401 Septic Inspection 1997 ENVIRONMENTAL FIELD SERVICES, INC.
P.O. BOX 518
LEEDS, MA 01053
1-413-586-7200
September 22, 1997
Mary Reutener
401 Sylvester Road
Northampton, MA 01060
re: Septic System Inspection at 401 Sylvester Road , Northampton, MA
Dear Mary:
Enclosed please find a copy of my report for the referenced inspection. I
have forwarded a copy of the report to the Northampton Board of Health per
the requirements of 310 CMR 15.300, and to Jim Locke per his request.
Based on the results of my inspection in accordance with 310 CMR 15.300,
I have concluded that the system does not fail to protect the environment
and/or the public health.
Please call if you have any questions, and thank you for this opportunity to
be of service.
Sincerely yours,
Mic :e1 J. /-vigne
Environmental Engineer
Certified System Inspector
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owner:
Date of Inspection:
BI SYSTEM CONDITIONALLY PASSES (continued)
Environmental Field Service:
P.O. Box 518 Leeds, MA
1413) 586-7200
Sewage backup or breakout or high static water level observed in the distribution box Is due to broken or obs
pipets) or due to a broken, settled or uneven distribution box. The system will pass inspection 0(with appros
Board of Health). Describe observations:
_ broken pipets)are replaced
_ obsuuctlon is removed
distribution box is levelled or replaced
The system required pumping more than four times a year due to broken or obstructed pipets). The system w
inspection 0(with approval of the Board of Healthy
broken pipets) are replaced
obstruction is removed
C] FURTHER EVALUATION 15 REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require funher evaluation by the Board of Health in order to determine if the system is failing lc
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE 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.
3) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERN
THE SYSTEM 15 FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC.HEALTH AND SAFETY AND THE
ENVIRONMENT:
3) OTHER
The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet to a surface wan
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water sup;
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supp
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 leer or more
private water supply well. unless a well water analysis for coliform bacteria and volatile organic compounds i
the well is Tree from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen i!
less than 5 ppm. Method used to determine distance (approximation.not valid).
Iravi..d 04/25/97) P.go 2 of 10
' WELD
UL CELLUCCI
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE 'INTER STREET. BOSTON. MA 0?108
617.292-f:00
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
idress:A-IOI S' Ive-S{e.r a. /Jo.-{I.oabl'loa�
pedion: 9 -12.-97, � Of
spec-tor: m,x< ,ypv/9AJ1_
Im a DEP approved system inspector pursuant to Section 15.340
tame: Environmental Field Services. Inc.
fress: P.O. fax 518 Leeds, MA 01053
Vum'eer: - J413) 586-7200
A
TRUDY CORE
Seeman
DAVID B.STRUHS
Commissioner
Address of Owner: mq Ze�,..&1L
different)Title ,a�O/7S'i jAJes r�.
dot nva oio&o
of Title $ (310 CMR 15.000) S-gy
'ION STATEMENT
I have personally inspected the sewage disposal system at This address and that the information reported below Is true, accurate
to as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
■ of on-site sewage disposal systems. The system:
V Panes
_ Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
Fails
Signature: ,a___t_'_E
Dale: 9/.22/97
Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30) days of completing this
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 appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner
lent to the buyer, if applicable, and the approving authority.
V SUMMARY: Check A, B, C, or D:
PASSES:
ave not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
y failure criteria not evaluate�dd//are indi ted below. ��II n
e C H�G ct ck CD 0.TCr� l�.y,� s-5S
CONDITIONALLY PASSES:
to or more system components as described in the 'Conditional Pass' section need to be replaced or repaired, The system, upon
mpletion of the replacement or repair, as approved by the Board of Health, will pass.
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 to the date of the inspection; or
the septic lank, whether or not metal, is cracked, structurally unsound, shows 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.
1/25/97)
Pa9e 1 of 10
DEP on to Wor1O Woe Web ne0/N+nww magnet stale ma usicleo
Property Address:
Owner:
Date of Inspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Environmental Field Services, 1
P.O. Box 518 Leeds, MA 01l
1413/ 586-7200
Check if the following have been done: You must indicate either 'Yes"or'No'as to each of the following:
Ves No
_ Pumping information was provided by the owner, occupant, or Board of Health.
V - None of the system components have been pumped for at (east two weeks and the system has been receiving
flow rates during that period. Large volumes of water have not been introduced into the system t
as pan of this inspection.
_ As built plans have been obtained and examined. Note if they are not available with N/A.
- The facility or dwelling was inspected for signs of sewage bas*-up.
• _ The system does not receive non-sanitary or industrial waste 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 condi
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 dete m'ned based on:
Y _ The facility owner land occupants, if different from owner) were provided with information on the proper mail
Sub-Surface Disposal System.
Existing information. Ex. Plan at B.O.H.
_ Determined in the field Id any of the failure criteria related to Part C is at issue, approximation of distance is
unacceptable) l 15.302(30bi1
(:.vt..d 04/25/97) aago 4 of 10
Address:
Inspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Environmental Field Services, Inc.
P.O. Box 518 Leeds, MA 01053
1413) 586-7200
EM FAILS:
t 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.
No
Backup of sewage into facility or system component due to an overloaded or dogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface wafers 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 than 1/2 day flow.
_ Required pumping more than 4 limes in the last year NQT due to clogged or obstructed pipets).
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 wafer 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, anach copy of well water analysis for
colliorm bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
DE SYSTEM FAILS:
tat indicate either "Yes" or "No' as to each of the following:
The following criteria apply to large systems in addition to the criteria above.
The system serves a facility with a design flow of 10,000 gpd or greater (Large System)and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
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)!of a
public water supply well)
Ainer ententtssrofp314 CMR 5.00 and s6.00. Please bring
c consult the local regional office oflthe with the
groundwater treatment program
.ea G4/15/77)
Page a of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of Inspection:
BUILDING SEWER:
(Locate on site plan)
Depth below grede:,gr
Material of construction: cast iron_40 PVC_other(explain)
Environmental Fie/d Service
P.O. Box 518 Leeds, MA
(413) 586-7200
Distance from private water supply well or suction Zinc n.S"U/ to p,-;rndr_ s;, tit
Diameter "-/"
Comments: (condition of joints, venting, evidence of leakage, etc.)
No t.,6/t„v- na irci.
SEPTIC TANK:j{
(locate on site plan)
Depth below grade:/8"; - rrcr—z o 9
of construction: joncrete _metal _Fiberglass _Polyethylene other(explain)
0 tank is metal. list age_ Is age confirmed by Cenificate of Compliance _(Yes/No)
Dimensions:
Sludge depth /-/"
Distance from top of sludge to bonom of outlet tee or baffle: 9.2
Scum thickness: ,7"
Distance from top of scum to top of outlet tee or baffle: N/A
Distance from bottom of scum to bottom of outlet tee or baffle: N/•
How dimensions were determined: pr ear .--alt ate{ Geri.,t■ti•
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, stm
integrity, evidence of leakage, etc.)
a .at_3,...,t. X —).,, x co 6.el e r 4r. ri/L e.—, , irk
"" st.r 1-et,i.
GREASE TRAP:
(locate on site plan)
Depth below grade:_
Material of construction: _concrete _metal_Fiberglass _Polyethylene _othedexplain)
Dimensions:
Scum Thickness:_
Distance from lop of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet inven, struc
integrity, evidence of leakage, etc.)
(revised QVxs/n) Pave a of 10
kddress:
sspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
FLOW CONDITIONS
Environmental Field Services, Inc.
P.O. Box 518 Leeds, MA 01053
(413) 586-7200
(IAL:
iw. 310 g.p.d/bedroom for S.A.S.
sf bedrooms) 7
sf current residents: 2
;Tinder (yes or no)'. ;w
onnecled to system (yes or no): yes
use tyes or no):;w
ler readings, if available (last two (2)year usage 1gpd): A//r4
Tip(yes or no):yCl f-ot rarest_-
of occupancy:S tAr-e...
ICIAUINDUSTRIAL:
stabl ishmenr
ow:
ap present: (yes or no)
Waste Holding Tank present: (yes or no)_
,ary waste discharged to the Tide 5 system: (yes or no)_
der readings, if available-
of occupancy
(Describe)
of occupancy.
GENERAL INFORMATION
IG RECORDS and source of information
771-6 Qv€7, 3y.-r r-s^
System pumped as pan of inspection: (yes or no). 0
If yes, volume pumped: gallons
Reason for pumping Y h ' r +s--I k 4t% , dioCoLJt.4-4 4.c .
F SYSTEM
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)
I/A Technology etc. Copy of up to date contract?
RIMATE AGE of all components, date installed (if known) and source of infomation: /taxi 7./1,r / /0
trc- 1-t_c_trd$ ro_k_k a,30 -ad y-.-, el-f.�•../t.
odors detected when arriving at the site: (yes or no)Imo
ed 04/25/f7) Page 5 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner: Environmental Fie/d Semi Box ox 578 Leeds,of Inspection: P.O. Beds, MA
1473/ 586-7200
SOIL ABSORPTION SYSTEM (SAS):J
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
/.inr-nvertc ( /A..OL /res z cG/ec .
Type:
leaching pits, number: 73t 5)012--
leaching chambers, number:_
leaching galleries, number:_
leaching trenches, number.length:
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.)
Ps 4. 1 ,�.,-so rlflu`, n 116-0.-u.i2 4.4 /p+el�...r ac4ed-
CESSPOOLS: .a24
(locate on site plan)
Number and configuration:
Depth-top of liquid to net invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater-
inflow (cesspool must be pumped as pan of inspection)
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.)
I v.v+..d 04/25/t7)
Page a of 10
Address:
'.specllon:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Environmental Field Services, Inc.
P.O. Box 518 Leeds, MA 01053
(413) 586-7200
R HOLDING TANK:/`f/i (Tank must be pumped prior to, or at time, of inspection)
site plan)
low grade:_
N construction: _concrete _metal _Fiberglass _Polyethylene _other(explain)
MS'.
gallons
ow: gallons/dm,
rel. Alarm in working order_ Yes; _ No
previous pumping.
ts:
n of inlet tee, condition of alarm and float switches, etc)
UTION BOX:
in site plan)
I liquid level above outlet Invert'.
level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.)
xia D -Lo x n. d7,0sy c%.at• O%Ler- ✓i< e A•*d(ant
:HAMBER:N 19
n site plan)
in working order: (Yes or No)_
in working order(Yes or No)_
nts:
andition of pump chamber, condition of pumps and appurtenances, etc)
and 04175/97)
e.q. 7 of so
Property Address:
Owner:
Date of Inspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Environmental Field Service
P.O. Box 518 Leeds, MA
(413) 586-7200
Depth to Groundwater>S Feet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
1/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. (Mys be completed)
(revised 09/25/90) Pye as of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
address:
notction:
DE SEWAGE DISPOSAL SYSTEM:
include lies to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
Environmental Field Services, Inc.
P.O. Box 518 Leeds, MA 01053
4131 586-7200
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