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23 Septic Inspection 1997 Commonwealth of Massachusetts 2 M R Execute Office of Environmental Affairs D LS V LS � Department of 'IiI )LIi r Environmental Protection ,. all I EN j PART A - CERTIFICATION j tperty Address: 23 Westhampton Rd.Northampton,MA `JRTHAMPf0N BOARD OF HEALTH' to of Inspection: 1 2/8/9 7 Fner's Name: Andrew Vickery 'ner's Address 23 Westhampton Rd., Northampton, MA 01060 py to: Board of Health,Northampton,John Pokier,Goggins Real Estate (ling Address: 226 King St.,Northampton,MA 01060 mess: Owner Number: SSDS-217 me of Inspector: Thomas S. Leue, Homestead Inc. mpany Address: 1664 Cape St., Williamsburg, MA 01096 (413) 628-4533 BTIFICATION CTATFMFNT .trtify that I have personally inspected the sewage disposal system at this address and that the information reported is true, :urate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the per function and maintenance of on-site sewage disposal systems. I do not represent or warrant the operation or proper function of system for any period of time. The system: pector's Signature: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Date. December 8 1997 System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is tared 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 artment of Environmental Protection. The original should be sent to the system owner and copies to the buyer,if applicable and the approving authority. SPECTION 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 OAR 15.303. Any failure criteria not evaluated are indicated below. 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. icate 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 to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exflltration,or tank failure is imminent. The system will pass inspection if the septic tank is replaced with a conforming 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 by the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four times a year 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 leveled or replaced vised edition 04125197 Page 1 Homestead Inc. rty Address: is Name: of Inspection: PART A - CERTIFICATION (continued) 23 Westhampton Rd., Northampton,MA Andrew Vickery 12/8/97 The system required pumping more than four times a year 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 FURTHER EVALUATION I S REQUIRED BY THE BOARD OF HEALTH: _ 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: 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 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. SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS PUBLIC HEALTH,SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system(SAS)and is within 100 feet to a surface water supply or a tributary to a surface water supply. _ The system has a septic tank and a SAS and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and a SAS and the SAS is within 50feet of a private water supply well. _ The system has a septic tank and a SAS 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). If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform,volatile organic compounds, ammonia nitrogen,and nitrate nitrogen. I) OTHER SYSTEM FAILS: indicate either"Yes"(Y)or"No"(N)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 CM 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 clogged SAS or cesspool. 7L Discharge or ponding of effluent to surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X._ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. i Liquid depth in cesspool less than 6"below invert,or available volume less than 1/2 day of calculated daily flow?(Part 7) 7L— Required pumping 4 times or more in the last yearlQTdue to clogged or obstructed pipe(s).Number of times pumped_ X_ Any portion of the Soil Absorption System,cesspool or privy below high groundwater elevation. 7L Any portion of a cesspool or privy is within 100 feet of a surface water supply or a tributary to a surface water supply. jL Any portion of a cesspool or privy is within a Zone I of a public well. 7L Any portion of a cesspool or privy is within 50 feet of a private water supply. X_ Any portion of a cesspool or privy is less than 100feet but greater than 501eel from a private water supply with no acceptable water quality analysis. LARGE SYSTEM FAILS: following criteria apply to large systems in addition to the criteria above: The design flow is 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 I I of a public water supply well) owner or operator of any such system shall bring the system and the facility into full compliance with the groundwater treatment Tram requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. ised edition 04/25/97 Page 2 Homestead Inc. rty Address: 's Name: of Inspection: PART B - CHECKLIST 23 Westhampton Rd., Northampton, MA Andrew Vickery 12/8/97 IF THE FOLLOWING HAVE BEEN DONE: 1. Pumping information was requested of the owner,occupant and/or Board of Health. 2. 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. 3. As built plans have been obtained and examined. Note if they are not available with N/A. 4. The system does not receive non-sanitary or industrial waste flow. 5. The facility or dwelling was inspected for signs of sewage back-up. 6. The site was inspected for signs of breakout. 7. All system components,excluding the Soil Absorption System,have been located on site. 8. 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. 9. The size and location of the Soil Absorption System on site has been determined based on: a) Existing information on file with the Board of Health. b) 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)) 10. The facility owner(and occupants,if different from owner)were provided with information on proper maintenance of Subsurface Sewage Disposal Systems(SSDS). FLOW CONDITIONS J)FNTIAL• Design Flow. unknown gallons/day/bedroom for SAS _ Number of bedrooms _ Number of current residents _ Garbage grinder(V or N) _ Laundry connected to system(V or N) _ Season use(Yor N) (actually intermittant use) _ Sump Pump into system(V or N) Water meter readings,if available 78 gallons per day (average over 6 months) Date of last occupancy of-snack) I use IMFRC IA L/IN DU STRIA L• Type of Establishment: Design Flow: gallons/day - Grease trap present(Y or N) - Industrial Waste Holding Tank present(Y or N) - Non-sanitary waste discharge to the Title 5 system(Y or N) Water meter readings,if available: Date of last occupancy {ER. (Describe) Date of last occupancy: gallons per day sed edition 04/25197 Page 3 Homestead Inc. rty Address: 's Name: of Inspection: PART C - SYSTEM INFORMATION 23 Westhampton Rd., Northampton,MA Andrew Vickery 12/8/97 ING RECORDS and source of information: Not nmmned since purchase in 191;1 frnm Owner's records System pumped as part of inspection(Y orN) [subsequent day] If yes,volume pumped: 1000 gallons Reason for pumping: System maintenance&inspection Name of Septage Pumper: Huntington Septic Service OF SYSTEM: Septic tank/distribution box/soil adsorption system. _ Single cesspool Overflow cesspool _ Privy Shared system(Y or N),if yes,attach previous inspection records,if any. I/A Technology etc. Copy of up-to-date contract? Other(explain) OXIMATE AGE of all components. date installed Of known) and source of information: Date of construction annroximately 1979 ge odors detected when arriving at the site:(Y or N) N DING SEWER• Y (located on site plan) IL" Average depth below grade ial of construction: cast iron X Sch.40 PVC _other(explain) DI Distance from private water supply well or suction line _ Diameter nents: (condition of joints,venting, evidence of leakage etc) rIC TANK: V (located on site plan) '.3"_ Average depth below grade rial of construction: concrete_metal_FRP_polyethylene_other(explain) nsions: A'-6" long by 60"deer,by 50"wide fnet measurements inside) dimensions were determined: measured (A) sludge depth - (B) top of sludge layer to bottom of outlet tee or baffle - (C) bottom of scum layer to bottom of outlet tee or baffle - (D) scum thickness (E) top of scum layer to top of outlet tee or baffle !menis: (recommendation for pumping,conditions of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, :tural integrity, evidence of leakage, etc.) Taffies in nlare Weer, hole i• center of tank nnwellinn Plvnaed with wooden noun and then sealed with hydraulic cement nlnn sed edition 04/25/97 Page 4 Homestead Inc. PART C - SYSTEM INFORMATION (continued) rty Address: 23 Westhampton Rd., Northampton,MA 's Name: Andrew Vickery of Inspection: 12/8/97 SE TRAP: N/A (Usually present in certain commercial systems) relow grade: d of construction:_concrete_metal_FRP_polyethylene_other(explain) -ions. _ (A) scum thickness _ (B) top of scum layer to top of outlet tee or baffle _ (C) bottom of scum layer to bottom of outlet tee or baffle _ (D) date of last pumping ents: (recommendation for pumping,conditions of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, Ira' integrity, evidence of leakage, etc.) r OR HOP limn TANK- N/A (Special circumstances only) below grade: al of construction:concrete_metal_FRP_polyethylene__ other(explain) Lions :ity: gallons i flow: _gallons/day level: _Alarm in working order_Yes. No lents: (conditions of inlet tees, condition of alarm and float switches, etc.) RIBUTION ROX. _Y (locate on site pan)("D-box") of liquid level above outlet invert: n" cents: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, emendations for repairs, etc.) Anx level and flow sPPms Prn,a1 ADCORPTION CYCTFM (CAC\- L' Locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods. If not determined to be present explain. leaching pits&number: leaching chambers and number: leaching galleries and number: leaching trenches,number,length' 4 nice, each about 4n'long leaching fields,number,dimensions* overflow cesspool,number: Alternative system,name technology: Comments: (note soil conditions,signs of hydraulic failure,level of ponding,condition of vegetation, recommendations for maintenance or repairs, etc.) No nrnhlems seen P rnwrend curt-ina brush arowina nvpr learhina field sed edition 04125)97 Page 5 Homestead Inc. •ty Address: 's Name: of Inspection: PART C - SYSTEM INFORMATION (continued) 23 Westhampton Rd., Northampton,MA Andrew Vickery 12/8/97 CHAMRFR• _Y—_ (part of pump-up systems only) in working order(Y or N) _L in working order:(Y or N) None found ants:(note condition of pump chamber,condition of pumps and appurtenances,etc.) Rimini check valve and float switrh rent aced in spring of 1997 @r[ ndwa ter within a few inches of overflowing into pumn chamber. which will result in excess pump onerati on and floss ihle flooding of leach field This situation should hp watched as it may he difficult to improve without major rehabi1itati on PORI S. N/A (locate on site plan,if any) Cesspools must be pumped as part of the inspection. wand configuration: top of liquid to inlet invert: of solids layer: of scum layer: sions of cesspool: als of construction: Lion of groundwater inflow: (cesspool must be pumped as part of inspection) cents: (note soil conditions,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) N/A (locate on site plan,if any) ials of construction: isions: of solids: tents: (note soil conditions,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) rH TO GROUNDWATER: >96" inches Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plan 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 Date ribe in your own words how you established the High Groundwater Elevation.(Must be completed) Deem hole on ad-anent lot found arrwndwater at annroximatply 60" depth This learh field lorated within 7S' of the deen hole hut at en elevation of at Jpagt 60" hinhpr !MENTS: gpntir inanertinnq in hongPg with minimal nganp may not reflprt oneratina rnnditinng when hnnge iq folly nrrnnied However no nrmhlema were gees in rhig gvgtem ied edition 04/25/97 Page 6 Homestead Inc. Septic tank Pump 2'\�� cr. s 80' Leach field ea E. _ - y 0 s \ po y 0 \ o CL J a I l: N CO D-box---___ Fence Line Note: No well water sources within 100' r r1 U Scale: 1 : 150 Owner: Andy Vickery HOMESTEAD INC. r As-built Drawing of I 123 Westhampton Rd. I 1664 Cape St.