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Home My WebLink About4360 MAIN ST./RTE 6A(BARN.) - Health (2) 4360 Main Street/Route 6A, Barnstable :Y A= 351 - 040 x i e } i ti } r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION REPORT Date. :TN IJLL4AY Z8,l of I /M,. W .rrlRr6_1' Property address: 4360 FaQli�; &A Ct, ,4,-tAQiAtO� E+ lif- 4S5. Maw Inspector: Tristram Weller PART A CERTIFICATION CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Signed: ?M' G Date: I=Ze--y6 INSPECTION SUMMARY: A] SYSTEM PASSES I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. The septic tank is metal,cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled,or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four(4)times a year due to broken or obstructed pipe(s). The system will pass if(with the approval of the Board of Health): broken pipe(s)are replaced obstruction is removed f Cl 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 the public health, safety,and the enviroment. SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIROMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIROMENT: The system has a septic tank and soil absorption system and is within 100 feet of a surface water supply or a tributary to a surface water supply The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volitale organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitro- gen is equal to or less than 5 ppm D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an 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 1/2 day flow 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 soil absorption system, cesspool,or privy is below the high ground- water elevation Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to surface water supply Any portion of a cesspool or privy is within a Zone I 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. c. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the enviroment because one or more of the following conditions exist: 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 nitogen sensitve area(Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. PART B CHECKLIST _ (L Pumping information was requested of the owner, occupant, or Board of Health X None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of the inspection 4 _00o5c t S w3o GCj?ke:O S��cc q-21E-17 As-built plans have been obtained and examined The facility or dwelling was inspected for signs of sewage back-up The system does not receive non-sanitary or industrial waste flow >L The site was inspected for signs of breakout All system components,excluding the soil absorption system, have been located on the site The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees, material of construction,dimensions, depth of liquid, depth of sludge,and depth of scum The size and location of the soil absorption system on the site has been determined based on existing information or approximated by non-intrusive methods X The facility owner and/or occupants were provided with the information on the proper maintenance of subsurface sewage disposal systems C T PART C SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL: Design flow: 440 4 ✓� Number of bedrooms: Number of current residents: O Garbage grinder: No Laundry: YcS Seasonal use: go Water meter readings: Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Design flow: Grease trap: Industrial Waste Holding Tank: Non-sanitary waste discharged: Water meter readings: Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS: Last pumped: tyE,/e 2--8G� Source of information: T,a1--i R.Eca s System pumped as part of inspection: Wc;, Volume pumped: Reason for pumping: TYPE OF SYSTEM: Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system Other Date installed: g- Source of information:-obi tzEcotz,oS Sewage odor detected: flip SEPTIC TANK: Depth below grade: 45 Material of construction: Dimensions:td`4;," c 4'8"x,q oK Sludge depth: 3" Top of sludge to bottom of outlet tee: 31 Scum thickness: `/Z" Top of scum to top of outlet tee: 4� Bottom of scum to bottom of outlet tee: I o" . Comments: GREASE TRAP: Depth below grade: Material of construction: Dimensions: Scum thickness: Top of scum to top of outlet tee: Bottom of scum to bottom of outlet tee: Comments: TIGHT OR HOLDING TANK: Depth below grade: Material of construction: Dimensions: Capacity: Design flow: Alarm level: Comments: DISTRIBUTION BOX: Depth of liquid level above outlet invert: O Comments: TI,Sjt'aBd<<z,,3 � lS �/�L lNaTc �ci IF'� PUMP CHAMBER: Pumps in working order: Comments: r SOIL ABSORPTION SYSTEM: Type of system: (5) t apgvpToCZ Comments: 1.0 WiCx-.-Puy Cf +r or2 LIU* ACZ-C� CESSPOOLS: 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: Comments: PRIVY: Materials of construction: Depth of solids: Comments: SKETCH OF SEWAGE DISPOSAL SYSTEM: 1?5C 174-Zoo I F god( DEPTH TO GROUNDWATER Depth: 00 Vkr Method of determination: Te:%T �6uz�F- TOWN OF BARNSTABLE '® LOCATION � ��R LQI� " • SEWAGE # C1gQ0D-- VILLAGE 120y Al y4 12121 ED ASSESSOR'S MAP & LOTY 4 Y` -` e E INSTALLER'S NAME & PHONE NO. ktiA T L 3� S pa SEPTIC TANK CAPACITY LEACHING FACILITYA ype) N � 2s (size) 5-Catt/I X NO. OF BEDROOMS PRIVATE WELL OR PUBLIC .R OR OWNER DATE PERMIT ISSUED: q DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes _f No - t 7 C o \f� s .