35 Septic Inspection 2000,10 PAUL CELLUCI
arty Address:
ar's Name:
3r's Address:
to:
of Inspector:
pany Address:
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIR
DEPARTMENT OF ENVIRONMENTAL PROTECT
ONE WINTER STREET,BOSTON MA 02198(617)292-5500
NOR ilAMPrDN
'4AL_ PgARD OF EAIre�
TRUDY COXE
SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM
PART A - CERTIFICATION
35 West Farms Road, Northampton, MA Date of Inspection: 7/26/00
Estate of G.B. Hubbard
c/o Elizabeth Lamoureux, 60 Highland Ave., Easthampton, MA 01027
Board of Health, Northampton;
Owner Number: SSDS-459
Thomas S. Leue Company Name: Homestead Inc.
I am a DEP approved system Inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000)
1664 Cape st., Williamsburg, MA 01096 Telephone: (413) 628-4533
1FICATION STATEMENT
fy that I have personalty Inspected the sewage disposal system at this address and that the information reported is true,accurate
omplete as of the time of the inspection. The inspection was pertormed based on my training and experience in the proper
an and maintenance of on-stte sewage disposal systems. I do not represent or warrant the operation or proper function of this
n for any period of time. The septic system condition must be evaluated and classified into one of the following four conditions:
Passes
Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails
ystem condition: Passes
:tor's Signature:
s
Date: July 26. 2000
Stem inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this Inspection. 11 the
i Is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submh the report to the appropriate
al office of the Department of Environmental Protection. The original should be sent to the system owner and copies to the buyer,a applicable
a approving authority.
:COON SUMMARY:Check A,B, C, or D:
SYSTEM PASSES:
I have not found any information which indicates that any of the failure criteria as described In 310 CMR 15.303 exist. Any
failure criteria not evaluated are indicated below.
BENTS.
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.
le 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
exfiltration,or tank failure is Imminent. The system will pass Inspection tf the 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 it(with approval by the
Board of Health). Describe observations:
broken pipe(s)are replaced
obstruction S removed
distribution box is levelled or replaced
ed 9/2198 Page 1 of 7 Homestead Inc.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A - CERTIFICATION (continued)
y Address: 35 West Farms Road, Northampton, MA
s Name: Estate of G.E. Hubbard
Inspection: 7/26/00
The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
Inspection it(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
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 is failing to protect
the public health,safety and the environment:
SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1Xb)THAT
THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBUC 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 PUBUC HEALTH AND 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 50 feet 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).
OTHER_
SYSTEM FAILS:
idicate either°Yes(Y)or"No"(N)as to each of the following:
I have determined that 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.
r NO
Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
Discharge or ponding of effluent to 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 less than 61 below invert,or available volume less than 1/2 day of calculated daily flow.(Part 7)
Required pumping 4 times or more 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 below high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or a tributary to a surface water supply.
Any portion of a cesspool,privy or any portion of the Soil Absorption System 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.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply with no acceptable
quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile
c compounds,ammonia nitrogen and nitrate nitrogen.
LARGE SYSTEM FAILS:
allowing criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 god 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(I WPA)or a mapped Zone II of a public
water supply well)
wner or operator of any such system shall upgrade the system in accordance with 314 CMR 15.304(2). Please consult the local
:al office of the Department for further information.
ed 9/2/98 Page 2 of 7 Homestead Inc.
ty Address:
's Name:
I Inspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B-CHECKLIST
35 West Farms Road, Northampton, MA
Estate of G.H. Hubbard
7/26/00
<IF THE FOLLOWING HAVE BEEN DONE:
' NO
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.
i 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 back-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 site.
The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles
,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.
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(h any of the failure criteria related to Part C is at issue,approximation of distance Is
:stable)[15.302(3)(b)].
The facility owner(and occupants,if different from owner)were provided with information on proper maintenance of
face Sewage Disposal Systems(SSDS).
FLOW CONDITIONS
inknown
2
210+
0
N
N
N
N
N/A
N
Z-11 since
11/98
Design Flow gallons/day bedroom for SAS
Number of bedrooms(design)
Number of bedrooms(actual)
Total DESIGN flow gpd
Number of current residents
Is there a Garbage grinder?(V or N) _
Is there a Laundry Hookup?(V or N)
Is the Laundry a separate system?(Y or N) (If yes,inspection required)
Seasonal use(Y or N)
Water meter readings,If available(last two years usage)(gallons per day)
Sump Pump(Y or N)_
Date of last occupancy_
ING RECORDS and source of information:
pumped 7/19/00 from Owner's information.
System pumped as pail of inspection(Y or N)
If yes,volume pumped: gallons
Reason for pumping:
Comments: nearly empty
le odors detected when arriving at the she: $
DXIMATE AGE of all components,date installed(if known)and source of information:
gaid to be built in late 1930's. with a system upgrade around 1997. as Der
Owner.
d 9/2198 Page 3 of 7
Homestead Inc.
fly Address:
is Name:
4 Inspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C-SYSTEM INFORMATION
35 West Farms Road, Northampton, NA
Estate of G.B. Hubbard
7/26/00
GENERAL INFORMATION
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. Attach copy of up to date operation and maintenance contract
Tight Tank
Other(explain)
ING SEWER: Y (located on site plan)
Average depth below grade
Material of construction: X cast iron _Sch.40 PVC _other(explain)_
Distance from private water supply well or suction line
Diameter
ents:(condition of joints,venting,evidence of leakage,etc.) Ho problems seen
C TANK: I (located on site plan)
Average depth below grade
sl of construction:_concrete_metal FRP polyethylene X other(explain)prick with treated lumber
S9&
is metal, list age_ Is age confirmed by Certificate of Compliance(V or N)
38
90
57
11
600
22
1
0
34
11
9
Septic tank width(inches)
Septic tank length(inches)
Septic tank height(inches)
Calculated gross volume(gallons)
Air space in tank(inches)
Net Volume(gallons)
Baffle depth(inches)_
Sludge Thickness (Average)
Scum thickness(inches) (Average)
Top of sludge layer to bottom of outlet tee or baffle(inches)
Bottom of scum layer to bottom of outlet tee or baffle(inches)
Top of scum layer to top of outlet tee or baffle(inches)
irnenslons were determined: hlpasnred. Note that the tank was emtty but normal working
depth is 48" water depth.
ents: (recommendation for pumping,conditions of inlet and outlet tees or baffles,depth of liquid level in relation to
outlet invert,structural integrity,evidence of leakage,etc.)
con inlet and outlet brick baffles on inlet and outlet ends Wood cover (7"
lick nominal) is not sianificantly deteriorated. but will not likely support
mazy traffic. Plastic sheet cover protects wood.
'.d 9/2/98 Page 4 of 7 Homestead Inc.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C-SYSTEM INFORMATION(continued)
ty Address: 35 west Farms Road, Northampton, MA
Name: Estate of G.B. Hubbard
In nectlon: 7/26/00
iE TRAP: ELA (Usually present in certain commercial systems)
relow grade:
I 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
:nts: (recommendation for pumping,conditions of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,
ictural integrity,evidence of leakage etc.)
BUTION BOX: X. (locate on site pan)("D-box)
,f liquid level above outlet Invert: 0"
;its: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box,
nendations for repairs etc.) Not a true d-box. but a box tvoe cteanout.
DSORPTION SYSTEM(SAS);
on site plan,if possible;excavation not required,but may be approximated by non-Intrusive methods. If not located,explain:
leaching pits 8 number: -
leaching chambers and number:
leaching galleries and number:
leaching trenches, number,length: one trench found, about to' on,
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.)
:oblems seen on surface.
'OOLS: ME_ (locate on site plan,if any)
Cesspools must be pumped as part of the inspection.
Number and 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 intlow(cesspool must be pumped as part of inspection)
ants: (note soil conditions,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
j1/A (locate on site plan,If any)
115 of construction'
Pons:
of solids:
ants: (note soil conditions,sgns of hydraulic failure, level of pending,condition of vegetation,etc.)
d 912/98 Page 5 of 7 Homestead Inc.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C-SYSTEM INFORMATION(continued)
tarty Address: 35 West Farms Road, Northampton, MA
per's Name: Estate of G.B. Hubbard
of Inspection: 7/26/00
P CHAMBER: ji/A (part of pump-up systems only)
ss in working order:(Y or N)
Is in working order:(Y or N) _
rnents:(note condition of pump chamber,condition of pumps and appurtenances,etc.)
T OR HOLDING TANK: N16 (Special circumstances only)
1 below grade: _
rial of construction:_concrete_metal_FRP_polyethylene_other(explain)
nsions:
city: gallons
in flow: gallons/day
level: Alarm in working order Yes No
nerds: (conditions of inlet tees,condition of alarm and float switches,etc.)
HATED DEPTH TO GROUNDWATER: >36 inches
3 Report name
Soil Type
Typical depth to groundwater
I Date website visited
Observation Wells checked
Groundwater depth: Shallow_ Moderate Deep_
EXAM Slope
Surface water
Check Cellar
Shallow wells
a 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.)
5... Determine it from local conditions
- Check with local Board of Health
- Check FEMA Maps
- Check pumping records
- Check local excavators,installers
- Use USGS Date
be how you established the High Groundwater Elevation.(MQQ be completed)
Reasonably dry basement below this depth. Sandy. dry coil
TENTS:
NOTE, This inspection complies with Title 5 of the MA code. Mostly unoccuoted
status of house does not eauate with the most demanding conditions for this
system. and this inspection does not Guarantee system functionality. Recommend
a inilnwnp Insp ction of d-hnx 30 days after reoccnpanry to verify system
acceotance of all 1ioo id wastes-
JRCES:
Department of Environmental Protection,Western Regional Office,436 Dwight St.,Springfield, MA 01103, (413)784-1100:
Title 5 Hotline-(800)266-1122
i 9/2/98 Page 6 of 7
Homestead Inc.
Plan
.
t6d Site built septic tank
60'
Called North
Cleanout "d-box"
end of pipe as located by owner,
not field verified.
Note: no known drinking water sources within 100' radius
r
As-Built Drawing Date: Owner:
Existing Septic System 7/26/00 Estate of G. B. Hubbard n HOMESTEAD INC.
p Y 35 West Farms Rd. Thomas S. Leue R.S.
Northampton, MA 01060 Revision Date: , / 1664 Cape St.
Scale: 1 :20' I r Wi101664 MA 01096
[41316 &-4533
` Except as Noted