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HomeMy WebLinkAboutL Inspection Report 2026 Apr 10,4.s.\Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every Owner's Name West Yarmouth Ma.02673 page Cityffown State Zip Code Date of lnspeclion lnspection results must be submitted on this form. lnspection forms may not be attered in anyway. Please see completeness checklist at the end of the form. A. lnspector lnformation MichaelSears lmpoftant: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Name of lnspecior Jim The lnspector Man Company Name P O Box 784 Company Address West Yarmouth Ma.02673City/Town 508-364-4398 State sr14430 Zip Code I certify that: I am a DEP approved system inspector in full comptiance with Section 15.340 of Tiile 5(310 CMR 15.000); I have personally inspected the sewage disposalsystem at the property addresslisted above; the information reported below is true, accurlte and complete as of the time oi myinspection; and the inspection was performed based on my training and experience in the proper functionand maintenance of on-site sewage disposal systems. After conduiting this inspection I have determinedthat the system: Telephone Number License Number B. Certification 1. X Passes 2. ! Conditionally Passes 3. E Needs Further Evaluation by the LocalApproving Authority 4. n 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 idesign flbw 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 tothe 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. tsinsp.doc . rev. 7 1261201 I Title 5 Official lnspection Form: Subsurface Sewage Disposal System. Page 1 of 18 4-10-26 OF M ICHAEL SEARS No.sI14430,k €5 IN ,4.Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg L Property Address Foxwoods Condomin ium 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 lnspection Summary: Complete 1, 2, 3, or S and all of 4 and 6. 1) System Passes: X I have not found any information which indicates that any of the failure criteria describedin 310 CMR 15.303 or in 310 CMR 15.304 exist. Any faiiure criteria not evaluated areindicated below. Comments: System meets minimum Massachusetts DEP standards, this lnspection is not a guarantee of futureworking conditions. 2l System Conditionally passes: E One or more system components as described in the "Conditional pass" section need to bereplaced or repaired. The system, upon completion of the replacement or repair, as approved bythe 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 structurallyunsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will passinspection if the existing tank is replaced with a complying septic tank as approvedby the Board ofHealth. * 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. tr V tr tt n NO (Exptain betow): tsinsp.doc. rcv. 7 12612018 Title 5 Official lnspection Form: Subsudace Sewage Disposal System . Page 2 of 18 5ft. Commonweatth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for voluntary Assessments 248 St. Foxwoods ll Address L Foxwoods Condominium Homeowners AssociationOwner information is required for every page Owner's Name West Yarmouth 4-10-26City/Town State Zip Code Date of lnspection C. lnspection Summary (cont.) 2l System Gonditionally passes (cont.): E pump Chamber pumps/alarms not operational. System will pass with Board of Heatth approval ifpumps/alarms are repaired. f] 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): n broken pipe(s)are reptaced tr v f] ru n ruo (Exptain betow): f] obstruction is removed E V n frf n ruO (Exptain betow): n distribution box is teveled or replaced E y tr rrr E ruo (Exptain betow): E fne system required pumping more than 4 times a year due to broken or obstructed pipe(s). Thesystem will pass inspection if (with approval of the Board of Health): ! broken pipe(s) are reptaced tr v tr ru E ruo (Exptain berow): n obstruction is removed tr v E rrr n ruo (Exptain betow): 3) Further Evaluation is Required by the Board of Health: I 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 Health determines in accordance with 310 CMR 15.303(1Xb) that the system is not functioning in a manner which will protect public health,safety and the environment: Ma 02673 tsinsp.doc. rcu. 7 12612018 Title 5 Official lnspection Fom: Subsurfa@ Sewaga Disposal System . Page 3 of 1B 5fu. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal System Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg L 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.) tr Cesspool or privy is within 50 feet of a surface water n Cesspool or privy is within 50 feet of a bordering vegetated wefland or a salt marsh b' System will fai! unless the Board of Health (and Public Water Supptier, if any)determines that the system is functioning in a manner that protects the pubtic -health, safety and environment: E In. system has a septic tank and soil absorption system (SAS) and the SAS is within100 feet of a surface water supply or tributary to a surfice waier supply.E fne system has a septic tank and SAS and the SAS is within aZone 1 of a public watersupply. E fne system has a septic tank and SAS and the SAS is within 50 feet of a private watersupply well. fl fne system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet ormore from a private water supply well"*. Method used to determine distance: 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 Title 5 Oflicial lnspection Form: Subsurface Sewage Disposal System. Page4 of 18 ** T-his system passes if the well water analysis, performed at a DEp certified laboratory, for fecalcoliform bacteria indicates 3bsent and the presence of ammonia nitrogen and nitrate nitrogen is equalto or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis mustbe attached to this form. c. Other: 4l System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes n n No x tsinsp.doc. rcv. 7 12612018 /ASr)Commonwealth of Massach usetts Title 5 Official lnspection Form subsurface sewage Disposat system Form - Not for voluntary Assessments 248 Camp St. Foxwoods tl Bldg L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma.02673 4-10-26City/Town State Zip Code Date of lnspection C. lnspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No tr 5) Large Systems: To be considered a large system the system must serve a facitity 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 ntrtrtr trtr x x x x tr tr n Static liquid level in the distribution box above outlet invert due to an overloadedor clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is lessthan % day flow Required pumping more than 4 times in the last year Nor due to clogged or 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 ortributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public water supplywell. 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 wellwith no acceptable water q-uality analysis. [Thissystem passes if the well water analysis, performed at a DEp certifiedlaboratory, for fecal coliform bacteria indicates absent and the presenceof ammonia nitrogen and nitrate nitrogen is equat to or tess than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysisand chain of custody must be attached to this form.l 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 failurecriteria exist as described in 310 cMR 15.303, therefore the system fails. Thesystem owner should contact the Board of Health to determine what will benecessary 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 Area - IWPA) or a mapped Zone ll of a public water supply well Tille 5 Official lnspection Fom: Subsurface Sewage Disposal System . Page 5 of 18 ! x n ! tsinsp.doc . rcv. 7 1261201 I x ?,,\.Sr\Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Blds L Property Address Foxwoods Condominium Homeowners AssociationOwner information is reguired for every page. Owner's Name West Yarmouth Ma.02673 4-10-26CityffownState 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 ine large system has failed. Theowner or operator of any large system considered a significant threat unOdr Section C.5 or failedunder Section C.4 shall upgrade the system in accordince with 310 CMR 15.304. The system ownershould contact the appropriate regional office of the Department. 6. You must indicate "yes" or "no" for each of the following tor altinspections: Yes No trX trxxtr trx xtr xtrxn xtr xtr !x Pumping information was provided by the owner, occupant, or Board of Health were any of the system components pumped out in the previous two weeks? Has the system received normalflows in the previous two week period? Have large volumes of water been introduced to the system recenfly or as part ofthis inspection? were as built plans of the system obtained and examined? (lf they were notavailable note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components, excluding the SAS, located on site? were the septic tank manholes uncovered, opened, and the interior of the tankinspected 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 withinformation on the proper maintenance of subsurface sewage disposal systems? The size and location of the soit Absorption system (sAS) on the site hasbeen determined based on: 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 issueapproximation of distance is unacceptable) [310 CMR 1S.302(5)]tr tsinsp.doc . rcv. 7 12612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 6 of 1B x /4.:h.}Commonwealth of Massach usetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for voluntary Assessments 248 CampSt. Foxwoods il BtdgL 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 1. Residential Flow Conditions: Number of bedrooms (design):12 12Number of bedrooms (actual) DESIGN flow based on 310 cMR 1s.203 (for example: 110 gpd x # of bedrooms): Description: 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 inspectioninformation in this report.) Laundry system inspected? Seasonal use? Water meter readings, if available (last 2 years usage (gpd)): Detail: NA nYesX No fl Yes I No EYesffi No EYesX No EyesX No NA Sump pump? Last date of occupancy: fl Yes X No Present Date tsinsp.doc . .ev. 7 1261201 8 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 7 of 1B /4.Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface sewage Disposat system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods il Bldg L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma. 02673 4-10-26CityffownSt'ate Zip Code Date of lnspection D. System lnformation (cont.) 2. Gommercia!/!ndustrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Basis of design flow (seats/persons/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 Tifle 5 system? Water meter readings, if available: Last date of occupancy/use: Other (describe below): Gallons per day (gpd) Eves! No !vesE No EyesE No Eves! 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 f]vesI No gallons tsinsp.doc . rcv. 7 1261201 I Title 5 Official lnspection Form: Subsurface Sewage Disposal System . pag6 g of 1g /4.!s.\Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system rtorm - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma. 02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 4. Type of System: X Septic tank, distribution box, soil absorption system n Single cesspool tr Overflowcesspool n 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 latestinspection of the l/A system by system operator under contract tl Tight tank. Attach a copy of the DEp approval. n Other (describe): Approximate age of all components, date installed (if known) and source of information NA Were sewage odors detected when arriving at the site? 5. Building Sewer (locate on site plan): Depth below grade: Material of construction : n cast iron X aO pVC E other (exptain) Distance from private water supply well or suction line:feet Comments (on condition of joints, venting, evidence of leakage, etc.) EYesI No 25" feet tsinsp.doc. rcv. 7 126120'tB Title 5 Official lnspsction Form: Subsurface Sewage Disposal System . page 9 of 1g r'F\.Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg L 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.) 6. Septic Tank (locate on site plan): Depth below grade: Material of construction : X concrete f] metat ! fibergtass 3000 gal 2 compartment tank & Fast System 15" E polyethylene E other (exptain) lf tank is metal, list age:years ls age confirmed by a Certificate of Compliance? (attach a copy of certificate) n 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 ouflet tee or baffle Distance from bottom of scum to bottom of ouflet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert, evidence of leakage, etc.): 3000 gal 2 comparment tank with in and out tees in place, both covers steel at grade 3000 1 29" 0 8" 18" Sludge , tape tsinsp.doc . rcv. 7 12612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . Page 1 0 of 1 8 feet 5fu. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bl L Property Address Foxwoods Condominium Homeowners Association Owner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 7. Grease Trap (locate on site plan): Depth below grade: Material of construction : ! concrete ! metal ! fiberglass E potyethytene n other (exptain) 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 : f]concrete I metat E fiberglass n polyethytene n other (exptain): Dimensions: Capaci$: Design Flow: gallons gallons per day Title 5 Official lnspection Form: Subsurfece Sewage Disposal Systom . Page 11 of 18tsinsp.doc. rcv. 7 12612018 /4.Sr\Commonwealth of Massach usetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248Camp St. Foxwoods ll Bldg L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 8. Tight or Holding Tank (cont.) Alarm present: Alarm level: Date of last pumping E yes fl ruo Alarm in working order:nyes ENo Date Comments (condition of alarm and float switches, etc.): * Attach copy of current pumping contract (required). ls copy attached? 9. Distribution Box (if present must be opened) (locate on site plan): Eyes Eruo Depth of liquid level above ouflet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, anyevidence of leakage into or out of box, etc.): D Box is 16x16 with 2 ouflet lines, cover is at grade tsinsp.doc ' rev. 712612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 12 of 18 0 5s. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposat system Form - Not for Voluntary Assessments 248 Camp St.Foxwoods ll L 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.) 10. Pump Chamber (locate on site plan): Pumps in working order: ! yes E No* Alarms in working order: E yes E No. Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * lf pumps or alarms are not in working order, system is a conditional pass. 1 1. soil Absorption System (sAS) (tocate on site plan, excavation not required): lf SAS not located, explain why: Type tr x ! tr tr ! ! 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: 14 tsinsp.doc. rcv. 7 12612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 13 of 1B 5s. Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Fonvoods ll L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26City/Town State Zip Code Date of lnspection 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 ofvegetation, etc.): SAS is 14 lnfilltrators with stone, chambers are dry 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 tto Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): tsinsp.doc. rcv. 7 12612018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page l4 of 18 5fu. Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface sewage Disposa! system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods Il Bldg L 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.) 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 1261201 I Title 5 Official lnspection Form: Subsurface Sewage Disposal System . Page 15 of 18 A Commonwea lth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal System rbrm - Not for Voluntary Assessments 248 Camp StJolqggqs Property Address Il Blds L Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West YarmouthCitl,lfown..-Ma. 02673 4-10-26 State -Zip Code -Date lnspection D. Syste m 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 6et. Locate where public water suppty entersthe building. Check one of the boxes below: xn hand-sketch in the area below drawing attached separately BLO. L ,fit r (,1 l,( atri a? v lsinsp.doc. rev. 712612,fi Title 5 Official lnspection Form: Subsurface Sewage Disposal System. page 16 of 1g $rd sfrd 5s' Gommonwealth of Massachusetts Title 5 Official Inspection Form subsurface sewage Disposal system Form - Not for voluntary Assessments 248 Camp St. Foxwoods ll BIdq L 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.) 15. Site Exam: I Check Stope I Surface water X Check cellar X Shallow wells Estimated depth to high ground water:11' feet n 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 local Board of Health - explain: Checked with localexcavators, installers - (attach documentation) Accessed USGS database - explain: tr tr 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 Gompleteness Checklist on next page. tsansp.doc. teu. 7 12612018 Title 5 official lnspection Form: Subsurface Sewage Disposal System . Page 17 of 18 Please indicate all methods used to determine the high ground water elevation: ,F\.s*.Com monwealth of Massach usetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for voluntary Assessments 248 Camp St. Foxwoods ll Bldg L Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26City/Town State Zip Code Date of lnspection E. Report Gompleteness Checklist Complete all applicable sections of this form inclusive of: X n lnspector lnformation: Complete allfields in this section. X e. 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 (Checklist) compteted X O System lnformation: For 8: TighUHolding 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. rcv. 7 12612018 Title 5 Official lnspection Form: Subsurface Sewage Disposat System . Page 18 of 1B All Cape Environmentat, lnc. 36 Checkerberry Rd I Abington, MA 02351508776 6219 i bpfeifer@allcape-environmental.com I www.altcape-environmental.com lnspection Report Your System had a scheduled maintenanc.e event today. Your inspection results are below, lab results wifl notbe.availablefor u.p to z0.davq..Tfrisinspection is requirLa ov vour Town Board of Health and the MaDEp. Thefollowing data will be entered into the barnstable c6uniy stpiic rracriing Dala e""J "" required by Townregulations. ,lLI, d;APE lNvl,:i i :ar-,lNC, RECIPIENT: Foxwoods ll Condominium Trust "/.Cape Realty lnc 299 lt/ain Street West Yarmouth, MA 02675 SERVICE ADDFESS: Foxwood ll BLDG L 248 Camp Street West Yarmouth, MA 026Zg Your System is Notes about your system Permit Details Address Owner Name lnspection Detail Component Other Component Date Time Operator Field Testing Color Odor Eifluent Solids pH DO Scheduled lvlar|9,2026 Other (see comments) L needs a new blower. Willcoordinate replacement. Foxwoods L FAST 3t19t26 1 145 Reese Grey Turbid No 6.9 1.98 I of 3 pages #\\t-All Gape 36 Checkerberry Environmental, lnc. Rd I Abington, tUA 0235i ALU 66PE Turbidity Settleable Solids Site Gonditions 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 Cloaning 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 Any further recommended conective actions? 508776 6219 | bpfeifer@allcape-environmental.com ; www.allcape-environmental.com 1.3 None No 39 Sunny 7 2 No No No No No Yes Cleaned Bio-Kenetic System Yes all Equipment tested for proper operation Yes Blower needs replacement. No No 2 of 3 pages All Cape Environmental, lnc. 36 Checkerberry Rd I Abington, MA 02951 5087766219 lbpfeifer@allcape-environmental.com,www.allcape-environmental.com Yes 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) See note at start of this report Data Base Notes to be entered. system Performing; No further action required at this time. Notes Other a .rlrcb 3 of 3 pages