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2003 12-13
i � � � ' y � , --: �� Massachusetts laepar�ment of Envirr�nmental Protection �� / � � m � 3 � Bureau of Resource Pratectior�-T�le 5 . ; � : ' � DEP A�}�roved Inspec�iort and O�M For-rn for Titie 51/A a � . Trea#me�t an�1 Disposai Systems ' ^ A. inst atio �m��� ��� � ��� ; ���� � J�`�� � ��.� only the tab key Fa�p S Ad � (J � /L D + to move your , /T � cursor-do n^t C� �P I use tt�4 retutn ' ; key. iVtailing �ress of owner,if�3ffieren� , . + � ��rn � � s�I _ " � StreetRddreasJPO 9o�c I � � �Y - State r-�P � ( ) - ead. Telephnee Nutnbet - ' r � r B. Authori�ed Servic� ProvEdet� /'+ , i �,�9���"• ��Vt7 �J(l�7G���� V P�Vt4PS , i+If� . .. � - ��F�1�1 � � ���)�•!�! V a• �+ �'� �. l�' j �f'd�f�A��'�C-�'_ �� �v�.�`4� f j ��fot�?�� - 413oext s� �� I � i - j�� ��r�lRS .�Q.� j certifiea op�at�r t�ame cesi�caciort Ne�nber i i � C.-FaGiI'itylSyste�n in€ormai��n � i D � ►��C��-��� INanufa�D F� t? ��'� '� � � v3 O � f insiaflatiort Start of O ion ' Ap�rova!Type: [I General Q Provisional Piioting 0 Rernedia! � � i Seasonai Residence—used less than 6 r�o.tye�r:�Yes o i . � � �. f3pQrating tc�forma� — ` � i �,�- -- / � � /� —1 � o , I I�PesSan Date Prtvious ItissPed'mn Date � � Siudqe Depth tto be chedce�yeariy} S�,�,��,�, Furnping Recommended ❑Yes Na j ; , C(,( ;-i-�(1,�/ ����'�� � �m J,�' ` , . . ' ; �tftuent DescriPtio � t,, : i TSIAQMi -3t28tb2 �-�t�< <"i O^--+� � _ Page 1 of: S�t:�i�} � � ..,,�� i • �• r:"_. ;w.} . _�_..:� . . -�' ' Massachusetts Department of Environmehta! Protection /�J� I� � � _ �� ' Bureau of Resuurcx3 Prate�tiort-T�ie 5 � '� -, .;::.:� ; � ; `=,a� ; DER A�proved lnspec�or� and a&M Forrn for Title 5 i!A �� Treatment ar�d D�sposal Systerr:� E. Sampiing Informatio, � Sartaples Taken:�IMiuent Efffuent Parametess samplecf:�`�- 4{� T�S�Q Other(list betaw) i -7r-y ,� // j� � ,� J � --.-.f-t—I� .� v 2 / V v � Other 1 Other 2 Other 3 _ � Oe,scciption af any mafntenar�ce performed since previous�nspe�chian�during this inspection: ; �D/I/ 7`d/� � SG� ,O��' ; � /����C c P�- �✓I'I rD T��iN(r- C'�J/1.�Pc� ; ,_, -�---- � Notes and Comments � 2 f C(�C � �,�/�t/ 'i i / � ; - � ; . . i F. Ce�ificatian � ! 1 certify; 1 tiave inspected the sewage treatcn�nt and disposal system at ttie addcess above,have � cxsmpieted this repoct and the aEtacE�ed technotogy ooeration and mairrtenance checklist,and the i ' inforrna�ion repartet�is fite,accurate,and comptefe as o€the time af!he inspection. i am a ' � AttaSsa. etEs c in ac^ord 7 CMR 2.00. k � i�t 3 - d3 _ - _nature �a;e � � f � . � System owner must submit this report,��:�naiogy O�M cneck3ist,and any�equirec s2mciing �=_s;��r: i to the facal bvard af heait�and L1EP a�s io�iows for each i�spectian pertortned: � � ` Remediat Use—by January P�toting�Prvvisianat Use- Ges�erai Use—by Septembe .'' ; 37�at`each year for#he within 30 days of inspectian 30"'of each ye�r for t�e ' ; previous c�lendar year date previaus 12 months � ! Department of Environmentaf Protectian ` Attertficm: T'�le 5 Prograrn : ; One Winter Street 6°i Ftoor � 8aston.MA 02148 � � � A . _ ; - - ` TSlHOM� •3�zeroz Page 2 ot i , - � , , �� I ;Y�' • � -- _ _.a y,,, . !ri ; . �� s o �,� ,�- :�:y �y ��1� 1�Il�� �2� , � SA�1GiTI.AIR SERYiCE CHECK LIS''.' -- (with Ssme Blte�l �ia fiha upright in tub.run ' ° ` ciean water into it umii che �'� SESI NQ.__��''�a � �� w�ver flows out of the hole in - DATE OF SERYICE:i ._L2 /3 3 _ c�e ftange.�at�ompTessea - - SERVIC�PE$FORMED BY:��� si�t=ose and agitate with air. ¢mtiais) KeeP agitating with cicu► . ' water slow►y flowing uoti!the - I.ocetion Work to be oaformed Done e�citiag water is ciear. First Remove concrete cove[:check F'mish lwsictg doWrn fitter ; chamber fur norma!watec level SciaPe hoPPer � � Chcck sEudge depth afiter � seow�d year of opaatioa Apply l�nt w fe7ttr flange SeCond Remove GOIIC�e6C cOver i . dumber � " Placc filttr m plux.£EI widt ! ciean waLer�d sink u ' Co�col Ope�t and set to"C�AiT" _ � . center positian Tcart o�¢locking tabs,replace .i • fituc cx�ver � 5econd C:Aecic air f[o�v rhxough aeranor � � dsamber 3. Regiace rnnccett Cover � Unp e aut Fast Rep}ace�te covu � � - -• eh�ber C�Ck fo�r wcun rnbber pads . . Secoad Plug in aerat�' G3ccic fa�weartuproblem.v ci�amber Chedc wiro in riser fuT�'�saf'utg, Cor�tivue so ic is aot in coraacc . tapc if necded snem anyd�iag ' � Wash off aerato� t it back ReFiace concrete oave[ - � x���.��f��k c�� Pttt SWI[CI1 QQ�•Au�o- ' ; ������. 3� � ���� : ; ������. � , _. Ctase�d ioek c�ver ' i Thi�l Rcr�tove conccert cover ar�d � cfiamber re�ove filter top_ Read aud recozd hour me � Ilua in t�lack Iocking tabs Paper L.eave notice of service with .� � work pwrxer . ' Instell gump and stazi gumpin� � ' from fiiter to fust ch�ber. y sle any � Lift filter with rope as irr'e���ularity or probiem � etecessary. ; , ; Indicate if any foltow-up is � � Lift out filter,put it�mb aecessacy i Gean the ouccide of 61cer wim Be surc co wmpleta file oa waxer,draiA badc to frrst setvic�,reEum it LQ offtcc , � chamDcr � � � �` �"1�i?I 7`��� � � I �� I �Mo: � e C�� i��.� � ' �- '° I' �C' � � � ��,�, C� v.�.� � � '', , / � � /-� I y . � S �� v)1 � fJ�/ � � ,� . - k . '�`-� f `�'�, S Lc�`�it/�, t � f ',, �, � � � �i'lti� r�_x�G'� ��YY� � --� �7 ��l� 3 J i /� �� � ��-s at� �.���,. a�c f . i r ► / � ' : . � GRl]UNDW�4TER � ANALYTICAL i Inorganic Chemistry Field ID: FE Project: Singulair/64 Melville,S.Yarmouth Matrix: Aqueous Client: Siegmund Environmentai Services Received: 01-27-04 15:30 Lab ID_ 69134-01 Sampled: 01-26-04 13:45 Conqiner: � �p��tic ^Anal e Preservation: Cool � Re3ult; �,t.l�l,t�3 .;�t�: ;DE volume Malyzed Q,�B.�ti�� ''. Meth�d Iqst areW.t: Nitrate(as Nitrogen) BRL fTlg/� Q.Q2 1 5 mL 07-27-04 18:28 NI-2059-W u`^°"a�o�oa�c�sn. ,soano,n � �L)D Nitrite(as Nitrogen) 0.06 mg/L �.OZ 1 5 mL 01-27-04 1828 NI-2059-W �n.�io-wvw.tc� � �soo-No3n 1 LJD � Lab�D: 69134-02 Sampled. 01 26-04 13:45 co�r��oe.:500 ml Plastic Preservation: HCl/Cool At���Ytt'i, `,� � . �;:����';: ,'u '� �,°. A�oiura� Aha1 �.�-., �..� �� `, y'x�"f1 ' 4����t�,.,�, �f�Igd It��t;��i Nitrogen,Total Kjeldahl(TKN) 7.5 m L �b��a,o,�:.o,E.,, $� 3 5 4 mL Ot 28-04 75:20 TKN-1277-W �s�s� 1 AVB Lab ID: 69134-03 Sampled: 01-26-04 13:45 Caitainer. 1 L plastic � Preservation Coo) ,+kh��yte �:: ° (�3rii��:, ,.�1� ,���: ,''�� vo(ume 'An11y14� �� �... . .:'I�'1+��Ift1d :In�t'�a1,�i Solids,Total Suspended 26 mg/L 20 2 ss m� oi-zs-0a oe:zb T5S-0920.W SM 2540 D a Mw pH__ �•4 pH NA 7 SOmI O1-27-04t8:07 PH-1615-W SM4500-H+B 2 DDW Lab ID: 69134-04 Sampled: O1-26-04 13:45 Conwmec 7 �p��jc Preservabon: Cool Arta�yE� . Re§tilt ��#�3s� '#��:.: 1�F Voluii�e An�ly1� ' �� � . ._ �.,��#�h,; 'M�fkot4`'"' tnst �� I Biochemical Oxygen Demand _ 27 mg/L ?O 30 tO ml 07-28-04 14:15 BOD-1528-W SM 5270 8 3 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 5tandard Methods for the Examination of Water and Wastewater,APHA,Twentieth Edition(t 99g),and Test Methods for Evaluating Solid Waste,US EPA,SW-846,Third Edition,Update III(7996). Report Notations: BRL Indicates concentration,if any,is below reporting�imit 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 ARSO 3 Instrument ID: YSI 5700 4 Instrument ID: Mettler AT 200 Balance f ! ' R i � i � f � = i , Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay,R�1A 02532 '