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7 Septic Inspection 1998 (revised 04'15,97) --Page 2 SUBSSRFACE SEWAGE DISPOSAL SYSTEM INSPECTION =ORM Part A Certification (continued) Property Address: 7 SHEPHERDS HOLLOW Owner: Date of Inspection: LEEDS,MA. 01053 TRUDY HOOKS APRIL 7,1998 B] SYSTEM CONDITIONALLY PASSES (continued) Indicate YES, NO, or Not Determined (Y,N, or ND). Describe basis of determination in all instances. If not determined' explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20) years prior tc the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, show substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. Yes Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled, or uneven distribution box. The system will pass inspection (with approval of the Board of Health): Describe observations: ❑ broken pipe(s) are replaced ❑ obstruction is removed Z distribution box is leveled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s).The syste will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 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 failing to protect the public health, safety, and environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THI ENVIRONMENT: ❑ Cesspool 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 2) SYSTEM WILL FAIL UNLESS BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTEC' THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. ❑ The system has a septic tank and soil absorption system and is within 50 feet of a private water sup well. ❑ The system has a septic tank and soil absorption system and the SAS is less than 100 feet BUT 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) Other eN 04/25797) --Page I William'F. Weld Governor Argeo Paul Celluci Lt.Governor Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection ONE WINTER STREET, BOSTON, MA. 02108 617-292-5500 Trudy Coxe Secretary David B. Struhs Commissioner iperty Address: :e of Inspection: npany Name: rnpany Phone: TITLE V REPORT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR: Part A Certification Address of Owner: 7 SHEPHERDS HOLLOW LEEDS, MA. 01053 APRIL 7, 1998 Greg's Wastewater Removal 239A Greenfield Road S. Deerfield, MA 01373 (413) 665-3989 (ONLY if different) APR 15 1998 '„MpTON e0A6n OF HEAL.' Name of Inspector: Gregory M. Gardner rm a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) CERTIFICATION STATEMENT ntify that I have personally inspected the sewage disposal system at this address and that the information reported below is accurate, and complete, as of the time of inspection. The inspection was performed based on my training and )erience in the proper function and maintenance of on-site sewage disposal systems. The system: ❑ Passes ® Conditionally Passes ❑ Needs Further Evaluation by the local Approving Authority ❑ Fails iPECTOR'S SIGNATURE: DATE: e System Inspector shall submit a copy of this inspection report the Approving Authority within thirty(30) days of npleting this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. e original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. 3PECTION SUMMARY: (Check A, B, C, or D) SYSTEM PASSES: ❑ I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.Any failure criteria not evaluated are indicated below. )MMENTS: 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. (revised 04/25/97) —Page 4 SUBS,;RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part B Property Address: 7 SHEPHERDS HOLLOW CHECKLIST Owner: Date of Inspection: LEEDS,MA. 01053 TRUDY HOOKS APRIL 7,1999 Check if the following have been done: You must indicate either "Yes" or "No" as to end the following: Yes No ® ❑ Pumping information was requested of the owner, occupant, and Board of Health. ❑ None of the system components have been pumped for at least two weeks, and the system has has been receiving normal flow rates during that period. Large volumes of water have not been introducer the system recently or as part of this inspection. ❑ ® As built plans have been obtained and examined. Note if they are not available with an NA O ❑ The facility or dwelling was inspected for signs of sewage back-up. ® ❑ The system does not receive non-sanitary or industrial water flow. ® ❑ The site was inspected for signs of breakout. ® ❑ All system components, excluding the Soil Absorption System, have been located on the site. ® ❑ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable)(15.302(3)(b)} 14/25/97) --Pap 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part A • Certification (continued) y Address: 7 SHEPHERDS HOLLOW Inspection: LEEDS,MA. 01053 TRUDY HOOKS APRIL 7,1998 YSTEM FAILS: You must indicate either"Yes"or"No" as to each of the following: ❑ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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. 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 the 1/2 day flow. 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 Soil Absorption System, cesspool, or privy is below the high groundwater elevation. Any portion of a 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 a Zone I of a public 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 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach a copy of well water analysis for colifonn bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. ARGE SYSTEM FAILS: You must indicate either"Yes"or"No" as to each of the following: ""THE FOLLOWING CRITERIA APPLY TO LARGE SYSTEMS IN ADDITION TO CRITERIA ABOVE:"" The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a sgnificant threat to public health and safety and the environment because one or more of the following conditions exist: 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) owner or operator of any such system shall bring the system and facility into full compliance with the indwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local oval office of the Department for further information. (revised 04/45,97) —Page 6 Property Address: Owner: Date of Inspection: BUILDING SEWER: (Locate on site plan) Depth below grade: T Material of construction: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part A Certification (continued) 7 SHEPHERDS HOLLOW LEEDS,MA. 01053 TRUDY HOOKS APRIL 7,1998 cast iron X 40 PVC other(explain) Distance from private water supply well or suction line Diameter 4" Comments: (condition of joints.venting, evidence of leakage, etc.) All good SEPTIC TANK - (locate on site plan): Depth below grade: 12" Material of Construction: ® Concrete ❑ Metal ❑ Fiberglass ❑ Polyethylene _Other(explain) If tank is metal, list age Is age confirmed by Certificate of Compliance (Yes/No) 9'x 5'x 5' Dimensions: o Sludge Depth 43° Distance from top of sludge to bottom of outlet tee or baffle o Scum thickness 5" Distance from top of scum to top of outlet tee or baffle 16" Distance from bottom of scum to bottom of outlet tee or baffle i11E$6 UIPrb How dimensions were determined: Comments: (Recommendations for pumping,condition of inlet&outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) Pump septic tank every 3 years, Baffles OK, Liquid at but not above outlet invert, Tank appears in ON condition, Starting to deterioate, but no signs of leakage. GREASE TRAP - ❑ (locate on site plan): Depth below grade Material of Construction: ❑ Concrete ❑ Metal ❑ Fiberglass ❑ Polyethylene ❑ Other(explain) Dimensions: Scum thickness Distance from top of scum to top of outlet tee/baffle Distance from bottom of scum to bottom of outlet tee/baffle Date of last pumping: Comments: (Recommendations for pumping,condition of inlet&outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) 04/25/97) -Page 5 ty Address: t Inspection: SJSSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part C SYSTEM INFORMATION 7 SHEPHERDS HOLLOW LEEDS,MA. 01053 TRUDY HOOKS APRIL 7,1998 FLOW CONDITIONS Jential: In Flow: 110 g.p.d./bedroom for S.A.S. er of bedrooms: 4 Der of current residents: 5 age Grinder (yes or no) No dry connected to system (yes or no) Yes onal Use (yes or no) No Ir Meter readings- if available st two (2) year usage(gpd) Well p Pump(yes or no) No Date of Occupancy: Unknown mercial/Industrial: of establishment: an flow: se trap present (yes or no) stria!Waste Holding Tank present(yes or no) sanitary waste discharged to the Title 5 system or no) :r Meter readings-- if available: Date of Occupancy: IER: (Describe) date of occupancy: gallons per day GENERAL INFORMATION (PING RECORDS and ce of information: Pumped by Greg's 9/26/97-Greg's em pumped as part of the action: (yes or no) No ES- enter volume pumped: gallons Reason for pumping: 'E OF SYSTEM: Septic Tank/D Box/Soil Absorption System Overflow Cesspool ❑ Single Cesspool ❑ Privy red system (yes or no) (if yes, attach previous inspection records, if any) No Technology etc. Copy of up to date contract? IER:) 'ROXIMATE AGE of all-components: Approx 1986 Installed, if Known: 1986 rce of Information:Trudy Hooks rage Odors detected when arriving at Site: (yes or no) No (revised 04/25/97) --Page 8 Property Address: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part C SYSTEM INFORMATION(continued) 7 SHEPHERDS HOLLOW LEEDS,MA. 01053 Owner: TRUDY HOOKS Date of Inspection: APRIL 7.1558 SOIL ABSORPTION SYSTEM N (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: TYPE: Leaching pits& number Leaching chambers & number Leaching galleries & number Leaching trenches, number, length 3 trenches 50' long Leaching fields, number, dimensions Overflow cesspool, number Alternative system: Name of Technology: Comments: (Note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Boney sandy gravel, No hydraulic failure, No ponding, Vegetation small brush recommend cutting down small brush &trees starting to grow over area of S CESSPOOLS ❑ (locate on site plan): Number&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 inflow(cesspool must be pumped as part of inspection) Comments: (Note condition of soil,signs of hydraulic failure,level of ponding,condition of ation etc.)) PRIVY El (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.) 04/25/97) —Page 7 ly Address: 1Inspection: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part C SYSTEM INFORMATION (continued) 7 SHEPHERDS HOLLOW LEEDS,MA. 01053 TRUDY HOOKS APRIL 7 199 TIGHT/HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locate on site plan): Depth below grade: Material of Construction: ❑ Concrete ❑ Metal ❑ Fiberglass ❑ Polyethylene Other(explain) Dimensions: Capacity in gallons Design flow in gallons per day Alarm level Alarm in working order Oyes ❑ No Date of previous pumping meats: (Condition of inlet tee,condition of alarm and float switches etc.) rRIBUTION BOX: ®Yes ❑ No ate on site plan): it; of liquid level above outlet invert: Not above Iments: (Note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)Distribution is slightly out of I No solids carryover, D-Box is rotten and cracked, the system will pass with a new D-Box installed. 7P CHAMBER: ❑ ate on site plan): Ips in working order: or No) ms in working order or No) invents: (Note condition of pump chamber,condition of pumps and appurtenances,etc.) (revised 04/33/97) —Page 10 Property Address: SUBSUR=ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part C SYSTEM INFORMATION (continued) 7 SHEPHERDS HOLLOW LEEDS,MA. 01063 Owner: TRUDY HOOKS Date of Inspection: APRIL T,1998 Depth to Groundwater 4'6" Feet Please indicate all the methods used to determine High Groundwater Elevation N Obtained from Design Plans on record ® Observation of Site (Abutting property, observation hole, basement sump etc.) ® Determine it from local conditions ❑ Check with local Board of health ❑ Check FEMA Maps ❑ Check pumping records ❑ Check local excavators, installers ❑ Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed): Sandy gravel in area of S A S, topography of land would indicate Hi groundwater elevation would be well below S A S Also no sump pump in cellar very dry, no stains on cellar wall see attached test pit data 04/25/97) --Page 9 ty Address: f Inspection: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Part C SYSTEM INFORMATION 7 SHEPHERDS HOLLOW LEEDS,MA. 01053 TRUDY HOOKS APRIL 7.1998 'CH OF SEWAGE DISPOSAL SYSTEM: {INCLUDE TIES TO AT LEAST 2 PERMANENT REFERENCES,LANDMARKS, OR BENCHMARKS- AND LOCATE ALL WELLS WITHIN 100 FEET}(Locate where public water supply comes into house) **** { SEE EXHIBIT A} **** s --ti d: / \ •Sa\ c-es• 47 1 • I ■ I ` Sam i 'o xa iii-Cr \ \y N it 1 aura o, ! 88 N vn1 -stirJ fav nc�9 JaPun-�i � 4 i - S- I-°-9 0001 101- s�¢b 7 -DJOd Jocki VI aJia .+a maS> •. \ j PM D4 4,00/ L4---f---- 7 r J � �,+Shs i7jO° 'G -c Corn-i 27njJn3PIC -CC) l 0 V i '.7',\-1)( 3 O �. 114-A---„,-..-,7 sas a.• aim'°tr di D�SdO�eC 101Ld/ �0�q T�7 : v t '5 V ICV�9A a A. 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F b M' i= v.1 x Y yE d er"* {t { l -i4-4`6"6 d i -1.n E' }< 4- u y r5xrd.5 F ." .4 . t, I' BOARD OF HEALTH FIN T.JOYCE.Chairman JNE BURES,M.D. 'NTHIA DOURMASHKIN.R.N. TER J.McERLAIN,Health Agent April 15, 1998 Trudy Hooks 7 Shepherds Hollow Leeds, MA 01053 Dear Ms. Hooks: CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH Re: Septic System Inspection 7 Shepherds Hollow Leeds 210 MAIN STREET 01060 (413)586-6950 Ext 213 The Board of Health is in receipt of a . rt on -wa•e • .osal5 -m ins.ec an conducted at 7 Shepherds Hollow Leeds by Gregory Gardner on April 7, 1998. That report indicates the following: • Distribution("D") Box is deteriorated and tipped and must be replaced Based on Mr. Gardner's report your sewage disposal system has been listed as` as conditionally."In order for your sewage disposal system to be classified as "passed,"you must do the following: • Replace the deteriorated"D"box and level the lines out of the `D"box (1't 2ft) All of the work described above must be done by a licensed septic system installer in accordance with the requirements of 310 CMR 15.000 and a Septic System Repair Permit must be obtained from the Board of Health office prior to beginning the work. 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 136 Chesterfield Rd.,within two years of the date of the original inspection, (by 3/14/2000). If further degradation of the sewage disposal system occurs, (e.g. sewage flowing to the surface of the ground),the repairs will be required sooner. 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. • Pg 2 Please feel free to contact the Board of Health office, at 587-1213 if you have any questions concerning this notice. Thank you for your anticipated cooperation in this matter. Very thuly yours, Peter J. Mc rlain, Agent Northampton Board of Health Cert. Mail #P 082 852 909 BOARD OF HEALTH MEMBERS JOHN T.JOYCE,Chairman ANNE BURES,M.D. ;YNTHIA DOURMASHKIN,R.N. TER J.McERLAIN,Health Agent (413)587-1214 FAX(413)587-1264 May 18, 1998 Ms. Trudy Hooks 7 Shepherds Hollow Leeds, MA 01053 Dear Ms. Hooks: CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH Re: Septic System Re-inspection 7 Shepherds Hollow, Leeds 210 MAIN STREET NORTHAMPTON,MA 01060 This letter will confirm that on May 18, 1998, I conducted a re-inspection of the septic system on your property, at 7 Shepherds Hollow, Leeds. That re-inspection revealed that the repairs to your septic system had been completed, Licensed Septic Installer Bill McGrath had replaced the "distribution box," and that the system was functioning properly. Therefore the designation"Passed Conditionally"has been removed from your Title 5 Inspection report and your system is now designated as"Passed." Thank you for your cooperation in this matter. Very truly yours, Peter J. McErlain Health Agent BOARD OF HEALTH HN T_JOYCE,Chairman JNE BORES M D. 'NTHIA DOURMASHKIN,R.N. TER J.McERLAIN,Health Agent October 2, 1998 Ms. Judy Boyle 1357 Burls Pit Road Florence, MA 01062 Dear Ms. Boyle: CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH Re: Septic System Inspection 7 Shepherds Hollow Leeds 210 MAIN STREET 01060 (413)586-6950 Ext 213 The Board of Health is in receipt of a report on a sewage disposal system inspection conducted at 1357 Burls Pit Rd.. Florence by Pamela Bissell on August 20, 1998. That report indicates the following: • The septic tank outlet baffle is badly deteriorated and the septic tank has a heavy sludge/scum buildup Based on Ms. Bissell's report your sewage disposal system has been listed as"passed conditionally" In order for your sewage disposal system to be classified as'passed."you must do the following: • Pump the septic tank and replace the deteriorated outlet baffle with an outlet a"T" baffle. The work described above must be done by a licensed septic system installer in accordance with the requirements of 310 CMR 15.000 and a Septic System Repair Permit must be obtained from the Board of Health office prior to beginning the work. 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 1357 Burts Pit Rd, within two years of the date of the original inspection, (by 3/14/2000). If further degradation of the sewage disposal system occurs, (e.g. sewage flowing to the surface of the ground), the repairs will be required sooner. 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. Pg.2 Please feel free to contact the Board of Health office, at 587-1213 if you have any questions concerning this notice. Thank you for your anticipated cooperation in this matter. Very truly yours, Peter dais,Agent Northampton Board of Health Cert. Mail#P 573 708 233