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377 Septic Inspection 2011 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo Owner Owner's Name information is Northampton required for every Pon page. City/Town Important:When filling out foss on the computer, use only the tab key to mote your cursor-do not use the return key EX ans.osoe 377 Coles Meadow Rd Ma 01060 10/11/11 State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way.Please see completeness checklist at the end of the for. A. General Information 1. Inspector Tom Martin Name of inspector Turkey Hill Field Services Company Name 140 Easthampton Rd. Company Address Westhampton City/Tram 413-527-5311 Telephone Number Ma State S1499 License Number 01027 Zip Code B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ▪ Pa<ors ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10/11/11 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. If the system is a shared system or 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 should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ""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. v H 1 5 ORVY Spxlia,rut 60vRero ewye oispot9&Oat•Pao 1 an 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner Owner's Name information is required for every Northampton Ma 01060 10/11/11 page. City/Town State Zip Code Date of Inspection eim•09106 B. Certification (cont.) Inspection Summary:Check A,B C D or E/always complete all of Section D A) System Passes: 0 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 My failure criteria not evaluated are indicated below. Comments: Please remember to pump your system every 2-3 years. This system has an outlet filter that needs to be cleaned periodically. B) 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. If"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 of Compliance indicating that the tank is less than 20 years ofd is available. ❑ Y ❑ N ❑ ND (Explain below): rm. 5 Oica Fpm Form:Subsurface Sewage Disposa System Page 2 an C); Owner intonation is required for every page. Owners Name Northampton City/Tan Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Properly Mdress Susan and Jerome Camposeo 377 Coles Meadow Rd. Ma 01060 10/11/11 State Zip Code Date of Inspection B. Certification (cont.) 8) System Conditionally Passes(cont): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box.System will pass inspection if(wig;approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ 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): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y O N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment 1. System will pass unless Board of Health determines In accordance with 310 CMR 16.303(1)(b)that the system is not functioning In a manner which will protect public health, safety and the environment: ❑ Cocspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh Title 5 q cis Y spedan Fen:Subsurface Sewage pgpy System.Pip,3 rl t7 0 0 Commonwealth of Massachusetts __ _ Title 5 Official Inspection Form -_'� Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner Owners Name information is Northampton required for every P Ma 01060 10/11/11 page. City/Tom State Zip Code Date of Inspection B. Certification (cont.) 2. 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 MS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply welI. ❑ The system has a septic tank and SAS and the MS is less than 100 feet but 50 feet or more from a private water supply well'. Method used to determine distance: "This system pates if the well water analysis, performed at a DEP certified laboratory,for 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. 3. Other. D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or dogged MS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged MS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or dogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6°below invert or available volume is less than %day flow TAr5 Official Pu Fora&burs"Serve pgwl Syyn.Peve 4 et 17 Owner information is required for every Page. n:.•osae Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Acspssments 377 Coles Meadow Rd., Northampton Properly Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner's Name Northampton City/rown Ma 01060 10/11/11 State Zip Code Date of Inspection B. Certification (cunt.) Yes No El 0 • 0 Required pumping more than 4 times in the last year NOT 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. My portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. My portion of a cesspool or privy is within a Zone 1 of a public well. My portion of a cesspool or privy is within 50 feet of a private water supply well. My 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. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliforn bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.) ❑ (81 The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. E) 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 D. Yes No ❑ ❑ 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(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered yes to any question in Section E the system is considered a significant threat, or answered°yes° in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Tea 6 Mail kepemm Fort sW°ro Savage Deposal Bram•Pile 6 on Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner Owner's Name information is Nh required for every ortam pton Ma 01060 10111111 page. City/Town State Zip Code Date of Inspestion e;ns•cam C. Checklist Check if the following have been done. You must indicate'yes'or°no'as to each of the following: Yes No ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ ® ❑ 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 normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available 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 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 systerus? The size and location of the 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 criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 3 330 nib 5 phial I apxLm Form&Wfb Se gal Disposal sytwn•Page 6 0117 Owner information's required for every Page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner's Name Northampton Ma 01060 10/11/11 City/Town State Zip Code Date of Inspection D. System Information Description: Standard gravity feed system comprised of 1500 gal tank(twin compartment)with leaching galleys. Number of current residents: Does residence have a garbage grinder? Is laundry on a separate sewage system?[d yes separate inspection required] Laundry system inspected? Seasonal use? Water meter readings, if available(last 2 years usage (gpd)): Detail: water usage between 100-125 gpd 2 ❑ Yes ® No ❑ Yes ® No ❑ Yes ❑ No ❑ Yes ® No not available Sump pump? Last date of occupancy: Commerciaglndustrial Flow Conditions: Type of Establishment Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sgR.,etc.): Grease trap present? Industrial waste holding tank present? Non-sanitary waste discharged to the The 5 system? Water meter readings,if available: ❑ Yes ® No currently Date Gallons per day(gpd) ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Teo 5 O'Neal I ysYm Fame Sbala,e Sewage Disposal System Page of 17 Owner information N required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Praperty Mdress Susan and Jerome Camposeo Owner's Name Northampton City/Town 377 Coles Meadow Rd Ma 01060 10/11/11 State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Other(describe below): Date General Information Pumping Records: Source of information: Was system pumped as part of the inspection? If yes,volume pumped: How was quantity pumped determined? Reason for pumping: Type of System: El Septic tank,distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes,attach previous inspection records, if any) ❑ Innovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. Other(describe): Septic Tank with leaching galleys Owner: not pumped since installed in 2000 ® Yes ❑ No standard 1500 gal.twin compartment tank galas plans and measurement. upon inspection sludge levels in first compartment found high enough to warrant pumping. The 5 Mast Y5petim Form:rata/face Swge Dipal*Om•Page8✓17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner Owner's Name Informations Northampton required for every P Ma 01060 10/11/11 page. City/Town State Zip Code Date of Inspection ISirs-Does D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: 2000 date installed(see attached Certificate of Compliance) Were sewage odors detected when arriving at the site? Building Sewer(locate on site plan): Depth bebw grade: Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: ❑ Yes ® No 1.9 feet Town water feet Comments(on condition of joints, venting,evidence of leakage, etc.): Fine Septic Tank(locate on site plan): Depth below grade: Material of construction: ®concrete ❑ metal tank is accessible below patio pavers. 1.1 feet ❑ fiberglass ❑ polyethylene - ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 10'x6'x 5' Dimensions: Sludge depth: 12-16"(first compartment only) The 5 Official FywMn Form:SLawa.sewage Diposs sys4an•Pe98 9 CO 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo Owner's Name Northampton City/Town 377 Coles Meadow Rd Ma 01060 10/11/11 State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle 6-6 inches(pumping warranted) 2 inches(pumping warranted) Distance from bottom of scum to bottom of outlet tee or baffle 16 Now 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.): No evidence of leakage of infiltration. Stuctural integrity fine. Some minor settling of outlet pipe. Outlet tee is fitted with filter.This filter should be cleaned annually. Fitter cleaned and replaced.Tees in good shape. measured Grease Trap(locate on site plan): Depth below grade: Material of construction: ❑concrete ❑metal feet ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or bathe Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date The 5 Official hapedion Pen SWVf®Sews 011001.5d Sy*m•P{p 10 an Owner information is required for every Page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owners Name Northampton Ma 01060 10111/11 Cdyfrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert evidence of leakage,etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: Design Flow: Alarm present: gallons gallons per day ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No T65 Official rupcyb,Fare.OJMSa Save dWsd Sys tn•Rp it of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. O^ner Owner's Name information is Northampton required for every P Ma 01060 10/11/11 page. City/Town State Tip Code Date of Inspection D. System Information (cunt.) 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.): no d-box indicated on as builts.A single line of leaching galleys used as SAS. Pump Chamber(locate on site plan): Pumps in working order ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.). Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: rM 5 0W Fpre•Lon rmrt SWerca Se+ape DiyoW System•Page 12 or 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Aeeessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner owners Name information required re Northampton Ma 01060 10/11/11 Par. tl far every Page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Type: ❑ leaching pits number ❑ leaching chambers number. leaching galleries number ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number. ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil, condition of vegetation,etc.): No evidence of hydraulic failure within the field. Excavated one of the leaching galley's access cover, but unable to open due to lack of real seam around the cover. 125 gallons of water were introduced into the system as part of this inspection and no rise in static levels in tank 6 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 Indication of groundwater inflow ❑ Yes ❑ No The 5 MIA W padon Form Subsystem smp aiWoS SyTm•Pp 13 3/17 Owner information is required for every page. rs:..rem Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Fonn-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner's Name Northampton Ma 01060 10/11/11 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil signs of hydraulic failure, level of ponding,condition of vegetation, etc.): 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.): r,N S fluids InsPecticm Font&bffes&Nage Disposal System•Page 14 do Owner information is required for every page. 15:..MOO Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd. Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner's Name Northampton Cayfrown Ma 01060 10/11/11 State Zip Code Date of inspection D. System Information (cont.) 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 rw 5 Official tape liar Fpm SbNn Smogs rxwma Sy.Mi•MVP 15 of 17 Omer infoenation is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owners Name Northampton Ma 01060 10/11/11 City/Town State zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 78 inches feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked, date of design plan reviewed: see attached(owners copy of soil evaluation from 1998) ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators,installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: See attached . Before piing this Inspection Report, please see Report Completeness Checklist on next page. Tubs NNW wpecian Raw$Wax1p Sexy pyotl System.Page 18 of 17 Owner intonation is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 377 Coles Meadow Rd., Northampton Property Address Susan and Jerome Camposeo 377 Coles Meadow Rd. Owner's Name Northampton Ma 01060 10/11/11 City/Town State Zip Code Date of Inspection E. Report Completeness Checklist El Inspection Summary:A, 8, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 1111e5 Official Hpnnn Flat adulate Sewage pgai System•Pap 17 of 17 OltNi 3A • CERTIFICATE OF COMM ANCE COMMONWEALTH OF MASSACHUSETTS Board of Health, /VOA 4-1wmphs" , MA. CERTIFICATE Of COMPLIANCE Individual Component(s) L3 Complete System The undersigned hereby certify that the Sewage Disposal System; /� / Constructed (Repaired 1 ), Upgraded ( L Abandoned 1 ) by:.. 9C/Qrkf accaym`f'r Yf, �J //T at. 377 Cotes �64daM f<'oq4 1 ThrOmf 1 ompoSeo, has been installed in accordance with the provisions of 310 CMR 1100{#Ile 5)and the approved design plans/as-built plans relating to applicahori No. dated 6 o /S o / - . Approved Design Flow Sol (god) rw Installer Designer: Date 71/1 lot The Issuance of this permit shall not be conslrued as a guarantee that the system will tuner as designed. Inspector A 3 BEDROOM HOME- 500 GAL. SEPn4'WNK • 1 I..,l ACCESS OVER SEPTIC:TAW- ' cemTER-covet Fitot^ 12 4X55' LEAC.H1NG GAU,ER/ 'D05T, fej M CORNER.B IG' 31' • -LEA41 TANK AKESS: CoVEC. 44( 7 " 504 " DIP APPROVED rORA1.5(94 115 arnarreim LS 9fPVra�A. Access covee< or., LSACH 'rINKs AaE B'APART- ti-t•.:.- • ...- •• i • • •'•••:::•;;;-•••Y"; ••••• '-' •••••• •••• .' 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( ....• ....:....... ..:;i:,.!. ::' • • - • I. , .. .. . .. •.: :.- .. • <•-••i;.?, MN VIRVNITICF6 InL r u+r1nn.v SOUTH DEERFIELD 01375 413/ 665-7903 TITLE 5:DRAFT PRINT SEPTEMBER 20. 1993 APPENDIX 4 PAGE 2 DATE: 8/20/98 LOCATION: Coles Meadow Road NAME: Walter Michalowski Northampton, MA ON-SITE REVIEW DEEP HOLE NO.:3 DATE: 8/20/98 TIME: 9:00 a.m. LOCATION: Lot 4(SEE SITE PLAN) LAND USE: Forested SLOPE: 12% VEGETATION: LANDFORM: Ground Moraine POSITION ON LANDFORM:Western part DISTANCE FROM: OPEN WATER BODY: None POSSIBLE WET AREA: 115' DRINKING WATER WELL:>200' DRAINAGEWAY: 130' PROPERTY LINE: 18' OTHER: WEATHER: clear SURFACE STONES' Few DEEP OBSERVATION HOLE LOG Depth from Soil Soil Soil Soil Other Surface (inches) Horizon Texture (USDA) Color (Munsell) Mottling (Structure, stones, Boulders, Consistency, %Gravel) 0-6' 0 10YR/4/4 Sandy None Loose Loam 6-16° A 10YR/6/8 Sandy None Loose Loam 16-21° B, 10YR/6/8 Sandy Loam None Loose, Friable with stones to 1.5° diameter - 21-35" 62 10YR/2/3 Sandy None Loose, friable with 15% cobbles Loam Fine roots to 50° 35-83° C 5YR/2/2.5 S dy am 2.5YR/6/4 >5% @ 78' Co pact,friable with a few cobbles PARENT MATERIAL:Ablation Till DEPTH TO GROUNDWATER: STANDING ESTIMATED SEASONAL HIGH GROU LSR06697 E5• . G'VV DEPTH TO BEDROCK:>83" WEEPING FROM FACE: None r EL. 85.0 SOILS EVALUATION FORM 2 Sewage Disposal System Walter Michalowski Coles Meadow Road Northampton,MA Sheet Li of 15 "5.5 T.R.A.K. SEPTIC PUMPING 60 Hyde Hill Road WILLIAMSBURG,MA 01096 (413) 26133168 -ustonrnsORDERNO pax 6/3oLflr-/'/ /1 —cat .Dom, �'�i i!t�—c»6c) 3/7-COLE 5. L a5,v.) fQ-7/4Amp7ad „etl; / o DESCRR 8c'VvEd -"S!';• va e " AMOUNT ary)(44/412 C(F44 ) --r 041". _,274 as ,rte`` — 4- _ eit —nowt --anniasE SEND NAME— ---� NW IRERWRN PAYMENT ......... — ---- C DAC ArC'm,arl Yd cow's 1LSi i¢u,onva tlMir+NJ .. .^. .