HomeMy WebLinkAboutT Inspection Report 2026 Apr 105s' Commonweatth of Massachusetts
Title 5 Official lnspection Form APR 27 21126subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camp St.Foxwoods ll Bldq T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma 02673 4-10-26
City/Town State Zip Code Date of lnspection
lnspection results must be submitted on this form. tnspection forms may not be attered in anyway. Please see completeness checklist at the end of the form.
A. lnspector lnformationlmportant: When
filling out forms
on the computer,
use only the tab MichaelSears
key to move your Name of lnspector
Jim The lnspector Mancursor - do not
use the return
key.Company Name
P O Box 784
Company Address
West Yarmouth Ma.02673
City/Town
508-364-4398
State
s114430
Zip Code
Telephone Number License Number
B. Certification
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Tifle S(310 CMR 15.000); I have personally inspected the sewage disposal system at the property addresslisted above; the information reported below is true, accurate and complete as of the time of myinspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems. After condutting this inspection I have determinedthat the system:
1. I Passes
2. n Conditionally Passes
3. E tleeds Further Evaluation by the LocalApproving Authority
4. E rails
4-10-26
lnspector's Date
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 Jdesign flbw of10,000 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 tothe buyer, if applicable, and the approving authority.
Please note: This report only describes conditions at the time of inspection and under theconditions 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.
tsinsp.doc. rcv. 7 12612018 Title 5 Official lnspection Form: Subsurfaca Sewage Disposal System. page'l of 1B
5$. Commonweatth of Massachusetts
Title 5 Officia! lnspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Blds T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma. 02673 4-10-26
City/Town State Zip Code Date of lnspection
C. lnspection Summary
lnspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) System Passes:
X I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR '15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
System meets minimum Massachusetts DEP standards, this lnspection is not a guarantee of future
working conditions.
2l System Conditionally Passes:
E One or more system components as described in the "Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for "yes", "no" or "not determined" (Y, N, ND) for the following statements. lf "not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
* A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate ofcompliance indicating that the tank is less than 20 years old is available.
nv nru Eruo(Exptainbetow):
tsrnsp.doc . rcv. 7 12612018 Title 5 Official lnspection Fom: Subsudace Sewage Disposal System . page 2 of .18
1$, Gommonweatth of Massachusetts
Title 5 Official Inspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldg T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page
Owner's Name
West Yarmouth Ma.02673 4-10-26
City/Town State Zip Code Date of lnspection
C. lnspection Summary (cont.)
2l System Gonditionally Passes (cont.):
n pump Chamber pumps/alarms not operational. System will pass with Board of Health approval ifpumps/alarms are repaired.
n Observation of sewage backup or break out or high static water level in the distribution box dueto broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System willpass inspection if (with approval of Board of Health).
tr broken pipe(s) are replaced E v n ru E ruo (Explain betow):
tr obstruction is removed E v n u E No (Exptain betow):
n distribution box is leveled or replaced ! v tr r.r n ruo (Explain betow).
! fne system required pumping more than 4 times ayeat due to broken or obstructed pipe(s). Thesystem will pass inspection if (with approval of the Board of Health):
tr broken pipe(s) are reptaced tr v n ru E ruo (Exptain betow).
tr obstruction is removed n v E ru E ruo (Exptain betow):
3) Further Evatuation is Required by the Board of Health:
! Conditions exist which require further evaluation by the Board of Health in order to determine ifthe system is failing to protect public health, safety or the environment.
a. System will pass unless Board of Heatth determines in accordance with 310 CMR15:303(1Xb) that the system is not functioning in a manner which wilt protect pubtic health,safety and the environment:
tsinsp.doc' rev 7t26t2018 Title 5 Officiat tnspection Form: Subsurface Sewage Disposal System . page 3 of 1g
5s. Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldq T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma.02673 4-10-26
City/Town State Zip Code Date of lnspection
C. lnspection Summary (cont.)
n 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:
n fne 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.f] fnesystemhasaseptictankandSASandtheSASiswithin aZonel of apubticwater
supply.
n fne system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
E fne 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:
** T1tis 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 niirogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the anllysis must
be attached to this form.
c. Other:
4l System Faiture Griteria Appticabte to Allsystems:
You must indicate "Yes" or "No" to each of the foflowing for all inspections:
Yes
tr
tr
No
X
Backup of sewage into facility or system component due to overloaded orclogged SAS or cesspool
Discharge or ponding of effluent to the surface of the ground or surface watersdue to an overloaded or clogged SAS or cesspool
Title 5 Official lnspection Form: Subsurface Sewage Oisposal System . page 4 of 1g
tsinsp.doc. rev. 7 12612018
5s. Commonwealth of Massachusetts
Title 5 Officia! lnspection Form
subsurface sewage Disposal System Form - Not for voluntary Assessments
248 Camp St Foxwoods ll Bldq T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page.
Owner's Name
West Yarmouth Ma.02673 4-10-26
Cityffown State Zip Code Date of lnspection
C. lnspection Summary (cont.)
4l System Failure Griteria Applicable to All Systems: (cont.)
Yes No
nxtrx
trx
trx
trx
!x
trxnx
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%day flow
Required pumping more than 4 times in the last year Nor 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 azone 1 of a public water supply
well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feetfrom a private water supply well with no acceptable water quality analysis. [Thissystem passes if the well water analysis, performed at a DEp certifiedlaboratory, 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 analysisand chain of custody must be aftached to this form.t
The- system is a cesspool serving a facility with a design flow of 2000 gpd-
10,000 gpd.
The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 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.
the system is within 400 feet of a surface drinking water supply
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
A re a - wPA) o' " 1:::""": :::: :: ::', i:::: :::::,:::,,::: l"n" u .,, u
5) large Systems: To be considered a large system the system must serve a facility with adesign 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 thequestions in Section C.4.
Yes No
n x
n
ntr
n
tsinsp doc . ev.712612018
!
tr x
5$. Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for voluntary Assessments
248Camp St. Foxwoodsll BtdgT
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma.02673 4-10-26
6
City/Town State Zip Code Date of lnspection
C. lnspection Summary (cont.)
lf you have answered "yes" to any question in Section C.5 the system is considered a significantthreat, 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 15.304. The system owner
should contact the appropriate regional office of the Department.
You must indicate "yes" or "no" for each of the following lor altinspections:
Yes No
tr X Pumping information was provided by the owner, occupant, or Board of Health
tr X Were any of the system components pumped out in the previous two weeks?
X tr Has the system received normal flows in the previous two week period?
tr X llilf,lT3:,[?umes of water been introduced to the system recently or as part of
Were as built plans of the system obtained and examined? (lf they were notlz\l lJ available note as N/A)
X tr Was the facility or dwelling inspected for signs of sewage back up?
X n Was the site inspected for signs of break out?
X tr Were allsystem components, excluding the SAS, located on site?
X n 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?
n ;y1 Was the facility owner (and occupants if different from owner) provided witha information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site hasbeen determined based on:
! X Existing information. For example, a plan at the Board of Health.
Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CI\nR 15.302(5)]
tsinsp doc . .ev.712612018
Title 5 Official lnspection Form: Subsurface Sewago Disposal System . page 6 of 1g
xtr
5s. Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldg T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth
City/Town
Ma 02673 4-10-26
State Zip Code Date of lnspection
D. System lnformation
1. Residential Flow Conditions:
Number of bedrooms (design):12 Number of bedrooms (actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms)
Description:
12
1320
Number 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:
NA
EYesX No
EYesX No
EYesX No
nyesX No
EYesX No
NA
Sump pump?
Last date of occupancy
EvesXI No
Present
Date
tsinsp doc. ev 712612018 Title 5 Official lnspection Form: Subsurfaca Sewage Disposal System . Page 7 of 18
5$. Commonwealth of Massachusetts
Title 5 Official lnspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldg T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma. 02673
City/Town State Zip Code Date of lnspection
D. System lnformation (cont.)
2. Commerciat/lndustrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203):
Basis of design flow (seatsipersons/sq.ft., etc.)
Grease trap present?
Water treatment 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:
Other (describe below):
Gallons per day (gpd)
IYesE No
!YesE No
!YesE No
EYesn No
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 pumping:
NA
fl Yes I No
gallons
tsinsp.doc. rcv. 7 12612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 8 of 1g
4-10-26
5\ Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page
Owner's Name
West Yarmouth Ma 02673 4-10-26
City/Town State Zip Code Date of lnspection
D. System lnformation (cont.)
4. Type of System:
X Septic tank, distribution box, soil absorption system
D Single cesspool
tr Overflow cesspool
tr Privy
tr Shared system (yes or no) (if yes, attach previous inspection records, if any)
X lnnovative/Alternative technology. Attach a copy of the current operation andmaintenance 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:
2005
Were sewage odors detected when arriving at the site?
5. Building Sewer (locate on site plan):
Depth below grade:
Material of construction :
E cast iron X aO pVC D other (exptain)
Distance from private water supply well or suction line:feet
!YesI No
22"
feet
tsinsp doc . rcv.7126t2018 Title 5 Official lnspection Form: Subsurface Sewage Dasposal System , page 9 of 18
comments (on condition of joints, venting, evidence of leakage, etc.):
$\, Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldq T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma 02673 4-10-26
City/Town State Zip Code Date of lnspection
D. System lnformation (cont.)
6. Septic Tank (locate on site plan):
Depth below grade:
[\Iaterial of construction :
I concrete n metal
2500 gal tank & Fast System
n fiberglass ! polyethylene n other (exptain)
12"
feet
lf tank is metal, list age:years
ls age confirmed by a Certificate of Compliance? (attach a copy of certificate) tr yes E No
Dimensions:
Sludge depth:
Distance from top of sludge to bottom of ouflet tee or baffle
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of ouflet tee or baffle
How were dimensions determined?
2500
29"
0
B"
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,Iiquid levels as related to ouflet invert, evidence of leakage, etc.):
2500 gal tank with in and out tees in place, both covers steel at grade
18"
Sludqe iudge, tape
tsinsp doc. tev 712612A18 Title 5 Ofiicial lnspection Fom: Subsurface Sewage Disposal System . page 1O of 1g
5$. Commonweatth of Massachusetts
Title 5 Officia! lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldq T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page.
Owner's Name
West Yarmouth Ma. 02673 4-10-26
City/Town St-ate Zip Code Date of lnspection
D. System lnformation (cont.)
7. Grease Trap (locate on site plan):
Depth below grade:
Material of construction:
! concrete f]metat ! fiberglass n polyethytene E other (explain):
feet
Dimensions:
Scum thickness
Distance from top of scum to top of ouflet tee or baffle
Distance from bottom of scum to bottom of ouflet tee or baffle
Date of last pumping:
Date
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to ouflet 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 :
I concrete ! metal ! fiberglass ! potyethytene ! other (exptain).
Dimensions:
Capacity:
Design Flow:
gallons
gallons per day
tsinsp.doc . rev. 7 t26l21ft Title 5 Official lnspection Form: Subsurface Sewage Disposal System . pege 11 of 1g
5$, Commonwealth of Massachusetts
Title 5 Official lnspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
248 Camp St. Foxwoods ll Bldg T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma.02673 4-10-26
City/Town State Zip Code Date of lnspection
Alarm present:
Alarm level:
Date of last pumping:
Eyes Eruo
Alarm in working order:IYes nruo
Comments (condition of alarm and float switches, etc.)
* Attach copy of current pumping contract (required). ls copy attached? ! Yes n ruo
9. Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D Box is24x24 with 6 outlet lines, cover is 5" below grade
Date
0
tsinsp.doc . teu.7 12612018 Title 5 Official lnspection Form: Subsurface Sswage Disposal System . page'12 ot 18
D. System lnformation (cont.)
8. Tight or Holding Tank (cont.)
5$. Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Ca St. Foxwoods ll T
Property
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page.
Owner's Name
West Yarmouth Ma.02673 4-10-26
City/Town State Zip Code Date of lnspection
D. System lnformation (cont.)
10. Pump Chamber (locate on site plan):
Pumps in working order: E yes fl No*
Alarms in working order: f] yes f] No.
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
. If pumps or alarms are not in working order, system is a conditional pass.
11. soilAbsorption system (sAS) (locate on site plan, excavation not required)
lf SAS not located, explain why:
Type:
tr
X
tr
tr
!
n
!
leaching pits
leaching chambers
leaching galleries
leaching trenches
leaching fields
overflow cesspool
innovative/alternative system
Type/name of tech nology:
number:
number:
number:
number, length:
number, dimensions:
number:
12
tsinsp.doc . rev. 7l26l20i\Title 5 Official lnspection Fom: Subsurface Sewage Oisposal System . page 13 of lg
5$. Commonweatth of Massachusetts
Title 5 Official lnspection Form
subsurface Sewage Disposal system Form - Not for voluntary Assessments
248 Camp St. Foxwoods ll Bldg T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page
Owner's Name
West Yarmouth Ma.02673 4-10-26
Cityffown State Zip Code Date of lnspection
D. System lnformation (cont.)
1 1. Soil Absorption System (SAS) (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition ofvegetation, etc.):
SAS is 12- 500 gal Drywells with stone, chambers are wet with no sign of failure at time of inspection
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
Dimensions of cesspool
Materials of construction
lndication of groundwater inflow E yes E ruo
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.):
tsinsp.doc' rev. 7 126t2018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 14 of.lg
A' Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for voluntary Assessments
248 Camp St. Foxwoods tl Bldq T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma.02673 4-10-26
CityiTown State Zip Code Date of lnspection
D. System Information (cont.)
13. Privy (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,
etc.):
tsinsp.doc. rcv. 7 126t2018 Title 5 Official hspecilon Form: Subsurface Sewage Disposal System. page 15 of 1g
,4.J*ir Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
48 Cernp t! Ig>oLoo!! Lt Btdg T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page.
Owner's Name
West Yarmouth Ma 02673
Zip Coae
4-10-26CityffownStateDate of lnspection
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 referencelandmarks or benchmarks. Locate all wells within 100 feet. Locate where pubtic water supply entersthe building. Check one of the boxes below:
X hand-sketch in the area below! Orawing attached separately
II ),4
!l,.,
,3I
'6tD'/'trytt
,1"rfi'
0lr lc
Clrrl'q,tf6 '
0l,tl0;
Grlt' gpq',
qt
t'$f
ta
t ar
at .r 1.. o'q .l fea-r-t,D .r
tsinsp.doc. rev. 71261201B Title 5 Officiat lnspection Form: Subsurface Sewage Disposal System . page 16 of 1g
/4.Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposa! system Form - Not for voluntary Assessments
248 Camp St. Foxwoods ll Blds T
Property Address
Foxwoods Condominium Homeowners Association
Owner
information is
required for every
page.
Owner's Name
West Yarmouth Ma 02673 4-10-26
Cityffown State Zip Code Date of lnspection
D. System lnformation (cont.)
15. Site Exam:
X Check Stope
I Surface water
X Check cellar
X Shallow wells
Estimated depth to high ground water:11'
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
X Observed site (abutting property/observation hole within 150 feet of SAS)
n Checked with tocal Board of Heatth - exptain:
Checked with local excavators, installers - (attach documentation)
Accessed USGS database - explain:
n
You must describe how you established the high ground water elevation
No ground water per last report
Before filing this lnspection Report, please see Report Completeness checktist on next page.
tsinsp.doc. rev 712612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page.17 of.lg
n
5fu. Commonwealth of Massachusetts
Title 5 Official lnspection Form
subsurface sewage Disposal system Form - Not for Voluntary Assessments
248 Camo St. Foxwoods ll T
Property Address
Foxwoods Condominium Homeowners AssociationOwner
information is
required for every
page.
Owner's Name
West Yarmouth Ma 02673 4-10-26
Cityffown State Zip Code Date of lnspection
E. Report Completeness Checklist
Complete atl applicable sections of this form inclusive of:
X n lnspector lnformation: Complete allfields in this section.
X A. Certification. Signed & Dated and 1, 2,3, or 4 checked
X C. lnspection Summary:
1,2, 3, or 5 completed as appropriate
4 (Failure Criteria) and 6 (Checktist)completed
X O 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
tsinsp doc. rev 7t26l2O1B Title 5 Official lnspection Form: Subsurface Sewage Disposal System .page 1g of 1g
All Cape Environmental, lnc.
36 Checkerberry Rd I Abington, I\4A 02351
508 776 621 I i bpfeifer@allcape-environmental.com www.altcape-environmental,comzli-", -PE-..-, lxg,
RECIPIENT:
Foxwoods ll Condominium Trust
"kCape Realty lnc
299 Main Street
West Yarmouth, MA 02673
Scheduled It/ar 19, 2026
SERVICE ADDRESS:
Foxwood ll BLDG T
248 Camp Street
West Yarmouth, MA 02673
lnspection Report
Your System had a scheduled maintenance event today. Your inspection results are below, lab results will notbe available for up to 20 days. This inspection is required by your Town Board of Heatth and the MaDEp. Thefollowing data will be entered into the Barnstable County Septic Tracking Data Base as required by Townregulations.
Your System is Performing, no further action required at this time.
Notes about your system Clear tank had excessive root growth into cover and
riser that was cleared.
Permit Details
Address
Owner Name
Foxwoods T
lnspection Detail
Component
Other Component
Date
Time
Operator
Field Testing
Color
Odor
Effluent Solids
pH
FAST
3t19t26
1 000
Reese
Clear
tvlusty
No
7.2
1 of 3 pages
#\
'-{r,/
.t\.a/All Cape Environmental, lnc.
/\L:. ,,.]rPE
Eri r'i --, tNc.
36 Checkerberry Rd I Abington, IVIA 02351
508776 6219 | bpfeifer@allcape-environmental.com I www.allcape-environmental.com
6.39
0.9
None
No
39
Sunny
DO
Turbidity
Settleable Solids
Site Conditions
Seasonal Residence
Air Temperature
Weather Conditions
Operating lnformation
Sludge Depth
Scum Layer Thickness
Pumping Recommended
Soil Absorption System Observations
Signs of Breakout
Depth of Ponding
SAS Ponding above invert
Maintenance lssues
Any apparent violations of the approval
Explain Violation
Any Cleaning or lubrication performed
Cleaning Done
Cleaning Notes
Any adjustments of control settings
Describe control adjustments
Any Testing of pumps, switches or alarms
Elaborate on testing
Any Equipment Failures
Describe equipment failures
Any Parts Replaced
Parts replaced and reasons
7
1
No
No
No
No
Yes
Cleaned Bio-Kenetic System
Yes all Equipment tested for proper operation
No
No
No
2 of 3 pages
,,il\,'Jil /
All Cape Environmental, lnc,
36 Checkerberry Rd I Abington, tvlA 02351
5087766219 lbpfeifer@allcape-environmental.com lwww.allcape-environmental.com
.ALL .;APE
Any further recommended corrective actions?
Describe recommended corrective actions to be taken
lnspection Completion
Was this inspection fully completed?
Reason for incompletion
Reason comments
Actions to be taken to resolve.
Any other comments
NOTES
Client notes to be addressed. (This note is not added to data base)
Data Base Notes to be entered.
Notes Other
No
Yes
Nothing at this time
System Performing; No further action required at this
time.
3 of 3 pages