183 Septic Inspection 1999 HEALTH
ORMASHKIN,R.N.,Chair
KARPARIS,R.N.,MPH
ERLAIN,Health Agent
214
7-1221
November 17, 1999
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
Mr.David O'Brien
104 St. James Avenue
Holyoke,MA 01040
Re: Approval of the Septic System serving 183 Sylvester Rd.
210 MAIN STREET
NORTHAMPTON,MA 01060
Dear Mr. O'Brien:
The Northampton Board of Health is in receipt of a report on a septic system inspection
conducted at 183 Sylvester Rd. on 10/26/99 by Michael McDowell. That report indicates that the
septic system at 183 Sylvester Rd. was functioning properly but required further evaluation by
the Board of Health because two dwellings on the same lot were tied into the system.
On November 16, 1999 the Northampton Board of Health reviewed that inspection report and
concluded that the septic system was appropriate and hereby approves of the continued use of the
system by both dwellings at 183 Sylvester Rd. This approval is subject to the septic system
continuing to function in accordance with the provisions of Title 5 of the State Environmental
Code.
Please contact the Board of Health office with any questions concerning this matter.
Sincerely,
Peter J. McErlain
Health Agent
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address:
183 Sylvester Road Northampton , MA
\lame of Owner: David O ' Brien
4ddress of Owner: Of different) 104 St James Avenue Holyoke, MA 01040
Date of Inspection: October 26 , 1999
Name of Inspector: Michael McDowell
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name, Address &Telephone Number: The Building Inspector of America
2 Brookside Circle
Wilbraham, MA 01095
1-800-626-4408
CERTIFICATION STATEMENT
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 inspection. The
inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
Passes
Conditionally Passes
X Needs Further Evaluation By the Local Approving Authority
Fails
r% �/CLC L. 2) yi.�7i'ZLtC�� Date: 10-76-99
Inspector's Signature:
Michael McDowell MW jt
The System Inspector shall submit a copy of this inspection report to the Approving Authority
(Board of Health or DEP) within thirty (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 Department of
Environmental Protection. The original should be sent to the system owner and copies sent to
the buyer, if applicable and the approving authority.
Notes and Comments: Septic system meets no failure criteria, however, waste
_umbing from two houses discharge into one septic system.
Original To: David O ' Brien (copy provided for buyer)
104 St . James Avenue
Holyoke , MA 01040
Board of Health (return receipt requested)
Copy to:
revised 09/02/98
Town of Northampton
210 Main Street
Northampton, MA 01060
NSPECTION SUMMARY: Check A, B, C, or D
) SYSTEM PASSES'
s
I have not found any information which indicates that any of the failure conditions
described in 310 CMR 15.303 exist. Any failure criteria not evaluated are
indicated below.
:omments:
I) SYSTEM CONDITIONALLY PASSES: N/A
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.
Idicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all
istances. 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
tank, whether or not metal, is cracked, structurally unsound, shows substantial
infiltration or ex-filtration, or tank failure is imminent. The system will pass inspection if
the existing septic tank is replaced with a complying septic tank as approved by the
Board of Health.
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 if (with approval of the Board of
Health):
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four 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
obstruction is removed
vised osiovsa)
2
:) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
ir Conditions exist which require further evaluation by the Board of Health in order to
determine if the system is failing to protect the public health, safety and the
environment.
1) System will pass unless Board of Health determines in accordance with 310 CMR
15.303 (1)(b) that the system is not functioning in a manner 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.
(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 and safety and the 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 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 the SAS is within
50 feet of a private water supply 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 No failure criteria was met at time of inspection, however ,
waste plumbing from two houses discharge into one septic system.
Both houses have two bedrooms without garbage grinders .
Board of Health and owner have no actualdesign records . Due
to the fact that there are no provisions in the Title 5 regulation:
for a situation such as this , further evaluation is required
by the Board of Health.
(lemsed 00102/98)
)) SYSTEM FAILS:
'ou must indicate either"Yes" or No to each of the following:
N I have determined that one or more of the following failure conditions exists as described
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.
'es No
N Backup of sewage into facility or system component due to an overloaded or
clogged SAS or cesspool.
N Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or dogged SAS or cesspool.
N/A_ Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool.
N/A
Liquid depth in cesspool is less than 6 inches below invert or available volume is
less than 1/2 day flow.
N Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped _.
N
Any portion of the Soil Absorption System, cesspool or privy is below the high
groundwater elevation.
N/A Any portion of a cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
N/A
Any portion of a cesspool or privy is within a Zone 1 of a public well.
_a/A _ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
N/A 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 copy of well water analysis
for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate
nitrogen.
N/4 = non-applicable
(re4sed 0 srovs8)
4
LARGE SYSTEM FAILS: N/A
u must indicate either"Yes" or"No" to each of the following:
The following criteria apply to large systems in addition to the criteria above:
is No
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:
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 11 of a
public water supply well).
to owner or operator of any such system shall upgrade the system in accordance with 310
NR 15.304(2). Please consult the local regional office of the Department for further
'ormation.
wised 09N2/90)
5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
ieck if the following have been done. You must indicate either"Yes" or"No" as to each of
e following:
.ts No
/A
Pumping information was provided by the owner, occupant, or Board of Health.
None of the system components have been pumped for at least two weeks and the
system has been receiving normal flow rates during that period. Large volumes of
water have not been introduced into the system recently or as part 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 backup.
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 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:
N Existing information. For example, Plan at B.O.H.
Determined in the field (if any of the failure criteria related to Part Cis at issue,
approximation of distance is unacceptable) [15.302(3)(b)].
The facility owner (and occupants, if different from owner) were provided with
information on the proper maintenance of Subsurface Disposal Systems.
v'sod 09102/90)
6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
FLOW CONDITIONS
ESIDENTIAL:
:sign flow: 110 g.p.d./bedroom each house
ember of bedrooms (design): 2 Number of bedrooms (actual):2 each house
dal DESIGN flow: 440
Amber of current residents: 5 total
erbage grinder (yes or no): no
iundry (separate system) (yes or no): no If yes, separate inspection required.
sundry system inspected (yes or no): N/A
?asonal use (yes or no): no
'ater meter readings, if available (last two years' usage (gpd): 26 , 300 for 2 year total
of both houses
imp Pump (yes or no): no
ist date of occupancy: currently occupied
GENERAL INFORMATION
JMPING RECORDS and source of information:
last pumped in spring of 1999
System pumped as part of inspection (yes or no): no
If yes, volume pumped: gallons
Reason for pumping:
YPE OF 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. Attach copy of up to date operation and maintenance contract
Tight Tank_Copy of DEP Approval
ether
Septic tank / two leaching pits
PPi ROXIMATE AGE of all components, date installed Of known) and source of information:
s old. leaching pits approx. 15 years
old based on materials used and their condition, owner and phone
sewage odors detected when arriving at the site (yes or no): no conversation with the
Board of Health.
vasm 09/O2/99)
7
JILDING SEWER:
ocate on site plan)
;pth below grade: 12"
aterial of construction: x cast iron 40 PVC_other (explain)
stance from private water supply well or suction line 21 ' -6"
ameter 4"
omments: (condition of joints, venting, evidence of leakage, etc.)
Building sewer exits #183 the right side .foundation wall 12 '
in from right rear corner .
Building sewer of 183A exits right side front area adjacent to
the bathroom.
EPTIC TANK: y
)tale on site plan)
epth below grade: 2" to 8" to risers
aterial of construction: x concrete metal Fiberglass_Polyethylene_other ((explain)
tank is metal, list age Is age confirmed by Certificate of Compliance (Yes/No)
imensions: 8 ' Lx5 'Wx4 ' 6"D approximately 750 gammons .
ludge depth: 6"
(stance from top of sludge to bottom of outlet tee or baffle: 26"
cum thickness: 0-1"
istance from top of scum to top of outlet tee or baffle: 8"
istance from bottom of scum to bottom of outlet tee or baffle: 12"
ow dimensions were determined: with a pde and tape measure
omments:
ecommendation for pumping, condition of inlet and outlet tees or baffles. depth of liquid level
' relation to outlet invert, structural integrity, evidence of leakage, etc.)
Fluid level was correct , that is , equal with outlet invert .
Build in baffle was in functional condition . There is black
staining on baffle from outlet invert down, which is an indication
that there has not been any backups . Septic tank is sound.
iised osmvvs)
8
;TRIBUTION BOX: N/A
:ate on site plan)
pth of liquid level above outlet invert:
mments:
■te if level and distribution is equal, evidence of solids carryover, evidence of leakage into or
of box, etc.)
)IL ABSORPTION SYSTEM (SAS): X
tale on site plan, if possible; excavation not required, location may be approximated by
n-intrusive methods)
)ot located, explain:
pe:
leaching pits, number: two
leaching chambers, number:
leaching galleries number:
leaching trenches, number, length:
leaching fields, number, dimensions:
overflow cesspool, number:
Alternative system:
Name of Technology:
)mments:
ote condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
:getation, etc.)
No evidence of hydraulic failure , ponding or damp soil at time of
inspection . There is no evidence of solids carryover , fluid level in
first leaching pit was 11 " in depth. Top of leaching pits are
17" below grade .
rlsed 091011981
9
.ETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house.)
if TO SCALE
1=Outlet Cover
3=Main Cover
=Inlet Cover
J=First leaching Pit Cover
WA=56 ' 6"
WB=57 ' 4"
WC-58 ' 0"
XA=10 ' 4"
XB=13 ' 3"
XC=16 ' 0"
ZD=44 ' 0" YD-41 '4"
Brnldrne
SCW.1rr
t/ 53
A J
public to ler .:30p0
NSed 0910L90}
183 5ylVe_ater c O
10
DS Report name
Soil Type
Typical depth to groundwater
GS Date website visited:
Observation Wells checked
Groundwater depth: Shallow Moderate Deep
E EXAM Slope X
Surface water
Check Cellar
Shallow wells
x
.imated Depth to Groundwater 7 Feet
ase indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
X Observation of Site (Abutting property, observation hole, basement sump etc.)
X Determine from local conditions
X
Check with local Board of Health
Check FEMA Maps
Check pumping records
Check local excavators, installers
Use USGS Date
!scribe how you established the High Groundwater Elevation. (Must be completed)
Grade falls off from houses to SAS and falls off again to rear
of property. Elevation drop within 100 yards to rear of SAS is
7+ feet .
Ised osmvse)
11