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83 Septic Inspction 2013 (2) lune 3,2013 CITY of NORTHAMPTON PUBLIC HEALTH DEPARTMENT BOARD OF HEALTH MEMBERS: Donna Sallow'', Chair—Joanne Levin, MD—Suzanne Smith, MD STAFF Merridith O'Leary RS, Director—Daniel Wasiuk, Inspector—Edmund Smith, Inspector—Jennifer Brown, RN,Nurse Nancy Ruscio and Michelle Sauve 83 Sylvester Road Northampton,MA 01060 RE: Sewage Disposal System Inspection 83 Sylvester Road Dear Homeowners: The Northampton Board of Health is in receipt of a report on the Subsurface Sewage Disposal System Inspection conducted by Tom Martin at your property, 83 Sylvester Road,on May 13,2013.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 owner of the property) are hereby ordered to repair the subsurface sewage disposal system at 83 Sylvester Road,within two years of the date of the original inspection,(May 13,2015). 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 your 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 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 587-1214 if you have any questions concerning this matter. Thank you for your anticipated cooperation in this matter. Sincerely, Da t asiuk Health Inspector FILE COPY 212 Main Street,Northampton,MA 01060 Ph (413) 587-1214 Fax(413) 587-1221 Owner ads iaaone —for—y Page Commonweakh of Massachusetts pE/ ws,¢'Fc7-iotof 6} FTE/t Rten i/o's Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments As QJ q; P51 May tor 70 *N/cfttLE- 31 0VE Po aT MA 6/ 060 /0 - 3 -1.3 A/d +ITHAN 9 'To�- aly/fowh Stele Zp Code case dimpadbi Inspection results must be submitted on this loon.Inspection tonnes may not be altered in any way.Please see completeness checklist at the end of the form. mod A. General Information on the comps. wadytistee key b raw yaw moor-do nd use the return key Important WMe 1. Inspector G&fARM ant" cHo �-' Noma Impeder b coNr/P4cT1 "' o EIPG c �'o arrvmY Cam 1/20 R,J3 ie /Po Company Address SOW Zip code y13 793 - 705 `/ ,S' I 1r7 Melee amber Telethons Number B. Certification I certify that I have personally inspected the sewage disposal system at tics address and that the below is bus,accurate and complete as of the time of the inspection.The inspection was perfor based on my halting and experience in the wooer function and nsYtwhahce of on site device sewage systems-i an a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CUR 15.000).The system: rye Passes ❑ Con/Mone®Y Passes ❑ Falls ❑ Needs Rather Evaluation by the Local Approving Authority /n - hg- -/3 fedora Signature owe The system inspector shall submit a copy of this inspection.report to the Approving A "Meal of Health or DEP)ettn 30 days of completing ties .If the ofiner slaved sy submit the has a design flow a 10,000 gpd or geater.the inspector and the system and tithe systitt owner report to the appmpaiaSS regional office of the DEP.The original should be and copies sent to the buyer.if app5mbie.and the a ineind a ltorfl*. °"This report only describes conditions at the time of inspection are wider the condWons of use at that tine.This inspection does not address how the system wit perform in the fume under die sane or dl faint covalent of use. Tae 50aid aReWm fart aeamn Same wow eyewn•now re IT Commonwealth of MassachuseS Title 5 Official Inspection Form Subsurface sewage Disposal System 3 owoomesss VA-Pc ,nor Owefs Nane lOmildion piked far/arevery ND PTU#✓ 6% Cltylfoen yeie•3n3 tiiA 0/06Er /O 3 "13 -- ep Cane our of lrppadioa Sete B. Certification (cont) Inspection SUMMIT Check &B,C,D or E l always complete all of Section D A) System passes: 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. B) System Conditionally passes: to be 'Conditional Pass*section need ❑ One Cr more system components as comp le t eF 1B pair,as approved by or repaired.The system,upon replaced the Board of Health,wilt pass- N.ND) •following statements tf'nd Check the box for'yet'no'or'not deMairniner(Y• dew'please explain. tank(vAtallter mil a net)is structure The septic tank is metal and over 20 on or old'or or taNk fatbae is in sinent System will pass amepecdon adding ' ',. BBpyc tank as appreYed by the Board of *A metal septic tank will pass Health- if it is s t r u c t u r a l l y sound,not 1 9 and if a Certificate of Compliance indicating that the less than 20 years old is available. 0 Y 0 N ►, ND(Explain below): Tom a aeee bepr:eon rua<9eerro&near Ellspossi System•peer 2 0117 Commomnaith of Massachusetts Title 5 Official Inspection Form subsurface Sewage Disposal System Form-Not for Voluntary Assessments 3S LI/ E F!P /f � Property /AA/C cry M Q± /� Lary rn A'Tdf✓ stem tip Code Date of Impaction owme,Wane ewedt«..en cayiro.n, ere B. Certification (cwt-) ❑ PPuummp atms ar Chamber e Me not operational s will pass with Board d of Health approval B) System Coadidoawly Passes(cant): box ❑ Observation of sewage backup or break out or high static ter level in the ddb bwttnS win to broken or obstructed pipe(s)or due to a lxoken. pass inspection if(with approval of Board of Huh ❑ broken pipe(s)are replaced ❑ y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explap1 below): • disbibution box is replaced ❑ Y ❑ N ❑ ND(Explain below): yryis•913 used pumplr!g share than 4 times a year due or obstructed pipe(s).The ❑ The system required d( approval of the Boats System broken pans inspection we ❑ ❑ N ❑ ND(Explain below): men pnire(S)are replaced ❑ y ❑ N ❑ ND(Explain below): ❑ obstruct removed C) Fudher Evaluation Is Required by the Board of Health: exist which require further evaluation by the in order to determine if ❑ the system is failing to protect public health,safety or Conditions _ in accordance with 310 CMS 1. dyers)(wig pass unless �stem Board of Health. •'M a ru mner*Ala will protect public health, safety anted the environment ❑ Cesspool or privy is within 50 of a surface water ❑ Cesspool or privy is 50 feet of a bordering veeetsded end or a self marsh Tie'Web IvpRMn Fan%StasbE.ter -Pep 3al? seer Idonnwtun s squired for—y sage. Ors•11e Commonwealth of Massachusetts Title 5 Official Inspection Fo mm Subsurface Sewage Disposal System Fenn.Not for Voluntary 3 S y L rE57E f1 ?O M rustic f M /co ea g _SO4UVC owners en Alt sin ctW*oos B. Certification (cont)System will fall unless the Board of Health(and Public WSW SupISer•N any) dtefll*wS that the system is funcdoSie te a manner that the public health, safety and enarunnusnt ❑ The system has a septic tank and soil absorption system( and the SAS is within 100 feet of a surface wafer supply or test utaly to a surface water : •• ❑ The system has a septic tank and SAS and the SAS is a Zone 1 of a public water The system has a s e p t i c tank and S A S the SAS'- within 5o feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS less than 100 feet but 50 feet or more from a private water supply welP'. Method used to determine distance: J O _/ Code of Inspection a system passes if the well water eellonn bacteria indicates absent and the to or less Mem 5 ppm,provided that no other be attached to this fpm 3. Other at a DEP certified an laboratory,n nitrogen is equal oiammonia irtri nitrogen A copy of the analysis must crimes are triggered. D) System Failure Criteria Applicable to All Systems: You M indicate-Yes"or"No"to each of the following for an inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or pending of effluent to the surface of the ground or surface waters drat to an overloaded leel i t or dogged i boa° 00 hared due to an overloaded Static liquid level in the distribution or dogged SAS or cesspool volume is less W depth to cesspool is less that G below invert or available than% flow T66 Oita+mePd^n rum Subsea=Sego—&+r^•P 4 Jtr nee mutton is ndrad Weedy 0000 80,•3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal> P0(1)1-Not for VoflltaY Assessments 3 5 t L/t3702 isropety $N5, —S o � MA- 0106 a cann State Zip Code B. Certification (cont) Yes No ❑ gl o ❑ Dit vita. ❑ ® Any portion of a cesspool or privy Is within 50 feet of a private water supply ) 0 -3 —/ 3 Dao(0 8010n Required pumpbg than 4 times in the last year NOT due to dogged or obstructed pipets). Number of times pumped: • Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 10o feet of a surface water supply or tributary to a surface S supply. Any portion of a cesspool or privy S within hit a Zone 1 of a public well. ❑ Ld 50 feet from of water supply well with no acceptable acceptable greater 8ry analysis. (This a cesspool or privy is sYstem passes If the was water analysis,perfoeuted at aMT certified parmo W an palace of ammonia nitrogen watenitrogen Se to or less than 5 ppm, provided 810 ed.A COPY of t the anahraw and churl of custody must be Shed .1 flow of 2000gpd- rn The system i a cesspool serving a fealty Met a desg ❑ 1o,000gpd. The 1 have determined that one or more of the above failure 0 The system Ma. ❑ as contact 310 ChM 15.803,therefore to lne what wit be necessary criteria exist system owner should to correct the failure. E) Large Systems- To be coesfdersd a late system the sysbin mudseme a fad with a following,it addition to the design flow of 10.000 fled to 15,000 god. For large systems,you must indicate q in Soapyou ems °or°no°tceach Yes No ❑ ❑ the system is within of a surface drinking water supply ❑ ❑ the system is in 200 feet of a tributary to a surface drinking water supply n a nitrogen sensitive area(interim Wellhead Protection ❑ ❑ Area• A�mapped Zone II of a public water supply well °to any question it Section E the systems y rage ovmer or operator D above the large system has fatted. Serserh D shall upgrade the If you have answered of answered'yes- _• SyStern • a Under SigriEldin l . 1 system contact the appropiate should system regional _• the Department. 805 eetln Inman!Fair Bsraar send Sam•Paso 6 d11 commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface sewage Dispeeel System Form-Not for Voluntary Assessments �s s r/ s di N Nc 6 0 negation na RTNA PTO / oio m C ,ry 7,p Cade teed for —y (2 rawm Mee C. Checklist Check If the following have been done.You must indicate eyes'or°n0 Yes No hoard d Health❑ pumping information was provided by the owner,occupant o 0 Were any of the system components pumped out in the previous two weeks? /o —3—/3 MUM trey-dime as to each of the following: Has 07e system received nom flaws in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this pans of the system obtained and examined?(n they ware not available rate as WA) ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑ Was the site inspected for signs of weak out? "2 ❑ Were all system components,excluding the SAS,located on site? ❑ tank manholes uncovered,opened,and the Interior of the tank inspected for the d.,rerwlons,depth of Squid, sludge tees,material and d of of Was the facility owner(and occupants if different from owner)provided with ? information on the proper maintenance of subsurface s )os The alas and location of the Sol Absorption System site has been detemined based on: Existng infomatlon.For example,a plan at the Board of Health. Determined in the field(if any of the failure ai criteria 3oPartCisatissue approximation of distance is unacceptable)@ ❑ D. System information Residential Flow Conditions: actual): Number of bedrooms(design): Number of bedrooms DESIGN flow based on 310 CHAR 15203(for example. 110 gpd x$of bedrooms): N Ti 5 parr9rW^d'n Fora aONa 6w4 Pspreal Swam•nes6d MW nab area for away D. System Information Gommcnwr ahfi of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assam 83s yL ve TE14.0. Property Address AF NC RNs L10 CS R7Ifh PION M/LI/zt LC ,$''9V VF ,A o/o4o /0 13 Dale of Inspecbon Din: Stale rip Code Number of current residents. W Yes ❑ No Does residence have a garbage grinder? Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ( ' No information in this report) ® laundry system Yes ❑ No ? Yes 0 No Seasonal use? Water meter readings.If available Oast 2 Years usage(gpd)): Detail: Sump pump? Last date of occupancy CommerctstAndusbial Flow CondWa : Type of Estabf t ❑ Yes 0 No Date Design lbw(based on 310 CMR 15203): Wag Were Basis of design flow pmetelpersonagit.,a.): ❑ Yes ❑ No Grease lisp present? Yes ❑ No Industrial waste holding tank present? 0 Yes ❑ No Non-sanitary waste discharged to the 5 system? Water meter readings,if available: ter Site The S COS hspodon Felt StSN®Swop agwr S)tlw•Mae Toll? Commomvealth of Massachusetts Inspection Form Title 5 ; _Not for Voluntary Assessments 3 S C //ESTER ii10 NJ NC. 0+5hrrs _ ,rON fhb w A/c RT hn for awry CtYlram D. System information (cot*) Last date of occupancy/use: Other(describe below): Dee General arfonsa++O1 Pumping Rte` Source of information: ❑ Yes ❑ No Was system pumped as Part of the inspection? If yes,volume pumped. gas How a quantity pumped determined? Reason for pumping: Type of System Septic tank,distribution box,sal absorption syste m ❑ Single cesspool O Overflow cesspool ❑ Shared system(yes or no)(if yes,attach previous inspection records,t any) ❑❑ Innovative/Alternative technology- a copy of the cmed operation and maintenance (to e obtained from systems �a copy of latest inaction of the VAsystemtNtoperator Tight tars.Attach a copy of the DEP approval. ISOO 73-0 f / Other*sate): 1 .5 oesim.a.F-R etSsew.. •ipnUP Commomvoatth of Massachusetts Title 5 Official Inspection � sae«wtwe Sewage Disposal System 3 s LG'e3T 6 O ER .S� uvE NANCL iUSCl6 i' M CHi,EgSSCOlo60 /0=3 13 Owner's Nerve Date of Inspection Property Addis's Won me /T o RT H M — sa+e Tip Code sitar way �oY+n D. System Ikon (coot) Alitaroximate of aRmmaona Date installed Of known)and source of information: 6 .r.e • Were sewage odors detected when arriving at the site? Building Sewer(locate on site plan): Depth below grade: Material of construction' E140 PVC 0 otter(ems): —cast iron D❑iistance from private water supply well or suction Ma feet Comments(on condition of joints,venfing,evidence of leakage,etc.): feet 0 Yes al No septic Tank(locate on site plan): I , e seat Depth below grade: Material of construction: 0 metal ❑fiberglass 0 polyedmylene 0 otter(explain)yews concrete !Hank S meta est age: ❑ Yes No Is age confirmed by a Certificate of Comp ?(attach a copy oflD ) Dlnenelo S Sludge depth: Tee e oew Marston r arm!'C W°"bwP(*mid Grimm•ra.o a r Commonwealth of Massachusetts Title 5 Inspection Form subsea=Sewage Disposal ; _Not for S t.VES7F if SA U !!� ,y i-c H ELF.E mm-ic rf (i USc l o dos Is °too RN.B-n FLn/ n for way MPI O/oGrJ L SWIs Zip Code De or inspeceon apnea D. Syatlrrrt Information (cont) Septic Tank(cont) Distance from top of stodge to bottom of outlet the or barns Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of cutlet tee of baffle Comments How were dimensions determined? Yd and outlet tee Q baffle condition,structural integrity, (as of leakage, ): liquid levels ❑ dew ale Grease Trap(locate on site plant Depth below grade: Materiel of construction: ❑ ❑metal ITherglass Dom' scum thickness Distance from top of scum to top of outlet tee Distance from bottom of sasm to bodom outlet We or baffle Dos Date of last pum natamKam se..r°s...sucersra..-ws,m„ Wks �50� feet ❑polyethylene ❑other(em*** of Massachusetts Title m c5 Official ,F - Voluntary 1 3S srE: 'i Q Property PA/VC Cranes*Me ,�.oU ion la No RT the =� foreleg `'°mom l Inspection Form p, Ru s c / o �./ i ifiEILE S0uv� 3`lf O/o 6 0 State DA Cale /6 pegs of se0edb^ `own on (cont) pd¢grlly, D. S Comments ystem(pumping recommendations,evidence Imo'etc.): o Baffle corder structural liquid as to outlet hwert, [yo•3115 7 +Attach copy of current pumping contract(required).Is 'attached The 5Mid Fornt Stateless tame O Sydo^•pp 11 SIT Yes ❑ No ten IS d foreMrs Commonwealth of Massachusetts Title 5 Inspection Form Sewage D4 m-Not for Voluntary Assessments 73 s ea RD ^�.° h jcHEt LC ° rrc f, c guscio oR TNA1 dN 0/0C.0 o /0 — 3 —r3 OMIKf3 O Code pfd Inspection Informa n (coot.) D. Sys Distribution Box(if present must be opened)(locate on site plan): Depth of Squid level above outlet invert evidence of solids •any Comments(rota if box is level and d fo outlets equal,any of leakage into or out of M.etc.) evidence ekes 9 •It pumps or alarm am not in working order,system is a conditional pees Soil Absorption System(SAS)(locate on sits plan,excavation not req uired): If SAS not located,edam why. -�-_ Tee 5o11tlM Ys-wive Faror eaftedeofieee.o er •raw not Commonwealth of Massachusetts Title 5 Inspection Form Assessments 83 �S tL'a-tZ i Sdfu E P,opedy Address 2, i s , n -i- Al /c 1.--(Et 3 _ i3 MIS 0I060 JO of Inspection no Code wms dune WerliA /1 i Her every D. Information (cont) D. System tans•3M3 5m Type: number. ❑ leaching pits P leaching chambers number. number. ❑ leaching galleries number,tenge ❑ leaching 1 .❑ number,dimensions: caching fields number: ❑ overflow °t oM OSSSPO O innovative/alternative system Typefname of technology od,dihoa of comments(note won c sod,signs of hydraulic failure.level Ponding'damn soil. vegetation,etc'): 7-5(3 £A� Cesspools(cesspool must be pumped as p of inspecti0n)t , on site plan): Number and configuration Depth—top of liquid to inlet Invert Depth of solids layer Depth of scum layer Dir ension5 of cesspool Materials of construction Indication of grounttweb inflow ❑ Yes CI No ime sme+ssw'scsrn Waage}M`°' •nsraan CommonW0Mht of Massachusetts Title 5 Official Inspection Form ts Subsurface Sewage Disposal System Fonn-Not for Voluntary Assessmen g-3 s c. ve R az ProPaIY G IO F M !C N =I C t= Sp}t�f/E N9 NC � owlet.wmo MT3— 07� ° e.n is t✓o�PTitfrn d:' a✓ , Z code f for erg' Ceyrtoen D. System Information (overt) conn of son.shins of h •, failure,level of ago ding.condition of vegetation, etc.): —•NIS t0 -3 —23 Date,rwvem?^ Fairy(notate on Ste plan): Materials of Dimensions Comments(note condition of sot of hydraulic fabure,level of bonding, condition of vegetation, Depth of salts etc.): MRS Official wwci 'ime abeam SUMO MOS slime•PiYa 14011 Mon Is diorama commonwealth of Manacisusotts Title 5 Official Inspection Foy Subsurface Sewage Disposal ars Form-.Not far Pmedy Address 04.1063 NOM Zip Cads Deaf wwctio^ Chiltern D. System Information (cart) inducing ties to it leas brio pumped os ls Q n,®L Sall w 100 feet Locals where public weber supply enters the bolding.check one of the balms Sew: Ohand-sketch in the see baba drawing attached sepanialy lift 5 Onoa Yew Fsaa SuaSafam ——'PP 15 of 1T L.$•11110 Commonweene of reassachusees Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 .s_ YEC? 1? au NAwcy .Riofccio + M /c• HELLE 3°4 v rer Ovate p/ oGc� 10^3'1-3 term mmtipnr POtriHA-HPTe" M� ' • kw every cayrram Stele alp Cade Date of inspection D. System Information (cons.) Site Exam: X1 Check slope ) 1 Surface water lb Check cellar ❑ Shallow wells > /O Estimated depth to high ground water. rest Please Indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record Ste•3113 If checked,date of design plan reviewed: Dys ❑ Observed site(abutting property/observation hole wdhin 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators,inse9ans-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing us Inspection Report,ldellee see Report Completeness Checldst on next page- us swousDw3wram ewerrw ewe.papas swim•reps tofl fi commonwealth of Massachusetts Ls/ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 83 Sylvester Rd., Northampton Property Address Nancy Ruscio and Michelle Sauve 83 Sylvester Rd. )weer Owners Name iformanens Northampton Ma 01060 5/1312013 squired for every CM/rown State Zip Code Date of Inspection age. E. Report Completeness Checklist {Sins un0 ® Inspection Summary:A, B, 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 The 5 otft N k,spNon Furor Subsurface Swag Diequb Spam•Peps 17 d 17 DATE: s- tr-» GROUNDWATER - New// OIDDE PERC. RATE NOTES •• Na NI a it O h.aittr 9 ♦ ' _••••�•..n nvn rl 1:-t DATE -I'- t,r-mss EMS tAnar I r F t SAND r/CtA•FL tents: STOWS GROUNDWATER OXIDE: PERQ. RATE s IMP 'a !' 3° waive Nom, M A. AU.TITLE STATE t DONE RONMENTA COD NiH SEPTIC TANK SHOULD BE INSPECTED AND CLEANED AT LEAST ANNUALLY PER TITLE 3. SEC. tie ALL PIPING FROM HOUSE TO SEPTIC TANK AND FROM SEPTIC TANK TO DISTRIBUTION BOX OR LEACHING PIT TO BE SDR-33, RING—TITE. RECOMMENDED ONE O BE qc NOTICE�E PRIOR TO BEQNNING CONSTRUCTION TO DESIGN ENGINEER IF FIELD INSPECTION IS REQUIRED. CLEAN—OUT MANHOLE TO BE INSTALLED TO %!NIN 8" OF GRADE OVER SEPTIC TANK, RECOMMENDED PL A N CA LC' /-• :'p'