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HomeMy WebLinkAboutInspection Report 2024 April 26:i-. CommonwealthofMassachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Capta in Weiler Road Property Address Joseph + Evelyn Soave Trust a ntrtYdiffii;f l6ttKtoD .te8Eifrty*0rffi, Owrler informalion is required for every page Owneis Name South Yarmouth Ma 02664 Clly/Town State Zrp Code lnspection results must be submitted on this form. lnspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. lnspector lnformation Kevin Bloomquist www.Tatle5MA.com lmponant \ryhen filling out forms on the computer, use only the Iab key to move your cursor - do not use the retum key. Name of lnspector Kevin Bloomquist LLC Company Name 1286 Old Pleasant Streel Company Address Bridqewater Ma City/Town 774-517 -8936 State s114523 Telephone Number License Number B. Gertification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); I have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspect,on I have determined that the system: 1. x Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails L.DL= e_LilJn,rle\f L5 APR 2 s 2024 H EALTH DEPT, 4127 t2024 lnspectols Signature Dale The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. lf the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. 15 nsp doc,.ev 7/26/201I Tte 5 orfical lnspecr on Fom Subsurrace sewage Dsposal system. Fage 1 or21 4126t2024 D-raaf tnspecton - ffi 02324 Zrp Code 2. 4. 5}. Commonwealth of Massachusetts Title 5 Officia! lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Roa .^"rc6 M A'co' ,U[t a d Property Address Joseph + Evelyn Soave Trust Owner information is required for every page. Owner's Name South Yarmouth City/Town Ma 02664 4t26t2024 State Zip Code Dale of lnspectlon x I have not found any information whjch indacates 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 2) 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. Check the box for'yes", "no" or "not determined" (Y, N, ND) for the following statements. lf "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 Certaficate of Compliance indicating that the tank is less than 20 years old is available. nY trru E ND (Explain below): lSnsD doc. rev 22612018 T e 5 Oftici.l lnspecrron Fom Subsurta.e S aqe OsposalSystem. Page 2 ot21 C. lnspection Summary lnspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: This septic system is in good working condition for its age. 3. Commonwealth of Massachusetts Title 5 Official lnspection Form ",...au 5 M A'oo\ 'Uh a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + Evelyn Soave Trust Owner information is required for every page. Ownefs Name South Yarmouth Ma 02664 Cily/Town State Zip Code Date of lnspection C. lnspection Summary (cont.) 2) System Conditionally Passes (cont.): ! Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. E Observation of sewage backup or break out or high static water level in the dastribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (wath approval of Board of Health): tr broken pipe(s) are replaced tr Y tr N fl ND (Explain betow): tr obstruction is removed tr Y n N E ND (Explain below): tr distribution box is leveled or reptaced trY flN E ND (Explain below): ! The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): n broken pipe(s) are replaced n Y tr N fl NO (Exptain betow): tr obstruction is removed tr Y D N fl ND (Exptain below): 3) Further Evaluation is Required by the Board of Health: E Conditions exist which require further evaluataon by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 3.10 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: t5i.s! doc . rev 7t26201a litle 5 Offio.l lnspeclron Fom Subsurlace Sewage OspGdSystem. Paqe3 ot21 4t26t2024 €:, Commonwealth of Massachusetts Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + Evelyn Soave Trust "'t'M", Sepli. lnsFe<tiroa Owner information is required for every page. Owner's Name South Yarmouth lvla 02664 4t26t2024 City/Town State Zip Code Date of lnspection C. lnspection Summary (cont.) tr Cesspool or privy is within 50 feet of a surface water tr Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. 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. E The system has a septic tank and SAS and the SAS is within 50 feet of a pdvate water supply well. E 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 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 must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You ![!g! indicate 'Yes" or "No" to each of the following for all inspections: Yes tr ! 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 Ti{e 5 Ottical lnsp€don Fom Subsu.race Se{age Disposal System. page! ot 21t5 nsp doc . rev 7/26/2018 No Title 5 Official lnspection Form g\ Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road ^6 M A.^ ^$",* t,, 'o?, dryt Sept i{ h}ts*a:ler}s Property Address Joseph + Evelyn Soave Trust Owner information is required for every page. Ownefs Name South Yarmouth lvla 02664 4t26t2024 Cily/Town State Zip Code Date o{ lnspeclion C. lnspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No trx trxtrxnxnxnxnxtrx 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. lThissystem 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.I The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. The system Igjlg. I have determined that one or more of the above failure criteria exist as described in 3'10 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. 5) 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 C.4. Yes No n tr the system is within 400 feet of a surface drinking water supply x 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 Y, day flow Required pumping more than 4 times in the last year A/Of due to clogged or obstructed pipe(s). Number of times pumped: _. Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. trnnn tsrnsp doc. rev. 7/26/2013 the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (lnterim Wellhead Protection Area - IWPA) or a mapped Zone ll of a public water supply well Ttle 5 C,ff.iallnspecrion FomrSLrbsu.race Sewage OisposatSystem. Pege 5 of21 Xn n ;!-., CommonwealthofMassachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + Evelyn Soave Trust ^..'"Sr Owner information is required for every page. Owner's Name South Yarmouth lvla 02664 412612024 State Zip Code Date of lnspection 6 C. Inspection Summary (cont.) lf you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section C.4 above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section C.4 shall upgrade the system in accordance with 310 CMR 1 5.304. The system owner should contact the appropriate regional office of the Department. You must indicate "yes" or "no" for each of the following for a/ inspections: Yes No tr X Pumping information was provided by the owner, occupant, or Board of Health tr X Were any ofthe system components pumped out in the previous two weeks? tr X Has the system received normal flows in the previous two week period? tr X Hffi:X3:,[1i."s of water been introduced to the svstem recentlv or as part of Tt tr-t Were as built plans of the system obtained and examined? (lfthey were not available note as N/A) tr X Was the facility or dwelling inspected for signs of sewage back up? X tr Was the site inspected for signs of break out? X tr Were all system components, excluding the SAS, located on site? X tr 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 ofthe 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 crlteria related to Part C is at jssue approximation of distance is unacceptable) [31 0 CMR 15.302(5)] N/A n l5nsp doc. rev 7/2612018 Trlle 5 Oifoallnspeclo. Fom Subsunace Ssage Dsposat System . Page 6 or 21 City/Town tr .{:,, CommonwealthofMassachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + [yslyn Soave Trusl ..,',,u 6 M A'oo ^- dh a Scptk lnlfc<tioor O\^/Yrer information is required for every page. Owner's Name South Yarmouth Ma 02664 412612024 City/Town State Zip Code Date of lnspection D. System lnformation 1. Residential Flow Conditions: Number of bedrooms (design)Unknown Number of bedrooms (actual) DESIGN flow based on 310 CMR 15.203 (for example: 1 10 gpd x # of bedrooms) Description: 3 Unknown Septic design calculalions are not available 2Number of current residents: Does residence have a garbage grinder? Does residence have a water treatment unit? lf yes, discharges to ls laundry on a separate sewage system? (lnclude laundry system inspection information in this report.) Laundry system inspected? Seasonal use? Water meter readings, if available (last 2 years usage (gpd)): Detail: Water usage was requested, but no response in time for the report n ves8 No E YesX No EYesX nYesI XYesE No No No nYesXruo current Date l5nso.do.. rev 7/2M018 Ti e 5 Otnoal lnspecoon Fom Subsurtae Saage Osposat Syslem . page 7 or 2l Sump pump? Last date of occupancy: i.].-. CommonwealthofMassachusetts Title 5 Official lnspection Form ,*te6 M A'co'9,a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Properly Address Joseph + Evelyn Soave Trust Owrler informalion is required for every page Owneis Name South Yarmouth Ma 42664 412612024 City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 2. Commercial/lndustrial Flow Conditions: Type of Establashment: Design flow (based on 31 0 CMR 15.203): Basis of design flow (seats/persons/sq.ft., etc.) Grease trap present? Water trealmenl unit present? lf yes, discharges to: lndustrial waste holding tank present? Non-sanitary waste discharged to the Title 5 system? Water meter readings, if available: Last date of occupancy/use: Othei (describe below): Gallons per day (gpd) n Yesn ruo ! ves! No Evesn ruo n vesE ruo Date 3. Pumping Records: Source of information: Was system pumped as part of the inspection? lf yes, volume pumped: How was quantity pumped determined? Reason for pumpang: no information available fl ves X No gallons t5 nsp d... rev 7/26/2013 Ti0e5 Oticiallnspecrion Fom Subsurtace Sea96 Oisposal System. paqe B of21 i$' Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + Evelyn Soave Trust ..ru6 4'oo -.r.' 'r{ lif, ^ n#', i..rt.:i. \t)tf,ra | )._a.. Owner informalion is required for every page. Owner's Name South Yarmouth Ma 02664 4t26t2024 City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 4. Type of System: X Septic tank, distribution box, soil absorption system tr Single cesspool tr Overflow cesspool tr Privy n Shared system (yes or no) (if yes, attach previous inspection records, if any) n lnnovative/Alternative technotogy. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the l/A system by system operator under contract tr Tight tank. Attach a copy of the DEP approvat. tr other (describe): Approximate age of all components, date installed (if known) and source of information Unknown - The house was built In '1978 Were sewage odors detected when arriving at the site? 5, Building Sewer (locate on site plan): Depth below grade: Material of construction: ! cast iron X +o pvC n other (explain) Distance from private water supply well or suction line: E YesX No Unknown feel 100+ feet Comments (on condition of joints, venting, evidence of leakage. etc.) tSrnsp do.. rev. 7/26120i8 The building sewer is not accessible TrUe 5 Oflicallnspection Eom Subsu.face Sewage Disposat Sysrem . page 9 ot21 4,, Commonwealth of Massachusetts Title 5 Official lnspection Form ^*\e 6 M A'oo'd[r n Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + Evelyn Soave Trust Owner information is required for every page Owne/s Name South Yarmouth Ma 42664 4t2612024 City/Town State Zip Code Date of lnspeclion D. System lnformation (cont.) 6. Septic Tank (locate on site plan) Depth below grade:11" feel Material of construction: X concrete ! metal ! fiberglass I polyethylene ! other (explain) The baffle is in functional condition at this time.The septic tank does not have a filter. lf tank is metal, list age years ls age confirmed by a Certiflcate of Compliance? (attach a copy of certificate) ! Yes! No Dimensions 4x5x8 Sludge depth IJ Distance from top of sludge to bottom of outlet tee or baffle 21" Scum thickness 0" Distance from top of scum to lop of outlet tee or baffle 9" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were damensions determined?plastic orade stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank is in good functional condition. The liquid level is normal lshsp d@. rev 7/26/2018 Title 5 Oficial Insp6ction Form Subsurtae SewaEe Dspos.t System . page 1 O ot 2j SA Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road Property Address Joseph + Evelyn Soave Trust ,rte 6 M A'oo. 8tr,a Septi. lhsrertioi! Owner information is required for every page. Owner's Name South Yarmouth lVa 02664 4t2612024 City/Towl Slate Zip Code Date of lnspection D. System lnformation (cont.) 7. Grease Trap (locate on site plan): Depth beiow grade: Material of construction: ! concrete E metal feel ! fiberglass I 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 batfle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: E concrete E metal ! fiberglass ! polyethylene f] other (exptain) Dimensions: Capacity: Design Flow gallons gallons per day Tille 5 OfflciallnspecUon Fom Srbsudace Sewage Dsposat Sysrem. Page 1t ot 21lsinsp.do. ' rev 7/262018 1}.. Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Fotm - Not for Voluntary Assessments 30 Captain Weil Property Address er Road Joseph + Evelyn Soave Trust .'.':&fr"a septi. lnepc.tioltr Owner infomation is requared for every page South Yarmouth Ma 02664 4t26t2024 CityfTown Slate Zip Code Date oI lnspeclion D. System Information 1cont.) 8. Tight or Holding Tank (cont.) Alarm present: Alarm level: Date of last pumping n Yes ENo Alarm in working order ! Yes Eruo Date Comments (condition of alarm and float switches, etc.) Ihe box is old, but in funclional condition t5 nsp doc. rev.7/262018 Title 5 Otlidal lnspeclEn Fom: Subsurra@ Sdage Dsposat Sysrem . paqe j2 ot21 - Attach copy of current pumping contract (required). ls copy attached? E yes E No 9. Distribution Box (if present must be opened) (locate on site p'an): Deprh of liquid level above outlet invert 0 inches 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.): €l Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road -*r" 6 M 4'oo* dtrr \ septi. lnsrectionr Property Address Joseph + Evelyn Soave Trust Owner information is required for every page Owner's Name South Yarmouth Cily/Town Ma 02664 412612024 State Zip Code Dale of lnspection D. System lnformation (cont.) 10. Pump Chamber (locate on site plan): Pumps in working order: n Yes n ruo. Alarms in working order: ! Yes n tlo. Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): There is no pump chamber on this septic system ' lf pumps or alarms are not in working order, system is a conditional pass. 1 1. Soil Absorption System (SAS) (locate on site plan, excavation not required) lf SAS not located, explain why: 1leaching pits leaching chambers Ieaching galleries leaching trenches leaching fields overflow cesspool innovative/alternative system Type/name of technology: number: number: number: number, length: number, dimensions number: t5nsD.doc.rev 7/26/201A Tille 5 Oilici6l lnspBctron Fom Subsurace S4ag6 Orsposat System , page I 3 of 21 Type: x tr tr n tr tr tr €i Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessmenls 30 Captain Weiler Road -.a"6,M A'oo "'- dy, a septi. ln3pc(tioo! Propeny Address Joseph + Evelyn Soave Trust Owner information is required for every page. Owner's Name South Yarmouth Ma 02664 4t2612424 City/Town State Zip Code Dale of Inspection D. System lnformation (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching pit was inspected with a camera. The plt had a small amount of water immediately below the inlet pipe High water mark is about a foot above the bottom of the pit. The grass is normal. 12. 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 Damensions of cesspool Materials of construction lndication of groundwater inflow n yes ! trto Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5!/rsp.doc.re! 7/26/2018 Tille 5 Oiioal lnspecro. Fom Slbsurt .eSewage Dsposat System. page t4 or21 1$, Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Fotm - Not for Voluntary Assessments 30 Captain Weiler Road ^",Mt s*ptr. lfipa<tiorii Property Address Joseph + Evelyn Soave Trust Owner information is required for every page. Ownels Name South Yarmouth Ma 02664 4/26t2024 City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condation of soil, signs of hydraulic failure, level of ponding, condition of vegetation. etc.): t5nsDdoc..ev. 7/26/2018 Tille 5 OncEllnspecuon Fom Slbsudae Sewage DsposatSyslem. page 15 or21 g\ Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road .*re 6,M A'co^.Yt , Property Address Joseph + Evelyn Soave Trust Owner information is required for every page. Owner's Name South Yarmouth lvla 02664 4t26t2024 City/Town Slate Zip Code Date of lnspeclion D. System lnformation (cont.) '14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within '100 feet. Locate where public water supply enters the building. Check one of the boxes below: hand-sketch in the area below drawing attached separately Deck -c A BI depth 1 6.7 25.0 11" 25.7 14" 26 4 16.0 22.0 27' 2 3 t1.) I:] 4 7.2 13.4 &rlt Heid Garage lsinsp d@ . rev. 7/26/201 8 Tile 5 OiicGl lnspecrd Forn Subsurhe Sseag€ DspBt Sy$en . page 16 ot 2j xtr I 26.6 $' Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captelln Weiler Road Property Address Joseph + Evelyn Soave Trust .rto5,M A'co^'Yt , O\/l/rrer informalion is required for every page. Owrer's Name South Yarmouth N4a 02664 4/26t2024 City/Towlr Slate Zip Code Date of lnspeclion D. System lnformation (cont.) 15. Site Exam: Xl check Slope [] Surface water E Check cellar n Shallow wells Estimated depth to high ground water:feet Please indicate all methods used to determine the high ground water elevation tr Obtained from system design plans on record lf checked, date of design plan reviewed:Date n Checked with local excavators, installers - (attach documentation) Accessed USGS database - explain: Before filing this lnspection Report, please see Report completeness checklist on next page, t5 nsp doc. rev 7/261013 TrUs 5 Oltcial lnspedjm Fom Subsudace S*age Di3posd System, p.qe 17 of21 X Observed site (abutting property/observation hole within 150 feet of SAS) X Checked with local Board of Health - explain: Records are not available at the BOH. You must describe how you establjshed the high ground water elevation: Cape Cod Topographic map shows house to be 25' above sea level. The pond about a quarter mile away is about 1O' above sea level. Therefore ground water is about 15' below the ground. Soil logs are not available at the BOH. ;}. Commonwealth of Massachusetts Title 5 Official lnspection Form .rte 6 M A'co^'y'a Property Address Joseph + Evelyn Soave Trust information is required for every page- Owner's Name South Yarmoulh City/Town [,4a 02664 4/26t2024 State Zip Code Date of lnspeclion E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: I A. lnspector lnformation: Complete all fields in this section. I B. Certification: Signed & Dated and 1,2,3, or4 checked X C. lnspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed X D. System lnformation: For 8: TighVHolding Tank - Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For '15: Explanation of estimated depth to high groundwater included t5 nsp doc. rev.7/262018 Ti{eS Ofiiciel lnsp6cl6n Fo@:Subsuda@ Seage Dsposal System. P.qe 10 ot21 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Captain Weiler Road t5 nsP.d@. rev 7/262013 Iitle € Oficrallnspedi.n Fom Subsdace Sewage OsposatSystem, page 19 or21 / t A L{r 5 Oficial lnsD€cton .otrn Slbsurt ce Sewrge osposat Sysl€m . Page 20 sr 21 ;.,. I lb* .:i I 1 I i te Ttde a Or.jd lnspadion Fom: Subs\rrace S€vage Dsposat Sysrem . Page 21 or 2i EF G,