Loading...
1431 Septic Inspection 2016 F/j£ C4py RM Scott&Associates 31 Shutesbury Road Pelham, MA 01002 Office: (413)256-0647 Mobile: 413-658-4921 Email: rscottpe<dcomcast.net April 27, 2016 Dan Wasiuk Northampton Health Department 212 Main Street Northampton, MA 01060 Subject: Title 5 Septic System Inspection at 1431 Westhampton Road, Florence (Property of Richard Ciach) On April 7, April 17 and April 23, 2016, 1 completed on-site inspection activities for the septic system at the subject property in accordance with 310 CMR 15.000 (Title 5) requirements. This original system was installed in 1998, per the owner. Inspection activities before and after the pumping on April 20 show that the system is "Passed"per the Title 5 criteria. All components are found to be in good condition and no failure criteria are observed. A copy of the inspection report is enclosed for your use and files. Additional comments are included in the report. If you have questions on any aspect of the inspection or the report please contact me at the address, email or telephone contacts above. Sincerely, Richard Scott. P.E. cc: Richard Ciach, Owner Julie Held, Realtor Buyer do Julie Held ;ion is I for every Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach, 154 Cooke Avenue, Northampton, 01060 Owner's Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. rM:when A. General Information it forms :impute/ y the tab 1. Inspector: nove your •do not Rick Scott return Name of Inspector RM Scott&Associates, LLC Company Name 31 Shutesbury Road Company Address Pelham MA 01002 City/Town State Zip Code 413-256-0647 MA SI#1030. MA P.E. 31199. License Number a •3/13 Telephone Number B. Certification 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 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 ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 4-23-16 Inspector's Signature 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 original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions 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 conditions of use. Tithe 5 Olraal Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ion is I for every •3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I 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: System passes. Inspection activities on April 7, April 17 and April 23, 2016. Pumping was completed on April 20, 2016. No failure criteria are present See additional notes in report. B) 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If not determined' please explain. 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 exiltration 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 if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): Tine 5 Official Inspection Form'.Subsurface Sewage Disposal System Page 2 of 17 ion is for every 3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): /t//p C) 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 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: ❑ 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 Title 5 Official Inspection Form &twe face Sewage Disposal System.Page 3 of n ion is for every 3n3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection B. Certification (cont.) 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: ❑ 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 SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ 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 fecal coliform bacteria indicates absent 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: ✓ D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the 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 is less than 6" below invert or available volume is less than '%day flow tee 5 Official Inspecton Fong.Subsurface Sewage Disposal System•Page 4 of,t ion is for every 3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Properly Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). 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 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 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. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. 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. El 0 El IF] NL E) Large Systems: To be considered a large system the system must serve a facility with a �M design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. 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—IWPA)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. Tele 5 Olfioal Insperdon Form Subsurface Sewage Disposal System•Page 5 at 17 on is for every 3/13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road(Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection C. Checklist 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 the owner, occupant, or Board of Health ❑ Z Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ® ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?-11(If they were not available note as N/A) Zoo' T-S Tose.REe02i. rv�p t- J, t zotA t°I 8 ' ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? Z ❑ 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: ® ❑ Existing information. For example, a plan at the Board of Health. T-t tate.Rerawt • ❑ Determined in the field Of any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] Cow isrEJr iJ/ aNlf,TC O0.3egy IJJ4. /D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual). DESIGN flow based on 310 CMR 15 203 (for example: 110 gpd x#of bedrooms): 3 330 True s Official Inspection Form-.Subsurface Serb Disposal System•Page 6 of 17 ion is for every VIZ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information Description: Gravity flow to a two-compartment 1500 gallon septic tank. Gravity flow to a 3-outlet D-box and estimated three trenches each 40 feet long. System is original to the house construction in 1998. Iv� Number of current residents: Does residence have a garbage grinder? Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) Laundry system inspected? Seasonal use? Water meter readings, if available(last 2 years usage (gpd)): Detail: Currently, a garbage grinder is installed. Use of a garbage grinder with this system is not recommended. 3 Z Yes ❑ No ❑ Yes ® No ❑ Yes ❑ No ❑ Yes ® No Not available. Private well. Sump pump? ❑ Yes ® No Currently Last date of occupancy: Occupied. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seatslpersonslsq.ft., etc.): Grease trap present' ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Title 5 Official Inspection Fam:Subsurfae Sewage Disposal System.Pape]of n ion is for every Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Other(describe below): /Pumping Records: Date General Information Source of information: Per owner, previous pumping was 2 years ago. No pump record at Health Dept except May, 2009. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: How was quantity pumped determined? Reason for pumping: 'Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) Of yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract 1500 gallons From Pumper Very Heavy Solids Accumulation. ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe) 3/13 Title 5 Ofreal Inspection Form:Subsurface Sewage Disposal System•Page B of 17 ion is for every 311 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components date installed (if known)and source of information: System installed in approx. 1998 with construction of the house. /Were sewage odors detected when arriving at the site? /Building Sewer(locate on site plan): Depth below grade' Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain). 1.0 feet ❑ Yes ® No Distance from private water supply well or suction line: fro fro m m h 70 feet, well to sewer exit house. Comments(on condition of joints, venting, evidence of leakage, etc.): AU exposed, in-house plumbing is in excellent condition. No evidence of any previous problem. Vented to roof. 'Septic Tank(locate on site plan): Depth below grade: Material of construction: 1.0 feet ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 gallon concrete with pipe tee inlet baffle pipe-tee outlet baffle with filter. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 126"X 68"X 54"effective depth. Dimensions: Sludge depth: 12" title s Office!Inspecton Form'.subsurf ace Sewage Disposal system.Page 9 of n ion is for every 3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 22" 30" How were dimensions determined? Probed at inlet during inspection. Scum &Sludge are at inlet end. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Very heavy solids accumulation. No significant separation between bottom of scum and inlet pipe tee. Effective tank volume was significantly reduced by scum and sludge buildup, so there is very little retention time in the septic tank, and some solids have been carried out of tank to D-box. Liquid levels are correct. No indication of recent high liquid level or leakage into or out of tank. Conditions of the concrete tank and pipe tees are good. Next maintenance pumping recommended in 2018, depending on rate of usage. NA Grease Trap(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal feet ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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: Date Tore 5 Ofnal Inspatllm Gann:Subsurface Sewage Disposal System Page 10 of 17 ion is for every 3/13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owner's Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): HA Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes LI No Ti11e s OProal Ins ion Form:subsurface sewage Disposal System.Page 11 N n ion is for every 3/13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) /Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Three-outlet distribution box is buried 18". Some solids carry-over resulted in 2"scum in D-box. Box was cleaned as part of pumping activity. Liquid depth in D-box is now correct. No significant deterioration of the D-box. No indication of leakage into or out of box. A//A Pump Chamber(locate on site plan): Pumps in working order: Alarms in working order: ❑ Yes ❑ No' ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass /Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Documented SAS is three trenches @.40 feet long. See sketch. Title s ORioal Inspection Form Subsurface Sewage Disposal system•Page 12 of IT ion is for every 3113 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owner's Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: 3@40 feet long ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Al/A Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No sign of problems observed from ground surface. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): 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 inflow ❑ Yes ❑ No Tithe S Official Inspegim Form:Subsurface Sewage Disposal System.Page 13 of 17 ion is for every !13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66J Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Fans.Subsurface ssre9e Disposal syst Page 14 N 17 Fir on is for every Y13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 55-1•SLCr 58'-fd' C¢.,n2 60'-4„oucLS- S4rr.YIW<NN* 4e- r- / •a,Lieo Woo..sea'iav i •1 "' PaeveaTrj. Ar'lo OF a c'JYYO taAw 40 of $AS Tim Ytv�Toa-i3ov.Tr\PSI 624.4 3-8R t-Iousc 1 OPEw 9aacry yo-1* �L — 25-9"SN 2't•-etre 28-5 For 2■ 3-owv r -So‘ aftcoSo 115' Dil 5&Wel hsperuon Farm Disposal SY&Bm•Pege 15 a117 ion is for every Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope Z Surface water Z Check cellar ❑ Shallow wells Estimated depth to high ground water: 6 feet Please indicate all methods used to determine the high ground water elevation: • Obtained from system design plans on record If checked, date of design plan reviewed: T-5 Insp Report 5-13-2009 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) • Checked with local Board of Health -explain: Record at Health Department. T-5 Insp Report 5-13-2009 ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Reviewed previous inspection report on file at Health Department. The record information is consistent with ground-surface observations. Cellar is dry. Ground surface slopes consistently away from the house and SAS to both north and south. Before filing this Inspection Report, please see Report Completeness Checklist on next page. Title 5 official Inspection Form Subsurface Sewage Disposal System•Page 16 N 17 ion is for every Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1431 Westhampton Road (Route 66) Property Address Richard Ciach Owners Name Northampton MA 01062 4-23-16 City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Z Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed Z System Information—Estimated depth to high groundwater Z Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file Tale 5 Official Inspection Form.Subsunace Sewage Disposal System.Page 17 of 17