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Home My WebLink About0195 ROUTE 149 UNIT 7 - Health (5) 195Unit 5 Route. 149 f Marston; Mills' A = 078 018Unit 5 r 'I I ty� Town of Barnstable Barnstable Ai-AmericaCitl� � °"` eL ` Board of Health 9 6� `fig Pr fD a 200 Main Street, Hyannis MA 02601 a 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi November 13, 2013 Mr. Joseph and Mrs. Diane Cabral 195 Route 149, Unit E Marstons Mills, MA 02648 RE: Operation and 1vlamtenance:(O&1vI) of your Innovative/A 6ina6` (OMNI)'Systern at 195 Route 149,:#E,Marstons 1Vlills A=078 Ol 8-40E: Herring Run Place Condo Dear Mr. and Mrs. Cabral, ` You are granted permission to reduce operation and maintenance of your innovative/alternative technology (OMNI 2000 Recirculating Sand Filter system) at 195 Route 149, #E to two times per year. A public hearing was held before the Board of Health on November 12, 2013. The Board reviewed your previous years of service records in regards to the operation and maintenance of your innovative system as well as the testing results of the effluent wastewater. The system has been functioning very well with the median total nitrogen level at or below 19 mg/liter, which meets the discharge limits. Permission is granted to reduce the frequency of operation and maintenance of your I/A system at your property will the following conditions: ❖ The wastewater effluent shall be tested for Total Nitrogen once per year. ❖ Operation and Maintenance Inspections shall be conducted twice per year in accordance with MA DEP Regulations. Sincerely Wayne Mil er, M.D., Chairman. BOARD OF HEALTH Q:\WPF I LES\CabralIAOperation&Maintenance2013.doe 5 - I I y ��-) )0 -e- 2/1,�e,, V,/- Herring Run Place 195 Route 149, Unit#E." Marstons Mills ,gyp el) Iq6,e)/;J-7 &`7 r 9 1� 9w^M _ y � CamlodyTM Service History Page 1 of 1 Property History Property Information Property ID BAR49195RSF-E (Tracking Number) Name Cabral, Joseph and Diane Site Address 195-E Route 149 Marstons Mills, MA Service Statistics Total Service Events (To Date) 49 Service History -All Date Report Type Entered Gallons Recorded By or Comments Date Pumped Disposal Site Serviced 9/17/2013 0 Bennett Sampling System not operating correctly at time of 3:16 PM Environmental Report sampling event. 9/11/2013 Associates, Inc. 12:15 PM ------ Using: The Web Site 9/17/2013 0 Bennett "Inspection" General O&M visit along with effluent quality 3:13 PM Environmental field testing. Pulled effluent samples for lab 9/11/2013 Associates, Inc. analysis. 12:15 PM ------ Using: The Web Site 8/1/2013 System No service No service event reported within service 12:00 AM Generated recorded schedule: 07/31/2012 to 07/31/2013. 8/1/2013 12:00 AM Notes: No service event was recorded by the system for this flag: Maintenance Contract 6/7/2013 0 Bennett "Inspection" Conducted O&M visit along with effluent quality 12:49 PM Environmental field testing. 6/5/2013 Associates, Inc. 11:15 AM ------ Using: The Web Site 3/7/2013 0 Bennett "Inspection*" Conducted O&M along with effluent quality field 1:07 PM Environmental testing 3/6/2013 Associates, Inc. 11:15 AM ------ Using: The Web Site 1/2/2013 System No service No service event reported within service 12:00 AM Generated recorded schedule: 09/05/2012 to 01/01/2013. 1/2/2013 12:00 AM Notes: http://carmody.biz/pump/Service_History.aspx?pmode=l&permit_id=254228&ha=10 10/4/2013. CarnriodyTM Service History Page 1 of 2 Carmody TM Environmental Management Services BARNSTABLE County, Massachusetts-Thomas McKean- 10/4/2013 Main Menu Sampling Report Home Question Color Key: (Sample)=Required Question ,_ 1 L--o- --................ g_Out _ jHow To:All Tutorials Tracking Number: BAR49195RSF-E 4ppyl for Passwords Name: Joseph and Diane Cabral Support Phone/Fax Report Tech Problem Site Address: 195-E Route 149 Change/Request Form Marstons Mills, MA jChange Password Mail Address: 88 Kates Path 'Carmo�Tr_ aining� Yarmouth Port, MA Register Event Assigned Provider: Bennett Environmental Associates, Inc. (File a Service Event_ From Property Profile How To:File Event Management Level: General with Nitrogen Requirements Data Resources ;Search for a Property _ Selected Service Provider ID: 12580 ServiceActivitr _ __,_ Selected Service Provider: Bennett Environmental Associates, Inc. Create a Report Creat a Excel File Report Filed By: David C Bennett Statistics Report _ ;Split Parcels Components that were sampled: Setup 1: RSF l R�ev_iew Questions [Send Payment Last Report Dates Lid Depth Inspection: 9/11/2013 Septic Tank: Maintenance: None Filed Lift Tank/Siphon Chamber: Pump: None Filed Aeration Unit: Date&Time Serviced: 9 i/ 11 /PiT , 12 15 PM«% Month /Day /Year Notes/Comments/Message System not operating correctly at time of sampling event. or Other Observations: (Viewable by Regulators and Service Providers ONLYI) Laboratory Alpha Analytical Sampling Report Sampler Name 14oseph Smith Data Quality Bad 112 Sample Type grab Effluent (Leave item blank if not tested) BOD5 Amount(mg/L) Nitrate Amount(mg/L) Nitrite Amount(mg/L) 0.025 pH Amount(mg/L) TKN'Amount(mg/L) t 41.6 Total Nitrogen(mg/L) 141.68 TSS Amount(mg/L) - This report only describes the conditions at the time of service and under the conditions of use at that time.This report does not address how the system will perform in the future under the same or different conditions of use.Carmody,Compass and Septic Search are independent business entities and are not associated with business practices or liabilities assumed by the inspection,inspectors and or their business entities. "This is a copy of an electronic document generated from Carmody. ©Copyright 2013 CDs Holding,Inc.All rights reserved. http://carmody.biz/Pump/Service_Reports.aspx?ha=10&hi=1&id=1075627&permit_id=25... 10/4/2013 CarniodyTM Service History Page 2 of 2 Report Active Question Color Key: (Sample)=Required Question This is a privately operated web site. Sponsorship does not constitute an endorsement from any participating regulatory agency. Copyright©2013 Carmody&All rights reserved. Legal Privacy http://carmody.biz/Pump/Service_Reports.aspx?ha=10&hi=1&id=1075627&permit_id=25... 10/4/2013 CarrriodyTM Service History Page 1 of 2 Sampling Report Tracking Number: BAR49195RSF-E Name: Joseph and Diane Cabral Site Address: 195-E Route 149 Marstons Mills, MA Mail Address: 88 Kates Path Yarmouth Port, MA Assigned Provider: Bennett Environmental Associates, Inc. From Property Profile Management Level: General with Nitrogen Requirements Selected Service Provider ID: 12580 Selected Service Provider: Bennett Environmental Associates, Inc. Report Filed By: David C Bennett Components that were sampled: 1: RSF Last Report Dates Lid Depth Inspection: 9/11/2013 Septic Tank: _ Maintenance: None Filed Lift Tank/Siphon Chamber: Pump: None Filed Aeration Unit: Date & Time Serviced: 9/5/2012 1:30:00 PM Notes/Comments/Message System is operating correctly. Effluent quality passed field testing or Other Observations: parameters. New property owners-Cabral, Joseph and Diane. (Viewable by Regulators and Service Providers ONLYI) Laboratory Alpha Analytical , Sampling Report Questions Sampler Name jJoseph Smith Data Quality Good Sample Type grab Effluent (Leave item blank if not tested) BOD5 Amount(mg/L) i Nitrate Amount (mg/L) 1 7 Nitrite Amount(mg/L) 0.21 pH Amount(mg/L) F777- ' TKN Amount(mg/L) 7 g Total Nitrogen (mg/L) 9.51 TSS Amount(mg/L) i http://carmody.biz/Pump/Service_Reports.aspx?ha=1&hi=1&po=1&id=970983&permit_i... 10/4/2013 Carm'odyTM Service History Page 2 of 2 This report only describes the conditions at the time of service and under the conditions of use at that time.This report does not address how the system will perform in the future under the same or different conditions of use.Carmody,Compass and Septic Search are independent business entities and are not associated with business practices or liabilities assumed by the inspection,inspectors and or their business entities. **This is a copy of an electronic document generated from Carmody. ©Copyright 2013 CDs Holding, Inc.All rights reserved. Report Active Question Color Key: (Sample)=Required Question http://carmody.biz/Pump/Service_Reports.aspx?ha=1&hi=1&po=1&id=970983&permit_i... 10/4/2013 °F THE r°�y Town of Barnstable Barnstable Board of Health jefica C j � MASS. 200 Main Street, Hyannis MA 02601 'm 9 ASS. t639' �0 PrfD MAl A 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Joseph &Diane Cabral, 195 Route 149, Unit#E, Marstons Mills, MA 02648 ACKNOWLEDGEMENT OF RECEIPT: October 21, 2013 We have received your submission to the Board of Yfeafth 12e: 195 route 149 — E, Marston 9liffs for a hearing to reduce your monitoring requirements for your I/A septic system. 2-hankyou. Your item will be heard at the Board of Health Meeting on the: Date of: Tuesday,November 12, 2013 You, or a representative for you, is expected to be present to answer questions the Board may.have. r Meeting Location: Town Hall, 367 Main St, Hyannis Hearing Room, Second Floor Time: 3:00—6:00 P.M. Approximately three days prior to'meeting, an agenda will be sent out to you— once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to ..."Boards & Committees > Board of Health - or- Go to Official Agendas QAAGENDAS BOH\lei Receipt of BOH Submission 2013.doc I rt ; ENNETT 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: Brian Baumgaertel,Program Coordinator 7/31/12 BEA12-10453 Barnstable County Department of Health and Environment 3195 Main Street/P.O.Box 427 Barnstable,MA 02630 REGARDING: Innovative/Alternative Septic System Maintenance Contract SHIPPING METHOD: Regular Mail 0 Pick Up ❑ Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail ❑ Green Card/RR ❑ COPIES DATE DESCRIPTION 1 7/10/12 Unit 195-E Herring Run Place-Marstons Mills,MA For review and comment: ❑ For approval: ❑ As requested: ❑ For your used❑ REMARKS: Please find enclosed authorized operation and maintenance agreement for the new owners of the above referenced residence`s'Thank°}ou. I cc:Barnstable Board of Health W w: FROM: Samantha Farrenkopf,Wastewater Program Coordinator If enclosures are not as noted,kindly notify us at once BENNETTENVIROI�4MENTALAsSOCffATES9 NCO LICENSED SITE PROFESSIONALS A ENVIRONMENTAL SCIENTISTS & GEOLOGISTS & ENGINEERS 1573 Main Street- P.O. Box 1743, Brewster, MA 02631 508-896-1706 0 Fax 508-896-5109 www.bennett-ea.com I; July 10, 2012 Mr. &Mrs.Joseph and Diane Cabral 88 Kates Path r Yarmouthport,MA 02675 RE: OPERATION AND MAINTENANCE CONTRACT 2012 AND 2013 Innovative/Alternative Wastewater Treatment System:OMNI RSF Unit 195-E Herring Run Place—Marstons Mills, MA Dear Mr. &Mrs. Cabral, BENNETT ENVIRONMENTAL ASSOCIATES,INC.(BEA),is pleased to provide aproposal for the 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 unal'r;the Barnstable Health Department. This contract transfers to you as the new owner of the alternative soli.c system at Unit 195- E Herring Run Place.,<: These. services.,include quarterly inspection :for Mandard operation and maintenance of the treatment system,:as well as annual effluexzt sxrping for total nitrogen. The costs for such services are presented below as annual costs for the first and second year ofthis contract reflecting standard laboratory fees and repoxtrng xequrrements.: The quoted costs are effective from the date of this contract through October 20l and.include 5 (five) quarterlyirispectrbn events and 2 annual sampling event. QUARTERLY INSPEGTI0N/lO:IAINTENANCE/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/iiitrate/TKN for total nitrogen. At the time of sampling events the.conditlops of the system will be inspected and documented with regards to the blower units, sludge level and associated piphlg. 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[Sept 2012] $ 118.75 Professional Fees Operation/Maintenance and Reporting[Dec 2012,Mar 2013,June 2013,Sept 2013] $ 600.00 Laboratory Analysis[2x Total Nitrogen(NO2,NO3,TKN)] $ 95.46 Barnstable County Data Base Fee $ 50.00* r EMERGENCY SPILL RESPONSE WASTE SITECLEANUP SITE ASSESSMENT PERMITTING SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 0 WASTEWATER TREATMENT,OPERATION&MAINTENANCE JULY 10,2012 CABRALJPROPOSAL PAGE 2 OF 2 UNIT 195-E 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 ofHealth and Environment(BCDHE)and the local Boards of Health. At this time,BCDHE has found if 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. 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 for the transfer of this contract. 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 indicating acknowledgement and acceptance of our Terms&Conditions 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,P Wastewater Program Coordinator cc: Kara Risk,Business Manager encl. Terms&Conditions(2009)/Fee Schedule(2010) AUTHORIZATION: °� , o `_ �, ,DATE: . , „. _per -- ---_._-- ----._a.•-. �a Postal ru CERTIFIED MAIL,,., RECI�-,IPT Ln (Domestic Mail Only; .•. m r� For delivery information visit our website at wwvhusps.com Ln 1 ruj7OFFIG AL US Ln Postabe $ QCertified Fee ...sss O Return Receipt Fee O re r(Endorsement Required) Restricted Delivery Fee O f` (Endorsement Required) G _' l p Total Postage&Fees $ S1 r-� Mr. David Walsh P O Box 302 Marstons Mills, MA 02648 Certified Mail Provios: ■ A mailing receipt is A unique identifier for your rlailpiece� in A record of deliver;kept by the Postal Service for two years Important Reminders: ■ Certified i0ail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVrIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Retum Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete . Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X dressee so that we can return the card to you. B. a Ived by jPrinted Name) TC..�ate 7e�4 ■ Attach this card to the back of the mailpiece, // // or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: O No r Mr. David Walsh P O Box 302 \✓,cps Marsions Mills, MA 02648 3. Service Type ❑Certified Mall ❑Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7011 0470 0001 4525 7352 (transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE F•i"- Ipss Mail R ..a a• •q.,•:T•I.v'i4.•O..s.'W, '1%a"ii �v � "� �"`A . o. e mi • Sender: Please print your name, address;�ffl +�I�i i5 Town of Barnstable Public Health Division 200 Main Streety Hyannis, MA 02601 III.„i,IIIIII lift „r1111„111„1111,,,11I111III11,M IJil cY • s Town of Barnstable Barnstable �p THE Taw yWP �r Regulatory Services Department M"aM i l IIA MASS6LE, = public Health Division rfa M°`A. 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7011 0470 0001 4525 7352 July 9, 2012 Mr. David Walsh PO Box 302 Marstons Mills, MA 02648 Dear Mr. Walsh: The septic system located at Herring Run Place, 195 Route 149, #E, Marstons Mills, MA was last inspected on 6/15/2012 by Joseph R. Smith, a certified septic inspector for the State of Massachusetts. The Health Division has determined that the system "passes". It is recommended, however, that cleanouts be installed for the pressure distribution laterals in the SAS. Sincerely, , omas McKean, R.S. CHO Agent of the Board of Health $ L Q:\SEPTIC\Letters Septic Inspection Failures or Future EvahReCOmmendations\195 Route 149#E.doc I Commonwealth of Massachusetts v W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 6-15-12 every 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: A. General Information When filling out forms on the 2 computer, use 1. Inspector: 0 only the tab key to move your Joseph R. Smith (also 4m WWTO for I/A system) cursor-do not Name of Inspector use the return key. Bennett Environmental Asscoiates, Inc. Company Name f� 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 i B. Certification certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority _s l 6-25-12 s or's Signature Date d 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 CO report to the appropriate regional office of the DEP. The original should be sent to the system owner Y and copies sent to the buyer, if applicable, and the approving authority. ****Th is,report only describes conditions at the time of inspection and under the conditions of use Uri s at that time.This inspection does not address how the system will perform in the future under � _:A ttesame or different conditions of use. t5ins•11/10 Title 5 Offic*nson Form:Subsurface Sewage Disposal System•Page 1 of 17 Y Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 6-15-12 every 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: 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 6-15-12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 a t5ins•11/10 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 Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 6-15-12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: System is in working condition and is functioning as intended. None of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 existed at the time of inspection. A garbage disposal was found to be installed in the dwelling, the design plan does not allow for a garbage disposal to be allowed for use with this system. Removal of the garbage disposal will be required for this system to pass inspection. Installation of cleanout at ends of pressue distribution system laterals recommended to facilitate maintenance. 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 El ® 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 '/z day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. Cityrrown 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. City/Town State Zip Code Date of Inspection D. System Information Description: Septic System that serves a single family residence is comprised of a 1,500 gallon Septic Tank, Innovative/Alternative septic technology(OMNI Environmental Systems, Inc. OMNI Recirculating Sand Filter System), Pump Chamber, and a pressure dosed trench that is 65' long, 2.7'wide, and 2' effective depth. Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No 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: 2010-87,000 gallons=238 gpd. 2011 -74,000 gallons.=203 gpd Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 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: Barnstable Health Department- No Recent Record 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): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Installed: 11-15-2002, Started Up: 8-25-2003 Barnstable Counties Carmody Database for I/A Treatment Technologies. 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: NA-Town Water feet Comments(on condition of joints, venting, evidence of leakage, etc.): Vented property to roof. No evidence of leakage in piping or joints for building sewer line. Septic Tank(locate on site plan): Depth below grade: 2.0 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1,500 concrete septic tank, with polylok outlet riser and cover to grade. Furnished with 4" Schedule 40 PVC inlet and outlet Tees, outlet tee houses an effluent filter. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'6"L x 68"W x 68" H Sludge depth: 4" t5ins•11/10 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 �M ,.•' Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. CityfFown 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 37" 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, "sludge judge"and 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 as based on solids content(sludge/scum). Sch 40 pvc inlet and outlet tees functioning properly. Liquid level as related to the outlet invert is at a normal operating height. No evidence of leakage encountered while conducting the inspection on the 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 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•11110 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 Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 6-15-12 every page. Cityrrown 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 No D-Box Present, Pressure Distribution SAS 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 accessable cleanouts for pressure distribution laterals in SAS. 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 concrete Pump Chamber with polylock risers and cover to grade. Pump, on/off float switch, and alarm float switch functioning properly. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Located per plan as probed. No cleanout for pressure distribution laterals shown on plan or found in field as recommended to facilitate maintanance of field. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 6-15-12 every page. CityTTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: (W 1: )x 2' x 2.7 (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.): Vegetation is normal in the area of the leaching trench, no signs of backup to pump chamber or hydraulic failure of SAS present at the time of inspection. 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. CityTFown 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. CityTrown 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts v w Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 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: 7.0+ 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: Plan Date: 9-12-02 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Established estimated depth to high groundwater by referencing the septic system design plan by Christopher Costa&Associates, of East Falmouth, MA with a plan date of September 12, 2002 wherein it is noted that the bottom of the leaching trench Is at elevation 57.7. Also the soil test data taken by Bruce Murphy and witnessed by Jerry Dunning notes within the same plan that no groundwater was encountered at elevation 50.7, which puts groundwater at an elevation greater that 7.0'+from the bottom elevation of the leaching trench. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Herring Run Place Route 149 Unit 195-E Property Address David Walsh Owner Owner's Name information is required for every Marstons Mills MA 02648 6-15-12 page. Cityfrown 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTAKE qq LOCATION Aa 151-0 k)A {_ .SEWAG9 . r. VILLAGE f U ASSESSOR'S MAP' INS'I'P►I-I.ER'S NAME&PHONE NO. SEPTIC TANK CAPACrrY LEACHING FACn=: (typo) _ i,�Gl��yLG 71?9: l i (size) s "r. _ NO.OF BEDROOMS BUILDER OR OWNER hSERMTTDATE: r� _.. COWLIANCE DATE: �? `� - Separation Distance Between the: Maximum Adjusted Groundwater'fahle to the Bottom of Leaching Facility Fe#t Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of teaching facility) P-dge'of Wetland and-Leaching Facility(If any wctlands exist within'300 feet of leaching facility) - Feet �. Furnished by 1 . ...... ....... i t t � J W 073 8i�'d 6OTS96880S:cl V02906180ST H11U8H 1SN�JUG:wOJJ ZT:OT 2TO2-20-AUW Envhronmental Systems, Inc.. OMNI RSF Operation and Maintenance Inspection Checklist A. Installation & Service Information (A 16A 1--'1 Facility Street Address DA of dervice h �gg— City Operator/O&M Firm �\NvN System Startup Date Weather Conditions p B. Septic Tank �\ ` ��5 �p� � c� A\`L \i, C� V05; . Sludge Pumping Required: Yes ❑ Nd�A ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yesq> No ❑ If yes, inspectgA &clean at least yearly (�.J If the sludge layer is within 12"of the outlet invert, recommend that the homeowner have the septic tank pumped, note the approximate scum layer thickness as well.Also, inquire if the homeowner has a pumping schedule established with a licensed septage hauler, if not recommend a two to four year pumping schedule depending on how heavily the system is used. C. Recirculation Tank e`\)�-T U\-, -1A\A\'t✓ OV1 ❑ Check if sludge accumulating Pumping required: Yes ❑ Nou Odor problems: Yes ❑ NoQ, If yes,description Effluent tee filter: Yes ❑ NoQ2� If yes, inspect❑ &clean at least yearly ❑ If the sludge layer is greater than 4"request that the homeowner pump out the recirculation tank in order to prevent clogging of the filter modules. Note the characteristics of the effluent coming out of the manifold this may indicate that the filter bed may need servicing. D. Equalization Tank (if installed) Sludge Pumping Required: Yes ❑ No ❑ ❑ Sludge Depth: ❑ Scum Depth: Effluent tee filter: Yes ❑ No❑ If yes, inspect❑ &clean at least yearly❑ Same inspection criteria as septic tank: E. Pump Chamber/Vault (if Installed) Pump Inspections(all units) If problems,describe (,Float switches Check all switches for operation Make Sure the pump is operational by pulling up the float switch; if the pump is not operational immediate corrective actions need to be taken. F. Pumps, Switches, Floats, Alarm System Pump Inspections(all units) If problems,describe Test pump alternator, or record hours Hours of operation �] Float switches Check all switches for operation Test alarm If non-functioning,corrective action(s) Make sure pump(s), Float(s)and audible alarm(s)are functional,if not make a note so that corrective actions can be made. G. Filter Modules ("Sand Filters") N Inspect for ponding Ponding Present: Yes ❑ No{ Clean bed: Yes ❑ No b�jDistribution pipes Flush: Yes ❑ No� Brush: Yes El NOW Any obstruction of airflow to filter modules: Yes❑ No(V If Yes, explain below(i.e. snow, dirt) To inspect the condition of the filter modules remove the mulch layer at one corner of the filter module area, then lift the filter fabric so that the media can be inspected through the end of the contactor. The media should have a thin biomass layer growing on it and should have a brownish shaggy coloration. If the surface of the filter module area appears to be clogged,or the biomass layer is too think it is suggested to completely expose the filter modules,and rake the filter beds thoroughly,then wash the filter beds down with a garden hose(with a pressure nozzle on it).Then Recover the filter beds as they were found. H. Sample Collection Yes ❑ NcQ& 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: soy u' .V. \.Pt= rn : c,�i� -� , \i �. �, a BENNETTENVMONWNTAL AsSOCIATES INC. 1573 Main St.,P.O.Box 1743, > Brewster,MA 02631 � 3 508-896-1705®www.bennett-ea.eom ` \�� Date&time of visit:° ,L a , A site visit was conducted today for: " &M ? Testing Repair Alarm Call Your system is operating correctly MYES ❑ NO Tank(s) in need of pumping ❑YES ® NO Further maintenance required ❑YES ® NO Repairs needed ❑YES 0 NO Please contact our office ❑YES Ed NO Contract renewal required ❑YES NO Field testing: C Pass j/ Fail Sample pulled: YES / NO Laboratory sampling conducted ❑YES vR.NO ,1 t (A a �r �Z•.Zo-.�t..('�:�`> S3V� EJ� 'ilfizs??.��`a+gt',�°...hv� , �� Y•"e\�Ji'\"1 - 'tE�`ASSESS'EN77?;>3E!i;:%: ii; r BENNETTENVIRONMENTALAssOCIATES, INC® LICENSED SITE PROFESSIONALS A ENVIRONMENTAL SCIENTISTS 0 GEOLOGISTS 0 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 6 508-896-1706 & Fax 508-896-5109 0 www.bennett-ea.com BEA09-10138 November 30,2011 Mr. &Mrs.David Walsh _ P.O.Box 302 -FILE Marstons Mills,MA 02648 RE: OPERATION AND MAINTENANCE CONTRACT 2012 AND 2013 Innovative/Alternative Wastewater Treatment System: OMNI RSF Unit 195-E Herring Run Place—Marston Mills,Mik Dear Mr. &Mrs.Walsh, 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 0 WASTE SITECLEANUP SITE ASSESSMENT PERMITTING SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE NOVEMBER 30,201I �L :Ar_SBEA09-10138 PAGE 2 OF 2 UNrF 195E HERRING RUN PLACE,IMARSTONS 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 ifyou do not wish to proceed. Otherwise, please sim the authorization be and return one copy of this proposal to our office. Should you have any queKdons or need additional information,please con€ae;t rye directly at our office Very truly yours, BENNETT ENVIRONMENTAL ASSOCIATES, INC. 20 Samantha Farrenkopf,ES WWTO,PWSO Wastewater Program Coordinator cc: Kara Risk,Business Manager encl. Terms&Conditions(2009)/Fee Schedule(2010) AUTHORIZATION: �I/l�,ttid�P ��"l.�i ,DATE: 4 7a :� u. w CUSTOMER'S ORDER NO. DEPARTMENT DATE NAME ADDRESS CITY,STATE,ZIP SOLD BY CASH C.O.D. CHARGE ON:.ACCi.;. MDSE.RETD. OU . PAiD T QUAh"CITX::..: . DE8GH{PTIGN AMOUfff 1 7 2 3 e 4 j 5 6 8 9 10 11 12 13 14 15 16 17 18 RECEIVED BY A-5805 .. . ......- .._.._ .. T46320/463W KEEP THIS SLIP FOR REFERENCE aft MASSACHUSETTS:UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY S C MA DATE JOBSITE ADDRESS /i- `'j OWNER'S NAME OWNER ADDRESS - TEL Vt -G,?e_a 12 DFAX= TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL © RESIDENTIAL R! PRINT CLEARLY NEW:® RENOVATION:® REPLACEMENT-© PLANS SUBMITTED: YES EI NO[j FIXTURES Z FLOOR— BSM- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB _ CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM _ DEDICATED WATER RECYCLE SYSTEM DISHWASHER �- DRINKING FOUNTAIN - FOOD DISPOSER _- FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN _ - SHOWER STALL SERVICE/MOP SINK _ -- TOILET — — - - - WASHING MACHINE CONNECTION WATER HEATER ALL TYPES -- - WATER PIPING - - -- -- OTHER - - -- - INSURANCE COVERAGE: - - -- I have a current fiabilitv insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES R'NO Q IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1 OTHER TYPE OF INDEMNITY® BOND OWNER'S INSURANCE WAVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and.that my signature on this permit application waives this requiremem CHECK ONE ONLY: OWNER © AGENT SIGNATURE OF OWNER OR AGENT I hereby ceriafy that all of the details and information 1 have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application vwll be in compl' ce all Perfine9tprovislon of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME �f/ E LICENSE#- OS' 6 SIGNATURE MP[2-, JP© CORPORATION El#[=PARTNERSHIP[]#�LLCQ#� . COMPANY NAME ��E S ,E �f} .fJ ADDRESS CITY STATE ZIP G y ra TEL �o ^Lf 23 FAX , CELL oa'-G EMAIL �= f� pF� Tpy, Barnstable ?j P� Town of Barnstable Al-AmedcatSty IIARNSTAF3LE. ' y niAss. � Board of Health f; Arfb MAl a 200 Main Street, Hyannis MA 02601 2007 .F Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi September 15, 2009 Mr and Mrs. David Walsh PO Box 302 Marstons Mills, MA 02648 RE: Sampling of Wastewater Effluent from your Innovative/Alternative (OMNI) System at 195 Route 149, #E, Marstons Mills A= 078-018-40E Herring Run Place Condo Dear Mr. and Mrs. Walsh, Your request to discontinue sampling and monitoring of the wastewater effluent from your onsite sewage disposal system consisting of innovative/alternative technology (OMNI 2000 Recirculating Sand Filter system) at 195 Route 149, #E , is not granted. A public hearing was held before the Board of Health on September 8, 2009. The Board has received the report of eight test results with a median total nitrogen level of 19.2 mg/l. In 50% of the test results, the total nitrogen was greater than 19.0 mg/l. This does not meet the minimum of 90% required. The Board will need to see more consistency in the lower test results to approve the request to reduce the monitoring plan. At this time, you must continue with the current frequency of testing the wastewater effluent from the I/A system at your property: ❖ The wastewater effluent may be reduced to twice per year. ❖ Operation and Maintenance Inspections shall be conducted on a regular basis in accordance with MA DEP Regulations'. Sincerely, Wayne Miller, M.D., Chairman BOARD OF HEALTH Q:\WPFILES\IA Monitor Adj Walsh Rte149 E SEP2009.doc ` - Page 1 of 1 McKean, Thomas From: Sue Rask [srask@barnstablecounty.org] Sent: Monday, July 20, 2009 11:26 AM To: momdec15@comcast.net Cc: McKean, Thomas Subject: RSF Data 195 Rt 149 Unit E Mrs. Walsh, Attached please find an Excel spreadsheet with all of the sampling data for your RSF system —at 195 Rt 149 Unit E. A total of 8 samples have been taken; these samples have a median of 19.2 mg/L total nitrogen. I also put a paper copy of these results in the mail to you. Please call if you have questions or if I can be of further assistance Susan Rask Environmental Health Specialist Barnstable County Department of Health and Environment PO Box 427 Barnstable MA 02630 Phone: 508 375 6625 Fax: 508 375 6880 N� a �ja)C Z Li L 7/21/2009 .f SAMPLE DATA h 195 Rt 149 Unit E Owner: David and Francine Walsh Effluent: Effluent: Effluent: Effluent: Effluent: Effluent: Effluent: Service Date Service Provider Sampler Name Sample Type Nitrate Nitrite TKN Total BOD5 TSS pH Nitrogen 12/8/2004 8:OC OMNI Environmental Systems, Inc. grab 2.6 0.37 19 21.97 23 19 7.3 2/23/2005 11:1 OMNI Environmental Systems, Inc. Joseph R. Smith grab 8.7 0.28 8.6 17.6 0 7.3 5/23/2005 13:2 OMNI Environmental Systems, Inc. Joseph R. Smith grab 7.6 0.4 101 18 7.1 4/6/2006 12:0 OMNI Environmental Systems, Inc. Joseph R. Smith grab 8 0.85 13 21.9 8 11 7.3 3/14/2008 12:2 OMNI Environmental Systems, Inc. Joseph R. Smith grab 1.3 0.12 19 20.4 19 22 7.1 8/13/2008 9:0 OMNI Environmental Systems, Inc. Joe Smith grab 14 0 2.3 16.3 30 1 12/17/2008 11:0 OMNI Environmental Systems, Inc. lJoe Smith Igrab 1 211 0 4.5 25.5 8 32 6.5 4/8/2009 11:1 qOMNI Environmental Systems, Inc. jJoe Smith 1grab 1 5.91 0 0.4 6.31 2 1 7.3 19.2 MEDIAN EFFLUENT TOTAL NITROGEN 1-888-450-OMNI (508) 548-0343 u OFFICE . MANUFACTURING P.O. Box 128 Falmouth Technology Park 465 East Falmouth Highway - 520 Thomas B. Landers Road East Falmouth, MA 02536 nvtrarimsn"n ,s'St �t1S, East Falmouth, MA 02536 August 27, 2003 MAR 1 9 2004 Mr. Thomas A. McKean, Health Agent TOWN OF BARNS g HEALTH DEPT. Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: Recirculating Sand Filter Systems Operation and Maintenance Inspections Dear Mr. McKean: Enclosed, please find a copy,of the Recirculating Sand Filter Systems Operation and Maintenance Inspection Checklist for the property located at Lot 18, Route 149, Unit 5 Herring Run, Marstons Mills, MA. If you have any questions or need additional information, please contact me as soon as possible. Sincerely, M t ew . Costa, President NI Environmental Systems, Inc. Encl. RSF System Reports D.E.P. Certified wastewater Operators Recirculating Sand Filters Manufacturing • Testing • Maintenance • Installations Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 RSF System Operation and Maintenance Inspection Checklist A. Installation & Service Information rc � . 5 Faciiity W-Mdresj j Date of Se City OperaitorlbWFAW Inspect&note if B. Septic'tank(sj pumping is required. Inspect&clean effluent Sludge Pumping Required: Yes❑ No ❑Sludge Depth: tee filter. Effluent tee filter. Yes No❑ if yes, inspect clean at least yearly Clean as necessary. C. Recirculation tank Inspect for sludge. ❑Check if sludge accumulating Pumping required: Yes B No Odor problems: Yes❑ No If yes,description Inspect for sludge. D. Equalization tank (if installed) ❑Check if sludge accumulating Pumping required: Yes❑ No❑ Inspect pumps& . E. Pumps, switches, floats, alarm system electrical switches,test Run . Pump Inspections(ail units) as necessary. . - , if probtems,describe pumps in manual Test pump alternator,or record hours mode.Record readings Hours.of operation from meters& Float switches counters. Check all switches for operation �]Test,alatm \ if non-functioning,corrective action(s) Note if weeds& F. Recirculation Sand Filter • debris are present on ' bed.Clean/maintain inspect for ponding Ponding Present:Yes ElNo bed surface to allow ❑Clean bed: Yes❑ �o proper operation of the system: ❑ Distribution pipes Flush:Yes.O No❑ Brush: Yes❑ No❑ ❑Check head loss in pipes Headloss and comments •-G. Sample Collection Yes❑ No 1] If yes: ❑BOD 0\TSS ❑pH EITN DOther TOWN OF BARNSTABLE LOCATION ��— / �� i�y SE VILLAGE • i'{ !II S ASSESSOR'S MAP & LOT Q'7601S'"14,E: IN - &PHONE No. �f��c le (96n a l I SEPTIC TANK CAPACITY 1500 LEACHING FACILITY: (type) f/'- 0C"1 /25 (size) NO.OF BEDROOMS BUILDER OR� rr PERMITDATE: C�CE DATE: q o ®S 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 �1 `i1 `�� Zf� 2� ►� `� . L TOWN OF BARNSTABI;E LOCATION 1956/ AL9r "i/1 C �U h 1��Q C�- SEWAGE # VILLAGE W(OLA&;�f?fv ASSESSOR'S MAP & LOT eFl Ogg' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I SOO Q.L L 014 S LEACHING FACILITY: (type) (size) NO.OF BEDROOMS --ram BHE&-OR OWNER_ �O;cScade PERMUDATE: COMPLIANCE DATE: 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 rr' - Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 4 1 PART C ' SYSTEM INFORMATION(continued) Property Add— 14 S H 2{ lQR Owner. Date of inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system mcludmg ties to at least two perm m eue reference laninmorirs or benchmaft.Locate all wells within 100 fret Locate where public water supply emus the building. / S� 12 c'�b Sep1t� P to r,4 � cbN lY t f No. / Fee O®• THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _,V� Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ,�_ 01p�pitcatton for��tg�pool *p5tem Con!tructton Permit hcation for a Permit to Construct(�)Re air( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components PP P Pg P Y P Location Address or Lot No./7� Owner's Name,Address and Tel.No. Assessor's Map/Pazcel u�.c� 3� Installer's Name Address,and Tel.No. 1 QS 7016 Designer's Name,Address and Tel.No.;TO,�f J a y '154 11 z_ Type of Building: �DwellingNo.of Bedrooms 3 Lot Size sq.ft. Garbage GrinderType of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date rS Number of sheets Revision Date Title -o_J •G - eei d� / 1>Lent Size of Septic Tank /,:�F-06 &A-//or/,g Type of S.A.S. y Description of Soil �� 9 ' L�A�L�/ �/fc/i� 01,4 9—a2 5/ ' L evyi2�K _::E�A6P 3 G -/ f)'' ��/J✓� T.4.�1� Nature of Repairs or Alterations(Answer when applicable) SUPERVISEDESIGNING ENGINEER MUST INSTALLNfION AND CERIIFY IN WRITING Date last inspected: THE SYSTEM WAS INSTALLED IN STRICT Agreement: ACCORDA.":^,E TO PLAN. 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 place the system in operation until a Certifi- cate of Compliance has been issue 2^is Board of Hea Signed Date �� Application Approved by - Date 3 Application Disapproved for Me following reasons Permit No. 2 U U f 3 g -7 Date Issued 2 CA�- �.No. E.° '4 ,a / Fee ep DO. ..... vd "d"` w Entered'in computer: t THE COMMONWEALTH OF MASSACHUSETTS Ye + V; 1k PUBLIC HEALTH DIVISION -TOWN OF-BARNSTABLE, MASSACHUSETTS.. . ' Zo lication for Migpogar *pgtem Congtruction Permit r... �-�—�,kpplication for a Permit to Construct( Repair Upgrade Abandon . ❑Complete System ❑Individual Components Location Address or Lot No. �,�':(J,�/j-�T Owner's Name,Address and Tel.No. �y9 ,sa�-�Erdr�s Po �3px Assessor's Ma /Parcel —i'' CQY��e�V 1'e M R 0d 3a Installer's Name Address,and Tel.No. S0-8 77/'7016 Designers Name,Address and Tel.No.,TOf �f'VO-PS-O- - Y a -1t D A emeaA 4s. , Type of Building: , - _ Dwelling 'No.of Bedrooms Lot Size Tw sq.ft. Garbage Grinder( ) ✓' O er Type of Building T No.of Persons Showers( ) Cafeteria( ) .' Other Fixtures"`- ! } �! -,5 c�c� 1 f f' Design Flow gallons per day. Calculated daily flow gallons. Plan Date / o?'7/.J 1366 Number of sheets Revision Date 61 Title d 1-' Apt/ 4E /Ak 7 •e Size of SepticTank /,SOd 6A//01./.3 Type of S.A.S. '. Description of Soil U- Z 1AM d -: iWAAD 01A 17 S� �del il?�! SA,✓A i G -Z&2 n:�� i✓� Barra �.:. � R �. Nature of Repairs or Alterations P (Answer,when applicable) �«.� �®Jc%��J2�1�-/%on/ Date last inspected: 71. 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 place the system in operation until a Certify- cate of Compliance has been issuer b. nis Board of Hea y Signed Gam. ,e�....w-' '_.. Date 5✓:� -: Application Approved by• e. - Date r IJJ. Application Disapproved for t e following reasons Permit No. 2 UU/ ' 3 g '7 Date Issued 2 d�- r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS k Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(✓ )Repaired ( )Upgraded( ) Abandoned( )by A-zu; fJ, re e. .�X(U 11A hi5n/ at IJWl;� - ,/9.� P / Sl �f.t� ( /t / i,//S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a UU J- T h '7 dated-4/21 U Installer Designer The issuance of this permit shall not be construed as a guarantee that the system:will function as designed. Date Inspector --------------------------------------- Fee00/ J. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5 pogat *p! tem Congtruction Permit Permission is hereby granted to Construct X)Repair( )Upgrade( )Abandon(-de )-/ System located at deli;/� � }/F.S W 10 /V9 aAW_31.QA1S 0J i/zs 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 thl err�it. Date: 3 -°z�' G Approved by �, .ti✓ j TOWN OF BARNSTABLE LOCATION 4�SEWAGE # 900/-3 97 VILLAGE *llk3 ASSESSOR'S MAP & LOT -78 INSTALLER'S NAME &PHONE NO. ASSu�A��c� �xC✓✓Aan 77� "�`�'�' SEPTIC TAN`; CAPACITY / o LEACHING FACILITY: (type) (size) NO. OF BEDROOMS' 00 BUILDER OR OWNER / ,I 2 COMPLIANCE DATE: PERMIT DATE: l y v 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 ��a 3 a � hn� %r2nGl[S L.eAc v0 BI-qo' Across S�n22. a r' 13L-s3', t33 ;s, 7 S? ' 67 ' 87- 63' b�� y- 7d` v TOWN OF BA.RNSTABLE � L(XAT10N le,4 / On 3 - d > : EWAGE # VII.LAGE A lr5 011,I(4 ASSESSOR'S MAP & LOT -7 K— INSTALLER'S NAME& PHONE,NO. 1q55Lj A,?cce Z—tC.4v,9L, SEPTIC TANK CAPACITY /SOO n LEACHING FACILITY: (type) CC(,rr sad-Fes'��er (size) NO. OF BEDROOMS ' BUILDER OR OWNER N PERMIT DATE: I2 ti I u 2 COMPLIANCE DATE: 7 l h v 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 i i o� ICA (— C J r� p b y v t• A r -ao; 8�-40' pq 5 5 5 al 132,-33', A3- a3' 133_3S, r3N-ad-' AS_aa 66- SS' 87- 63', �I 9 r3 S- b 3 6 S- 762' No. v Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppfication for �Digozar 6potem Construction Permit Application for a Permit to Construct(/Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or ��U/� �yg /}�(�/-rjTO/f S mr//S owner's Name,Address and Tel.No. I/am Flom fea/fy 7rrt.sf'��-7�i 39/9 Assessor's Map/Parcel 7 G/f 9 %,n f- t� O (.t �J P 0.60 /aay atM4 InA Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Car/ ( 1les raj Tr. 50k-59'0-343_3 8,55 .�J_yn , -17rC 5.0E-5116 615-7 Palmer A✓e . Fa lmDaA In A 16 V f4,AannN 4 ee,$a+ef&- Fa/m oll-fAt /i1 R( Type of Building: Dwellin No.of Bedrooms_ Lot Size yj 5bysq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily now 3 9,2 S gallons. Plan Date Z (5 Number of sheets Revision Date Title P/o 'PlanPr ical a S trt Size of Septic Tank +Cc/ o n S Type of S.A.S. reSS d re' A Is li-#_ " Atoll Description of Soil " L O 1- 0-amV sand 06 - /1?0 "i din sand e a, Nature of Repairs or Alterations(Answer when applicable) N�P_&) Cnn S rcc C �o st � lr FN(31N1r_71 PAJTT SUPERVISE 11 INSTALLI IN WRITINU THEE Date last inspected: ACM-1— 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 place the operation until a Certifi- cate of Compliance has been i u y th' Board of Health Signed Date v Application Approved by Date Application Disapproved or the ollowing reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System CjyTMWWENRIt " tISE AG ) Abandoned( )by INSTALLATION AN C TRlCT at I N A _ r'�. �i� THE S as structeo in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. " ated G 1 aO I p ) Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector = .: No. ,*^ t Fee Entered in computer: r THE COMMONWEALTH OF'MASSACHUSETTS p r - Yes °r^ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for �Di5pogal *pgtem Construction Permit Application for a Permit to Construct(/Repair( )Upgrade( )Abandon( ) 14 Complete System ❑Individual Components Location Address or1. Route- /1/9 4ar510/7SM,%1S Owner's Name,Address and Tel.No. �`f/am h�o� ��a/fy 7'rust'S�-7�i 39/9 Assessor's Map/Parcel n f 1 ,q o, OX iaa y amus 1n Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. earl eavos.SR., Tr. 50S -5Y0-3933 855 50.s�-55/6 -f805' a57 Pa llrer A✓e .1, Fa lmogA I M A l6V 61a artne 4ffB9+P,r ed. Fa Imoa- M q Type of Building:'` Dwellin No.of Bedrooms Lot Size t/y, 56ysq. ft. Garbage Grinder( ) r P Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures 338 2S Design Flow gallons per day. Calculated daily flow gallons. Plan Date 1 o 71a o Number of sheets Revision Date ' �/��[�� Title R/o f /, Pr u 44 t S a rn Size of Septic Tank a/�o n.S Type of S.A.S. rP_S Description of Soil — C O -.7 00 M V SO nd 2 V` !o '� L m a a � t Nature of Repairs or Alterations(Answer when applicable) Nei ) Date last inspected: 5. 41-- 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 place the s . operation until a Certifi- cate of Compliance has been i u y t 's Board of Health , Signed Date1OX1,71,01 - ` � v Application Approved by Date r - Application Disapproved or the ollowing reasons Permit No. Date Issued ----------------------------L-- -- — THE COMMONWEALTH OF MASSACHUSETTS o BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned( )by at N T' P �� M. �L i, S has been x tructeo in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "" ated 61 D C Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector L , F ---- No. �—�9-------------------------- -- Fee-- �� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po0ar *p5tem Construction Permit Permission is hereby granted to Construct( 34 Repair( :)-Upgrade( )Abandon( ) System located at T � G� ,r� i\ T'��.W - �1 vW l�� _4 e�.W.il^C��. ♦ dl % ' v, y1F�..,� y 'I t11 and as described m the a1ove ppltcationosal ystem_ �'Cnstr�(y�n r i hcan recognizes,his/her duty to comply withTitle S n3d` '' S Gftt `local pr"ovzc,�i c ar�g aL¢ol?d�t � � ' Provided:Construction must be completed within three years of the date oft 's p* t. �� Date: 1-888-450-OMNI (508)548-0343 ChF/C'L'- CAPE COD,:VASS HANUFACTUR/NC—CAPE COD.MASS. 11.0.Box 128 Fahuoulh Technology Park'-@Acne Precast 465 East Falmouth llightrc9' .520 Thomas B.Landers Road East Falmouth,.WA 02536 OMNI East Fahnoulh,MA 02536 Envirionmental"�) env" Inc.. Property Owner:—Rayside Building, Inc. Property Location: Unit 5, Herring Run, Route 149 Address: P.U. Box 95 Town: Marston Mills Property Phone: N/a City,State zip: Centerville, MA 02632 Alternate Phoneme 508 771-1040 5rw � -_t ��. ..q"*i^�' , '• �,� � '��.:iX � � ?,L.,,A �' ,i�z'r�'. �w R� "✓s,�k a�,r,�'E;;,�i��,`n,''x` 4� ti Start Date: 9/18/2002 End Date: 9/18/2003 Terms: $350.00 Terms and Agreement for Standard and Preventative Maintenance OMNI 2000 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)Year(s). 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 locations not within a 20 mile radius of East Falmouth. In consideration of the services contained in this agrrement 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 effect 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. T. Please Print Name 11/t;h)Z Autho 0;qnat�ure ate Land Ovnlner's Signature Date OMNI Environmental Systems, Inc. 1-888-450-OMNI (508)548-6424" OFFICE P.O. Box 128 OMNI MANUFACTURING 465 East Falmouth Highway Falmouth Technology Park East Falmouth, MA 02536 Envirotini(11nta Systems,..In..C. East Falmouth, MA 02536 September 19, 2002 Attn: David Stanton Barnstable Health Department 200 Main Street Hyannis, MA 02601 RE: ROUTE 149, LOT 18, UNIT 5 — BARNSTABLE, MA Dear Mr. Stanton: The OMNI 2000 Recirculating Sand Filter at the above referenced address has been installed and is operating in accordance with the engineers design plan. It has a maintenance agreement in place and will be maintained as outlined in the attached "Maintenance Agreement". If you have any further questions don't hesitate to contact us. Sincerely, Matthew C. Costa CC: John Bowes, Bayside Building, Inc. I D.E.P.Certified Wastewater Operators Recirculating Sand Filters Manufacturing • Testing • Maintenance • Installations •1 I _ •0eI I J� V.- I PhTWAC M•-.O IOTt►ITT I . 608•4]{•e191 i ! r � i I' ..`"i. �awe\v w wvw KuTTnK Cvt0111 - �\'NIfj1 Prate T[nNtorl :1e{I9flS • 1. 'f--1,1 u tr + p[CK ._ _� i - s u.uL. �r..,•aw smlt I _ ,:e• ,.o ! .Nrrtr,nw• -9om,.IPttn. 'p __ FRONT.... - ." FRONT ELEVATION _. OO:fIRbT t'l R PLAN _ 3 ' � � � rnumm•'r 9rrm.at urauo 9y oco r mr.n,ry 9 N N unary pr9mmu i •• _ _ LI ...__._..._...L. Yo:e' ._.:.. a:o �•'Yee.Iri.wa.....� -- -- e 9 ' n 0 r ...r ultrT7TI .... ..-._._..-..... -r g t t. .:. —'--IfF]-Et7VhTQ7a r` ... _ r I{ .I C Lr.V.r•M cone. ry � .... i � j w<�o eole.nuso wY'IfYOA '. n I 508-428.0191 - I .rayYwccmi. evlin ILIAI Iml I i ®ustom I :...:.. (Assigns r I � ..:iC ]nHi:AMXN<Y �{1�Y-� Aopy'ly„IrO 11f1 r. r e.YYla� eu rw•.e- �__�-_. '4rai6410fSel:_._��_� . r i - �FOUNDATION'Pl4N ... '' � • .. .. 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SCR,r1,4 rP ee 1-088.450-OMNJ `I (808)548-0343 01FIF)CE- C4117COAdMY, 11µ� dfdA'(1('i!C%�Jlil�►'ri�at"ci1F►b�aTJr A/AYS,• P.Q,Da,r 128 f 10 1�,:�:T 1i41A1nraulJ►?uuJlgalr3l�,A4�rkr tAIN►+d F,mear 4GS�:!{1!I JIQJNlONI!!l�r��l11�Se �i V 1�IOtlIQ!�.i•FIIl�fnl•Rind &XI!'ahnrMA,"A 07536 OM„],'IdA111F Apt Forrnarrrh,AfA 42_536', l=�z�rit't�n�arc+�rfitf'-�1sf��r,�,Inc. __ •,-:�q � r r ,1N��1�+`��►H�4 {?-N�1:.,lI fj<►I�I�tIU;illlfip{{11!�j�l;�"r�1lj�jrihr:t ��'.I?IIli,1,l?� °Itrr;:l�f��:�lku,l�ltl�,lllf��Fll1�f�,�t9�s�hl�llilll 'lh.i.i�LAw lt.A.Mdi.1L....b'dR1, �""I i'�, �„ _,,;.y.. F9l;4^',.^ ;5;"•,"' Proportq Brian T. Dacey PropaRy Lot is—unit 6 w Route 149 Owner: Lonallon: Add101W p, O: BOX 9,5 Town: Barnstable Properly Phana: N t A CRY. Centerville, MA 02632 Alternate Phone; N/A StAim Zip .!,,;,1 •,k.�rh ti114db�11a sit"' 11/15102 Rnd 11/15/03 Par,,.„. " $0.00 Total Cost Date: data; Inddenl ' I Terms And Agrapment for Effluent Testing OMNI 2000 Recirculating Sand Filter You are hereby authorized to render Effluent Testing for the OMNI 2000 lReeirculating Sand Pllter 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,Irtc.With 30 days written notice of Intent to extend, OMNI will provide the landowner with notice of it's aurrentpricing � schedule should the landowner elect to extend this agreement. This agreement consists of bl-annual testing for:Total Suspended Solids(P-PA 160.2), Total Nltrogen (EPA 350.1-351.4),Total Phosphorous(EPA 365,1)and Biochemical Oxygen i3emand EPA(405,1), All testing shall be performed by a laboratory certlfled by the Commonwealth of Massachusetts. OMNI Environmental Systems, Inc. shall provide the landowner and local approving authority with test results, In consideration of the service&contained In this agreement we agree to pay OMNI lnvironmental Systems,Inc,the sum of$300,00 per Incident, Payment Is due 10 days froln 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 plart:y and is nelthor non-cancelable nor non-refundable, Please Print Name Ate a e 8rgnaI.ure to Land Ownaes Signature Gate p N� Aviro+2manf4l Syrtcma,fn0, , J !j I _ a ! SEWAGE SYSTEM & OMNI 2000 - RECIRCULATING SAND �. 'ILTER PROI-�'. LE & DETAILS NOT TO SCALE I s 5 4 3 2 NOTE: RISERS AND COVERS TO WITHIN 6" OF FINISH GRADE i ! TOP FOUNDATION=70.0 6" PINE BARK MULCH OMNI 2000 i RE-CIRCULATING SAND FILTER 2 MODULES REQUIRED I' FILTER FABRIC COVER (NO SUBST TUTION) 00 � FINISH GRADE..=69.3 AIRATION HOODS II s 8 Il ,� (3) COVERS TO GRADE F.FL.=71.07 1.5" PRESSURIZED LINE 40 SEPTIC - 3" PVC RETURN LINE 6 .25 TOP OF I � EFFLUENT FILTER &' TANK- 69:15 c' i GAS BAFFLE RECIRC. Acme Precast Model PL122 R.S.F. 1� FINISH GRADE 68.8 TANK= 69.2 SLOpr 2, ilf y.` R.S F. G AC FLOW .: '' 3„ N 65.7 - - PEASTONE KEY MAP 10" SPLITTER .PCV COVER TO GRADE HOUSE #� �' INV. 65.5 14 65.25 . - 66.07 t7� 1 ff_60' _ 1,--1/2" Pvci I' 11- . G •A "19 3" 4 0 GAS 64.92 I -0. . . . . 'a , , • LIQUID BAFFLE r �AC ''65.8 { ' , •`!: •. ed q LEVEL pc - t d 24 HR. RES. d b. 4 _ "HIGH WATER ALARM" �;UMP ON ,•• . ••" <r, I - . •` 3,�4a TQ 1-1/2 •.CRUSHEl7;. • 64.75 o co I WASHED'STONE a 1 : r 1500 GALLON SEPTIC TANK . Y d . -•�_ LOW WATER SHUT OFF FUMP OFF 1 a• . SET LE "OMNI » _ TT-, . vEL-�'rJ 1000 GALLON OM N 12000 � !; ' 'T`=-`�---;i ��-,I -- 'I -i i{_ T T - • -I-T' EFFLUENT FILTER RECIRCULATION TANK 63.8m OMNI 2000 PUMP CHAMBER BOTTOM By. "Zoeller" (NO SUBSTITUTION) '_ - SOIL ABSO PTION SYSTEM » r ,� 250 GAL.PUMP CHAMBER BY-PASS ORIF DESIGNED BY BSS DESIGN „ NOTE: TIMER AND EVENT' COUNTER CHECK VALVE SHOULD EE MONITORED FROM 2/30' LONG, 1 .00" DIA. PVC LATERALS DESIGN SPECIFICATIONS CONTROL PANEL „ EACH WITH TEN 1 /4 DIA. HOLES SPACED 3' O.C. ALONG PIPE INVERT. Sand Filter Media . . . . . . . . . . 24 min. depth <1% #200 sieve, 2mm to 4mm size jl , > AVERAGE DAILY FLOW . . . . . 55 gpd/per` person/per bedroom TRENCH IS 65 LONG, 2.7 WIDE WITH Wastewater strength-BOD5 230 mg/liter/residential DESIGN CRITERIA ( 2' EFFECTIVE DEPTH. Re-Circulation Ratio . . . . . . . . • 4: 1 NUMBER OF BEDROOMS 3 Re-Circulation Tank Size . . . . . . 150% of design flow (Use a 10C'0 gal. tank) , PERSONS PER BEDROOM 2 _ / Sand Filter Loading Rate(Residential) Loading Rate(gpd/sf)=1150/,BOD5=5` gpd/sf DAILY FLOW PER PERSON 55 TOTAL DAILY FLOW 330 � • s- 3<99.4 Sand Filter Surface Area SA=Flow gpd/Loading Rate gpd/ft2 LEACHING AREA REQUIRED 445.9 sq, ft.(330 gal. © O 74 gal./s.f.) SOIL EVALUATOR'S LOG w 8 330 gpd/5 .,gpd/sf = 66 S.F. REQ. (69.3 S.F. PROVIDED) LEACHING AREA PROVIDED 446.3 sc. ft. Depth from Soil soil Soil Soil Other 330.26 p 446.3 0.74 I Surface Hor. Texture Color Mott. Relative p LEACHING CAPACITY PROVIDED _�9• •d• C )( ) .i (Inches) (USDA) (Munsel) Factors � � 6$/ ROA'FiQTY Re-Circulation pump Size'-. �. _ . [330 + (4x330)] x ,103% = 1,F>50 gpd.... CALCULATIONS �, 69.0 DEEP OBSERVATION HOLE #3A 68.75 gal min. cycle -- 9 _ ,. [g"4n y...,. 3-,f; •x .A:.nW.e•i �a`,..r' 5� .-. �f _�«/li-t f Cr�." I..+:1.P /Jv a ls. sue' �2 TH 1 T i,� i L/S. t Co : ��..• ��.yv, .A�u rr t BG� TOM , OA i �.i > v� x, � 7 _. I i .may, ,n r n A �� 7 � co 2 MNI RSF MODULES M ASSESS LOT 24-9 o� �, Sand Filter Setbacks . . . . . . . Some as Title V septic tank SIi7EWALL a- p ry n/f JOSEPH P. FELLOWS ; I BONNIE B. HAYDEN 135.4 If x 2' x 0.74 - 200,39 d. I 1500 GAL: SEPTIC TANK DEED BK 8354 PG 209 g p j 67.0 24"-36 C1 L/S AND GRAVEL o '�,. 330.26 g.p.d./0.74 446.3 s.f. CI �� s9 ryo GENERAL NOTES I! 66.0 » 36 -120 C2 F/S 6 \ p GAP 1. ALL ELEVATIONS SHOWN ARE I N Opo000 o Xs90 sa ASSUMED. I 59.0 pR pR �X 9•e 6 • ECK 2. ALL PIPES IN THE SYSTEM TO BE '' 0 3 g�0�5E 69• �O f FEMALE CAST IRON OR SCHEDULE 40 P.V.C. ! 62.0 DEEP OBSERVATION HOLE #E-2 66 ADAPTER „ » C0� �° �� w/PLUG 3. REMOVE ALL UNSUITABLE MATERIAL 0 -6 OA S/L i O �' , \ a BENEATH THE INVERT ELEVATION W i RECIR TANK c� PROP 1 7S 10.0 a I2_ FOR A RADIUS OF 5 AS PER 310CMR 15.255(5) 6"-24" B L/S q h 3 BEoosEo AND BACKFILL W/ CLEAN COARSE h'oUs�Ma9.ao 04RgGE �,� 45" BEND GRANULAR MATERIAL. ! I 60.0 » » v� g l 24 -144 C M/S P� } < ��o 4. ALL BACKFILL SHALL BE CLEAN SW PUMP COARSE GRANULAR MATERIAL FREE 1 9.4 69.2X j `" 69oX 45' BEND FROM DEBRIS & LARGE STONES. �A6. v iL 1 5. CHRISTOPHER COSTA & Assoc. � '`�P�cNOF444 I ,. s9.a 4" PIPE cP I I NOTE: MUST BE NOTIFIED WHEN THE 50.0 Z W SLEEVE THIS Pl�f; LINE g• m N ,Q,Qo CLEAN-OUT SYSTEM IS INSTALLED PRIOR TO N. DoucLAS s . ao FOR 10' ON EAGi SIDE I. o �' ";� " `�BFpos�`'° uNNECTION DL_I L BACKFILLING FOR INSPECTION. (o SC�b�flER `�, I PERCOLATION RATE _ <5 MIN./INCH r' 69 -o ,r 'S'o '�'°o No. 3854r " I DEPTH TO GROUNDWATER = NONE ENCOUNTERED }- v� F�F s'F 6. UNLESS OTHERWISE NOTED ALL OBSERVATIONS BY: OF THE WATER MAIN P� el si NOT TO SCALE E 0 �n xe4.3 v 66 I °p �c �� ED BARRY J � 6 SYSTEM COMPONENTS SHAD BE a, -:c /sT�� '' 65.OX INSTALLED IN ACCORDANCE WITH �' �SS�ONAL i TAKEN BY: LAWRENCE PERRY MASSACHUSETTS TITLE V SANITARY X 6g. / a ( :e►. 7 22 99 _ c,, CURB LrJ CB FND 7P a9.as ti 3q srop / �`` .,�` SEWER CODE AND LOCAL RULtS ,4, ,-'r`, I DATE TESTED. / / WHICH MAY BE APPLICABLE IN A I 69y 0 w ae ' 0� c� �� .� e WORKMAN-LIKE MANNER. I 0 2 -2 �, >> 7. THIS LOT IS NOT IN THE FLOOD PLAIN. 0 •� 69k �� NOTE TO INSTALLERS h 8. A GARBAGE GRINDER WILL NOT BE Ap INSTALLED ON THE SYSTEM. i 9. NO CHANGES SHALL BE MADE TO THIS PLAN YOU MUST BE AN OMNI ENVIRONMENTAL SYSTEMS CERTIFIED INSTALLER. YOU CAN BECOME CERTIFIED WITHOUT PRIOR APPROVAL FROM CHRISTOPHER COSTA & Assoc. v� p� EAa , rw AT THE TIME OF INSTALLATION. PLEASE CONTACT 10. DIG-SAFE SHALL BE NOTIFIED FOR THE .PROPER ROPE / ` , OMNI AT 1 -888-450-OMNI FOR DETAILS ! APPLICANT: BAYSIDE BUILDING CO. INC. CB FND RTY UN ENO ; /� E �rS a4.a o LOCATION OF EXISTING UTILITIES PRIOR TO ANY 46•p1' Y EXCAVATION. 'P�- of ss { PROPOSED DWELLING LOCATION r� 36 W � 9� �I �9.60f ►)�'' e 11. OMNI 2000 PRODUCTS AVAILABLE THROUGH CHRISTOPHERyG �- l r' OMNI. ENVIRONMENTAL SYSTEMS AT 1-888-450-OMN1 PROPOSED SEWAGE SYSTEM LOCATION 11 Z J. CB FN :. ., 12. OMNI, 2000 CONTROL PANEL TO BE LOCATED J o COSTA a2.a 6ti INSIDE DWELLING IN A VISIBLE & AUDIBLE LOCATION. f 31305 �I 00 14. ONLY OMNI 2000 810-FILTER COMPONENTS /U /V O .� S v LOT 18 UNIT 5 ROUTE 1 �-- NO SUBSTITUTIONS _ o REVISIONS �I BARNSTABLE (MARSTONS MILLS), MASSACHUSETTS Lil PLAN VIEW SCALE: AS NOTED DATE: 4/9/02 ~ I SCALE: 1"= 20' a LEGEND CERTIFIED PLOT PLAN & 7OPOGRAP��' Y i DRAWN BY: JAB CHECKED BY: C.C. JOB NO.: ry PROP. cP01" ELEV. = X60.5 » » r DONE QY. CHRISTOPH�'R COSTA & / POT ELEV. - X56.04 The site is situated in Flood Zone C assoc. PROP. CONTOUR = ++'ir/�46 BSS DESIGN 1 4/23/02 Change System Lccation 'JAB P.O. BOX 128/465 E. FALMOUTH HWY. EXIST. CONTOUR = ._.. - -'-46 ASSESSORS MAP #78 LOT 18 No. DATE DE'SCRIP41:ow eY EAST FALMOUTH, MASSACHUSETTS i