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HomeMy WebLinkAboutInspection Report 1995 May 31 ! R TOWN OF YARMOUTH eN y� 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 rd, MAT TAC S "' "r xH 0, Telephone(508)398-2231,Ext. 241 — Fax(508)398-2365 BOARD OF HEALTH July 19, 1995 • Don Shaw 35 Hastings Road West Yarmouth, MA 02673 Re: Subsurface Sewage Disposal System Inspection Dear Mr. Shaw: This department is in receipt of a subsurface sewage disposal inspection report on yourproperty, conducted June 8, 1995 by Jim Sears, and received on May 31, 1995, by this department. The report reflected a need for repairs to the septic system as follows: 1.) A new distribution box is needed. Any repair work that is done on your system must be performed by a licensed septic installer. If you should have any questions or comments relative to this matter, please contact me at the Health Office. I can be reached by calling (508)398-2231, ext. 241, Monday through Friday, from 9:00a.m. to 11:00a.m. r Sincerely, Bruce G. Murphy Health Agent BGM/cg cc: file RePrintedcycled on LTA Paper i • 6t Y4A � o TOWN OF YARMOUTH -1�`\ 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 MATTACMEES7 '"�*+roono�,, Telephone(508)398-2231,Ext. 241 — Fax(508)398-2365 BOARD OF HEALTH July 18, 1995 . Jim Sears A & B Canco 350 Main Street West Yarmouth, MA 02673 Re: 35 Hastings Road, West Yarmouth Dear Mr. Sears: This department is in receipt of a subsurface sewage disposal inspection report on the above property conducted on May 31, 1995 by your company, and received on June 8, 1995, by this department. The report does not comply with the town's policy for septic system inspection reports due to the following reason(s): 1.) There was no additional as-built submitted, on town approved format, with this report. The missing information must be completed before this office will accept the aforementioned report. Please revise the report appropriately and forward such copies to this department within 2 weeks upon receipt of this letter. If you should have any questions or comments relative to this matter, please contact me at the Health Office. I can be reached by calling (508)398-2231, ext. 241, Monday - Friday from 8:30 a.m.-4:30 p.m. Sincerel c"- 1;;;!(246 ruce G. Murphy, MPH Health Agent BGM/cg cc: file Printed on SRecyled Papecr • &3r. Copy • MIR SEPTIC PUMP INO AND INSTALLATION 350 Main St • W. Yarmouth, MA 02673 • 775-2800 Heating&Plumbing,Fire Sprinklers. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property y tiFstv_ MAP# 5-7 Owner's name 7)4v 5/1", Date of Inspection PAR* .L 3 ,3 ti ti 0 8 1995 1 PART A CHECKLIST - - Check if the following have been done: V Pumping information was requested of the owner, occupant, and Board of Health. Alone of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that • period. Large volumes of water have not been introduced into the system recently or as part of this inspection. • trAs built plans have been obtained and examined. Note if they are not / available with N/A V/ The facility or dwelling was inspected for signs of sewage back-up. V/ The site was inspected for signs of breakout. V ,;•All system components, excluding the SAS, have been...located'on the site. ✓, The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. 'd The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. V The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. ;u r O '' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM • PART B • SYSTEM INFORMATION jz. FLOW CONDITIONS �: . • If residential 1' number of bedrooms A. number of current residents garbage grinder, 6/331•r no • laundry connected to s stem, es) or no seasonal use, yes or no Sovfeet'' If nonresidential , calculated flow: ' 33 7r/, °° G vyR u,qThe Water meter readings, if available: Last date of occupancy • GENERAL INFORMATION Pumping records and source of infgrmation: pi/mPt3 y-�3 -y,i SouecE. Y9A ,6o,9/t3.0 oi= h7r41.711 System pumped as part of inspection, yes or e if yes, volume pumped Reason for pumping: • Type of system ..V 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) Other (explain) Approximate age of all components. Date installed, if known. Source of information: /ire /4,57;). LLQ y'- i3-72 pi,1m T• Sewage odors detected when arriving at the site, yes or SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: yf-s (locate on site plan) depth below grade: material of construction: iZc.oncrete metal FRP other(explain) dimensions: jovt 6.44 51 sludge depth 47 distance from top of sludge to bottom of outlet tee or baffle 0 , scum thickness it distance from top of scum to top of outlet tee or baffle 15- distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) /t/ €t a r,L T 8,)F,/«s L ,O v,� s-sv&. ,47 vtiee INo • ."1.Fvf1.. ND A.ng,,,.-I, N£f2f,) 7/7;w¢ r,,/ 4a,>) CoADi,, • DISTRIBUTION BOX: (1E3 (locate on site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal , evidence of solids carryover, evidence of leakage into or out of box, recommends on for repairs, etc. ) '/ - ak jf ly 5' 4i0 .S/04-4- h.4«S -- 4,4< ‘.4-E jv£1z s 8f ,9(,9A,rr2 ? 0k.--14/41 9E JFr + PUMP CHAMBER: r/. E (locate on site plan) pumps in working order, y- = -or no Comments: (note condition of pump chamber, of pumps and appurtenances, recommendations for maintenance or repairs, etc. ) ' i lv - - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART` B . SYSTEM INFORMATION continued • SOIL ABSORPTION SYSTEM (SAS) : Yrs Itj' (locate on site plan, if possible; excavation not required, but may be • approximated by non-intrusive methods) A; If not determined tO be present , explain: ; , - x fl J Type leaching pits and number (I /oo© A1- leaching chambers and number leaching galleries and number leaching trenches, number , length leaching fields, number, dimensions overflow cesspool , number Comments: • (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) • i 44 wdTcs. - Lv,7sc. .twv t /A., n,,-- H,0 s 49 r f.-- 4r 3' p,r- /3 i-rTri.,.Z. a,-� o.v STs 4.-.4,1- 0ar- nJ0N 4 . CESSPOOLS (locate on site plan) : number and configuration depth-top of liquid to inlet invert depth of solids layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc. ) PRIVY: 3U 0,1✓' (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, recommendations for maintenance or repairs, etc. ) • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' 8/,k Ic • va Avg/ DEPTH TO GROUNDWATER depth to groundwater method of determination of approximation: }SAND -.3,F -fo /544 t rlrph,0-77/L /,r J0 , 15 'To 14,177;,- (S'vt/R c . d°1:1)/n i �`,,� - 1-/3. 29 • • SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not A/ Backup of sewage into facility? Ai, Discharge or ponding of effluent to the surface of the ground or surface waters? 1/ Static liquid level in the distribution box above outlet invert? X/ Liquid depth in cesspool <6" below invert or available volume< 1/2 da flow? 1✓ Required pumping 4 times or more in the last year? number of times pumped N Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: , A/ below the high groundwater elevation? /✓ within 50 feet of a surface water? A/ within 100 feet of a surface water supply or tributary to a surface water supply? A/ within a Zone I of a public well? _ IV within 50 feet of a private water supply well? /U less than 100 feet but greater the 50 feet from a private water suppi well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds , ammonia nitrogen and nitrate nitrogen. . e ox - - -71 ex oe c AVAc l ,` //hiJ A. "Fg," c p/rvvr a�m�fr-iwh del SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector V .eml i s :r7 ,sEmt'S" Company Name A & B Canco Company Address 350 Main Street , West Yarmouth MA 02673 Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and maintenance of on-site sewage disposal systems. Check. one: ✓ I have not found any information which indicates that the system fail to adequately protect public health or the environment as defined in 310 CMR 15 .303. Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15 . 303. Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. NOTE: A & B Canco has had no control over the use and/or routine maintenance of the septic system. Circumstances such as a recent pumping will'ilignificantly alter evaluation results . No guarantee or warranty is hereby given, express or implied, as to the evaluation. THE ISSUANCE OF THIS INSPECTION FORM SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY Ifyou have any questions, please call me at 508-775-2800 between 8: 30 am and 4:30 pm, Monday through Friday. . f Inspector 's Signature Date J-9 /-75- Original -9 /-7Original to system owner Copies to: Buyer ( if applicable) Approving authority • a .Yc TOWN OF YARMOUTH 476 ° t 32- cKd /o6 2, --_!� `j� 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-44+51( MATTA:c' S "4 LL 1- rr,,, t,,. i Telephone(508) 398-2231, Ext. 241 — Fax(508)398-2365 MAY 0 4 1995 BOARD OF HEALTH REQUEST FOR SEPTIC SYSTEM INFORMATION (FORM MUST BE FULLY COMPLETED) 1. LOCATION OF INSPECTION: ,35 4 QST mil(S R b . W. A r n•0 2. TOWN ASSESSOR'S MAP # 3I , LOT # 3 3. DATE HOUSE WAS BUILT: J l '77 4. WELL ON PROPERTY, INCLUDING IRRIGATION WELLS? YES NO (SHOW LOCATION ON SEPTIC INSPECTION FORM.) 5. OWNER'S NAME AND ADDRESS: S K A J 3 5- (4 RST i'iv GS Rocuca LL-s-r � jk( r+tio 044. (Y\A- 63-V73 6. BUYER'S NAME AND ADDRESS: 7. OTHER INFORMATION REQUESTED: The Health Department will provide: 1. Last four (4) years of septic pumping history; 2. Septic system location "AS-BUILT" card, if on file; 3. Septic system description; 4. Copy of Septic Disposal Application; 5. Percolation card, if on file (New houses since 1980); 6. Review of engineered septic plan, if on file. ALLOW TEN (10) BUSINESS DAYS FROM DATE OF SUBMITTAL FOR THE HEALTH DEPARTMENT TO PROVIDE INFORMATION REQUESTED. ON COMPLETED SEPTIC INSPECTION FORM, ATTACH "AS-BUILT" LOCATION CARD SUPPLIED BY THE HEALTH DEPARTMENT. MAP AND LOT NUMBER MUST ALSO BE PLACED ON THE FRONT PAGE OF THE INSPECTION FORM. NAME OF STATE CERTIFIED SEPTIC INSPECTOR: try\ SeiNcs ADDRESS:. 356 P&A I t ST 025-x. Artoo-h h1 A 0Q-03 3 TELPHONE NUMBER: r/i7 i-. 411 FILING FEE OF $30.00 PAID ON: Printed on Recyclec 04/06/95 L Paper