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80 perc and LUA 1998 BOARD OF HEALTH MEMBERS JOHN T.JOYCE,Chairman ANNE BURES,M.D. CYNTHIA DOURMASHKIN,R.N. PETER J.McERLAIN,Health Agent CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH 210 MAIN STREET 01060 (413)587-1213 June 29, 1998 Tom&Judith Martin 80 Country Way Florence,MA 01062 RE: Sewage Disposal System Inspection 80 Country Way,Florence Dear Mr. &Mrs.Martin: The Northampton Board of Health is in receipt of a report on the Subsurface Sewage Disposal System Inspection conducted by Dennis Lacourse at 80 Country Way Florence on June 26 1998 That inspection report indicates that your subsurface sewage disposal system fails to protect the public health and the environment as defined in Section 15.303 of CMR 15.000,State Environmental Code,Title 5. Therefore,in accordance with the provisions of 310 CMR 15.000 of the State Environmental Code,Title 5,and under authority of Massachusetts General Laws,Chapter 21A,Section 13,you(or the subsequent owners of the property) are hereby ordered to repair the subsurface sewage disposal system at 80 Country Way,Florence,within two(2)years of the date of the inspection,(by June 26,2000). If further degradation of the sewage disposal system occurs (e.g. sewage flowing to the surface of the ground),you may be required to complete the repairs sooner. All work to repair/upgrade the subsurface sewage disposal system must be performed by a licensed sewage disposal system installer, in accordance with the requirements of 310 CMR 15.000,and with plans prepared by a Registered Sanitarian or a Registered Professional Engineer and approved by the Northampton Board of Health. Please be advised that you are entitled to a hearing on this order to upgrade your subsurface sewage disposal system, provided that you file a written petition requesting such a hearing in the Board of health office within seven(7) days of the receipt of this notice. Please feel free to contact the Board of Health office, at 587-1213, if you have any questions concerning this matter. Thank you for your anticipated cooperation in this matter. Very truly yours, Peter J.McErlain Health Agent Certified Mail#P 573 708 239 FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL PAGE 1 OF 5 Commonwealth of Massachusetts AtofzTrievneTONl , Massachusetts Application for Local Upgrade Approval Title 5, 310 CMR 15.000 DEP Approved form required by 310 CMR 15.403(1) To be submitted to Local Approving Authority/Board of Health: For the upgrade of a failed or - nonconforming system with a design flow of < 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. - - To be submitted to DEP: For the upgrade of a failed or nonconforming system with a design flow of 10,000 up to 15-,000 gpd and/or for upgrade of a state or federal facility, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of new design flow to a cesspool or privy or the addition of new design flow above the existing approved capacity of a system constructed in accordance with either the 1978 Code or 310 CMR 15.000. -- 1) Facility/system owner Name Trio MAS ✓ t\n12 14 Address 6 Pfrlk6, Gtt€ STAR ,LktfVC - l7:247NP.M aI.rt Phone / &o3] 773- -Ba.IO Address of facility 80 Cc, Air / &M/ _ A orn-IA/ (Al /ix r)- U/O t.• 0 2) Applicant (if different from above) Name SAME, A-S AaoVC Address Phone 0 3) Type of facility ✓residential commercial _ school institutional /^ _ (Specify) SING FA LE (AM &FOM C DU Rfl RO'TD FORM • 12 01'S UR.AI YA At'rLIIAjJUN I'UK LULAL IYGKAM. APPROVAL PAGE 2 OF 5 4) Type of existing system / pricy cesspool(s) ✓ Conventional system Other (describe) Type of soil absorption system (trenches, chambers, pits,etc.) 5) Design flow based on 310 CMR 15.203 a) Design flow of existing system gp d UNKNaA»/ Approved? yes approval date urJKNOWN/ no why? b) Design flow of proposed upgraded system 1/60tpd c) Design flow of facility 333Ogpd 6) Proposed upgrade of existing system is a) ✓ Voluntary - - Required by order, letter, etc. (attach copy) _ Required following inspection required by 310 CMR 15.301 (provide date inspection form was submitted to the approving authority) (date) b) Describe the proposed upgrade to the system Rcp c6 F9 iL )Aft 56/L Ai350Rf3TIov sysTemi out./ c) Which of the following are applicable to the proposed upgrade? N/4. Reduction of setback(s) (list setbacks to be reduced with pro- roposed setback distances) Percolation rate of 30-60 minutes per inch (state actual pert rate) DU APPROVED FORM- 12 0''5 FORM 9A - APPLICATION FOR LOCAL UPGRADE APPROVAL PAGE) OF5 ___/ ni A Up to 25% reduction in subsurface disposal area design requirements (sate required & proposed size) Relocation of water supply well (identify well, describe relocation) Reduction of required separation between bottom of SAS & high groundwater (specify proposed reduction & pert rate) PERC RATE • e, I - - 3ecv 5&pcRHl /Gv KE&ics eO ni 111 IA Other requirements of 310 CMR 15.000 that cannot be met (specify sections of the ��� Code) System upgrades that cannot be performed in accordance with 310 CMR 15.404 & 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410-15.417. 7) If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high ground water elevation pursuant to 310 CMR- 15.405(1)(i)(1). The evaluator must be a member or agent of the local approving authority: Dktance from soil absorption syster to high groundwater _ 3,0 feet As determined by -- Evaluator's name DaJ /CS 2-ACOORer, l Pi /tl CEi�l,J Evaluator's signature / , Date of evaluation jLt,y 6 /�9B DEP APPROVED FORM- Il 0'1S FORM 9A • APPLICATION FOR LOCAL UPGRADE APPROC.&L PAGE 4 OF 8) Notice to Abutters • No application for upgrade approval in which the setback from property lines or a private water supply well is reduced shall be complete until the applicant has notified all abutters whose property or well is affected by certified mail at least ten days before the Board of Health meeting at which the upgrade approval will be on the agenda. Such notice shall include the date, time and place where the upgrade approval will be discussed. If the Department is the approving authority, then such notice to abutters must be completed prior to the date of submission of the application to the Department. The notices to abutters shall include a copy of the completed application form and shall reference the standards set forth in 310 CMR 15.402 through 15.405. List of affected Abutters: Abutter Name M/ia Date notified Address. Abutter Name - - Date notified _ Address Abutter Name - Date notified Address - Abutter Name Date notified _ Address 9) Explain,why full compliance, as defined in 310 CMR 15.404(1), is not feasible (each section must be completed): . a) an upgraded system in full compliance with 310 CMR 15.000 is not feasible: u N i �c.�c�..,�:-.11 FJhI f31f' . t'(2u f��dj� _ ri - l IAN M1L X✓4:03 AA .) _>r ' L r A , J �.l G I V A ?A.cl b) an alternative system approved pursuant to 310 CMR 15.283-15.288 is not feasible � -%/s NOT (3Stu(x PP- opcSbO DU*PPROVID FORM 11.41 f6 FORM 9A • APPLICATION FOR LOCAL UPGRADE APPROVAL PAGE50F5 c) a shared system is not feasible: P 51/HRE D Sy$E i5 ,y07- E{)j?(3(E NE)&}/sca /495 NOT/3.TAJ APP2a-lcittb . ' '4P Cc,575 CA) 0..q0 136 PRoh,b,tuvE. d) connection to a sewer is not feasible. /JO S&uJ€R f9UHILAI3 LE 10) An application for a disposal system construction permit, including all required attachments (e.g. plans & specifications, site evaluation forms), must accompany this application. Is the DSCP application attached? ✓yesno - 11) Certification • "I, the facility owner, certify under penalty of law that this document and all artachmenti, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for knowing violations." - - `, 1 4ww• , MAPitN Facility owner's s I ricrn,fl5 3"r-9& fv� nR"ft J Date Print Name —rivt of kJ t= , A\r161NMS Name of prep&er Date 3 ebb L 4413) Si:, - 5? H tc.) flI c TAL%vE lbb - LJi )-%m ia) ib Telephone I & address of preparers NOTE: Title 5, 310 CMR 15.403(4), requires the system owner or operator to submit to the Department a copy of the local upgrade approval upon issuance by the Board of Health and prior to commencement of construction. Nyieati vv A *77r DU APPROVED FORM.I1473S No. ■ FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 Date:?—/.fx Commonwealth of Massachusetts uo. rn.0..,73-.,,,,, Massachusetts Soil Suitability Assessment for On-site Sewage Disppl Periotmed By: aS.i.a._R• _t,/.)."0c sE Witnessed By: Plc _6ie4_N.__..___.__.._.._ Darer 2.•4'291f.._ Laaumat AddrIELI La veto Construction 0 Repair Office Review � Published Soil Survey Available: t : No ❑ Yes ICt Year Published 3..1 Publication Scale J.l$2.4D Soil Map Unit /3I/at Drainage Class .41e14-.._.... Soil Limitations .4erteRy y-.gg Surficial Geologic Report Available: No Yes ❑ Year Published .;._ Publication Scale Geologic Material (Map Unit) Lacdfotm 3:21U2 ei .. Flood Insurance Rare Map: Above 500 year flood boundary No ❑Yes 5 Within 500 year flood boundary.No Er Yes ❑ Within 100 year flood boundary No -Yes © . Wetland Area: National Wetland,Inventory Map (map unit) Wetlands Conservancy Prolcam Map (map unit) Current Water Resource Conditions (USGS): Month Rance :Above Normal ZNormal ❑Below Normal ❑ Other References Reviewed: T nw F 7-va e'rtf )374.e77.o Telopre y $0 Cn eir-t y -Lyfy/ • N.aYye•lProwr var9. 0/St 4t3 5-29- 72Y2 DEP APPROVED FORS_ ;2,07/95 Ed Wdbb:TO 8661 £I '1^f 892P+96z+£TP : 'ON BNOHd 3S211107tl1 a SINN31 : WOa • ■ FORM 11 SOIL EVALUATOR FORM Page 2-of 3 Location Address or Lot rio. 4 ) PKfenttx .fat, f�8-- On-site Review Deep Hole Number . Date0.-4 Location (identify on site plan) . -. -.-_.. r.,. Land Use .1 tya &i!P.i... ... Slope (%) b . Vegetation LL *C . 1.100.# .a> __._ Landform Position on landscape (sketch on the back) .... Distances from: Open Water Body _5aD feet Possible Wet Area .LQOY. feet Drinking Water Well LSYr fest Time:2: D . Surface Stones L>. Weather 4CZ9 - Drainage way to feet Property Line feet Other .., . .. DEEP OBSERVATION HOLE _OG• i - VSoil Depth ham Surface Scenes) Sail MPrizcn Tenure (USDA) Sol Caor (faunse)l Sal Mording Othu ISuueture,5:ones. Boulders, Gnsiszency, % Craveq 11- ' 7b r 54 (u• A 1 3„ /r �( l.� C. ?% 5,../L /L Lv g--,' Jar y! �b •y 54 ,,y 5ripe7 4Da )Dyag 1°tya 9 11 1Zm7} L Lao-fl Fin.:.' sa>y u.['4L 1'Y¢.y •- theary - eey FQ.•D 1 4Y tSt Ge „tqL t / • 'co U • •LE6 cuUlboa Al t e • rnOeTOSeb Eroa6aauA.A Parent Material Inebpic) naYw4 $ Oeotn ro5reundwa ter: Standing Water in the Hole erlmated Samurai Hide Ground Water: LiO • 1.f Oapdaaaadmeb 1,Ln Weeekig from Pit Face: J/-.z DEP APPROnE:FORM•12/07/95 £d wdSb:TO 866T £1 •lnt 89£1,1963+£TP : 'ON 3N0Hd 3safllJdl a SINN3Q : WOa 2DM : DENNIS R LHCOURSE PHONE ND. : 413+296+4368 Jul. 13 1998 131:45PN P4 Location Address or Lot rile. r yi[Peea;s1 FORM I1 - SOIL EVALUATOR FORK( Page 2 or 3 On-site Review Deep Hole Number ._. Oate:774:1 TimeZ'tl•iy Location (identify on site plan) Land Use 1 etc.Lp. - are..+_ ... . Slope (%) 0 . Surface Stones Vegetation ct'sTrse,P .4?a_!Atf-t-j- .._.. Landfarm 7t 0-0,-*T.CX Position on landscape (sketch on the back) ...._ Distances from: t ppan Water Body S46 fees Drainage way -.ask feet Possible Wet Area ./4101 feet Property Line . . feet Drinking Water Well 4sX y feet Other . .. . .. Weather DEEP OBSERVATION HOLE LOG. Depth fret: Surface Penes) Soil hehmn sail Texture (USJAI Sod Cofer (Mansell soli Mottling Other 1Strootve.Scones, Boulders. Consistency, % Gravel) p Ttl (L NS A C 404^1 [seise +r sa Seats- Csayt) Are s.P..l.' td:--,, *angst Agars 1314Saky P.e.sit Ucay FI een, t}jL.peks,77 tSS.> tti-eu 3 ia14.. 6arut L iniE(VMZ}YMVIaf noctu1N_3 nT EV ear rrwru,ce DfS/OSA DeoaReaeback: f parent Marshal leeobaiol b D7hsar P 4 9aoth rocewnl.narer: ScanGngWater in the Hele: /VD Estimated Sezzenel tap C,ct,d Weer: 4V Weeping tram Pie Feet: MD DEP APPROVED FORM-11/09Ns - ■ T 0y o.a a?�" e Os S.er'i- �� - 04 .- Y rn y Sd Wd9b:Te 866T £T 'I^f 89Eb+96z+£ib : TN ANY-Id assnootl1 21 SINN AU ' WO2