HomeMy WebLinkAboutTitle5pt2 (2)Aug 13'09 09:49p Ellls Brothers
s\ \rlr!.rra arrl.irrEcts t rrra iial-Er.tr..,ra_EL._
256 Old Main
TiUe 5 Official lnspection FormSuDarfrce Setqe Oipoea Sfan form _ Not brvofuntary^ssesgoeds
508-3626266 p,8
StseeL Sotdh YsflnoulhProFtyAd*E€s
P.fri..!t&m.
Solrdt Yarmou0t
Cty/Tryt
D. System lnformation
Desqipfion:
Itrmter d qlrre'tt rE:id6r{s
Does rq*lence i e a gat{o gider?
ls larE&lr on a sep.*e sa,ags rystsn?
Larrt(ky systsnirqecb@
Seasone use?
Wstef mcter rEa(lus, f adaue 0sst 2
Defet
Sump punp?
Gr€sse lrap preser ?
lncfiHrid wtste Dobtng tanl( presen(,
ilut5eflftary wase dbctBrgEd to trle TiEe
l rder mder readngs. f alrailaHc:Joel SB E-.
MA 02664 07h6m@
Salo 4Cc,fr Die d liEpc.lloir
y.. soparde insP€d,m reqtirEdl
usege (gpd))r
t2#1OU'E
inbllnaalon brtqulrd hr.t rylalE ,4
EvosE nr
E YesE nr
Evus315
El ves E tlo
E. yes E ruo
LasldabofocqD cy:
Cootdrcrciaglnfi saial Flow Condi6oos:s s?tiri..DrL
\,
TYPB o(F3.bl{'mqf:67iffi7{i+upc*rnt tuIEilI notr, (tessd (U 3tO Ctfr t520O: n
llt4/*L sb ge lbpt o't*,ila.tt €<a- IBGts of dc!fun no9(sersrlE s6G{Sq.tt- AcI:
l.xro 51.
pals{(Nt(xo
A vos {xo
D Y*d,b
Q Y.o,g/rb
/'*a
t*8. m!$..5,Ottol g-r. tu 7d17
.Aug 13 09 09:50p Ellis Brothars 508-362-0266 p.9
t rrlrll!f,rt tItuntut rI m:,alR,lGrll^'Et|:i
Title 5 Official lnspection,FormguDsurfa' s".'g! oisposets@r rirm -ruor g votrhy Assessmeils
256 old Sodrr Yamdri, lrA
Saflluit TIust,P.O.Bq agz,otE , t A 0256.1(lrrErl rrdl-l bn$rEd rqallt!!eE-
Ort,rl.f3 NarE
Sarth Yannoulh MA 02564 07nBtzuisSrabtHed lnrp€cdo,.System Informatio
Lsst rtrte of ccr4la Elrilrse:
OEE (descrile bqghr:
ryf{tt
D n (cor[.)7J+*eH.
64/(t
Oqreral hfolmalirn
P.mfing&cordsl
Souroe of hfunndion:
I'Vas sycern Prrflpod as pa,t of l,l€ inspodion?
ff yes, ralrrna pumped:lElqr
Htr ures qranlly trmped ddsrffisd?
Reason for trlmplng:
//
rtwo)t@I,,;
d Sedb tanlq diti0ution bo( sol ebsorption qrCem
tr slrixle cEsspool
tr o1redtqcasspool
tr Privy
tr shared slsem (yr6 or no) ff, yes, 8ttacfi plErrldE i7lspec oo f€cods, lf srry)
tl tnnovalidAltsmdiB tectrnobqy- Altr.r, a sopy dthe oficrt op.r4ron andrn -nlqErce codrad @ beottaanod frun w;n anprt au acopy r ldstfisfdim of the UA syslorn b, Wr operalor urder co{lraa
tr Tlgnt tdrk /qfreci e copy ofthe OEp app.o\El.
tr oher(dosc{ibe):
D v* {no
II 'On ttE do. F.hj nnfte C.q.II+..rt SFtit . ltir ! o, i7
74 co<i
Aug 13 09 09:50p Ellis Brothers 50&362S266 p.10
q CorcDont wdth of lragsacftoseffs
Title 5 Official lnspection FormSuburfdo. S6Eg! Dfr"d S!/slem fom - m trVotuntary Asses<tr,€rts
256 old Main w,sodh MA
PrWGtt, A*,'Ers
O)fisfttfsrtqt brql.dE
cvcry psg!.
Soldh Yannoutn uA W4stllD 4@
07A6t200f,Ctyffl ir Otl€D. System lnformation (cont )
otlnEpdbo
ApFqimate ag, of 8I compoo€nts, dare ins{aled (f kn,vn) and source ot in[om€tion:
,eet
Cmm€rlts (on condtion ofidnt3, verfling, 6yuence of bakage, etc.):
Evesapo
let
s€gtb Tenr (loc4e on site ptan):
DepO bolow grade:
iltiretid of msudion:
t"rn" Eme,,
leet
E] nbergbs D poayertgene E ofrer (eobin)
lf lonk is nlelal, H ag6:
Dimenslsrs:
,/,4-
b agE confirmed tya ffie ot curIrlanoe? (alsdt a cory d cerfficato) fl Ves g 6
4*
6lE . @o
Sltldge depth:
tu 6 OtH h.t-h rbf &E!!b.. Sr,ia. rp.- S'*n. E!,, cl tz
Sanui TirJsf, P.OAor( e2, SaqE llor€ , UA O25Ei
\rGrE sstEge o(lors (bH6d when arireu ai the s e?
BuiEirg Scr,lrer (locate on site plen)r
Dep& b€hu ora(b:
Mslerid o, consitrudim:
E csst iron D 40 pVC E dter (e)(dstu):
Dittance trorn pn'rftde t /der g,lpply ndl or sucum Ene:
'€!r!
Aug 13 09 09:51p Ellis Brothsrs
:8"\
508-3626266 p.11
Title 5 Official lnspection:Form
SubsurfaGa Sexrag€ Dirposd SySo folEt - lllof fDr Vonmayy Assessrnents
256Ol4Mtri/n Sr€et Soulh MAProFtyAddB
Santuit TrusL P.O.Bo(@2, Saoam6e . lrA v25f,1Ana.ittr6rbrt*db
6rary PEgE
otrn€r'. lllm,
Sodh Yamodrl itA 02664
Z+ Co.b
trrn*m9Cay/f{t $a6 D&of hspedbo
D. System lnformatbn {ont.)
s.ltlc Trnt (cont)
Distane fmrn top of slurrge io bdorn of oslet lee or bdo
Scum ttid(oess
DistatE fifir lop d sdrr! to top cf oou€a Eo or btrllte
Di*ance from bdorn of sqm to boEdn of oulr€{ lee or Def,€
llor rem drnenCms (Etsrmln€fl
Corrmeots (on F ndrlg recom[Endrions. iraet a]d odl€l tee trk|(je,as to oud€t inv€rt et idence ofleqbQe,.E
/,/4
3o'
O
O
<)
l:'ty',**.-,?
oy'
Qaase Trap (locde on sIE den):
Dep0r be[tv gmate
iaab.lrl of consfi.i,oo:
E conaete Emae tr
H
tr Polye$llerle E orfrer (eflain):
ryk
vrrr r wr rrrqctLr gt itaElatl;tllt.'grtti
baffe dtdion, su.frrd idegr&,
Df,rFEios;
Sqm Otctness
Dtratcs fiqn top of sam to rop of qdsa bc
Dl{ance frorrt botlom of scrm b r.*--
.. -<_ <,.t,rir_ sr@.Ir.96.r *r . F!!E tC C ti
508-362$266
sL_\ uonBnonvyeatmorirassacnusefrEs
TEtle 5 GfficEai inspectiem Fsr-rr
Aobsurtuce Sorage Dasposd S![Eiem For[t - l$l for- Voiunhry As+ssmeots
256 Old Main Street, South YannGjth, IIIA
p12
EYcpdty AdJ.erE
Safitfi Trusil. P.O3ox 892, Sagamore . MA 02561
i*rrrrah b.!,rt84 b.
r,-tf,-,rer.5 i.l-fie
SiEiE
a2€61 s7h6t2s0g
E *" ir,s,pBciiEal
D. System lnfurmafion (coil)
co.rEneots (oo purnprng recomrn€ndafiorE. inlel and ordet tee or bafile oond iorl, s[rudural ifitegrtty,4.thi Br=iS d r#d=i io oirtki iir.reri. g'ij=-,!= .tr hi,t4E Ei,: ):
.€.*f
,d//a
TiEiit i,r iiEldirE -i -rh ir&iii inrAsi * *r#?{ ilL i;i irrq,eaio*) gora.le uii siie ,aari)
Oef,h b6low grde:
Aratgrad o, aofldrudon:
I concrae D metsl
Dingrsions;
Capaclty:
De.lg[l Flor
Aarm fesent
Alerm l€vat
Dde of bt prrrpirp:
D ss I polyerhreos fl orher iexdaln)
iI
I
I
g.Id.s',!r@y
[.ves E r'ro
Alarn h wqting ,&'t:fl ves E xo
D@
elc.);
{ A!t86h ,:cpy of cunent trJrnping contrac{ (r*qri#(,). Is ospy a+f2chEd? n Yer, D rrto
I
r ii! .: S.ut l,ra:E:::r. i_drt: ari1sa.-sd.sE C&ri 51.6 . ._ri! ; : .; :;
Aug '13 09 09:52p Ellis Brothers
South Yanno{$fi
Cofirnents (@0daion of alafm and floa!
!ffi'-'
Aug 13 09 09:52p Ellis Brothers 508-362€266
S, uornrrprtrream or GsacousGuc
Title 5 Official lnspection Form
Subarrrface Ser.iege Dispca, StiEtm Form - lrbt br tffrniary Aloessrnems
256 OU Mein Strcd, South Yarrnou$, llA
p,13
PrestrA&E
Ssfttlt Tnrsl P.OAU 69., A@$1Ort qmcirn Lrtqti.dturvlly P€a
Omt! tagtr
SoufiYrmouth uA .028An 07h612009
Clty/Torf,n SlrL Zp Cod.Daar cf lrupaatbn
D. System lnfoflnafion (cont.)
Dietrihnifi Bor (tr presant mst be openeo (ocde on sit6 plan):
Dep& ot thdd l€v€l eboys outet inye a 71/A
Cfime{tls (nde f bq is lsrrd and ddrlx"ttofl to outleG egual, xry orrftEnce of solus carryovtr,e+l(,e'rcs dbd€oe l o 9r ol,t of borq slc.):t{T'Y/5
2./ ,D ?
Itr[lp Ctamoer (lccde m 3fr6 dan):
PrrarF h sflfihg o(Fc
AlarrE In wl&g odec
@mrnents (oote crdakr of plltp
Sof ADcorplio.r St*lE (&CS) (lrcaE on
lf SS not bcde4 qd.h wlry:
E yes Ewo
E ves E trto
corwqr of Plmps ard appulenano€r 6tc):
C€n, €ocalalion not Equired):
TD Sorldrl h+.c&o Fdlt S&../lta S.i/r!! ryd St&r. Er. l?.al7tI!B- @ar!