1260 Septic Inspection 2002 BOARD OF HEALTH
MEMBERS
CYNTHIA DOURMASHKIN,R.N.,
OSEMARIE KARPARIS,R.N.MPH
tICHARD P. BRUNSWICK,M.D.,
MPH
ETER J.McERW N,Health Agent
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
210 MAIN STREET
01060
(413)587-1213
ty 13, 2002
orge Graham
50 Westhampton Rd.
I rence, MA 01062
ar Mr. George Graham:
RE: Sewage Disposal System Inspection
1260 Westhampton Rd.,Florence
Northampton Board of Health is in receipt of a report on the Subsurface Sewage Disposal System Inspection
ducted by Tom Leue at 1260 Westhampton Rd.,Florence on May 9, 2002.That inspection report indicates that your
surface sewage disposal system fails to protect the public health and the environment as defined in Section 15.303 of
IR 15.000,State Environmental Code,Title 5.
aefore,in accordance with the provisions of 310 CMR 15.000 of the State Environmental Code,Title 5, and under
aority of Massachusetts General Laws,Chapter 21A, Section 13,you(or the subsequent owners of the property) are
eby ordered to repair the subsurface sewage disposal system at 1260 Westhampton Rd.,within two(2)years of
date of the inspection, (by May 9, 2004).If further degradation of the sewage disposal system occurs (e.g. sewage
ving to the surface of the ground),you may be required to complete the repairs sooner.
work to repair/upgrade the subsurface sewage disposal system must be performed by a licensed sewage disposal
em installer,in accordance with the requirements of 310 CMR 15.000,and with plans prepared by a Registered
itarian or Registered Professional Engineer and approved by the Northampton Board of Health.
ise be advised that you are entitled to a hearing on this order to upgrade your subsurface sewage disposal system,
Tided that you file a written petition requesting such a hearing in the Board of health office within seven(7) days of
-eceipt of this notice.
se feel free to contact the Board of Health office,at 587-1213,if you have any questions concerning this notice.
lk you for your anticipated cooperation in this matter.
/truly yours,
r J.McErlain
th Agent
ified Mail#7001 2510 0004 8173 5181
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAI
DEPARTMENT OF ENVIRONMENTAL PROTECT
r
TITLE 5
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
ty Address: 1260 Westhampton Road, Northampton. MA
's Name: George Graham
's Address: 1260 Westhampton Rd. , Florence. MA 01062
'Inspection: 5/9/02
Board of Health, Northampton:
s: Owner Number: SSDS-670
of Inspector: Thomas S. T,eu e
any Name: Homestead Inc.
I Address: 1664 Cape St. , Wi3liamsburg. MA 01096
hone Number: (4131 628-4533
IMAY 1 32002
AMITON BOARD OF HEALTH
TIFICATION STATEMENT
fy that I have personally inspected the sewage disposal system at this address and that the information
ed below is true, accurate and complete as of the time of the inspection. The inspection was performed
on my training and experience in the proper function and maintenance of on-site sewage disposal
Ts. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).
ptic 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
(stem condition: fAila
ctor's Signature:
Date: May 9. 200?
ystem Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health
P) within thirty (30) days of completing this inspection. If the system is a shared system or has a design
if 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate
tat office of the DEP. The original should be sent to the system owner and copies to the buyer,if
able and the approving authority.
and Comments
Phis report only describes conditions at the time of inspection and under the conditions of use at that
This inspection does not address how the system will perform in the future under the same or
ent conditions of use.
Inspection Form 6/15/2000
page 1 of 10
Homestead Inc.
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
rty Address: 1260 Westhampton Road, Northampton. MA
r: George Graham
A'Inspection: 5/9/02
:lion Summary: Check A, B,C, D or E/ALWAYS complete all of Section D:
System Passes:
I have not found any information which indicates that any of the failure criteria as described in 310
CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
dents:_
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. Answer yes,no,or not determined(Y,N,or ND) in the 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
rally unsound, exhibits substantial infiltration or exfiltration, or tank failure is imminent. The system will
ispection if the existing septic tank is replaced with a complying septic tank as approved by the Board of
1. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
liance indicating that the tank is less than 20 years old is available.
:plain:
K Observation of sewage backup or break out or high static water level in the distribution box due
ken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass
:Eon if(with approval by the Board of Health). _ broken pipe(s)are replaced
obstruction is removed
_ distribution box is levelled or replaced
(plain:
The system required pumping more than four times a year due to broken or obstructed pipe(s).
ystem will pass inspection if(with approval of the Board of Health):
broken pipets)are replaced
obstruction is removed
(plain:
II_ Other: explain:_
drther 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
n is failing to protect the public health, safety or the environment:
ystem will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that
ystem 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.
Inspection Form 6/15/2000
page 2 of 10
Homestead Inc.
)FFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION (continued)
•ty Address: 1260 Westhampton Road. Northampton. MA
George Graham
f Inspection: 9 02
System will fail unless Board of Health (and Public Water Supplier,if any) determines that the
1 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
water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone I 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
water supply well** Method used to determine distance
s system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria
datile organic compounds indicates that the well is free from pollution from that facility and the presence
nonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria
tgered.A copy of the analysis must be attached to this form.
her:
System Failure Criteria applicable to all systems:
lust indicate either"Yes" or "No" as to each of the following for inspections:
Y)or NO (N)
Backup of sewage into facility or system component due to an 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 less than 1/2 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 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 cesspool privy is within a Zone 1 of a public well.
Any portion of 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 with no acceptable water quality analysis. [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.]
w system fails. I have determined that one or more of the above failure criteria exist as defined in 310
5.303,therefore the system fails. The system owner should contact the Board of Health should be
„ted to determine what will be necessary to correct the failure.
Inspection Form 6/15/2000
page 3 of 10
Homestead Inc.
IAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION (continued)
ty Address: 1260 Westhampton Road. Northampton. MA
George Graham
Inspection: 5/9/02
ge Systems:
onsidered a large system the system must serve a facility with a design flow of 10,000 to 15,000 gpd.
ist indicate either"Yes" or"No"as to each of the following-
.owing criteria apply to large systems in addition to the criteria above:
) or NO (N)
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
I Zone I1 of a public water supply well)
answered "yes"to any question in Section E the system is considered a significant threat, or answered
Section D above the large system has failed. The owner or operator of any large system considered a
ant threat under Section E or failed under Section D shall upgrade the system in accordance with 310
5.304.The system owner should contact the appropriate regional office of the Department.
PART B: CHECKLIST
f the following have been done You must indicate "ves"or "no" as to each of the following:
i) or NO (N)
Pumping information was provided by the owner,occupant or Board of Health,
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 the inspection?
Were as built plans of the system obtained and examined? (If they are not available note as N/A)
Was the facility or dwelling was inspected for signs of sewage back up?
Was the site was inspected for signs of break out?
Were all system components,excluding the SAS,located on site?
Were the septic tank manholes uncovered,opened,and the interior of the septic tank inspected for the condition
affles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
:e and location of the Soil Absorption System (SAS)on the site has been determined based on:
a) Existing information. For example, a plan at the Board of Health.
I)) Determined in the field(if any of the failure criteria related to Part C is at issue approximation of
e is unacceptable) [15.302(3)(b)],
The facility owner(and occupants,if different from owner)were provided with information on proper
nance of Subsurface Sewage Disposal Systems(SSDS).
nspection Form 6/15/2000
page 4 of 10
Homestead Inc
IFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART C: SYSTEM INFORMATION
by Address: 1260 Westhampton Road, Northampton. MA
Georae Graham,
Inspection: 5/9/02
FLOW CONDITIONS
ENTIAL
cnown DESIGN flow based on 310 CMR 15.203 (gallons/day)
Number of bedrooms (design)
3 Number of bedrooms (actual)
2 Number of current residents
Is there a garbage grinder ?(Y or N) _
Y Is there a Laundry Hookup?(Y or N)
N Is the Laundry a separate system?(Y or N) (If yes, separate inspection required)
N Seasonal use(Y or N)
4/A _ Water meter readings, if available(last two years usage) (gallons per day)
N Sump Pump (Y or N)_
JSlkloUS Date of last occupancy _
IERCIAL/INDUSTRIAL
establishment:
flow (based on 310 CMR 15.203): gpd
f design flow (seats/persons/sqft, etc.):
trap present(yes or no):
3i1 waste holding tank present(yes or no):
neter readings,if available:
Le of occupancy/use:
2(describe):
GENERAL INFORMATION
mg Records
of information:Not Dumped in 7 years, says Owner.
1N Was system pumped as part of the inspection (Y or N)
es, volume pumped: _ gallons--How was quantity pumped determined?_
son for pumping: recommend Dumping at this time
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)
Innovative/Alternative technology. Attach 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):
ispection Form 6/15/2000
page 5of10
Homestead Inc.
JFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART C:
SYSTEM INFORMATION(continued)
ty Address:
['Inspection:
1260 Westhampton Road. Northampton. MA
George Graham
5/9/02
Were sewage odors detected when arriving at the site (Y or N):
DXIMATE AGE of all components,date installed(if known) and source of information:
.c plan dated 1/15/88
)ING SEWER: (located on site plan)
Average depth below grade 6' Distance from private water supply well or suction line
Material of construction: _cast iron X Sch. 40 PVC _other(explain)_
ents: (condition of joints, venting,evidence of leakage, etc.) No problems seen. Deep...
C TANK: F (located on site plan)
Material of construction: X concrete _metal _FRP_polyethylene_other(explain)
46 Depth below grade
59 Septic tank width
126 Septic tank length
59 Septic tank height
1,904 Calculated gross volume
12 Air space in tank
1 500 Net Volume
24 Baffle depth
9 Sludge thickness
7 Scum thickness
Top of sludge layer to bottom
26 of outlet tee or baffle (inches)
Bottom of scum layer to
7 bottom of outlet tee or baffle (inches)
Top of scum layer to top of
8 outlet tee or baffle (inches)
(inches)
(inches)
(inches)
(inches)
(gallons)
(inches)
(gallons)
(inches)
(inches) Represents average
(inches) Represents average
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.)
Tank structurally OK. Baffles intact.
imensions were determined: Measured.
nspection Form 6/1512000
page 6 of 10
Homestead Inc.
DFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART C:
SYSTEM INFORMATION(continued)
•tyAddress: 1260 Westhampton Road, Northampton. M11
George Graham
f Inspection: 5/9/02
' CHAMBER: N/A (part of pump-up systems only)
in working order: (Y or N)
:in working order: (Y or N) _
ents: (note condition of pump chamber, condition of pumps and appurtenances, etc.)
tIBUTION BOX: (if present must be opened) (locate on site plan) ("D-box")
of liquid level above outlet invert:
ents: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into
of box, recommendations for repairs, etc.) D-box appears level and flow equal.
:ed under a buildtnc-
ADSORPTION SYSTEM(SAS) (locate on site plan, excavation not required)
not located explain why
ig pits &number: -
ig chambers and number:
tg galleries and number:
tg trenches,number, length: 2 tr- ch-s ab.
ig fields, number, dimensions
cesspool,number:
tive/altemative system,Type/name of technology
ents: (note soil conditions, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
-oblems seen on surface. No evidence of breakout. Dug observation
in one trench and found retained water to level seen in d-box.
:hes under building.
nspection Form 6/15/2000
page 7 of 10
Homestead Inc.
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART C
SYSTEM INFORMATION(continued)
ty Address: 1260 Westhampton Road, Northampton MA
George Graham
I Inspection: 5/9/02
I OR HOLDING TANK: NA, (tank must be pumped at time of inspection)(locate on site plan)
below grade:
d of construction:_concrete _metal FRP_polyethylene_other(explain)
;ions:
y: gallons
flow: gallons/day
level: Alarm in working order Yes No
last pumping:
:nts: (conditions of inlet tees,condition of alarm and float switches,etc.)
'OOLS: N/A (cesspool must be pumped as part of inspection)(locate on site plan, if any)
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(cesspool must be pumped as part of inspection)
.nts: (note soil conditions, signs of hydraulic failure,level of ponding, condition of vegetation,etc.)
': Na, (locate on site plan, if any)
ds of construction-
;ions:
if solids:
ants: (note soil conditions, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
SE TRAP: N/A (Usually present in certain commercial systems) (locate on site plan)
al of construction:_concrete _metal FRP polyethylene_other(explain)
below grade: inches
lions: _ inches
hickness: _ inches
scum layer to top of outlet tee or baffle: _ inches
of scum layer to bottom of outlet tee or baffle _ inches
last pumping:
ents: (recommendation for pumping, conditions of inlet and outlet tees or baffles, depth of liquid level in
:lion to outlet invert, structural integrity, evidence of leakage,etc.)
nspection Form 6/15/2000
page 8 of 10
Homestead Inc.
)FFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART C
SYSTEM INFORMATION(continued)
ty Address: 1260 Westhampton Road. Northampton. MA
George Graham
r Inspection: 5/9/02
:XAM
;water
Cellar
v wells
ted depth to ground water: 3.4 feet
indicate(check)all the methods used to determine high groundwater elevation:
Obtained from system design plan on record- If checked, date of design plan reviewed: 1/15/88
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
- Check local excavators,installers-(attach documentation)
_ Accessed USGS database-explain:
ust describe how you established the high groundwater elevation.
Depth of groundwater below surface of well , near around surface.
Actual depth to be determined during repai r plan
TENTS:
Recommend pumping on a 3 to 5 year schedule. Also. a copy of the
ttached plan posted in the basement/utility area would keep this
pformation accessible in future years for maintenance.
URCES:
Department of Environmental Protection,Western Regional Office,436 Dwight St.,Springfield,MA
01103, (413)784-1100; Title 5 Hotline-(800) 266-1122
Ispection Form 6/1512000
page 9 of 10
Homestead Inc.
Partial House Plan i
leaching trenches approximate outline of
existing storage building
above leaching field
Deck
opp ->e,
1,22 4
septic tank era
distribution box
Date: Owner:
HOMESTEAD INC.
As-Built Drawing
Existing Septic System 5/8/02 George Graham Thomas S. Leue R.S.
1260 Westhampton Road
Revision Date: Northampton, MA 01060 1411,
1664 Cape St.
Scale: 1 : 20' p Williamsburg,MA 01096
`�-+!' 1413]628-4533
Except as Noted