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2004 09-08
� ' -�ff" � �' � . M Massachusetts Departme�t of Environmantat Protection � � Buteau of R�source Pratect�on-T�le 5 � � �"�� DEP AN�rovec� ir�spection and a&AI! Form for Title � 1/� Treatrnent and DisposaE Sys�ems � ' � � �7 � A. tnst �io � . fmportartt � �-� � �� , Whot�fll(ksq out �� fortns ort�e c:OfifpUtOt.U38 onty ttlo tab key Fad�ty /� � ( , to nwve yax � (.' �/)//I �� cursor-do rt^t . �p - usa the►ewm C'ti . Koy. Mailing a ress o#awner, if different �i�il Stroet emc � � � � r � � ) - P.Xt. ` Teteprione Numbes �. a4u#hor�ed Service Pro�€�c��r i S�P9���d ��v,��rs�ne�,�� S��rcP.s , Lmc__ � � � _ �F� � 9 �q u�•f��'d� � -�.- ��'o ifi a���tc-� �� 002...�'os i ��ff3l�?�S` -4J3oexc. � � � ��JC7e- m��#r�!tS .S^OS"? i Gert[tied�Per�tor Name cert3ficatlart Nturber i • ' i C.-Facit�tylSystem Enformatio� � n �S' �1 /�/a��rPc v 9'(�d _ � �°�; �.�� c� � �� �{ �. �� V�� _ , Instaftat�on UaDa Start of Opetatton i Approvai Type: C�Cer�era!� Pnovisional�Pitating� Rernediai i S�asonaE Residence—used less than 6 mo.tyear_QYes�No � - / \ D. Operating information —� �-� 0 .., i�o�cao�r�c� ��5 i � o�.� Studge aeom ttc be yearty) Pumping Recommended ❑Yes Na —_,���i1 �ttluent oescriptfocr TSIAQMI-3t28i02 Page t f V GROUNDWATER ANALYTICAL Inorganic Chemistry Field ID: FE Matrix: Aqueous Project: 64 Melville Rd South Yarmouth/Singulair Received: 09-09-04 15:47 Client: Siegmund Environmental Services Lab ID: 76426-01 Sampled: 09-08-04 16:45 Conwiner: 1 L PlastiC Preservation: Cool � � ��' `q Y k-- :'•^�'+�•'• "� � � � �. � ) �£R�'�a�� � .�' . . r � , .-. - ♦ �,.,, . -: . . . ... ta e,._. �-'x ..- , .... &�A .'±k . 6:. • y�,.. Nitrate(as Nitrogen) 6.2 f11g/� 0.1 5 1 mL 09-09-04 20:56 NI-2298-W �cha11Pt01'04�"��� 1 LJp ' — asoo-rro�Fl ,. Nitrite(as Nitrogen) 7.3 mg/L �.� 5 TmL 09-09-0420:56 NI-2298-W �°`��010'#�{�'" 1 LJD OSOUN03 f) . Lab ID: 76426-02 Sampled: 09-08-04 16:45 ca,w��: 250 ml Plastic Preservation: H2SO4/Cool ���"'. �s �� , m�= �t,f��"` � ?�,.� f;'. 1. '� �� `"}j:. Nitrogen,Total Kjeldahl(TKN) 7.4 mg/L 0.5 i Zom� 0996-0411:09 F TKN-1430.W '"'""",°'�:-o�. � A�B 34t.3) Lab ID: 76426-03 Sampled: 09-08-04 16:45 Conwiner. 500 mL Plastic Preservation: Cool � ��:'� � ,�. �,_;� :�� �t �.. _ ,.�'�v�r'?'r r � _�:�� a; �:� 'F��;�s..r ,:s '�;d�Ij�j.., .. Sol ids,Total Suspended 15 mg/L 10 � 100 ml 09-10-04 09:38 TSS-0994-W SM 2540 D� a rnw ' PH 6.5 pH NA 1 50 mL 09-09-04 17:30 PH-1749-W SM 4500-H+B 2 LJD Lab ID: 76426-04 Sampled: 09-08-04 16:45 Container. � t,plastic Preservation: Cool s '�� t E` � a {a..a.��`t�r"� .�� y�+`��� ��( ��, Biochemical Oxygen Demand 35 mg/L 6 3o io m� 09-70-04 15:52 B00.1805•W [SM 5270 B[ a =�w� 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 SubsWnces in Environmental Samples,US EPA,EPA/600/R-93/700(1993),and Standard � Methods for the Examination of Water and Wastewater,APHA,Twentieth Edition(1998),and Test Methods for Evaluating k Solid Waste,US EPA,SW-846,Third Edition,Update 111(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 i DF Dilution Factor. 1 Instrument ID: Lachat 8000 Auroanalyzer 2 Instrument ID: Accume[AR50 3 Instrument ID: Y51 5100 4 Instrument ID: Mettler AT 200 Balance I i Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 r i . MaSSaC��S��l�li@!i't Of�llVi[�OtiM@l�Ld� PCO�Cb0i1 � B1I(�tl Qf�,IfCQ�-TI�$ DEP Appr�aved tnspection a�d 08�M Fornt for 1"[tie 5 UA Te�eatment artd �sposal Sys#ems .Z E. Sampling tnformafia samples Taken:p�rtftuenc C-fftuent _�� �-- P�ametess samp�ed:�]pH B00�TSS TN Q Ofher(list beiaw) . � IV � Other t Otl�er Z Otber 3 D�tion of arry•mainte�arx:e�e+rf�rmed since p�vious insp�dian 8�during this insp�c�ion: - L Notes snd t� . �,� r�. � u � I� F. Gectificatian 1 c�rtify:l trave�ed the s�wage breaur�ent aad disposa!system at the address above.have . ' campieted this repott and the atta�ed tec.hnoto9Y operaGon and rt�air►tenance checic�st.and the iMa.rtrr�tiOtt axur�te,antl compiete as of ttte time of the icyspedtan. 1 am a ed in ant�w�257 CMR 2.OQ i � �; � � � �: System ownet must submit this report,tecnnotogy 08�M cneddist,�ci anY r�equirsd sam��ing-asutts ta the bcal board of heaittt and OEP as�011ows�or each inspecUon perTosmed: R�t Usa—by January Pllotfng b Provkslonat Use- Go�eral l�sa—tty Septembet 3�'`�eact�year�the within 3�days of inspec�ian 3�"'of each year for fhe � prevfous�year dab2 previous 12 rnonths r i Departt�tent of Ertvirot�tner�Protec�ion ' � At�e�feon: T'�fle 5 P�ogram ' One Wmter S#neet,6a'Fioor ' 8ostor�.MA a'1108 T5i�4o0�A1 •3r28�oz PaQ.z otz � a � � . � u✓� 11 e �� S ` ��m ��'� � (� y �1P � snvcvr��s�xvicE c�cR i�s* s��„�„,�.� c.�s,��� a�.�oer�oo a�a a� SESINO.__: m,�- �I��-- ,�������p DATE OF SESVICE:i���� ���°0�"`� - �1tVIC2 PER�'ORME7) Y.��r� air wome aod abi�te widtba � t�1 g�s�c��vgh deaa � a�er sbarty f�ring ae�me � wo�x a��«a � �.�r�d� - Fmish hosiu�do�n filcer � FQSt RemOVE DO[ICCCte CO�C� �� i d�mblS [+0[ vraoer 7CIR] -! �� " �}s(ndg`deptQ'Ra pppty�m Sloerflange secood yrear of aQrr�on j . Seeoad RtmoYe owraeoe covK pf�ct fihet in phoG 5i1�ds t c�amber dan�oer�od rint a ' Ccabroi t�pa►md sec�o"'OOi�ll"' - � � � - Tom aa tod�$ad�s.�epiaee �1 �r4o�*Ct - - Se000d (3eck air Saw��'� - 1 ci�amsber � l �,S- .� Repiao�coeaeeeoorer Uopbng ae+ca�or aoa rr�t a�c First - Reptace waa�c co� - �' Cbecic for waa nbber pads .,_ � �ffi� - . CLaak fa v�ar oc pcobtaos� . � - C6eck wi+��risv f�r;�g. G�ara�so g is sa�n cancacx . ��� »�p►'u�+Lto� • ' Wash oKaeiatoF p�r[rt back � ��°O� - Iiaok ug a�negr,c�oclC � Cod.`ai Pac s9visi��A � «,�x�n:or�ar m�. 3 «7�c� n� C� � , ���" Closasmd loctc ca�vrr � Tb�ird Ra�o�re cooc�e�c oover asid g�aead ncocd�ar�er -� � r�e�iloec oop. ,( � 'tltcD en bla�Clc loCl�g taM P�(xr Lur��sOtice of SetviCe wah i i .�O�k o'Rnar � vKtatl pamp aad sact� _ ' fmm fiiorr!o St�sha�bct_ H0K�OD1qP"�'�� : I.ifi t�r wi��'oQe as � �°��10� ` f �y hd,catc�,m�foI�v-+Ep is � LiR o�5tas,pet't ia a� � � ' Clcan tbc ot�tside of fiher wid� Ac sme so caoo�a6le on '' wa�dcain badE 6o fust savia,[W�n��v oHKc � cmmDer - ; \ � � ` n � f�1 MEMO: 1 � � I � ��� � ' ` I�V �� � �`�`5 � G �' PS n�l� P 1 ' 2e � � : z S�e ��r� a.��.�v f K�� � � � � � � � t�1� r� G�� �p0 b'�r ; I i � � . �