248 Septic Inspection 1998 ENVIRONMENTAL FIELD SERVICES, INC.
P.O. BOX 518
LEEDS, MA 01053
1-413-586-7200
January 21, 1998
Julie Spencer-Orrell
46 Hastings Heights
Florence, MA 01062
re: Septic System Inspection at 248 Spring Grove Avenue, Florence, MA
Dear Julie:
Enclosed please find a copy of my report for the referenced inspection. I
have forwarded a copy of the report to the Northampton Board of Health per
the requirements of 310 CMR 15.300, and to George Andrikidis at the DPW
per your request.
Based on the results of my inspection in accordance with 310 CMR 15.300,
I have concluded that the system fails to protect the environment and/or the
public health.
Please call if you have any questions, and thank you for this opportunity to
be of service.
Sincerely yours,
Micha- J. L. igne
Environmental Engineer
Certified System Inspector
aOARD OF HEALTH
N T.JOYCE.Chairman
JE BORES.N.D.
«TIIIA DOURMASHKIN.R.N.
ER 1 MOFRLAIN,Health Agent
January 21, 1998
John & Mireillc Buteau
248 Spring Grove Ave
Florence, MA 01062
Dear Mr. & Mrs. Buteau:
CITY OF NORTHAMPTON
MASSACHUSETTS 01060
OFFICE OF THE
BOARD OF HEALTH
Re: Septic Inspection, 248 Spring Grove Ave.,
Florence, MA
210 MAIN STREET
01060
(41115866950 Ent 213
The Board of Health is in receipt of a report on a sewage disposal system inspection
conducted at 248 Spring Grove Ave., by Mike Lavigne on January 4, 1998. That report
indicates that t e tics stem . 4: • n• rove Ave. f. 1 • .rotect the •ublic health
and the environment as defined in Sec.15 303 of CMR 15.000 State Environmental
Code Title 5.
Because your dwelling is located on a street where the city's sewer system is now
available you must, in accordance with the requirements of Mass. General Laws Ch. 83
Sec. 11, connect your dwelling to the sewer line.
Therefore, in accordance with the provisions of 310 CMR 15.000 of the State
Environmental Code, Title 5, and under authority of Massachusetts General Laws,
Chapter 21A, Section 13, and Chapter 83, Section 11, you(or the subsequent owners of
the property) are hereby ordered to connect the dwelling at 248 Spriae Grove Ave. to
the city sewer system within two years of the date of the original inspection. (by
1/4/00). If further degradation of the sewage disposal system occurs, (e.g. sewage flowing
to the surface of the ground), the connection will be required sooner.
In order to tie into the city sewer you must obtain a sewer connection permit from the
Northampton Dept. Public Works. Any questions concerning sewer connection should be
directed to Asst. City Engineer George Andrikidis at 413-587-1574
Please be advised that you are entitled to a hearing on this order to upgrade your
subsurface sewage disposal system, provided that you file a written petition requesting
such a hearing in the Board of Health office within seven (7) days of the receipt of this
notice.
Please feel free to contact the Board of Health office, at 587-1213, if you have any
questions concerning this notice.
Thank you for your anticipated cooperation in this matter.
Very truly yours,
Peter J. McErlain, Agent
Northampton Board of Health
cc: Asst. City Engineer George Andrikidis, DPW
Julie Spencer-Orrell
Cert. Mail# P 082 852 893
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:
Owner:
Date of Inspection:
B( SYSTEM CONDITIONALLY PASSES (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obsti
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approva
Board of Health). Describe observations:
broken pipets) are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four times a year due to broken or obstructed pipets). The system wi
inspection if(with approval of the Board of Health):
broken pipets)are replaced
obstruction is removed
C) FURTHER EVALUATION 15 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
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A M
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.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATED DETERMI
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
3) OTHER
The system has a septic tank and soil absorption system (5A5) and the SAS is within 100 feet to a surface water
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water suppl
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more I
private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds in
the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is
less than 5 ppm. Method used to determine distance (approximation not valid).
(revised 04/25/94) Page 2 of 10
CLAM F WELD
cmor
iEO PAUL CELLUCCI
sovemor
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET. BOSTON, MA 02108 617-292-5500
fi� ti i 7 c u.✓v-e n
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM NBOARDOFH
PART A .9piNAM�
CERTIFICATION
erty Address: ,ati8 Sp.- a:4 G-evc Awe, F/a-C.-04..-of Inspection: 7— Al-9E (If different/
ie of Inspector: ,77,j-e__,/_,•4 v/9.5-_
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000)
pany Name: E -F.S'.
ins Address: O ■or — O.S—/B
shone Number: rEs)6 — '7.1.00
Address of Owner:
CJ
DB
CONE
e crttary
TRUES
issioder
nwl• e_S�p enccr-0s-.-tJ�
s-IG Nnc-t;...nr Me;. L1-,"
fIFICATION STATEMENT
:ify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and
tenance of on-site sewage disposal systems. The system:
Passes
_ Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
• Fails
actor's Signature: Date: 98
System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30) days of completing this
tction. 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
epon to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner
copies sent to the buyer, if applicable, and the approving authority.
ECTION SUMMARY: Check A, B, C, or D:
YSTEM PASSES:
_ I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
1MENTS:
YSTEM 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.
n , 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 Cenificate of
Compliance (attached) indicating that the tank was installed within twenty(201 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 if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
ate yes, y
1..d 04/25/9n Page 1 of 10
DEP on me Wodd YAde Web. hnonw nv magnetstate.ma.ua/dep
0 Printed on Recycled Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:
Owner:
Date of Inspection:
Check if the following have been done: You must indicate either "Yes' or "No"as to each of the following:
Yes 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
A 1 s----44,1.'.0s:.`.:.--x"`dr Large volumes of water have not been introduced into the system rec
as pan of this inspection.
_Ni'q_ 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 the site.
The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for conditi,
baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
The size and location of the Soil Absorption System on the site has been determined based on.
The facility owner and occupants, if different from owner) were provided with information on the proper maint
Sub-Surface Disposal System.
Existing information. Ex. Plan at B.O.H.
Determined in the field fif any of the failure criteria related to Part C is at issue, approximation of distance is
unacceptable) (15.302(3)(b)7
(revised 09/25/97) Page 4 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
perty Address:
ner:
e of Inspection:
SYSTEM FAILS:
� myst indicate e;.er "Yes" or"No" 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 CMR 11303. 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.
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 1/2 day Bow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipets).
Number of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
ARGE SYSTEM FAILS:
must indicate either "Yes" or"No' as to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 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:
No
the system is within 400 feet of a surface drinking wafer 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)
owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
sirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
wind 04/25/97) Pay. 3 0! 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of Inspection:
BUILDING SEWER:
(Locate on site plan)
Depth below grade: (
Material of construction: 1/cast iron _40 PVC_other(explain)
Distance from private water supply well or suction line N/4/
Diameter H"
Comments: (condition of joints, venting, evidence of leakage, etc.)
r Pr< #,tr Uc Acted"
SEPTIC TANK:
(locate on site plan)
r
Depth below grade:PO
Material of construction: 4/Concrete _metal _Fiberglass _Polyethylene other(explain)
If tank is metal, list age _ Is age confirmed by Certificate of Compliance _fYes/Nol
Dimensions: a X H X H
Sludge depth: /0"
Distance from top of sludge to bottom of outlet tee or baffle: 20"
Scum thickness: ,-2"
Distance from top of scum to lop of outlet tee or baffle: H'
Distance from bottom of scum to bottom of outlet tee or baffle: /H"
How dimensions were determined: A—+-4-5-44—e.6( •
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.) t•&&■ fro 4 9 act:ti9 1,-10
ti.ss sfr' c_r
GREASE TRAP: /Si!/9
(locate on site plan)
c svo If Le ro —r.A* r� r Cr h Mw..,c,y.R r'�,.rt
Depth below grade:_
Material of construction: _concrete _metal _Fiberglass _Polyethylene _othedexplain)
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: _
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural
integrity, evidence of leakage, etc.)
(revised 04/25/97) Page a of 10
erty Address:
er:
of Inspection:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
FLOW CONDITIONS
)ENTIAL:
in flow: N/H g.p,d./bedroam for S.A.5.
er of bedrooms: 7
aer of current residents: 0
iv grinder(yes or no):Iw
fry connected to system (yes or not:,s�eS'
nal use (yes or no):fi-n
meter readings, if available (last two (2)year usage (gpd):
Pump (yes or
late of occupancy: Fc"--1 97
MERCIAL/IN D USTRIAL:
of establishment:
n (low:_gallonsfday
e trap present: (yes or no)
,rial Waste Holding Tank present: (yes or no)_
anitary waste discharged to the Title 5 system: (yes or no)_
meter readings, if available:
ate of occupancy:
(Describe)
late of occupancy:
GENERAL INFORMATION
'ING RECORDS and source of information:
NO /1%. 2(0 Ct varYet-ALC
System pumped as pan of inspection: (yes or nol.
If yes, volume pumped: gallons
Reason for pumping:
9F SYSTEM
_ Septic tank/distribution box/soil absorption system
_ Single cesspool
_ Overflow cesspool
_ Privy
_Shared system (yes or not (if yes, attach previous inspection records, if any)
_I/A Technology etc. Copy of up to date contract?
Sr"-rt.ec S-ybpord ?e E roileru, A c !rci
OXIMATE AGE of all components, date installed (i(known) and source of information: ' 'O mr-Ci
;e odors detected when arriving at the site: (yes or no)LO
..a 04/25/9]) P.g. 5 et 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Dale of Inspection:
SOIL ABSORPTION SYSTEM (SAS): ✓
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
A4.72 41 a!iced. e✓1deL-c4- oft d 0.c Li ,
ri
Type
leaching pits, number:
leaching chambers, number:
leaching galleries, number_
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:_
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs of hydraulic lailurex level of ponding, condition of vegetation, etc.)
Pv,O (-. Lc_ f O d 4-114.4-114. n.rm drrC e✓e,-7( epC C Asx�•c-
CESSPOOLS: N/H
(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 (cesspool must be pumped as part of inspection)
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY: y/3
(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.)
(revised O4/]5/9.7) Paye a of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
operty Address:
wner:
ate of Inspection:
GHT OR HOLDING TANK: /J/(Tank must be pumped prior to, or at time, of inspection)
scale on site plan)
epth below grade:_
aterial of construction: _concrete metal _Fiberglass_Polyethylene _other(explain)
imensions:
spaaity: gallons
esign flow: gallons/day
arm level: Alarm in working order_Yes;_ No
ate of previous pumping:
>mments:
ondition of inlet tee, condition of alarm and float switches, etc.)
ISTRIBUTION BOX:Jgi
>cate on site plan)
epth of liquid level above outlet invert:
omments:
ole if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.)
UMP CHAMBER: A//f`
>care on site plan)
imps in working order: Ives or No)_
farms in working order (Yes or No)_
omments:
rote condition of pump chamber, condition of pumps and appurtenances etc.)
mimed 04/25/97)
Page 7 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner:
Date of Inspection:
Depth to Groundwater 7cp Feet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
Observation of Site (Abutting property, observation hole, basement sump etc.)
y//Determine it from local conditions
Check with local Board of health
Check FEMA Maps
_ Check pumping records
Check local excavators, installers
Use USGS Data
Describe in your own words'how you established the High Groundwater Elevation. (Must be completed))
F�Yi Act�Ld` n� /0cL bat__ Von— tin/ tr. Jo
(revised 04/25/97) Page 10 ee 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Ty Address:
r:
if Inspection:
H OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
) Q7`:
tad 04/25/97)
Page 9 of 20