0 4 7.8 96 83-113 6
General Chemistry-'Westborough Lab Associated sample(s): 01 QC Batch ID:WG635446-4 QC Sample: L1317789-01 Client ID: MS Sample.
Nitrogen,Nitrite 0.075 4 4.3 105 80-120 20
General Chemistry-Westborough Lab Associated sample(s): 01- QC Batch ID:WG635627-4 -QC Sample: L1317798-01 Client ID: MS,Sample-`
Nitrogen,Total Kjeldahl 41.6 8 50.8 115 Q 77-111 24
Page 8 of 18
Serial No:09171310:50
Lab Duplicate Analysis
Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Parameter Native Sample Duplicate Sample Units RPD Qual RPD Limits
General Chemistry-Westborough Lab xAssociated sample(s): 01 QC`Batch-ID: WG635443-3 QC Sample: L1317789-01 Client ID: DUP Sample
Nitrogen,Nitrate 4.0 3.8 mg/1 4 6
General Chemistry-Westborough Lab Associated sample(s): 01 QC Batch ID: WG635446-3 QC Sample: L1317789-01 Client ID:- DUP,Sample
Nitrogen,Nitrite 0.075 0.064 mg/I 16 20
General Chemistry Westborough Lab Associated sample(s): 01 QC Batch ID: WG635627-3 QC Sample: L1317798-01 Client ID: DUP Sample
Nitrogen,Total Kjeldahl 41.6 44.8 mg/I 7 24
Page 9 of 18 ���
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Sample Receipt and Container Information
Were project specific reporting limits specified? YES
Reagent H2O Preserved Vials Frozen on: NA
Cooler Information Custody Seal
Cooler
A Absent
Container Information Temp
Container ID Container Type Cooler pH deg C Pres Seal Analysis(*)
L1317794-01A Plastic 250ml unpreserved A 7 4 Y Absent NO2-353(2),NO3-353(2)
L1317794-01B Plastic 250ml H2SO4 preserved A <2 4 Y Absent TKN-4500(28)
*Values in parentheses indicate holding time in days XiPHA
Page 10 of 18
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
GLOSSARY
Acronyms
EDL Estimated Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated
values,when those target analyte concentrations are quantified below the reporting limit(RL).The EDL includes any
adjustments from dilutions,concentrations or moisture content,where applicable.The use of EDLs is specific to the analysis of
PAHs using Solid-Phase Microextraction(SPME).
EPA Environmental Protection Agency.
LCS Laboratory Control Sample:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes
or a material containing known and verified amounts of analytes.
LCSD Laboratory Control Sample Duplicate:Refer to LCS.
LFB Laboratory Fortified Blank:A sample matrix,free from the analytes of interest,spiked with verified known amounts of analytes
or a material containing known and verified amounts of analytes.
MDL Method Detection Limit:This value represents the level to which target analyte concentrations are reported as estimated values,
when those target analyte concentrations are quantified below the reporting limit(RL).The MDL includes any adjustments from
dilutions,concentrations or moisture content,where applicable.
MS Matrix Spike Sample:A sample prepared by adding a known mass of target analyte to a specified amount of matrix sample for
which an independent estimate of target analyte concentration is available.
MSD Matrix Spike Sample Duplicate:Refer to MS.
NA Not Applicable.
NC Not Calculated: Term is utilized when one or more of the results utilized in the calculation are non-detect at the parameter's
reporting unit.
NI Not Ignitable.
RL Reporting Limit: The value at which an instrument can accurately measure an analyte at a specific concentration.The RL
includes any adjustments from dilutions,concentrations or moisture content,where applicable.
RPD Relative Percent Difference: The results from matrix and/or matrix spike duplicates are primarily designed to assess the precision
of analytical results in a given matrix and are expressed as relative percent difference(RPD). Values which are less than five
times the reporting limit for any individual parameter are evaluated by utilizing the absolute difference between the values;
although the RPD value will be provided in the report.
SRM Standard Reference Material:A reference sample of a known or certified value that is of the same or similar matrix as the
associated field samples.
Footnotes
1 The reference for this analyte should be considered modified since this analyte is absent from the target analyte list of the original
method.
Terms
Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:EPA 8260B is
shown as 1,8260B.)The codes for the reference method documents are provided in the References section of the Addendum.
Data Qualifiers
A Spectra identified as"Aldol Condensation Product".
B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated field samples that
have detectable concentrations of the analyte at less than ten times(I Ox)the concentration found in the blank.For MCP-related
projects,flag only applies to associated field samples that have detectable concentrations of the analyte at less than ten times(1 Ox)
the concentration found in the blank.For DOD-related projects,flag only applies to associated field samples that have detectable
concentrations of the analyte at less than ten times(I Ox)the concentration found in the blank AND the analyte was detected above
one-half the reporting limit(or above the reporting limit for common lab contaminants)in the associated method blank.For NJ-
Air-related projects,flag only applies to associated field samples that have detectable concentrations of the analyte above the
reporting limit.
C Co-elution:The target analyte co-elutes with a known lab standard(i.e.surrogate,internal standards,etc.)for co-extracted
analyses.
D Concentration of analyte was quantified from diluted analysis.Flag only applies to field samples that have detectable concentrations
of the analyte.
E Concentration of analyte exceeds the range of the calibration curve and/or linear range of the instrument.
G The concentration may be biased high due to matrix interferences(i.e,co-elution)with non-target compound(s).The result should
be considered estimated.
H The analysis of pH was performed beyond the regulatory-required holding time of 15 minutes from the time of sample collection.
I The lower value for the two columns has been reported due to obvious interference.
Report Format: Data Usability Report
, rd�l:e�l-iA
Page 11 of 18
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
Data Qualifiers
M Reporting Limit(RL)exceeds the MCP CAM Reporting Limit for this analyte.
NJ Presumptive evidence of compound.This represents an estimated concentration for Tentatively Identified Compounds(TICS),where
the identification is based on a mass spectral library search.
P The RPD between the results for the two columns exceeds the method-specified criteria.
Q The quality control sample exceeds the associated acceptance criteria.For DOD-related projects,LCS and/or Continuing Calibration
Standard exceedences are also qualified on all associated sample results. Note:This flag is not applicable for matrix spike recoveries
when the sample concentration is greater than 4x the spike added or for batch duplicate RPD when the sample concentrations are less
than 5x the RL.(Metals only.)
R Analytical results are from sample re-analysis.
RE Analytical results are from sample re-extraction.
S Analytical results are from modified screening analysis.
J Estimated value.This represents an estimated concentration for Tentatively Identified Compounds(TICs).
ND Not detected at the reporting limit(RL)for the sample.
Report Format: Data Usability Report
f�B s IiA
Page 12 of 18
Serial No:09171310:50
Project Name: STRAUBING RESIDENCE Lab Number: L1317794
Project Number: BEA09-10139 Report Date: 09/17/13
REFERENCES
30 Standard Methods for the Examination of Water and Wastewater.APHA-AWWA-
WPCF. 18th Edition. 1992.
44 Methods for the Determination of Inorganic Substances in Environmental Samples,
EPA/600/R-93/100,August 1993.
LIMITATION OF LIABILITIES
Alpha Analytical performs services with reasonable care and diligence normal to the analytical testing
laboratory industry. In the event of an error,the sole and exclusive responsibility of Alpha Analytical
shall be to re-perform the work at it's own expense. In no event shall Alpha Analytical be held liable
for any incidental, consequential or special damages, including but not limited to, damages in any way
connected with the use of, interpretation of, information or analysis provided by Alpha Analytical.
We strongly urge our clients to comply with EPA protocol regarding sample volume, preservation, cooling,
containers, sampling procedures, holding time and splitting of samples in the field.
Page 13 of 18
Serial No:09171310:50
Certificate/Approval Program Summary
Last revised August 29,2013 -Westboro Facility
The following list includes only those analytes/methods for which certification/approval is currently held.
For a complete listing of analytes for the referenced methods, please contact your Alpha Customer Service Representative.
Connecticut Department of Public Health Certificate/Lab ID: PH-0574. NELAP Accredited Solid Waste/Soil.
Drinking Water (Inorganic Parameters: Color, pH, Turbidity, Conductivity, Alkalinity, Chloride, Free Residual Chlorine,
Fluoride, Calcium .Hardness, Sulfate, Nitrate, Nitrite, Aluminum, Antimony, Arsenic, Barium, Beryllium, Cadmium,
Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Mercury, Nickel, Selenium, Silver, Sodium, Thallium,
Zinc, Total Dissolved Solids, Total Organic Carbon, Total Cyanide, Perchlorate. Organic Parameters: Volatile Organics
524.2, Total Trihalomethanes 524.2, 1,2-Dibromo-3-chloropropane (DBCP)504.1, Ethylene Dibromide(EDB)504.1, 1,4-
Dioxane (Mod 8270). Microbiology Parameters: Total Coliform-MF mEndo (SM9222B), Total Coliform - Colilert
(SM9223, Enumeration and P/A), E. Coli. - Colilert (SM9223, Enumeration and 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 (SM9221B), E. Coli-Colilert (SM9223 Enumeration), HPC- Pour Plate (SM9215B),
Fecal Coliform-MF m-FC (S.M9222D), Fecal Coliform-A-1 Broth (SM9221 E), Enterococcus- Enterolert.
Solid Waste/Soil(Inorganic Parameters: pH, Sulfide, Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium,
Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury,
Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability,
Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs,
PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, CT-Extractable Petroleum Hydrocarbons
(ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Dalapon, Volatile Organics (SW 8260), Acid
Extractables (Phenols) (SW 8270), Benzidines (SW 8270), Phthalates (SW 8270), Nitrosamines (SW 8270),
Nitroaromatics & Cyclic Ketones (SW 8270), PAHs (SW 8270), Haloethers (SW 8270), Chlorinated Hydrocarbons (SW
8270). )
State of Illinois Certificate/Lab ID:003155. NELAP Accredited.
Drinking Water (Inorganic Parameters: SM2120B, 2320B, 2510B, 2540C, SM4500CN-CE, 4500E-C, 4500H-B,
4500NO3-F, 5310C, EPA 200.7,200.8,245.1, 300.0. Organic Parameters: EPA 504.1, 524.2.)
Wastewater/Non-Potable Water (Inorganic Parameters: SM2120B, 2310B, 2320B, 2340B, 2510B, 2540B, 2540C,
2540D, SM4500CL-E, 4500CN-E, 4500E-C, 4500H-B, 4500NH3-H, 4500NO2-B, 4500NO3-F, 4500P-E, 4500S-D,
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: 8.011 (NPW only), 8015C, 8081 B,
8082A, 8151A, 8260C, 8270D, 8315A, 8330.)
Maine Department of Human Services Certificate/Lab ID: 2009024.
Drinking Water(inorganic Parameters: SM9215B, 9222D, 9223B, EPA 180.1, 353.2, SM2120B, 2130B, 2320B, 2510C,
2540C, 4500CI-D, 4500CN-C, 4500CN-E, 4500E-C, 4500H+B, 4500NO3-F, 5310C, EPA 200.7, EPA 200.8, 245.1, EPA
300.0. Organic Parameters: 504.1 524.2.
9 )
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,
g6010C, 200.8, 6020A2 245.1, 1311, 1312, 3005A, Enterolert, 9223B, 9222D. Organic Parameters: 608, 624, 6252 8011,
Page f�ofi 8082A, 8330, 8151A, 8260C, 8270D, 3510C, 3630C, 5030B, ME-DRO, ME-GRO, MA-EPH, MA-VPH.)
• Serial No:09171310:50
Solid Waste/Soil (Inorganic Parameters: 9010B, 9012A, 9014, 9040B, 9045C, 6010C, 6020A, 7471 B, 7196A, 9050A,
1010, 1030, 9065, 1311, 1312, 3005A, 3050B, 9038, 9251. Organic Parameters: ME-DRO, ME-GRO, MA-EPH, MA-
VPH, 8260C, 8270D, 8330, 8151A, 8081 B, 8082A, 3540C, 3546, 3580A, 3620C, 3630C, 5030B, 5035.)
Massachusetts Department of Environmental Protection Certificate/Lab ID: M-MA086.
Drinking Water (Inorganic Parameters: (EPA 200.8 for: Sb,As,Ba,Be,Cd,Cr,Cu,Pb,Ni,Se,TI) (EPA 200.7 for:
Ba,Be,Ca,Cd,Cr,Cu,Na,Ni) 245.1, (300.0 for: Nitrate-N, Fluoride, Sulfate); (EPA 353.2 for: Nitrate-N, Nitrite-N);
(SM4500NO3-F for: Nitrate-N and Nitrite-N); 4500E-C, 4500CN-CE, EPA 180.1, SM2130B, SM4500CI-D, 2320B,
SM2540C, SM4500H-B. Organic Parameters: (EPA 524.2 for: Trihalomethanes, Volatile Organics); (504.1 for: 1,2-
Dibromoethane, 1,2-Dibromo-3-Chloropropane), EPA 332. Microbiology Parameters: SM9215B; ENZ. SUB. SM9223;
ColilertQT SM9223B; MF-SM9222D.)
Non-Potable Water(Inorganic Parameters:, (EPA 200.8 for: AI,Sb,As,Be,Cd,Cr,Cu,Pb,Mn,Ni,Se,Ag,TI,Zn); (EPA 200.7
for: AI,Sb,As,Be,Cd,Ca,Cr,Co,Cu,Fe,Pb,Mg,Mn,Mo,Ni,K,Se,Ag,Na,Sr,Ti,TI,V,Zn); 245.1, SM4500H,B, EPA 120.1,
SM2510B, 2540C, 2340B, 2320B, 4500CL-E, 4500E-BC, 426C, SM4500NH3-BH, (EPA 350.1 for: Ammonia-N),
LACHAT 10-107-06-1-B for Ammonia-N, SM4500NO3-F, 353.2 for Nitrate-N, SM4500NH3-BC-NES, EPA 351.1,
SM4500P-E, 4500P-B,E, 5220D, EPA 410.4, SM 5210B, 5310C, 4500CL-D, EPA 1664, SM14 510AC, EPA 420.1,
SM4500-CN-CE, SM2540D.
Organic Parameters: (EPA 624 for Volatile Halocarbons,Volatile Aromatics),(608 for: Chlordane, Toxaphene,Aldrin,
alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, Dieldrin, DDD, DDE, DDT,Endosulfan I, Endosulfan II, Endosulfan
sulfate, Endrin, Endrin Aldehyde, Heptachlor, Heptachlor Epoxide, PCBs-Water), (EPA 625 for SVOC Acid Extractables
and SVOC Base/Neutral Extractables), 600/4-81-045-PCB-Oil. Microbiology Parameters: (ColilertQT SM9223B;
Enterolert-QT: SM9222D-MF.)
New Hampshire Department of Environmental Services Certificate/Lab ID:200307. NELAP Accredited.
Drinking Water(inorganic Parameters: SM 9222B, 9223B, 9215B, EPA 200.7, 200.8, 300.0, SM4500CN-E, 4500H+B,
4500NO3-F,2320B,2510B, 2540C,4500E-05 5310C, 2120B, EPA 332.0. Organic Parameters: 504.1, 524.2.)
Non-Potable Water(Inorganic Parameters: SM9222D, 9221 B, 9222B, 9221E-EC, EPA 3005A, 200.7, 200.8, 245.1, 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, 2540B5 2540D, 4500H+B,
4500CL-E, 4500CN-E, 4500NH3-H, 4500NO3-F, 4500NO2-B, 4500P-E, 4500-S2-D, 4500SO3-B, 5210B, 5220D,
2510B, 2540C, 4500E-C, 5310C, 5540C, LACHAT 10-204-00-1-A, LACHAT 10-107-06-2-D, 3060A. Organic
Parameters: SW-846 3510C, 3630C, 5030B, 8260C, 8270D, 8330, EPA 624, 625, 608, SW-846 8082A, 8081 B, 8015C,
8151A, 8330, 8270D-SIM.)
Solid& Chemical Materials (Inorganic Parameters: SW-846 6010C, 6020A, 7196A, 7471 B, 1010, 1010A, 1030, 9010C,
9012B, 90145 9030B5 9040C, 9045C, 9045D, 9050, 9065, 9251, 1311, 1312, 3005A, 3050B, 3060A. Organic
Parameters: SW-846 3540C, 3546, 3050B, 3580A, 3620D, 3630C, 5030B5 5035, 8260C, 8270D, 8270D-SIM, 8330,
8151A, 8015B, 8015C, 8082A, 8081B.)
New Hampshire Department of Environmental Services Certificate/Lab ID:2064. NELAP Accredited.
Drinking Water(Organic Parameters: EPA 524.2: Di-isopropyl ether(DIPE), Ethyl-t-butyl ether(ETBE),Tert-amyl methyl
ether(TAME)).
Non-Potable Water(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene. EPA 8015C(M): TPH.)
Solid& Chemical Materials(Organic Parameters: EPA 8260C: 1,3,5-Trichlorobenzene.)
New Jersey Department of Environmental Protection Certificate/Lab ID: MA935. NELAP Accredited.
Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500CN-CE, 4500NO3-F, 4500E-C, EPA
300.0, 200.7, 200.8, 245.1, 2540C, SM2120B, 2320B, 2510B, 5310C, SM4500H-B. Organic Parameters: EPA 332,
504.1, 524.2.)
Non-Potable Water(Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-E, EPA 300.0, SM2120B, 2340B,
SM4500E-BC, EPA 200.7, 200.8, 351.1, LACHAT 10-107-06-2-D, EPA 353.2, SM4500NO3-F, 4500NO2-B, EPA 1664A,
SM5310B, C or D, 4500-PE, EPA 420.1, SM510ABC, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B,
SM15 426C, 9222D, 9221B, 9221C, 9221E, 9222B5 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, 350.2,
SW-846 1312, 7470A, 5540C, SM4500H-B, 4500SO3-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, 8081 A, 8081 B, 8082, 8082A, 8151A, 8330, 1,4-Dioxane by NJ Modified 8270, 8015B, NJ EPH.)
Chemical Materials (Inorganic Parameters: SW-846, 6010B, 6010C, 6020, 6020A, 7196A, 3060A, 9030B, 1010,
Page li A, 1030, 1311, 1312, 3005A, 3050B, 7471 A, 7471 B, 9010C, 9012B, 9014, 9038, 9040B, 9040C, 9045C, 9045D5
Serial No:09171310:50
9050A, 9065, 9251. Organic Parameters: SW-846 8015B, 8015C, 8081A, 8081B, 8082, 8082A, 8151A, 8330, 8260B,
8260C, 8270C, 82701), 8270C-SIM, 8270D-SIM, 3540C, 3546, 3580A, 3620C, 3630C, 5030B, 5035L, 5035H, NJ EPH.)
New York Department of Health Certificate/Lab ID: 11148. NELAP Accredited.
Drinking Water (Inorganic Parameters: SM922313, 9222B, 9215B, EPA 200.8, 200.7, 245.1, SM5310C, EPA 332.0,
SM2320B, EPA 300.0, SM212013, 4500CN-E, 4500E-C, 4500NO3-F, 2540C, SM 2510B. Organic Parameters: EPA
524.2, 504.1.)
Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, 5310C, EPA 410.4,
SM5220D, 2310B, 2320B, EPA 200.7, 300.0, SM4500CL-E, 4500E-C, SM15 426C, EPA 350.1, SM4500NH3-BH, EPA
351.1, LACHAT 10-107-06-2, EPA 353.2, SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2340B, 2540C, 2540B, 2540D, EPA
200.8, EPA 6010C, 6020A, EPA 7196A, SM3500Cr-D, EPA 245.1, 7470A, SM2120B, 4500CN-CE, EPA 1664A, EPA
420.1, SM14 510C, EPA 120.1, SM251013, SM4500S-D, SM5540C, EPA 8315A, 3005A, 3015, 9010C, 9030B. Organic
Parameters: EPA 624, 8260C, 8270D, 8270D-SIM, 625, 608, 8081B, 8151A, 8330, 8082A, EPA 3510C, 5030B, 8015C,
8011.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, EPA 6010C, 6020A, 7196A, 7471B, 8315A, 9012B,
9014, 9065, 9050A, 9038, 9251, EPA 1311, 1312, 3005A, 3050B, 9010C, 9030B, 9040C, 9045D. Organic Parameters:
EPA 8260C, 8270D, 8270D-SIM, 8015C, 8081 B, 8151A, 8330, 8082A, 3540C, 3546, 3580A, 5035A-H, 5035A-L.)
North Carolina Department of the Environment and Natural Resources Certificate/Lab ID : 666. (Inorganic
Parameters: 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, 8260B, 625, 8270D, 8151A, 8015C, 504.1,
MA-EPH, MA-VPH.)
Drinking Water Program Certificate/Lab ID: 25700. (Inorganic Parameters: Chloride EPA 300.0. Organic Parameters:
524.2)
Pennsylvania Department of Environmental Protection Certificate/Lab ID :68-03671. NELAP Accredited.
Drinking Water(Inorganic Parameters:200.7, 200.8, 300.0, 332.0, 2120B,2320B, 2510B, 2540C,4500-CN-CE,4500E-
C,4500H+-B,4500NO3-F, 5310C. Organic Parameters: EPA 524.2, 504.1)
Non-Potable Water(Inorganic Parameters: EPA 120.1, 1312, 3005A,3015, 3060A, 200.7, 200.8,410.4, 1664A,
SM2540D, 5210B, 5220D,4500-P,BE,245.1, 300.0, 350.1, 350.2, 351.1, 353.2,420.1, 6010C, 6020A, 7196A, 7470A,
9030B, 2120B,2310B,2320B, 2510B,2540B, 2540C, 3500Cr-D,426C,4500CN-CE,4500CI-E,4500E-B, 4500E-C,
4500H+-B, 4500NH3-H,4500NO2-B,4500NO3-F,4500S-D, 4500S03-B, 5310BCD, 5540C, 9010C, 9040C. Organic
Parameters: EPA 3510C, 3630C, 5030B, 625, 624, 608, 8081B, 8082A, 8151A, 8260C, 8270D, 8270D-SIM, 8330,
8015C, NJ-EPH.)
Solid & Hazardous Waste (Inorganic Parameters: EPA 350.1, 1010, 1030, 1311, 1312, 3005A, 3050B, 3060A, 6010C,
6020A, 7196A, 7471 B, 9010C, 9012B, 9014, 9040B, 9045D, 9050A, 9065, SM 45001\11-13-13H, 9030B, 9038, 9251.
Organic Parameters: 3540C, 3546, 3580A, 3620C, 3630C, 5035, 8015C, 8081B, 8082A, 8151A, 8260C, 8270D, 8270D-
SIM, 8330, NJ-EPH.)
Rhode Island Department of Health Certificate/Lab ID: LA000065. NELAP Accredited via NJ-DEP.
Refer to MA-DEP Certificate for Potable and Non-Potable Water.
Refer to NJ-DEP Certificate for Potable and Non-Potable Water.
Texas Commisson on Environmental Quality Certificate/Lab ID:T104704476. NELAP Accredited.
Non-Potable Water(inorganic Parameters: EPA 120.1, 1664,200.7,200.8, 245.1, 245.2, 300.0, 350.1, 351.1, 353.2,
410.4,420.1, 6010, 6020, 7196, 7470, 9040, SM 2120B, 2310B,2320B, 2510B,2540B, 2540C, 2540D,426C,4500CL-
E, 4500CN-E, 4500E-C,4500H+B,4500NH3-H,4500NO2B,4500P-E,4500 S2 D, 510C, 5210B, 5220D, 5310C,
5540C. Organic Parameters: EPA 608, 624, 625, 8081, 8082, 8151, 8260, 8270, 8330.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312, 9012, 9014, 9040, 9045, 9050, 9065.)
Virginia Division of Consolidated Laboratory Services Certificate/Lab ID:460195. NELAP Accredited.
Drinking Water(Inorganic Parameters: EPA 200.7, 200.8, 300.0,2510B, 2120B,2540C,4500CN-CE, 245.1, 2320B,
4500E-C,4500NO3-F,4500H+B, 5310C. Organic Parameters: EPA 504.1, 524.2.)
Non-Potable Water(inorganic Parameters: EPA 120.1, 1664A, 200.7, 200.8,245.1, 300.0, 350.1, 351.1, 351.2, 3005A,
3015, 1312, 6010B, 6010C, 3060A, 353.2,420.1, 2340B, 6020, 6020A, SM4500S-D, SM4500-CN-CE, Lachat 10-204-
1- 7196A, 7470A, 2310B, 2320B,2510B, 2540B, 2540C, 2540D, 3500Cr-D, 426C,4500CI-E,4500E-B,4500E-C,
Page AM A3-H, 4500NO2-B,4500NO3-F,4500 S03-13,45001-1-13, 4500PE, 510AC, 5210B, 5310B 5310C,5540C, 9010Cm
Serial No:09171310:50
903013, 9040C. Organic Parameters: EPA 3510C, 3630C, 503013, 826013, 608, 624, 625, 8011, 8015C,8081A, 8081B,
8082, 8082A, 8151A, 8260C, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330, )
Solid&Hazardous Waste(Inorganic Parameters: EPA 1010A, 1030, 3060A, 3050B, 1311, 1312, 6010B, 6010C, 6020, ,
7196A, 7471A, 7471 B, 6020A, 9010C, 9012B, 903013, 9014, 9038, 9040C, 9045D, 9251, 9050A, 9065. Organic
Parameters: EPA 50306, 5035, 3540C, 3546, 3550B, 3580A, 3620C, 3630C, 6020A, 826013, 8260C, 8015B, 8015C,
8081A, 808113, 8082, 8082A, 8151A, 8270C, 8270D, 8270C-SIM, 8270D-SIM, 8330.)
Department of Defense, L-A-B Certificate/Lab ID: L2217.
Drinking Water(Inorganic Parameters: SM 4500H-B. Organic Parameters: EPA 524.2, 504.1.)
Non-Potable Water (Inorganic Parameters: EPA 200.7, 200.8, 6010C, 6020A, 245.1, 7470A, 9040B, 901013, 180.1,
300.0, 332.0, 6860, 351.1, 353.2, 9060, 1664A, SM 4500CN-E, 4500H-B, 4500Norg-C, 4500NO3-F, 5310C, 2130B,
2320B, 2340B, 2540C, 5540C, 3005A, 3015, 9056, 7196A, 3500-Cr-D. Organic Parameters: EPA 8015C, 8151A,
8260C, 8270D, 8270D-SIM, 8330A, 8082A, 8081B, 3510C, 5030B, MassDEP EPH, MassDEP VPH.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010C, 6020A, 7471A, 6860, 1311, 1312, 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, 8081B, 3540C, 3546, 3580A, 5035A, MassDEP EPH, MassDEP
VPH.)
The following analytes are not included in our current NELAP/TNI Scope of Accreditation:
EPA 524.2: Acetone, 2-Butanone (Methyl ethyl ketone (MEK)), Tert-butyl alcohol, 2-Hexanone, Tetrahydrofuran, 1,3,5-
Trichlorobenzene, 4-Methyl-2-pentanone (MIBK), Carbon disulfide, Diethyl ether. EPA 8260B: 1,214,5-
Tetramethyl benzene, 4-Ethyltoluene. EPA 8260 Non-potable water matrix: lodomethane (methyl iodide), Methyl
methacrylate. EPA 8260 Soil matrix: Tert-amyl methyl ether (TAME), Diisopropyl ether (DIPE), Azobenzene. EPA
8330A: PETN, Picric Acid, Nitroglycerine, 2,6-DANT, 2,4-DANT. EPA 8270C: Methyl naphthalene, Dimethyl
naphthalene, Total Methylnapthalenes, Total Dimethylnaphthalenes, 1,4-Diphenylhydrazine. EPA 625: 4-Chloroaniline,
4-Methylphenol. Total Phosphorus in a soil matrix, TKN in a soil matrix, NO2 in a soil matrix, NO3 in a soil matrix. EPA
9071: Total Petroleum Hydrocarbons, Oil &Grease.
Page 17 of 18
Serial No:09171310:50
Date;Rec'din ,c. } i. HA ` b#`
CHAIN OF CUSTODY PAGE IOF1 l>� �;�::, ALP J O
u
Westborough,MA Mansfield,MA ❑ FAX ® EMAIL ® Same as Client info PO# 10139
TEL:50B•898-9220 TEL:50B-822-9300 Project Name:Straubing Residence ❑ ADEX ❑ Add'I Deliverables
FAX:508-898-9193. FAX'508.822-3288
RegulatoryRequirements/Report
Client Information Project Location:Marstons.Mills,MA State/Fed Program . Criteria
Client:Bennett Environmental Associates Project#:BEA09-10139
Address: 1573 Main Street/P.O.Box 1743 Project Manager:David C.Bennett
Brewster,MA 02631 ALPHA Quote#;
Phone:508-896-1706 . Time
ANALYSIS •
Fax:508-896-5109 ®Standard ❑-Rush(ONLY IF PRE-APPROVED) SAMPLE HANDLING
Filtration
Email:sfarrenkopl@bennett-ea.com G) i 7' ❑ Done
❑These samples have been Previously analyzed by Alpha Due Date: Time: ® Not Needed
❑ Lab to do
Other Project Specific Requirements/Comments/Detection Limits: Preservation •
❑ Lab to do
(Please specify
below)
ZE
ALPHA'Lab.)[D Sample ID Collection Sample Sampler's z
:(Lab.use Only) Date Time Matrix Initials
...._... ..s:L':..:.:. .... .t—., z Sample Specific
Comments
Effluent 1 3 Cl® WW ® ® ❑. ❑. ❑ ❑. El El ❑ ❑ ❑. x
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 01
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11
El
is ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ JEEDID
❑ ❑ ❑ ❑ ❑ ❑ ❑ 2
Container T e P P
Yp C- . ..:i-..'::
'Pleese;print cleerly,iegby
Preservative 0 D - "bnd completely: Sa&I-6s can.'
riotibelogged in:and:::.:.:::::::
Relinquished By: Date/Time Received By: D errime turharou'h_?time clockwlliinbt.;,
startauritii;drny ambiguitiesta{e ':
1111 A resolved.All.'samples.; .:' .;.n
5 Itt d aresublect is "!
FOR N0:01.011MJ)
G3� �j j pfaaPaynt)Terms:
(rev.M2"FR-R _
Page 18 of 18
pU THE Toiy, Barnstable, ~ 0 'Town of Barnstable
M-Amm;cac"
lARA,ASS Board of Health
iFi34. ��
�ATefl�x+° 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Wayne Miller,M.D.
FAX 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
August 30, 2014
Ms. Kimberly Straubing
Mr. Jeffrey David
195 Route 149, Unit G
Herring Run
Marston Mills, MA 02648
RE Sampling of Wastewater Effluent from your Innovative/Alternative,e(FAST) System at
195.Route;149,,Umt G Herring Run, Marstons 1�ilills, MA ..
Dear Ms. Straubing and Mr. David,
You are granted permission to reduce the frequency of Operation and Maintenance (0&M) of
your onsite sewage disposal system consisting of innovative/alternative technology(FAST
system) at 195 Route 149, Unit G, Herring Run, Marston Mills.
A public hearing was held before the Board of Health on May 13, 2014. Although Operation
and Maintenance (O&M) has occurred quarterly during the past four years, the Board received
effluent test results only,once per year in 2012 and 2013 for Nitrate, Nitrite, TNK and Total
Nitrogen (TN): Missing were test for cBOD5, pH< and TSS. Nonetheless, the Total Nitrogen
levels were at 8.85 mg/litter in 2012 and 16.47 mg/liter in 2013, which are within acceptable
limits.
This permission is granted with the following.conditions:
Operation and Maintenance inspections shall be conducted twice per year, in
accordance with MA DEP Regulations.
The wastewater effluent shall be tested twice per year for Total Nitrogen, pH,
cBOD5, and TSS.
Since e ',
, � ,
Wa.'n i 1 er, D., Chairman
BOARD, F HEALTH
Q:\WPFILES\IA MonitoringAdj StraubingDavid 195 Rte149 G.doc
�b<-�C�
o� 'k�S-f� � � �U,vttilrlQ.lR.1'c�
l@� CO�.t.r.�(-:., ��?'f i}b `ICJ
�- °�a�-� ��m� �
(��� �/a) ���
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:
Town of Barnstable Board of Health 4/11/14 BEA09-10139
Attn:Thomas McKean
200 Main Street
Hyannis,MA.02601 REGARDING:
Hearing Request for Reduction of Innovative/Alternative Septic System
Operation and Maintenance
SHIPPING METHOD: !Mar:stons
-G Herring Run
Mills,MA 02648
Regular Mail � Pick Up ❑
Priority Mail ❑ Hand Deliver ❑
Express Mail ❑ Other ❑
Certified Mail ❑ Green Card/RR ❑ ® -2S �� ��
4 � c I�
COPIES DATE DESCRIPTION
j CD
re)
td ;tz"
For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑
RKS:
Bennett Environmental Associates,Inc.would like to request a hearing date on behalf of our client Kimberly Straubing,of Route 149,Unit
195-G in the Herring Run Place Development. This hearing is requested to review the applicability of reducing the required operation and
maintenance of the Alternative Septic System servicing the residence.
cc:Kimberly Straubing
FROM: Samantha Farrenkopf,Wastewater Program Coordinator
If enclosures are not as noted,kindly notify us at once
5/9/14
Summary of I/A Monitoring Results
195 Route 149, Unit# G, Herring Run Place Map/Parcel 078-018-40G
Marstons Mills, MA 02648
Data:
Inspections and sampling from Carmody reports:
53 Service Visits Reported 2003-2014
2003 Installed Recirculating Sand Filter(RSF)
2003 —2006 O+M with sampling quarterly
2007 O+M bi-annually with one sample
2008 O+M 4 visits, one for repairs and 3 samplings
2009 O+M 1 visit(4/09), but no sampling
2010 O+M quarterly with 2 samplings
2011 - 2014 O+M has been reported quarterly by Bennett Environmental Assoc., with
one grab sample per year, with only testing for Nitrate,Nitrite, TNK and
TN. *No reports, since 12/17/2008?
*These parameters of cBOD5, PH, Alkalinity, and TSS are required
unless approval has been given to reduce monitoring. (See attached
Regulations B.ii)
Nonetheless, the TN in both 2012+2013 was within required limits:
2012 On 9/05/12 TN 8.85 mg/L (required 25 mg/L)
2013 On 9/11/13 TN 16.47 mg/L (required 25 mg/L)
Notes:
Not clear whether Unit G is a seasonal or year-round dwelling??
Recommendations:
If Year-Round: Recommend 2 X per year with field testing PH, DO and
turbidity with sampling for TN both visits.
If Seasonal Annual monitoring with field testing PH, DO and turbidity
(< 6 months): with sampling for TN for the one visit/yr.
Karen Malkus
Town of Barnstable Health Division
Coastal Health Resource Coordinator
QA1A systems\Summary 195 Route 149 Unit G-IA Monitoring May2014.doc
j .
-En 4z� Iq5 7�k C,
Title V — I/A Monitoring A44S00r_ �
Certification for General Use- Generic 5 of 7
( Recirculating Sand Filter(secondary or nitrogen reducing)
ii. No System shall be used until an 0&M agreement is submitted to the local approving
authority which:
a Provides the name of an operator competent in providing services consistent with
the System's specifications, which must be a Massachusetts certified operator if
one is required by 257 CMR 2.00, that will operate and monitor the System
(hereinafter the "System operator"). The System owner shall notify the
Department and local approving authority, in writing,within seven days of a
change in the operator of the System.
b. Contains procedures for notification to the Department and the local approving
authority.within five days of knowledge of a System.failure, malfunction or alarm
event and for corrective measures to.be taken immediately;
13. Systems designed in accordance with Section II, item 7, in a Department designated
nitrogen sensitive or limited area as defined in 310 CMR 15.214 and 15.215 shall meet the
following requirements:
i. Effluent shall meet the requirements in 310 CMR 15.202(4); 30 mg/L Carbonaceous
Biochemical Oxygen Demand.(CBODS), 30 mg/L.Total Suspended Solids (TSS), and ,
25 mg/L Total Nitrogen (TN). Effluent pH shall be maintained between 6:0 and.9.0.
ii. The operator.must inspect, and maintain the System according to the following, and
anytime there is an alarm event.
i 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.
e following parameters shall be monitored: pH, effluent CBODS, 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. . er two years lof monitoring
and at the written request of the System owner, the oca approving authority may
reduce the ins ection_and monitoring requirements for residential systems to two
ins ections er e with field testing for H DO and turbidity and laboratory
testing for
b. For Systems inFuse seasonally,where the facility is occupied fewer than six
months-per year;effluent from the System shall be monitore twice per season;,
initially 45 days after occupancy and prior to shutdown, and i t e acr ity is
occupied during an additional calendar quarter, once during that following quarter
prior to System shut down. T}ae following parameters shall be monitored: pH,
CBOD5, TSS, TN and alkalinity. 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 seasons of monitoring and at
the written.request of the System owner, the local approving authority may I
— reduce the inspection and monitoring requirements for residential systems to -
anni,�l;ncpP�t;onS with field testing for pH, DO and turbidity and laboratory
testing for-'FN.
i
- t
t
5/9/14
Summary of I/A Monitoring Results
195 Route 149, Unit# G, Herring Run Place Map/Parcel 078-018-40G
Marstons Mills, MA 02648
Data:
Inspections and sampling from Carmody reports:
53 Service Visits Reported 2003-2014
2003 Installed Recirculating Sand Filter(RSF)
`2003 —2006 O+M with sampling quarterly
2007 O+M bi-annually with one sample
2008 O+M 4 visits, one for repairs and 3 samplings
2009 O+M 1 visit (4/09), but no sampling
2010 O+M quarterly with 2 samplings
2011 - 2014 O+M has been reported quarterly by Bennett Environmental Assoc., with
-one grab sample per year, with only testing for Nitrate,Nitrite, TNK and
TN. *No reports, since 12/17/2008?
*These parameters of cBOD5, PH, Alkalinity, and TSS are required
unless approval has been given to reduce monitoring. (See attached
Regulations B.ii)
Nonetheless, the TN in both 2012+2013 was within required limits:
2012 On 9/05/12 TN 8.85 mg/L (required 25 mg/L)
2013 On 9/11/13 TN 16.47 mg/L (required 25 mg/L)
Notes:
Not clear whether Unit G is a seasonal or year-round dwelling??
Recommendations:
If Year-Round: Recommend 2 X per year with field testing PH, DO and
turbidity with sampling for TN both visits.
t
If Seasonal Annual monitoring with field testing PH, DO and turbidity
(< 6 months): with sampling for TN for the one visit/yr.
Karen Malkus
Town of Barnstable Health Division
Coastal Health Resource Coordinator
QA1A systems\Summary 195 Route 149 Unit G-IA Monitoring May2014.doc
Title V — I/A Monitoring
Certification for General Use- Generic 5 of 7
Recirculating Sand Filter(secondary or nitrogen reducing)
ii. No System shall be used until an 0&M agreement is submitted to the local approving
authority which:
a Provides the name of an operator c6inpetent in providing services consistent with
the System's specifications, which must be a Massachusetts certified operator if
one is required by 257 CMR 2.00,,that will operate and monitor the System
(hereinafter the "System operator"). The System owner shall notify the
Department and local approving authority, in writing, within seven days of a
change in the operator of the System.
b. Contains procedures for notification to the Department and the local approving
authority.within five days of knowledge of a System failure, malfunction or alarm
event and for corrective measures to,be taken immediately;
B. Systems designed in accordance with Section II, item 7, in a Department designated
nitrogen sensitive or limited area as defined in 310 CMR 15.214 and 15.215 shall meet the
following requirements:
i. Effluent shall meet the requirements in 310 CMR 15.202(4); 30 mg/L Carbonaceous
Biochemical Oxygen Demand (CBODS), 30 mg/L.Total Suspended Solids (TSS), and .
25 mg/L Total Nitrogen (TN). Effluent pH shall be maintained between 6.0 and 9.0.
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 monitore
least once per calendar guarter.(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. . er two years of monitoring
and at the written request of the System owner, the oca approving authority may
reduce the in ection,.and monitoring requirements for residential systems to two
ins ections er e` with field testing for idity and laboratory
testing for
b. For Systems in use seasonally, where the facility is occupied fewer than six
months.per year•,.effluent from the System shall be monitore twice
initially 45 days after occupancy and prior to shutdown, and if the facility is
occupied during an additional calendar quarter, once during that following quarter
prior to System shut down. Th6 following parameters shall be monitored: pH,
CBOD5, TSS, TN and alkalinity, 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 seasons 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 L '
anmal i�srP�+inns with field testing for pH, DO and turbidity and laboratory
testing fot'FN. -
i
5/9/14
Summary of VA Monitoring Results
195 Route 149, Unit# G, Herring Run Place Map/Parcel 078-018-40G
Marstons Mills, MA 02648
Data:
Inspections and sampling from Carmody reports:
53 Service Visits Reported 2003-2014
2003 Installed Recirculating Sand Filter(RSF)
2003 —2006 O+M with sampling quarterly
2007 O+M bi-annually with one sample
2008 O+M 4 visits, one for repairs and 3 samplings
2009 O+M 1 visit (4/09), but no sampling
2010 O+M quarterly with 2 samplings
2011 - 2014 O+M has been reported quarterly by Bennett Environmental Assoc., with
one grab sample per year, with only testing for Nitrate,Nitrite, TNK and
TN. *No reports, since 12/17/2008?
*These parameters of cBQD5, PH, Alkalinity, and TSS are required
unless approval has been given to reduce monitoring. (See attached
Regulations B.ii)
Nonetheless, the TN in both 2012+2013 was within required limits:
2012 On 9/05/12 TN 8.85 mg/L (required 25 mg/L)
2013 On 9/11/13 TN 16.47 mg/L (required 25 mg/L)
Notes:
Not clear whether Unit G is a seasonal or year-round dwelling? - ANS. Year Round.
Recommendations:
If Year-Round: Recommend 2 X per year with field testing PH, DO and
turbidity with sampling for TN both visits.
If Seasonal Annual monitoring with field testing PH, DO and turbidity
(< 6 months): with sampling for TN for the one visit/yr.
Karen Malkus
Town of Barnstable Health Division
Coastal Health Resource Coordinator
QA1A systems\195 Rt149\Summary 195 Route 149 Unit G-1A Monitoring May2014.doc
B E NNETT ENVIRONMENTAL ASSOCIATES, INC.
LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,SANITARIANS
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 9/23/10 BEA09-10139
Attention:Title 5 Program
1 Winter Street-6th Floor
Boston,MA 02108 REGARDING:
Straubing and David Residence
195 Herring Run Plac 4_6'Mo►�t W1 T
Marstons Mills,MA I
SHIPPING METHOD: S E P 2 8 REC'0
Regular Mail ❑ Federal Express ❑
By
Certified Mail ❑x UPS ❑
Priority Mail ❑ Pick Up ❑
Express Mail ❑ Hand Deliver ❑
COPIES DATE DESCRIPTION
4 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems(Jan-Sept
2010)
1 9/16/10 Alpha Analytical Laboratory Report
For review and comment: ❑ For approval: ❑ As requested: ❑ For your use:
REMARKS:
Please find enclosed the DEP Inspection and O&M Form,and laboratory test results of wastewater samples collected during this
reporting period for the above referenced property. If you have any questions or require additional information,please contact us at your
earliest convenience. Thank you.
cc:Barnstable Board of Health
Ms.Kim Straubing and Mr.Jeffrey David,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
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: Kim Straubing
When filling out Owner
forms on the
computer,use Route 149 Unit 195-G
only the tab key Facility Street Address
to move your Marstons Mills 02648
cursor-do not
use the return City Zip
key. Mailing address of owner, if different:
P.O. Box 863
Street Address/PO Box:
Marstons Mills MA 02648
City State Zip
(508)428- 1831 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/2003 8/25/2003
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
d
D. Operating Information
1/6/10 '
Inspection Date Previous Inspection Date
6"of Sludge, and No Scum Layer Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
t5aiom.doc•rev.11-07-05 Page 1 of 1
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 6.92 SU DO 7.53 mg/L Turbidity 14.2 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 pulled effluent sample for field testing
Notes and Comments:
None
t5aiom.doc•rev. 11-07-05 Page 2 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
H. Certification
I certify: I have inspected the sewage treatment and disposal system at the address above, have
conducted the required Field Testing and/or sample collection in accordance with Standard Methods,
have completed this report and the attached technology operation and maintenance checklist, and
the information reported is true, accurate, and complete as of the time of the inspection. I am a
Massachusetts certified operator in accordance with 257 CMR 2.00.
9-'e-V�sa nk-2s'a"M� Ci lz�')Io
Operator Signature Date
System owner must submit this report, technology O&M checklist, and any required sampling results
to the local board of health and DEP as follows for each inspection performed:
Remedial Use—by January 31st of each year for the previous calendar year
Piloting Use-within 45 days of inspection date
Provisional Use—by March 31th of each year for the previous 12 months
General Use—by September 30th of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6 Floor
Boston, MA 02108
t
t5aiom.doc•rev.11-07-05 Page 3 of 3
i
i
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: Kim Straubing
When filling out Owner
forms on the
computer,use Route 149 Unit 195-G
only the tab key Facility Street Address
to move your Marstons Mills 02648
cursor-do not City Zip
use the return
key. Mailing address of owner, if different:
P.O. Box 863
Street Address/PO Box:
Marstons Mills MA 02648
'BQ1l1 City State Zip
(508)428- 1831 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508) 896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf ' 13265
Certified Operator Name Certification Number
C..Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/2003 8/25/2003
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
r
D. Operating Information
3/16110 1/6/10 j
Inspection Date Previous Inspection Date I,
6"of Sludge, and T'Scum Layer Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
1.
t5aiom.doc-rev. 11-07-05 Page 1 of 1
I
h
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Title 5
DEP Approved Inspection and OW Form for Title 5 I/A
Treatment and Disposal Systems
E. Field Testing
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify):
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
Effluent Solids: ® no ❑ some
pH 6.80 SU DO 6.18 mg/L Turbidity 5.27 NTU
6 to 9 2 or greater 40 or less
Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected
per Standard Methods and analyzed for BOD and TSS.
F. Sampling Information
Samples Taken: ❑ Influent ❑ Effluent
Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use
nitrogen reducing systems:
gpd
Parameters sampled: ❑ pH ❑ BOD ❑ CBOD ❑ TSS ❑ TN ❑ Other(list below)
Other 1 Other 2 Other 3
G. Inspection and Maintenance
Description of any maintenance performed since previous inspection &during this inspection:
General O&M visit for system functionality, and pulled effluent sample for field testing
Notes and Comments:
System functional, and passed field testing.
t5alom.doc•rev.11-07-05 Page 2 of 2
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: Kim Straubing
When filling out Owner
forms on the
computer,use Route 149 Unit 195-G
only the tab key Facility Street Address
to move your Marstons Mills 02648
cursor-do not City Zip
use the return
key. Mailing address of owner, if different:
P.O. Box 863
Street Address/PO Box:
Marstons Mills MA 02648
city State Zip
(508)428- 1831 ext.
Telephone Number
B. Authorized Service Provider
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C..Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/2003 8/25/2003
Installation Date a Start of Operation
Approval Type: ® General ElProvisional ❑ Piloting ❑ Remedial
Seasonal Residence—used less than 6 mo./year: ❑ Yes ® No
D: Operating Information
9/8/10 6/9/10
Inspection Date Previous Inspection Date
9"of Sludge, and 1" Scum Layer Pumping Recommended ❑ Yes ® No
Sludge Depth(to be checked yearly)
Page 1 of 1
t5aiom.d6c-rev. 11-07-05
i
I
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/A
Treatment and Disposal Systems
E. Field Testing
Field Inspection:
Color: ❑ gray ❑ brown ® clear ❑ turbid
❑ Other(specify):
I
Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid
i
Effluent Solids: ® no ❑ some I
pH 6.49 SU DO 5.47 mg/L Turbidity 4.46 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)
TKN NO2, NO3
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, pulled effluent sample for lab analysis and conducted
field testing
Notes and Comments:
System functional, and passed field testing.
1
I
I
t5aiom.doc•rev.11-07-05 Page 2 of 2
t
LLIMassachusetts 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.
23)10
O rator 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, 6 Floor
Boston, MA 02108
t5aiom.doc•rev.11-07-05' , Page 3 of 3
Serial_No:09161012:56
HA
! C A L
ANALYTICAL REPORT
Lab Number: L1013948
Client: Bennett Environmental Associates
1573 Main Street
PO Box 1743
Brewster, MA 02631
ATTN: David Bennett
Phone: (508)896-1706
Project Name: STRALIBING RESIDENCE
Project Number: BEA09-10139
Report Date: 09/16/10
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:09161012:56
Project Name: STRAUBING RESIDENCE Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
Alpha Sample Collection
Sample ID Client ID Location Date/Time
L1013948-01 EFFLUENT MARSTONS MILLS, MA 09/08/10 15:00
aHA
Page 2 of 17
Serial No:O9161O12:56
Project Name: STRAUBING RESIDENCE Lab Number: L1O13948
Project Number: BEAO9-10139 Report Date: 09/16/10
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 correctivg 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 A.DEx 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; "�Z� Elizabeth Simmons
Title: Technical Director/Representative Date: 09/16/10
{ :�,.
Page 3 of 17 ����
Serial No:09161012:56
INORGANICS
MISCELLANEOUS
Page 4 of 17
Serial No:09161012:56
Project Name: STRAUBING RESIDENCE Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
SAMPLE RESULTS
Lab ID: L1013948-01 Date Collected: 09/08/10 15:00
Client ID: EFFLUENT Date Received: 09/09/10
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
Geriei-al.Chemis .'
Nitrogen,Nitrite 0.11 mg/I 0.05 - 1 - 09/09/10 23:32 44,353.2 DD
................ ..._...._..............----.._.....--..�..__.._.._.._.__...__... -..._ ......_._._.._._..------
Nitrogen,Nitrate 1.5 mg/I 0.10 -- 1 09/09/10 23:32 44,353.2 DID
........_..._......................._.......---........._.._............................................_._......_.._..__..........._........_......................._.........._.._.....................---....................................__._..................-_--._._...................................................---.................._.................._......_..._............._....__.....__.......---------..-..............._.....__
Nitrogen,Total Kjeldahl 6.3 mg/I 0.30 1 09/14/10 17:10 09/15/10 20:18 30,4500N-C AT
L�r�HA
Page 5 of 17
Serial No:09161012:56
Project Name: STRAUBING RESIDENCE Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
Method Blank Analysis
Batch Quality Control
Dilution Date Date Analytical
Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst
' '�,s ``✓�:` .p -' s�s•�,��*�` '�s ''""�`"°"�€""' ����`""'P`al +�i's Y'r'� •.zz..�-�"' rrx�'�'�� `�'_�•'.-�t€ ;��j•y' � �,�
GLLeneral Chi lstry;e WestEorough;Lab forsa�mpl(s)�0.1;�. B WG4317�17�� °� �KM; � � �,' °N
Nitrogen,Nitrite ND mg/I 0.05 1 09/09/10 23:10 44;353.2 DID
GenerallChe'mistry „Westborough'Lab:"forsampie(s)= 0101te
hAWG4312�� s
Nitrogen,Nitrate ND mg/I 0.10 — 1 09/09/10 23:03 44,353.2 DID
Gene""ral Chemist• `•�=W�estboro�u h abtor•�I�s�•01 Batch�WG4324021- �� � �
Nitrogen,Total Kjeldahl ND mg/I 0.30 1 09/14/10 17:10 09/15/10 20:04 30,4500N-C AT
i
L�L?FiA
Page 6 of 17
Serial No:09161012:56
Lab Control Sample Analysis
Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
LCS LCSD %Recovery
Parameter %Recovery Qual %Recovery Qual Limits RPD
Qual RPD Limits
.,. �z �r�m �x ; .:, -'��xa.-tax�'•�. - s �-r-- � ;
General Chemist.,.Westborou hLabAssociatedfsa le s<<:.01 Ba *~ �� }"'""" "":w
Nitrogen,Nitrite 101 - 90-110 20
......................-------- —...........-........._..— __ M ._,n,;;::��_.
�_ r e ,.,r, he.. ._ _:estbor..ou h,Lab:,Assoc[ated,sam le s,,01,..Batch...WG431.71�9 1-:...: �• -�.. �,- � :�. � . _ � '�� � -
....�„:•5�. �� ,. .ry ,,�,. �,..;,-.g,,.. ..;. .. . . .e_...: p ,.� �: � ..�..,. _ � .Y �fiE�.��ck,� ..�xs 3-. «:�• �.:�� `n*- .::�<�..., :`..�.e�-..',�,r,�
Nitrogen,Nitrate � 102 90-110
a,....._._.—_...._...---......_._....__._.....—_..........._....__...__._._._.__..—_—..............----.._...._..__..—.__.._..---._....--------------.____..._.._.._—.....-------......_.__._....--.--..._...___...-------------_—._.._...
General>Chemisi =CN
e tborou h_ab. Assoctat . sam r
r, rY z..-., g,. . P ).
Nitrogen,Total Kjeldahl 102 85-110
Page 7 of 17 '
Serial No:09161012:56
Matrix Spike Analysis
Project Name: STRAUBING RESIDENCE Batch Quality Control Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
Native MS MS MS MSD MSD Recovery RPD
Parameter Sample Added Found %Recovery Qual Found %Recovery Qual Limits RPD Qual Limits
G nera ;•. < , ,
West orou h a Associ teal ix . . ,,� , ;. _
..... .. :Y g < T h a,..w, a rp..,( ) 011,,, QC;tBatch.ID WG.,4,31717:3 'QC.Barn Le. L1w0,13949 0,1. .Cltent ID... MS,Sam le ..•.
indits,. ::x'' •;.. ,.;3k.:is�":....F,�F •aM,a.,,ac:; .a.,:., ::r3e., ;..w..S�:: :,:; e,�, ��...,w:zt�, Y.xp�`, =,_a.,=a...,.ai«.��.a,.ia.,,. x�.,:�a.R..�.o•,a..�
Nitrogen,Nitrite ND 4 4.1107 - 80-120 20
__ .---_..........-----------------------._.._..---------------------------..._..-----...._._...........----._._.._...._.......-.--_-.._.. :..............._ era-------------....._------ __...._.._.......-................................................................._...................--._.......---._.............. _._..................._.._..--.....-...............
- :r h-� �,r,.� w .„;y .c. ,., ,,:. •. ,1. ",�':'y'v;', ' "�"�•"'�'General Chemistry •W.. estbgrou,9 h.La.b� Associated3sarn P_Le,�s). 01,r 3 QCK,13atc�hID.. W�G4 F.3 171.9t. _a�xQ C:S�am ple�: L1�:0 �-= 'y. #7g nU S`-..S13 64 CI ;+ D Mwa mp•InZ
.X
Nitrogen,Nitrate 3.1 4 7.0 t98"-. - 83-113 6
--.......--............................. ...............................
----- ..._ .......................................................................__..............
General Chemist a. Westbocou h Lab.Associatetl sam le s .01` t - ' _: ._M`
tL101>3952,01 .CIie�nt IQ.,,,MS Sam,le.
Nitrogen,Total Kjeldahl 1.2 8 9.3 '101 - 77-111 - 24
_..............._........._.._......__._.._.....__...._....—_._. ter,..:
Page 8 of 17 ALPHA
Serial No:09161012:56
Lab Duplicate Analysis
Project Name:' STRAUBING RESIDENCE Batch Quality Control Lab Number: L1013948
Project Number: BEA09-101.39 Report Date: 09/16/10
Parameter. Native Sample Duplicate Sample Units RPD Qual RPD Limits
General Chernlstr �=Westborou hkLab Assoclat d- am le s �Ot1'" �l3at 117:.:WG4.317.1r P1013 49=0;1k°Client ID:= DUP Sam 1e:: .- ?
�QG ch t 7 QC�Sarnple ,L 9 r„ ,
..
P
Nitrogen,Nitrite ND ND mg/I NC 20
..........................._..............--.._.................._......__........................................................-....................................,.............._....__........._...........................................................................................-......................................................................................................................................................................................................... . ........................................
.................................................._...............................
,G.eneral.Chemistr�: .tyWestbo.rou h�Lab Asso aced sam le.s :��0;1'� �� � Batch LD: WG43=1�:�1z .-4 . . C:, am I , L.1..0,13 .46.�Or9 Y:Cll�ent`D:� DUP�:S'a le'��; � � <
..��. �
Nitrogen,Nitrate 3.1 3 1 mg/I , 0^ 6
�a^
G:eneraP Chemist �UVi3stborou h�!_ab� Associated, am 1e s : 0A QC�Batch�ID...n WG43240 -4 QC Sam;le L1�0.13952a01 I�Glient'D UP
iak.n���.ire:;.:4.�;:i:,.�#sk.:�5.�,w:,.t �xran„Rri ,c.h•.ar1F+..... =M�n.,s..5:::M;!.xm.[b��4f:R� ��F wv.�ruin'.��.c �. 4�42"n�€s.�`..�x...�,.a+.a.,.�oiA.i.x.�:-�—.�'. ':.e. ::�' - ''.�".�.��.F.�.��.�.aa�.•�r..°.::*1....�....a.�...+�„nb.
Nitrogen,Total Kjeldahl 1.2 1.8 mg/I 40 Q 24
........................_.. ..............-..............................._..................._................................................._. ........................... sA ..........................................._._.......................................................................
Page 9 of 17 ��'�
Serial No:09161012:56
Project Name: STRAUBING RESIDENCE Lab Number:.L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
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(*)
L1013948-01A Plastic 500ml unpreserved A 7 3.6 Y Absent NO2-353(2),NO3-353(2)
L1013948-01 B Plastic 250ml H2SO4 preserved A <2 3.6 Y Absent TKN-4500(28)
5
*Values in parentheses indicate holding time in days �;,�
Page 10 of 17
Serial No:09161012:56
Project Name: STRAUBING RESIDENCE Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
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.
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.
Terms
Analytical Method:Both the document from which the method originates and the analytical reference method.(Example:
EPA 8260B is shown as 1,8260B.)The codes for the reference method documents are provided in the References section of
the Addendum.
Data Qualifiers
A Spectra identified as"Aldol Condensation Product".
B The analyte was detected above the reporting limit in the associated method blank.Flag only applies to associated
field samples that have detectable concentrations of the analyte at less than five times(5x)the concentration found in
the blank.For MCP-related projects,flag only applies to associated field samples that have detectable concentrations
of the analyte at less than ten times(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.
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.
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.
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.
Report Format: Data Usability Report
- L�L?HA
Page 11 of 17
Serial No:09161012:56
Project Name: STRAUBING RESIDENCE Lab Number: L1013948
Project Number: BEA09-10139 Report Date: 09/16/10
Data Qualifiers
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
�L1Lr�HA
Page 12 of 17
• Serial No:09161012:56
Project Name:
J STRAUBING RESIDENCE Lab Number: L1013948 '
Project Number: BEA09-10139 Report Date: 09/16/10
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:09161012:56
Certificate/Approval Program Summary
Last revised July 19,2010 -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))
WastewaterdNon-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 (SM9221B), HPC - Pour Plate (SM9215B), Fecal
Coliform-MF m-FC(SM9222D), Fecal Coliform-A-1 Broth(SM9221 E).)
Solid Waste/Soil(Inorganic Parameters: pH, Sulfide,Aluminum,Antimony,Arsenic, Barium, Beryllium, Boron, Cadmium,
Calcium, Chromium, Hexavalent Chromium, Cobalt, Copper, Iron, Lead, Magnesium, Manganese, Mercury,
Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Thallium, Tin, Vanadium, Zinc, Total Cyanide, Ignitability,
Phenolics, Corrosivity, TCLP Leach (1311), SPLP Leach (1312 metals only), Reactivity. Organic Parameters: PCBs,
PCBs in Oil, Organochlorine Pesticides, Technical Chlordane, Toxaphene, Extractable Petroleum Hydrocarbons
(ETPH), MA-EPH, MA-VPH, Dicamba, 2,4-D, 2,4,5-T, 2,4,5-TP(Silvex), Volatile Organics, Acid Extractables (Phenols),
3.3'-Dichlorobenzidine, Phthalates, Nitrosamines, Nitroaromatics & Cyclic Ketones, PAHs, Haloethers, Chlorinated
Hydrocarbons. )
Maine Department of Human Services Certificate/Lab ID:2009024.
Drinking Water(Inorganic Parameters: SM921513, 9222D, 9223B, EPA 180.1, 300.0, 353.2, SM2130B, 2320B, 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, Lachat
10-107-06-1-B, SM2320B, 2340B, 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.5, 4500P-
E, 5210B, 5220D, 5310C, EPA 200.7, 200.8, 245.1. Organic Parameters: 608, 624, ME DRO, ME GRO, MA EPH, MA
VPH.)
Solid Waste/Soil(Organic Parameters: ME DRO, ME GRO, MA EPH, MA VPH.)
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)
353.2 for: Nitrate-N, Nitrite-N; SM4500NO3-F,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),314.0, 332.
Microbiology Parameters: SM921513; ENZ.SUB. SM9223; 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,Cr,Co,Cu,Fe,Pb,Mn,Mo,Ni,Se,Ag,Sr,Ti,TI,V,Zn,Ca,Mg,Na,K)
245.1,SM4500H,B, EPA 120.1,SM2510B,2540C,2540B,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-B,C-Titr, 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,SM4500-CN-CE, SM2540D.
Organic Parameters:(EPA 624 for Volatile Halocarbons,Volatile Aromatics)
Page 14 of 17
Serial No:09161012:56
(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
New Hampshire Department of Environmental Services Certificate/Lab ID:200307.NELAP Accredited.
Drinking Water(Inorganic Parameters: SM6215B, 9222B, 9223E Colilert, EPA 200.7, 200.8, 245.2; 120.1, 300.0, 314.0,
SM4500CN-E, 4500H+B, 4500NO3-F, 2320B, 2510B, 2540C, 4500E-C, 5310C, 2120B, EPA 331.0. Organic
Parameters: 504.1,524.2,SM6251B.)
Non-Potable Water(Inorganic Parameters: SM9222D, 9221B, 9222B, 9221E-EC, EPA 200.7, 200.8, 245.1, 245.2, SW-
846 6010B, 6020, 7196A, 7470A, SM3500-CR-D, EPA 120.1, 300.0, 350.1, 351.1, 353.2, 420.1, 1664A, SW-846 9010,
9030,9040B, SM426C, SM2310B,2540B,2540D,4500H+B,4500NH3-H,4500NH3-E,4500NO2-B,4500P-E,4500-S2-
D,5210B,2320B,2540C,4500E-C, 5310C, 5540C, LACHAT 10-117-07-1-B, LACHAT 10-107-06-1-B, LACHAT 10-107-
04-1-C, LACHAT 10-107-04-1-J, LACHAT 10-117-07-1-A, SM4500CL-E, LACHAT 10-204-00-1-A, LACHAT 10-107-06-
2-D. Organic Parameters: SW-846 3005A, 3015A, 3510C, 5030B, 8021B, 8260B, 8270C, 8330, EPA 624, 625, 608,
SW-846 8082, 8081A.)
Solid& Chemical Materials (Inorganic Parameters: SW-846 6010B, 7196A, 7471A, 7.3.3.2, 7.3.4.2, 1010, 1030, 9010,
9012A, 9014, 9030B, 9040, 9045C, 9050C, 1311, 3005A, 3050B, 3051 A. Organic Parameters: SW-846 3540C, 3545,
3580A, 5030B, 5035, 8021B, 8260B, 8270C, 8330, 8151A, 8082, 8081A.)
New Jersey Department of Environmental Protection Certificate/Lab ID: MA935.NELAP Accredited.
Drinking Water (Inorganic Parameters: SM9222B, 9221 E, 9223B, 9215B, 4500NO3-F, 4500E-C, EPA 300.0, 200.7,
2540C, 2320B, 314.0, SM2120B, 2510B, 5310C, SM4500H-B, EPA 200.8, 245.2. Organic Parameters: 504.1,
SM6251B, 524.2.)
Non-Potable Water (Inorganic Parameters: SM5210B, EPA 410.4, SM5220D, 4500CI-D, 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, SM4500P-B5+E, 2540B, 2540C, 2540D, EPA 120.1, SM2510B, SM15 426C,
SM92210E, 9222D, 9221B, 9222B, 9215B, 2310B, 2320B, 4500NH3-H, 4500-S D, EPA 350.1, SM5210B, SW-846
3015,6020,7470A, 5540C,4500H-B, EPA 200.8, SM3500Cr-D, EPA 245.1,245.2, SW-846 9040B,3005A, EPA 6010B,
7196A, SW-846 9010B, 9030B. Organic Parameters: SW-846 8260B, 8270C, 3510C, EPA 608, 624, 625, SW-846
5030B,8021B,8081A,8082,8151A,8330, NJ OQA-QAM-025 Rev.7.)
Solid& Chemical Materials(Inorganic Parameters: SW-846 9040B, 3005A, 6010B, 7196A, 5030B, 9010B, 9030B, 1030,
1311, 3050B, 3051, 7471A, 9014, 9012A, 9045C, 9050A, 9065. Organic Parameters: SW-846 8021B, 8081A, 8082,
8151A,8330,8260B,8270C,,1311, 1312,3540C,3545,3550B,3580A,5035L, 5035H, NJ OQA-QAM-025 Rev.7.)
New York Department of Health Certificate/Lab ID: 11148.NELAP Accredited.
Drinking Water (Inorganic Parameters: SM9223B, 9222B, 9215B, EPA 200.8, 200.7, 245.2, SM5310C, EPA 314.0,
332.0, SM232013, EPA 300.0, SM2120B, 4500CN-E, 4500E-C, 4500H-B, 4500NO3-F, 2540C, EPA 120.1, SM 2510B.
Organic Parameters: EPA 524.2, 504.1.)
Non-Potable Water (Inorganic Parameters: SM9221 E, 9222D, 9221 B, 9222B, 9215B, 5210B, EPA 410.4, SM5220D,
2310B-4a, 2320B, EPA 200.7, 300.0, LACHAT 10-117-07-1A or B, SM4500CI-E, 4500E-C, SM15 426C, EPA 350.1,
LACHAT 10-107-06-1-B, SM4500NH3-H, EPA 351.1, LACHAT 10-107-06-2, EPA 353.2, LACHAT 10-107-041-C,
SM4500-NO3-F, 4500-NO2-B, 4500P-E, 2540C, 2540B, 2540D, EPA 200.8, EPA 6010B, 6020, EPA 7196A,
S\M3500Cr-D, EPA 245.1, 245.2, 7470A, SM2120B, SM4500-CN-E LACHAT 10-204-00-1-A, EPA 9040B, SM4500-HB,
EPA 1664A, SM5310C, EPA 420.1, SM14 510C, EPA 120.1, SM2510B, SM4500S-D, SM5540C, EPA 3005A, 3015.
Organic Parameters: EPA 624, 8260B, 8270C, 625, 608, 8081A, 8151A, 8330, 8082, EPA 3510C, 5030B, 9010B,
9030B.)
Solid & Hazardous Waste (Inorganic Parameters: 1010, 1030, SW-846 Ch 7 Sec 7.3, EPA 6010B, 7196A, 7471A,
9012A, 9014, 9040B, 9045C, 9065, 9050, EPA 1311, 1312, 3005A, 3050B, 9010B, 9030B. Organic Parameters: EPA
8260B,8270C, 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.
Pennsylvania Department of Environmental Protection Certificate/Lab ID:68-03671. NELAP Accredited.
Non-Potable Water(Organic Parameters: EPA 3510C,5030B,625, 624.608,8081A,8082,8151A,8260B, 8270C,
8330)
Solid & Hazardous Waste (Inorganic Parameters: EPA 1010, 1030, 1311, 3050B, 3051, 6010B, EPA 7.3.3.2, EPA
7.3.4.2, 7196A, 7471A, 9010B, 9012A, 9014, 9040B, 9045C, 9050, 9065. _Organic Parameters: 3540C, 3545, 3580A,
5035,8021B,8081A,8082,8151A,8260B,8270C,8330)
Rhode Island Department of Health Certificate/Lab ID: LA000065.NELAP Accredited via NY-DOH.
Refer to MA-DEP Certificate for Potable and Non-Potable Water.
Refer to NY-DOH Certificate for Potable,and Non-Potable Water.
Page 15 of 17
Serial No:09161012:56
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,231013,232013,25106,254013,2540C,2540D,426C,
4500CL-E,4500CN-E,4500E-C,4500H+B,4500NH3-H,4500N026,4500P-E,4500 S2 D,510C, 5210B,5220D,
5310C,5540C.Organic Parameters:EPA 608,624,625, 8081,8082,8151,8260,8270,8330.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 1311, 1312,9012,9014, 9040,9045, 9050, 9065.)
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, 90406, 300.0, 9251,
9038,350.1,353.2,351.1, 120.1, 9050A,410.4,9060, 1664,420.1, LACHAT 10-107-06-1-B,SM 4500CN-E,4500H-B,
4500CL-E,4500E-BC,4500SO4-E,426C,4500NH3-B,4500NH3-H,4500NO3-F,4500NO2-B, 4500Norg-C, 4500PE,
2510B,5540C,5220D,5310C,2540B,2540C,2540D, 510C,4500S2-AD,3005A,3015,9010B,9030B. Organic
Parameters: EPA 826013,8270C,8330, 625,8082,8151A, 8081A,3510C,503013, MassDEP EPH, MassDEP VPH.)
Solid&Hazardous Waste(Inorganic Parameters: EPA 200.7, 6010B, 7471A,9040B,9045C,9065,420.1, 9012A, 6860,
1311, 1312,3050B,9030B,3051, 9010B, 3540C, SM 510ABC,4500CN-CE,2540G,SW-846 7.3, Organic Parameters:
EPA 82606, 8270C,8330,8082,8081A,8151A,3545,3546,3580, 5035, MassDEP EPH, MassDEP VPH.)
Analytes Not Accredited by NELAP
Certification is not available by NELAP for the following analytes: 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 Dimethyl naphthalenes, 1,4-Diphenylhydrazine
(Azobenzene). EPA 625: 4-Chloroaniline. EPA 350.1 for Ammonia in a Soil matrix.
Page 16 of 17
. L71 Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Title 5
DEP Approved Inspection and O&M Form for Title 5 I/
Treatment and Disposal Systems
A. Installation
Important: Kim Straubing
When filling out Owner
forms on the
computer,use Route 149 Unit 195-G
only the tab key Facility Street Address
to move your Marstons Mills 02648
cursor-do not
use the return City Zip
key. Mailing address of owner, if different:
P.O. Box 863
Street Address/PO Box:
Marstons Mills MA 02648
BQiD City State Zip
(508)428- 1831 ext.
Telephone Number
B. Authorized Service Provider .
BENNETT ENVIRONMENTAL ASSOCIATES, INC.
O&M Firm
1573 Main Street/PO Box 1743
Street Address
Brewster MA 02631
City State Zip
(508)896- 1706 ext. 129
Telephone Number
Samantha Farrenkopf 13265
Certified Operator Name Certification Number
C. Facility/System Information
OMNI Environmental Systems OMNI RSF
DEP ID Manufacturer ID Model Number
8/25/2003 8/25/2003
Installation Date Start of Operation
Approval Type: ® General ❑ Provisional ❑ Piloting ❑ Remedial
Seasonal.Residence—used less than 6 mo./year: ❑ Yes ® No
D. Operating Information
6/9/10 3/16/10
Inspection Date Previous Inspection Date
9"of Sludge, and 1"Scum Layer Pumping Recommended ❑ YE
Sludge Depth(to be checked yearly)
t5aiom.doc•rev.11-07-05
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 6.48 SU DO 4.24 mg/L Turbidity 4.57 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 pulled effluent sample for field testing
Notes and Comments:
System functional,and passed field testing.
t5aiom.doc•rev. 11-07-05 Page 2 of 2
r
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.
q
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 31 n,of each year for the previous 12 months
General Use—by September 30t'of each year for the previous 12 months
Send to:
Department of Environmental Protection
Attention: Title 5 Program
One Winter Street, 6 Floor
Boston, MA 02108
t5aiom.doc•rev.11-07-05 Page 3 of 3
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WESTBORO,MA` MANSFIELD,MA. - • • on •• • • - •TEL'508-898-9220 TEL 508-822-9300 . '
FAX:508-898-9193 FAX: 50"22-3288 Project Name: � S` y; ❑FAX EMAIL Same as Client info PO#: 0�l
c,i Project Location yn
-
Qi l]ADEx t7 Add'I Deliverables
Client:` + roject#: it .. - Require - ..
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ly P
Address: Q U•�� Project Manager. ' State/Fed Program Criteria
o -ESUMPTIVE CERTAINTY CT REASONABLE CONFIDENCEPRO TO
fv\k OIX3 ALPHA.Quote#:
Phone: ( ❑Yes: ❑No Are MCP Analytical Methods Required?
a) `° y �� �' ❑Yes ❑No Is Matrix Spike(MS)Required on this SDG? (If yes see note in Comments)
Fax:'bm V L k..-'5`o ❑Yes ❑No Are CT RCP(Reasonable Confidence Protocols)Required?
Standard ❑RUSH(onry canfi med�preayproved8
Date Due: tiex-
Time: ;
❑ These samples have been previously analyzed by Alpha .ti fT�' SAMPLE HANDLING
�� ^`'
F��!il4i
Other Project Specific Requirements/Comments/Detection Li tt§: •.-'• �; f=filtration
+`
If MS is required,Indicate in Sample Specific Comments which samples and what tests MS to be performed. '�� ❑Done -
(Note: All CAM methods for Inorganic analyses require MS every 20 soil samples) C> Not needed
❑Lab to do'
�1 Preservation '
❑Lab to do
Collection Sample Sampler's (PWase•p9oiy
4;(LatCJ;stie4�f�i�YZ Sample ID '
Date Time Matrix Initials Sample Specific.Comments
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PLEASE ANSWER QUESTIONSABOVEt Container Type IBM NO
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PROJECT
Preservative 'k ° " '{ °
IS YOUR PR Q �u �. bIpe`„�
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MA MCP or CT RCP?
q ed BY• Date/Time Received By: DateiTlme ��ty�tk�arayFi4i9uii8rsb(ge
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FORM NO:01-01 rev.18Jan-2010) • � �'� i a17eye""t�+ter�e `4y �y't"�K
• ,4�Eh_•e�..,y.�t�+.��•Pb":2'i9n'i��7�.r;�.w*1.�.�Jti:a��%S~
03/26/03 13: 17
It 5085480350 LCR. INC P.04
1-888-450—OMNI .� 008)548-0343
OFF-A-7i- CAPK COP,MASS. � AIANrl!-ACTC121N0—!.'APF.COP,AlAS1'..
t;...,..
P.O: Box 128 Ftrlmordh 1'cch�:oingy,Pmk-(i�)Acme f'rrrns!
dO5 F.a t Fa/moulh Highwa.1, OMNI _ 520�lrarnav R,Ionrlcrs Roca(
,basr halrooulh.MA 02336 EnWrorlp ent41 Systems, Inn. Last l%almuurh,Mil 02536
_ --
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Property Brian T. Dacey Property Lot 18 - Unit 7- Route 149
Owner: Location:
Address; P. O. BOX 95 Town: Barnstable
Property Phone: N/A
city, Centerville, MA 02632 " Alternate Phone: N/A
State zip
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Start ._:...:::...._._
03/19/02 End 03/19103 Per $0.00 Total Cost
Date: Date: Incident
Terms and Agreement for Effluent Testing
OMNI Recirculating Sand Filter
You are hereby authorized to render Effluent Testing for the OMNI Recirculating Sand Filter listed at the
above address for the contract period of two years. This agreement maybe extended by the landowner
for an additional agreed upon term by providing OMNI Environmental Systems,Inc. with 30 days written
notice of intent to extend. OMNI will provide the landowner with notice of it's current pricing schedule
should the landowner elect to extend this'agreement. _
This agreement consists of bi-annual testing for: Total Suspended Solids (EPA 160.2), Total Nitrogen
(EPA 350,1-351.4), Total Phosphorous(EPA 365.1)and Biochemical Oxygen Demand EPA(405.1). All
testing shall be performed by a laboratory certified by the Commonwealth of Massachusetts. OMNI
Environmental Systems, Inc, shall provide the landowner and local approving authority with test results,
In consideration of the services contained in this agreement we agree to pay OMNI Environmental
Systems, Inc.the sum of$350.00 per Incident. Payment is due 10 days from Invoice date. This
agreement Is not In effect until payment has been received by OMNI Environmental Systems, Inc.
This agreement Is not assignable by either party without prior written consent of the other party and is
neither non-cancelable nor non-refundab!e.
Please Print Name
All& r--
3/2Y�O3
Auth ri t at Land Owner's ignature Date
OM 6 !d ►onta!Systoms,Inc. `,
03/28/03 08:48 a 5085480350 LCR. INC P.02
1-088.450-OMNI (508)548.8424
OFFICE ^
P.O.Box 128 OMNI MANUFACTURING
465 East Falmouth Highway Falmoulh Technology Perk
East Falmouth,MA 02536 Env rot'ment.0S) Ievis,Mc. East Falmouth,MA 02538
March 26, 2003
Attn: Sam White
Barnstable Health Department
200 Main Street
Hyannis, MA 02601
RE: Route 149, Herring Run -- Units 7.9
Dear Mr. White.:
The OMNI Recirculating Sand Filter at the above referenced address has been installed
in accordance with the engineers design plan. It is scheduled for testing as defined in
the attached "Testing Program" and will be maintained as outlined in the attached
"Maintenance Agreement".
If you have any further questions don't hesitate to contact this firm.
Sincerely,
at ew C. Costa
Cc-. John Bowes
P.E.P.C`.enlfled Woetewmer Oporatora
Ranimi lalin0 Snnd Filters
+ Manufacturing = Teating,a Malnlononoo �?Inetailatione
„ 1
03/26/03 13: 16 2 5085480350 LCR, INC P.02
1-888-450-OMNI �-�_
50f 548-0343
OFF1C'F—CAPE COD,AMSS. =_ MANUFAC'TURING—CAPE[:Ol,•MASS.P.O.Box 128 V l�l�1- raLnouth Tee:hrtotagr,Park-(u;Acrne Precast
463 Last Fabnouth HighHmy a _ 520 7hanos B.LapidC.rs leoad
Favt hirinrouth,AM 02,536 LlysWrozo tentTl! vsteyns,ine. Vast Falmouth.MA 02S36
,:.r 1'.i t ,r!.::!„i4'iiiiraertv::,,;,;:,;..:y':i.d,.!' I'h'ix`;SIn.!$,.y:d,,:...... ......:.r![e.iy[a•uv:cy
Y.h.JY3f xrer lranllad r. R,v...:c;•�I aS Obi... ,..,t1N nani 1 d ..:r5 �.,,,.ier by e, �P,;tU n., � ,.( ;(.... �a.,6.l;�{is..I_:.aa11,_•ilarn k;.ia,ayill...I::r, !1ysi c'd�."iis.edv<rh.i � .R,
.1„a,:a.l... l avd rv..,.lr�rq-(r161�,;�:.y�.rILIC:::ei!{f;c�?....dKi:r�l�h.t.....�1. •.....3.f�,.i .l la..L.,,. .;�. kl: ,.,t.. ... ,1�1„�i:.�.�..a. '•n�.i�,y:,.,e:.ir4!Tt��LW.,: [...r.h1,r,
Property owner: Bayside Building, Inc. Property Location: Unit 7; Herring Run, Route 149
Address: P,O. Box 95 Town: Marston Mills
Property Phone: N/a
City,state zip: Centerville, MA 02632 Alternate Phone: 508 771-1040
... f.... d its,.... t.:• PlAcrc." 16.>w 1...';.i`'"[ i!°!..,.r...+r y.3......."7, ,• •'1' •„c;pi.::.)r..,...,r Rt,....... fr ..,......;.1 1..1,1....... .J`! id....,..{ d.1d.Lr-•.,..pf. 7ie..;y;::" :t;:;(e':3;;
....... � d I p�ft,im,r'f dl•cu1CA�4�U:a::rr ddrf�l.;,-''cav�c:::61�rrn„Pr„;-eA�•all',�r.�:x::flPt�1�;f:adlvliJ:a.n�:xr,;!!a;�;f:::�`ut:ail!)'�:::G::.:,ntl �,�(•:,alatA��#�Ydt�lr�i.: di�l�ly,�t,tt �, itl�l: ;. i
,.f1.f�.N e u t�1,,.: l lydt:.::};dell?i:-•••r,1 11 e16.M�r.�, I,rdrrl... .1
Start Date: 3/19/2002 End Date' 3/19/2003 Terms, $350.00
Terms and Agreement for Standard and Preventative Maintenance
OMNI Recirculating Sand Filter
You are hereby authorized to render Standard and Preventative Maintenance for the OMNI 2000
Recirculating Sand Filter listed at the above address for the contract period of (1)VOWS). This
agreement may be extended by the land owner for an additional agreed upon term by providing OMNI
.Environmental Systems, Inc. with 30 days written notice of intent to extend. OMNI Environmental
Systesms, Inc. will provide the land owner with 30 days written notice of its then current pricing schedule
should the land owner elect to extend this agreement.
The agreement consists of all Standard and Preventative Maintenance listed in the Operators Manual.
The OMNI 2000 Recirculating Sand Filter has a 3 year manufacutres warranty against all defective
components including parts and labor.
�- This agreement includes semi-annul site visits and does not include costs occasioned by neglect, misuse
and accident or consumables. This agreement does not Include travel costs for the Islands any
,h locations not within a 20 mile radius of East Falmouth.
In consideration of the services contained in this agreement we agree to pay OMNI Environmental
Systems, Inc. the sum of$$350.00 for the above maintenance agreement. Payment is due 10 days from
Invoice Date. This agreement is not in affect until payment has been received by OMNI Environmental
Systems, Inc.
This agreement is not assignable by either party without the prior written consent of the other party and is
neither non-cancellable and non-refundable.
IdAl T. �)IY_Ey
Please Print Name
t ri n tur at Land Owner's Signature ®ate
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No. /toJ- 2 I(o Qj FEE VV .
�+ \ Board of Health, 6LLJ €—-,-,MA. (p�
APPLICATION FOP, DISPOSA "MtTION PERMIT
Application for a Permit to Construct( ) Repair( ) Upgrade(44/Abandon( ) - ❑Complete System ❑Individual.Components
Locations nAAtOwner's Name
Map/Parcel# Address
Lot# Telephone# SOB— 771 _ 10 5rD
Installer's Name Designer's Name C "
Address Address
Telephone# _ 7S ® Telephone# 50 g _ a 4 A 5r
Type of Building Lot Size sq.ft.
Dwelling-No.of Bedrooms Garbage grinder ( )
Other-Type of Building AI A No.of persons o Showers ( ),Cafeteria ( )
Other Fixtures AIA
Design Flow (min.required) �) ® gpd Calculated design flow Design flow provided gpd
Plan: Date 4 01 0---3 Number of sheets Revision Date 71V I e 3
Title
Description ofSoil(s)
Soil Evaluator Form No. Name of Soil Evaluator eisc Date of Evaluation �O
DESCRIPTION OF,�EPAIRS ORALTERATI S
_4STALLATlON �� MU SL60� Mv
AND Ocr,,. Y" Y,V
I BEM WAS INST 'J-CORDANCg TO �-L[D w�
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance the provisions of TITLE 5 and
further agrees to rjot to place th tem in operation until a Certificate of Comp'ante has been issued by the Board of Health.
Signed ' Date
rov¢ .. .S 1 97
3
I spections
FEE VV
MASSACHUSETTS
COMMONWEALTH OF
Ir
Board of Health, 94J�'� MA.A.,,PLIC&N FOP, (�
fD
ISPOSAL 'SYSTEM CONSTRUCTION PERMIT �A
Application for a Permit to Construct( Repair(`) Upgrade(�AbandonO - ❑Complete System ❑Individual Components
Location �,�� yr Owner's Name C
i
Map/Parcel# 7 Address
Lot# Telephone# S�g_ 7 71 _ 10 5�0
Installer's Name Designer's Name
Address 60 Address
�Telephon�ell _ _ 7� Q Telephone#
Type of Building r Lot Size sq.ft.
Dwelling-No. of Bedrooms ��-- Garbage grinder ( )
Other-Type of Building AI A No.of persons o) Showers (/),Cafeteria ( )
Other Fixtures AIA `
Design Flow (min.required) `i gpd Calculated design flow Design flow provided gpd
Plan: Date 4/30./ 0-3 Number of sheets l Revision Date
Title 911Wa►_e , �a9a.esA_ .e�el dC,(.a-•
Description of Soil(s) r)u-...,. .
Soil Evaluator Form No- Name of Soil Evaluator = Date of Evaluation .?p
DESCRIPTION OF REPAIRS ORALTERATIONS Sl`f s ,Gd /vd.- �✓�
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further agrees to not to place th ystern in operation until a Certificate of Compliance has been issued by the Board of Health.
Signed Date
S 7g
- O
A-�pe V ons
ff'. - 3 ..
V No.?-CO3- 2 94 FEE l w
COMMONWLA T14 Of MASSACHUS ETTS �.�
5
f Board of Health, MA.
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) ❑Complete System
The undersigned hereby certify tliaLtbe Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( )
by:
at
-e
s
has been installed in accordance with the provpiof s of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application No. 203-29(,, dated 03 Approved Design Flow (gpd)
Installer G�.d�(�yt,t.•�c_ ry
Designer: (f (.w�:,C.,� Inspector: Date: / 3 .
The issuance of this permit shall not be,construed as a guarantee that the system will function as designed.
Q(
No. 20o 3 2(Cj FEE t
C®MMONWEALT14 Of MASSAC14USETTS
Board of Health, 94-m� MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) R pair( ) Upgrade( ' ) Abandon( ) an individual sewage disposal system
G
at < as described in the application for
Disposal System Construction Permit No._2 oM—2-Y(q, dated D�
Provided: Construction shall be completed""thi three years of the date of this per 1 ca iti s must be met.
Form 1255 Rev,5/56 A.M.Sulkin Co.Boston,MA Date �3 Board of Health
Y
TOWN OF BAMSTABLE
�SEWAGE #
LOCATION Z.12�
r-CA) d2LIa- 'S MAP &LOT-2 Z-E
VILLAGEeEdg/u 5ASSESSOR
/0
INSTALLER'S NAME&PHONE NO. LIZ h-
CITY AJ
SEPTIC TAN,K'CAPA
ze)
LEACHING� ILITY: (type) J- (si
NO. OF-BEDROOMS---Z/�
BUILDER OR OWNER
0'2�.COMPLIANCE DATE
PERMITDATE:--,-��
Separation Di,stance Between the: Feet
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility
Priv.ate Waiter Supply Well and Leaching Facility (if any wells exist.
Feet
on site��or within 200 feet of leaching facility)
Edge.of Wet I land and Leaching Facility (If any wetlands exist Feet
within 300 ieet of leaching facility)
Furnished by
�01
A
*v,
A, 3
13-3
r I C15-
J,
�7 5o 13-
U .
17(-)
7v
0 0 �-
19) TOWN OF BARNSTABLE t/
LOCATION 2� l l,W 1/ k7`/ SEWAGE # Q00/— 3?7
VILLAGER/3-2/V 11A4-Q r2W- 4-Vi ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. 1,1//A!L M / VU4;
SEPTIC TANK--:CAPAC=. �SAAI 9-f'7:�Z
Y5
LEACHING FACII..ITY: (type) 4 7'��av� S (size) y
NO. OF BEDROOMS
BUILDER OR OWNER
PERMIT DATE: 2� O Z COMPLIANCE DATE: `)
Separation Distance Between the:
Maximu .Adjusted.Groundwater Table to the Bottom of Leaching Facility Feet
Private Water'Supply.Well and Leaching Facility (If any wells exist r
on site`or within 200 feet of,leaching;facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) - Feet
Furnished by
A% 5 o )3-
17
4..
Q
C
5
No. Od ` L t� Fee
r
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE,t MASSACHUSETTS
01ppYication for�3Di9;po!6ar *p5tem Construction Vermtt
Application for a Permit to Construct Repair( )Upgrade( )Abandon( ) eComplete System ❑Individual Components
Location Address or Lot No.JJv/V/ �/ Owner's Name,Address and Tel.No.
Assessor'sMap/Parcel R� -/`j W4 .0 �S``_e_ GU�\�\�//,L� W
Installer's Naal�anne,Address,and Tel.No.�X e -68-771 7 Y16 Designer's Name,Address and Tel.No.
410, '44 /Nov O �A/
Type of Building:
welling' No.of Bedrooms _ Lot Size J!/ sq.ft. Garbage Grinder( )
Ot er Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 3.3 D gallons.
Plan Date Number of sheets off. Revision Date 6-I&cZd aiz
Title /A.✓ sle-AA
Size of Septic Tank i,1-06 6416 a 4 Type of S.A.S. &_A:� 7—
Description of Soil (J-7 ' _SAd yaA '7- .30
Nature of Repairs or Alterations(Answer when applicable) rS�UNGP W/ �1 PE ,VISE
INSTALLATION AND
THE SYSTEM
ACCORD !,
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 the Enviro ental Code and not to place the system in operation until a Certifi-
cate of Compliance has been i`s,�su d oazd of �----
Signed ,� Date
Application Approved by Date 0 2
Application Disapproved for the following reasons
Permit No.3,o p l�'3W Date Issued V a rli
No. [ 1 J )*_17
Fee
Fa i.
THE COMMONWEALTH OFfMASSACHUSETTS ' ` Entered in computer: ,ti
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
1,
rtcation for` iopogar *potern Conmructton Permit/
Application for a Permit to Construct( . Repair( )Upgrade( )Abandon Complete System ❑Individual Components
Location Address or Lot No. (fN/;� `/ Owner's Name,Address and Tel.No. P O [3px Q
P �sc\e gu��cl�nc� C'e�n �•11e MA
Assessor's Ma% �1 #14R_j-1D�S 11// *4 '` f^ ' 1
Installer's N ne,Address,and Tel.No. d'0&-7'7 I-7 y//0 Designer's Nam,.Address and Tel.No.
ss axe . N.�-,�e
s-so w/i/a w .' � Ze BA s n,
Type of Zuilding:
ling No.of Bedrooms Lot Size S6 sq.ft. Garbage Grinder( )
f - JE;e
Or Type of Building No.of Persons Showers( ) Cafeteria( )
y Other Fixtures
Design Flow _'3_ gallons per day. Calculated daily flow _3.3 6,A r gallons.
. Plan Date /,42 Number of sheets vc7., Revision Date 6 5/ ? a
Title ;P/d,� /A.✓ Z91�lss�o.7.P� tA00je1, -Q .IP444 .5 1/sle.,X
T
---u,a:Size of Septic Tank /,?-06 6A4110ni s Type of S.A.S. GATT '
' Description of Soil /f- __�54A/,D Ge /dR/X -7- 30 ' / 8 /n,q 11X
i
i7' Nature of Repairs or Alterations(Answer when applicable) t� 1 �tJ,t/�3ff PtIL� one
C
j
Date last inspected: .- --
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
i, in accordance with the provisions of Title 5,f the Environmental Code and not to place the system in operation until a Certifi-
Cate of Compliance has been issu d tgoard of ea th-----
Signed Date
!' Application Approved by _ Date ?_5" 0,-"-''r
Application Disapproved for the following reasons
t
it Permit No. ad l- 3" Date Issued
' ---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage'Disposal System Constructed(r/)Repaired( ,)Upgraded( )
Abandoned( )by e_�&A t/I9�idnl
at jbf;4- 7 Vf-°- /V 9 a4g:Y AZ Jl &i)1,S has been construc ed i accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.9001-31!7 dated 2.)o.2-
' Installer Designer
! The issuance of this ermit shall not be construed as a guarantee that the system w l n '6 as�igned.
i Date I i f1 3 Inspector
3 /q
No. ,1Ud 1 � ---------------------------Feed -.......
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Mi5po!gal *p5tem Construction Permit
Permission is hereby granted to Construct Repair( )Upgrade( )Abandon
O ( )
System located at XI 7 /9 7" /Tt 1-C_ /y9 /?/�' A-1/A,v J 0,
i
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this @ermit.
Date: w Approved by
v'
No. ) -3 99 y, Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
0[pprication for �Otgpoga[ *pgtem Congtruction Permit
Application for a Permit to Construct(VI'Repair( )Upgrade( )Abandon( ) Q'Complete System ❑Individual Components
Locat n Add Ass or Lot No. Owner's Name,Address and Tel.No.
49� RDufe /y9 Mj, or7s � l #am door Rea lily 7ru.5f'
Assessor's ap/Parcel 7 p /l 0 Y'
b n,-f 7 .o,g o x /,PA y ll a p P1 Is m A
Installer's Name,Address,and Teel..No.O Designer's Name,Address and Tel.No.
d Q rl Ca VO.S.Sa y-r. ,�D�3 yD-3933 e"S -b es•,` n' zn c 5d J-.5y0-88 oS
.57 Aalmer 4.11e, almouM MA /Gyeu�-Aarise tee B&A%Rd, IcaImo0-A A
Type of Building:
Dwelli No.of Bedrooms 3 Lot Size q.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3,30 gallons per day. Calculated daily flow -3 3®, 2 6 gallons.
Plan Date / 0?7 .0DD Number of sheets a. Revision Date_.(af/y-
f
Title d t 'Iola h PrADd f U,T _ CU r CP 1C�tJQG Ls�d,! vS Wl
Size of Septic Tank l 500 6'a on S Type of S.A.S. re SSur e �IS-Eri b Luton
Description of Soil �' 7 Sand•/ L O a m 7-3 0 L oa wt y
Medium Sark/
Nature of Repairs or Alterations(Answer when applicable) Me b n on S-1-ra c�
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to plac system in operation until a Certifi-
cate of Compliance has been is this oar H lth.
Signed d Date J/
Application Approved by Date
Application Disapproved for the following reasons
Permit No. 1 Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed )Repaired( )Upgraded( )
Abandoned( )by
at LA N k .� 21_ 1`Ec1 r-1. �`l c S has been constructed`,in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. ';1- 3r"i C1 dated ! ��('1 f
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date Inspector
ii
p7_� l
No. � '-�3 !C5-Iq
Fee N G
THE COMM"ONWEALfH OF MASSACHU$, TS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes `
0(pplication for -Miopool *p.5tem Conotructton Permit
Application for a Permit to Construct(VI'Repair( )Upgrade( )AbandoL�'Complete System ❑Individual Components
n( _)
Local n Address or Lot No. f mi�� O ner shame,Address and Tel.No.
f?ou fe Nq Mar_5 ores tom ,Pea if y Tru Sf" 5-4- '77/-3919'
(I ter^ / L Gm /�
Assessor's Map/P cel p / G Ll n,7 7, �,0, U X �aeZ y 1y ya k)11 is m A
Installer's Name,Address,and Tel.No.O Designer's Name,Address and Tel.No.
Curl C�a VOSsQ, 7r, SDI-_5W-3933 q �.�s BPS%yam, 7,qc So�-SyU-88oS
.5'7 Pa/rnpr e a1inouMi In>q Rd. ��r l�+outti /Y1�
Type of Building:
Dwelli g- No.of Bedrooms .3 Lot Size J�6 sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 330 gallons per day. Calculated daily flow 3 3O. 2 gallons.
Plan Date )7 1 0000Number of sheets a Revision Date a Do
Title u J d .S& {a! P S Q Q f _S 4em
Size of Septic Tank 1500 6A 1 1c)n S Type of S.A.S.
Description of Soil '0' 7 Jr-a n zoom "7_ O � " ,.� L D,G[m
30 - /gy /YI eCLU M .Sahel
Nature of Repairs or Alterations(Answer when applicable) Ne u) C On S+r ct C f( o r)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to plac system in operation until a Certifi-
cate of Compliance has been is of d by this BB-oard H lth. �)
f Signed 17 4 1�..// _ � Date 7
Application Approved by Date 2Old/
Application Disapproved for the following reasons
Permit No. 1 Date Issued
----------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(,X)Repaired( )Upgraded( )
Abandoned( )by
at L,M\Z _.? . (ZT `'act �_t . H,�kS has been constructed1in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. '��- 3 7 C' dated 6,1 �o/C� 1
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
rr
Date > 1;,• 1 r Inspector -' --- , / , ✓"
t L
--.-^—� ---------------------------------//—��--
No. /��7 ' � 7 Fee( �-iJ J
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migpogar..*pgtem Conztruction Permit
Permission is hereby granted to Construct(_. ..);Repair( )Upgrade'(,- )"Xband,6ri
& ` System located at 7 �`(P / �!
and as described ml above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
. ,
comply with Titlek5,,'0 49(` o owing local provisions or special conditions.
l Provided:Construction must be completed within three years of the date of thi pe o 't. J
Date: 1�2 /l 11 Approved by
SEWAGE SYSTEM & OMNI 2000 RECIrCULAri'IIVG S IVD FILTER PROFILE & DETAILS
NOT TO SCALE
G B 4 3 2 \N^\✓\ .- NOTE: RISERS AND COVERS TO WITHIN 6"OF FINISH GRADE ` M
1 V✓ ..
• PINE BARK MULCH OMNI 2000 RE-CIRCULATING SAND FILTER
(}'1 -3 MODULES REQUIRED
h - FILTER FABRIC COVER (NO SUBSTITUTION)
�.
FINISH I;12ADE=59.7 AIRATION HOODS -
B / (3)COVERS TO GRADE - -• - -
�� F.FL=62.0 LS"PRESSURIZED LINE
I SEPTIC 3"PVC RE
7 TANK=59.0 TURN LINE - j
58.5' TOP OF
EFFLUENT FLTER R.S. _RECIRC. . .
Acme Preconl Model PL122 TANK=60.0Nish GRADE F• FINISH ADE 57.0 57.5
SLOW"2x TIP.
-R.S.F.
54.7 •y y _ - -MODULE
FLOW ••1 - - 3'PEASTD, -
KEY MAP N HOUSE #9. 55.15 -�- AG SPUTTER __ - T <;.: y• -
INV. 55.0 I ta' 55.33 '�- '.�' 'Pw• 'It'
1"=60' j
4'0' ,Eu 54.45
. a• DOUID
54.2
LEVEL rye` 24 HR.RES. "HIGH WATER ALARM" I PUMP ON 3/4'TO 1-1/2'CRUSHED.
54.35 WASHED STONE
1500 GALLON SEPTIC TANK "LOW WATER SHUT OFF" I tPUMP OFF
_ SET LEVEL 1000 GALLON"OMNI 2000" 52 2
EFFLUENT FILTER RECIRCULATION TANK OMNI 2000 PUMP OIANBER.,'.r, 6oTTOM SOIL ABSO PTION SYSTEM
_ By. 'Zoeani (NO'SUBSTITUTION) 250 GALPUMP CHAMBER ':
"BY-PASS ORIFACE". NOTE:TIMER AND EVENT COUNTER
DESIGNED BY OTHERS
"CHECK VALVE" SHOULD BE MONITORED FROM .
.// LONG,
W CONTROL PANEL EACH WIITHFIVE 1/4" DIAV LATERALS HOLES
3" O.C. ALONG PIPE INVERT.
1
DESIGN CRITERIA ?z ONE TRENCH: 93.0' LONG, 4' WIDE iMTH
ea ��.•.::''". Jam' DESIGN SPECIFICATIONS NUMBER OF BEDROOMS 5 2' EFFECTIVE DEPTH.
a - PERSONS PER BEDROOM 2
srov Sand Filter Media . . 24" min. depth G7% 00 sieve, 2mm tb.4mm size DAILY FLOW PER PERSON 55
P #` TOTAL DAILY FLOW 550
w �/ /�/.. _•.S`d' +'V- AVERAGE DAILY FLOW. . . . . . . . 55 gpd/per person/per brlroom LEACHING AREA REQUIRED 744 :4 rz:(550,;ga:.00.74 gal./s.f.) SOIL EVALUATOR'S LOG
�' / j62 _ yCP Wastewater strength-BOD5 . . . 230 mg/liter/residential LEACHING AF : PROVIDED" 750 ,v.rcy oeP1N rtoal Sul'Soa soa sou c•�or
d / 4 Re-Circulation Ratio 4:1 - LEACHING CAPACITY PROVIDED 562 '..P.a (76D)(0.74) SuHoce Ha.Texture caor Mott. R:!atl,•e
', /` / 4Q' 4 0.
Re-Circulation Tank Size . . . . . . . 150% of design flow (Use o 1000 gal. tank) pc�+e•) (usoA) (Munvei) F.=lore
m CALCI il_ATIONS 11 56.7 DEEP OBSERVATION HOLE ;0-1
N
g / 2q s>o Sand Filter Loading Rote(Residential) . . Loading Rate(gpd/si)=1150/BOD5=5 gpd/sf _ - !
u� _ BOTTOM .. o..aa
T?ssOgAa - '8 Sand Fitter Surface Area . . SA=��ori gpd/goading Roie '7`f1�--- 4'x 93'x 0.74= 275.3 a.p.d.
/ 440 gpd/5 gpd/sf 88 S.F. REQ. (103.9 S.F. PROVIDED) SIDEWALL 56•� Loam
!., / •sso ,N 3 a�•�, 194 If x 2 x - p.d 7"-30" B Send
Cu _ / ti\° 6a,x 64 , Re-Circulation pump Size . . . . . . . [440 + (4x440)] x 103?= 2.266 gpd 4 �' - I
N / ,,,Jjf .:-, yam: 94.42 gals./60 min. cycle - 563 g.p.d./�Qj4, 760 sf -
. !J + - f�•t- ''° - �- .Use Myers Model f/ME40:u equal (65 gals. 0.12 TH) - __-•- 30-t4a"C Med.
44 a _ GEf FERAL NOTES Sand
v 5ase=�-ti �.. .
�I' � •`� Sand Filter Setbacks., .•. Same as T!Ue V septic 'vnk � 1.ALL-ELEVATIONS SHOWN ARE
I_
_ ASSUMED. ':3iSNG ENeilNEM MUST SUPi:.'^: 44.7
b ` ..:fALIATIOiI AND CERTIFY IN
roM 2.ALL PIPES IN THE SYSTEM TO BE
rn m _ _ CAST IRON OR SCHEDULE 40 P.V.C.3:REMOVE ALL UNSUITABLE MATERIAL 0"-7" A Sandy
==_v__rEM WAS INSTALLF ca sT��_:. ss.s DEEP OBSERVATION HOLE #C-2
6 --••smaETOPLVv.
xea3-� \TP D-1
Li BENEATH� v � � � BENEATH THE INVERT ELEVATION _ 55.9 Loam
cq p� a FOR A RADIUS OF 5' AS PER 310CMR 15.255(5) 7"-30" B Loam
`JJ 6 AND BACKFlLL W/CLEAN COARSE
vvmosm GRANULAR MATERIAL _
54.0 Sand
w n.az HA o' 4. ALL BACKFILL SHALL BE CLEAN 1
I'_ .erg, ts m COARSE GRANULAR MATERIAL FREE 30"-144" C Med. ,
62B FROM DEBRIS&LARGE STONES. Sand
oE� + - 5.CHRISTOPHER COSTA&Assoc. �d'txDF 44_5
MUST BE NOTIFIED WHEN THE eF
a \ 1500 GALLON SEPTIC TANK SYSTEM IS INSTALLED PRIOR TO
4 BAC SYSTEM
IS I FOR INSPECTION. m PERCOLATION RATE= c5 MIN./INCH
0 srn 0 ONE MODULE PIPED BACK TO ._ Na8am5 DEPTH TO GROUNDWATER=NONE ENCOUNTERED
J - _ SEPTIC TANK 6.UNLESS OTHERWISE NOTED ALL JERRY DUNNING
• roa _ `�+�OMNI 2000 RE-CIRCULATION TANK SYSTEM COMPONENTS SHALL BE `��y0 OBSERVATIONS BY:BRUCE MURPHY
INSTALLED IN ACCORDANCE WITHs3.D OMNI 2000 RE-CIRCULATING MASSASEWER HUSCOD AND LOCAL RULES
TAKEN BY-
NIT Y � . DATE TESTED: 3
+D �_�_`=-- - _= _-_-• -o SAND FILTER-(3 MODULES REQ.)
T R ,;'; /20/98
s- '£-°"" - -..w� - +___ WHICH MAY BE APPLICABLE INA
Hw-• RESERVE AREA 7VI0 MODULE PIPED BACK TO
C3 RE-CIRCULATION TANK WORKMAN-LIKE MANNER. _ 1
o 7.THIS LOT IS NOT IN THE FLOOD PLAIN.
PUMP CHAMBER
CD INSTALLED
A GARBAGE GRINDER WILL NOT BE ��Txor
_ INSTALLED ON THE SYSTEM.
�a "NOTE.TO INSTALLERS" 9.NO CHANGES SHALL BE MADE TO THIS PLAN 8 Sp9
ca WITHOUT PRIOR APPROVAL FROM CHRISTOPHER afro
til r COSTA&Assoc. N6a
YOU MUST BE AN OMNI ENVIRONMENTAL SYSTEMS 10.DIG-SAFE SHALL BE NOTIFIED FOR THE PROPER _
>_ R CERTIFIED INSTALLER. YOU CAN BECOME CERTIFIED APPLICANT: BAYSIDE BUILDING CO., INC.
LOCATION OF EXISTING UTILITIES PRIOR TO ANY �arvn�
AT THE TIME OF INSTALLATION. PLEASE CONTACT EXCAVATION. PROPOSED DWELLING LOCATION
OMNI AT 1-888-450-OMNI FOR DETAILS 11. OMNI 2000 PRODUCTS AVAILABLE THROUGH T PROPOSED SEWAGE SYSTEM LOCATION
a, OMNI ENVIRONMENTAL SYSTEMS AT 1-888-450-OMNI
0 12 INSDIE2000 CONTROL DWELLING IN APVISBLE&AUDIBLE ANEL TO BE LOCATED
LOCATION.DO1
14.ONLY OMNI 2000 BIO-FILTER COMPONENTS LOT 1 S N UNIT 9 N RO(TTP I
_
o NO SUBSTITUTIONS
REVISIONS
BARNSTABLE (mARsroNs Mnrs), MASSACHUSETTS
PLAN VIEW - SCALE:AS NOTED DATE:10/1/02
N
SCALE-- 1"= zo' TOPOGRAPHY ERTIFIED PLOT PLAN & T 0.:
� C DRAWN •C.C. JOB N
o LEGEND - Enlar a SAS.0 5 BR ca acit CC
A N BY:JAB CHECKED BY.
I
' 03
� NE BY.
6 30
_ .5 p0 •
PROP. SPOT ELEV. = X60
I i JAB CHRISTOPHER COSTA & assoc.
K - -
11 12 02 Adi Third Sand Filter.
EXIST. SPOT UR - x56.04
i situated in ood Zone C"- 4 The sde s stua fl � .BS',S' DESIGN t: 11 7 Oz 3 Bedrooms io 4 Bedrooms JAB P.O. BOX 128/465 E. FALMOUTH HWY_
a
PROP. CONTOUR �/' 6
EXIST. CONTOUR = ASSESSORS MAP #78 LOT 18 - N0. DATE DESCRIPTION BY EAST FALMOUTH° MASSACHUSETTS
,l
,I
SEWA 4_T SYSTEM �c OMNI �D 0 0 R7 CIR C ULA TING SAND FILTER PROFILE & DETAILS
� -� TO SCALE
1
g 5 4 3 2
a
NOTE: RISERS AND COVERS TO WITHIN 6" OF FINISH GRADE '
k�`
1
6" PINE BARK MULCH 01ANI 2000 RE-CIRCULATING SAND FILTER
�2 MODULES REQUIRED
FILTER FABRIC COVER �- (NO SUBSTITUTION)
FINISi1 GRADE=56.2 AIRATION HOODS I
8
,o
F7
�O (3) COVERS TO GRADE
40 F.FL.=58.0 1.5" PRESSURIZED LINE
O f SEPTIC '
� TI 3" PVC RETURN LINE
I
b TANK= 55.7 56.0_ TOP OF
EFFLUENT'F{LTER RECIRC.
Acme Pre�,ast Model PL122 R.S.F. FINISH GRADE 56.0-57.3
TANK= 55.5
° g 1L��11[=lll 111-,'li 1ir 1Lt 1L1 u l Lu SLOPE 27.
I-i i I I' L- I ,
-
52.3 MODULE
-- :h r
` -� AC FLOW ,. "
KEY MAP HOUSE #7 - - -
«'� 52 72 I i 3 PEASTONE
1 D" SPLITTER��
„ ' + -
1 '-6d INV. + 52.61 ! 14 52 36 -
- 52.83 " PVC
1-1/2 -
� � I � •.. ,1llI
4'0" �, i 52.05 `''--! °" a• ° ' e • -J .`l�
n °
' 3 LIQUID h ."�-- AC ° e ;.4 1
- 11 °. 'A tl 4. C .°
54.2 ° . '-
LEVEL 4 tl e e
� PUMP ON a °�. 24 HR. RES. .. . . .
10 _
I I "HIG VNATER ALARM" I f L-1 � - d :` 3/4"a TQ 1-..1/2"-.CRUSHEDr,
�- 52.0 I I c� W,ASHEO STONE a s Ad. I
°. . e jL
?SCaC GALLON SEPTIC TANK ' - a
; .
_ ; e L PUMP OFF = e . .
I �- LOW W;ATER SHUT OFF" `• ° _ ' _ _ °
_" SET LEVEL-��- " " �__.._. �
1000 GALLON OMNI 2000 - II II II II I I
LFFLUENT FILTER RECIRCULATION TANK 52.2
U "Zoeller" (No SUBSTITUTION) OMNI 2000 PUMP CHAMBER eOTTOM SOIL 1�SO PTION SYSTEM
�, 250 GAL.PUMP CHAMBER
BY-PASS ORIFACE DESIGNED BY OTHERS
� ,. ,1 NOTE:TIMER ,'ti�GD EVENT COUNTER a�
56.54 CHECK VALVE / ► �,
o�T�cLeFPA;�oL MONITORED FROM 4 15 LONG, 1 .00 DIA. PVC LATERALS
EACH WITH FIVE 1 /4 DIA. HOLES SPACED
3" O.C. ALONG PIPE INVERT.
55.88 ' � � % DESIGN SPECIFICATIONS
ONE TRENCH: 75.0' LONG, 4' WIDE WITH
» �. DESIGN CRITERIA
4 Sand Filter Media . . . . . . . . . . 24 rnin, depth <1% #200 sieve, 2mm to 4mm size 4 2 EFFECTIVE DEPTH.
NUMBER OF BEDROOMS
AVERAGE DAILY FLOW . . . . . . 55 gpd/der person/per bedroom c 2
. PERSONS PER BEDROOM `
rq / Wastewater strength-BOD5 . . . . 230 mc�/iter/residential DAILY (FLOW PER PERSON 55
M. 55.55 Re-Circulation Ratio . . . . . . . 4: 1 TOTAL DAILY FLOW 440
cF i SOIL EVALUATORS LOG
Re-Circulation Tank Size . . . . . . . 150% of design flow (Use a 1000 gal. tank) LEACHING AREA REQUIRED 59r4.6 :•;q. ft.(440 gal. ® 0.74 gal./s.f.)
LEACHING AREA PROVIDED 616 _ ,a,, ft. Depth, from Soil Sotl Soil Soil other r
Sand Filter LoadingRate Residential Loac,� -Rate d sf =1150 BOD5=5 d sf surface Hor. Texture Color Mott. Relative
5s•39 Rate(Residential) 9 (9P / )- / gP / LEACHING CAPACITY PROVIDED 455.84 r.p, .: (616)(0.74) (Inches) (USDA) (Munsel =actors
/� �1 Sand Filter Surface Area . . . . . . . SA=Flcw gpd/Loading Rate gpd/ft2
c \ G r _ CALCULATIONS 56i-7 DEEP OBSERVATION HOLE -
69.3 P VIDED _. r. --
1/ 330 o -pd sf 66 S.F. REQ ( S.F RO ) - .. ..
JJ
56.7 56.39` . ssao.,, k BOTIOA 0"-7" A Sand
Re-Circulation pumlp Size . . . . . . [330 +;'4x330)] x 103% = 1,650 gpd 4' x 75'' x 0.74 = 222 a.o.d. 56.1 Loam
r+ 57.2 56.83
cu ` 68.75 cIs / 0 rriiCD n. cycle � 3
SIDEV'ALL 7"-° 0" B Loam
56.31 > - r
� Use MyF�s: Model #ME40 or equal (65 gals. C 12 TH) 158 Ir xc � 0.74 2_3.3.84 g.p.d. 54.2 Sand
57.13
CU ��G
0 1500 GALLON SEPTIC TANK \te r E� Sand Filter Setbacks . . . Same cs Title V septic tank 455.84 g.p.d./O.74 = 616 s.f. �(
�5 GENERAL NOTES 30"-144" C Med.
i
9 �� 1. ALL ELEVATIONS SHOWN ARE I\o ONE MODULE PIPED BACK TO 3R �q Sand
�9 c� cuRe ASSUMED. 44.7
M SEPTIC TANK 5roP
0 0 3A���0 ,� �� 2. ALL PIPES IN THE SYSTEM TO BE 56.5 DEEP OBSERVATION HOLE #C-2
�. 56.s , 'nc. y�(`�ps i \\
CAST IRON OR SCHEDULE 40 P.V.C.
m F pG 1p F� Rs.az I 3. REMOVE ALL UNSUITABLE MATERIAL 0„-7,, A Sandy
3 OMNI 2000 RE-CIRCULATION TANK' �� s\y BENEATH THE INVERT ELEVATION` 55.9 Loam
Q PUMP CHAMBER s��`F� S�, FOR A RADIUS OF 5 AS PER 31 OCMR 15.255(5)
a�. p - ---� 72 AND BACKFILL W/ CLEAN COARSE 7"-30" B Loam
GRANULAR MATERIAL. 54.0 Sand
TWO MODULES PIPED BACK TO
RE-CIRCULATION TANK / 4. ALL BACKFILL SHALL BE CLEAP< -.4 'A oF ,�
A �'e 57.5 COARSE GRANULAR MATERIAL FREE �' , 30"-144" C Med.
/ -E7 FROM DEBRIS & LARGE STONES,
N1.DOUGL AS
(� OMNI 2000 RE-CIRCULATING ti -_ - �. . . . ..• .� s�Nv Dirt , ,• Sand
I- -/57.9
�' ( --•-- ----- 5. CHRISTOPHER COSTA & Assoc. ;R
SAND FILTER (3 MODULES REQ.) "--- ---`- h• w tmo.3s�54o 44.5
Z 75 0' ` �, °M MUST BE NOTIFIED WHEN THE� \ ' 5s.4 i SYSTEM IS INSTALLED PRIOR `C ��
;:..:::.. :. .:. ..... .. :. �... = MIN./INCH
- i BACKFILLING FOR INSPECTION. ;
PERCOLATION RATE 5
0° RESERVE AREA N ! �,� DEPTH TO GROUNDWATER NONE ENCOUNTERED
�z,�NSFa4n� 6. UNLESS OTHERWISE NOTED ALL •�l v
l` o"n' OBSERVATIONS BY:Ui
JERRY DUNNING
�Aucr SYSTEM COMPONENTS SHALL BE , � /
m
w ' INSTALLED IN ACCORDANCE Wi iH TAKEN BY: BRUCE MURPHY
+ 57.2 MASSACHUSETTS TITLE V SANITARY
,- - -- _ P >> SEWER CODE AND LOCAL RULES DATE TESTED: �20/98
W 5s.
----- 56 ---"- -3g,QQ NOTE TO IN STALL_E WHICH MAY BE APPLICABLE IN A
57.3 WORKMAN-LIKE MANNER.
-0� S \s�r `52 7. THIS LOT IS NOT IN THE FLOOD PLAIN.
YOU MUST BE AN OMNI ENVIRONMENTA. SYSTEMS
m ., CERTIFIED INSTALLER, YOU CAN' BECG,IE: CERTIFIED 8. A GARBAGE GRINDER WILL NOT BE.
\�,, , INSTALLED ON THE SYSTEM.
AT THE TIME OF INSTALLATION. PLEAS= CONTACT
9. NO CHANGES SHALL BE ":1ADE To 'THi� "_A,N
WA - ; WITHOUT PRIOR APPROVAL FROM CIHRIS i t)�%HER -
/ OMNI AT 1•-888-450-OMNI FOR DETAI. COSTA & Assoc. w _C 'p1�1
10. DIG-SAFE SHALL BE NOTIFIED FOR THE PROPER APPLICANT: BAYSIDE BUILDING CO., INC.
LOCATION OF EXISTING UTILITIES PRIOR TO ANY � : of
" ASS PROPOSED DWELLING LOCATION
10:11EXCAVATION. wP y
11. oMNI 200o PRODUCTS AVAILABLE �HRouGH ;Q , PROPOSED SEWAGE SYSTEM LOCATION
F- OMNI ENVIRONMENTAL SYSTEMS AT 1-888-450-OMNI ,. CHRISTOPHER TION
� COSTA �
Z 12, OMNI 2000 CONTROL PANEL TO BE: LOCATED ' " No. 31305 �
`l
�I ' INSIDE DWELLING IN A VISIBLE & AIUDIBLE LOCATION. �y,pFCYs ° 04 R
00 14. ONLY OMNI 2000 BIO-FILTER COMPONENTS �1�' LOT 18 N UNIT 7 N ROUTE 149
o NO SUBSTITUTIONS REVISIONS
J
BARNSTABLE MARSTONS MILLS MASSACHUSETTS
w PLAN \/I E W SCALE: AS NOTED DATE: 9/30/02
o LEGEND SCALE: 1"= 20' ;
CERTIFIED PLOT PLAN �c TOPOGF�APHY DRAWN BY: JAB CHECKED BY: C.C. JOB NO.:
PROP. SPOT ELEV. = ` X60.5 DONE BY-
EXIST. COSTA & assoc. �.
EXIST. SPOT ELEV. x56.04
PROP. CONTOUR = �'�./'46 The site is situated in Flood Zone "C" SS D SICAT 1 10/22/02 3 Bedrooms to 4 Bedrooms JAB P.O. BOX 128/465 E. FALMOUTH HWY.
es p
EXIST. CONTOUR 46 ASSESSORS MAP #78 LOT 18 NO. DATE DESCRIPTION BY EAST FALMOUTH, MASSACHUSETTS
I
i