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Home My WebLink About0153 SCUDDER'S LANE - Health 153 Scuddertane�i-w Barnstable P A = 258 060 f ' R 4 3 TOWN OF BARNSTABLE ` i4.,,C�'-'ATION �S3 S CV GI ANL SEWAGE # '�.LAGE 6A&i4�AUL ASSESSOR'S MAP & LOTo1-5?' (0 vSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) oZ' P' /-s 6'X 6 (size) low WO. OF BEDROOMS f / BUILDER OR OWNER UI PERMITDATE: 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) l / Feet Furnished by —��SOcu'ria, T �iC y//10.r ��. '_ � A iron' �` y a �� A � 0 � a� �g .. � _ 3 aS3ay 3 �3 `��` '� y �° y� r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS . DEPARTMENT OF ENVIRONMENTAL PROTECFC�P '2Z 02 • x �.. �!I'�i510�1 TITLE S OFFICIAL INSPECTION FORM,=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:. 153-Scudder Lane Barnstable, MA 02630 Owner's Name: Neil Ringler Owner's Address: Date of Inspection: April], 2005 _ Name of Inspector: (Please Print) James M. Ford Company Name: James M.Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and thafthe 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: • r Passes r 'Conditionally Passes Needs Further Evaluation by the Local Approving Authority Y, Fails Inspector's Signature: Date: A `rd 9 2005 The system inspector.sh\subm4� copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the_system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ' ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in,the future under the'same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 ' OFFICIAL INSPECTION'FORM'-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A " y•} CERTIFICATION`(cohtinued) Property Address: 153 Scudder Lane - Barnyable. MA ' Owner: Neil Rinzler Date of Inspection: April 1. 2005 . Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D , A. System Passes: I have no t fo und 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. Answer,yes,no or not determined(Y,N,ND)in the for the following statements. If"not detennined",please explain. The septic tank is metal and over 20 years old* or the septic.tank(whether metal for 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. ND explain: 3 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 obstruction is removed ; �t distribution.box is leveled,or replaced ND explain: r 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 obstruction is removed ND explain: • 2 .. y Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A t -CERTIFICATION (continued)e Property Address: 153 Scudder Lane : Barnstable. MA Owner: Neil Rineler Date of Inspection:. April 1. 2005- - 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 2. System will fail unless the Board of Health(andPublic Water.Supplier,Jif any)`determines that the system is functioning in a manner that protects the public health,safety and environment: The system hw a septic tank and soil absorption system(SAS)and the SAS is within'l00 feet of'a surface water'supply or tributary to a surface water supply. The�system has a septic'taink 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 thewell water analysis,'performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from'pollution from that facility and the presence of ammonia nitrogen aqd 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: t, 3 Page 4 of 11 - OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION FORM PART A ;CERTIFICATION (continued)' Property Address: 153 Scudder Lane Barnstable, MA Owner: Neil"Ringler Date of Inspection: April 1,�2005 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: 17 Yes No y ✓ Backup of sewage into facility or system component due to overloaded'or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground'or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert-due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than 'h 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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] No (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes'.'or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above). 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B _ CHECKLIST,` - Property Address: ::-153 Scudder Lane' 4 Barnstable, MAa rr Owner: Neil RinQler Date of Inspection: April-1;'2005 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? v _ Were as built plans of the system obtained and examined?(If they.were not available note as N/A) - ✓ ''` Was the facility or dwellm 'inspected for signs of sewage back up? ' i = Was the site inspected,for'signs of break out? _ A ✓ Were all system components,,excluding the SAS;located on.site y ✓` Were the septic tank manholes uncover4d 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 s6n '? 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 locatiowof&Soil Absorption System(SAS)on-the site has been determined based_ on • Yes No, u -y ✓ — Existing information.-For example,a plan at the Board of•Health. _ Determined in{.the field(if any of the failure criteriarelated to Part C,is at issue approximation of distance is unacceptable)[310 C1VIR 15302(3)(b)]. 5 } R Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C �. SYSTEM INFORMATION Property Address: 153 Scudder Lane Barnstable, MA Owner: Neil Ringler ` Date of Inspection: April 1, 2005 - FLOW,CONDITIONS` . RESIDENTIAL Number of bedrooms(design): 4 Number of,bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: I10 gpd x#of bedrooms): 440 Number of current residents: 2 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No - Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or.no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203):i epd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe). ,:GENERAL;INFORMATION Pumping Records . . ' Source of information: Pitnzped 2 vears ago-per owner Was system pumped as part of the inspection(yes or no): -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) . = Tight Tank Attach a copy of the DEP approval Other(describe): A r ximate age , pp o g of all components,date installed(if known)and source of tnformarion: Installed on 518178-per as=built card Were sewage odors detected when arriving at the site(yes or.no):, No . 6 r Page 7 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART C SYSTEM INFORMATION(continued) -Property Address:_ 153`Scudder Lane Barnstable-AM Owner: Neil Rinl;ler Date of Inspection: April 1, 2605 BUILDING SEWER(locate on site plan) Depth below grade: " Materials of construction: cast iron - 40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 12" Material of construction: ✓ concrete _metal x_fiberglass _polyethylene _other(explain) r If tank is metal list age: 'Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth:' 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness:• 2„ 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: 10 How were dimensions determined:. Measurin iz stick Commments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Cement tees were present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage GREASE TRAP: None (locate on site plan). Depth below grade: Material of construction: _concrete metal _fiberglass°_polyethylene _other (explain): r _ y Dimensions: r F Scum thickness: Distance from top of scum to top of outlet tee or baffle: dr Distance from bottom of scum to bottom of.outlet tee or.baffle: Date of last pumping: Comments(on pumping'recommendaiions,inlet and outlet tee or baffle condition,structural integrity,'•liquid levels as related to outlet invert,evidence of leakage,etc.):, - ` r Page 8 of 11 s OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSP_ECTION FORM PART C. SYSTEM INFORMATION (continued)•.. Property Address: 153 Scudder Lane Barnstable, MA Owner: _ Neil Riniler Date of Inspection: April 1. 2005 TIGHT or HOLDING TANK: None'(tank must be pumped.at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain):!, ' y Dimensions: Capacity: eallons Design Flow: gallons/day- Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Comments(note if box is level and distribution to outlets equal,any evidence bf solids carryover,'any evidence of - leakage into or out of box,etc.): The D-box was level. No solids were present. PUMP CHAMBER:• None `(locate on site plan) Pumps in working order(yes'or no): , Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 - ' Page 9 of 11 t OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM }, PART C SYSTEM INFORMATION(continued) Property Address: 153 Scudder Lane Barnstable, MA Owner: Neil Ringler 4 ' Date of Inspection: April 1,' 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type, ✓ leaching pits,number: 2-6'x 6'(1000 gal.) leaching chambers,number: leaching galleries,number: leaching trenches,number,length: 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.): 0. The pits had 3'of liquid on the'bottorn. The scum lines were approximately 4'up from the bottom There did not appear to be any signs offailure. The bottoms to grade were 7.5'. The covers were`20"below°grade CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: g Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Continents (note condition of soil,signs of hydraulic failure,level of ponding,,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL.INSPECTION FORM-NOT FOR•VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE'DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address_: 153 Scudder Lane Barnstable, MA Owner: Neil Rinzler Date of Inspection: April 1. 2005 ' SKETCH OF SEWAGE DISPOSAL;SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pei7nanent reference landmarks or benchmarks. Locate all wells within 100 feet.•Locate where public water supply enters the building.. 1proti 10 j IQ. Page 11 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued)G, Property Address: 153 Scudder Lane Barnstable, MA" Owner: Neil RinQler Date of Inspection: April 1. 2005 SITE EXAM Slope Surface water Check cellar. Shallow wells Estimated depth to ground water 25 +/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board'of Health-explain: topographic and water contours maps r Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps, the maps were showinapproxizzzately 25'+/-to ground water at this site. y This'report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees,either expressed, written or implied,relating to the system, the inspection and/or this.report. {g J - L} c ZoT '� ! (70 - rgoo { 14 �g '6 q Z r; Zn, , � E ; F 0' : _.` oaf r. .) CE I FI ED PLOT PLAN LOCATION 431k!�/ 7 A� -�: 1:��s... . . . SCALE I. . .`: 'o. . DATE PLAN REFERENCE . ..S,,5rniG. . .L,,7- I CERTIFY THAT THE t`X!S?tt�/G... ivti��3 "is?!v' r!7 SHOWN ON THIS'PLAN IS LOCATED-ON THE GROUND AS SHOWN_ HEREON AND THAT IT CONFORMS TO THE \ SETWK REQUIREMENTS OF THE TOWN OF 8.qg, 77 G4� . . . . . WHEN CONSTRUCTED. . - PETJTIONER N�iG L Rya SA2A ?� : �'/N�G�.e DATE N4 � REGIS E E` ND SUR OR: y- '^.• sr,:w;ic�.'!q,{k'k7,Y!�Sk,.Ili}{1 e'E 1 :„�,. � •to '�,+ t ,•t e a n'v4 y -,.„} _ut k, i�#'t,�`i��`�1�'.eryi€�k$ TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION OWNER AND INSTALLER INFORMATION 060 ADDRESS: r �d.V� C Cke - MAP NO. + PARCEL NO. 1� OWNER NAME: ! y�� C�,�'G�. C�.1 1 '��E_rVILLAGE: f�G1 �, r INSTALLATION DATE: i '1 BY: p6l) ADDRESS- - TANK INFORMATION LOCATION OF TANK: Ca CAPAC I TY IC TYPES e-�Ji� €�l ,FU ' CHEMICAL . TESTING CERT I F'I CATION C '? PASS 1- �FA I L D.,j TE j► s LEAK DETECTION C 7 CHECK IF N/A .P. /B AND ZONE OF CONTRIBUTION C I YES C ].'NO JlaTE_T_Q,_p_EREMO ED {FIRE DEPT. PERMIT ISSUED CVj YES E I NO DATE - CONSERVATION C CHECK IF, N/A DATE BOARD OF HEALTH.. TAG' NO. C ]C 1 C ]C ] DATE a PLEASE PROVIDE' A SKETCH SHOWING' THE -TANK LOCATION ON THE, BACK OF THIS CARD Y LO CAT ION ✓�� SEWAGE ilP`EER;JIT VILLAGE INS A LE 'S;,- NAME & ADDRESS ; —Tay art 6Cj IfU PL D E R _ OR 0 a E13 f f DATE PERMIT ISSUED DAT E C0MPLIANCE. ISSUED / .� ., - ,� :< � , j _ _ _ '� � \ � %� �� Q� 4 T o • � A. ��• TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS �rTyQD �.F NAME NQA ADDRESS VILLAGE LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL[-ZC(.Q It S�AQ, 6V vvs� p�nee� �►� WVwwv1. 1-v ms (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS