Loading...
HomeMy WebLinkAbout0055 TONELA LANE - Health 55 Tonela Lane Barnstable A = 336 019 l 5 c � Lt `<6- a cyv-� -�- c ( �C� I F , u c i1 1 8-- 1 4-0 `-7 3 4 }• r i F C i, f map v PITNEY BOWES U.�u.POSTAGE>> z, oF��E*anti Town of Barnstable •�j��Z�� p ° Public Health Division o� ARN5fABLE.e! 200 Main Street ZIP 02601 $ 006-980 MASS. 0 pfFO Mn+"0 Hyannis,MA 02601 '' ' 02 1W . 0001.38:3424 FEB. 24. 2014. 7012 ;1010 0000 2851 2019 - Or ' John and Elizabeth Mulak, TRS 55 Tonela Lane Barnstable, MA 02630 _ .. • .. �3 l .r.d':.�' �i.�:t• :.C• , a. a (y� g �y,,�g g 7 qy _ �y @�. ,p + ��,r,P �: . ..`'h ..a�:fix.,-,� iY.E:..iM1�'+'L Lida GAl3'd�-�7 iS5 .'�� 6�r 3+rp`��SB'�V KS.fJi���.��.sL�•�' e s • 4 RE'-'UK41 T1 sEi'IEER NOT irEL.1VERAEL.E AS ADi)RE:SS'E1J - - - UNABLE TO FORWARD : 23: > .3 Fl, t 'I t °I�i���!° _ L --_— �n3. .. _ .. _. __ _ .,. k ...�.,' 2�s � it _...._..�.�y � _ � � �, ,; ;� � �` �,% - - ,�, .. I � ,i r �`� _ % , � � �' / SF Town of Barnstable Barnstable Regulatory Services Department ;eftg�I Public Health Division 9b�fo�a`0 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTI.F:IED-MAIL #70 1240'1,0=00.00 2851.2019 - February 24, 2014 John and Elizabeth Mulak, TRS 55 Tonela Lane Barnstable, MA 02630 RE: Operation and Maintenance Contract for the Innovative Septic System installed at 55 Tonela Lane, Barnstable, MA in the Town of Barnstable. The Barnstable County Department of Health and Environment has informed us that the operation and maintenance contract for your innovative/alternative wastewater treatment system on October 1, 2012. To date, they have not received evidence that you have entered into a new Operation and Maintenance contract. Therefore, we are writing to instruct you that the{Massachusetts Department of Environment Protection (MA DEP) and the Town of Barnstable require you to keep an Operation and Maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at http://www.barnstablecountyhealth.or /c l� ia-systems/ia-owners-guide. The Barnstable County Department of Health and Environment oversees I/A septic system management and compliance efforts for the Board of Health in the Town of Barnstable. The Public Health Division is hereby contacting you to inform you of the above requirement and to order you to comply. Accordingly, please forward a copy of a signed contract via mail, fax or e-mail within thirty (30) days of receipt of this letter. Q:\SEPTIC\O&M Itr\55 Tonela Ln Barn 2014.doe Please be advised that if you do not respond within thirty (30) days of your receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing on April 8, 2014 to provide information relative to the required contract. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health CC:.Bar"nstable.Depar-ment-of Health and Environment - QASEPTIC\O&M Itr\55 Tonela Ln Barn 2014.doc TON N OFF BAI NSTABLE °140C TIr?N t ���� ' "TsfD� SEWAGE # �y � ILLAGE� P�illS ,�� ASSESSOR'S NL4P LOT _ INSTALLER'S NAME&PHONE NO. .�/�' i!/7P1�r��/�%C Md-36 'fV SEPTIC TANK CAPACITY '/ T !✓✓T� ��G��i LEACHING FACILITY: (type)) 1iYl�iti.��7--j�J� (size) g!? l X 7` NO. OF BEDROOMS BUILDER OR OWNER'�_1�L1 PERMI'I'DATE: p � COMPLIANCE`DATE: Separation Distance Between the: Maximum AdjustedGroundwater Table to.the Bottom of Leaching Facility Feet i Private Water Supply Well and Leaching Facility (If any we. Us 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 leac g facility) Feet Furnished by all y . �•--�. 1 I .to: �M �c M �S.ro . w c CiAizAije—: t` ' o L Yi '. c4: r v J'• ,. .. t p ® Complete items 1,2,.and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. I E ® Print your name and address on the reverse X ❑Agent so that we can return the card to you. ❑Addressee ® Attach"this card to the back of the mailpiece, B Received by(Printed Name I l or on the front if space permits. C. Date of Delivery l r I '1 Article Addressed to: D. Is delivery address different from item 1? ❑Yes 4 w. If YES,enter delivery address below- ❑No j John � d an-d'`"8izbeth Mulak,'TRS 55 Tonela Lane � S i BarnstaJae, MA 02630 3. Service Type C'�Certifffiieded❑Registered ❑Express Mail _ d ❑Return Receipt for Merchandise i ❑Insured Mail ❑C.o.D. ? !' I 12. Article Numbe— 4. Restricted Delivery?(��Fee) ❑Yes (Tiasfer from 7 12 1010 0 0 0 0 ,,2 8 51' 2 019 — ,j.PS;Fiirm 3811. February n04 _ Domestic Return R t. I r _.-_w _.:,m -ea 102595-02-M-1540:j - THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITYORIGI-NAL (S) DATA . •i `AID s • • . e i items 1,2,and 3.Also Complete A 4Sign , 3estricted Delivery Is desired. ❑Agent ~,' name and address on the reverse Addressee tom ( t-a. . e can return the card to you. B, ecei d b (Printed Name) C. Date of Delive Is card to the back of the mailpiece, 0_1 I t front if space permits. D, Is delivery address different from Rem 1? ❑Yes Tressed to: If YES,enter delivery address below: ❑No _ �O x Icy ' y ✓ .®v -4'1 �,= " GIXYYNO v4+N p,,- ( M 3: Service Type 3 a Certified Mail ❑Express Mail e h 0Z 6 O Registered ❑Return Receipt for Merchandise i ' ❑Insured Mail ❑C.O.D. ,a 2- If 4. Restricted Delivery?(Extra Feel ❑Yes - n, . iber r )m service labeo L 7012 �010 0000 2851 2774 _ } February 2004 Domestic Return Receipt +.02595-024'isao B tcel It I ,fret t 4ta6 it6 tr9 ,i� L'Ai:h • - � �-Z=��� �r Z00iy�. Er D r� •' • ONVASO,� O1 3" SVNdI) Q at.cl.r t sy ru rl t ky p a t< A Ln w sr NPostage $ Certified Fee CO C3 Re um Receipt J Fee t SDI j a (EndorsemenCRegwred) ) Restricted Delivery Fee �® 6•� O (Endorsement Required) CT C3 Total Postage&Fees q CQ 6 r\ a ru Sent To a John and Elizbeth Mulak, TRS C3 Street,Apt.No.; •--- r�- or PO Box No. 55 Tonela Lane 611 CiryState,ZrP+4 Barnstable, MA 02630 £B£1000T "° rr 109ZOdYOiuu109H ,wwoa� M6 ZO ., 09Z0 dIZ laaTlS u►EW OOZ .•a•revtsNnve . .� uoTsrAIQ TIEaH oflgnd r , ' aiqu;suaug jo ue&o1, "Mo D .� - •; N rui 4-1 Ln CO Postage $ �� ru Certified Fee Q rt t ark' a Retum Receipt Fee �- R 0 G6� rtre C3 (Endorsement Required) —� j P Restricted Delivery Fee (Endorsement Required) ,f O Total Postage&Fees 'p r=1 Sent To ruoh Eif U1'u 1la� `T -. rq ! 0 Street,Apt.No.; t2 or PO Box No. P.Q• f`- ------------------ - ----------- _. City State,ZIP+�(Y,v �^ r5�r VYl� v j u / ` r /III Cape Environmental Services Inc. 7 Stratford Lane Yarmouth Port Ma. 02675 www.alIcapeenvironmentalseryice.com Operation & Maintenance Service Contract For Singulair 960-600 DN This Contract is between John & Elizabeth Mulak (hereafter referred to as "Owner') and All Cape Environmental Inc. (hereafter referred to as "ACE") for Operation& Maintenance of the treatment system listed below (hereafter referred to as the "System") System Owner; John & Elizabeth Mulak System Address; 55 Tonela Lane Cummaquid, MA. 02630 , Permit Information; State Permit SING 57, Carmody #BATon055Sin Management Level; Remedial Contact Information, John & Elizabeth Mulak.P.O. Box 144 Yarmouth Port, MA. 02675-0144 1. Maintenance and Other Services. ACE agrees to provide the following services to Owner during the Term of this Contract; (See attached Schedule C for additional &specific service requirements related to SINGULAR system) 1.1.1aspection & Operation.ACE agrees to inspect and operate the system in accordance with Massachusetts DEP approval and manufactures requirements. Interval for inspections to be Bi-Annually 1.2 Maintenance&Service.ACE agrees to maintain system in accordance with Massachusetts DEP approval and manufactures requirements. Interval for maintenance to be Bi-Annuall (to be combined with inspections) 1.3.Field Sampling, ACE agrees to field sample effluent samples for PH, Temperature, DO, and Turbidity..All meters to be in good working order and calibrated per manufactures requirements. 1.4,Laboratory Influent&,EffluentSampling.ACE agrees to pull influent &effluent;samples for laboratory analysis from a Massachusetts Certified Laboratory, per DEP and Town Board of Health requirements No Influent Sample Interval, Effluent Sample Interval to be only if field test fails 1.5.Influent Testing for;No Influent Testing Required 1 r � x Ali Cape Environmental Services Inc. 7 Stratford Lane Yarmouth Port Ma. 02675 www.aIIcageenvironmentalservice.com 1.6.Effluent Testing for; BODs, and TSS, only if field testing does not pass 1.ZPumping of Ho/ding Tanks.ACE agrees to check scum & sludge layers. ACE will recommend when to pump tanks. Please note that all grease traps are required,to be pumped no less than N-Annually. 1.8.Emergency Service Calls ACE agrees to provide emergency service calls as provided in Section C 1.9.Warranty Service. ACE agrees to provide warranty service as provided by manufacturer and Section C 2. Payment for Services. Payment for services will be in accordance with Schedule D 3. Contract Term. The term for this contract shall start on March V'2014 and continue on an annual basis, unless the contract is terminated early as provided in Schedule C. 4. Requirement for Service & Maintenance, Advise to Agencies. Owner acknowledges that Government agencies may require the following activity; 4.1. That the above referenced treatment system requires regular service and inspections. 4.2. That a copy of this contract will be made available to government agencies by ACE. 4.3. That ACE must advise the agencies if this contract is terminated at any time regardless of the reason 5. Limits on Contract Services. Actual contract fee covers only the specific services as set forth in this Contract. Any additional services requested by Owner or required by regulatory agencies, including any additional testing services that are not specifically listed above and may be required by regulation or permit(s) to operate, will be provided at an additional cost. This Contract applies only to services relating to the treatment system itself and does not apply to any other parts of the building, wiring, or the like. 6. Care of the System by Owner or Tenant; Owner agrees to operate the system in a way consistent with DEP approval letter, Town Board of Health requirements, and Manufactures recommendations and instructions. 7. Other Parts of Contract. Attached and made part of this contract as if set forth in full here are the following; • Schedule A (describing unit location and regulatory requirements • Schedule B (operating conditions) • Schedule C (contains additional terms and conditions of"this contract) • Schedule D (schedule of fees and payment terms) • Schedule E (addendums and or other terms/conditions) SCHEDULE A— DESCRIPTION OF TECHNOLOGY& REGULATORY REQUIREMENTS Make and Model; Serial No; State Permit # Town Permit # Management Level &Testing/Inspection information (list town requirement and tests required) 2 L i All Cape Environmental Services Inc.' 7 Stratford Lane Yarmouth Port Ma. 02675 www.aI Ica peenvironmentaI service,com D6.4 Collection Costs In addition, ACE shall be entitled to recover its actual and reasonable costs incurred in collecting any such overdue amounts, including reasonable attorney's fees and court costs. SCHEDULE E —OTHER TERMS AND CONDITIONS NOT MENTIONED ABOVE THIS SERVICE CONTRACT WILL BE VALID AND BINDING WHEN OWNER AND O&M PROVIDER HAVE SIGNED IN THE APPROPRIATE PLACES BELOW, All Cape Environmental Inc: (Full Legal Name of Owner) (Full Legal Name of O&M Provider) By: (Authorized Signature) (Authorized Signature) As: As: Manager (Title of Person Signing) (Title of Person Signing) Date: Date: 3/11/2014 8 i All Cape Environmental Services Inc. 7 Stratford Lane - Yarmouth Part Ma. 02675 www.aI Ica Qeenvironmento Ise r" ire.com D6.4 Collection Costs. In addition, ACE shall be entitled to recover its actual and reasonable costs incurred in collecting any such overdue amounts, including reasonable attorney's fees and court costs. SCHEDULE E—OTHER TERMS AND CONDITIONS NOT MENTIONED ABOVE . THIS SERVICE CONTRACT WILL BE VALID AND BINDING WHEN OWNER AND O&M PROVIDER HAVE SIGNED IN THE APPROPRIATE PLACES BELOW. c 4:� VN ���. ,\,, `� All Cape Environmental Inc. (Full egad Name of Owner) (Full Legal Name of 0&M Provider) Digitally signed by%Mnsw,A,S,eaoman II / DR Cn^=WinSCon A.jtp3Gmdn if BY: 1 a,lP?o,41s,,19, •aacm (Auth 'zed Signat (Authorized Signature) I As: As: Manager (Title of Person Signing) - (Title of Person Signing) . Date: Date: 3/11/2014 8 22 7 3 2- o oat 3 75 PROPOSED SUNROOM ADDITION ��n ✓?n/M (r. ru i4�J� ,F ' ')� Betty &John Mulak 55 Tonela Lane eX�iri� �e i <<. 0A General Notes: Barnstable MA - . All construction to comply with 8th Ed. MA Building code All measurements to be veirified in field by Contractors Page l of All lumber to be SPF #2 & Better unless specified. 7/12/2017 t _ 1 : j -t \- Q,-,?j6 - 17 PROPOSED SUNROOM ADDITION Gr Betty&John Mulak 5�1 lP '��v Sip. - 55 Tonela Lane� z Barnstable MA 24'�� o C _ 1+t,vt-rc IC A"�I— Page2 of 7/12/2017 FlpvArv,-"tCW—j- � 1 4, 6 f 71,6 pS-(�Nk p -2- LV ?UWS ��e� itw�s s i f PROPOSED SUNROOM ADDITION Betty &John Mulak 55 Tonela Lane Barnstable MA Page3of� 7/12/2017 lb x a (0 CC� I 0 p , ► •+o N p a d , A!!Q a V zD aAu'� � Q Avib rwcr�owb i 1-7% b L-00 jLP1,.1— s C�-� ►/gyp= r' PROPOSED SUNROOM ADDITION Betty &John Mulak 55 Tonela Lane Barnstable MA Pagel of 7/12/2017 FOOT, tAG-c' 2500 IPSt I Y� 0? A i P. 1 e, Communication Result Report ( Feb, 28, 2018 1 :34PM ) 1 2) Date/Time ; Feb, 28, 2018 1 : 27PM File Page No. Mode Destination Pg (s) Result Not Sent -------------------------------------------------------=-------------------------------------------- 0617 Memory TX 915083622603 P. 1 OK ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang uP or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—mail size E. 6) Destination does not support IP—Fax New UA System Permit Summary Sheet Site Irdo.mafion Town:bAR-At5rA13t4-- Town Permits lei?L - msessarMspJParcet 11)3(a —6tq U-dq eTown ID6 .. Site Addmn SS Tonclo� - oemerName Sohn w A. AP--Na— lo_� ♦r_,,Nil Tru5 Hwne Phone: Maa Adttr¢ss: P-o C3oX i`t 4 wmk Phone TaA 4- yYl/ Ttle 5 lnlomtation BWMgTyPSAJ- Slrw.Tkkr;i(N{ ry,.l Design Flow. gLfo S..B vt Yes Nn❑ ummoam❑ Badmomw Tnle v USA: Yes❑ No(9, unknown❑ Lot size Non-standard components: Aerie fat a6omnponeatr eA.uA twabhem rant Pwap crember,pm-endpod egaa&au-"a6 peswre OGaMDrrbarr sA$Mient1Ner•Uvw4 9tr andmahhaenarheesdwdate foreach cmapwrenf e.g.quad rfy,2K4:wwx*etc. UA Treatment Unit ` '^4 545 ' Make and Model WC)rg err, >;nimu�nir mmrm..n. Oar a.,nr.•k Inspection Frequeney:0-fM btarxu.-i rec.6,tm.pa_�DEp Pent Type: ❑O al ens . Approval Dals:.1,h,w COC Dater it r J❑P�r�,,wwwrml Contract Entity. CA.uc FrlUlrMrw,.v,tL.�• pl edal Contract Start Date: f.onbv d 0k"Wa g i t ❑Pact . InstatlaWn Data: „/a Z Unit StwrtuP Date: 1 a i DEP Pemdl ID# InfluenVEtguent Monitoring Requirements and water Quality Limits Please bxawta wetorgua&y parameters that must be monaomdand any fawn mmrdalad wWwqua9yfwft Brm arias are stmmn,we wffi ssnme pwawW=and 910mad tenets epar CW bh the aystem's DEP appovel wd vppfy. Effluent PAO, Looy>eut y f- a..tra. w0+ ,-Jkt PN 9 aoD,9! CBM❑_ TGS 9�_ TN❑_ Nhala ET-- NdriM Orgmde N❑_.M.-w❑_ TKN❑_. . Fecel Ca6fwm IT— Teal P Organic P TOS Oi IGn—❑_ CwWwUnce� E sag Akaarhty weter ue� Temp. - Mmeaungadhaduhe men Retc,kaf' OthwAppftAIe Unit . Influent F"❑.. BOOT❑ ce00 rI TSS❑— TN❑ Nbrele Q— Nanita E— OrM*N❑— Ammmde❑_ TKN�. Fowl Coefmm Tara)P orgartlo P❑ IDS❑ Oah3 ❑_ CO��rrw IE Ak.&* Vd aw'usage❑E= Temp. Montoring Sdodida: OlherApprxeble umae: Tradnbhg 6 Entered_Entered Or._ FAX SW362 4603 r New I/A System Permit Summary Sheet Site Information Town: ®Ae-NsTA,( Town Permit# 2_CX3 2- Assessor Map/Parcel: 9536 --0k a Unique Town ID# Site Address: S5- y n� Owner Name: Altername Name: c� ,y-\ T "s t- Home Phone: Mailing Address: Work Phone: Title 5 Information Building Type/Use: ; �1i( (� � Design Flow: �,f(4 C) Seasonal: Yes ❑ No ❑ Unknown ❑ Bedrooms: Title V N.S.A.: Yes ❑ No [R, Unknown ❑ Lot Size: �o c.r-eS Non-standard components: Please list all components e.g. 1/A treatment unit, pump chamber, pre-and post equalization tanks, pressure distribution SAS, effluent filter, UV unit, etc., and maintenance schedule for each component e.g. quarterly, 2x/yr, annual, etc. C' UM Ghc.vv`b-v I/A Treatment Unit Make and Model: PCP Q��r�e..ce, Siilc,'i0'�� Inspection Frequency: O.fM bianr c't rec . bu �„ �n DEP Permit Type: ❑ General Approval Date: i , c, COC Date: ,2 0 2 ❑ Provisional Contract Entity: hI I Cga*--e. F n u i rznvy, ^IT- tSlRemedial Contract Start Date: 3 Contract Duration: 3 i ,❑ Pilot Installation Date: 1T Unit Startup Date: DEP Permit ID# J_ L_ "�- Influent/Effluent Monitoring Requirements and Water Quality Limits Please indicate water quality parameters that must be monitored and any town mandated water quality limits;if no limits are shown, we will assume parameters and effluent limits specified in the system's DEP approval will apply. Effluent + zoo y 1> Q_UCW4_1 i� r.c.+.,s �v Z:Ir-� pH BODS`� CBOD ❑ TSS TN ❑ Nitrate ❑ Nitrite ❑ Organic N ❑ Ammonia ❑ TKN Fecal Coliform ❑ Total P ❑ Organic P ❑ TDS ❑ Oil/Grease ❑ Conductance ❑ Alkalinity ❑ Water Usage ❑ Temp. ❑ Monitoring Schedule: L),.;ben Other Applicable Limits: .4-x.+ i cry Fcs Influent y3`'"^.9/'- gS_5 pH ❑ BOD5 ❑ CBOD ❑ TSS ❑ TN ❑ Nitrate ❑ Nitrite ❑ Organic N ❑ Ammonia ❑ TKN ❑ Fecal Coliform ❑ Total P ❑ Organic P ❑ TDS ❑ Oil/Grease ❑ Conductance ❑ Alkalinity ❑ Water Usage ❑ Temp. ❑ Monitoring Schedule: Other Applicable Limits: Tracking# Entered: Entered By: FAX: 508-362-2603 .I Town of Barnstable . Barnstable Regulatory. Services Department BAWM1 1 MAS&"H r Public Health Division �. 1659. 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Interim Director. FAX: 508-790-6304 Thomas A.McKean,CHO . . - CERTIFIED MAIL# 7012.1010 0000 2851 277.4 March 10, 2014 John and Elizabeth_ Mulak, TRS P.O. Box 144 Yarmouthport, MA 02675 i RE: Operation and Maintenance Contract for the Innovative Septic System. installed at 55 Tonela Lane, Barnstable, MA in the Town of Barnstable. I The Barnstable County Department of.Health and Environment has info rmed us that the operation and maintenance contract for your innovative/alternative wastewater treatment system on October 1, 2012. To date, they have not received evidence.that you have entered into a.new Operation and Maintenance contract. Therefore, we are writing to instruct you that the Massachusetts.Department of Environment Protection (MA DEP) and the Town of.Barnstable require you to keep an Operation and Maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at http://www.barnstablecountyheaIth.org/ia-systems/ia-owners-quide. The Barnstable County Department of Health and Environment oversees I/A septic system management and compliance efforts for the Board of Health in the Town of Barnstable. The Public Health Division is hereby contacting you to inform you of the above requirement and to order you to comply. Accordingly, I please forward a copy of a signed contract via mail, fax or e-mail .within thirty (30) days of receipt of this letter. Q:\SEPTIC\O&M Itr\55 Tonela Ln Barn 2014#2.doe Please be advised that if you do not respond within thirty (30) days of your receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing on April 8, 2014 to provide information relative to the.required contract. PER ORDER OF TH BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health CC: Barnstable Department of Health and Environment QASEPTIC\0&M Itr\55 Tonela Ln Bam 2014#2.doc ,y Town of Barnstable Barnstable Department Regulatory Services artment al�I . � STABM . p p b 9 r Public Health Division fD h1°�A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 2019 February 24, 2014 John and Elizabeth Mulak, TRS 55 Tonela Lane Barnstable, MA 02630 RE: Operation and Maintenance Contract for the Innovative Septic System installed at 55-Tonela Lane, Barnstable, MA in the Town of Barnstable. The Barnstable County Department of Health and Environment has informed us that the operation and maintenance contract for your innovative/alternative wastewater treatment system on October 1, 2012. .To date, they have not received evidence that you have entered into a new Operation and Maintenance contract. Therefore, we are writing to instruct you that the Massachusetts Department of Environment Protection (MA DEP) and the Town of Barnstable require you to keep an Operation and Maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide. The Barnstable County Department of Health and Environment oversees I/A septic system management and compliance efforts for the Board of Health in the Town of Barnstable. The Public Health Division is hereby contacting you to inform you of the above requirement and to order you to comply. Accordingly, please forward a copy of a signed contract via mail, fax or e-mail within thirty (30) days of receipt of this letter. Q:\SEPTIC\O&M Itr\55 Tonela Ln Bam 2014.doe • 1 Please be advised that if you do not respond within thirty (30) days of your receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing on April 8, 2014 to provide information relative to the required contract. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health CC: Barnstable Department of Health and Environment rip QASEPTIC\O&M ltr\55 Tonela Ln Bam 2014.doc 9 C�rmo yTM Service History Page 1 of 3 Property History Property Information Property ID BATon055Sin (Tracking Number) Name Mahedy, Thomas Site Address 55 Tonela Lane Cummaquid, MA Service Statistics Total Service Events (To Date) 15 Service History -All Date ReportGallons Report Type En Date Pumped Recorded By or Comments Serviced Disposal Site 10/2/2012 System No service No service event reported within service 12:00 AM Generated recorded schedule: 06/18/2012 to 10/01/2012. 10/2/2012 12:00 AM Notes: No service event was recorded by the system for this component: Aerobic (Singulair Bio-Kinetic) 8/1/2012 0 All Cape Onsite **Inspection** System Performing;no further action required 5:32 AM ------ 6/18/2012 Using: The Web 2:00 PM Site 7/1/2011 System No service No service event reported within service 12:00 AM Generated recorded schedule: 12/30/2010 to 06130/2011. 7/1/2011 12:00 AM Notes: No service event was recorded by the system for this component: Sample Report(Effluent) 4/21/2011 0 All Cape Onsite Sampling 3:31 PM ------ Report 12/30/2010 Using: The Web 4'3,0+ Site 3/9/2010 All Cape Onsite **MESSAGE** Hi Brian -Can you please check on this system 8:57 AM Came From for me. He is my realtor and he bought this 3/4/2010 Message Board house last year. I did a complete service, and we 1:00 PM pumped the tank. The system is doing well, but I need to know how many lab tests are needed if any. Prior owner did not have maintenance agreement it is listed as quarterly but that seems wrong.Thanks -Winston 3/5/2009 Siegmund **MESSAGE** Contract expired 11/1/04 with old homeowner 12:28 PM Environmental Came From Ted Meyers. 3/4/2009 Services, Inc. Message Board 2:42 PM '� http://www.carmody.biz/pump/Service_History.aspx?pmode=l&permit_id=191222&ha=10 2/12/2014 C,armb&yTM Service History Page 2 of 3 9/1/2005 "Saved Sample 54 mg/L exceeded the limit of 30 mg/L for BOD5 10:53 AM Local Regulator Message— Amount : 24.67 mg/L exceeded the limit of 19 mg/L for Total Nitrogen 9/1/2005 "Saved Sample 41 mg/L exceeded the limit of 19 mg/L for TKN 10:53 AM Local Regulator Message— Amount : 41 mg/L exceeded the limit of 19 mg/L for Total Nitrogen 7/22/2008 0 Siegmund "Inspection" Contract renewal letter sent 10/04/04. 9/03-testing 8:58 AM Environmental letter sent. Service Notice 913/07 Serviced -filter 12/17/2004 Services, Inc. overloaded w/solids. by JM 12:00 AM ------ Using: The Web Site 7/22/2008 0 Siegmund "Inspection" Contract renewal letter sent 10/04/04. 9/03-testing 8:57 AM Environmental letter sent. Service Notice 9/3/07 9/13/2004 Services, Inc. testing/inspection, Nitrate: 6.2, Nitrite: .08,TKN: 12:00 AM ------ 6.8, BOD: 13, TSS: 13, pH: 7.4 Using: The Web Site 2/28/2005 0 Local Regulator Sampling 9:08 AM ------ Report 9/4/2004 Using: Data 12:00 AM Import . 7/22/2008 0 Siegmund "Inspection`* Contract renewal letter sent 10/04/04. 9/03-testing 8:56 AM Environmental letter sent. Service Notice 0/3/07 Regular service 6/21/2004 Services, Inc. 12:00 AM ------ Using: The Web Site 2/28/2005 0 Local Regulator Sampling 9:08 AM ------ Report 6/21/2004 Using: Data 12:00 AM Import 7/22/2008 0 . Siegmund "Inspection" Contract renewal letter sent 10/04/04. 9/03-testing 8:56 AM Environmental letter sent. Service Notice 9/3/07 rodded aerator, 3/19/2004 Services, Inc. replaced denite pump-(slow) by JM 12:00 AM ------ Using: The Web Site 7/22/2008 0 Siegmund "Inspection" Contract renewal letter sent 10/04/04. 9/03-testing 8:55 AM Environmental letter sent. Service Notice 9/3/07 See notes! by 12/27/2003 Services, Inc. JM 12:00 AM ------ Using: The Web Site 7/22/2008 0 Siegmund "Inspection" Contract renewal letter sent 10104/04. 9/03-testing 8:54 AM Environmental letter sent. Service Notice 9/3/07 Serviced, 9/16/2003 Services, Inc. checked timer, aerator,filter-all okay by JM 12:00 AM ------ Using: The Web Site 7/22/2008 0 Siegmund "Inspection" Contract renewal letter sent 10104/04. 9/03-testing 8:53 AM Environmental letter sent. Service Notice 9/3/07 Serviced. 3/24/2003 Services, Inc. Aerator back to 30/30. Sampled. BOD:34, TSS:29, 12:00 AM ------ pH:7.3 by JM ' Using: The Web Site http://www.carmody.biz/pump/Service_History.aspx?pmode=l&permit_id=191222&ha=10 2/12/2014 CarriAyTM Service History Page 3 of 3 2/28/2005 0 Local Regulator Sampling 9:08 AM ------ Report 2/15/2003 Using: Data 12:00 AM Import 7/22/2008 0 Siegmund . "*Inspection" Contract renewal letter sent 10/04104. 9/03-testing 8:52 AM Environmental letter sent. Service Notice 9/3/07 Tested &— 12/17/2002 Services, Inc. Monitored BODA'2, TSS:13,TN:14,TKN: 14 12:00 AM ------ pH:7.9 by JM Using: The Web Site 2/28/2005 0 Local Regulator Sampling 9:08 AM ------ Report 12/17/2002 Using: Data 12:00 AM Import 7/22/2008 0 Siegmund *"Inspection*" Contract renewal letter sent 10/04/04. 9/03-testing 8:52 AM Environmental letter sent. Service Notice 9/3/07 Inspected. 2/15/2002 Services, Inc. Increased aeration to 100%continuous. by JM 12:00 AM ------ Using: The Web Site Total Gallons Pumped=0 S http://www.carmody:biz/pump/Service_History.aspx?pmode=l&permit_id=191222&ha=10 2/12/2014 Commonwealth of Massachusetts' ., Q Title '5 Official Inspection Form x ; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r arc lid 55 Tonela Lane r Property Address r Ted Myers < Owner Owner's Name t information is ' '. required for Barnstable '. MA 02630' 05/09/2007 aR � Tj every page. City/Town State' Zip Code Date of Inspectwn Inspection results must be submitted on this form Inspection forms may not be�altered in any way. s { Important: 'A.'A. General Information z r' When filling'out r forms on the computer,use 3 r 1. Inspector: s,r a only the tab key �# to moveur o not Brad J. White cursor f use the return Name of Inspector key. =: ` Wind River Environmental Company Name, rae P.O. Box 85' - f , Company Address North Carver MA 02355 0 City/Town . State Zip Code ," $" Al G 508-866-2576. s4 Telephone Number . , License Number < t Ez k B. Certification" f ` I.certify that I have personally inspected the sewage disposal system at this address and that they %> x information reported below is true, accurate and complete as of the time of the inspection The inspectionr txif°x '{ r was erformed based on my training and experience in the proper function and maintenance of on siteg .a{ sews a disposal systems.I am a DEP approved system inspector pursuant to Section 15:340 of - ,y( � t�' ` °' Tale 310 CMR 15. system: ~r r r 4 s z 000)•The ` Passes El Conditionally Y Passes ElFails , r�' [deeds Further Evalua ion b the Local Approving Authority } { t t" Y pP 9 Y ; N 14 { 05/09/2007" t In,pectors Signa a Date z ,. , . The system i ector shall submit a copy of this inspection report to'the Approving'Authorlfy(Board A .H of Health or DEP)within 30 days of completing this inspection. If the system is a shared system 00% ' . has a design flow of 10,000 gpd or greater, the inspector and the system`owner shall submit the ... x t report to the appropriate regional office of the DEP. The original should be sent to the system ownte'•gr and,copies sent to the buyer, if applicable, and the approving authority..*-,, ****This report only describes conditions at the time.of inspection and under the conditions of use; iat that time.This inspection does not address how the system will perform in the future underw the same or different,conditions of use. r AnAi c' 55tonellalanebarnstable 08/06 y x { y Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 F T.fif.`�i�'d'w'� A,tu."'J-3a.3 er�-r_ J�'� K... •y,"i. r•� ' ; � r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 55 Tonela Lane Property Address Ted Myers ' Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 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: System passes. Meets title v pass criteria. Serviced system also 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. 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. ND Explain: ❑ 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 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: The system required pumping more ❑ o e than 4 times a year due to broken or obstructed i Y q p P 9 Y ted p pe(s). The system will ass inspection if with approval of the Board of Health): Y p P ( pp ) ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: 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 (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. 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 i Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 55 Tonela Lane M Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and.nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 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. 55tonellalanebarnstable-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 55 Tonela Lane Property Address Ted Myers Owner Owners Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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. 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every 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 art of ❑ ® this inspection? Y or as p ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) Was the® ❑ e facilityor dwelling inspected for signs of sewage back up? 9 p 9 9 ® ❑ 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)] 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440gpd 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 98.63 GPD 9 ( Y 9 (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: Last date of occupancy/use: Date Other(describe): 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Our Records Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1,500 gallons How was quantity pumped determined? Septic tank size ( 10'-6"x 5'-8" x 5'-8" ) Reason for pumping: check tanks structural integrity and remove sludge and solids. 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): Singular system Approximate age of all components, date installed (if known) and source of information: System was installed 2002 per as built plan of septic system. Were sewage odors detected when arriving at the site? ❑ Yes ® No 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 30"feet Material of construction: ❑ cast iron ® 40 PVC schedule 40 pvc ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): Building sewer is in good condition. Septic Tank(locate on site plan): Depth below grade: 28"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Inlet and outlet have risers to grade. 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" x 5'-8"x 5'-8" Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle 31" li 2" Scum thickness 9„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Measured 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 l Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every 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.): Inlet and outlet tees are in condition. Filter ok. Tank appears to be structurally sound 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 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): 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box is level. No evidence of solids carryover. No evidence of leakage in or out of box. No evidence of solids carryover. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is in good condition. alarms and floats are all in good working order. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ® innovative/alternative system Type/name of technology: Singulair treatment plant Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): soil is dry. no sign of hydraulic failure. vegetation is normal, grass. No ponding to the surface. 55tonellalanebarnstable•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 55 Tonela Lane j Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 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.): 55tonellalanebarnslable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 55 Tonela Lane ^s.F Property Address . Ted Myers Owner Owners Name information is required for Barnstable MA 02630 05/09/2007a every page. City/Town State Zip Code Date of Inspection F D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties j tto at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. n StNtrl�uuR r�earr►�,cr ��P �7r142u Ce 32.31 340'`G CG 27 �1 • 5/ Z 2 r SLr 19.5f v¢G`� 22. .ZCp Z im,N z. b S 0 u A na Dg0L D 2 I .P4,-A 1X ojva.S 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 , r.. ' .3� .t�.m y • ..' ...,rh4 .t,•:e45+ '� ;. .. a ,. - e - . - � .. ' .....cuFJ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 55 Tonela Lane Property Address Ted Myers Owner Owner's Name information is required for Barnstable MA 02630 05/09/2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water: 5'-9"feet Please indicate all methods used-to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 10/30/2002 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: Taken from as built plan of septic system. There is abutting wetlans 49' away from edge of leaching. 55tonellalanebarnstable•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 ill 't IMassachusetts Department4.of Environmental Protection Bureau of Resource Protection-True 5 l� DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important Whan Mang out Owrl fonrss on the ' cornputet.use noe onry the tab key Fadty Addreds or-do rY't f_f/� �A� r' v J� ! ) -� to rsove.yaur v CAY S` ,•_■-�S ")1 C ��ylN l��__ _t 1`I j// curs � Z"'iii use the return key Mailing address of owner, if different Skeet v Ut► s z s - ext Terephone Number . B. Authorized Service Provider SP `rrvnd Eiv,e- rrI Aig l SPreutcPs .L'MC oaaw Fm, - 9Shed �-- --re Vi a f,7C-e- L 002 dos C-4yzip ��� s c Yol)W.5' - 0130exL Telep Number. � .Ngr7"ras Certified Open W Name Certffication Nunger C.-Facility/Systern Information S N(r S7 /�/oRe+lec o 9C d _ DEP 1D AAaAda+~nret ID A&4odn1 Number lnstaWon Date start of opetatlon Approval Type: General❑ Provisional❑ Piloting [Remedial Seasonal Residence_used less than 6 mo.lyear.0Yes KNo D. Operating Information T lnspectlon Dale LP:cvious tr:spcdicr.Oats Sludge De (to be c3tecic6d yeatry) Pumping Recommended El Yes XNO C I'C W/ Efiruent Description T51AOM1 -3r2m2 h/ Page t LjMassachusetts Department of Environnwi al Protection Bureau of Resource Prowcuort-Titk 5 DEP Approved Inspection and O&M Form for title 5 UA Treatment and Disposal Systems. E. Sampling Information ' Samples Taken:❑influentEfi}uent ' Parameters sampled: oado ✓ Tss V�A❑Other(list below) odw t Other 2 Other 3 Descrlptian of any maintenance rmed since previous inspection&dorm this inspection: T�.�lns�C/7j4, ,- '575-13-0 Notes and Comments; C ��e a� .p er is]r y22sJ 2-e .S+t� d LLd w G (ea✓ Lxe ra t,crS _ F. Certification I certify:l have inspected the sewage treatment and disposal system at the address above,have completed this report the attached technology operation and maintenance checklist and the Inf VrFg�e ;dcomplete as of the trine of Spec$on. I am a e#Esance with 25l CMR 2. % System owner must sub n*this report,technology O&M checklist,and any required sampiing results to the kscal board of health and DEP as follows for each inspection performed: ReeMediai Use-by January Piloting&Provisional Use- Gemrai Use—by September 31-'d of each year for the within N days of inspection 3e of each year for the previous Calendar year dab2 previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6!4 Floor Boston. MA 02108 T5tAOM 1 •3r2m Pap 2 of 2 � f S7w -e LA- SINGULAIR SERVICE CHECK LIST Set finer urigbt is tubL ran (with same filter) dean crater into it wa the SESI NO._AA Q 3q I water flows Ga of the hole in DATE OF SERVICE:_/ t 3 d dr-flangr Insw comp ezed SERVICE PERFORMED Y:_ amr hose and a�iuhtc wahhir. (tmuais) Keep a with clean waw sbovty$owing tnstiil the L,ocatim work tv tx performed P229 exiting wain is F-wst Remove concrete coves cheer Finish hosing dawn fiker chamber for no:msf water Icrc Serape hopper Checsecond sledge opth after -,d— ply hAncaat too sber flume woad year of operasion - Stow d Remove tonne corn Placefiltes in pbtsq fib with chamber 1 dent anus and sink it Control Open nod set to"COMr � txut<r I Tam out locking tabs.replace filter cover Seaoad Check akAow thratzgh2Cr2t0KL 0 cf nsber h!( 04 RgAam concrete cover LhWlug aerator and lift out First Replace couauc cave dixeiber Check for acorn rafter pads Second ping in aera w, Check for war or ptobleniv chamber Check wire in riser fw, CrQ 6i m so it is not in contact tape if needed Wash off wraW pLa it back Replace concrete Cover Hook itp aneaetr .r.check Cahsx`d Flaw as`AUTO" carr=vDal h rtnano& O tX,tiler poa y remonwa t Close and kick cover Third Rw4ove concrete cover and dkunber h&wAe fiber top_ . Read and record hour teeter Lcavanot=oCsesvice wdh Two in black locking tabs Pami . work o^hvrtha h2s all pomp NW start pompizg 6vom filter to firs chamber_ Nose is company tole say Lift f fter with rope as knularky°r Pimb I= i Indicabc if any fuDow-up is i Lift ova fitter.put it in tub Clean the outside of fitter with Be some to couilicte,We on ward:drain batY m_first servicc,retwo it to office chamber MEMO: Req Mej Yq 3 Qo �� vvtJ Votc ae"V- OIL- . Z P C GROUNDWATER NALYTICAL ►' �i Inorganic Chemistry Field ID: FE Project: Singulair 3 onela Barnstable,MA Matrix: Aqueous Client: Siegmund Environmental Services Received: 09-14-04 12:40 Lab ID 76531 01 Sampled 09 13 04 16 15 Container _ yriAnal to #_ K 1 L Plastic Preservation Cool -Y. .. r Nitrate(as Nitrogen) 6.2 mg/L ha o 0.1 5 1 mL 09-14-04 21:03 NI-2303-W Fl 4s00.NOJ Nitrite(as Nitrogen) O.OB mg/L 0.02 1 5 mL 09-i4-04 20:44 NI-2303-W lachal,0.10)-00.,.0(SM 45oa-NO]Fl 1 DDW Lab ID 76531 02 Sampled 09 13-04 16 15 Container 250 mt.Plastic Preservation H2SO4/Cool Nitrogen,Total Kjeldahl (TKN) 6•8' mg/L 0.5 1 20 mL 09-21-04 13:s2 TKN-1434-W E cha11410)d63-n(EPA` Lab ID 76531 03 Sampled 09 13 04 16 15 Container 1 L Plastic Preservation:.Cool - �^ .. ..f.a+. ➢.s.zr�., �.�.1:�. 3. _y'.� �._���. dteh��; e�hs¢d'.'�s ,�r15�r�n�y�3t: Biochemical Oxygen Demand 13. mg/L 2 1s zo mL o9-ls oa 11.zo BOD lao9-w sM szlo B 3 DB Lab ID 76531 04 Sampled 09 13 04 16 15 Container 1 L Plastic fr n t Preservation Cool Solids,Total Suspended 13 mg/L 10 1 100 mL 09 16-04 08:59 T55-0996-W SM 2540 D 4 MW pH 7.4 pH NA 1 50 mL 09-14-04 16:02 PH-1752-W SM 4500.H+B 2 DDW Method Reference: Methods for Chemical Analysis of Water and Wastes,US EPA,EPA-600/4-790-020(Revised 1983),and Methods for the Determination of Inorganic Substances in Environmental Samples,US EPA,EPA/600/R-93/100(1993),and Standard Methods for the Examination of Water and Wastewater,APHA,Twentieth Edition(1998),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. RL Reporting Limit. DF Dilution Factor. 1 Instrument ID: Lachat 8000 Autoanalyzer , 2 Instrument ID: Accumet AR50 3 Instrument ID: YSI 5100 4 Instrument ID: Mettler AT 200 Balance Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 December 28, 2004 Siegmund - ENVIRONMENMAL SERVICES INC. Dr. Dale Saad 49 PAVILION AVENUE Health.Department PROVIDENCE, RI 02905 Barnstable Board of Health 200 Main Street P/401/785/01 30 Hyannis, MA 026o>l F/401/785/3110 s www.siegmundgroup.com Dear Dr. Saad, HUNGARY Enclosed,please find copies of the MA DEP Inspection reports&test results for the following Singulair®Wastewater Treatment Systems currently in operation in and Ma Kff. Barnstable: an Profes-Aqua,Kff, Budapest Address MA.DEP ID RUSSIA 55 Tonela Road, Barnstable SING57 Sesi-Krasnodar Krasnodar If you have any questions regarding the enclosed information, please do not SLOVAK REPUBLIC hesitate to contact me directly. Ekostar/usa spot,sr.o. Tomosov f� WEST INDIES (� Rosewater Systems, �t t N.V. Regards, St.Maarten r' McAlastair,Ltd. :Js Nevis olZlis*gmZ cn a enc. cc:file FLUOR UNDSOMo (EWAM goaM&S, r � Jul t I Massachusetts Department of Environmental Protection Bureau of Resource Protection-True 5 DEP Approved Inspection and O&M Form for Title 5 IIA Treatment and Disposal Systems - �3 A. Instaitation Important: �R Whalt NOW out o n el- forma an the computer.use only the tab key Fity Addrais to move your ✓ ` '^(n ��/� U rl 3 cursor-do rt^t city -pup r use the return key. Mailing address of owner, I different Street Addm=RO ear CRY slice zip - ext Telephone Number .. B. Authorized Service Provider O&M FM S1e9�1vr�d ��uj��rr�n��,�� S�eurcPs ,� Lee Y qP41 y1Shed- '�l`,'�� .� �a CAY zip ("I i WS' - 0130eA s Telepe Number Certified operator Natne Cetttfi=don Number C.-FaciiWSystetm Information s /V(r S 1 1 ,0jtWeC v - DEP ID Mawfacaw ID Modal Number InstattaWn Date Start of Qpetatton ^' Approval Type: Cl General El Provisional❑Piloting [ Remedial}, Seasonal Residence—used less than 6 mo.tyear_0Yes N0 = ' 1 > D. Operating Information tv, /0 r'-111 --- irnpec!!on Dace L I rcmus Icspcc'tcr,Owe stucige (to be checked yeasty) Pumping Recommended ❑Yes ko C 'C0A," IA)/ 5d1It Efttuent Description T51ACM1 •3,2"2 Page 1 so h r J' LjMassachusetts Department of Environnmra l Protection Bureau of Resource Protection-Tdle 5 DEP Approved Inspection and O&M Form for Title 5 UA Treatment and Disposal Systems E. Sampling Information Samples Taken:Q influent i(Effluent Parameters sampled:P�PHP�801)i, Tw ❑Other(list below) Other 1 outer 2 other 3 Description of any maintenance rmed since previous inspection&du this inspection: T�N� lns�� rin�. Mm� -5z5-V 3-y Notes and Comments: �2�&T� Sty d lL'd S (Al r �ea� ra LV_S F. Certification I c ertifyr:i have inspected tfte sewage treatment and disposal system at the address above,have completed this re the attached technology operation and maintenance checklist,and the in f. n port accurate, d complete as of the time of ' apection. I am a in ance wfth 257 CMR 2.00/ IN re �e System owner must submit this report,technology O&M cheddistand any required sampling resurcs to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting&Provisional Use- General Use—by September 31'of each year for the within 32Q days of inspection 3e of each year for the p calendar year date previous 12 months Department of Environmental Protection Attention: Tittle 5 Program One Winter Street,a Floor - t Boston.MA 02108 G T5IAOMI .32Bl02 Page 2 of 2 GROUNDI/l/ATER ANALYTICAL Inorganic Chemistry Field ID: FE Project: Singulair/55 Tone]a'Barnstable,MA Matrix: Aqueous Client: Siegmund Environmental Services Received: 09-14-04 12:40 Lab ID 75531 01 Sampled 09 13-04 16 15 Container.- r1 L Plastic Preservation Cool �Resu(t�:��`_ -Units � � r `�, Nw _ 6.2L �5 Volume �Arr�lyzed QC16aichr x �yteftrod� k :_. Nitrate(as Nitrogen) mg/L 0.1 5 1 mL 09-14-04 2103 NI-2303-W Nitrite(as Nitrogen) <SOaNOIn 1 DDW 0 08 mg/L 0.02 1 5 mL 09-14-04 20:44 NI-2303-W m�11 a,oro+ic sin 1 DDW '<500-NO)F) Lab ID 76531 02 Sampled 09 13-04 16 15 Container -�- 250 mL Plastic Preservation H2SO4/Cool Nitrogen,Total Kjeldahl (fKN) r n �YkA= W _ 6.II' mg/L 0.5 1 20 mL 09-21-0413:52 TKN-1434-W Lacha lalo)053-0(EP ss,.�t 1 AVB Lab ID 76531 03 Sampled 09 13 04 16 15 Container: r A1 L Plastic Preservation Cool n y� tlYtaT' a§ eyult� U. Its 'RL N " DF'.1�olµYiier Aly�ed „' �6at�h Biochemical'Oxygen Demand _ ?" L1tI iAnall' 13 mg/L 2 15 20 mL 09-15-04 11:20 BOD-1809-W a SM 5210 B 3 DB Lab ID 76531 04 Sampled 09 13 04 16 15 Container s r 1 as� .� � L Plastic Preservation Cool Solids,Total Suspended 13 mg/L 10 1 100 mL 09-16-04 08:59 TSS-0996-W SM 2540 D q pgyy pH 7.4 pH NA I1 50 mL 09-14.04 16:02 PH-1752-W SM 4500.H+B 2 DDW Method Reference: Methods for Chemical Analysis of Water and Wastes,US EPA,EPA-600/4-790-020(Revised 1983),and Methods for the Determination of Inorganic Substances in Environmental Samples,US EPA,EPA/600/R-93/100(1993),and Standard Methods for the Examination of Water and Wastewater,APHA,Twentieth Edition 0 998),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. 'RL Reporting Limit. DF Dilution Factor. 1 Instrument ID: Lachat 8000 Autoanalyzer 2 Instrument ID: AccumetAR50 3 Instrument ID: YSI 5100 4 Instrument ID: Mettler AT 200 Balance ro.) d-t- �Xll }l (h- C1.) t Groundwater Analytical, Inc., P.O. Box 1200,'228 Main Street, Buzzards Bay, MA 02532 f �v n-P SINGULAIR SERVICE CHECK LIS"r Set fll=Upright is tUb.Mn (-dh same®ter) dean,rater iaoo d wo the SESI NO._M,�- P-j wowflow►s out of the holein DATE OF SERVI ! do flange.'u-s=cotopressed SERVICE PERFORMED Y: air hose and agiuetc wahtiir. (tmdaic) Beep with dean wam slowly 8owmg umd the Location Work to be oof2o ed ll�e exidm water is dear_ Fast Remove ct omm ever.check Finish hosing down filter comber for normal wao.r levd ' Serape hopper Ctxcl`shaige depth after Apply lubrx ant to fiker flange second year of operation second Remove mete cover Place fiher is phhce.fdl with i dean water and sink a i Couhd Open and set to"CONI" I antes P Ttua one tabs,rcpUcc -I fitter cover Second Check N*WUO Q 3Replawcoacmie cower Unplug aerator and lift ow ` F"ust Replace caaaeae coMc chamber Check for wota timber pads Second Plug in aermr Check for wear or prdbkniv chamber Check wire in riser for . CPR w;=so it is not in cwA= tape if needed Wash off aerazoe peer it back Repbhce coacmw cover Flock up ascender,check Coded Pita swim on`AUr(r uureru wad aerator meaning, o �� POSNMi reurov�J�L t Close sand lock cancer Third R AuA ,e coocretz cover and dtamber reAove fiber top_ Read rind texaord hoar htteter Leave notice of service withwork i Than in btadk wringtabs uwner i Install p=p and start potnpina from filter to fires chamber_ Nate in OOP' ' Lift Eater with rope as kregWarity or p1°bhM icy- t Indicate if any fetfow-W is i Lift out Rites,pot it in tub Clem the outside of fiher wph Be store tocompitwfilco. water drain bank t+o.f ra st mcc,omen it to other i chamber QD MEMO: 517N 6- 21, .: / -T �.v 3 eo l a__ V1(�Aj vs 0 <<- a.�►� o�� ���„ � ok- r July 8, 2004 Siegmund ENVIRONMENTAL SERMCESINC Dr. Dale Saad 49 PAVILION AVENUE Health Department PROVIDENCE,RI 02905 Barnstable Board of Health 200 Main Street P/401/785/0130 Hyannis, MA 026ol F/401/785/3110 www.siegmundgroup.com Dear-Dr. Saad, HUNGARY Enclosed,please find copies of the MA DEP Inspection reports&test results for the following Singulair®Wastewater Treatment Systems currently in operation in and Ma Kft. Barnstable: an Profes-Aqua,Kft. Budapest Address MA DEP ID RUSSIA 55 Tonela Road, Barnstable SING57 Sesi-Krasnodar 562-Main Street, Centerville Not Yet Assigned Krasnodar If you have any questions regarding the enclosed information, please do not SLOVAK REPUBLIC hesitate to contact me directly. Ekostar/usa spot.sr.o. Tomasov WEST INDIES Rosewater Systems, N.V. Regards, St.Maarten - McAlastair,Ltd. Nevis o 1 ter . SiegIYd enc. cc:file- 3 GROUNDWATER ANALYTICAL Inorganic Chemistry Field ID: FE Matrix: Aqueous Project: Singulair/55 Tonela, Barnstable Received: 06-22-04 16:20 Client:. Siegmund Environmental Services Lab ID: 73967-01 Sampled: 06-21-04 14:30 Container: 1 L Plastic Preservation: Cool Analyte" tReslilt t Units RL, DF VolumeA GBatch Method *-lost nrial`1 Nitrate(as Nitrogen) 2.2 mg/L 0.02 1 5 mL 06-22-0419:07 NI-2217-W 4a)°Foa){� 1 LJD S00 NO3 F) Nitrite(as Nitrogen) 0.50 mg/L 0.02 1 5 mL 06-22-04 19:07 NI-2217-W hato-ro)onlL sn 1 LJD 45-03 n Lab ID: 73967-02 Sampled: 06-21-04 14:30 Container: 250 mL Plastic Preservation: H2SO4/Coo1 Result lJmts R.L ' DF VotumeAnalyzed QC Batch Method Inst Ana(y$f .� Nitrogen,Total Kjeldahl(TKN) 3.7 mg/L 0.5 1 2omL o7-01 0409:4o TKN-1376-W h 'a)',7 s—D(EPA 1 AV6 151.:) Lab ID: 73967-03 Sampled: 06-21-04 14:30 Container 1 L Plastic Preservation: Cool •,'�`�� Analyte'` �,r � �� ResulY> �; Unrts "�rRL `DF voturrie �Anal�zed,��y`QG�Bat�h �_ Method ,,lost nnalrs% Solids,Total Suspended BRL mg/L 10 1 �100 mL 06-23-04 08:32 TSS-0968-W SM 2540 D 4 MW pH 7.1 pH NA 1 50 mL 06-22-04 17:29 PH-1704-W SM 4500-H+8 2 DDW Lab ID: 73967-04 Sampled: 06-21-04 14:30 container: 1 L Plastic Preservation: Cool . „, - 1° , �,,�� ,�� ,•�,;��Resuft; ,'� 1Uuts .RL_ DF volume 'Analyiel��QC Batch� _'�,;Method_v�Insf-nnatrs Biochemical Oxygen Demand 17 mg/L 5 30 10 mL 06-23-04 15:20 BOD-1709-W SM 5210 B 3 AB Method Reference: Methods for Chemical Analysis of Water and Wastes,US EPA,EPA-600/4-790-020(Revised 1983),and Methods for the Determination of Inorganic Substances in Environmental Samples,US EPA,EPA/600/R-93/100(1993),and Standard Methods for the Examination of Water and Wastewater,APHA,Twentieth Edition(1998),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(1996). Report Notations: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample size and dilution. RL Reporting Limit. DF Dilution Factor. 1 Instrument to: Lachat 8000 Autoanalyzer 2 Instrument ID: AccumetAR50 3 Instrument ID: YSI 5100 4 Instrument ID: Mettler AT 200 Balance f Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 :6ARHISTABLE .2pQ4 MaR'3Q �� 3' 25 March 29,2004 ;� *','i , � .• Siegmund ENVIRONMENTAL SERVICES.wc. Dr.Dale Saad Health Department 49 PAVILION AVENUE Barnstable Board of Health PROVIDENCE,RI 02905 200 Main Street P/401/785/0130 Hyannis,MA 02601 F/401/785/3110 www.siegmundgroup.com Dear Dr. Saad, Enclosed, please find copies of the MA DEP Inspection reports for the following HUNGARY Singulair Wastewater Treatment Systems currently in operation in Barnstable: Marleff Kff. and Profes-Aqua,Kft. Address MA DEP ID Budapest 55 Tonela Road,Barnstable SING57 RUSSIA Sesi-Krasnodar If you have any questions regarding the enclosed information,please do not hesitate Krasnodar to contact me directly. SLOVAK REPUBLIC Ekostar/usa spot,sr.o. Tomasov Regards, WEST INDIES Rosewater Systems, olllster S. Siegm N.V. St.Maarten enc. McAlastair,Ltd. Nevis cc:file C�6�DD�1DaC3D�o Qd�a gQ�laag4 K t 50 f Massachusetts Department of Environmental Protection f Bureau of Resource Protection-Title 5 � DEf' Approved inspects;©n and O&M Form for Title 5 #IA Treatment and Disposal Systems A. 1nsti Uation When tflrog:out owner roans(o tht I computer;use itte tab key Facility Address to to move your cursor-do r^t ` ` ' use ttW return city Zip f key. Mailing address of owner;if different: -�` i StreetRddressJPO Box i City 7 W Start zp Telephone Number B. Authorized Service Provider _ O&M Font Y 2 Agvr'/h eA /f y e Address Pro di We4'r-e_ f f�o2gps Ct _ StaCe zip ( 461)WS 0)30ext. T JIJG � Rr'�!4S ,mods T i Certified Operator Narita Cerrtifrcation Numbef C.-Facifity/System Information . 966 DEP i Manufaehrrer ID Model Number ln3tallattori Oaft Start f Operation roval Type:App Q Genera)Q Provisionsi Q Piiotin emedial Seasonal Residence—used less than 6 rno.lyear[]Yes XNo D. Operati g Information 1 3 t1 2 ,l irmp6e ion 06te Previous Ins flabe Sludge be r3tet'lred yearly) Pumping Recommended Q Yes Nc Striueed Descrown T51AOM1.3J2tdd2 Page I.oft r LlI Massachusetts Department of Environmental Protectior /� /S Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systerr.�a E. Sampling Informationtin r/ - Samples Taken: ❑ Influent '4 Effluent Parameters sampled: ❑pH Q BOO❑TSS Q TN Q Other(list below) Other t Other 2 Other 3 Oescription of any maintenance performed since previous inspection&during this inspection: Notes and Comments: 0/-j 00 tu Pe Ak Pan Al m W 6 F. Certification i I certify: I have inspected the sewage treatment and disposal system at the address above,have completed this report and the attac technology operation and maintenance checklist,and the jinformalfttrue, te, and complete as of thetime of the inspection. I am a c for in accordance with.257 R 2.0 c i IV f System owner must submit this report,technology O&M checklist,and any required samaing results to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting&Provisional Use- General Use—by September 31st of each year for the within 30 days of inspection 30"'of each year for the previous calendar year date previous 12 months t i Department of Environmental Protection . Attention: Title 5 Program One Winter Street, 6'r"Floor Boston. MA 02.108 ; TSIAOMI •3J2=2 Page 2 of 2 I i � n f - W TO it, Q F AR6aSTABLE SUNGLLAIR SERVICE CHECK LIST ;Q filter uLUUpn t'i cub. re (with same 6lter1 %�� clear.water into it until the I I SESI NQ. �� i waer flows out of the hole DATE OF SE _ _3� the flatte..Inc SERVICE PE9F0RME.D BY: air hose and agitate[ *WJ{0 N ? Keep agitating with clean.. `r water slowly flowing until the Location Work to be performed hone exiting water is clear. . First Remove concrete cover,check Finish hosing down filter chamber for normal water level 17 Scrape hopper Check sludge depth after second year of operation Apply htbricant to falter flange Second Remove concrete cover champ Plate filter in place,fill with ! clean water and sink it Control Open and set to"CON-17 i center position Turn out locking tabs.replace _ filter fover Second Check air flow thmugh aerator chamber Replace concrete'caver a-5 Vnplug aerator and lift out (/� FirstReplace concrete cover 1 chamber w - Check for worn rubber pads Second Plug in aerator Chxk for wear or problem_- chamber Check wire in riser fo*Anafng. Cniz wire so it is not in contact tape if needed mitt anything r Wash off aerator,put it back Replace concrete cover Hook up aru�aeter,check Coto-=Gl Put switch on"AUTO" current whit aerator Punning, center position renT07'2tgtaiL , Close and lock cover Third Redave concrete cover and s j: chamber reaftnve falter top. Read and record hour meter �. Tarn in black locking tabs Paper Leave notice of service with work owned Immll pump and start pumping from filter to fast chamber. Note in company file any Lift filter with rope as irregularity or pvbiem necessary_ Indicate if any follow-up is Lift out filter,put it in cub necessary Clean the outside of filter with Be sure to complete file on water.Chain back to firs service.return it to office chamber MEMO too r� i Massachusetts Department of Environmental Protection i Bureau of Resource Protection-Title 5 DEP Approved Inspection and O&M Form for Title 5 IIA Treatment and Disposal Systems A. Installation Important• when filling out forms on the j computer.use only the tab key Faa"tky Street Address to move your i cursor-do n^t t / l / I use the return city ! Zip key.. . iVlailin address of owner,if different: =ICI i S t Address/PQ Box I city State Zip - ext. Telephone Number B. Authorized Service Provider Sle � orm E t n' e'lig l 's eRofcPs L .c 9 O&M Fsrmell �q I Address Pro d i 40� li �� 117€S _ D�30.eg. state zip i Tele ph Number Certified Operator Name Certification Number C.-Facility/System Information _��fl/lJ S7 MpX JA✓Pc 0 e I DEP ID ManufaCurer IQ Model Number �l Z) c�Z Installation Oat& Start of Operation Approval Type: General(]provisional Q Piioting❑ Remedia} I . Seasonal Residence—used less than-6 mo.tyear. FYes o D: Operating Information c Inspeefio�n Date % ; Previaus Inspection Date ,/ Sludge Depth(to�be checked yeartyJ(�� il' Pumping Recommended El YesXNo 1 Effluent Description '!. (fY7V. ' T51AQM 1 •3l2t3/02 L / (c� C,�,c (1 c' <f/ page 1 of Z v� S Massachusetts Department of Environmental Protection - Bureau of Resource Protection -Tibe 5 DEP Approved Inspection and O&M Form for Title 5 !/A Treatme nt and Dis osat S e �p yst r�:..a- E. Sampling Information Samples Taken: ❑ Influent M Effluents Parameters sampled: ❑pH ❑ B0D❑,T5S❑TN Q Other(list below). Other 1 other 2 Other 3 Description of any maintenance performed since previous inspection&during this inspection: j i Notes and Comments: i Ct > �1 ✓Q�� `S y;�Y4 P G� G� /,� 0VP G(ICf c w �� .� ��rti� 7VI y,z So )l:cZIJ I, 2�2 � t F. Certification ! (certify: I have inspected the sewage treatment and disposal system at the address above.have completed this.report and the attached technology operation and rpaintenance checklist,and the ` information reported is true,accurate,and complete as of the time of the inspection. I am a MassT^ch etts j rled:Z for in a rdance with 257 CMR 2.00: Goes r Sm azure �a,a i •j - i i i • System owner must submit this report, technology O&rvt'checklist, and any required sam.pung -esuit: to the local board of health and DEP as follows for each inspection performed: Remedial Ilse—by January Piloting&Provisional Use General Use—by Septembe 31 St of each year for the within 30 days of inspection 30"'of each year for the previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street, 6n`Roor, ( Boston_ MA 02108 i T51AOM1 3/28/02 Page 2 of: SINGULAIR SERVICE CHECK LIST (with same Mter) �a filter upright in tub,run clean water into it until the SESI NO. w:rei flows out of the We in DATE OE SERVICE: —Z 7' the flange Insert compressed SERVICE PERFORMED BY: air hose and agitate with air. .. (Initials) Keep agitating with clean water slowly flowing until the Location Work to be performed Done exiting water is dear. First Remove concrete cover,check . Finish hosing down filter chamber for normal water level Scrape hopper Check sludge depth after j second year of operation l/ Apply lubricant to filter flange Second Remove concrete cover chamber Place filter in place,fill with clean water and sink it Control Open and set to"CONT' i center position Turn out locking tabs,replace °I fiher cover Second Check air flow through aerator chamber `� S Replace concrete cover Unplug aerator and lift out ' First Replace concrete cover !� chamber Check for worn rubber pads Second Plug in aerator Check for wear or probletnv chamber, Check wire in riser fa*Eitafing, Cnd woe so it is not in contact tape if needed - --rim anything Wash off aeratof put it back Replace concrete cover Hook up antrieter,check CORK01 Put switch on"AUTO" current w ilh aerator running, _ �j- i c%cer position - removr!itgtail. Close and lock cover ' Third Rerlove concrete cover and chamber rediove filter top. Read and record hour meter ` Turn in black locking tabs Paper Leave notice of service with work owner i Install pump and start pumping from filter to first chamber. Note in company file any Lift filter with rope as ' irregularity or problem V necessary. Indicate if any follow-up is j Lift out fitter,put it in tub necessary i Clean the outside of filter with ✓ Be sure to complete,file on r / water.drain back to first service.return it to office V chamber l sCAs�'K I V i<-At MEMO: , J o>i�m pa �3 15(G'(Ap .i Cf y l') 1�I0c</,s�. �rcr-v a---. 1-0 q'/�t'U 1A ;C Se1;ds Cfeni ?rt' � 11Ci/h.6 s77Q C/�t cf/yj /1Ci 06—. 3 �ct� CG;vtl 07/11/2002 10:16 5087901238 PRICE & WERS, P. C. PAGE 01 7z �JIEE:L-fl%r �• ` i t r July15, 2003 SIEGMUND ENVIRONMENTAL SERVICES,Inc., Dr. Dale.Saad Health Department 49 Pavilion Avenue Barnstable Board of Health Providence,RI 02905 200 Main Street Tel 401-785-0130 Fax 401-785-3110 Hyannis, MA 02601' E-mail:sesi@ siegmundgroup.com Dear Dr. Saad, A SiegmundGroup Company ASSOCIATED COMPANIES: Enclosed, please find installation, .service, ,maintenance and testing results information for following Sin-gulair®Wastewater Treatment Systems currently,in' U.S.A. operation in Barnstable: A_J.Resources Massadnisetu HUNGARY Address MA DEP ID Marlett Kft. and 55 Tonela Road, Barnstable SING57_ Profes-Aqua,Kft. Budapest RUSSIA If you have any questions regarding the-enclosed-information, please do not sesi-Krasnodar hesitate to contact me directly. Krasn"zr r SLOVAK REPUBLIC Ekostar/uses spol.sr.o. Regards, Tomuao WEST INDIES o lister S. Sieg nd Rosewater Systems,N.V. SLMaanen enc. MCAlastair,Ltd. Nees. . YUGOSLAVIA cc:file EKS/uses Nmi Sad . Find us all in www.sieg mundgroup.com T WASTEWATER TREATMENT& ENGINEERED CONTROL`SYSTEMS s PAI(6, ) Massachusetts Department of Environmental Protection Bureau of Resource Protection -Title 5 i� DEP Approved Inspection and O&M Forte for Title 5 I/ Treatment and Disposal SysteMS A. d'hstaliati pn ire T / le*,- ' t ��1►�r; oirt owner famm on the computer,use az Only tM tab key Fa Street-Addms— year cursorrsor- ; a 2 6 ,?7 doct^t i,isrs the return Zia key. Mailing address of owner, if different: 8Bree1Addre3slPo$ex: City state �p Telephone Number B. Authorized Service Provider 151'e7 un rmir, erl 1 UIC&S-A . Pic OW Firmrm Stree address Cl¢y State zip Teieph a Member Cer ifled Operator Name Cetthlmfiort Nmber C.-Faciiity/Systern Information PEP 10 Manuf curer ID Model Number f nstailation Oa St*att-of Operition Approval Type: [1 General❑ Provisional iloting n Remedial �/✓ Seascnal Residence—used less than 6 mo.tyear:[]Yes R�40 D. ,'Operating Information L3 Ld YZd lnspedcA Date �r Previous"'n'specfion Ow.i 7,er (ta cat y�arty) Pumping Recommended ElYes N0 it e- S v kI jEflguent Dascriptton T51AOMI-34�o/o2 Page 4 i MassaChu-safts DepaMent of Environmental Protection i Bureau.of Resource proteoti., -TtIle 5 DP Approved Inspection and O&M Form for Title 5 IIA Treatment and Disposal Systems E. iampiing Information Samples Taken: [j lnfluentX Muent Parameter sampled: p�4BOD ZSS T i TN Q Other(list below) - ic Other wider Z ®esccMr,Of anY maintenance performed since pre inspection&during this in Pection:14- r��/O Notesiard Comments: R .r cr i1vGs dr /o oy� 20 OAF 14 % � R��ct r �2ect�viced. 740 5�,,�s v�� 0�2 �v MI A,/.��'� S�n�9 ,f�Pcc2c #. Certificataow 1 certify: ! have inspected the sewage treatment and disation and maintenance checklist system at the address above,have cgmptted this re ott and the attached technology operation and ttve •ti tiara re , accurate,and.complete as of the time of the ins aS use ed tator na inspection. !am a ante with 257 CMR 2.0 G to!Signature � mate SYstern owner must submit this report, technology O&m checklist,and any requirad sam.ping resits to the local hoard of health and OEP as roAaws for each inspection performed: Remedial Ilse—by January Piloting&Provisional Use:- Genami Use—by September 31 of'ach year€ar the within 30 days of inspection 3p�of each year for the Previous calendar year date - previous 42 months ®epanment of Environmental Protection Attention: Title S Program One WInter Street, r door Sostonl MA 02108 . T51A©mj >3J2W2 Page 2 of 2 f " To i010811178792 P,01 St3E 'C't[g2T tt`t`J - SINGULAIR SERVICE CHECK LIS'-r Set filter upright in tub,run synth same ; r) clean water into it until the / SES1 lei©. /q(.$� "�f?+'(�j water flows aft of the hole in d DATE OF 99-RVICEs _ the flange insert compressed SERVICE PERiF IR D$�: air hm and agitate with air. (initials) Keep agitating wij �i water slowly flow i� kff&tof tAfnrk to he��tt��er��fo77tne[roi7troe exiting water is cl g us¢ Remove 't chock Fmishi lws„ug dow ✓ ! dwwber for norr�taf watts loyal Scrape hopper / Chock sludge depth after — Apply lt*dcant to �p�yew at�speration Second Remove Place f !" chamber t7ter in laces fill with p clean waw and sink it ! C a see ttD"COIdT' Turn out locking tabs,replace Ct nBes position filter en+Mx Second tkrftavrthcougkta~taws t chamber Replace mete cover UnP aeraw and lift out / Flrst Replace aen®eete Cover .r / cT�ar s Check'for wom rubber pads 5econtt Plug in aetatV ✓ Checirforw:jnriser ofgtoblem- u+C chamber Checkiv*e for4hafeng, CCQ mire so it is not in contacttape Ifj! d yntJt anything Wash atrseraiar p�.rt back C ✓, Hook�p anrnetcr,check COW.-M Put swi®eh one"AUTO" ctatnrrt flail actator running, Coffer position i ? L Close and lock cover Thhd Rertove concrete cover and chamber redtove filter top. Read and reoord,bour meter Leave nufm of service with. Tlutlit►blartd<loc�ng tab s ✓ i work owrtf8' Instmil plump and start ptunping from flter m fast chamber. in company file any Lift filter with rope as invgulariry or problem nee es�iaty. ! Indicate if any follow-tip is i Lift cart filter,put it in tub necessary i Be svre to Ie'te�file on Clesu'the outside of fl stet with COA'tP watch,drain baste to fist service,tcxutn it to office chatttba MEMO. wm tioT _wo �?& CAI' ' ,P c 1 P�� °l%7 I-0e Al-e 7-.Y ��e�> eat &-I Cblo� 1 dram/ TOTAL P.01 Was N.OW o PA *4 D FIT C C-7 i.--7 , yjvA-C, Ao &L+r1OA1 IN T I T)c r/ pell SAmPk 1,577 -rE M P :ORN' ............ 1,7 P H PH IDS) Mg L • 0 L 10 ET T, F-e,e eN le/o I GROUNDWATER ANALYTICAL Inorganic Chemistry Field ID: FIE Matrix: Aqueous Project: Singulair/55 Tonela Cumaquid,Ma. Received: 06-23-03 Client: Siegmund Environmental Services Lab ID 62285 01 Sampled 06 21 03 14 00 Container 1 L Plastic Preservation Cool 'AraalYte `� Result 5�fs p � g � � ' �� �� ,Method Nitrate(as Nitrogen) I 2.5 mg/L 0.02 06-23 03 20:36 I NI-1807-W SM 4500-NO3 F Nitrite(as Nitrogen) 0.86 mg/L 0.02 06-23-03 20:36 NI-1807-W SM 4500-NC3 F Lab ID 62285 02 Sampled: 06-21 03 14 00 Container 500 mL Plastic Preservation H2SO4/Cool ra " �Atnal e �, r E` RCPott�ng s yNO � "t R/esul3t � Aal;yzed a QC�Batc"ham Method Nitrogen,Total Kjeldahl (TKN) 13 mg/L 0.5 06-30-03 TKN-1125-W EPA 351.2 Lab ID 62285 03 Sampled 06 21 03 14 00 Container 1 L Plastic Preservation Cool Biochemical Oxygen Demand 23 mg/L 40 06-23-03 18:59 $OD-1372-W SM 5210 B Solids,Total Suspended 30 I mg/L 20 06-25-03 TSS-0841-W SM 2540 D pH 7.4 pH NA 06-23-03 18:28 PH-1486-W SM 4500-H+B Method References: Methods for Chemical Analysis of Water and Wastes, US EPA,EPA-600/4-790-020,.Revised(1983),and Methods for the Determination of Inorganic Substances in Environmental Samples, US EPA, EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater, APHA, Eighteenth Edition (1992). Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is the lowest value that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample dilution and sample size. Groundwater Analytical, Inc., P.O. Box 1,200, 228 Main Street, Buzzards Bay, MA 02532 RECEIVE APR 2 4 2003 TOWN:OF.BARNSTABL: HEALTH DEPT. *. . April 23, 2003 ` - --------�__ SIE GMUND ; ENVIRONMENTAL SERVICES,Inc. Dr. Dale Saad Health Department 49 Pavilion Avenue Barnstable Board of Health Providence,RI 02905 200 Main Street r Te1.401-785-0130 Fax 401-785-3110 Hyannis,.MA 02601 E-m-A.sesi@ siegmundgroup.com Dear Dr. Saad;, , A SiegmundGroup Company ASSOQATED'COMPANIES: Enclosed;`please- find installation, service, maintenance' and "testing results information for following Singulair®Wastewater Treatment Systems currently in ` u-S.A_ operation in Barnstable: A.J.Resources Massadnrsetn HUNGARY Address MA DEP ID Marlett;Kft. and 55 Tonela Road, Barnstable SING57 . Profes-Aqua,Kft. Budapest RUSSIA If you have any questions regarding,the enclosed'information, please do not Sesi-Krasnodar hesitate to contact me directly. - Kraswdar SLOVAK REPUBLIC Ekostar/usa spol.sr.o. Regards, - Tarasau 'WEST INDIES e S. leg Rosewater Systems,N.V. SGMaanen enc. McAlastair,Ltd. Neui YUGOSLAVIA cc:flle ' EKS/usa Nad Sad s -Find us all in www.siegmundgroup.com WASTEWATER TREATMENT&ENGINEERED CONTROL SYSTEMS 4 Massachusetts Department of Environmental Protection 1 Bureau of Resource Protection -Title 5 t� DEP Approved Inspection and O&M Form for Title 5 11 , Treatment and Disposal Systems . A. Installation when filihn out Owner /forms ors the ` To ✓_!-e( � corttputer,use only tho tab key Facit�c reez Address ,to move your C�(� •N\ /11 a C1(.i i cursor-do n^t use the return city Zip key. Mailing address of owner, if different: Stree AddressJPL'Box ilia City State zip - ext. Telephane htumtw-r B. AUthWlzed service Provider mpg f O&M Firm 9 416?v� o'ell -e- Stx Rddress +y R-2:: Ci lL #)79'5- - 0 130ext. State Zip Te�leph �Number Certified Operator Name Certification Number C.-Facility/System Information 1760 DHA ID Manufacurer 10 Model Number i� G 2, f I Z 2. a-/d �--- Instaiiawn Clate Stan or Operation Approval Type: [] General[] Provisional 9,Piloting[] Remedial Seasonal Residence_used less than 6 modyear:CjYes( Ufa Da Operating Info,nnedon - l S- o '2-- aOi'7/G 2- inspection Date previous lnspsctian Date Sludge Depth(to be chedmed yearly) Pumping Recommended Q Yes❑No Effluent DeacrOtion T51AONife?o2 Pam. H T 4/ Massachusetts DePeFtMent of Environmental Protection Bureau of n esource Protecti9rt -Title 5 ®EP ApPIrOVed Inspection and Treatment and Disposal Syste � Form ��� Title 5 i/� ` E. Sampling Information Sample$Taken: ❑influent 11 Effluent Parameters sampled:D pH D BOD❑TSS L7 TN er(list below) other t Other 2 Description of an p �,y tntenance erforrned since previous inspection&during this inspection: Dotes and Comments: F. COrtification I cerplet 1 have inspected the sewage treatment and disposal system at the address completed this report and the attached technology operaEion and maintenance checklist and the above, have MassZinformation reported is true accurate,and complete as of the time of the inspection. i am a e � 'led e r in a raance with 257 CMR 2 Q. - ` - ° "�'oCA System owner must submit this report, technology O&M checkiist,end an, require . , to the local board of health and DEP as tilows for each inspection performed: ° 'amaing._s,!its Remedial Use—by January Piloting&,Provisional Use _ 31 of eactt year for the General Us®—by September Previous calendar year within 3i�?days of inspection date 30d1 of each year for the Department of Environmental Protection Previous 12 months Attention: Title 5 Program One YVinter Street, G"Floor Pastors. MA 02108 T51AOM1 .312W2 Page 2 of 2 09-21-2002 06:17AM FROM JOE MARTINS TO 101081117079220356 P.01 SINGULAIR SERVICE CHECK LIST (with same inter) Set filter upright in tub,run SESI NoPW,�-3 .� clean water into it until the DATE OF SERVICE•_' 1!5--i O3 water flows out of the hole in SERVICE PERFORMED BY. the flange.insert compressed air hose and agitate with air. Keep agitating with clean water slowly flowing until the Location Work to be performed Doue exiting water is clear. Flnu Remove concrete cover,check_ Finish hosing down filter chamber for normal water level Scrape hopper 1 Check sludge depth after second year of operation Apply lubricant to filter flange Second Remove concrete cover i chamber Place filter in place,fill with I clean water and sink it Control Open and set to"CON'"' center position Turn out locking tabs,replace i filter cover Second Check air flow through aerator amber Replace concrete cover Unplug aerator and lift out First Replace concrete cover chamber Check for worn rubber pads Second Plug in aeratpe Check for wear or problem.. chamber Check wire in riser for,Aafing, Cr+it.Vice so it is not in contact tape if needed ^un anything _.. _.. Wash off serato{put it back Re accrete cover Hook up anrneter,check Conlhol Put switch on"A current v#Ui aerator running, cedmr _.position mmovv-?tgtail. j Close and lock cover Third Rer4ove concrete cover and chamber rerftove filter top. Read and record hour meter Turn in black locking tabs Paper Leave notice of service with work owner Install pump and start pumping from filter to first chamber. Dote in company file any Lift filter with rope as irregularity or problem necessary. Indicate if any follow-up is j Lift out filter,put it in tub necessary Clean the outside of filter with Be sure to complete file on water,drain back to first service,return it to office chamber MEMO: C�1-M 14t7gc TOTAL P.01 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 71 1� DEP Approved Inspection and O&M Form for Title 5 1/A Treatment and Disposal Systems ' A. Installation When fluky out Owner forms on the ,corn utet,use. only the tab key Faratrty S t Address to move your 0 • �j 4! ✓ /1 � /�(�/p cursor-do n^t - /47 use the return city zip key. Mailing address of owner, if different Street Address/PO t3ox; City -? State Zip(ri d n 3b•Z.- ext. telephone Number B. Authorized Service Provider ' S/Pq�v�d �llyi�'D�?/19P��31 SPretJICP O&M Forst Street-Address --pro 1/1os- C Zp TelegW Number Certified Operator Name Certification Number C.-Facility/System information. NoRwec 0 ��d DEP ID Manufacturer Ir? / � d Z I Number ' Instaltatt Gate Start of Operatlon Approval Type: Q General Cl Provisional Piloting❑ Remedial 61' Seasonal Residence—used less than 6 moJyear.❑Yes o D. Operat'ng to ormation s-/ 3 Inapedian Date Previous Inspection Date sludge Depth(to be chedwd yearW Pumping Recommended YeSANo `rV P_ 1 t� Effluent Descnphon T61AOmi -WiNO2 Page t of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 DEP Approved Inspection and O&M Form for Title 5 11A Treatment and Disposal Systems E. Sampling Information Samples Taken: fluent Q Effluent Parameters sampled: 9 H[- RdO l_i'fs's ER N Other(list below) Other 1 Other 2 Other 3 Description of any maintenance perfarmed ince previous inspection&during this inspection: Notes and Comments: F. Certification I certify: I have Inspected the sewage treatment and disposal system at the address above. have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, ccurate,and complete as of the time of the ins tion. I am a efts led a r in ac rda 257 CMR 2.00. 0 for Sionature �y 3 Date System owner must submit this report, technology O&M checklist, aid any-required samciing resuirs to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting&Provisional Use- General Use—by September 31. of each year for the within 32 days of inspection 30th of each year for the Previous calendar year date previous 12 months r Department of Environmental Protection Attention: Title 5 Program One Winter Street, tip'floor Boston. AAA 02108 T51AOM1 •31202 Page 2 of 2 09--21-2002 06=17AM FROM JOE MiRRTINS TO 1010B11170792203% P.01 ;f SINGULAIR SERVICE CHECK LIST (with same rater) ` Set fi:ituupright in tub,run 7 3 N class water into it until the SESI NO.__, waterowsota r DATE OF SERVICE: .•_ �' Q the flan insert comphole in ressed SERVICE PERFORMED BY:` air hose and agitate with air. (trait Keep agitating with clean water slowly flowing until the Location Work to performed Done exiting water is clear. bier Remove concrete ewer,check Finish basing down filter 1 chamber for normal water level Scrape hopper Check sludge depth after second year of operaaiou Apply lubricant to filter flange Second Remove concreto cover. I chamber Place filter in place,fill with drtnt wader and sink it � Ctnttrd Open ad set to"C ONr' eeubtr position Turn aid locking tabs,replace I - filtarpover Second Check air flow dwough acracor j chamber 3• Replace Concrete cover Unplug aerator and lift out First Replace concrete cover Chamber Check for worn rubber pads Second Plug in aerator Check for wear or pmblem.v chamber Check wire in riser fmthafing, CoR'wire so it is not in contact tape if needed r,►ut anything Wash off eerwo?"pus it beck Replace concrnre cover Hook up en r mter,check Cowl-ld Put switch on"AUTO" eurmM v¢Ru aerator running, cancer position retnov�,�tgtail. ' Close am lock cover Third Rerkove concrete cover and ' chamber rc&ovV filter top. Read and record hour meter 1 Turn in baack locking tabs Pages Leave notice of service with work owner' i Iassall pump and start pumping from filter to first chamber. Mote in cc npaiV file any Lift fllter with rope as irregularity or problem necessary. Indicate if any follow-up is Lift out filter,put it in tub necessary i Clean the outside of fitter with Be sure to complete,file on water,drain back to first t service,return it to office chamber MEMO: '« `'W Q�W�'riC6 c���K�"` a s 3� .S� S Cr-A, t s a ��n.� r� N�w,-Ot dA_ _ r r hi TOTAL P.01 1 i v GROUNDWATER ANALYTICAL Inorganic Chemistry Field ID: 55 Tonela Barn Matrix: Aqueous Project: Singulair/55 Tonela Barnstable Received: 03-26-03 Client: Siegmund Environmental Services Lab ID: 59439-01 Sampled:903-24-03 14:00 Container:: 1 L Plastic Preservation: Cool rVWr � r Analyte� ;� Result �mt5 :� Anal zel Ct3atch a "Method . Nitrate(as Nitrogen) 8.6 mg/L 0.1 03-26-03 19:14 NI-1725-W SM 4500-NO3 F Nitrite(as Nitrogen) 0.07 mg/L 0.02 03-26-03.18:57 NIA 725-W SM 4500-NO3 F Lab ID: 59439-02 Sampled: 03-24-03 14:00 Container: 500 ml Plastic Preservation: H2SO4/Cool o`s`�. ""y' 'S'Lt r "-; �s. �,.eF :'YrX . RepOrtlllgf?` ,"". `'r'f "':k E`Y"'*t+^ 4 ca5•�' `•; 'S "s "r `'A v w-`h rt;� .�Analyte,,�� � "'Mr9.,.z Nitrogen,Total Kjeldahl (TKN) 16 mg/L 0.5 04-04-03 TKN-1072-W EPA 35.1.2 Lab ID: 59439-03 Sampled: 03-24-03 14:00 Container: 1 L Plastic Preservation: Cool r z r Re ortin Analyte, '' � *Result" Umts p ,�g' ,Anat zeil� �QC Batch =Method X�",�,,`'aa*.`• Biochemical Oxygen Demand 54 mg/L 10 03-26-03 21:24 BOD-1316-W SM.5210 B Solids,Total Suspended 29 mg/L 10 03-28-03 TSS-0806-W SM 2540 D pH 7.3 pH NA 03-26-03 20:46 PH-1435-W SM 4500-H+B Method References: Methods for Chemical Analysis of Water and Wastes, US EPA,EPA-600/4-790-020, Revised(1983),and. Methods for the Determination of Inorganic Substances in Environmental Samples, US EPA, EPA/600/R-93/100,(1993),and Standard Methods for the.Examination of Water and Wastewater, APHA,Eighteenth Edition(1992). Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is the lowest value that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample dilution and sample size. Groundwater Analytical, Inc.,'P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 S MUND C11 � January'i3, 2003 IEG ENVIRONMENTAL SERVICES,Inc. Dr. Dale Saad Health Department . - 49 Pavilion Avenue Barnstable Board of-Health Providence,RI.02905 200.Ma1ri Street Tel'401-785-0130 _ Fax 401-785-3110 Hyannis,MA o26o1 E-mail:sesi@ siegmundgroup.coin.. Dear Dr. Saad„ A SiegmundGroup Company ASSOCIATED COMPANIES: Enclosed, please`',find installation, service, maintenance and testing.results, . .information for following ,Singulair®Wastewater Treatment Systems currently in U.S.A. operation in-Barnstable: A,J.Resources - Massachusetts HUNGARY" Address Marlett Kft. and 55 Tonela ',BarnstableProfes-Aqua,Kft Budapest Also,please find a copy of-the database coverpage which details all of the service, RUSSIA maintenance and testing information. -for,the life .of the system. Finally, also included is some cursory information regarding the SingulaO itself.: Sesi-Krasnodaz Krasnodar If you have any questions`regarding the enclosed information;please do not hesitate SLOVAK REPUBLIC to contact me directly. Ekostar/usa spot.sr.o. ' Tomasov _ WEST INDIES - Regards > Rosewater Systems,N.V. St.Maarten McAlastair,Ltd. 1 e S gmun } ', Nevis , YUGOSLAVIA enc. . EKS/usa Novi Sad mfile Find us all in www.siegmundgroup.com WASTEWATER.TREATMENT& ENGINEERED CONTROL SYSTEMS. Owes to SESI: Siegmund Environmental Services, Inc. 49 Pavilion Avenue,Providence,R1 Tel.401-785-0130 Fax.401-785-3110 SINGULAM Service Record Work To Be Done: MASSACHUSETTS ServiceFesting i Next Service Due Contract Exp.Date ❑Call ahead for service In SESI doesn't have to test/monitor � Cape Cod Size p January, 2003 11/25/2004 Contract Ex I-tr Sent []Waiting for test results 500 p• 9 Off Cape Cod Job Number Date Operational Motor Ser.# DEP Permit# MA-153(DN) 11/25/2002 17626CR� Owner Name Street Address City/Town State Zip Code Telephone Ted Meyers 55 Tonela Lane Cummaquid MA 02637 Off-site Address Street Address City/Town State Zip Code Telephone Installer Name Street Address City/Town State Zip Code Telephone PKM Contractors w 313 Hokum Rock Road E. Dennis I MA 02641 508-385-5993 Memo Contract Expiration Date Years 1 Initial Service Contract Inspection 1 Inspection 2 Inspection 3 Inspection 4 Date Date Date Date 12/17/2002 Water Meter Water Meter Water Meter Water Meter Inspector Inspector Inspector Inspector J M �— Comment Comment Comment Comment Tested&Monitored BOD:12,TSS:13,TNA1,TKNI:41 pH:7.9 Date Date Date Date Water Meter Water Meter Water Meter Water Meter Inspector Inspector Inspector Inspector comment comment Comment Comment V I rile I Massachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 DEP Approved inspection and O&M .Form for Title 5 UA L I , Treatment and Disposal Systems X Installation lrnportanl: when ttt"out fornauw use o 'er s� /� g✓L� f only ft tab key Fac14 SbW Address to move your cursor-do n-t i use the return C;ty Zp key. Mailing address of owner, if different ! Street AddrsssJPO Box: jCity State rip Telephone Number B. Authorized Service Provider. S�Pq�u�r� �lly�r�rt�Pn�t� SPrwrCPS, _LrlG osM Fern StreelLAddresS S zip 1678',V - 0130ex Terep 5e, r r i s �B Certified Operator Name Certifrcatiort Number i ; C.-Facility/System Information NoR�r�c v 960 I DEP 10 blanufacwter ID AAodei Number S Ilo ✓ or z Installation Date Start of operation ' Approval Type: Q General Q Provisional noting Q Remedial jSeasonal Residence—used less than 6 moJyear:Ql 4NO D. Operating information, Inspection Date Previous Inspection Date Sludge Depth(bo be dtedwd yearly) Pumping.Recommended Q Yes ONO E[nuent Description T51AOM I-U1 802 page t of 2 j0'd 9SC0Z36L0LTT1e0i01 01 SNIi2Kl '30f WO2U Wd20:60 Z00Z-6Z-60 Y a Z0'd -"Ml Mal MassachUsett:s Department of Environmental Protection LiBureau of Resource Protection-Title 5 DEP Approved Inspection,and O&M Form for Title 5 IIA Treatment and Disposal Systems E. Sampling Information Samples Taken: Influent Q Effluent Parameters sampled:❑pH❑BOO❑TSS❑TN E Other(list below) i II Other 1 Other 2 Other 3 i Description of any maintenance performed since previous inspection&during this inspection: k I Notes and ommen : 4 ee F. Certification ! I certify: I have inspected the sewage treatment and disposal system at the address above. have completed this report and the attached technology operation and maintenance checklist and the in on reported Lis1rue, ,and complete as of the time of the inspection. I am a _ ass use tts pe acco an 257 CMR 2.00. or signature �aie System owner must submit this report,technology O&M checklist,:=any required samcung Jesuits to the local board of health and DEP as follows for each inspection performed: i Remedial Use_by January Piloting&Provisional Use- General Use-by September 31. of each year for the within 30 days of inspection 30°t of each year for the previous calendar year date previous 12 months i ! Department of Environmental Protection Attention: Tide 5 Program One Winter Street; a Floor Boston. MA 02108 ! I i f T51AOM1 •3J2Bd02 Page 2 of z i l - Z0'd 9S202E6LOLITTSOTOT 01 SNI12lHW 3CIf WMH 141300:60 200Z-6Z-60 09-21-2002 06:17RM FROM JOE MARTINS TO 101081117079220356 P.01 SINGULAIR SERVICE CHECK LIST (with same Blter). Set filter upright in tub,run SESI NO. "` clean water into it until the water flows out of the hole in DATE OF SERVICE. �.�_ ,. the flange;Insert compressed SERVICE PERFORMED B _5� _ air hose and agitate with air. Qnitlats3 � Keep agitating with clean ' water slowly flowing until the L Sadon Work to be performed Done exiting water is clear. Fn'st Remove concrete cover,check Finish hosing down filter chamber for normal water level Check sludge depth after Scrape hopper second year of operation 'Apply lubricant to filter flange Second Remove concrete cover chamber Place filter in place,fill with I clean water and sink it Control Open and set to"CONT' i center position Turn out locking tabs,replace j filter cover ' Second Check air flow through aerator chamber Replace co v I Rep concrete cover Unplug aerator and lift out First Replace concrete cover chamber Check for worn rubber pads Second, Plug in aerate Check for wear or problems/ chamber Check wire in riser fo*,Ahafing, Cnii'wire so it is not in contact tape if needed -icn anything Wash off aerato{put it back Replace concrete cover Hook up anfneter,check Cowsbl Put switch on"AUTO" c urrem wiUi aerator running, ctir''cer position remov!✓ptgtaii. i Close and lock cover Third Reriove concrete cover and chamber rethove filter top. Read and record hour meter Turn in black locking tabs Paper Leave notice of service with %rock owner ! Install pump and start pumping fmm filter to first chamber. Note in company file any Lift filter with rope as itregularity or problem necessary. j Indicate if any follow-up is j Lift out filter,put it in tub necessary Clean the outside of Stier with Be sure to complete file on water,drain back to first service,return it to office chamber MEMO: TOTAL P.01 V, IMassachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 DEP Approved lnspection and O&M Form for Title 5 I/A Treatment and Disposal Systems ' A. Installation Irnportardw e L �� VVMn fluky out Owner �-- forms e computer.th use (k, only the tab key Facft Address / j move your c cursor-do n^t 1 use the return c y Trp key. Mailing address of owner, if different _Its s Street Addreis/PO 8ox city (, 0f 3`7--021.3 . State Zip Telephone Number .T B. Authorized Service Provider SiPqmverd. Erly�ronm P it l swulews , TA O&M Fin" ' S Address ! /'D ✓i a"mr-e. I State Zi �3oext p Telep .rs Numbs :/O� /�/�qr 7`i SOS"7 Certified Operator Name Cwtiflcation Number I I C.-Facility/System Information. A/oxwec o 960 DEP 10 ManufaCuref 10 Model mber Installation Oa)6Start of Operallon f Approval Type: [I General Q Provisional Piloting❑ Remedial Seasonal Residence—used less than 6 moJyear.QYeskNo D. Operating Information . 1112, Inspection Date Previous Inspection Oate m in Recommended .❑Yes❑No j Sludge Depth(to be checkW yearly) P g Effluent Description TSIAOMI-3tiwo2 Pape t of 2 T0'd 992022GLOLITTeOTOT 01 9NIi8JW 90f WONA Wd20:60 200z-62-60 Z0'd -1ti101 F Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection-Title 5 DEP Approved Inspection and O&M Form for Title 5 IIA Treatment and Disposal Systems E. Sampling Information Samples Taken: ❑Influent❑Effluent i Parameters sampled:❑pH❑BOO❑TSS❑TN❑Other(list below) Other 1 Other,2' Other 3 Description of any maintenance performed since previous inspection&during this inspection: i Notes an Comments: PG G r � i2d PvL� F. Certification I certify: I have Inspected the sewage treatment and disposal system at the address above,have completed this report and the attached technology operation and maintenance checklist,and the information reported is true ccurate, and complete as of the time of the i Spec n. I am a ass Chu tts i p in a w dance - 7 CMR 2.00. i Z L O Z _ tar Signature Date System owner must submit this report,technology O&M checklist,and any required samcung resuirs to the local board of health and DEP as follows for each inspection performed: i Remedial Use-by January Piloting&Provisional Use- General Use-by September i 31 st of each year for the within 12 days of inspection 3e of each year for the previous calendar year date previous 12 months i I Department of Environmental Protection I Attention: Title 5 Program One Winter Street, a Floor Boston. MA 02108 i T51A0M1 •3MOM2 Paps 2 of i 20Id 9SCO226L0LTTTe0T0T Ol SNI18fJW 30f 1408d Wd00:60 200Z-62-60 i 09-21-2002 06t17RM FROM JOE MARTINS TO 101081117079220356 P.01 SINGULAIR SERVICE CHECK LIS'T'- Set filter upright in tub,run (with same filter clean water into it until the SESI NO._.: P �/Z water flows out of the hole in DATE OF SERVICE: IZ 4 the flange.Insert compressed SERVICE PERFORMED BY: � air hose and agitate with air. l Deep agitating with clean water slowly flowing until the Location Work to be performed Doe exiting water is clear. I Fist Remove concrete cover,check Finish hosing down filter chamber for normal water level i Scrape hopper Check sludge depth after second year of operation Apply lubricant to filter flange Second Remove concrete cover cham ber Place filter in place,fill with clean water and sink it Control Open and set to`CONY' center position Turn out locking tabs,replace ' filter cover Second Check air flow through aerator chamber Replace concrete cover Unplug aerator and lift out First Replace concrete cover chamber ' Check for worn tubber pads Second Plug in aerator Check for wear or problemse chamber Check wire in rise'fbr,t_hafing. Cnil wire so it is not in contact tape if needed aim anything Wash off aerator put it back Replace concrete cover Hook up aneneter,check Conteroi Put switch.on"AUTO" current v4a aerator running, cohcer position rernovgr?tgtail. Close and lock cover Third Re 4ove concrete cover and chamber re&ove filter top. Read and record hour meter Tian in black locking tabs Paper Leave notice of service with work owner Install pump and start ptunping _ from filter to fast chamber. Note in company file any Lift fiber with rope as irr eguiatity or problem necessary. Indicate if any follow-up is Lift out filter,put it in tub necessary i Clean the outside of filter with Be sure to complete file on . water,drain back to first service,return it to office . " chamber MEMO: ' it 10 12� 1�2 4. �c fan- o "h[(/�(/l, ✓I CCU✓✓`P��GU I/�'�PO� TOTAL P.01 IMassachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 Approved 1 DEP A pp Inspection and O&M Form for Title 51/A Treatment and Disposal Systems ' A. Installation Itttpot'lartt+ When ffil"out I forms an the owner computer,use only the tab key FacK4 S Address to move your i cursor-do n-t ,o�-T-_ use the return CAy Zip I key. Mailing address of owner,if different; Sheet Address/P0 Box City State - Zrp ext - c -PGI� -���°Cte� , Telephone Number A- sT77i&77//' B. Authorized Service Provider SiP �nv� 9 d �/Iy,r�n�►Pnr�� SPrw�cPS, .Lhc oaM i='.n„ � Sft r0✓i�� i State Zip ��1)7e1'5- - 0)3oe"- 0)3oezt: Tel_p=Number •y� ..- JOB �qr/ l•rS �'Ds�T Certftied Operator Name . Catilicabolt Number i i C.-Facility/System Information /I/ogAl ec o 960 DEP 1D O' MWufac:UW ID Model Number. j .. Installation Date Start of Operation Approval i App Type: ❑General❑ Prrnrisional Piloting❑ Remedial Seasonal Residence—used less than 6 moJyear.❑Yes No D. Operating Information Z,- -� Inspection Date Previous Inspection oats Sludge Deem(to be checked yearly) Pumping Recommended ❑Yes❑No Effluent Description i T51AOM I.3r2=2 Pape t of 2 T0'd 992022GLOLTTT80TOT 0i SNIiaM 2U W08A WU£0:60 200Z-6Z-60 F Massachusetts Department of Environme ntal Pr otection tection Bureau of Resource Protection-Title 5 DEP Approved Inspection and OEM Form for Title 5 I!A Treatment and Disposal Systems E. Sampling Information Samples Taken:❑Influent❑Effluent Parameters sampled:❑pH❑BOO Q TSS❑TN❑Other(list below) i s ` Other 1 Other 2 Other 3 I i Description of any maintenance performed si previous inspection 8�during this inspection: ! Notes and Comments- F. Certification I certify: I have inspected .the sewage treatment and disposal system at the address above.have completed this report and theched technology operation and maintenance checklist,and the info n report ,a rate, and mplete as of the time of the_inspection. I am a f+A sac cpe in ac with 257 CMR 2.00. _ / —Z � -) Z ff Oo gn tie mace i E System owner must submit this report,technology 0&M checklist,an any required samming resurcs ' to the local board of health and CEP as follows for each inspection performed: i Remedial Use-by January Piloting&Provisional Use- General Use-by September 31 of each year for the within 32 days of inspection 30'h of each year for the i previous calendar year date previous 12 months i I Department of Environmental Protection i Attention: Mlle 5 Program One Winter Street,a Floor Boston. MA 02108 i i T5IAOM1 •31=2 Page 2 of 2 i 201d 9SI=0ZZ6L,&iTTeoT0T of SNIIdM 30f W021d Wdt70:60 aE2-6z--G0 ., 09-21-2002 06:17AM FROM JOE MARTINS TO 101081117079220356 P.01 5INGULAM SERVICE CHECK LIST (with same filter) Set filter upright in tub,run clean water into it until the SESI NO. I' "��Z water flows out of the hole in DATE OF SERVICE:, Z the flange.Insert compressed SERVICE PERFORMED BY: 71/ air hose and agitate with air. (Initials) Keep agitating with clean water slowly flowing until the Locstfon Work to be performed Done exiting water is clear. First Remove concrete cover,check Finish hosing down filter chamber for normal water level Check sludge depth after. Scrape hopper second year of operation Apply lubricant to filter flange. Second Remove concrete cover chamber Place filter in place,fill with i clean water and sink it Control Open and set to"CONT' center position Turn out locking tabs,replace filter Nver Second Check air flow through aerator' chamber Replace concrete cover Unplug aerator and lift out First Replace concrete cover. chamber Check for worn rubber pads Second Plug in aeratgs Check for wear or problems chamber Check wire in riser fo*,Aafing, Cur:wire so it is not in contact tape if needed yun anything Wash off aerator put it back Replace concrete coved Hook up anrneter,check CoWV_ Put switch on"AUTO" current w ibi aerator running, caper position removS✓pgtail. j Close and lock cover ' Third Rersfove concrete cover and chamber reifiove filter top. Read and record hour meter i Turn in black locking tabs Paper Leave notice of service with work owner i Install pump and start pumping from filter to first chamber. Note in company file any Lift filter with rope as irregularity or problem necessary. E Indicate if any follow-up is Lift-out filter,put it in tub necessary ! Clean the outside of filter with Be sure to complete file on water,drain back to first service.return it to office chamber MEMO: G Aw �Glc -�' e c6o 4,&f vl Sc -C, c /%" TOTAL P.01 Y=- �j}� _ S.�li 4��i 1•, J r.r. f -D„/ IMassachusetts Department of Environmental Protection Bureau of Resource Protection-Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems ` A. Installation When NIN out Owner Important /i�� �/lf computer,use A.- only the tab key Facdrty Address to move your " C""Atp�I�Yit r1 y/ W cursor-do n^t - use the return o'ti Zip key Mailing address of owner, if different Street Address/PO Bax City State Zip Telephone Number B. Authorized Service Provider S1'e2mv4d Ew,rOnA6nAg SeRUIe-P.r •. O&M Fk" S Address too ✓1 a���lc-e_ �� Do2 has_ C7 State zip col 79'5' - 0130exc Telep Numbs__ w JOB / gr r`�.�s ,�D.�T CerCfied Operator Name Certification Number C.-Facility/System Information oep 10 /1loxwec v 960 G/ 0 \2 ' Manuha=rer ID - LZ d �--Number - tnstaitation to Start of Operatlon Approval Type: [Q General❑ ProvisionalOPiloting❑ Remedial Sen sonal Residence—used less than 6:rno.tyear:QYes�o. D. Operating Information /2- Icapeatlon Date Previous Inspection Date Sludge Depth(to be checked yea" Pumping Recommended ❑Yes C No j Effluent Description T51A0M t-Ur U!2 Pape t"04 2 f- Massachusetts Department of Environmental Protection Bureau of Resource Protection-.Title 5 DER Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems -E. Sampling Information- Samples Taken: ❑Influent L; Muent Parameters sampled; H►�'j00T I—_TN Other(list below) other 1 Other 2 Other 3 ' Description of any maintenance performed since previous inspecction&during this inspection.- Notes and Comments: 0 ! ' /yi Gi F. Certification certify: I have inspected the sewage treatment and disposal system at the address above.have completed this report and the attached technology operation and maintenance checklist,and the - information reported is true,accurate,and complete as of the time of the inspection. I am a ssac etts for in ac^ ra th 257 CMR 2.00. Coe -n u Gate_ System owner must submit this report, technology O&M checklist, and any required samciing ressrrs to the local board of health and DEP as follows for each inspection performed: Remedial Use—by January Piloting&Provisional Use- General Use—by September . - 31"of each year for the within days of inspection_ 301°of each year for the - previous calendar year date previous 12 months Department of Environmental Protection Attention: Title 5 Program One Winter Street,6a'Floor Boston. MA 02108 T5lAOM1 •312=2 Page 2 of 2 SINGULAIR SERVICE CHECK LIST (with same 6lter) Set filter upright in tub,run SESI NO. clean water into it until the DATE OF SERVICE: water flows out of the hole in L_ ' --��—��� the flange.Insert compressed SERVICE PERFORMED BY: air hose and agitate with air. (Initials) Keep agitating with clean water slowly flowing until the Location Work to be oerfoemed Done exiting water is clear: First Remove concrete cover,check Finish hosing down filter. chamber for normal water level Scrape hopper Check sludge depth after secondyear of operation - Apply lubricant to filter flange Second Remove concrete cover chamber Place Filter in place,fill with I Clean water and sink it Control open and set to"CONT' center position, Turn out locking tabs,replace filter ever Second Check air flow through aerator chamber Replace concrete cover Unplug aerator and lift out, First Replace coa Crete cover chamber Check for worn rubber pads Second Plug in aerator Check for wear or problems chamber Check wire in riser for,Aafine, Cnii wire so it is not in contact tape if needed y un anything Wash off aeratoe put it back Replace concrete cover. Hook up anrneter,check Cow'tol Put switch on"AUTO" current w iUi aerator running, eciher position removfo�igtai.l. Close and lock cover Third Remove concrete cover and chamber redtove filter top. Read and record hour meter Turn inbtack locking tabs Paper Leave notice of service with work owner i Install pump and start pumping from frherto first chamber. Note in company file any Lift lf1mr with rope as irregularity or problem necessary. s Indicate if any follow-up is Lift ootftlter,put it in tub necessary Clean the outside of fitter with Be sure to complete,file on water,drain back to first service,return it to office chambtr MEMO: A01 J �z� f f i GROUNDWATER A NALYT/CAL Inorganic Chemistry Field ID: 55 Tonela Matrix: Aqueous Project: Singulair Received: 12-17-02 Client: Siegmund Environmental Services- Lab ID. 57018-03 Sampled. 12-17-02 09:00 Container: 1 L Plastic Preservation: H2SO4/Cool r s4' a rReporttng x s " r Analyte ,* Result _;Units ; AnalyzedQC Batcli i.Method._, 4' LimIt� I Nitrogen;Total^Kjeldahl (TKN) 41 mg/L,, 0.5 I 12-23 02 pTKN-1011-W EPA 351.2 Nitrogen,Total (as TKN, 41 i mg/L 0.5 12-23-02 TKN-1011-W EPA 351'.2 I Nitrate and Nitrite) I 12-17-02 NI-1640-W SM 4500-NO3 F Lab ID: 57018-07 Sampled: 12-17-02 09:00 Container: 1 L Plastic Preservation: Cool 'Reo A Li°m t B nalyte Units �A,,. z .zx e thod i .., Biochemical Oxygen Demand 12 1 mg/L 8 12-18-02 16:06 BOD-1254-W SM 5210 B Solids,Total Suspended 13 I mg/L 101- 1 12-19-02 TSS-0771-W SM 2540 D PH .. 7.9 I pH NA 12-17-02 20:40 PH-1384-W SM 4500-H+B ? _ Method References: Methods for Chemical Analysis of Water and Wastes; US EPA,EPA-600/4-790-020,Revised(1983),and Methods for the Determination of Inorganic Substances in Environmental Samples, US EPA, EPA/600/R-93/100,(1993),and Standard Methods for the Examination of Water and Wastewater, APHA,Eighteenth Edition(1992). Report Notations: BRL Indicates result, if any, is below reporting limit for analyte. Reporting limit is,the lowest value that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample dilution and sample size. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 F SingulairO Wastewater Treatment System The Singulair®utilizes extended aeration to achieve an over 95% removal of the pollutants found in normal household wastewater. The Sing u lair"provides pretreatment,.aeration, clarification and tertiary filtration within a single,three chambered precast concrete tank,The only mechanical component is the aerator,and the patented filter device assures that.all flow through the unit is equalized and completely treated. The Singulair®is constructed of 4,000 psi reinforced concrete,and is manufactured locally by J &R Precast, Inc. of Berkeley, MA. The tank is delivered and set at the project site.for easy installation. The Singulair®is designed to be engineer and contractor friendly., It is simple to install,.maintain and;service and is an easily implemented solution to difficult TitleV applications. The Singulair® is the least expensive alternative treatment technology available on the market today. { s�►x .y: z -installation of the Singulair®tank: Atypical Singulair®installation. Installers & Contractors Engineers & Title Designers Contractor.Friendly - installation.is the same as Approved for General and Remedial Use in the a standard,septic tank.(except for electrical work) Commonwealth of.Massachusetts Tanks.delivered and set on your schedule 50% Leachfield reduction for Remedial installations Quoted price is actual price with no surprises, hidden costs or extra charges Variances granted for high groundwater and distance to critical resource areas Complete,easy to follow instructions provided with every sale.&free tech support Design and site considerations are the same as a standard 1,500 gallon septic tank, Least expensive alternative technology available for a 3 to 4 bedroom home - Comprehensive O&M program including D'E.P. and local B.O.H. notifications Tanks are available, in stock and ready to go! CAD drawings.available for easy downloading on our website siegmundgroup.com ; Siegmund Environmental411) 785-0130 ♦ 1. 822-3311 SingulairO Wastewater Treatment System 500 GPD tank dimensions: Aerator Motor Height to inlet invert-5'0" .Height to outlet invert-4'8" L 9'3"x.W 5'6"x D 6' Inlet Uses 18"high Poly-lok®risers ku .. � 2 `4 �ya. ar ;• # { Outlet _ r a Bio-Kinetic® Filter System Pretreatment v� Aeration Clarification Removes over.95% of the BOD and TSS found in domestic wastewater LOW Produces clean, clear and odorless effluent with 85% Nitrogen reduction Easy installation, maintenance and service LOO The most affordable innovative wastewater treatment technology available 01 Over 250 systems installed in Rhode Island and Massachusetts Licensed in over 40 states nationwide, over 100,000 systems installed worldwide Solution for difficult sites where high groundwater and critical resources are a concern AP Treatment capacity ranges from 500 GPD to 1,500 GPD Singulair® Denitrification system available under Piloting Approval 40 Most Comprehensive O&M program including D.E.P.and local B.O.H. notifications Siegmund Environmental Services, Inc. 411) 785-0130 ♦ 1. 822-3311 SIESMUND13ROURSCOM Providing technical services around the world. . . Singulair Wastewater Treatment System AERATOR -� The SINGULAIR wastewater treatment system is designed to treat domestic sewage for individual XXX:: <:A:> homes clusters of homes or commercial developments.It received Class 1,Standard 40 certification by the National Sanitation Foundation International and it is approved in most of the United States,including Rhode Island,Massachussetts and in many foreign OUIIET countries. y f J•. "E' '` The SINGULAIR is constructed of F:' :• 5,000 psi reinforced concrete. The BIO-K[NETICSYsum tank is delivered to the project site fi `¢ { ready for installation, similar to the AERATIONCHAMBER CLARMCATIONCHAMBER septic tank it replaces. The SINGULAIR utilizes the extended aeration method ofwastewater treatment to achieve the level oftreatment demonstrated by the NSFI Certification.The treatment process takes place in the three-compartment precast concrete tank. THE MODEL 960 WAS CERTIFIED TO HAVE DEMONSTRATED THE FOLLOWING EFFLUENT QUALITY: BOD 6 MG/L, SS 10 MG/L. THE EFFICIENCY IN TKN REMOVAL IS 85%. I 35% Leach field reduction is approved in Rhode Island. 50% Leach field reduction in Massachusetts for remedial installations. PAVILION49 R1 02905 WWW.SIEGMUNDGROUP.COM PROCESS DESCRIPTION F...� The SINGULAIR is constructed of 5,000 psi reinforced concrete. The tank is delivered to the project site ready for installation, similar to the septic tank it replaces.The SINGULAIRutilizes the extended aeration method of wastewater treatment to achieve the level of treatment demonstrated by the NSFI Certification. The treatment process takes place in the three-compartment precast concrete tank. 1.Pretreatment Chamber The first chamber acts as an anaerobic settling area for the incoming wastewater stream.In this chamber the heavy solids settle and the anaerobic decomposition process preconditions the wastewater during its approximately 12 hours of residence. 2.Aeration Chamber The aeration chamber provides in excess of twenty-four hours of detention time during which the wastewater is aerated. Aeration is performed via the action of the aerator motor and an aspirator shaft which draws the air into the water.The aeration chamber's length-width-depth ratio is designed to ensure uniform mixing for optimal treatment. 3.Clarification Chamber The clarifier is designed to provide satisfactory settling and clarification for the aerated wastewater. ~� 4.Bio-Kinetic Filter The Bio-Kinetic filter is located totally withinthe clarification chamber.The filter provides flow equalization,filtration,optional chlorination and dechlorination and final settling to ensure acceptable effluent quality. All components are manufactured with inert synthetic materials or corrosion resistant stainless steel, assembled into the cylindrical filter and connected to a plastic outlet coupling cast into the tank. 5.Mechanical Aerator The air and the mixing needed during the treatment process is provided by the aerator.It is installed in the concrete riser at the center ofthe aeration chamber.The aerator motor is a single phase 1/6 1HP,115 V,60 Hz unit operating at 1,720 RPM.Operation time is adjustable but the NSFI certification is with a 50%running time(30 minutes of every hour). 6.Electrical Control Panel Aerator controls are mounted in a weather-tight plastic enclosure for protection.Included are:manual reset circuit breaker, ron-off-automatic selector switch,adjustable timer mechanism and an audible/visual warning system to report malfunction. 77.Capacities The SINGULAIRMode1960 is available in 500,750,1000,1250 and 1500 gallons per daytreatment capacities. Parallel configuration(where permitted)extend capacities. C SIEGMUND ENVIRONMENTAL SERVICES,INC. 49 PAVILION AVENUE PROVIDENCE,RHODE ISLAND 02905 Tel 401-785-0130 Fax 401-785-3110 E-mail:sesi@siegmundgroup.com Website:www.siegmundgmup.com S. V., .. F� On Ca eCod: ir: Mr.John P.Lally Cape Cod Sales Manager Te1.508-394-0057 Associated offices in Russia,Hungary, Slovakia, Yugoslavia, St. Kitts, St. Maarten. ti To Whom It May Concern: Please be advised.that we; SALLY R..WALKER and TBEODORE 1 MYERS, both of.36 Piney Point Drive; Centerville, MA.02632 purchasers of property located at:55 Tonela Lane, Barnstable(Cummaquid),,MA.as evidenced by a duly executed Purchase and Sale Agreement dated,January 25, 2002,-Alison Piasecld Smith et al, sellers, hereby grant permission for ROBIN W. WILCOX of-Sweetser Engineering, 235 Great Western Road, South Dennis, MA 02660 to represent us before:the:Barnstable.Conservation Commission and before the Barnstable Board-of Health,and/or any ancillary boards which might.be connected with the siting of and permission to install.a.Title.V compliant:septic system at the 55 Tonela. Lane, Barnstable(Cummaquid),.MA property. Sally R W cer Theodore:J. Myer Dated: April 22, 2002,, ' f� . ABUTTERS OF: 55 Tonela Lane Cummaquid(Barnstable) APPLICANT: Theodore Myers P. O. Box 605 AM 336/19 Job#5345 West Barnstable MA 02668 Board of Health Theodore Myers P. O. Box 605 APPLICANT West Barnstable,MA 02668 Alison S. Piasecki, et al 4333 Tonela Lane AM 336/19 Barnstable, MA 02630 Estate of Wm. &Irene Smith F 4333-Tonela.Lane AM 336/63 Barnstable, MA 02630 Robert Gerrier Marie Geirier AM 336/18 P. O. Box 401 Cummaquid, MA 02637 John D.Potter Maria Potter AM 336/66 42 Tonela Lane Cummaquid,MA 02637 Robert E. Guertin Joanne E. Guertin AM 336/42 9 Candy Lane Cummaquid, MA 02637 Malcolm K.Hickey Karen J. Hickey AM 336/68 P. O. Box 406 Cummaquid, MA 02637 Joan M. Terkelsen P. O. Box 394 AM.335/64 Cummaquid, MA 02637 SWEETSER ENGINEERING P.O. BOX 713 —SOUTH DENNIS MASSACHUSETTS 02660 TEL(508) 398-3922 FAX(508) 398-3063 . LAND SURVEYING - ENGINEERING - TITLE 5 SEPTIC SYSTEMS April 24, 2002 NOTIFICATION TO ABUTTERS OF: Applicant: Theodore Myers CERTIFIED MAIL P.O.Box 605 RETURN RECEIPT REQUESTED . West Barnstable,MA 02668 Re: Septic System at 55 Tonela Lane,Cummaquid(Barnstable) Dear Abutter, A public hearing has been scheduled for the Barnstable Board of Health to take action on an application for variances from the Regulations of the Mass. Department of Environmental Protection, Title 5, and/or the Town of Barnstable Regulations for Subsurface Disposal of Sewage, as follows: TITLE 5 REGULATIONS Section 15:211 Distances requires all Septic System Components be installed 50' from Wetland A 0.89' variance for S.A.S.and A 639'variance for Tank&Pump Chamber are requested Distance between S.A.S.and Cellar wall-20' required— 10' requested Section 15:248 Reserve S.A.S.required for new system—.no reserve—variance requested BARNSTABLE BOARD OF HEALTH REGULATIONS: Chapter III,Section 31 Town Distance requires all Septic System Components be installed 100' from Wetland A 50.89'variance for S.A.S.- and A 81.39'variance for Tank&Pump Chamber are requested Town Distance requires S.A.S.be 20' from cellar wall—10'variance requested Reserve S.A.S.—No reserve S.A.S.area proposed—variance requested The application and plans are available for review at the Barnstable Health Department, 200 Main Street, Hyannis,MA 02601, Monday through Friday(excluding holidays) from 8:30 AM to 4:30 PM.A tentative hearing date is scheduled for May 28, 2002,please call Barnstable Health Department to confirm date and time(508-862-4644) Sincerel , Robin W. Wilc6x 1•p0 n %w. {O 10 AMC b 1ef IN 71 1.81� 9 L9►f' 1.�I M fef pjC `4APAS, 0 • .9!AC. ee �� _ q It 31 - - - \.\b&A- G 6{ i�► 46 O � rJ iZ Joe"o' a'A I�y85P�• '� l4"� i-� _ � .�. ice•'► ,TCtINt • 16 .low` W' 10 1 1 .76 ! AS 9 Z Q e ,59 K 4 yfT 41 lows fto/rrs i bg .� 42 zAo►r- � i .04 Nc• � lt. � so - \ 0 7!1•C• SIC p C. < ;tewi. r t 1s��.. 9U• .mow' 17on o 1. u .1.1 t.11 .610 W gee 6f1�c 23 t- 11 J9 AC tje E .43 AC e-st{ BgtF do e a oU t to .w,tt.-is. b I �" D _ � e ` Q © {w� no O too ss ` �'G tie ' D4 LIIo it 1.05 Kit 0 5049 48 to .39AC 7 AC 40 �� OQU Fee THE COMMONWEALTH OF MASSA `HUSETTS Entered in computer: Y��✓ PUBLIC HEALTH DIVISION -TOWN OF BARNST�4BLEs MASSACHUSETTS 01ppitration for 30i5poal *pztem Con!trurtfon Permit Application for a Permit to Construct( )Repair(Upgrade(A Abandon( ) *omplete System El Individual Components Location Address or Lot No.6� 7" g O��A�ef�'�s J e ddvress aaid�/T���1.No. Assessor's Map/Parcel ;1er's Name dre Te N Designer' Addr and Tel.No. , pe of u'ding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other 'I)rpe of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) VISE U vP1�N,1B CERIIEY IN WRITING Q ra Inc` �l�`Tf;L.�ED IN STRICT Date last inspected: ACCOrs_ Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisi s of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been s by hi o of He It Signed Date Application Approved by Date Application Disapproved for the following reas s Permit No. Date Issued IV ' ✓/ . `• Entered in computer: f- THE COMMONWEALTH OF MASSAaHJ1SS _ Y- .� /PUBLIC 1.1EALTH DIVISION-TOWN OF BARNSTA_BL'Es MASSACHUSETTS Z plicatio,�n for Ziopooar *p.5tem Cottgtruction Pertain Application for a Permit to Construct( )'Repair Upgrade(A Abandon Aomplete System 0 Individual Components Location Address or Lot No. f 1 f 4���►►►""""L-M , Ow er.'s ame ddpresss i T�/1.�No. Assessor's M,ap/Parcel ' } er's Name A, dress Te N *Desligner's ari e,Addremand Tel.No. b� 7� -;, 5 Type of fiu• ding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) ' Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. ' Plan Date Number of sheets Revision Date Title '•,� - Size of Septic Tank Type of S.A.S.CA // Y `Description of Soil v J J V .. / Nature of Repairs or Alterations(Answ Jr when ap licable) .:-p . s Date last inspected: ti - �,�, Agreement: `r The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage isposal system in accordance with the provistoAs of Title 5 of the Environmental Code and not to place the system in operation until a Certif,- Cate of Compliance has been is ',e. b o,�r ! 't, Signed —Date C Application Approved by �' � Date �) Application Disapproved for the following teas ns �, s tr ; I Permit No. j ".V rK2i Date Issued THE COMMONWEALTH OF MASSACHUSETTS (0/4 BARNSTABLE,,MASSACHUSETTS Certificate of Compliance THIS IS TO CE a the O, -site Sg Dis sal ystem=ted( )Repaired( )Upgraded� ) Abando ed b e at L has been constructed in accordance with theio�vij�io s of T' le 5 and for DM stem C truction Permit No. dated Installer Y 1� .� �� V 1 l Designer ) % The issuance of this permit shall not be construed as-a guarantee that th�s, stem will function as des' ;ed. p a of g Inspector @ / �V/ .ffi) �y, ��I /r '� ' l!�'� Date j�� w � � I -= - - ------------------- -_- o No. ti Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLES MASSACHUSETTS Oigooar *p5tem Cougtruction Permit Permission is hereby gr to,_ stru=t ' R,e�jair(r )U grade( �Ab nydo System located at ' t �� �f"f � and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to " comply with Title 5 an the following local provisions or special conditions. Provided: Construction/must bi comp eted within three years of the date of this e Date: Approved by i P.RCJECT DES'CRUTION: V/ L 7' �N6TXAN - SI�VC,�Vf_A R " 7-1tErArMscA/7- A E i 7,G' C EE -'32.3 , r _2 7,2' PUM P U it A H.._.__34�.-_41.__. CN _26.7f EcEc 0 Rar-�.vG, $C® 7 S i 47eO Z2.9 w 70 w.ezL" zEc 19.3 ' SZ4 I?.] ' � 1 - C V FA1 T LLPY-PE_.1!v v rtT s l•vc, r.A i �. ELFvIt If of V A'PPia VeD f o�c 7"esr �Ir"_ 4C40AJJe RET: .....lit "4.L _�aa:•2g 47 N 0 20 Member ASCEOF , 17011: TM4r0Z)0,e E #yge S CRAIG"R..SHORT, P.E. o ®FIAIG �C P.O.BOX 1044 G 51i0RT SOUTH DENNIS.MA 02660 0 � LOCUS: CIVIL Professional Civil Engineer-Soil Evaluator No. 27483 'r OWN /-),e•1 j7-09 E3 4.E" 41 f4, Licensed Construction Supervisor•Septic:Inspector �o'QFGtST�° Septic:«Site-Piers-Structures-House Designs �� Office:(508)398-Ml1 Fax:(508)398-3083 TOWN OF BARNSTABLE LOCATION �„ /lJt�1Ef�' ofD�� SEWAGE # iIJ � VILLAGE._ # /IIS eQ ASSESSOR'S MAP & LOT _ 7 —�-- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �� 7= d✓/T .��10&,�)t�� LEACHING FACILITY: (types) .�iF�FitT��7 S (�j� (size) X 7'A NO.OF BEDROOMS BUILDER.OR OWNER PERMITDATE: G�LJ C� :*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 lea g facility) Feet Furnished by - 14 �( M oZ S.b ni-a� N -3 i +11 1. -_ _t. LG� � -4 i A,Z Aej*-I �+ r PROJECT DESCRIPTION : rtFiiv�a�cr Cavc2ErE �R,Z�i�rL. ,,,�,.,,�� 1�G.� : 1 MINIMUM'CONCREMSTRHVGM-f Fy = 3;000. PSI MINIMUM STEEL STRENGTH- Fa ='80,000: PSI ALL CONNECTION&SPUCES TO SEMED PER CODE ARCHITECHTURALVEVEER: STOCXADEFENCE LATTICE< #4 RC BAR ALL AROUND STUCCO, OR SHRUBS TOP W/S'OVERLAPS I 1w, I ELEV / o is z 3: •qx . ,er /• [i T'MIN w 1 I I # 3 RE-BARS 41&'O.C. #R`� RE-BARS 0: 9'O.C. LU a. " ASPHALTCQAT &DOUBLE. 8 MIL POLY SEALANT ELEV 9-9.c 7 SWALE ELP-V FiLL ON .,ER r # 3 REBARS:4:1 S"O.C. r LONG ELEY Sc s *44 RE-BARS. �I .n I3� • 4,. AS SHOWN 7 TO'Be PLACED ON-VIRGIN ELEV.93.9 WATER (ADJUST) 2/ " OR COMPACTED SAND ELEV 87.3 WATER (OBSERVED) SIE=SHE'ET T OF 2 FOR INSFIE MON SCHEmUL CROSS SECTION. Member ASCF- FOR: 7HE0'00/ZE- CRAIG.R.-SHORT,-P.E. P.O.BOX 1044 0A. Uf ;` '= r T LOCUS:SS' o.�r�CA L s3nrE SOUTH DENNIS.MA Maw CRAIG Pn3fessional Civil Engineer-Soii Evaluator SIyOi3T TOWN: Licensed Cons=c8on Supervisor-Septic Inspector '�� =;I .�A 1Z'�!S i/-J,[3 _, M�4SS I.- CIVIL y! Septic* Site-Pies-Structures-House Casigrm No DATE L.-//2/oz OHfce:(508)398-Mil c Mho .L•_2/a2 fali•:1•:i' Z t11' 2 l . e CRAIG R. SHORT; P. E. . 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis, MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER,SOIL EVALUATOR, SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS, COASTAL&BUILDING DESIGNS TO ALL INSTALLERS MINIMUM INSPECTION OF SYSTEM,BREAK-OUT WALL&PUMP INSTALLATION CLIENT: Po FILE# PROJECT ADDRESS: 55 n eJ a I! A e)a ra a-lo 1 DATE: L v v MINIMUM CONSTRUCTIONINSPECTIONSCHEDULE: 1. Any Time Problems or Questions Arise 2. Stake out of concrete wall (Minimum 48 hours notice required) 3. Inspection of removal of unsuitable material PRIOR to placing new sand 4. Inspection of reinforcing steel in footing PRIOR to pouring of concrete 5. Inspection of reinforcing steel in wall PRIOR to pouring of concrete 6. Inspection of asphalt and vinyl barrier PRIOR to placement of sand 7. Inspection of new sand 8. Supervision of Soil Absorption System 9. Supervision&testing of Pump System --10. Final Inspection and measurements of system PRIOR to baclfll 1.1. FinaNnspection after finish grading � 12. "As-Built"Plan and Certification Letter to the Town of&i'1cS7z��J 1P� 6nS C...�? m NOTE: IT IS THE RESPONSIBILITY OF-THE CONTRACTOR TO NOTIFY THE DESIGN ENGINEER 48 HOURS PRIOR TO EACH INSPECTION PAGE 1 OF 2 L f CRAIG R. SHORT, P.E. 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis, MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER, SOIL EVALUATOR,SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS, COASTAL&BUILDING DESIGNS �noa�3 7S TO: Thomas McKean Health Director . , Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: CERTIFICATION OF SUBSURFACE SEWAGE DISPOSAL SYSTEM LOCATION OF SYSTEM: 55 Tonela Lane,Barnstable(Cummaquid),MA CLIENT: Theodore Myers PLAN DATE: 04/23/02; revised 06/04/02 FILE#: CRS#1-908; SRS#5345-00; DEP#SE 3-3967 DATE(S)OF/TYPE OF INSPECTIONS_ 10/01/02& 10/02/02 Inspect Overdig 10/08/02 Inspect Footing Steel 10/09/02 Inspect Wall Steel and Measure for As Built . 10/16/02 Inspect Asphalt Coating 10/25/02 Inspect Vinyl Liner and Sand Fill 10/28/02& 10/29/02 Measure and Pictures for As Built As of 10/29/02,the architectural veneer has not been installed I, Craig % Short, Civil Engineer, duly licensed as such in the Commonwealth of Massachusetts, do hereby certify that this firm has visually inspected the constructed subsurface sewage disposal system shown on the referenced approved plan, and further certify that the system, as constructed and shown on the attached As-Built, generally conforms within acceptable tolerance to the regulations, as varied, set forth in 310 CMR 15.000 and the Town of Barnstable Board of Health Regulations. / Q�3oja � Craig RAort,P.E.,Engineer Date cc: File 1-908 Client Theodore Myers Contractor P.K.M. Barnstable Conservation Commission � t w Town of Barnstable Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,RS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. June 24, 2002 Mr. Robin W. Wilcox, P.E. Sweetser Engineering Co. P.O. Box 713 South Dennis, MA 02660 4 yr" tdLid✓ L 5£�'3� '4 R%Et,r ,.rrJ'Zorze�aLao� mt1A336 'Ik 9�l3 A3 ,k Rl" Ean a1'a1�1. . �n � ,r.L o { ✓r {+�,., k �' t- 9v 5 ,i'1+,. ram..Gis+ a,3,n, ! "z,•rr.k. ?.xr Sing� tr'�61�U���"r Dear Mr. Wilcox, You are granted conditional variances on behalf of your client, Theodore Myers, to construct an onsite sewage disposal system at 55 Tonela Lane, Cummaquid. The variances granted are as follows: PART VIII, SECTION 1.00: The soil absorption system will be located only 49.11 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The septic tank will be located only eighteen 18.61 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. 310 CMR 15.211: The soil absorption system will be located only 49.11 feet away from wetlands, in lieu of the fifty (50) feet minimum separation distance required per Title V. 310 CMR 15.211: The septic tank will be located only eighteen 18.61 feet away from wetlands, in lieu of the fifty (50) feet minimum separation distance required per Title V. Wilcox4 r 310 CMR 15.211: The leaching facility will be ten (10) feet away from the cellar wall of the dwelling, in lieu of the twenty (20) feet minimum separation distance required. 310 CMR 15.248: No reserve area provided for a soil absorption system. These variances are granted with the following conditions: (1) The applicant shall submit an operation and maintenance (O&M) plan for the proposed Singulair Treatment Facility to the Public Health Division prior to obtaining a disposal works construction permit. (2) The applicant shall submit an influent and effluent wastewater monitoring plan to the Public Health Division prior to obtaining a disposal works construction permit. The influent and effluent shall be sampled and analyzed once every six months for a period of two years and annually thereafter. Results of each testing shall be mailed to the Public Health Division Office , 200 Main Street, Hyannis, Massachusetts. (3) The Total Nitrogen levels shall be reduced by 50% or greater with the use of the innovative/alternative nitrogen reduction system proposed. (4) No more than four (4) bedrooms maximum • are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (5) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (6) The septic system shall be installed in strict accordance with the engineered plans dated revised June 4, 2002. (7) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated revised June 4, 2002. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the close proximity wetlands adjoining the property at three sides. It is the opinion of this Board that the proposed new soil absorption system is designed to meet the Wilcox4 i � Y maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincer ly you W Miller, M.D. Chair an Wil=4 - t � Er APR 2 4 2002 DATE: TOWN OF tH;: ;6iHbILE FEE:. D ��-e-- • BABrterABCE. HEALTH DEPT. 9 NAS9 059. 5t A`� REC. BY Town of,Barnstable Ste_ DATE: 0 Board of Health 367 Main Street,Hyannis MA 02601. Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.11 Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 55 Tonela Lane,.Cummaquid(BARNSTABLE) Assessor's Map and Parcel Number: MAP 336 PARCEL 19 Size of Lot: .84 acres Wetlands Within 300 Ft. Yes XX Business Name:'.... No Subdivision Name: APPLICANT'&NAME: Theodore Myers Phone: 508-790-1238 Did the owner of the.property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name Alison S.Piasecla,et al Name Robin W.Wilcox Sweetser Engineering Address 4333 Tonela Lane Address P. O.Box 713 Barnstable,MA 02630 South Dennis,MA 02660 Phone Phone 508-398-3922 . VARIANCE FROM REGULATIONS REASON FOR VARIANCE See attached sheet See attached.sheet NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System Checklist(to be completed by office staff-person receiving variance request application) ✓ Four(4)copies of the completed variance request form ✓ Four(4)copies of engineered plan submitted(e.g,septic system plans) 4 Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) ✓ Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) fl.i+ Full menu submitted(for grease.trap variance requests only) % Variance request application fee collected( fee for lifeguard modification renewals,grease trap variance renewals[same �.. owner/lessee only];outside dining variance renewals[same owner/leases only],and variances io repaiF failed sewage disposal systems [only if no expansion to the building proposed]) Variance iequest submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask;R$.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. JvL T A REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ. I VARIANCES REQUESTED FOR SEPTIC DESIGN AT 55 TONELA LANE,CUMMAQUID(BARNSTABLE) AM`336/19 TITLE 5 VARIANCES REQUIRED: A. Section 15.211 Distance between S.A.S and Wetland—50' Required A 6.89'variance requested B. Section 15.211 Distance Septic Tank&Pump Chamber and Wedand—50'Required A 639'variance requested C. Section 15.211 Distance between S.A.S.and Cellar Wall—20'Required A 10'variance requested D. Section 15.248 Reserve S.A.S.-New System requires a Reserve Area Variance requested—No Reserve S.A.S.area proposed TOWN OF BARNSTABLE VARIANCES REQUIRED: Chapter III,section 31 A. Town Distance of S.A.S. to Wetland—100' required A 50.89'variance requested B. Town Distance of Septic Tank&Pump Chamber and Wetland—100' required A 81.39' variance requested C. Town Distance of S.A.S. to Cellar—20' required A 10' variance requested D. . Reserve S.A.S.-No reserve S.A.S.area proposed' A variance requested 07/11/2002 10:16 5087901238 •r 1tiE¢R� MYERS,~P. C. t Y PAGE 02 87/11/2882 10:21 5887786%6 RBA LAW PAGE Qi etc 15313 P=234 0546737 06-28-2002 DEM RESTRICTION Aj a requirement imposed by the Tom of Barnstable Board of Health is order to be p=cd a c•,ertif cats of compliance for tho iistallatim of a new septic systm ou the herrdaatter mentioned We, SALLY R. WALXER and THEODORE J.MYERS of 35 Tonela Lane, Cummaquid (Baraetab I MA tsehg the owners of a cw-Wn parcel of land is Cu tmaquid(Barnstable),Barnstable County. ?dassachusetts,shown as LOT 4B on a plan entitled"Revised Flan of Lots in Cummaquid, 11amstaNa,Mass. As Surveyed For Cbadoa W and Aran P.Jones, Scale 1 in_m 100 Ft.,Apn'19, 1968,Nilson Beare-RiWwd Law, Surveyors,CemesvUla.Mass.",recorded with the Barnstable �t:omty Registry of Deeds in Book 219,Page 57(hadmfter known as"the precim"),hereby udw ad declare Bald parcel subject to the ibllowiq restrictive covenant and providom 0=41 he sin&.ihmity mddeace which cw ently exists on the afvrosai0 premises shell forever be to a Wa*rum of FOUR(4)BEDROOMS; P' ro QaMd[SES ADDRESS: 55 Toula Lane,Cuu maquid(Barnstable),MA M637 ° Q'�-VITNESS ow heads and seals pia OV j Day of Am*, 2002. 7 Say I elkar Theodore J.Myers COKMONWEALTH OF blASSACHUSETIS Bwustabl%u. IuM . ,�(r, . 2002 Then pemnally appeared before me the above SALLY R WALKER and THEODORE I. - IVFVI S and acknowledged the fbreRoing' to be tbeir fee ct and deed. N Public S'a JOA AFL My commisilon Expires: 9/4/®' - ISTA OWN F PARV 'PRE i. DIV ON ol i c --_._y ` I a,ca rc a •..�2. o .a a.���-."g 1 �('�I _ � u Y- EO ct L og WX IV 23S C;-�.e.�RT wssrce .ZD ' `' i _ i �rt rt� ! s ( t t s i j �----- - `-----� -. -- -- -- .-.--_- _ � ----- - SOIL TEST P10,173 :, --- 20 4' SCHEDULE �� PVC PIPE DATE OF SOIL TEST FEBF_� 14, 2002 20 FT M dIMUM FROM CELLAR MIN. PITCH 1 PER FT.- i SOIL TEST DONE BY SfFTSFR ENGINEE$Ij�G TOP OF FOUL' ATION " - _ 1C ra'NIMUM FRl1 SLAB OR CRAWL SPACE .LEAN SAND INSIDE FACE IS TO BE WITNESSED BY _ DA STANTON 'L LAYER r V�-�_---__ ELEV. � _ - I 1/8" TO `,'2" ASPHALT COATED AND HAVE -- 10 FT. W,,.IMUM 2" PRESSL*E P!f., I DOUBLE 6 ML. POLY ATTACHED (ASSUMED) S ® WASHED STONE OBSERVATION HOLE ELEV. 24" MANHOLFI - 'TREATMENT PLANT 1524SMANH ,l EM ELEV. = 10318 IIM VENT 1 _ COVER �MOiE.L 960 DIN � COVERS "A 100.93 �• \ PERCOLATION RATE <� MIN./INCH IN C2 HORIZON i DEPTH HORIZ TEXTURE COLOR MOTT. OTHER " ELEV. = 100.?5 1 CU. FT. OF 100.18 °' CONCRETE 0-6 0/A SANDY LOAM 10YR3/4 NO ROOTS 4.50 4" CAST IRON PIPEANCHOR (OR EQUAL) MIN7_1 0. c , o STEEL STRENGTH 11 PITCH "4" PER L L VEL 1 0 9� o•� ELEV. _ _�9.10 Fy=60,000 PSI �' 6-8 8 SANDY LOAM 10YR6;4 I ROOTS _ ---- ELEV. _ 6" SUMP ELEV oy.77 _ - - ELE. _ _99.0 _ - UN 99.94 ELEV. 9&50 _ %I I, DISTRIel 'TI`,.,N ELEV. = 5.306 ABOVE irwTTtEs I10"i l 3/8" DRILL pp -�'�-� 9 � NTH °STONE INATORS W CONCRETE STRENGTH 8`108 C1 SILT LOAM t0YR6/2 OYR6/8 ELEV. = _95.17_-�I MIN LE�V. ( HOLE TO Br WATER TE:>TED t 23' X 26' X 7r FIELD FORMATION WELL AJW 247 I i 3,000 PSI - 0 o (TO BE PLACED ON FIRM BASE) j ZONE- 08 158 C2 COARSE SAN i LEGEND: ____� CHECK 3/4" TO 1 1/2"- SOIL ABSORPTION INDEX 27.3T12__ ° I VALVE WASHED STONE ADJUSTS ELEV. EXISTING SPOT ELEVATii _ _98� n: DOXO 1 (TO BE PLACED ON FIRM BASE) SYSTEM (SAS) i WATER ENCOUNTERED AT _20___ ELEV = 87.30__ EXISTING CONTOUR ----00---- F;NAL SPOT ELEVATION 1500 GALLON MYERS ►,. J 4 OR 5 - - - - NAL CONTOUR- PUMP FOR EQUAL) MOTTLES OBSERVED AT ELEV. = 98.05 _ DESIGN CALCULATIONS I Sit, "' LOCATION ZEI- TIC TANK f�H 11BER T USGS PROBABLE WATER,TABLE ELEV. = ll� WALL SCHEMATIC NUMBER OF BEDROOMS 4-- !T!�ITY .c -Q- ! 6" CONCRE E OBSERVED WATER TABLE (2/ 4/02) ELEV. _ _ (SEE CONSTRUCTION PLANS} GARBAGE DISPOSAL UNIT _ tOWN WATER -W °��+iW-� SAMPLE' CATCH AND �**-20) BOTTOM OF TEST HOLE ELEV. = �_�_ TOTAL ESTIMATED FLOW 1 CATCH BASIN ®; RECIRCULATING PUMP ELEV. AT INVERT INLET _�4-;80= ?UMP CHAME�ER CALCULATIONS: (110 GAL/SR./DAY X 4 SR.) � GAL /DAr' GAS LINE '� ' REQUIRED SEPTIC TANK CAPACITY _ Q GAL ELEV. AT ALARM ON CESSPOO, P. Y ACTUAL SIZE OF SEPTIC TANK (DOSTING) _1QQQ GAL. O� _�/ SEWAGE DISPOSAL SYSTEM PROFILE ELEV. AT PUMP ON - - REQUIRED ;'!-OW PER CYCLE 25 X _�Q = _11Q_ GAL./CYCLE CLEANOUT C.0 NOT TO SCAIt ELEV. AT PUMP OFF - �- VOLUME PER CYCLE 11Q_ GAL/CYCLE /7 48 GAL./CU. FT. - 14_7�_ CU. FT./CYCLE SOIL CLASSIFICATION _1__ BOTTOM OF INSIDE PUMP C VOLUME O- WATER IN PIPE 3.14 X 0.00694 X _ dS _ FT = _12- CU. FT. DESIGN PERCOLATION RATE <8__ MIN.iIN b,3TTOM OF OUTSIDE PUMP n - V TOTAL MIN`MUM VOLUME PER CYCLE __tG1.3CU. FT. EFFLUENT LOADING RATE 4.7� GAL./DAY/S.F BOUYANCY CAL�,ULATIuNS: DISCHARGE C13 CU. FT. / 36.11 CU.FT./FT. _ --OYL3 FT. (1000 G.S.T.) LEACHING AREA SQ. FT. STORAGE :APACITY (+�- GAL./DAY /7.48 GAL./CU.FT./36.11 CU.FT./FT. _ _�83_ FT. (23M) _]ll_ REQUIRED _�.QQ PROVIDED LEACHING CAPA- WEIGH` OF WATER DISPLACED (AREA X RATE) 44?•52 GAL./DAY 5.25X9X(98.05-90.30)X82.5 16.981 LBs. 598.00 X 0.74 WEIGHT OF TANK PER MANUFACTURER 14,500 LB& 17. ALL DISTURBED AREAS ARE TO BE REVEGETATED. RESERVE LEACHING CAPACITY NONE GAL./DAY WEIGHT OF WATER IN 10" SUMP 18. THE POOL AND APRONS ARE TO BE REMOVED AND REVEGETATED. 8.17X4.42XO.83X62.5 1,873 LBS. 19. THE HAYBALE WORKLIMIT IS TO BE PLACED BEFORE ANY OTHER WEIGHT OF 6" OF CONCRETE BVW A5 96.9 WORK COMMENCES ON SITE. NOTES: 8X4.17 .42X0.5OX135 Z 37 LB': � � 20. CONTRACTOR IS TO SUPPLY AND PLACE ANY SHORING WHERE _- I EXCESS WEIGHT TG OFFSET FLOTATION' NEEDED. 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 14,500+1,873+2.437-18,981 1,829 LBS. I 21. VARIANCES TC TITLE 5: TITLE 5 AND THE TOWN OF R ACE DISPOSAL RULES AND 1 A. SOIL ABSORPTION SYSTEM LESS THAN 50' FROM WETLAND. REGULATIONS FOR THE SUBSURFACE UN 4CE DISPOSAL OF SEWAGE. 2. ALL COVtRS TO SANITARY UNITS SHALL BE BROUGHT TO B. SEPTIC TANK & PUMP CHAMBER LESS THAN 25' FROM WETLAND. WITHIN 6" OF FINISHED GRADE. BVW A JT / C. SOIL ABSORPTION SYSTEM LESS THAN 20' FROM CELLAR. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF D. NO RESERVE AREA. WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN . g.4 22. VARIANCES TO BARNSTABLE REGULATIONS: 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE SOP( ;, .,5 6 99.0 A. SOIL ABSORPTION SYSTEM LESS THAN 100' FROM WETLAND ,.ISED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS TES " 97 5 / B. SEPTIC TANK & PUMP CHAMBER LESS THAN 100' FROM WETLAND, 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL SINGULAIR 960-DN - - 3y.3 C. SOIL ABSORPTION SYSTEM LESS THAN 20' FROM CELLAR BE MORTARS . IN PLACE. ik PUMP -,RE"TMENT FACILITY v"e D. NO RESERVE AREA 5. NO DETERMIN. 'RON HAS BEEN MADE AS TO COMPLIANCE WITH CVP� . v CIi/1M9ER „ CiAt1ON DEEDED OR ZONING REGULATIONS OWNER / APPLICANT IS TO 4 - sb-TIC TANK i tAIN ,Ul H uL ILMMINA IIuN rROM AF-HRUF'k,A EE Al1!HC?at81 Y. 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR i -- ;• \ IS TO CALL "DiG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE 7 CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS y DECK f y SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION 15 TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER y4 3� IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE i / 9. LOT IS SHOWN ON ASSESSORS MAP __3' __ AS PARCEL 10. PUMP AND ALARM ARE TO BE ON SEPERATE CIRCUITS. H. 11 ALARM iS TO BE BOTH AUDIO AND VISUAL. �---A--Z Ae t *t8e&-F -TfR IS Te BE- INSTAttf B-: { \ 113. AN ELECTRIC PERMIT IS REQUIRED TO WIRE PUMP AND ALARM. f- ERTSTING DWELLING , , 671 !� 4 BEDROOMS � � 14. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER AND FOR A MINIMUM OF 5' AROUND SOIL ABSORPTION SYSTEM AND BE Bvw A10 l 949 " (FULL CELLAR) re+s,eN,�1� REPLACED WITH MATERIAL AS SPECIFIED IN 310 CMR 15.255:(3). W 7 15. SEPTIC TANK AND PUMP CHAMBER ARE TO BE IPX WATERPROOFED 4 lj 1, AT THE MANUFACTURER (OR EQUAL'. o I" gg 3 'tN o CRAIG 's, ! 16 EXISTING SEPTICS ARE TO BE PUMPED AND REMOVED. i _ �r- SHORT v Bvw A 49 34' ° ` � X r - ° BOX $ t � '13.� �T CIVIL u� APPROVED: BOARD OF HEALTH N0. 27 5z; 10 / 0 G�RAGE � •,f i rn N SLAB) / DRi v DATE AGENT POO! i (TO BE s REMOVED) � -u�t i PROPOSED SEPTIC DESIGN l I y6)_ VENT I FOR li 23.00' I ! ' LOCUS LIMIT OF / THEODORE MYERS OVERDIG WALL - 98.2 �9� I LOC.LOT 4B, 55 TONELA LANE LOT 4 B pis � �� � BvW B2 � 9 � R T �1""�25.-HAYBALE- WORKL:MIT f �� r y8.ES _ r BARNS TABLE ( � �S �} Bvw A13 , 7 � _ J6, 48C S.F. i " as z - I j • 96 t ROvTE BVW A14 r-94.3 " ,�8 �95.3 SWEETSER ENGLNEERING qw Wit 235 GREAT WESTERN ROAD �-r o � 508- P. 0. BOX 713 ' 94 i 398-3922 SOUTH DENNIS, MASS. 02660 I `f rg3'7 o RVW A15097.2 0�� T1 D Bvw w2 ( ®� �. , DATE SCALE EDGE OF * rr 2002, 1 - 20' 2.310T dVw W3 � " 95-21 t � REV. DUNE 4, 20021 JO8 N0. 5345-00 j ■ 95 LOCATION MAP REVISED FSHEET 1 OF 1 93 E II ?, N A I _ G• �58�PRO✓`5345-00 �dwg\5345-OO.DWG 02002 SWEETSER ENGINEERINGI j BENCHMARK 4" SCHEDULE 40 PVC PIPE SOIL TEST P10,173DATE OF SOIL TEST FEB._14 I 20 FT. MINIMUM FROM CELLAR L20O2-___ TOP OF FOUNDATION I MIN, PITCH 1/B" PER FT. SOIL TEST DONE BY _ yWEETSEE_ NQi�;FfLnc,I �G' MINIMUM FROM SLAB OR CRAWL SPACE --CLEAN SAND INSIDE FACE IS TO BE ELEV. _ -_---- --- ASPHALT COATED AND HAVE WITNESSED BY ___ DAVE ':STANTON____ 100.00 _ 2" LAYER OF � 10 FT. MINIMUM � 2" PRESSURE PIPE 1/8" TO 1/2" (ASSUMED, SINGULAIR 150 PSI MINIMUM ELEV. WASHED STONE DOUBLE 6 ML POLY ATTACHED OBSERVATION HOLE 1 ELEv.=_- 97 30 I 103.18 �., I 24" MANHOLE TREATMENT PLANT 24 COVERS - �- - t _ 100.93 �• VENT \ 1 PERCOLATION RATE -__<?__ MIN./INCH IN C2 HORIZON I COVER � MODEL 960 DN � -_____� / \ Z DEPTH HORIZ TEXTURE COLOR MOTT OTHER i E 71 CU FT. OF ELEV. _ 100.18 a, CONCRETE 0-6 O/A SAND r LOAM 10YR3/4 NO ROOTS 4" CAST IRON PIPE ANCHOR (OR EQUAL) MINIMUM PITCH 1/4" PER FT 2'p• ° ° a 4 � _ a ° STEEL STRENGTH L LEVEL �� m - � 7' - Fy=fi0,000 PSI UN ELEV. = 6" SUMP ELEV _ �•77 ° c oWl ELEV. _9�.10_ - 6-8 B SANDY LOAM 10YR6/4 ROOTS 99.94 ELEV. j T , DISTRIBUTION � ELEV. - 95.50 _ LLEV 3.05 ABOVE MOTTLES 10"I 3/8" DRILL _I�.,K_ STANDARD INFILTRATORS 5� ,�g,�p 8-t08 Cl SILT LOAM 10YR6/2 ® 15" ELEV. _ _95.17_ MIN BOX WITH STONE IN AN WATER TABLF CONCRETE STRENGTH OYR6/8 HOLE FIELD FORMATION 3,000 PSI 9&00 0 ( 0 BE PLACED ON FIRM BASE) `26 X T' WE' L_Nw 247 LEV. m in T TO BE WATER 3 TESTED4 TO 1 1 2' 23 X ZONE -- 08-158 C2 COARSE SAN LEGEND: i - - CHECK / / ' c�OIL ABSORPTION NDEx 27.3 112- WASHED STONE I AL'�U`•-- - EXISTING SPOT ELEVATION 0010 PTO BE PLACED VALVE ON FIRM BASE) SYSTEM (SAS) -- ELEV. EXISTING CONTOUR ----00---- WATER ENCOUNTERED AT 12°----__ ELEv 87.30 _ FINAL SPOT ELEVATION F070 1500 GALLON MYERS MHV 4 OR 5 FINAL CONTOUR PUMP (OR EQUAL) MOTTLES OBSERVED AT ELEV = 96-05 DESIGN CALCULATIONS SOIL TEST LOCATION 5, SEPTIC TANK CHAMBER USGS PROBABLE WATER TABLE ELEV. = � .90 _ WALL SCHEMATIC NUMBER OF BEDROOMS 4__ UTILITY POLE �r SAMPLE CATCH AND (H-20) 6" CONCRETE OBSERVED WATER TABLE (2/14/02) ELEV = _ (SEE ONSTRUCTION PLANS) GARBAGE DISPOSAL UNIT _ NO _ TOWN WATER =Ww BOTTOM OF TES'' HOLE ELEV = d4_1� _ TOTAL ESTIMATED FLOW CATCH BASIN ® , RECIRCULATING PUMP ELEV. AT INVERT INLET _�4-�__ 4 440 GAS LINE - _ PUMP CHAMBER CALCULATIONS: (11I c.� SEPTIC TANK X BR.) _. _ GAL./DAY NO GAL. CESSPOOL �' C ELEV. AT ALARM ON s ACQUALESIZE POF SEPTIC TANK CAPACITY �(EXISTING) GAL. CLEANOU7 - 'c.o SEWAGE DISPOSAL SYSTEM PROFILE ELEV. AT PUMP ON -� - REQUIRED =LOW PER CYCLE 25 X _L4 11Q_ AL./CYCLE NOT TO SCALE ELEV. AT PUMP OFF -9213_ VOLUME P.P CYCLE _ 110- GAL/CYCLE /7.48 GAL./CU. FT. 14.71- CU. FT./CYCLE SOIL CLASSIFICATION 1__ BOTTOM OF INSIDE PUMP CHAMBER - �_ VOLUME 0 WATER IN PIPE 3.14 X 0.00694 X _aL_ FT _1.42 CU. FT. DESIGN PERCOLATION RATE <_� MIN./IN. BOUYANCY CALCULATIONS: BOTTOM OF OUTSIDE PUMP CHAMBER TOTAL MINMUM VOLUME PER CYCLE _tfi.13 CU FT. EFFLUENT LOADING RATE Q1�_ GAL./DAY/S.F. DISCHARGE 1�13 CU. FT / 36.11 CU.FT./FT. - _Q• FT. (1000 G.S.T.) LEACHING AREA SO. FT, WEIGHT OF WATER DISPLACED STORAGE CAPACITY (_+10_- GAL/DAY /7.48 GAL./CU.FT./36.11 CU.FT./FT. _ _1•� FT (23X28) 5.25X9X(98.05-90.30)X82.5 16,981 LBS. -1,4al_ REQUIRED -,2dXL PROVIDED LEACHING CAPACITY (AREA X RATE) 442.52 GAL./DAY WEIGHT OF TANK PER MANUFACTURER 14.500 LOS 598.00 X 0.74 17. ALL DISTURBED AREAS ARE TO BE REVEGETATED, RESERVE LEACHING CAPACITY _NONE GAL./DAY WEIGHT OF WATER IN 10" SUMP 18. THE POOL .AND .APRONS ARE TO BE REMOVED AND REVEGETATED. 8.17X4.42X0.83X625 1.873 LBS. 19. THE HAYBALE WORKLIMiT IS TO BE PLACED BEFORE ANY OTHER WEIGHT OF 6' OF CONCRETE WORK COMMENCES ON SITE. NOTES: 8.17X4.42XO.50X135 Z437 LBS Bv+�` A5 j 96 u EXCESS WE;GHT ' OFFSE' _OTATION 1 20. CONTRACTOR TOR IS TO SUPPLY AND PLACE ANY SHORING WHERE 1 ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 14.500+1.873+2.437-18.981 1.829 LBS. TITLE 5 AND THE TOWN OF RULES AND A 21. VARIANCES TO TITLE 5 REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. A. SOIL ABSORPTION SYSTEM LESS THAN 50' FROM WETLAND. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO BVW A7 B. SEPTIC TANK & PUMP CHAMBER LESS THAN 25' FROM WETLAND, WITHIN 6" OF FINISHED GRADE. r �7 C, f C. SOIL ABSORPTION SYSTEM LESS THAN 20' FROM CELLAR. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF 22446' D. NO RESERVE AREA. WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 4 .1 22. VARIANCES TO BARNSTABLE REGULATIONS: 10 FT OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE SOIL c • x :'7 . . ,a A. SOIL. ABSORPTION SYSTEM LESS THAN 100' FROM WETLAND. USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. TEST / �7 ` B. SEPTIC TANK & PUMP CHAMBER LESS THAN 100' FROM WETLAND. 4 ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL 3 SINGULAIR 960-DN - -- � C. SOIL ABSORPTION SYSTEM LESS THAN 20' FROM CELLAR, BE MORTARED IN PLACE. �O \9 PUMP TREATMENT FACILITY 100 D. NO RESERVE AREA 5. NC DETcry1.;1NAT:vh =!AS BEEN MADE AS TO COMPUArr':E Wirti j �� CHAMBER 1000 GALLON ! DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO SEPTIC TANK OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. - 5- _ 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR O r IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. E 2 '� �v 7 CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS DECK < <y SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION y j C. �G c_ ---- �2s -" - - _ IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER v ` IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE - _C____ 9. LOT IS SHOWN ON ASSESSORS MAP _ 6 _ AS PARCEL 10. PUMP AND ALARM ARE TO BE ON SEPERATE CIRCUITS. 3 H. 11_ ALARM IS TO BE BOTH AUDIO AND VISUAL. _ 0 BE INST -MTI G DWELLING I . Iy� 13. AN ELECTRIC PERMIT IS REQUIR 0 WIRE PUMP AND ALARM. 4 BEDROOMS 14. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER AND 6vw a1C R ? h FOR A MINIMUM OF 5' AROUND SOIL ABSORPTION SYSTEM AND BE (FULL CELLAR) 41 �.na�q� REPLACED WITH MATERIAL AS SPECIFIED IN 310 CMR 15.255:(3). W -- W i, �►'P 1N OE g��Z�. 15. SEPTIC TANK AND PUMP CHAMBER ARE TO BE iPX WATERPROOFED I •� AT THE MANUFACTURER (OR EQUAL). 0 27 97 o f ,Ir, , 4 :� ORgIG ��`` 16. EXISTING SEPTICS ARE TO BE PUMPED AND REMOVED. / �►, t, BvYi All, '` ± 49.34' ' D BOX (J / y \ '� 'elf o SHOFfiT ^` I `� N�CIViL v>1 APPROVED: BOARD OF HEALTH G�RAGE � - �/ •• � ,'��►,. • �/...s�� ��orf.�ECi rn asSLAB) DRIvE BV Al2 93.9 POOL o J DATE AGENT (TO BE i z REMO✓ED) PROPOSED SEPTIC DESIGN i ■.z I I VENT - 23 00' ' 9 FOR L I LIMIT OF locus THEODORE MYERS j i OVERDID ' WALL' \ �9. O LOC. 4 LOT 4B 55 TONELA LANE LOT 4B 1 Z BARNSTABLE (amwa w MASS krAY$ALE WORKLhv1iT ` j BVW A13, - I � o 36, 480 S. F. \ . 44 J . y w r Q R ZE 6P I W r j 6V A14 F-94.3 l < OU SWEETSER ENGINEERING yw rut _ 235 GREAT WESTERN ROAD o � 98 0 � I � � P. 0. BOX 713 o 94 Goo_ yy 2 I 508- ``P w SOUTH DENNIS, MASS. 398-3922 02660 Bvw Al + 97.2 mac^ I WETLAND a `A A2 (^�5.2 � 0 OF WE j ' �3_ _EDGE r�� - = Z DATE APR. 23, 2002 SCALE 1 " - 20' BVW W3 tv*i l I Z � I �2,31.07' t REV DUNE 4, 2002 JOB N0 5345-00 I LOCATION MAP REVISED SHEET 1 OF 1 i C.- k,581PRCV�5345-00 �dwg�5345-OO.DWG 02002 SWEETSER ENGINEERINGI