809 Septic Inspection 2003 AMHERST CIVIL ENGINEERING (413) 256-3400
PO Box 3312, Amherst, MA 01004-3312
June 2, 2003
Pauline M. Pothier
41 Walnut Street
Northampton, MA 01060
Re: Title 5 Septic System Inspection for 809 Westhampton Rd., Northampton, Mass.
Dear Ms. Pothier:
I inspected the septic system specified above and the most important fact I can report is that it's
capacity, by present standards, is small. The tank has about a 300-gallon capacity (by way of
comparison, any new system being built today is required to have a 1500-gallon tank). The each
pit has an inside diameter of 4-feet and a depth below inlet of 2-feet. 1 suspect it has survived this
long because the number of residents of this house has been small,there has been no washing
machine or garbage disposal in the houseiand because, according to the S.C.S. (USDA) Soil
Survey, the leach pit is in Hinckley soil and Hinckley soils are very pervious and good for
leaching.
Structurally the system is in good condition although I do strongly recommend replacing the cover
of the leach pit. The septic tank is small but appears to have an especially effective two-
compartment design. To prolong the life of this system I recommend that neither a washing
machine nor a garbage disposal be installed in this house. It's also important to pump the septic
tank regularly, I believe that pumping it at least once every two-years would be a good
investment. As your brother-in-law stated,when pumping this tank it is very important that
both of the tank's lids be uncovered and that both compartments of the tank be pumped.
And since the tank has a capacity of only 300-gallons more or less I think that the leach pit could
be pumped out at the same time without an extra charge.
Department shat be required. The The Department replaced a permit
be reached from the
5871213 pion Health
Thank you very much for the opportunity to be of service.
Very truly yours,
Robert Stover
Cc: Northampton Health Department
Page 2 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: B o? %des f/,o,..,1.kp,.l
T_r-IMa.^ny'fon I
Owner: av'J rl1 t y'
Date of Inspection:_ C,T / 6/3A/ 3
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
_L/ 1 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.Any failure criteria not evaluated are indicated below.
Comments:
_set. pue-
B. System Conditionally Passes:
2 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.
Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please
explain.
/[ —
U The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and ifa Certificate of Compliance
indicating that thetank is less than 20 years old is available.
ND explain:
rip Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with-
approval of Board of Health): , d kf, Lo)c LAoc '4tt
_ broken pipe(s)are replaced /5 a �eaC�' P��
obstruction is removed
distribution box is leveled or replaced
ND explain:
06 The system required pumping more than 4 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
ND explain:
2
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECT
TITLE 5
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address:
Owner's Name:
Owner's Address:
Oct
of
Date of Inspection:
Name of Inspector:(
Company Name:
Mailing Address:
Telephone Number:
D)o(or)
• ease print) Siever-
t
i =Vpji I✓le=r1
or- 33r ti
"A snags
CERTIFICATION STATEMENT
1 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 the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
- Passes
_ Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
�,,
Fails
Inspector's Signature: ,464h l Date:
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 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
DEP.The ginal should be sent to the system owner and copies sent to e layer, applicable,and the approving
S/30/a3
authority. .S{'F a " I --. �,�,,���/�% (//��.CM/ 14 - jC 2, I"e5)11".t/+
Notes
,,and fComments 300rt ytt¢ 'f+vt I4— „5J'•"".",,'” _ -{o soI6" s.,,17' °' / 5ys-W^'
ptt `T L °{✓ o1-(- .Q .o'fr D-,..c 7�"�"' yqears-o �t of aJL2, _1-
Leafk Pif V4r is $cr-Jlccab� �} L2rtsrtt$o nQ t to Wa,2d%-
pe�mreJcndn¢
+ �
**This report only describes conditi s at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future under the same or different A�
conditions of use. 1 % / /S ilk "�D Cg/1'!-CO'I._�L �1c/ `"t KA nC
Lbt11 (.s "P
o -tits e.,C. p a -f Feu oue_ -Hint&t
Title 5 Inspection Form 6/152000 page 1
S. 6/LA)
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Add r'esss:
n4-Owner: Ilt
Date of Inspection:
809 wes f - .4v-., p,.a0
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
/DiBackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
scharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
N�� Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
NJn_ cesspool
Liquid depth in cesspool is less than 6"below invert or available volume is less than '/:day Flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s)..Number
/of times pumped ,
Any portion ofthe SAS,cesspool or privy is below high ground water elevation.
_ N k Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
_ N Any portion of a cesspool or privy is within a Zone 1 of a public well.
N /I Any portion of a cesspool or privy is within 50 feet of a private water supply well.
h
I- y 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. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for conform 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,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this forma
No(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems: D-1 • Apply
/
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd.
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes 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–I WPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered
"yes"in Section D above the large system has failed. The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304.The system owner should contact the appropriate regional office of the Department.
4
,Page of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERRTIFICATION(continued)
Address: 801 CST ,4
Owner: ®Oth/Cr
Date of Inspection: 5/2D/0f
C. Further Evaluation is Required by the Board of Health:
0 Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health,safety or 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 public health,safety and the environment:
N CI 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,safety and environment:
/1 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.
R O The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
no The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
n D The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well".Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory,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,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other. .-�.--
3
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Ad ress: 8 ocio Wa-4-h `. r ld
�4Owner. 1 cr.
Date ofInspection: �j Q,�
. FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):_ Number of bedrooms(actual):
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): I/O
Number of current residents: Q
Does residence have a garbage grinder(yes or no):/(O
Is laundry on a separate sewage system(yes or no): [if yes separate inspection required]L
Laundry s stem ins pe cted(yes or no): / }
Seasonal use: (yes or no): tip
Water meter readings,if available(last 2 years usage(gpd)):
Sump pump(yes or no): n 35 days
Last date of occupancy: 51/V03
COMMERCIAL/INDUSTRIAL
Type of establishment: p�
Design flow(based on 310 CMR 15.2031 gpd
Basis of design flow(seats/personsisgft,eta):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
no W4SlflV Mac
243 o„te, 9P�
GENERAL INFORMATION
Pumping Records 1 (' /�
Source of information: tie/ 1d'7-er7 pun peJ P� r1y -Ytt'( 7_00-2- &loo Pun-Pci
Was system pumped as part of the inspection(yes or no): S q.� a
If yes, volume pumped: 3027 gallons How was uanti determined?I 5 `� c7 2`/�
Reason for pumping:� e��, a - q ty Pumped ���S""j�7.
P a /'Ot/'f1 ht�(77 t tFtert
TYPE OF SYSTEM
1 Septic tank,db8ibxtieo-box,soil absorption system
Single cesspool
_Overflow cesspool
Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any)
Innovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all componen ate installed(if known
¢aLh h W,
and source of information:
Were sewage odors detected when arriving at the site(yes or no): 00
6
Paf5 i
Page of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
90? k/t5/L n49
Property Address: . Idv Athol . f
Date of J07ion: /V /o3 /'rte' /C..��
Date of Inspection:
Check if the following have been done.You must indicate`yes"or"no"as to each of the following:
Yes No
Pumping information was provided by thVS nerrccupant,or Board of Health
_ 1 Were any of the system components pumped out in the previous two weeks??
/
y Has the system received normal flows in the previous two week period??
eviovs ae_aspawfl Mo -eJ oo+ 2 Nett> a
Have large volumes of water been introduced to the system recently or as part of this inspection?
N'k- Were as built plans of the system obtained and examined?(If they were not available note as N/A)
t/ / Was the facility or dwelling inspected for signs of sewage back up??
✓J/ Was the site inspected for signs of break out?.
✓/ !n LA&ay
_ _ Were all system components,rxGWdi ig the SAS,located on site?
�//_ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition
of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been-determined based on:
Yes no
d Existing information.For example,a plan at the Board of Health.
_ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)] f(
Le&c' ( 2( L.Y�, � C wotalAtt Or
5
Page 8 of 1]
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: SpQ WC'S* P4cK
II D✓
Owner: Dtit ICY
Date of Inspection: S./icy 0
TIGHT or HOLDING TANK: If (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: IA �y
Material of construction:—concrete—metal—fiberglass__polyethylene other(explain):
Dimensions:
Capacity: gallons
Design Flow: allons/day
Alarm present(yes or no):_
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: (if present must he opened)(locate on site plan)
Depth of liquid level above invert: r/+ Sy"� �W
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):
PUMP CHAMBER:_(locate on site plan)
hot arpy7�
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.):
8
`age 7 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
Q SYSTEM INFORMATION(continued)
Property Address: 904 v./ey} q-in-t
pp �U/ tic,-.tft. 1-64A.
Owner: tblvlier
Date of Inspection: 4 /30/D3
BUILDING SEWER(locate on site plan)
Depth below grade: I A''±
Materials of construction: ,/cast iron _40 PVC_other(explain): y / D I
Distance from private water supply well or suction line:
Comments(on condition le of joints,venting,evidence , D /Q
SEPTIC TANK: /locate on site plan)
, ,
Depth below grade: /Z'- 4
Material of construction: concrete_metal fiberglass polyethylene
other(explain) 2 d,5crc-f
If tank is metal list age: NIA Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate) ` G 914 y� \ '(.�$ t ' ' �e 124144-
Dimensions: l\ / '� J
Distance from top of sludge is or baffle: 1 gi
Scum thickness: -FY orrf — a 3r- IInok = f'/et rr=
Distance from top of scum to top of outlet tee or baffle: 8 n
Distance from bottom of scum to bottom of outlet tee or baffle: CO
How were dimensions determined: p10.. /1d
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integity,liquid I
'd fleakage,etc.):
s '(ov. b coon)
'd of leakage,etc):
7o°O"1 (o rf� de X 3 oo c e � 14,--
F✓o+t4- i.o�n a.-1'mcn'�'
Sludge depth: QQ
to boito of tee
3" Sock �o.^ip"�'I" Z 3p0
as related to outlet invert,evidence o ,ry d r it!/�'(lYCr
oHA+le.ib. < -Wet/ls g
wm i e b .-f -Fell reflta v) Vvc- Tee.. TG+..L
GREASE TRAP• (locate on site plan) bo-4 ctopcQ *frVc4sro) IN#c Jriiy
J✓n aSL
h grade:_ ;k 5 S✓n a�( Z'd rimy , J— cm ce. H,.e.�.,/ 3 yccc's
Depth below grade:
Material of construction: concrete metal fiberglass polyethylene other f erne- d
(explain): I
Dimensions: f cSICl erli5.
Scum thickness:
Distance from top 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: q
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
7
Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
O /
Property Address: So �fT
..w�-iUry /24/
Owner: b fits II
Date of Inspection: 3_ CO
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet.Locate where public water supply enters the building.
5 Ha> ON —
A co) �I
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10
T\G5 TO PER MAtUEAT. LA.•Ji> t==-;.
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Page of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
g
Property Address: ` �Oq Wey�1-em f-ft+n,rein
Owner: Pb 4-i,,i tt^
Date of Inspection: S/3 DA)2 /
SOIL ABSORPTION SYSTEM(SAS): 1. /(!orate on site plan,excavation not required)
If SAS not IEtep explain w� / e, Gerel C /_/k YCtj (at/tri
#WQ is S'1� orer�'t.._
Type �t /A
t/leaching pits,number: /i7/
leaching chambers,number. 'Q '-c x tre-
_leaching galleries,number: —
leaching trenches,number, length:
leaching fields,number,dimensions:
overflow cesspool,number:
innovative/alternative system Type/name of technology:
j ihVr1� o-C In It 2(o"+ be lo'./ -lor
O¢
p:4- To-h- d-1*. ,2 I, , 4- ix k.J ,
'& K.T 1s ' 2yu
Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,
rrla.Q e!/
etc): 1
.nor Sar / ' 4l '
/7 0 5; n, 11,.7 d r a C -- bra412 w o b-4e't,u-Cd.
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
frla-�' air 1.1
Number and configuration:
Depth—top of liquid to inlet invert:
Depth of solids layer.
Depth of scum laver:
Dimensions of cesspool:
Materials of construction: -
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure,level of pending,condition of vegetation,etc):
PRIVY: (locate on site plan)
YW,
Materials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
9