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April72021packet
OF ❑4ELaEag F��' Board of Health Carmen Scherzo Chair Penny Holeman Vice Chair Annette Graczewski Joe Ford Jeannie Kampas Health Director Amy von Hone Assistant Health Director Sherrie McCullough Senior Department Assistant Tammi Mason Town of Brewster Board of Health 2198 Main St., Brewster, MA 02631 brhealth@brewster-ma.gov (508)896-3701 MEETING AGENDA Remote Participation Only April 7, 2021 at 7:OOPM This meeting will be conducted by remote participation pursuant to Governor Bakers March 2020 orders suspending certain Open Meeting Law provisions and imposing limits on public gatherings. No in-person meeting attendance will be permitted. If the Townj$ unable to live broadcast this meeting, a record of the proceedings will he provided on the Town website as soon as possible The meeting may be viewed by.- Live broadcast (Brewster Government TV Channell 18), Livestream (livestream.brewster-ma.gov) , or video recording (tv.brewster-ma.gov) Meetings may be joined by: 1.Phone: Call (929) 435-2866 or+ 1 (253) 215- 8782 or + (346) 248 -7799 or +(669)900-6833 Webinar ID: 892 2893 8785 Passcode: 315152 To request to speak: Press *9 and wait to be recognized 2. Zoom Webinar: https://usO2web.zoom.us/j/89228938785?pwd=bXNSTENOQXhhalBTR2doYLJwlT2V3ZzO9 enter password: 315152 To reouest to soeak: Tan Zoom "Raise Hand" button or tune "Chat" comment with vour name and address. then wait to be recoenized 1. Call to Order 2. Chairman's announcements 3. Citizen's forum 4. Chatham Bars Inn - Retail Food Service Permit application 5. Chad Simmons- Annual report for Brewster Landing 6. Phosphorus presentation & discussion - Emily Michele Olmsted; George Heufelder 7. Discussion & possible approval of In House Food Service Permit approval policy 8. Discuss and vote on Definitive Subdivision plan for 409 & 413 Great Fields Road 9. Liaison reports 10. Matters not reasonably anticipated by the Chair 11. Next meeting April 21, 2021 12. Informational items: a. Monthly report for Kings Landing b. Monthly report for Cape Cod Sea Camps c, Monthly report for Cape Cod Sea Camps d, Monthly report for Wingate e. Monthly report for Maplewood E Monthly report for Pleasant Bay Health & Living Center g. Monthly report for Maplewood h. Monthly report for Pleasant Bay Health & Living Center 13. Adjournment Date Posted: Date Revised: Received by Town Clerk: N:\Hea1th\B0H Agendas and Minutes and Remote Schedule\BOH Agendas\ Apri1721a. doc.docx4/ 2/ 2021 r�? OWN OF BREWSTER orFIcEoG TOWN 3) Establishment Mailing Address (if different): 2198 M.►ix STREET' i-iEALTH L7 -PARTAWNT BREWSTER, MA 0263I r 7 PHONE: (508) 396-3791 Exr 120 7) Applicant Telephone No: 24 Hour Enlergency No: ��3 - �!4-f• ���3 8) owner iName & Title (if different from applicant): 9) Owner Address (if different from Applicant); � fi �- s tom';-� fz-� . �s� ❑ Z.�3 3 f.ax: (508).896-4538 11) If a corporation or partnership, give name, title, and home address of officers or partner. h'a:me Title Home Address I 0jVtA ,Ajjor+S LA -r- S i ' >*-1-0, BBiiEALTH{[�TOWN,BRENVSTER.MA.US Food Establishment Permit Application (Application must be subniiiied ev least 34 days befi)re the ple naed 01)ej7h7g dare) 1) )Establishment Name: 2) Establishment Address: 3 r.3 to tPQ--,j 5"F- �r�s r��-- r-� ►� 67 -Gal 3) Establishment Mailing Address (if different): 4) Estahlishntent Telephone No: 5) Applicant Name & Title: 6) Applicant Address: vt-t r<.+ 5T- &rc�s i7=� , r�-t i� o � 3 7) Applicant Telephone No: 24 Hour Enlergency No: ��3 - �!4-f• ���3 8) owner iName & Title (if different from applicant): 9) Owner Address (if different from Applicant); � fi �- s tom';-� fz-� . �s� ❑ Z.�3 3 10) Establishment Owned By- ❑ n Association C� A corporation An individual 0 A partnership D pllter legal entity 11) If a corporation or partnership, give name, title, and home address of officers or partner. h'a:me Title Home Address I 0jVtA ,Ajjor+S LA -r- S i ' >*-1-0, arY�tw' 6-Z.4 3 3 12) Person Directly Responsible For Daily Operations (Owner, Person in Charge, Supervisor, Manager etc.) Name &c Title: j e,5 H -dA S r` --A-?L4+-1 M 1�1r►'I�t Le�`Y� Address: G w- SVJ. 2-<,3 Telephone Na: -+3 G If 3 r as Emergency Telephone No: L4. 174vlt3 13) District Or Region of Supervisor (if applicable) Name &: Title: Aw qj-i- r'jCSL 4—' Address: Z q S Ff-O VLAF- rte• 1M 6 07-6 33 TL-Iephone No: fr3419 - -4-11-f - 41,-1j.r Fax: FOR BOARD OF HEALTH USE ONLY Hate Received Date Inspected Approved by Permit ## Issued 1- LV W: i0WN.BREW STERA1A.US Food Establishment Information 14 Water source: nTown Water ElPrivate Well 'Fater 15) Selvage disposal: Title 5 s}'stetn ❑ Cesspools { DEP Public Grater Supply No: (if applicable) ❑ Grease Trap 16) Days and Hours of Operation:' 5 {,c1�-'Zv J&Pom r 17) No. of food Employees: � 18) Name of Person In Charge Certified in FoA Protection 'Iaoagement: DpN'14 W CO LQ—_._ --- Re uired cis of 101117001 in accoi-do ace with 105 C14R 590.003 (A) Please attach cop}, of ce)-lificale. 19 Person 'Trained in Anti -Choking Procedures if 25 scats or more): Nfes, Naune ©>So 20) Locatiosi: (cheek one) try) Establishment Tvpe(cherk all rhat apply} I ❑ Caterer M etail ( Sq. Ft) i"' kd G ❑ Food Delivery f &` permanent Struchare ❑ Food Service - ( Seats) # of SeaTs_--_. ❑ Residential Kitchen for Retail Sale 11 Mobile E) Food Service -Takeout ❑ Residential .Kitchen For Bed and Breakfast ❑ Other Food Service - Institution Home Explain: ft of vleals— 4. of Days ❑ Residential Kitchen for Bed and Breakfast Establ ishstteuts ❑ Fozen Desert Manufacturer `Other (Describe) _ 21) Length Of Permit. -(check JOne) 1✓i Aaanual ❑ 5easonali'F3at�s 23) Food Opet ations: Definitions., PHF J olentially cond•als required) Noe: -PH>: S - 1I0a9- Potentially hazardous fool] (no tli}teltea'Aa1JerCltilrf contro4 F"egIlared) (check all Mae apply): RTE- reaclp-to-eai foods (Er. sandwiches, salads, muffins which need no father prrscessila ) Sf Sale of Comniercially Pre- - ❑ PHF Cooked To Order ❑ Hot PHF Cooked and Cooled or Hot Held Packaged Nan-Pl ifs for More Than a Sijiele ivleal Service. Sale of Coutuuercially Pre- El Preparation.OF PF1Ts For Hot And ❑ PHF' and RTE Foods Prepared For Hight Packaged PHFs Cold 1loiding For Seigle Meal Service Susceptible Population Facility ❑ Delivery of -Packager! PHFS ❑ Sale Of Raw Animal Foods Intended ❑ Vacuum Packaging/Cook Chill �To be Prepared by Consenter. ❑ Reheating of Commercially ❑ Customer Self -Service ❑ Use Of Process Requiring A Variance And!Or Processed Foods For Service HACCP Plan (including bare hand contact /Within d Hours. alternative, time as'a public health control) Customer Self -Service OfNj on-PHF and ❑ Ice Manufactured and Packaged for ❑ Offers Raw Or Undercooked Food Of Animal Non -Perishable Foods Onlv. Yeetail Sale Origin. Preparation OrNO11-111lFs MJulce Manufactured and Packaged ❑ Prepares Food/Single Mcals for Catered for Jteiail Sale Events or Institutional f=ood Service Rf )ffers R I'L PHF 1Ii Butk, Quantities ❑ Retail Sale of Salvage, Out -of Date or Reconditioned Food E Other (Describe): pV-ig- -r f t:Z3 s`o� f To be completer) b3; the Board of Health Total Permit Fee: S Payment is due with application 1, the undersigned, an est to the accuracy of the in Form at ion ltrovided in this application and I affirm that the fUod es I ab I i s I nri e n t operation will comply with 105 CMR 590,000 and all outer applicab)e law. I have been instructed by tate board of health an how to obtain copies of 105 CMR 590.000 and tate federal F000,9 -de. 24) Signature of Applicant: Pursuanf to MGL Ch. 62C�.s�9A, I (Cc -rd ry ander the penalties of lierjury thsif I, to my best knowledge and - be]ief, have filed all state tax returns and paid state taxes required under lave, 25) Social Security Number or Federal 11): 26) Si;nnNre. of Individual or Corporate ..- 3 Z. _ -2-1,?C, Town of Brewster BREWSTrR, MASSACHUSETTS 02631-1898 FOOD ESTABLISHMENT PLAN AND SPECIFICATION REVIEW '/'NEW REMODEL Name of Establishment: HATI-h� Ura -2-s f Nei MICE OF: BOARD OF HEALTH (508) 8963701 EX7#20 Address: -3 6 3 4 N A I N r. phone if available Name of owner: TH c4q--N oe-r4- Mailing address: `r " 1� � f tA.. G(rt n4yh-M MA- Telephone - Applicant's rq-Telephone:Applicant`s Name: J O SH -a g S C j-7 r -r - Mailing address: [3f�-Ulsr 7 Telephone: -2:23 '/- ? C► `} --3 Title (owner; manager, architect, etc.): M ttv�-f FV t£ 0 -2- We STRONGLY recommend that you visit each of the offices listed below and check if any licenses, approvals, inspections are needed. Existing buildings are not necessarily "grandfathered", and some things that were allowed before, may require changes today. Please check off that you have visited each of the fol wing. �/ . Board of Selectmen (liquor, common victular, etc.) ,,Zoning (signs, usage, outdoor seating, etc.) lanning olive (liquor, outdoor coolers, etc,) uilding (Plumbing, electric, building, etc.) ire (hoods, smoke detectors) Conservation Other Meals to be served:. No. of seats: N 1 to, Breakfast Lunch f"< Dinner No, of staff: (per shift) Square Feet: -T-- A. Finish Schedule Applicant fill in materials (Le. quarry tile, stainless steel,. 4" plastic covered molding, etc.) Floor Coving Walls Ceiling Lighting KitnhPn N I f - Cher storage Bathroom 77 L,(' W Dressing Room "Ail surfaces must be finished. smooth, non-absorbent, and easy to clean B. Insect and Rodent Harboracte Please answer yes or no. .Explain all "no" answers below. Are all outside doors self. -closing with rodent proof flashing? ." Are screen doors provided on outside doors for use in summer'? Are they self closing? -- L 145o all operable windows have a minimum 416 mesh screening? �L4 V Are all pipes, electrical conduit chases, ventilation systems exhausts and intakes sealed? FIs area around building clear of unnecessary brush, litter, boxes or other harborage? C. Garbage -and -Refuse Do all containers have lids? NO Will refuse be stored inside? If so, where? N 0 1 there a can cleaning sink or area? If so, where? Will a dumpster be used? Number/ Size Frequency of Pickup Z!S W Q___V_ Contractor N4vSe'r-- pr.rpdSO"— i"� will a compactor be used? Number Size Frequency of Pickup Contractor Will cans be stored outside? Describe surface dumpster/compactor/cans are to be stored on: P VtA-Z� f2AYLV-i N (s [.,C) i D. Restroorns Restroo s must be provided for the convenient use of employees. e soap dispensers provided? ✓ Is a covered trash barrel provided? Is ventilation mechanical or via a window? -- j^ ±r" Z-Fti�C► f i c+°� �- NO Is the door self closing? What method will be provided for drying hands? E. General Are storage facilities for employeespersonal belongings provided? (i.e-, purse, coats, boats, etc,) If so; where? Describe facilities for separation of storage of insecticides/rodenticides and detergentslsanitizerslcleaning agents/caustics/acids/polishes znd first aid supplies/pe rsonaI medications/cleaning equipment? - --.;- jt'' L?A3 � M ewT` Are {sundry facilities icated on premises? If so -where? 1Y f4- . i; so, what will be laundered? Location of clean linen storage ►•-� R Location of dirty linen storage i►v er. If you will only be serving pre-packaged foods products. ,You may stop here. If nu will serving open foods (this ingudesbut is not limited to coffee, ice, fountain soda, prepared foods etc.you must cnm lete the reMainder of this form. F. Sinks 15 is a separate mop sink present? (Required for all new and remodeled establishments) L_Is a separate food preparation- sink present? Is a separate handwashing sink present in each food preparation area? Will a dishwasher be used? What type of sanitizer used? q„`�) Is a three compartment sink present? (required of all new and remodeled establishments along with all establishments which undergfl a change in ownership.) Does the largest pot and pan fit in each compartment? Are there drainboards on bath ends? What type of sanitizer is -used? (Chlorine, iodine, Quaternary ammonium or Hot Water) "Please make certain the corresponding test kits are available at the preopening inspection. *A record keeping system for maintaining 30 days records of testing, such as a calendar, must be present, "Instructions must be posted at the three bay sink which tell how to make sanitizer at the proper concentration G. Water Supply Is water supply public (tor private ( )? If private, has source beery approved? Please attach copy of written approval. Is ice made on premises or purchased commercially ? If on premises, are specifications of machine enclosed? Will ice be served in drinks? If so, where stored? Will ice scoops or tong be provided? if so, where stored? H. Exhaust _Hoods Odor Supp.Dvicel Fire Air Capacity Hood Locations __ Filters Sq. Ft. Protection QFM r Alf requests for new permits must go before the Board of Health for approval. The i30H usually meets the first Tuesday of the month. All paperwork must be submitted no later than 4 P.M., one week prior to the meeting.. . No work should be started until the plans are approved by the BOH. Any work done without BOH approval is done at your own risk; and may not be accepted at a later date. . 'You should plan on at least two inspections; one preopening to be dune about 1 week prior to opening and; one final inspection scheduled closer to the proposed opening date. These can be scheduled once your completed application has been received. Please enclose the following docume9 ts: Proposed,WMu Ah - O(Uu[ >> Specification sheets for each piece of equipment ite pian showing location of business in building, location of building on site including alleys and streets, location of any outside facility (dumpsters, walk-ins) Plan drawn to scale of facility showing location of equipment, plumbing and electrical Please make certain the following information is available on the plans: Location and size of ail grease traps. Location of employee and/or patron restrooms including lavatories, water closets and urinals. Location of employee dressing roams and/or lockers. Note that ceiling, walls and floors must be suitably finished to facilitate cleaning. All studs, joists and rafters must not be left exposed_ Utility service lines and pipes must not be unnecessarily exposed. Details of special operations such as salad bars, bulk foods and vacuum packing. STATEMENT, I hereby -certify that the information contained in this application is correct, and I fully understand that any deviation from the above without prior permission from the office may nullify this approval. -j-de)l2v4 Date representative(s) Approval of these plans and specifications by this Health Department does not indicate compliance with any other code, law or regulations that may be required -- federal, state, or local. It further does not constitute endorsement or acceptance of the completed establishment {structure or equipment}. A preopening inspection of the establishment with equipment wilt be necessary to determine if it complies with the local and state laws governing food service establishments. Town of Brewster 2198 MAIN STREET BREWSTER. MASSACHUSETTS 02631-1898 TO: Brewster Board of Health PHONE: 508.896.3701 EXT. 1120 FAX: 548.896.4538 brhealth a,brewster-ma.gov W WW.BREWSTER-MA.GOV MEMORANDUM FROM: Sherrie McCullough, Assistant Health Director RE: Chatham Bars Inn Farm Stand DATE: March 31, 2021 Health Department Amy L. von Hone, R.S., C.N.Q. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Joshua Schiff, Chatham Bars Inn Farm Manager, is applying for an annual Restrictive Retail Food Establishment Food Service Permit to operate the Chatham Bars Inn Farm Stand located at 3038 Main Street. The Chatham Bars Inn Farm Stand has been operational in the past selling seasonal whole farm produce, honey and maple syrup. Mr. Schiff would like to expand the operation to include the sale of pastries, pies, breads, cheese, coffee beans, farm fresh eggs, salsas, sea salt, herbs, spices, hot sauces, olive oils, vinegars, granola mixes, locally made chocolate, bottled juices and boxed water. Additional amenities will include non -edible items such a soap. All products offered for sale will come from licensed food establishments. The farm fresh eggs will come from "The Country Hexa", where the eggs are graded, labeled, and certified. They will be transported in a refrigerated van. The goal of the Farm Stand is to sell produce and herbs grown on the farm, as well as other area farms throughout Massachusetts. The food will be sold as take out only. Mr. Schiff has submitted to this department a completed application package, which includes a detailed floor plan has been submitted for review. The food establishment meets all state and federal code requirements. Anthony Cole will be the Certified Food Manager {CFM} who will oversee health and hygiene, cleaning and sanitation and food handling procedures for this establishment. This department has received current copies of his CFM Certificate as well as his Allergen Awareness Certification. A pre -operational inspection was conducted on March 31, 2021, and no violations were noted Based upon my review of this proposal the new business should be accepted provided that all provisions of the Federal and State Food Codes are being met. Mr. Schiff has made contact with the other necessary N:\HealffiMcCullcughloldsmlMy DocumentslCBI farm stand 2021.doc town offices regarding his business proposal. Z would recommend the following based upon information provided for this review; 1.) obtain or have access to a copy of the State and Federal Food Code and operate this food establishment under all applicable provisions of the code; 2.) The approval of this business is based upon information submitted to this office by Mr. Schiff for this review. Any changes or additions to this request must .be discussed with this office and any other relevant agencies or town offices prior to implementation; 3.) THIS DECISION IS VALID ONLY WHEN THE USE AUTHORIZED IS EXERCISED IN CONDUCTION WITH ALL OTHER NECESSARY PERMITS AND APPROVALS; 4.) Permit shall be issued pending Board of Health approval. NAHea1tKMcCu11oughlo1dsm\My DocurnentKBI farm stand 2021.doc w m m w N o w m m vWi - w N H 4 •�P w �i r a lD co V ❑1 111 A W N Y Z ❑> m r�i 11 N d CC !0 C a n ❑ �_ G In w ? ? A a io N c n O n O n O N O O v ro ro CT C ro n ❑ 'n ❑ s C a v W w n ❑ ❑ @ fD rte!' 7 rV: o fD in ❑ ❑ C a rD pq Q ❑_ N G C w � V� p 7 [➢ ❑ � 17 w O w r�i Q R � ry ❑' j Q Q ❑ � a n a 'D 3 Q n S ❑ N "S i❑ rD O N rP Q 3 D fD C T w w. 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M D '❑ �' 6 . d '❑ 0 ❑ H i0 i @ r+ C R fl �' d r77 Z w N ❑ rP ❑ .+ .0 d w rD wo 'z 4 fO w G D � f7 a r➢ iz° � � ry, ""� �° rNe ro m v aEl N a n• ¢ O q a ❑' Q C ro ❑ ❑ N N 3 �• Z El 11 0 03 3 ❑ '. -a a p rD L'• ro a O "13 N R y a N �n N rt fl) Q. 7 Q n-' N Fr "a [D �^ G W H r5 d a X ❑ O C faD n O 9prD 2. �' fA ❑ rF7 fD „, 7 [➢ rD W H20 n C ❑ rD CD a r+ p � LA 7 f7 h a � u µ w rD ❑ G of r. „ O " N m> a f 2- ut ,C N ❑ 0+ jjj o H c❑ �4J v ami CIJ y Y C r' o ro mm m r+ CO 4 °nom 0 A TITLE: BREWSTER LANDING BIOCLERE WASTEWATER TREATMENT SYSTEM 2020 ANNUAL OPERATION & MAINTENANCE REPORT PROJECT IO: WBR006.01 SITE LOCATION: BREWSTER LANDING SACHEMUS TRAIL BREWSTER, MA PREPARED FOR: ATTN: TAMMI MASON SENIOR DEPARTMENT ASSISTANT BREWSTER HEALTH DEPARTMENT BREWSTER TOWN HALL 2198 MAIN STREET BREWSTER, MA 02631 PREPARED BY: COASTAL ENGINEERING CO., INC. 260 CRANBERRY HIGHWAY ORLEANS, MA 02653 �1 COASTAL engineering co. TECHNICAL SERVICES r d?11 � -Wt COASTAL 02/01/2021 engineering co. Project No. WBR-006.01 Attn:Tammi Mason TECHNICAL. SERVICES Senior Department Assistant Brewster Health Department Brewster Town Hall 2198 Main Street Brewster, MA 02631 Subject: Brewster Landing Sachemus Trail Brewster, MA 2020 Annual Report Dear Tammi: Enclosed, please find the 2020 annual report for the Brewster Landing Wastewater Treatment Facility. Included in this report are the following: • Appendix A - Discharge Monitoring Report Form with Laboratory test Results. ■ Appendix B - 05M Field Inspection Forms. A sampling of the system's effluent was conducted quarterly. The results are summarized in the enclosed discharge monitoring report form. The laboratory test results indicate the proper treatment of the system. Tested parameters for all four quarters met their respective minimum and maximum discharge limits. Following the MA Standard Conditions for Secondary Treatment Units for General Use, we will collect effluent samples of BODS and TSS when field tests indicate a pH outside the specified range, an exceedance of the turbidity limit, or D.O. below the desired minimum. During the 03/09/2020 06M inspection, the system was operational and the Zabel filters were inspected and cleaned. During the 06/15/2020 05M inspection, the system was operational with the exception of the Zabel filters being filled with wipes and needing to be unclogged. During the 09/15/20 inspection, the system was operational and the Zabel filters were inspected and cleaned. During the 11/05/2020 O&M inspection, the system was operational and the Zabel filters was inspected and cleaned. Please note, along with the quarterly 05M inspections, the site is also being visited monthly to check and clean the Zabel filters, check pump operation, and check tank levels. The system was last pumped on 08/02/18 by Robert B. Our Company, Inc., who pumped a combined 5000 gallons from the solids tank and Bioclere. The majority of these liquids were pumped from the solids tank, do not hesitate to contact us if you have any questions about the report or the wastewater treatment system. Sincerely, COASTAL ENGINEERING CO, INC. Cha.' immons is CAS/acc Orleans I sandwich I Nantucket NAME OF PROJECT: Brewster Landing FACILITY LOCATION: Sachemus Trail PROJECT NUMBER: WBR-006.01 DATE SAMPLED: 03/09/2020 PARAMETER UNITS EFFLUENT Solids, Total Settleable mill <0.10 pH s.u, 6.70 Dissolved Oxygen mg/1 3.00 Turbidity ntu 3.2$ REMARKS: Field tests ana laooratory tesi resut[5 MUILaLe good treatment of the system. DATE SAMPLED: 06/15/2020 PARAMETER UNITS EFFLUENT Solids, Total Settleable MI/I <0.10 pH SM. 7.50 Dissolved Oxygen mg/1 2.00 Turbidity ntu 6.98 REMARKS: Field tests ann lanoratory test results indicate goad treatment of the system. DATE SAMPLED: 09/15/2020 PARAMETER UNITS EFFLUENT Solids, Total Settleable MIA <0.10 pH SM. 7.11 Dissolved Oxygen mg/1 2.00 Turbidity ntu 4.04 REMARKS: Field tests and laboratory test results indicate good treatment of the system. DATE SAMPLED: 11/05/2020 PARAMETER UNITS EFFLUENT Solids, Total Settleable MIA X0.10 pH s.u, 7.23 Dissolved Oxygen mg/1 2.00 Turbidity ntu 5.03 REMARKS: Field tests and laboratory test results indicate good treatment of the system. NOTE: In accordance with the MA Standard Conditions for Secondary Treatment Units for General Use we will collect effluent samples of BOD5 and TSS when field tests indicate a pH outside the specified range, an exceedance of the turbidity limit, or D.O. below the desired minimum. D:\DOC\W\WBR\006.01\2020 Annual Report\[DMR.xlsx]2020 Report APPENDIX A: OISCHARGE MONITORING REPORT FORM WITH LABORATORY TEST RESULTS 9L AL KA A N A L Y T I C A L Serial No:03122018:30 ANALYTICAL REPORT Lab Number: L2010659 Client: Coastal Engineering Company 260 Cranberry Highway Route 6A Orleans, MA 02653 ATTN: Chad Simmons Phone: (508) 255-6511 Project Name: BREWSTER LANCING Project Number: WBR006.01 Report Bate: 03/12/20 The original project report/data package is held by Alpha Analytical. This report/data package is paginated and should be reproduced only in its entirety. Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications & Approvals: MA (M-MAOB6), NH NELAP (2064), CT (PH -0574), IL (200077), ME (MA00086), MD (348), NJ (MA935), NY (11148), NC (257001666), PA (68-03671), RI (LA000065), TX (T104704476), VT (VT -0935), VA (460195), USDA (Permit #P330-17-00196). Eight Walkup drive, Westborough, MA 01 581-1 01 9 508-898-9220 (Fax) 508-898-9193 800-624-9220 - www.alphalab.com HA Page 1 of 13 K x Project Name: BREWSTER LANDING Project Number: WBR006.01 Lab ID: L2010659-01 Client ID: EFF Sample Location: BREWSTER Sample Depth: Matrix: Water Parameter Result Qualifier Units General Chemistry - Westborough Lab Solids, Total Settleable <0.1 mill ................................ . ..................... Page 6 of 13 SAMPLE RESULTS Serial No:03122018:30 Lab Number: L2010659 Report Date: 03/12/20 Date Collected: 03/09/20 14:30 Date Received: 03/10/20 Field Prep: Not Specified Dilution Date Date Analytical RL MDL Factor Prepared Analyzed Method Analyst ............ .......... . .1 NA 1 03/10/20 19:22 121,2540E AS ......................... .............................................................................................................. . ......................................................... ....... ...................................... Serial No:03122018:30 CHAIN O F CUSTODY PAGE F OF 1 Dake Roed In 4a5: � /�, ALPHA Job �: MA Report I formatiun Data ©Fnx ®Palnlr, PO ii: riuslcw-ou9n, ifl. Mandfeltl.:b.0. TEL `F,2876A270 TEL:5(%.64.4900 Prajecl Name: EJ d RAFx El Add 6elrvargbtes FA)c M&A&91yd F'AX,• SQ9.B2237 _ Sr""Ifad F)=- m I crivrrd owl"IPmj ed Lumffon: ? ']..'Y. i.9.rg �.l .< Prae m wG 6 _ i7 Yes Ne Are IACD Analyli�al Methods Required? pl 1t:t"U95C iE n Cd. F Address: 260 Cranbufry FCi tmva P-- AAana er. Chad A Simmons ❑rlearm, MA 02$53 )1 liso?reel ❑ Yns ® +de Ara CT RCP Raawnabs■ Corgidemm Prar9oc�sI Re wmV P}omi; $06 2 11 1 ANALYSIS SNd1`:E ktANl7Ll[dG Fsrc 509 255-6700 ® Standard d Rush (0�.Y IF PRE•rPPRnwtr� ARtwom malE: cslmmons�cecrapeaod.com .. ...._. '� is rmar it Hal N—¢ .d © T■ —Pim l— 8oan pm ih :y er 1l -d by Alone Due Da€i� TG1 'nos � •rL� 0 L *b re do Pm1m fma Meda fP7aesc s�nr�ry aefe><a Other Project 5pecific Req uirementslComment50o€edion Limits: Ct � � J go 'S�i? ALF RA Lab iample 10 D S Callcdian 5ampk Bernp3ePx IiFle 'rme (LalbUae0mv) Matrix 1nl;red3 x.gnraymn. c■mml�s ' S z,3 -yl- czw ❑ C] -TT 7T ❑ ❑ ❑ Ll❑ ❑ El I ❑ Elo ❑ ❑ ❑ ❑ El El I ❑ —a -U ❑I❑❑ ❑ ❑ ❑ ❑ PLEASE ........ Id CillE5TE0€QS R6QYEf( c 7yjse "� - -e .. . . 1S YOUR PROJECT M A MCP o r C T RCP? Prsselvafiv® - �Epdmd"dr.Iar �emr. �, 4iN6 j na-d NEIN [IoCk kitl nh[ M" -a ntlm;,g-tisane R,� ■d. At,�mole9 1 y. � 374 v %t �••• �'r'^ "�e.,J sf a[c �iajt:c! to mphv%Pay—1 Tenm. rage i d aT 13 ■ L FSA A NALY,'TJ CA L Serial No:06172019:07 ANALYTICAL REPORT Lab Number: L2025167 Client: Coastal Engineering Company 260 Cranberry Highway Route 6A Orleans, MA 02653 ATfN: Chad Simmons Phone: (508) 255-6511 Project Name: BREWSTER LANDING Project Number: WBR006.01 Report Date: 06/17/20 The original project report/data package is held by Alpha Analytical. This report/data package is paginated and should be reproduced only in its entirety. Alpha Analytical holds no responsibility far results and/or data that are not consistent with the original. Certifications & Approvals: MA (M-MA086), NH NELAP (2064), CT (PH -0574), IL (200077), ME (MA00086), MI? (348), NJ (MA935), NY (11148), NC (25700/666), PA (68-03671), RI (LA000065), TX (T104704476), VT (VT -0935), VA (460195), USDA (Permit #P330-17-00196). Eight Walkup Drive, Westborough, MA 01581-1019 508-898-9220 (Fax) 508-898-9193 800-624-9220 - www.alphalab.com Page 1 of 13 Project Name: BREWSTER LANDING Project Number: WBR006.01 SAMPLE RESULTS Lab ID: L2025167-01 Client ID: EFFLUENT Sample Location: 0 SACHEMUS TRAIL, BREWSTER Sample Depth: Matrix: Water Parameter Result Qualifier Units RL General Chemistry - Westborough Lab Solids, Total Settleable 60.1 mlll 1 Page 5 of 13 Se rial_No:06172019:07 Lab Number: L2025167 Report Date: 66/17/20 Date Collected: 06/15/20 13:00 Date Received: 06/16/20 Field Prep: Not Specified Dilution Date Date Analytical MDL Factor Prepared Analyzed Method Analyst .............. .............. NA 1 06116/2020:40 121,254OF AS ....................................... ................................................. . ............................................................... l�Lr Fir'i, Serial No:06172019:07 CHAIN 0 F CUSTODY �� ��� ^ �� t� i 6 � �✓ Ai PHA Sab 7�: �� � � � [� � � , � , HA ...�. 0 FAX ❑ Aim t ®EiiA� ❑ Addt E?elrrwaWes ❑ same a& cli�l woo Pok" wsstboranph.KA hrms¢em, MA Projecl Name: Brewster Landing r :Da-$9"zm r-: soa46nn.s3w FAX 500 1913 4s D3 kAX: SDfl_M"2Ee 51St cif. proJed Locatlon: 0 Sachem usTriO, Bremter C eat: Coastal Enconaering Co. In¢ Proecd #: WBR006.01 Yes � Na Rza hACPAtH tiicffi Merlwtls Rn red? Addrass: 2W Cmba Hi hard PrO ed Mana er. Chad Simmorla II Yes idn A*e CT RCP F?aas�naaleL"p1711ACr1Cp Prpocda aF? prieans, MA 02553 ALPHA Cnrote #: #2011501rev1 ANALYSIS $RAifiEHR3�LjNG Phene' 5M556514 Turn -Around Time WMtlnn Fax 6061556700 ® Standard ❑ RUeh ({yp$Y IF Q "at Heeded Emad;, eslrn r nns asiai neeringcom ❑ L61) w d. j rnw+s�m§Nea ru�9 Lamdyaxd LyAeuh® C3ue Oaie: me: Prr=r.nr— Ci Libla rrcase specify Other Project Specific Regumwr enisiComrrte WIDeted" Limits: Pc?O FYI a % swlg cwnrar�� ALPHA Lab 16 Sample ID Comeam Sample Sampler's iLa>: Llse:.01 yJ Dale I Time MaInK tnitleis S i JL7 / W..... Effluent j„i' f+,O 1,yqEll❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑[ 0 El 10 PL€ASE ANSWER QUESTIONS A9ovEi Container Type � r P n 11 R A b _ A - - F pang �Ay.1 piety Preservative .agd.glq3pi"E S—Pp M f IS YOUR PRCJECi' Re shEd gY Ckdeme F£eca}vatl By_ na efTx .rte ka 4a�4 � �d i ms doa rp mt MA MCP or CT RCP?" yd aw a�.a40 /� -'yy I➢ A10b P¢gnl TpnY. ,L T wN.�ts ` 1 !G% W*kftvFR -t Page 13 of 13 R 7x L hurl r 1 c A L Serial Na:09212018:58 ANALYTICAL REPORT Lab Number: L2038650 Client: Coastal Engineering Company 260 Cranberry Highway Route 6A Orleans, MA 02653 ATTN: Chad Simmons Phone: (508) 255-6511 Project Name: BREWSTER LANDING Project Number: WBR006.01 Report Date: 09/21/20 The original project report/data package is held by Alpha Analytical. This report/data package is paginated and should be reproduced only in its entirety. Alpha Analytical holds no responsibility for results and/or data that are not consistent with the original. Certifications & Approvals: MA (M-MA086), NH NELAP (2064), CT (PH -0574), IL (200077), ME (MA00086), MD (348), NJ (M A935), NY (11148), NC (25700/666), PA (68-03671), RI (LA000065), TX (T104704476), VT (VT -0935), VA (460195), USDA (Permit 4fP330-17-00196). Eight Walkup Drive, Westborough, MA 01 581-1 01 9 508-898-9220 (Fax) 508-898-9193 800-624-9220 - www.alphalab.com Page 1 of 13 Project Name: BREWSTER LANDING Project Number: WBR006.01 SAMPLE RESULTS SerialNo:09212018:58 Lab Number: L2038650 Report Date: 09/21/20 Lab ID: L2038650-01 Date Collected: 09/15/20 14:30 Client ID: EFFLUENT Date Received: 09/16/20 Sample Location: BREWSTER LANDING, 0 SACHEMUS TRAIL, BREWSTER Field Prep: Not Specified Sample Depth: Matrix: Water Dilution Date Date Analytical Parameter Result Gualifier Units FiL MDL Factor Prepared Analyzed Method Analyst General Chemistry - Westborough Lab Solids, Total Settleable X0.1 mIA 1 NA 1 09/16/20 18:47 121,2540F AS ........................................................... ................................................. .. `�l11;i�liA Page 5 of 13 CHAIN OF CUSTODY ?AGE ILF7 1L1 PHA WAWw vt, MA PAan4rwid, HA TCL: ptii:•6659:=o TEL 50MM-13D9 PITIPFI ' 5M 2a5 5511 Mmiarl Mame: Brewsicr I-andog Project LOM10n: Brewster Landing, 0 Sachamus Fax: 598 256-6706 Standard Email: cs mman ca acod.cam © Tr_ phhl 444 bw WPhe Qua Hale' Other Project Spectfx €.fi pR 7,!R DO:, iurhidily: �,Ca�{ Q Ru5h my it PRC•.RPPROt+EOi. Tm o: ALPHA Cat ID 8amp}a 10 collacli— (Lab the Only, bOam Time pats Recd In Lab: [] FAY Q ADFt m a L� slamlaa 5 apple s 4laV1x Inreals � Serial No:09212018:58 ALPHA.loh#: L)p ® Ermk 10Samd�ts C6en1 m[p PQ = MQI Ooliveraw" .c.mMEHAWLINC q Gio[K Ei Afo! lfaadcd 13 U&tedo 0 Lab w du Mmamf V-0 av AmW PLEASE ANSWER QuEsTionSAsove .CanlainerType � Please Pnn[1.. ie1[vp. . PlQSBeYSttlYB id arn�otolr;�+es:k�r: S YOUR PROJECT By: WEI 5 n 1111A MCP or GT RCP? Iia 4+a• �I .. a 1 ■A :..A..N.ALYTI CAL ANALYTICAL REPORT Lab Number: L2048791 Client: Coastal Engineering Company 260 Cranberry Highway Route 6A Orleans, MA 02653 ATTN: Chad Simmons Phone: (508) 255-6511 Project Name: BREWSTER LANDING Project Number: WBR006.01 Report Date: 11/12/20 Serial—No: 11122012:56 The original project report/data package is held by Alpha Analytical. This reportldata package is paginated and should be reproduced only in its entirety. Alpha Analytical holds no responsibility for results andlor data that are not consistent with the original, Certifications & Approvals: MA (M-MA086), NH NELAP (2064), CT (PH -0574), IL (200077), ME (MA00086), MD (348), NJ (MA935), NY (11948), NC (257001666), PA (68-03671), RI (LAO 00065), TX (7104704476), VT (VT -0935), VA (460195), USDA (Permit #P330-17-00196). Eight Walkup Drive, Westborough, MA 01581-1019 508-898-9220 (Fax) 508-898-9193 800-624-9220 - www.alphalab.com ]t�HA Page 1 of 13 I I L Project Dame: BREWSTER LANDING Project Number: WBR006.01 SAMPLE RESULTS Sevial—No: 11122012:56 Lab Number: L2048791 Report Date: 11/12/20 Lab ID: L2048791-01 Date Collected: 11105/20 13:15 Client ID: EFFLUENT Date Received: 11/05/20 Sample Location: BREWSTER LANDING, 0 SACHEMUS TRAIL, BREWSTER Field Prep: Not Specified Sample Depth: Matrix: Water Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry - Westborough Lab Solids, Total Settleable ............. .............................................. . <0A mill 1 PIA 1 ....................................................... ................................................................. . ......................................................................... 11/05/20 22:00 121,254Q1= AS ..................................................... ........................... .................................................. ;11Lr Hr"i Page 5 of 13 CHAIN OF CUSTODY Firs! Wesibuiough,tAA iaas O -K MA Piojeci Name: BrOMM-w Ldnding ilii: gOg.8R.R D TEL' VA -M-0$ 0 . Pmject Locatlon, Bro%Vii r LandbTg, d Saet}emus 'Frail, Brewster, MA k Serial No:11122012:56 oaia.Roc',4MLg,: ALPHA Job 9- © PAX 0 MAIL ❑ 3sme as Client 6da PDA: ❑ ADEx ❑ Add'1 Dnfio- mMes re= r� k-9MOPAnal - MVI WS ulred7 Address: 260 C-anber Hi hwa Pra eat tu9bnd -Chad A. 5dmmans ❑ Yea CA1 No Are CT HCP (Reasonable Crmrdenee Praocalg WmuIrrdT orleans, MA 92653 ALPHA Q xAil 2p176pirevl ANALYSIS Phone: 5G8 255-6511 _ SAFRrLE FIAr+nLl.`u3 xnrnnan Fax: 608 255-670+0 ZI Slarward ❑ Rwh toyLv>K aa�awwaavm 17 DDM �ge=aogc0d.R1 email' esimmonsG] I7 MM Fled D ra,ywuo TheyWV-e hkOt&M PrVl' uWIq °rsnl}a3 V A10% tJu .C]atq; Tune_ Prossrrata°n Q "ov'aao Other Proieet Specft Reg€FiremflntsfComMentsf[7 Kttorl Limits -o {PjypdP Sp°Cr%y p}{; DOI Turbidity 5-;3 ALP HALats €CS: Sample ID C90 11r smnpde sampler', (Ln6.0 OrsfYi NO Tfmz Matf Ihiliala � I twn�nwl: U ED ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ El © ❑ _ ❑ pi„EASEANSWER QUESTION 5ASOVEt ConiainerType ] P- PFesarr<aSiVerialeu.H• PS99',rpnlH deeflg, FCIy siM1SNmc.69 1S YOUR PROJECT _ iieli:quished 8y: ad in mM �YFC*WWLA06t wr>:l� e<mtlerrs cell nm Be rmo By; ie 74nC MA MCP or CT RCP'? kt °"�' ;� SB . P APPENDIX B: OEM FIELD INSPECTION FORMS ...................... R 1. In Austin Cahill -Coastal Engineering, Co. Inc. ............... _..... ... Main Submit My Clients My Reports Help ..................... Cancel Inspection Print Inspection __......................................................... ............. 8:,23 am RrPw0Pr I andinn ........................................................................................................................................ Seasonal Residence: No ................................................................................................................... .. .. ... .... Air Temperature: °F ............................ .. _.... _......... .... ._.._.................................................. :............................................................................................................................................ .... ................... ................ Weather Conditions: ............. ..... .................................................................................................................................................................................... ... ............................................................................................................ ............................................................................................................................................................... Sludge Depth. 8.00 in ................................................................................................................. .................................................................................................................................................................................... . Scum Layer Thickness: 0.25 in .........................................................................................................................._...................: Pumping Recommended: No ...............................................................................................................................................................:................................................................................................................................................................................ __................ ; Signs of Breakout: No .................... ........................................................................................................................................................................................................... ._......... ........................... .......................................................................... _.... ..... ..... Depth of Ponding: in Pending Above Invert: No ........................................................................................................................................................................................................................................... Any Apparent Violations of the Approval? t None Reported Any Cleaning or Lubrication of Parts Performed? Cleaned and brushed nozzles to ensure an efficient spray. Any Control Adjustments Made? None Reported .................................................................................................................................... Pumps, Switches, Aiarms Tested? Checked panels, amps, switches, tank levels, alarms, and general condition of the system. .................................................................................................... . ................................................. ............................................................. Any Equipment Failures? ...................................................................................................................................... None Reported ................. Any Parts Replaced? None Reported Any Recommended Corrective Actions? None Reported Inspection CompEeted7..............................................................................Yes........... .................... .._........................................................................................................................................................................ Odor Around Site ... ..................................................... Yes(_�'J No ....................................................... Source of Odor Not Reported. Odor Description Check all that apply n ED n C O Scum Depth in Primary Tank 0.25" Sludge Depth in Primary Tank 8" Does Grease Trap Need Pumping ................................................................................................ O YesC No .............. ............................... ._........................................ _........... _ ......... ........ __...... _... .. Unit 1 C Air Ras sing Through Vent ...... Fan Operating .......................................................................... . .................... .... . ...................... .............................................................. ._.._................................. [€ ........ ................. Genera[ .......................................... External Damage ........................................ . .......... CDYesONo .................................. .. Cover/Fan BoxlCtrl Panel Locked Yes CNo ...................................... __ Flies on the Unit ...................................................... Lj Yes: No __................. —.... —.... Number of Flies E FewC Many .................. ........ ..................................... Location of flies Not Reported. -Locks/Latches/Handles Ok �YesCENo .. ................. =Lid Gasket Ok ......................._. —YesoNo — ........ Standing Water in Fan Box ....................... ... .......... .......... L Yes' j No .......... ......... ............................... ... 1 13 ................................................... Cancel Inspection Addres Print Inspection Owner .................... _..... ................ . ....... u sacnemus i rarr, orewscer Brewster Landing .. ................. .. ........................................................................................................ Seasonal Residence: No Air Temperature: °F ................._....................................... .. Weather Conditions: Sludge Depth: ........................................................... ........ ............................. 0.00 in .............._.......................................... _................ ... Scum Layer Thickness: ...................... ............. 0.00 in ....: ......................................... .......................... ........... ...... ............ ........... __.............. _.......... _- ....... _................... Pumping Recommended: No Absorption O. ................. Signs of Breakout: .................................................................................................................................... ............................................................................................................... ... ... ..................................... — ...._ ............................ 'No .... ..... .................... _... : Depth of Ponding: in Ponding Above Invert: No Maintenance Issues ................................................. ...................... Any Apparent Violations of the Approval? .................................... ......................................................................................................................................... .................... _... f None Reported Any Cleaning or Lubrication of Parts Cleaned and brushed nozzles to ensure an efficient spray. Performed? Unclogged wipes in Zabel. ................................................................. Any Control Adjustments Made? None Reported ................................... . Pumps, Switches, Alarms Tested? Checked panels, timers, amps, switches, tank levels, alarms, and general condition of the system. Any Equipment Failures? None Reported .Any Parts Replaced? None Reported Any Recommended Carrective Actions? None Reported s. .. ... ........................ Inspection Completed?Yes Technology:Cbecklist ...................................... ......... .................................... ........... Odor Around Site Yeses - Na Source of Odor Not Reported. Odor De5cripfian Mild Medium S.tf EK all that apply r J Scum Depth in Primary Tank 0' I Sludge Depth in Primary Tank 0" Does Grease Trap Need Pumping ....................................... .. .. Yes[; No ................. f j Unit 1 Air Passing Through Vent Fan Operating General External Damage YeNo Cover/Fan BOX/Ctrl Panel Locked €viye" No Flies on the Unit ✓:Yeses Na Number of Flies ............... . f Few Many Location of flies Inside lid Locks/La tch estH a nd les 0 �_1Yes No Lid Gasket Ok Yesi: No ..................... Standing Water in Fan Box ^i YesiY' No IJ. .......................................................... ...... ......................................... ..s �_................. Canct:I 1etails Inspection Address ac emus Trail, Brewster M r` lizsy ctivi ; Owner Brewster Landing 1 .... _. _......... _ _.. _................ _. _........ _... _............................ _.. _. Inspectiori Details Component: i' ................ Bioclere Date: 2020-09-15 •.................. Time. 14:00:00 . _._............. ............. _= Operator Name: Jeff Selens License #: 11444 Operation and maintenance conducted — system operational at the time of the visit, Sampled. Color: Odor: Effluent Solids: pH: Dissolved Oxygen: Turbidity: Settleable Solids ...................... Seasonal Residence: Air Temperature: Weather Conditions: .......... ........... ........ No °F Sludge Depth: in .. . ... .............. ... . Scum Layer Thickness: in ......................................................................................... ................................... Pumping Recommended: No ................................................................................ ................. . ......................................................................................... .................................................................. __ ....... Signs of Breakout: No ...................................................................................................................................................................... Depth of Ponding: in Ponding Above Invert: No vlaintenance Issues .... .............................................................................. Any Apparent Violations of the Approval? None Reported Any Cleaning or Lubrication of Parts Cleaned and brushed nozzles to ensure an efficient spray. Performed? ....................... Any Control Adjustments Made? None Reported ........................................ .............. ................... Pumps, Switches, Alarms Tested? Checked panels, timers, amps, switches, tank levels, alarms, and general condition of the system. Any Equipment Failures? None Reported ............... . Any Parts Replaced? None Reported Any Recommended Corrective Actions? None Reported 44 1 Check all that apply Scum Depth in Primary Tank Sludge Depth in Primary Tank Does Grease Trap Need Pumping !Unit i 1 Air Passing Through Vent 1 Fan Operating General External Damage .Cover/ Fan BoxJCtrl Panel Locked Flies on the Unit Number of Flies Location of flies Locks/Latches/Handles Ok Lid Gasket Ok .......................................................................................................................... Standing Water in Fan Box a ....... _....... ... Cancel Inspection Address ...... . Print Inspection Owner ................................ ............... ............ Component: Date: Time: Operator Name: License #: 0 Sachem us Trail, Brewster .............................................. Brewster Landing -..................................... Bioclere 2020-11-05 12:45:00 .. .............................................. . Jeff Selens .......... .......... 11444 Operation and maintenance conducted — system operational at the time of the visit. Field-tested and sampled. .................................. Color: Clear ..... ......... _. Odor: ........... ....... Musty ............. ............................... Effluent Solids: – – ........ .................. No pH: 7.2 SU Dissolved Oxygen: ................................................................................ 2.000 mg1L .........._....................................... ........... _.................. ............ . Turbidity: NTU ................................. .... ................_....... ....................... ............ ..... ........ .: Settleable Solids: ........................................................................................................................ ................. ---................................................ _.._—.._.............. _.... _........... _...... _.................................. __................. ..... ................................................................... __......................................... .............. _ _..... ... - Seasonal Residence: No ......................................................................................... :.................... ............................................................................................................................................. _..... ....... ....................._ Air Temperature: . °F ..................................................................................................................................................................................................................................... Weather Conditions: Sludge Depth: in .......................__.................................................................. ............... Scum Layer Thickness: in ........._. ................. Pumping Recommended: No ......................................................................................................... Signs of Breakout: No .... . Depth of Ponding: in .......... .Ponding Above Invert: No ..................... ........................................................................................................................................................................................................................................................................................ Any Apparent Violations of the Approval? None Reported .... ............................ ..... .............. .:..... .... ..... ......................... ..... ...... ... ..... ...................... ............................ .......... ... ........ Any Cleaning or Lubrication of Parts Cleaned and brushed nozzles to ensure an efficient spray. Performed? Shook out Zable filter. _............................................................................................................................................................................ Any Control Adjustments Made? None Reported ..................... ............ ................... Pumps, Switches, Alarms Tested? Checked panels, timers, amps, switches, tank levels, alarms, and general condition of the system. Any Equipment Failures? None Reported .............................. ... .......... ............. ......................................................................................................... ...... .. ....... ........ ..................... Any Parts Replaced? None Reported ............................................................................................................................................................................................................................................... .. ............................................ ........ Anv Recommended Corrective Actions? A •+ 4j Inspection Completion .......................................... Inspection Completed? Yes ........................................................._.................................................................................. ............................ Technology -........... ._•......................_ Odor Around site ..................................... ................................... . i-DYes��!� No Source of Odor Not Reported. Odor Description Check all that apply ...................................................................... 0 0 j .................................................................................................................. ................................................................................................................................................................................................ ........... Scum Depth in Primary Tank ............_ .................................... Not Reported. ................... . ................................................................................. Sludge Depth in Primary Tank Not Reported, Does Grease Trap Need Pumping ......................................................................................... ;Yes( No —............................................................................................ .. .............€ ............ ..................... Unit 4 .......... ...................... Bioulem Vents Yes No C . Air Passing Through Vent Fan Operating D .....................L General External Damage Yes W/ Cover/Fan BoxlCtrl Panel Locked Yes C No ......... Flies an the Unit ....................................................... ............................................................. RyesC No .... . Number of Flies Few M a n Y Location of flies Inside lid Locks/Latches/Handles Ok L1sYes 0 No ......................................................................................._ ..—.... ................. Lid Gasket Ok ....................... ...... ........................... ................. 2 Yes ❑ No ..... ............... ...................................... ..... _ _..... Standing Water in Fan Box Yes � No Commonwealth of Massachusetts Executive Office of Energy & Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.517-292-5500 Charles ❑. Baker Kathleen A. Theoharides Governor Secretary Katyn E. Polito Martin Suuberg Lieutenant Governor Commissioner January 28,'2021 Greg Corman Waterloo Biofilters Systems Inc 143 Dennis Street, P.G. Box 400 Rockwood, ON NOB 2K0 Re: Change in Monitoring Requirements after first 18 months of operation 40 Cranview Road, Brewster, MA DEP Transmittal Number: X273 I b0 Dear Mr. Carman: The Department of Environmental Protection (MassDEP) has reviewed your email dated November 4, 2020, regarding the change in monitoring requirements for 40 Cranview Road, Brewster, MA. MassDEP issued the approval for the alternative technology as a site specific piloting on October 28, 2019, Transmittal No. X273150 and required the monitoring and testing of the system quarterly for first 18 months. The system began operation and monitoring in June, 2019 and completed 18 months of operation in December 2020. After the review of the submitted data MassDEP approves a reduction in the sampling, monitoring and inspection requirement stated in the Site Specific Approval from quarterly to annually (at least once in 12 months). Please be advised that the Brewster Board of Health may have more frequent sampling and inspection requirements and this letter does not waive any conditions or requirements required by Brewster Board of Health. Should you have any questions regarding this letter please contact Hersh Thakor at Harshrai.Thakor@,mass.gov. Sincerely, Marybeth Chubb, Section Chief Groundwater/Title 5/Reuse Bureau of Water Resources Cc: Brewster Board of Health This information is available In alternate format. Contact Michelle Waters-Ekanem, Director of Diversity/Civil Rights at 617-292.5759. 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Box 439 South Orleans, MA 42662 Re: 40 Cranview Road (Map 10, Parcel 66) Dear Mrs. Sequin: On December 7, 2016, the Board of Health voted to approve the following variance from the Brewster Board of Health regulations: 1, To allow the proposed soil absorption system (SAS) and reserve area to be less than 300 feet from a pond as shown on the revised plan dated November 29, 2016 with the job number 11714 including the approval of a proposed Waterloo EC -P tank between the septic tank and pump chamber. Because the property is in an Environmentally Sensitive Area, the following conditions will apply: 1. The owner must agree to install water saving devices on all fixtures. Enclosed please find a Certificate of Granting of Variance form which must be properly recorded in the Registry of Deeds. Please submit a copy of the recorded document to this office. If you have any questions, do not hesitate to contact this office. Sincerely, Nancy Ellis Ice, CHO, RS Health Director Cc; Zevon Brian Dudley, DEP tswa). 9 TOWN of BREWSTER 2198 MAIN STREET BREWSTER, MA 02631 Noi e-, (508) 895-3701 Exi, 1120 FAx: (508)8964538 ssx LTU ro AewsTER mrn.cav BOARD OF HEALTH MEETING WEDNESDAY NOVEMBER 2, 2016 AT 7:OOPM TOWN HALL, ROOM B Board members present: Carmen Scherzo, DVM; Joe Ford; Annie Dugan, RN and James Gallagher Board members absent: Mary Chaffee, RN, PhD Others present: Nancy Ellis Ice, Health Director and Tammi Mason, Senior Department Assistant - 1. chairman's announcements OMCE or RaAL-m DEPARTMENT Dr. Scherzo talked about picking a date for a discussion on the Pond Nutrient Regulation. The Board will discuss this again at the next meeting. 2. Ryder & Wilcox- Local variance request for 40 Cranview Road Stephanie Sequin presented this to the Board. This is a new septic system. The lot is 37,000sf with a lot of upland. There Is a wetland on both sides, the bulk of the lot is within 100 feet of the resource areas. There is only 1 spot on the property that is outside of the 100 feet. `there is no part of the lot that isn't In the 300 feet area. Ground Water does flow towards pond, Existing building is in a state of disrepair. There is a cesspool system currently. House will be torn down and a new 3 bedroom will be built basically in the same footprint, there is a well on the property (no town water available). A new well will be installed, groundwater was hit at 9 feet while doing the test holes. Estimated seasonal high groundwater is less than 4 feet to groundwater. It will be a raised system. There are no other leaching facilities in the area and no other sources of contamination. The system wIl€ be roughly 102 feet from pond. The B horizon is receiving the effluent. 20 foot buffer strip is there currently but will be increased with conservation mitigation. Have met with Conservation Commission, hoping that it will be approved on November 22"a, Their issue is the location of the building, nothing else. Septic will stay the same. Ms, Dugan is concerned that there is not enough protection for the pond by building a 3 bedroom home. Mr. Gallagher is concerned about Conservation Commission approving the line and the installer using it properly, Also concerned about the Increase in flow. Dr. Scherzo stated that this one is a good example of where the pond nutrient regulation should carne Into play. He did a PSA on it and it was 8 years, which means that it is way over -due. The new system Is being proposed In the same location as the cesspool was. He would like to know if owners would be wllling to use a phosphorus reducing system. Ms. Sequin stated that there would not be more phosphorus, the owners are currently already living here and that's not changing. She did ask the owners If they would be willing to use a Phos Rid system and they said they felt they would have no choice if that's what the board wanted. Mr. Gallagher stated that using a phosphors reducing technology would make him feel better. WWW ,TOWN,BREWSTRR.MA,US BOH 11/2/16 Minutes Page 2 Mr. Ford has concerns but does not agree with putting a piloting system in. Bill Casey -abutter, owns the cranberry bog. Concerned with the owners moving it closer to the bog. Carol Casey -also own a strip of land between the applicant and them. Motion: Continue this hearing to the December r meeting. Looking for wetlands to be delineated and potentially use a Phos Rid system instead. Motion: lames Gallagher Second: Joe Ford (for discussion) Vote: 4-0-0 Action: Motion carried 3. Ryder& Wilcox- local variance request for 83 Cedar Hili Road Stephanie Sequin presented this to the Board. This is a 13,000sf lot with an existing 3 bedroom house on land. There is a cesspool system currently. They will be tearing the existing house down and replacing it with a larger 3 bedroom home. It is 89 feet from top of the bank to leaching. Existing water service will be relocated. An 11' variance Is needed. They did meet with Conservation Corn misslon last night and they did ask for modifications to the plan. Mr. Gallagher wants to make sure the Conservation Commission has approved the delineation. Doesn't think there is anywhere else on lot to put system. Dr. Scherzo asked what the groundwater elevation was. Ms. Sequin stated that she did not encounter groundwater during pert testing. Motion; Approve the variance request contingent on the Conservation Commission confirming the resource area. Motion: Joe Ford Second: Annie Dugan Vote: 4-0-0 Action: Motion carried 4. J. M. O'Reilly & Associates Inc. — seeking approval for an I/A system at Lot 75 McGuerty Road John O'Reilly presented this to the Board, Mark Smith, potential owner of property was also present. They are seeking approval for a fast system for a 2 bedroom home. Motion: -Approve the I/A system for a 2 bedroom home on Lot 75 McCuerty Road. Motion: Annie Dugan Second: Joe Ford Vote: 4-0-0 Action: Motion carried 5. Joe Henderson — Horsley Witten Group -- 6 month review far Kings Landing WWTP Mrs. Ice stated that Mr. Henderson had called her and told her that he really didn't have any information to give the board and asked for her to continue this until the next meeting. She wlII re schedule for another time. 6. Request from Brewster Housing Authority to waive fee for upgrade of septic system Mrs. Ice told the Board what the actual fee that they waive would be $950.00 Motion: Waive the fee. Motion: Annie Dugan Second: Joe Ford Vote: 4-0-0 Action: Motion carried 7. Peter & Ellen Guidry-- failure to renew I/A Operation & Maintenance contract M rs. Ice stated that we had not received the certified card back. The Board agreed to continue this to the next meeting. The Board asked that Mrs. Ice try and send a letter to the Brewster address also and for them to confirm attendance, ®Hower TOWN OF BREWSTER 0MC12aP o .s 2198 MACK' STFtCt;T HSALTli DEPARTMENT I3REwsT>;it, KA 02631 Y PuoNp-; (508) 896-3701 1;xT 1120 �Fp•,�.p,� 1'AX: (509) 896-4538 rum BRI-IEALTHu) REWSTER-MA,DOV BOARD OF HEALTH MEETING WEDNESDAY DECEMBER 7, 2016 AT 7:00PM TOWN HALL, ROOM A Board members present: Carmen ScherzD, DVM, Chairman; Joe Ford, Vice Chairman; Annie Dugan, RN, and James Gallagher Board members absent: Mary Chaffee, RN, PhD Others present: Nancy Ellis Ice, MPH, CHO, R5, Health Director and Tam ml Mason, Senor Department Assistant 1. Chairman's announcements Attorney General Healy announced a new hotline for the public to call If they experience bias motivated threats, harassment or violence, The number to tali is 1-800-994-3228. Dr, Scherzo spoke about the Iowering of the nitrogen load to Cape Cod soils. Barnstable County Department of Health and Environment Is seeking volunteers to instal[ experlmentat layered salt treatment leach fie]ds, The Board of Health will be discussing the pond regulation and voting on it at the December 21, 2016 meeting. 2. Ryder & Wilcox-- Request for an extension of variance's granted to Lot 43 Landing Drive (April 11, 2012) Dr. Scherzo spoke about the Permit Extension Act and how It applies to this permit and its variances that were granted In 2012. Stephanie Sequin presented this to the Board. In April of 2012 variances were granted. At that time of granting the variances they fell under the Permit Extension Act, which allowed the owners to keep the variances and the permit to Install the septic system open for an additional years. The owners are getting ready to build, probably In the fall of 2017, They are requesting an extension of 1 year until the fall of 2018. Previous requlrement was that it only be a 3 bedroom and it will stay as a 3 bedroom. The lot is outside of the buffer shown on the Horsley Witten map, Mr. Gallagher asked about the revision on the 2016 plan with regards to the 3 bedrooms, Ms, Sequin stated that the plan was just updating the number of bedrooms. Motion: Extend the variance for one year until April 11, 2018, Motion: Joe Ford Second, lames Gallagher Vote: 4-0-0 Action: Motion carried 3. Ryder & Wilcox — Continued variance request application for 40 Cranview Road (Nov. 2, 7016) Stephanie Sequin presented this to the Board. This is a continued varlance application from November 2, 2016. Ms. Sequin stated that the lot is entirely within the 300 foot buffer of the pond and it is a very difficult lot to put in a system that complies with Title 5. At the last meeting, the Board had concerns about a 3 bedroom home being bu€it even though there Is 30.000sf of buildable upland on lot. A Waterloo ECP system Is now proposed to be installed. Conservation Commission has approved the plan. Ms. Dugan asked if there was a buffer. Ms. Sequin stated that there was. Dr. Scherzo asked about Zoning Board approval. WW W.TOWN.BREWSTER.MA.US Mjr,utes Page 2 F ed if the ECP unit was in the tank or a separate module, Ms. Sequin stated that it is in a separate module. ❑r. Scherzo atthecost was. Ms. Sequin stated that the quote for materials was $5200, septic installer has to Install It and that will add pprove the variance requests finding that this is an improvement over the current cesspool. The system will be a ECP which will help with the groundwater fEowing towards the pond and Conservation has approved the project. Motion: Joe Ford Second: James Gallagher Vote: 4-0-0 Action, Motion carried 4, Ryder & Wilcox— Request for an extension of variance's granted to Lots S & 8 Mill Pond Drive (Feb 25, 2015) Stephanie sequin presented this to the Board. Lot 6 and Lot 8 previously were granted variances. Lot 6 will be a 3 bedroom. Requesting a 1 year extension on both variances. Motion: Grant the extension of the variances for both lots for 1 year until February 25, 2018. Motion: Joe Ford Second: Annie Dugan Vote; 4-0-0 Action: Motion carried 51 Oceanside Septic —Title 5 and Local variance requests for 208 Canoe Pond Drive David Nadle from Oceanside Septic presented this to the Board. This is an upgrade of a failed system. They will be keeping the existing tank and installing a new leaching area. The following variances are requested: 1. Allow the pump chamber to be 72 inches below grade 2. Allow the SAS to be 5 feet from a property line 3. Allow the SAS to be 136 feet from Canoe Pond Mr. Nadle stated that the proposed system is as Far away from the pond as possible. Dr. scherzo read a part from DEP regulations stating that If It is a repair, no reserve area Is needed. Mrs, Ice spoke about the easement on the property and stated that it was for the abutting properties septic system. Mr. Ford asked about groundwater flow direction. Dr. Scherzo stated that the groundwater flow is awayfrom the pond. Mr. Gallagher asked if the wetland delineation had been looked at yet. Mr. Nadle stated that it was being looked at in-house by the Conservation Agent. Mrs. Ice stated that the Conservation Agent had approved It. Ms. Dugan asked what the distance to groundwater was from bottom of SAS, Mrs, Ire stated that it's shown on plan as 9.3 feet Ms. Dugan asked why they needed the extra 36 Inches for the pump chamber. Mr. Nadle stated that the way the lot is situated It slopes quite a bit. Motion: Flndingthat there is no increase in flow, the system is an improvement over what is there currently and there is no other place on the lot, grant the variances requested. Motion: Annie Dugan Second: James Gallagher Vote: 4-0-0 Action: Motion carried 6. I.M. O'Reilly & Associates --Title S and Local variance request for 102 Cedar Hill Road The applicant requested a continuance until the January 4, 2017 meeting. Phosphorus: What is Known It is generally believed that the rate of horizontal ground water flow on Cape Cod is 1.0 foot per day or 365 feet per year. Slower in the higher elevations and faster closer to Cape Cod Bay. Although phosphorus travels within the ground water, the rate of horizontal flow of phosphorus, or creep, is said to be between 3.7 feet to 7.3 feet per year in homogeneous calcareous sandy Canadian aquifers"', much slower than the rate of ground water flow. The actual rate of creep in Cape Cod soils depends on multiple in situ factors that will be discussed. On Cape Cod phosphorus travels horizontally through the ground water slower than the ground water flow because the negatively charged phosphate anions adsorb with the positively charged iron and manganese cations coating Cape Cod soils, which are mostly sand; the adsorbed phosphorus remains in place. The number of adsorption points on the volume of sand between the bottom of the soil absorption system, or field, and the nearby surface water or pond is finite. The greater the volume of sand between the embarkation of the phosphorus from the bottom of the field and the nearby surface waters, the more time it takes for phosphorus to reach the pond. Eventually, the phosphorus soil adsorption sites saturate, sorption ceases, and phosphorus flows to the nearby surface water. Phosphorus is a concern because phosphorus can impair water quality of lakes and ponds at much lower concentrations compared to nitrogen. Surface waters or ponds that have a concentration of 0.02 mg per liter or greater are said to be eutrophic. Eutrophic fresh waters are said to be "nutrient rich". This encourages the growth of plants; followed by increased nuisance algae growth that impair those waters for drinking, recreation, and cause fish kills. Factors that affect Septic System Phosphorus Loading Before the 2008 State of Massachusetts law limiting the use of phosphates to less than 0.5% in dishwashing detergents and soaps, septic system effluent phosphorus concentrations were typically 15.0 mg/L. After the ban effluent phosphorus concentrations dropped to 5.0 mg1L. A septic system that was installed in the 1970's, 1980's, or 1990's would have had received a significantly higher annual phosphorus loads compared to a septic system installed after 2008. Septic systems installed before 2008 had a much higher influent phosphorus load. This factor is not considered in the draft Brewster Phosphorus Breakthrough Analysis but must be weighed separately. The passage of this law has significantly reduced the amount of phosphorus currently entering our Cape Cod septic systems, soils, and surface waters. Disallowing a garbage disposal; using a scraper to place food waste in the garbage to be taken off site; and placing food not consumed in a compost bin rather than flushing that food down the drain all remove sources of phosphorus from entering the in situ septic system. The U.S. EPA (2002) estimates that each person in the United States contributes through the toilet 1.6 grams of phosphorus daily to a septic system (1.6 grams x 365 days = 585 grams per year. 584 484 grams pound = 1.2 pounds phosphorus per year per person).' In Brewster we average 2.0 residents per household. The typical septic system received 2.4 pounds of phosphorus per year (1.2 x 2.0 = 2.4). As phosphorus entering the septic system is a by-product of human waste, the greater the number of residents utilizing the septic system the greater the amount of phosphorus leaving that septic system. Seasonal use of a septic system usually results in about half the quantity of phosphorus entering that septic system in a year. Adjusting for the number of months habited per year and the actual number of occupants gives a more accurate measure of the phosphorus load of an individual septic system. Factors that affect the amount of phosphorus leaving the Septic System: Pumping out (recommended every three years) the sludge/sediment in the bottom of the septic tank will remove the suspended solids. This sludge/sediment accounts for about 10% of the total phosphorus not leaving in the effluent. After pumping, bacterial growth in the new sediment expands and traps more phosphorus in the sediment, but this effect does not last more than a few weeks. Factors that affect the amount of phosphorus removed from the Septic System effluent; Precipitation and Adsorption Precipitation. The highest concentration of phosphorus is found just below the field, in the so-called oxygen rich vadose zone. The high concentration of phosphorus and bacteria in this area favor precipitation. Doyle et al. (2005) found that precipitation is very likely immediately after the effluent is released to the soil. Precipitation of phosphorus is not limited so long as sufficient concentration of phosphorus is available, and so long as there is space for precipitate to grow. Crystalline mineralization is the desired end effect that isolates phosphorus thoroughly from the water resourse.4 In 2006 George Heufelder found that there was a 47% (4.8 mg/L to 2.5 mg/L) reduction in total phosphorus concentration in a conventional Title 5 septic system following 5 feet of passage through medium sand at the Massachusetts Alternative Septic System Testy Center.3 Adsorption. Phosphorus is also removed from the effluent by adsorption onto particles of soil below the soil absorption system. The removal of phosphorus is related to the volume of soil that the percolating effluent is exposed to. Adsorption is limited by the number of sorption sites in the soils between the bottom of the SAS and the nearby surface water. The composition of the soils beneath the SAS and the soils that the ground water flow contacts greatly affect the ability of that soil to adsorb phosphorus. A soil that can be described as loam or clay has a phosphorus adsorption capacity of 405 ppm (ppm = mg/Kg). A soil described as loamy sand has a phosphorus adsorption capacity of 250 ppm. A soil described as fine sand has an adsorption capacity of 80 ppm, medium sand 50 ppm, and coarse sand 30 ppm'. The higher the rate of application or effluent flow, the lesser the contact time that the effluent has with individual soil particles. Although soils with high adsorption capacities adsorbs more .phosphorus, Title 5 specifications does not favor these soils because of the slower perk times. When a Cape Cod septic system installation occurs the native soils below the SAS are usually removed and replaced with medium sand. Location, Location, Location. A septic system that has been in place for multiple years has an existing, persisting phosphorus plume in that location extending in the direction of the ground water flow. Many and possibly most sorption sites will be saturated. If that soil absorption system can be relocated to virgin sand which has not been exposed to septic system effluent, then the phosphorus breakthrough time to nearby surface water will be dramatically increased, A phosphorus breakthrough time to the nearby surface water, to be discussed later, can be calculated for the septic system in the existing location and for the septic system in the new location. Merits of Various Dispersal Systems 1. Drip dispersal systems have a slow rate of effluent application (drip) evenly over the entire SAS resulting in increased soil contact time and greater phosphorus adsorption and precipitation. In addition, with drip dispersal systems some of the effluent phosphorus is consumed by the growth of surface plants. Drip dispersal systems usually require a larger field surface area than other soil SAS's resulting in an increased volume of phosphorus to soil contact compared to other SAS's. 2. Pressure -dosed systems have a somewhat greater rate of application over the entire SAS compared to drip technology, but they can be batch regulated to limit the amount of flow. Like drip systems pressure dosed systems disperse effluent to the entire soil absorption system. 3. Conventional gravity fed Title 5 SAS's have a greater rate of effluent application to the near field of the SAS compared to pressure dosed or drip dispersal systems. However, conventional gravity fed Title 5 SAS's, pressure dosed systems, and drip dispersal systems can have the longest dimension of the field installed perpendicular to the ground water flow to greatly increase the volume of soil in contact with the effluent phosphorus. 4. Leach pits have the same rate of application as conventional gravity fed SAS's, but the effluent is concentrated upon the smallest footprint or surface area reducing and limiting the vertical soil contact time. For example, when a perk test is done in a test hole, gravity will pull multiple gallons of water down to establish a perk rate recorded as inches per minute. In the sandy soils of Cape Cod, the perk rate is usually greater than 0.74 inches per minute. That equates to 44.4 inches per hour. In a leach pit, which has no distribution box compared to other soil absorption systems (SAS), does the pull of gravity on a pool of effluent flooded on a small area, usually less than 100 square feet, result in a faster phosphorus transit time to the ground water? There is certainly the same amount of effluent phosphorus in contact with significantly less soil absorption sites below a leach pit compared to the other soil adsorption systems described. Measuring Phosphorus Breakthrough Times The states of Idaho and Montana require a Phosphorus Breakthrough Analysis (PBA) prior to issuing a Disposal Works Permit for septic systems near surface waters. These states developed a customizable Excel work sheet for each site location to measure the adsorption capacity of the volume of soils between the bottom of the SAS and the nearby surface water. For permitting, the PBA in these two states require sufficient soil adsorption capacity of 50 years prior to phosphorus discharge to surface water.5,6 However, there is a significant difference between the soils of these two states and Cape Cod. In 2015, 1 looked at the test hole data from 13 different properties in Brewster. The depth of the A Horizon ranged from 2" to 24" with an average of 10.2". The A Horizon of all properties was composed of only one type of soil, loamy sand. The depth of the B Horizon ranged from 4" to 72" with an average of 23.8" In the B Horizon nine of the properties contained loamy sand; 3 properties contained sand only; and one property contained sandy loam. The average depth of the C Horizon was 100". In the C Horizon there were three different sizes of sand: 2 fine sand, 8 medium sand, and 4 coarse sand. Two properties had silt loam. One property had loamy sand. One property had a gravel layer. Typically, with a conventional Title 5 septic system installation on Cape Cod the A, B, and C Horizons are removed and replaced with medium sand. The soils below the Montana and Idaho SAS's have a much greater phosphorus adsorption capacity of 200 ppm (mg/KG) compared to Cape Cod soils of mostly medium sand with an adsorptive capacity of 50 ppm. The draft PBA attached, modified for Cape Cod, measures the adsorption capacity of the volume of soil between the bottom of the SAS and the nearby surface water to determine a phosphorus breakthrough year. The annual per person influent phosphorus load is 1.2 pounds.' If 10% of the phosphorus load is retained in the septic tank then the effluent phosphorus load is 1.1 pounds per year per person. If 47% of the effluent phosphorus load in a conventional Title 5 septic system is removed 5' below the SAS by precipitation, then that leaves 0.5 pounds phosphorus (1.1 x 53% = 0.6) per person to be adsorbed by the soils. Please see the attached Excel worksheet. Note how easy it is to change the inputted parameters. A PBA for an individual property can be completed in minutes. A Brewster phosphorus breakthrough analysis (PBA) is more likely to be computed with a conventional gravity fed Title 5 septic system or a leach pit. Example attached: A 10' wide leach pit that is 202' from the pond; from the bottom of the pit to ground water is 31'; the occupancy rate is unknown, so the average Brewster occupancy rate of 2.0 individuals is used; the property is occupied year-round; the phosphorus load of 1.2 (2.0 x 0.6 = 1.2) pounds per year is inputted. To input into the worksheet the length and width numbers for a circle one must first determine the surface area of the leach pit. The area of a circle is rj Radius'. The value of TT, 3.14, X 51 = 79. If 10' is inputted as the length, then 7.9' is inputted as the width. The PBA time is 33.5 years with an annual creep of 6.0 feet per year. If that same property had 5 occupants 1n this 4 -bedroom residence, then the phosphorus load would be 3.0 pounds per year (5 x 0.6 = 3.0). The PBA time is reduced to 13.4 years with an annual creep of 15' per year. If the leach pit of this 4 -bedroom house with 5 occupants instead was a field 40'x 15' with the 40' length perpendicular to ground water flow, then the PBA time is 50 years with an annual creep of 4.0' per year. My conclusion: Since 1998 Title 5 has not allowed leach pits to be installed. Existing leach pits would have had to been installed more than 20 years, 10 or more years before the 2008 Massachusetts law limiting the use of phosphates. Leach pits, because of their small footprint and narrow plume, should be removed from upgradient Environmental Sensitive Areas as leach pits facilitate the transfer of septic system source phosphorus to nearby surface waters. The replacement soil absorption system should be placed perpendicular to the ground water flow, if possible, and pressure dosed, if possible, to facilitate effluent reaching the entire field for exposure to the maximum number of sorption sites. Effluent 1/A Treatment As phosphorus limiting Innovative/Alternative systems that are approved for Pilot Use in Massachusetts can have effluent phosphorus concentrations below 1.0 mg/L (compared to 5.0 mg/L from a septic system without phosphorus limiting technology), the annual effluent phosphorus load per person is approximately 0.1 pounds or less. Such a small amount of effluent phosphorus would be subject to further soil adsorption. For example, using low energy iron electrochemistry of. the Waterloo ECP process, dissolved ferrous iron reacts with sewage phosphorus ions and precipitates onto filtration medium. Crystalline mineralization is the desired end effect that isolates phosphorus thoroughly from the water resourse,9 The crystalline mineralization does pass with the effluent and remains just below the field. The nearby surface water would be protected from phosphorus for a hundred years or more even if the SAS is placed within an Environmental Sensitive Area. Any upgradient SAS within 100' of surface waters should have phosphorus limiting I/A technology as there is insufficient sorption sites to prevent phosphorus from reaching the surface waters in the near future. Submitted March 29, 2021 by, Carmen S. Scherzo, DVM Chairman, Brewster Board of Health References: 1. Lusk Mary, GurpaI S. Qbren, T. 0nsite Sewage Treatment and Disposal Systems: Phosphorus July 2011 2. Doyle, 5, J.E. McCray, K.S. Lowe, and G. D. Thyne, "Modeling Phosphors Reaction and Transport at an Experimental Onsite Wastewater Site." Proc, of the NOWRA 2005 Annual Technical Education Conference, 2005. 3. Huefelder, George, Evaluation of Methods to Control Phosphorus in Areas Served by Onsite Septic Systems. June, 2006, p.4. 4. Spokane County onsite Sewage Disposal Systems Phosphorus Loading Estimate Technical Memorandum, June 27, 2007, Prepared by HDR, p. 10. 5. How to Perform a Nondegradation Analysis for Subsurface Wastewater Treatment Systems under Subdivision Review Process, Montana Department of Environmental Quality, Public Water and Subdivision Bureau, October 2015, p. 39 — 43. 6. Individual and Subsurface Sewage Disposal Systems Technical Guidance Manual, State of Idaho Department of Environmental Quality, August 2016, p. 2- 10. 7. Irreversible Phosphorus Sorption in Septic System Plumes?, W. D. Robinson, 2008 8. Brewster Freshwater Ponds: Water Quality Status and Recommendations for Future Activities draft Final Report, April 2009, page 17. 9. Removal of sewage phosphorus by adsorption and mineral precipitation, with recovery as a fertilizing soil amendment. Craig Jowett, I Sointseva, L Lu, C James, and S Glasaer, Water Science & Technology, 77.8, 2018. Brewster Board of Health Draft PHOSPHOROUS BREAKTHROUGH ANALYSIS Address 28 Daisy Lane Map # 1 Lot # Owner Date of PBA 10,21 .2020 Plan Date Agent Septic System Installation Year Breakthrough Year VARIABLES DESCRIPTION Lg Length of Primary Drainfield as Measured Perpendicular to Ground Water Flow L Length of Primary Drainfield's Long Axis W Width of Primary Drainfield's Short Axis B Depth to Limiting Layer from Bottom of Drainfield Laterals* D Distance from Drainfield to Surface Water T Phosphorous Mixing Depth in Ground Water (0.5 ft for coarse soils, 1.0 ft for fine soils) SW Soil Weight (usually constant) B Horizon Depth of B Horizon C1 Horizon Depth of C 1 Horizon C2 Horizon Depth of C2 Horizon Pa B Horizon Phosphorous Adsorption Capacity of Soil** Pa C1 Horizon Phosphorous Adsorption Capacity of Soil** Pa C2 Horizon Phosphorous Adsorption Capacity of Soil" Pa to Surface Wa Phosphorous Adsorption Capacity of Soil (100 ppm constant) 41 Dumber of Single Family Homes on the Drainfield IPt Phosphorous Load per Single Family Home*** Conversion Factor for ppm to percentage (constant) Total Phosphorous Load per year Soil Weight under Drainfield = (L)(W)(B Horizon)(Sw) Soil Weight under Drainfield = (L)(W)(C1 Horizon)(Sw) Soil Weight under Drainfield = (L)(W)(C2 Horizon)(Sw) Soil Weight from Drainfield to Surface Water = [(Lg)(D) + (0,0875)(D)(D)] (T)(Sw). Phosphorous Adsorption by B Horizon Phosphorous Adsorption by C1 Horizon Phosphorous Adsorption by C2 Horizon Phosphorous Adsorption Drainfield to Surface Water Total Phosphorous Load Breakthrough Time to Surface Water = P 1 Pt 1988 2021 VALUE UNITS 10.4 ft 10.0 7.9 31.0 ft 202.0 ft 0.5 ft 100.0 Iblft3 0.0 ft 0.0 ft 31.0 ft 250.0 ppm 150.0 ppm 50.0 ppm 100.0 ppm 1.0 1.20 lbs/yr 1000000 1.20 lbs/yr 0 lbs 0 lbs 244900 lbs 279518 lbs 0.0 lbs 0.0 lbs 12.2 lbs 28.0 lbs 40.2 lbs 33.50 NOTES: Information to be Entered * Depth to limiting layer below the bottom of the drainfield is typically based on depth to a limiting layer (such as clay, bedrock or water) in a test pit or bottom of a dry test pit. ** Material type is usually based on test pit data. A soil that can be described as loam or clay (e.g. gravelly loam, sandy loam, silt, silt loam, sandy clay etc.) or finer according to the USDA soil texture classification system is considered a "fine" soil and would have a P adsorption capacity of 405 ppm. A soil that can be described as loamy sand would have a P adsorption capacity of 250 ppm. A soil described as fine sand would a phosphorus adsorption capacity of 80 ppm. A soil that can be described as medium sand and would have a phosphorus adsortion capacity of 50 ppm. A soil described as coarse sand would have a phosphorus adsorption capacity of 30 ppm. *** Based on available science, each Brewster residence produces a septic system phosphorus load of 0.6 pounds per year to be adsorbed. If the number of occupants is unknown, then a phosphorus load of 1.2 pounds per year is used because the average household in Brewster has 2.0 residents. 1. Header Information 2. Year of Septic System Installation 3. Lg 4.L 5, W 6, B 7, B Horizon Depth 8. C1 Horizon Depth 9. C2 Horizon Depth 10. Pa B Horizon if different** 11. Pa C1 Horizon if different** 12. Pa C2 Horizon if different" 13. Pt *** Page 2 of 2 Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02531-1898 PHONE: 508.896.3701 EXT, 1120 FAX: 508.895.4538 brhealth brewster-rna. ov W W W.BREWSTER-MA.GOV Frepesed-Brewster Board of Health Policy In -House Approval of Food Service Establishment Permits April 7, 2021 Health Department Amy L. von Hone, R.S., C.H.O. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant All new or revised Food Service Permit applications shall be reviewed and approved In- House by the Brewster Health Director and/or the Assistant Health Director. Applications that require a Hazards Analysis Critical Control Point (HACCP) Plan or a variance will require full Board of Health review and approval. All In -House approved food service permits shall be presented to the Board of Health at their next scheduled meeting for approval under a Board of Health Consent Agenda. Applicants will be notified verbally or by email of the date and time of the Board of Health meeting for purposes of participating in any discussion on the Consent Agenda approval. Any applicant aggrieved by a decision of the Director or the Assistant can appeal the decision to the.full Board of Health. A request for appeal shall be in writing and received by the full Board of Health within 10 days of receipt of the Director/Assistant's decision. If no request for appeal is received within said 10 day period, the decision of the Director/Assistant shall be final. N:1Health\McCulloughTOOD\Letters\Food reviewslln-/-louse food permit approvals.doc AGENDA ACTION ITEM FORM BOH Variance Agenda Item ❑ In -House Local Upgrade Approval ❑ Other: Subdivision Approval Health Department Amy L. von Hone, R.S., C.H.O. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Board of Health Meeting Date: April 1, 2021 Project Location: 409 & 413 Great Fields Road Map & Parcel: 46134 Owner's Name & Address: Thoburn M. Stamm, Jr., Trustee 409 Great Fields Road Brewster, MA 02631 Applicant: Same as above Date Requested: March 17, 2021 Title 5 Variance Request: Yes❑ No® Board of Health Variance Request: Yes❑ No❑300' Pond Setback Other: Yes ❑ Na ❑ 1. Outside Zone Il and Private Wells 2. In ESA --- existing dwellings and septic systems within 300' of Griffiths Pond Health Director's Comments: 1. The existing property consists of an existing 3 bedroom dwelling and an existing 2 bedroom dwelling for a total of 5 bedrooms onsite. Both structures are serviced by private wells and 2002 Title 5 septic systems which met the state and local regulations at the time of construction. The pre- and post -subdivided parcel(s) are located within the Zone of Contribution (Zone II) to the private wells servicing the existing structures and are bound by the nitrogen loading restrictions of MA Title 5 Regulations and the Brewster Regulation Regarding Variance Requests for On- site Sewage Disposal Systems Applications which limit the number of bedrooms allowed based on the square footage of the lots. Proposed Lot 1 (3 bedroom dwelling) will consist of 134,700 s.f and proposed Lot 2 (2 bedroom dwelling) will consist of 137, 900 s.f of land area meeting the minimum 1 bedroom/10,000 square feet of land area requirement under both state and local regulations for the existing structures. 2. The existing septic leaching facilities for both structures are located within 300' of Griffiths Pond, however, both lots are located downgradient of Griffiths Pond. There are several wetlands (bordering vegetated wetlands and isolated wetlands) located on the property in addition to Griffiths Pond per existing septic plans on file. Further research would be required to determine N:IHealth113aH Decision Letters\Suhdivision Dee isions1409-413 Great Fields Road 04- 07.2021 Agenda Action ]tem Form .docx Town of Brewster `��111����u��uti�+�++rr�frrrrrrr111��� RE We MAINET C �•¢���� 0 MASTRSSACHUSETTS 5 02531-1898 BREWSTER,1 PHONE: 508.896.3701 EXT. 1120 0 Rz FAX: 508.896.4538 _ btewster-ma.gov brhealth@btewster-ma.gov WWW.BREWSTER-MA.GOV lllll�/z�E� IIr1J J Ill+l � I l 1111111111 AGENDA ACTION ITEM FORM BOH Variance Agenda Item ❑ In -House Local Upgrade Approval ❑ Other: Subdivision Approval Health Department Amy L. von Hone, R.S., C.H.O. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Board of Health Meeting Date: April 1, 2021 Project Location: 409 & 413 Great Fields Road Map & Parcel: 46134 Owner's Name & Address: Thoburn M. Stamm, Jr., Trustee 409 Great Fields Road Brewster, MA 02631 Applicant: Same as above Date Requested: March 17, 2021 Title 5 Variance Request: Yes❑ No® Board of Health Variance Request: Yes❑ No❑300' Pond Setback Other: Yes ❑ Na ❑ 1. Outside Zone Il and Private Wells 2. In ESA --- existing dwellings and septic systems within 300' of Griffiths Pond Health Director's Comments: 1. The existing property consists of an existing 3 bedroom dwelling and an existing 2 bedroom dwelling for a total of 5 bedrooms onsite. Both structures are serviced by private wells and 2002 Title 5 septic systems which met the state and local regulations at the time of construction. The pre- and post -subdivided parcel(s) are located within the Zone of Contribution (Zone II) to the private wells servicing the existing structures and are bound by the nitrogen loading restrictions of MA Title 5 Regulations and the Brewster Regulation Regarding Variance Requests for On- site Sewage Disposal Systems Applications which limit the number of bedrooms allowed based on the square footage of the lots. Proposed Lot 1 (3 bedroom dwelling) will consist of 134,700 s.f and proposed Lot 2 (2 bedroom dwelling) will consist of 137, 900 s.f of land area meeting the minimum 1 bedroom/10,000 square feet of land area requirement under both state and local regulations for the existing structures. 2. The existing septic leaching facilities for both structures are located within 300' of Griffiths Pond, however, both lots are located downgradient of Griffiths Pond. There are several wetlands (bordering vegetated wetlands and isolated wetlands) located on the property in addition to Griffiths Pond per existing septic plans on file. Further research would be required to determine N:IHealth113aH Decision Letters\Suhdivision Dee isions1409-413 Great Fields Road 04- 07.2021 Agenda Action ]tem Form .docx the capacity to meet the minimum 300' setback to Griffiths Pond and the minimum 100' setback to the vegetated wetlands required by the local regulation. 3. Most current well results on file are dated 2001 with potable drinking water results. N:1HealthlBOH Decision Letters\Subdivision Decisions1409-413 Great Fields Road 04.07.2 021 Agenda Action Item Form. doex 103 VESPER POND DRIVE Brewster Panning Board SOULE LAND SURVEYING BREWSTER, MA 02631 TEL/FAX: (508) 255-4728 RECEIVED MAR 1 7 2024 BREWSTER HEALTH DEPARTMENT Re: Thoburn M. Stamm, Jr. Trust Subdivision Waiver requests Dear Members: We are requesting the following waivers due to the fact that this subdivision: March 17, 2021 1. is creating two buildable lots for the two existing dwellings. 2. There is existing safe and adequate access and utilities. 3. The remaining lots (3 & 4) will be conveyed to the Brewster Conservation Trust to be held as Open Space in perpetuity. Waivers: 1. Plan & profile. 2. All road, drainage, and utility construction. 3. Road bounding. Thank you for your kind consideration. Peter W. Soule, PLS 1084 PETER W. SOULE, PLS REGISTERED PROFESSIONAL LAND SURVEYOR g\\V•t .. R F- W'9 a�41�i rfJ •FC 19 Brewster Planning Board 2198 Main Street Brewster, MA 02631-1898 (508) 896-3701 x 1133 brewplan@brewster-ma.gov FORM C APPLICATION FOR APPROVAL OF A DEFINITIVE PLAN Date & Time Received Town Clerk's Office Please file twelve (12) sets of the completed application along with twelve (12) sets of all required and related materials including ten (10) 11" x 17" sized plans and two (2) 24" x 36" sized plans. Please also provide an electronic copy of the application and pians in pdf format. Date 3/1712021 To the Planning Board: (check one) Application # 6D-1 C-'� The undersigned herewith submits the accompanying Definitive Plan of property located in the Town of Brewster for approval as a subdivision as allowed under the Subdivision Control Law, and the Rules & Regulations governing the subdivision of land of the Planning Board of the Town of Brewster. The undersigned herewith submits the accompanying Definitive Plan of property located in the Town of Brewster for approval of a Subdivision by Special Permit (include Special Permit application of Subdivisions) as required under the Town of Brewster Zoning Bylaws, in compliance with the Subdivision Control Law, and the Rules & Regulations governing the subdivision of land of the Planning Board of the Town of Brewster. Name of Applicant Thoburn M. Stamm, Jr., Trustee phone 508 896 1096 AddreSS 409 Great Fields Road, Brewster, MA 02631 Email cape2janeagmail.corn Owner, if different Phone Address Email Name of Surveyor/Engineer Peter V1!_ s❑uW Pt_S phone 508 255 4728 Company Name Soule land Surveying Address 103 Vesper Pond Dr., Brewster, MA 02631 Email pwsoule@gmail.com Title of Plan Thoburn M. Stamm, Jr. Trust Date of Plan 3/16/2021 s Drawn by Soule Land Surveying Location and description of Property 29.38 AC; property at 409 & 413 Great Fields Road with Assessor's Map 46/34. Revised 05-2018 Definitive Plan Page 1 of 3 Map 46 Lot 34 Total acreage (combined)29.38 Current number of lots 1 Proposed n[Unber of lots 2 buildable, 2 non -buildable Total feet of proposed roadway seaL Zoning District RR Required Frontage 200' Lot Area Required 100,000 s.r. Deed of property recorded in Barnstable County Registry Book 19062 Or Land Court Certificate of Title No. Was a Preliminary Plan submitted? no Please provide a one-page description of the proposal. Page 44 What relief, if any, will be requested from The Town of Brewster Subdivision Rules and Regulations, Chapter 299? Please describe. Waive: Plan & Profile; all road, drainage, & utility construction, road bounding. Will relief be requested from the Zoning Board of Appeals? Please describe. No. Signature of Owner or Authorized Representative If not Owner, please attach Agent Affidavit The undersigned hereby agrees with the Town of Brewster upon approval of the Definitive Plan: 1. To construct the ways and install the municipal services as finally approved by the Planning Board, 2. To design and construct the ways and design and install the municipal services in accordance with the Rules and Regulations Governing the Subdivision of Land, Town of Brewster, Massachusetts, with the rules and instructions of the Board of Health and Water Department, and with the Definitive Plan and its accompanying material as finally approved by the Planning Board. Revised 05-2018 Definitive Plan Page 2 of 3 3. At the laying out and acceptance of said ways all municipal services within the ways will become the property of the Town of Brewster at no cost to said Town, unless otherwise agreed upon. 4. Municipal maintenance services (i.e., snow plowing) will not be available if waivers of road construction is requested. This agreement shall be binding upon the heirs, executors, administrators, successors and assigns of the undersigned. Signature of Applicant/Owner (if not Owner, please atfach Agent Affidavit) Address 409 Neat Fields Road, Brewster, MA 02631 Note- The Agreement and Covenant must be riled along with this application. Revised 05-2016 Definitive Plan P09ti 3 V 3 17 March 2021 Mary Chaffee, Chair Town of Brewster Select Board 2198 Main Street Brewster, MA 02631 36 Red Tole Noad Bl,ewster, M,as achusetts 0263 �JL+ILN, i}rU'41°sfer�;o i���¢r�aii a �'�i.rE.ist.nr�i Re: Requested Waiver of Application Fees Dear Ms. Chafee, On behalf of the Brewster Conservation Trust (BCT), I respectfully request a waiver of application fees associated with the Special Permit SubdNision Application far property located at 409 Great Fields Road (Assessor's Map 46, Lot 34). The proposed subdivision will allow us to put more than 23 -acres of Pine - Oak woodlands and two acres of wetlands into conservation in 2021 and ensure that no new house lots will be created in the future, resulting from our partnership with the owners. This project contributes to many of the purposes, across multiple building blocks, identified in the 2018 Town of Brewster Vision Plan. The protection of this property as Open Space protects an area of critical natural landscape, two ponds — Ed Snow Pond and Griffiths Pond (a Great Pond) and helps maintain the community character of Brewster we all appreciate, Thorburn Stamm and BCT are scheduled to be heard at the April 28, 2021 Planning Board meeting and would appreciate if you could please add this to your Action Items for the next avallable Select Board meeting date. if you need any further information, please let me know. Sincerely, Amy Henderson Executive Director Cc, Brewster Planning Board n� 0"4 w*i " 'Nat S 1 xr way .nfi Lanr y R CR q �lOm= N ` co Av �a A i ❑ W V Q A u O C z mm� o n � c g y 25W 00'OG00� x N � R4 Z aoo"' zaov� � P x N � 1 mum a2fn Ley 0 om a� Q CR q �lOm= j^'7z axe AD 'it T ` y R- t ' �iMD �ppl a � d�1 �5 S iZLZVv ��Z16 0n0 �=50p DoT �xF�z � n r�moNA r zv ozv�o Q me ao a r � A N ` Ft .F7q . m g W V Q A u O C z mm� o n � c g y 25W 00'OG00� x R4 aoo"' zaov� P i'��r 1 mum a2fn Ley 0 om p�m❑S v➢�om - mPn yz09➢F� OC z Mac m a A m gp o m 0 0 a 0 'xn A i 0 A �m C P P Z N 2 o En co &�? 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J r +4.3. u Y 40 k cQ -41 Y f. , Ti t It yy VW `4 f � 1 � Ir ! r COASTAL engineering c©. 260 Cranberry Highway Orleans, MA 02653 508.255.6511 P 508.255.6700 F Orleans I Sandwich I Nantucket TECHNICAL SERVICES coa5talengirneeringcompany.com To: Preservation of Affordable Housing Attn: Mike Fitzgerald 40 Court Street Suite 700 Boston, MA 02108 Subject: King's Landing Apartments 3 State Street Brewster, MA Permit #934-1 []Plans Copy of Letter []Specifications We are sending the following items: Bate: Via: ®Other RECEIVED MAR 2 2 2021 BREWSTER HEALTH DEPARTMENT TRANSMITTAL 03/15/2021 Project No. WBR007.00 ®1st Class Mail Pick up oCertified [ Fed Ex Copies Date No. Description 1 0212021 934-1 Daily Log Sheet 1 02/26/2021 934-1 Annual G Monthly Discharge Monitor Report w/Laboratory Test Results 1 02/08/2021 934-1 Monthly Monitor Well Data Report (Field tested data) 1 03/15/2021 934-1 TDEP Electronic Receipt These are transmitted as checked below: Dor approval ®for your use ®as requested Qfor review & comment ❑ Remarks: Enclosed are the recent reporting forms for the wastewater treatment facility at the above -referenced location. Effluent test results show high levels of Total Nitrogen that exceed the upper discharge limit due to levels of TKN. We will adjust the system settings and use of process control chemicals to help improve treatment of the system, No VOC's were detected during the annual testing of the system. The average daily flow was approximately 10,405 gpd. If you have any questions regarding this report or the WWTF, please do not hesitate to contact us. cc: Brewster Board of health By: Chad A. Simmons, WWTP❑ CC Commission Horsley Witten Group, Inc. AquaPoint,3 LLC NOTE: If enclosures are nut as noted, please contact us at (508) 255-6511 1):\COC\W\WBR\007\TRANsh4rrTALs�TRANSMITTAL (FEBRUARY 2021).00C Orleans I Sandwich I Nantucket COASTAL engineering co. TECHNICAL SERVICES 260 Cranberry Highwa Orleans, MA 0265 508.255.6511 P 508.255.5700 Orlearns I Sandwich I N coastalen gin a eri ngcorn p a ny.co m OR 22 2tT ISI BRBWBTFR�N HEAJ-T DEPAR To: Brewster Town Hall Date: Board of Health Department 2198 Main St Via: Brewster, MA 02531 Subject: Cape Cod Sea Camps 3057 Main Street Brewster, MA GWDP 977-0 7 Plans ❑ Copy of Letter [] Specifications We are sending the following items: 03/15/2021 NSMITTAL Project No. C16845.02 ®ist Class Mail DPick rip L]Certified ]Fed Ex ® other Copies Date No. Description 1 0312021 016845.02 Daily Log Sheet (pH 6 GPD not recorded due to aft season) 1 03/2021 016845,02 Monthly Discharge Monitor Report (plot sampled due to off season) 1 03/15/2021 016845.02 eDEP Electronic Receipt These are transmitted as checked below: Ofor approval ®for your use Das requested for review I7 comment ] Remarks: Enclosed are the recent monthly reporting forms for the system at the above referenced location under GWDP 977-0. The laundry mat has been shut down for the off season and there is currently no flow. With the laundry mat shut down for the off season no flow or pH was able to be recorded and the distribution box was not sampled. Please do not hesitate to contact us if you have any questions or comments. JGS/acc By: John G. Schnaible, R.S. Cc: Ed Barber, Associate Director, Facilities VIA EMAIL: ed@capecodseacamps.Cam VIA EMAIL: nwgarran3367 mail.com NOTE., if enclosures are not as noted, please contact us at (508) 255-6511 Orleans I Sandwich I Nantucket ❑., 1DOC\CI6800\15845.021TronsrniftoIs12a21-03-15 Transmittal {GWDP March 2021}.dor COASTAL engineering co. TECHNICAL SERVICES RECEIVED 260 Cranberry H Orleans, MA 508.255.6511 P 508.25! Orleans I Sandwich I Nantucket ca astalengineerin gcom p any.com MAR 12 2021 =WSTER HEH'� DEPARTMENT To: Brewster Town Hall Date: Board of Health Department 2198 Main St Via: Brewster, MA 02631 Subject: Cape Cod Sea Camps 3057 Main Street Brewster, MA GWDP 977-0 [] Plans [] Copy of Letter El specifications We are sending the following items: 03/05/2021 NSMITTAL Project No. C16845.02 ®1st Class Mail []Pick up []Certified [Fed Ex ® Other Copies Date No. Description 1 0212021 C16845.02 Daily Log Sheet (pH Fy GPD not recorded due to off season) 1 0212021 016845.02 Monthly discharge Monitor Report (Nat sampled due to off season) 1 03/05/2021 016845.02 eDEP Electronic Receipt These are transmitted as checked below: [for approval ®far your use E]as requested Ofor review 6 comment D Remarks: Enclosed are the recent monthly reporting forms for the system at the above referenced location under GWDP 977-0, The laundry mat has been shut dawn for the off season and there is currently no flow. With the laundry mat shut down for the off season no flow or pH was able to be recorded and the distribution box was not sampled. Please do not hesitate to contact us if you have any questions or comments. JGSIacc By: John G. Schnaible, R.S. Cc: Ed Barber, Associate Director, f=acilities VIA EMAIL: ed ca ecodseacam s.com VIA EMAIL: nw arran3367 mail. m (VOTE: If enclosures are not as noted, please contact us of (508) 255-6511 Orleans I Sandwich I Nantucket 0:112aC1C1660d115845.021Transmittais12021-03-05 Transmittal [GWDP February 2021].dac Massachusetts Department of Environmental Protection 599 _..--.................................................. _................._........_...........-..Y..J Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number �._ Groundwater Permit MONITORING WELL DATA REPORT �• Tax identification Number .2021 FEB MONTHLY W ......... 3. Sampling Morith &Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer, use IBREWSTER MANOR only the tab key to a. Name move your cursor - do not use the 873 HARWICH ROAD return key. b. Street Address BREWSTER MA 02631 VQ C. City d. State e. Zip Code 2. Contact information: IM's DAVID FELDMAN W—K a. Name of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Number c. e-mail address 3. Sampling information: 2116!2021 JWHITEWATER a. Date Sampled (mmlddlyyyy) b. Laboratory Name JOHN APREA c. Analysls Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Feb Monthly T - All forms for submittal have been completed. 2.- This is the last selection, I — Delete the selected form. gdpdIs 2015-09-15. doe • rev. 09/15/15 Groundwater Permit Daily Log Sheet - Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT C. Contaminant Analysis Information ■ For "0", below detection limit, less than (<) vaiue, or not detected, enter "ND" ■ TNTC = too numerous to count. (Fecal results only) ■ NS =Not Sampled • DRY = Not enough water in well to sample. 599 1. Permit !+lumber 2. Tax identification Number 2021 FEB MONTHLY 3. Sampling Month re 6e Parameter/Contaminant MWI MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 PK 5.7 [5:4== 5.4 5.8 S.U. sTATic wATER LEVEL 730 379 527 230 FEI=T I Il SPEC;Flc CONDUCTANCE 58.3 58.T.....................................� 532.................... _...._......... i 28.4...................._�� UMHOS/C Well #: 5 Well #: 6 mwdgwp-blank.doc • rev. 09115115 Monitoring Well Data for Groundwater Permit • Page 1 of 1 Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Any person signing a document under 314 CMR 5.14(l) or (2) shall make the following certification if you are filing electronic -ally and want to attach additional comments, select the check box. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit Information REWSTER MANOR 599.... —.... ..... _........ ....� ...— ................... 1. Permit Number 2. Tax identification Number a. Name 873 HARWICH ROAD b. Street Address �. BREWSTER MA 02631 c. City d. State e. Zip Code Certification "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the Information, the information submitted is, to the best of my knowledge and belief, true, accurate and complete. I am aware that the are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations." ELI7ABETH BELAIR 13/17/2 D21 a. Signature h. Date (mmlddlyyyy) gdpols 2415-09-15Aoc • rev. 09115/15 Groundwater Permit • Page 1 of 1 3. Sampling information: 11t 12021 NOT APPLICABLE a. Date Sampled (mmlddlyyyy) b, LaborWory Name IDEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency ............ ............................... _... W....�. _,.................. i Daily Log Sheet - 2021 Jan Daily Y r- All forms for submittal have been completed. 2.- This is the last selection. 3. r Delete the selected firm. gdpols 2015-09-15.doc - rev, 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection t351 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number .................................. ............ Groundwater Permit DAILY LOG SHEET 2. Tax idertGfic.... Number ;2021 JAN DAILY 3. Sampling Month $ Frequency A. Facility Information Important:when filling out forms on 1, Facility name, address: the computer, use 1MAPLEWDOD AT 8REW5TER only the tab key to a Name move your cursor - -._..._..-..-. -. ._... _.... _... 113206HARWICH ROAD _ ,,-,..... .._. do not use the return key. b. Street Address IaREWSTER . (iA... - 631 C' city d. State e. Zip Code 2. Contact information: r�xn JOSEPH SMITH a. Name of Faculty Contact Person f7742125 h@NSUWater.cam b. Telephone Number C. e -mall address 3. Sampling information: 11t 12021 NOT APPLICABLE a. Date Sampled (mmlddlyyyy) b, LaborWory Name IDEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency ............ ............................... _... W....�. _,.................. i Daily Log Sheet - 2021 Jan Daily Y r- All forms for submittal have been completed. 2.- This is the last selection. 3. r Delete the selected firm. gdpols 2015-09-15.doc - rev, 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 11951 ..... Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number ............. . Groundwater Permit z. Tax identification Number iDAILY LOG SHEET I 2021 JAN DAILY t 3. Sampling Monlh & Frequency C. Daily Readings/Analysis information Date Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine LIV Flow GPD Flow GPD Flow GPD pH Residual Intensity (mgll) M.) gdpols.doc • rev- 68/75/15 Groundwater Permit Daily Lag Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Nurn her Groundwater Permit DISCHARGE MONITORING REPORT 2. Tax ideritificalinn Number 2021 JAN MONTHLY 3. Sampling Month & Frequency 3, Sampling information: 11I2812021 ALPHA ANALYTICAI-'-- a, hate Sampled (nurdddlyyyy) h. Laboratory Name ALPHA ANALYTICAL PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Foran Type and Sampling Month & Frequency .......... __...................................... . . Discharge Monitoring Report - 2021 Jan Monthly r- All forms for submittal bave been completed. 2, r This is the last selection. A. r Delete the selected form. gdpdis 2015-09.15.doc • rev. 09/15115 Groundwater Permit Daily Log Sheet • Page 1 of 1 A. Facility Information Impct'tant:When filling out forms on I. Facility name, address: the computer, use ----0 —..._.,..... JMAPLEWODD AT BREWSTER __.._.... ..................._._..,.,.. only the tab key to a. Name move your cursor - r .................. __ ....... 1820 HARWICH RQAD -- •--°w--_ _.....,,� do not use the return key. b- Street Address JBREWSTER AD�1fi31 Q G. city d. State e. Zip Code 2. Contact information: ISM JOSEPH SMITH a. Name of Facility Contact Person f7i4212 b. Telephone Number c. e-mail address 3, Sampling information: 11I2812021 ALPHA ANALYTICAI-'-- a, hate Sampled (nurdddlyyyy) h. Laboratory Name ALPHA ANALYTICAL PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Foran Type and Sampling Month & Frequency .......... __...................................... . . Discharge Monitoring Report - 2021 Jan Monthly r- All forms for submittal bave been completed. 2, r This is the last selection. A. r Delete the selected form. gdpdis 2015-09.15.doc • rev. 09/15115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Numbor DISCHARGE MONITORING REPORT 2021 JAN MONTHLY Ll j 3, Sampling Month & FregUoncy D. Contaminant Analysis information • For 7', below detection limit, less than (c) value, or not detected, enter "N D" ■ TNTC = too numerous to count. (Fecal results only) • NS = Not Sampled 7. ParameterfGontaminant 2. Influent Units am 52[i rvxc�,t_ rss q10 h9G+t TOTAL SOLIDS ............ ... _ 670 ............ .. ......................... MG,L AMMONIA -N ................................. . 1e.7 ...... _......... McIrt- NITRATE -N MGR_ TOTAL NITROGEN(NO3+NO2+TKN) MGL OIL & GREASE Val 3. Effluent 17 23 4. Effluent Method Detection limit 5.0 1D infeffrp-bfank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Important:when filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. r�mrn Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT A. Facility Information 1. Facility name, address: WPLEWOOD AT BREWSTER a. Name 1820 HARWICH ROAD b. Street Address 1BREWSTER c. City 2. Contact information: 951 1. Permit Number 2. Tax identiCcation Number 2621 JAN MONTHLY 3. Sampling Month & Frequency ...._.._......... ___ .__ . ................. IMA 102631 d. State e. Zip Code POSEPH SMITH a_ Name of Facility Contact Person 7742125045—�.".... .�....__.__. _..._.._ jsi nith�idSUWater.com b. Telephone Number c. e-mail address 3. Sampling information: ill 812 02 1 NOT APPLICABLE a. Date Sampled (rnmlddlyyyy) b. laboratory Name FBEA NSLI PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency I Monitoring Well Data Report - 2021 Jan Monthly r — All farms for submittal have been completed. l� 2. — This is the last selection. 3, Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Lag Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 951 _. .. ............ ................ ................... . ... ....... ......... . Bureau of Resource Protection -Groundwater Qischarge Program 1. permit um e Groundwater Permit 2, Tax identification Number MONITORING WELL DATA REPORT 2021 JAN MONTHLY . 3. sarnpling Month & Frttquency L1.1 1, . . C. Contaminant Analysh information • For "4", below detection limit, less than (<) vaiue, or not detected, enter "ND" ■ TNTC = too numerous to count. {Fecal results only} • NS =Not Sampled • DRY = Not enough water in well to sample. N1W-2 MW -3 UW -4 parameterlCantaminant MW-1 Well #: 4 Units Well #:1 Well #: 2 Well M 3 PH .5.52 .5AI 6.13 ..... 5,20 S U. .32.99 33.02 STATIC WATER LF-VEL.33,99 32.93 FEET SpECIF1C CONDUCTANCE 74.6 155.6 318.9 98.9 UMHDJC C Well #:5 e Well #: 6 Monitoring Well Data for Groundwater permit • Page 1 of 1 m,r,,dgWp-blank.doc •rev. 09/ 15115 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number .. .... .. Groundwater Permit 2. Tax identification Number Facility Information Important:When — __........_...___._.,.M.... .MAPLEWOOD AT BREWSTER filling out forms on a. Name the computer, use.......... only the tab key to 1826 HARWICH ROAD move your cursor - b. Street Address do not use the 61kEWSTER IMA [0263'1 return key. c, City d. Stats e. Zip Code Certification r� "I earthy under penalty of law that this document and all attachments ware prepared under my direction or supervislon in accordance with a system design ad to assure that qualified personnel properly gather and evaluate the information submitted. Based an my inquiry of the person or persons who manage the system, or those persons directly responsib]a for gathering the A¢f71 informatlon, the information submitted is, to the best of my knowledge and bellef, true, accurate and complete. I am aware that the are significant penalties for submitting false Information, including the passlbility of fine and imprlsanment for knowing violations" .. ._........ .. -. SAMANTHA FARRENKOPF 12128/2021 Any person signing a document under 314 CMR 5.14(1) or (2) shall make the foi lowing certification If you are fling electronic -ally and want to attach additional comments, select the check box. a- Signature artingPackage Comments b. hate (mmlddlyyyyj VETT ENVIRONMENTAL, ASSOCIATES, LLC. (BEA) HAS COMPLETED THE JANUARY 2021 THLY INFLUENT AND EFFLUENT SAMPLING OF THE BIOCLERE WASTEWATER NTMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 112$12021. )RECTORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT -ATIONS, EFFLUENT PH WAS REPORTED WITHIN THE 6.5 TO 8.5 RANGE THROUGHOUT MONTH. FLOW VOLUME MEASUREMENTS WERE ASSESSED DURING THE MONTH M THE SYSTEM'S EFFLUENT FLOW METER. DAILY FLOW REMAINED WITHIN THE 10 -GPD LIMITATION THROUGHOUT THE MONTH. THE MINIMUM, MAXIMUM AND AVERAGE FLOWS REPORTED OVER THE COURSE OF THE MONTH WERE 898 GPD, 3,501 GPD 1,798 GPD. RESPECTIVELY. gdpdIs 2015-09-15.doc • rev- 09/15/15 Groundwater Permit - Page 1 of 1 Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit DAILY LOG SHEET. Tax identification Number 2021 JAN DAILY 3. Sampling Month K Frequency A. Facility Information 1mportant:When filling out forms an 1. Facility name, address: the computer, use PLEASANT BAY HEALTH CTR - only the tab key to a. Name move your cursor ............... do not use the h83 SOUTH ORLEANS ROAD return key. b- Sheet Address BREWSTER MA 2631 tip C. City d. State e. Zlp Cade 2. Contact information: J26171&A� ._._.......... ., .............. JOSEPH SMITH . . . a. Name of Facility Contact Person 77a2125ao� ..._ _._. jsrn th@ N 5 U Water.sarn b. Telephone Number c. e-mail address 3. Sampling information: 11112021 NOT APPLICABLE a. Date Sampled (mmlddlyyyy) b. Laboratory Name (8EA NSU PERSONNEL c. Analysis Park med By (Name) B. Farm Selection 1. Please select Form Type and Sampling Month & Frequency Daily Lag Sheet - 2021 Jan Daily — All forms For submittal have been completed. 2. 1- This is the last selection. 3, 1- Delete the selected farm. gdpols 2015-09-15.doc • rev. D9115115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental roec lan 746 ................... j Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number S Groundwater Permit 2. Tax identification Number DAILY LOG SHEET 2021 JAN DAILY Ll i 3, Sampling AAanth & Frequency C. Daily Readings/Analysis Information Date 1 2 3 4 5 6 7 a 9 10 11 12 13 14 15 16 17 1s 19 20 21 22 23 24 25 26 27 28 29 30 31 Effluent Reuse Irrigation Turbidity Influent pH Effluent Flow GPD Flow GPD Flow GPD PH 16597 16597 16597 90576 17614 17935 14892 12591 12591 12591 15055 14114 13'167 ................ 12543 12877 12877 12877 ;15183 15130 16909 19358 12056 j12056 12056 t12725 ._., ::...... ... €11470 '14498 `15886 13393 13393 13393 7.9 7.9 :::........: 7.3 7.4 7.3 7.2 6.9 ._... 6,9 gdpdIs.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 I� Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater ❑Ischarge Program 1. Permit Number ......................... Groundwater Permit DISCHARGE MONITORING REPORT 2. Tax iWentification }umber 2021 JAN MONTHLY Ll ................ 3.5ampling Month &f=requency 3. Sampling information: .......... 1/8/2021 �,�..._... .....,w ...�. ALPHA ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name ........_........................................................ ALPHA ANALYTICAL PERSONNEL C- Analysis Performed By (Name) B. Form Selection 1. Please select Farm Type and Sampling Month & Frequency ............................. --- ................ .. -... _.. ......... ... ........................................... ...... Discharge Monitoring Report - 2021 Jan Monthly C- All forms for submittal have been completed. 2. This is the last selection. r 3, — Delete the selected iorm. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 A. Facility Information Important: W hen filling out forms on 1. Facility name, address: the computer, use IPLEASANT BAY HEALTH CTR only the tab key to a Name move your cursor - 383 __...SO.......UTH.... ORLEANS ....— ROAD,---,—...._..-.............-� .__ ._,....,,.._ �.-. do not use the return key. b. Street Add rass 1BREWSTER �Nl1AA 02f,31 VQ c. Clty d. State e. Zlp Cade 2. Contact information: _. .. H ...... SM_.ITH_. ., .,,... . __-..,.....,� _ _. .............. JOSEP a. Name of Facility Contact Person 7742125005 'jsmith@NSUWater.com b. Telephone plumber e, a -mall address 3. Sampling information: .......... 1/8/2021 �,�..._... .....,w ...�. ALPHA ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name ........_........................................................ ALPHA ANALYTICAL PERSONNEL C- Analysis Performed By (Name) B. Form Selection 1. Please select Farm Type and Sampling Month & Frequency ............................. --- ................ .. -... _.. ......... ... ........................................... ...... Discharge Monitoring Report - 2021 Jan Monthly C- All forms for submittal have been completed. 2. This is the last selection. r 3, — Delete the selected iorm. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 .. Massachusetts Department of Environmental Protection 746...... . Bureau of Resource Protection - Groundwater Discharge Program 1. Perm=it Number Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT -2021 JAN MONTHLY Ll ._......_...................... 3. Sampling Month & FregUOAGy D. Contaminant Analysis Information ■ For 10", below detection limit, fess than (<) vaIuc, a not detected, enter "ND" • TNTC = too numerous to count. (Fecal results only) ■ NS = Not Sampled 1. Paramater/Contaminant 2. influent Units 4.450 BM 250 MC -0t T55 920 MCI_ _ ........................... ........ 1.0 TOTAL SOLIDS 5560 MG -1 AMMONIA -N .5 .78 M01- NITRATE -N Nec1L TOTAL NITR0GEN(ND3+NO2+TKN) A1C4 OIL & GREASE PIII( i. FECAL COLIFORM 1100 ML. CHLORIDE MCAL infeffrp-blank.doc • rev. 09115/15 3. Effluent 4. Effluent Method Detection limit 8.1 .2.0 ND 5-0 230 10 3.5 0.10 3.93 4.450 Nb ............ .. 4.0 ... .......................... 3.0;2.Q 141 _ ........................... ........ 1.0 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection :745 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identi0cation Number MONITORING WELL DATA REPORT 2021 JAN MONTHLY L-_ 3. Sampling Month & Frequency gdpdIs 2015-09-15.dor, • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 A. Facility Information ImporLent:When filling out forms on 1. Facility name, address: the computer, use PLEASANT BAY HEALTH CTR only the tab key to a. Name move your cursor -_ . --. .. ............. j383 SCUTH ORLEANS ROA[] da not use the return key. b. Street Address _,........--_-..._...................................�.................. _ _,...- jSREWSTER MA2631 ................. ..._.... -.......... .� {— c. City d. State a, Zia Cade 2, Contact information: 1�6' jJOSEPH SMITH _ ..__..._ a. Name of Facility Contact Person 7742125005�-�.� �rnith@NSU Water,com b. Telephone Number e. a -mail address 3. Sampling infonnation: NaT APPLICABLE a. Date Sampled (mrrVd&yyyy) b. Laboratory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency _....._._..., ........................... rManitoring Well Data Report - 2421 Jan Monthly ........... _ ........_ F- All forms for submittal have been completed. r 2, This is the last selection. 3, F Delete the selected form, gdpdIs 2015-09-15.dor, • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 ........... .... ......... ... Massachusetts Department of Environmental Protection i74g Bureau of Resource Protection - Groundwater Discharge Program 1, Permit Number ;. Groundwater Permit 2; Tax identification Number ................. MONITORING WELL DATA REPORT 2t}21 JAN MONTHLY 3. Sampling !Month & Frequency C. Contaminant Analysis Information • For "0", below detection limit, less than (<) value, or not detected, enter "NO" • TNTC = too numerous to count. (Fecal results only) • NS= Not Sampled • DRY = Not enough water in well to sample. ParameterlContamInonI DG -1 DG -2 DGA UG -1 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 ............... .......... PH :5.98 6.51 6.42 5.85 Su, STATIC WATER LEVEL 11,71 11.71 11.62 12.76 IES SPECIFIC CONDUCTANCE .228,6 318.1 350.7 137.0 JMH;aru Well #: 5 C Well #: 6 mwdgwp-blank.doC • rev. 09/15/15 Monitoring Well Hata for Groundwater Pormit • Page 1 of 1 Massachusetts Department of Environmental Protection 746 Sureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax ideniifscation Number Facility Information Importarlt:When PLEASA..NT SAY ~ EALTH CTR _ ANT -- filling out Forms an a. Mame the computer, use 383 SOUTH ORLEANS ROAD -.... _.. only the tab key to accordance with a system designed to assure that quallfed personnel properly gather and evaluate the information submitted. move your cursor - b. Street Address do not use the 113R,EWSTER MA 102631 return key. c. City d. State e. Zip Code gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 Certification "I certify under penalty of law that this document and a0 attachments were prepared under my direction or supervislon in accordance with a system designed to assure that quallfed personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persuns directly responsible for gathering the �rvn infarm at'wn, the Information submitted Is, to the best of my knowledge and bel lef, true, accurate and complete. I am aware that the are signifGant penalties for submitting false Infom'Wion, including the possibility of Fine and imprisonment for knowing violations." SAMANTHA FARRENKOPF 12/13/2021 Any person signing a. Signature 6. Data Imrrdddlyyyyj a document under 314 CMR 5.14(1) or ng Package Comment's (2) shall make the ..epi following BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (BEA) HAS COMPLETED THE JANUARY 2021 certification MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE AMPHIDROME WASTEWATER TREATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 11812021. If you are filing LABORATORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT electronic -ally and LIMITATIONS. EFFLUENT PH WAS REPORTED AS GREATER THAN THE 8.5 LIMIT ONCE want to attach DURING THE MONTH. FLOW VOLUME MEASUREMENTS WERE ASSESSED DURING THE additional MONTH FROM THE SYSTEM'S EFFLUENT FLOW METER. DAILY FLOW REMAINED WITHIN THE 26,500 -GPD LIMITATION THROUGHOUT THE MONTH. THE MINIMUM, MAXIMUM AND comments, select AVERAGE GPD FLOWS REPORTED OVER THE COURSE OF THE MONTH WERE 10,576 GPD, the check box. 119,358 GPD AND 14,181 GPD, RESPECTIVELY. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DAILY LOG SHEET A. Facility Information . Facility name, address: ............ ._._.. {MAPLEWOOD AT BREWSTER _..._ .... . a. Name 1820 HARWICH ROAD b. Street Address IBREWSTER SMA C, Clty d. State 2. Contact information: . '951 1. Permil Number 2_ Tax identification Number 2021 FES DAILY 3. Sampling fAonth & Frequency ;02631 e. Zip Code ,............ . _ ..._._ . POSEPH SMITE# a. Name of Facility Contact Person T142'125005_ t_ .............._.. jjsm ith@ fV 5 U Wate r. co rn b. Telephone Number c. e-mail address 3. Sampling information: ... I ................... _._...... .... ....... ..... .......... _.._.......... . _... 12/1/2021 INOT APPLICABLE a. Date Sampled (mrnlddlyyyy) b. Laboratory Name ................................................................ JBEA NSU PERSONNEL c. Anaiysfs Performed By [Name] B. Form Selection 1. Please select Form Type and Sampling Month & Frequency ..... .. _ _..�.............. _...,,......... ... Daily Log Sheet - 2021 Feb Daily �I - All Corms f'or submittal have been completed. 2. r This is the last selection. r 3. -- Delete the selected form. gdpols 2015-09-15.doe • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1s 16 17 1B 19 20 21 22 23 24 25 26 27 28 29 30 31 Massachusetts Department of Environmental Protection .1951 Bureau of Resource Protection - Groundwater Discharge Program 1- Permit Number Groundwater Permit z, Tax identification Num r .................................................. DAILY LOG SHEET 2021 FEB DAILYf .................. 3. Sampling Month & Fwuency C. Daily Readings/Analysis Information Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine UV Flow GPD Flaw GPD Flow GPD pH Residual Intensity (mgll) 878 1383] 1019 1166 958 958 958 ............,r 1303 1926 994 ....,.,..W ::3 1097 960 - 960 sso .-_:-i M 1126 ..... ..... ;1329 '1169 1104 1104 1104 ................ 1230 1209 1002 697 347 .347 347 ....... -- 6.8 _............ . 6.9 1. 6.8 7.0 ........... ........ ....... _............. ' 6.9 B.9 I ; .......... 8.8 6.9 E... i 6.9 7.0 i .................. q $.9 6.9 x 6 8 6.7 7.0 8.8 W_. .:.........:.... .. .................. _ 16.8 1 7.0 i .................. 8.8 7.0. i ........... i 6.7 s.s 1 6.8 6.9 ............ 1 16,8 7.1 '- 6.7 7. ......... =6.8 7,0 ........ _......._......_._... !8.8 .::::::::::m. 7.0 _ IW _ s.8 s.s _ ... - 7.0 7.0 6.9 7.2 _ _, 6.$ I _ _ _ 7.1 - ............... __. - ---- ----- _ _ . ......... .... ...... �..._.........._ 1 f gdpdis.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 :.. Massachusetts Department of Environmental Protection s51 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit DISCHARGE MONITORING REPORT 2• Tax idenliftC3tian Number .2021 FEB MONTHLY 3. Sampling Month 6 Frequency A. Facility Information Important:W hen filling out forms on t. Facility name, address; the computer, use 'E_ W �................ .ww„„„.,,„„„�„, MAPLEWOOD AT SREWSTER --. -........... w._ . ......... only the tab key to a. Name move your cursor -_.._.................... 820 HARWICH ROAD _...._ do not use the return key. b. Street Address jBREWSTER jMiA Z$31 C. City d. State e. Zlp Code 2, Contact information: _.. SEP. E'P'- H S.......... MITH ............. ........ ............_ _... JO � ..... �......................... _...,M.....-.. - a. Name of Facillty Contact Parson ...._ - 12 . _........_ . _ 7742 5005 _. ... ._................. _.. ._ ... ........... smith@NSUWater,com b. Telephone Number c, e-mail address 3. Sampling inforrnation- 25!2029 JALPHA ANALYTICAL a. Date Sampled (mmlddlyyyy) b. t_attorak" Name LPHA ANALYTICAL PERSONNEL c- Analysis Performed By (Name) B. Form Selection 1. Please se lee[ Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Feb Monthly r All forms for submittal have been completed, r 2, — 'Phis is the last selective. r 3. -- Delete the selected form.. gdpols 2015-09-15.doc • rev, 09/15195 Groundwater Permit Daily Lag Sheet • Page 1 of 1 ...................... . Massachusetts Department of Environmental Protection 9a1 Bureau of Resource Protection - Groundwater Discharge Program 1. perrni! NUii6-or y Groundwater Permit 2. Tax identificalion Nomber DISCHARGE MONITORING REPORT 2021 FEB MONTHLY I Sampling Morith & Frequency D. Contaminant Analysis Information ■ Far "0", below detection limit, less than (<) value, or not detected, enter "N D" • TNTC = too numerous to count. (Fecal results only) • NS = Not Sampled 1. Parameter/Contaminant 2. Influent 3. Effluent 4. Effluent Method Detection limit Units BOD 441) 26 5.0 N'G.'L TSS 180 21 14 r,nG,t TOTAL SOU DS 1'500 .............. . MGL ....... ............ AMMONIA -N 14.6 MGR. NITRATE -N 0,11 0.10 MG1 TOTAL NITROGEN{NO3+NO2+TKNy 6.67 0.760 P,1G,L OIL & GREASE ND 4,0 MC31L infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 1 Massachusetts Department of Environmental Protection 951 Bureau of Resource Protection- Groundwater Discharge Program 1. Permit Number Groundwater Permit MONITORING WELL DATA REPORT 2. Tax identification Number 2021 FEB MONTHLY L1. 3. Sampling Month & Frequency 3. Sampling information: ...... _........................ I NOT APPLICABLE a. Date Sampled (mrrdddlyyyy) b. Laband” Name 113EA NSU PERSONNEL c, Analysis Performed By (Name) B. Form Selection 1. Please selcet Form Type and Sampling Month & Frequency Monitoring WeII Data Report - 2021 Feb Monthly i All forms for submittal have been completed. 2, r— This is the last selection. r 3. — Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 A. Facility Information Important:wnen filling out forms on 1. Facility name, address; the computer, use . ... . ......................................... ._ +MAPLEWOOD AT 13REWSTER �.. . .._... .......... .............. _.. _..... ...... ....... only the tan key to a Name move your Cursor - 820 HARWICH ROAD do not use the return key. n_ Street Address BREWSTER �3t TT ... C. City d, state e. Zp Code 2. Contact information; rears�..... JOSEPH SMITH .........�..,.......�....�... a. Name of Fac IIIty Contact Parson ....... .. _... ._..._........ 17742125005 � ..„. Fjsmith?NSUWater.cnm n. Telephone Number c. e-mail address 3. Sampling information: ...... _........................ I NOT APPLICABLE a. Date Sampled (mrrdddlyyyy) b. Laband” Name 113EA NSU PERSONNEL c, Analysis Performed By (Name) B. Form Selection 1. Please selcet Form Type and Sampling Month & Frequency Monitoring WeII Data Report - 2021 Feb Monthly i All forms for submittal have been completed. 2, r— This is the last selection. r 3. — Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 I 1 Massachusetts Department of Environmental Protection 195, 1 Bureau of Resource Protection - Groundwater Discharge Program 9. Permit Number L 1 Groundwater Permit. rax identification Number MONITORING WELL DATA REPORT2x21 FEB MONTHLY 3. Sampling Month & Frequency C. Contaminant Analysis Information . For "4", below detection limit, loss than (<) value, or not detected, enter "ND" ` . TNTC = too numerous to count. (Fecal rosults only) + NS = Not Sampled + DRY = Not enough water in well to sample. Parameter/Contaminant MW -1 MW -2 MW -3 MW -4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 ........ PH 6.27 6.12 6,23 5.86 .......... S.U. STATIC WATER LEVEL 33.69 32.8332.92 ............. . w. ................ 32.99 �. l FEET ..................................... SPECIFIC COt CIUCTANCE $4.8 152.9 ;388.2 87.2 ................. LiMHOS.'C mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data for Groundwater Permit • Page 1 of 1 I Massachusetts Department of Environmental Protection 351 i Bureau of Resource Protection - Groundwater Discharge Program 'I. Permit Number ............. Ll Groundwater Permit 2. Tax identification Number Facility Information Important:When....__...- ............................. . . MAPLEWOOQ AT BREWSTER filling out farms on a Name the computer, use only the tab key to 1820 HARWICH ROAD move your cursor - b. Street Address do not use the !BREWSTER MA (02631 return key. c. City d. State e. Zip Code gdpols 2015-09-15.doc - rev. 09/15/15 Groundwater Permit • Page 1 of 1 Certification ria "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that q ual i 11 ed personnel property gather and evaluate the into rmRtJ on submitted. based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, W the best of my knowledge and belief, true, accurate and complete. I am aware that the are significant penalties for submitting false information. including the possibility of fine and imprisonment for knoWng violations:' ............ ...... ....... .. __...... _.._ )SAMANTHA FARRENKOPF 31101262f Any person signing a. Signature b- Date (mmlddlyyyy) a document under 314 CMR 5.14(1) or RL eporting Package Comments (2) shall make the .. __.....__. following BENNETT ENVIRONMENTAL ASSOCIATES, LLC, (BEA) HAS COMPLETED THE FEBRUARY certification 2021 MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE BIOCLERE WASTEWATER TREATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 212512021. If you are filing LABORATORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT electronic -ally and LIMITATIONS. EFFLUENT PH WAS REPORTED WITHIN THE 6.5 TO 8.5 RANGE THROUGHOUT want to attach THE MONTH. FLOW VOLUME MEASUREMENTS WERE ASSESSED DURING THE MONTH FROM THE SYSTEM'S EFFLUENT FLOW METER. DAILY FLOW REMAINED WITHIN THE additional 119 800_GPD LIMITATION THROUGHOUT THE MONTH. THE MINIMUM, MAXIMUM AND AVERAGE comments, select ;GPD FLOWS REPORTED OVER THE COURSE OF THE MONTH WERE 347 GPD, 1,926 GPD the check box. AID 1,026 GRD, RESPECTIVELY. gdpols 2015-09-15.doc - rev. 09/15/15 Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DAILY LOG SHEET 2021 FEB DAILY LL1. 1 3. Sampling Month & Frequency 3. Sampling information - F2/112021 a. Data Sampted (mmhi IM) 116EA N86 PERSONNEL c. Analysls Performed By (Name) SMA � 2531 ---T_ d. State e. Zip Code usmith@NSLAtVater.com C. e-mail address JNOT APPLICABLE b. laboratory Name B. Form Selection 1, Please select Form Type and Sampling Month & Frequency f Daily Log Sheet - 2021 Feb Daily r All forms for submittal have been completed. 2. r This is the last selection - 3. r Delete the selected form, ., gdpols 21715-09-15.doc • rev- 09/15/15 Groundwater Permit Daily Log Sheet • Page I of 1 A. Facility Information Ir►lpartant:when filling out forms on 1. Facility name, address: the computer, use IPLEASANT BAY HEALTH CTR only the tab key to a. Name move your cursor- - •—• --- j383 SD[JTH ORLEANS ROAD do not use the return key. b- Street Address JBREWSTER C- City 2. Contact information: rafnna W'9EPH SMITH a. Name of Facility Contact Person 7742125005 b. Telephone Number 3. Sampling information - F2/112021 a. Data Sampted (mmhi IM) 116EA N86 PERSONNEL c. Analysls Performed By (Name) SMA � 2531 ---T_ d. State e. Zip Code usmith@NSLAtVater.com C. e-mail address JNOT APPLICABLE b. laboratory Name B. Form Selection 1, Please select Form Type and Sampling Month & Frequency f Daily Log Sheet - 2021 Feb Daily r All forms for submittal have been completed. 2. r This is the last selection - 3. r Delete the selected form, ., gdpols 21715-09-15.doc • rev- 09/15/15 Groundwater Permit Daily Log Sheet • Page I of 1 Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater i?ischarge Program 1. Permit Number Groundwater Permit 2. Taxidentification Number DAILY LOG SHEET 2021 FEB DAILY Ll 3. Sampling Month & Frequency C. Daily Readings/Analysis Information Date 1 2 3 4 5 6 7 8 9 10 til 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Effluent Reuse Irrigation Turbidity influent pH Effluent Chlorine W Flow GPD Flow GPD Flow GPD pH Residual Intensity (m911) V/6) 14470 10330 13200 19392 14031 14031 14031 12793 16092 22507 10728 I 14348 14348 14348 12771 15182 17555 17405 18362 18362 18362 J 14283 14705 13063 f 8717 16265 16265 16265 7.2 7.3 7.3 7.0 7.0 7.2 4 7.6 J 66.6 74.3 69.2 74.3 71.9 74.8 J 66.7 66.7 J &9.5 1 66.7 J 66.7 69.1 66-7 74.2 66.7 66.6 66.6 66-7 74.4 J 67.3 _.J gdpols-doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program �. Groundwater Permit DISCHARGE MONITORING REPORT 3. Sampling information: 746 1. Permit Number 2. Tax identification Number 2021 FEB MONTHLY I Sampling Month & Frequency 102531 e. Zip Code lismith@NSL)Water.com c. a -mail address 2/312021 — r PHA ANALYTICAL a Date Sampled (mmlddlyyyy) h. Laboratory Name IM PHA ANALYTICAL PERSONNEL c. Analysis Performed By (Name) B. Farm Selection 1. Please select Form Type and Sampling Month & Frequency 1 Discharge Monitoring Report - 2021 Feb Monthly .; rAil farms for submittal have been completed. 2. r- This is the last selection. r 3. — Delete the selected form. gdpols 2015-179-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 A. Facility Information lmportant:when filling out forms on 1. Facility name, address: the computer, use IPLEASANT BAY HEALTH CTR only the tab key to a. Name move your cursor - -- — 1383 SOUTH ORLEANS ROAD do not use the return key. b. Street Address [BREWSTER IMA C. City d-state 2. Contact information: r OSEPH SMITH a. Name of Facility Contact Person 17742125005 b. Telephone Number 3. Sampling information: 746 1. Permit Number 2. Tax identification Number 2021 FEB MONTHLY I Sampling Month & Frequency 102531 e. Zip Code lismith@NSL)Water.com c. a -mail address 2/312021 — r PHA ANALYTICAL a Date Sampled (mmlddlyyyy) h. Laboratory Name IM PHA ANALYTICAL PERSONNEL c. Analysis Performed By (Name) B. Farm Selection 1. Please select Form Type and Sampling Month & Frequency 1 Discharge Monitoring Report - 2021 Feb Monthly .; rAil farms for submittal have been completed. 2. r- This is the last selection. r 3. — Delete the selected form. gdpols 2015-179-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report - Page l of 1 Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater CAscharge Program 1. Permit Number Groundwater Permit 2_ Tax identification Number DISCHARGE MONITORING REPORT 2021 FEB MONTHLY 3, Sampling Month & Frequency D. Contaminant Analysis Information • For "0", below detection limit, less than (<) value, or not detected, enter "ND" ■ TNTC = too numerous to count. (Fecal results only) ■ NS = Not Sampled 1. Parameter/Contaminant 2. Influent 3, Effluent 4. Effluent Method Units Detection limit BOD iso NE) 2.0 MGdL TSS 60 ND 5.0 MCML TOTAL SOLIDS .410 240 10 MGL AMMONIA -N 8.73 MGrL NITRATE -N 3.8 � •�a __ MGL TOTAL NITROGEN(NO3+NO2+TXN) 4,56 i 19A50 C MGA- GLOIL OIL& GREASE ND 3.6 MGL FECAL COLIFORM ND 2.4 1100 ML CHLORIDE 43 1.0 MGL infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report - Page l of 1 Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit Ll MONITORING WELL DATA REPORT 2. Tax identification Number 2029 FEB MONTHLY I Sampling Month & Frequent a. Name of Facility Contact Person [77421-25005 b. Telephone Number 3. Sampling information: 1212021 a. bate Sampled (mmlddlyyyy) 113EA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection IMA 102631 d. State e. Zip Code li s m it hd NS L1Water. 0-0-M c- e-mail address MOT APPLICABLE" b. Laboratory Name 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report- 2021 Feb Monthly r All forms for submittal have been completed, 2.SO- This is the last selection, I- 3. — Delete the selected form. gdpols 2615-09-15.doc • rev. 09/15115 Groundwater Permit Daily Log Sheet • Page 1 of 1 A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer. use JPLEASANT BAY HEALTH CTR only the tab key to a. Name move your cursor - I 3 -S— OUTH ORLEANS ROAD do not use the return key. b. Street Address IBREWIISTER V City 2. Contact information: '+JOSEPH SMITH a. Name of Facility Contact Person [77421-25005 b. Telephone Number 3. Sampling information: 1212021 a. bate Sampled (mmlddlyyyy) 113EA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection IMA 102631 d. State e. Zip Code li s m it hd NS L1Water. 0-0-M c- e-mail address MOT APPLICABLE" b. Laboratory Name 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report- 2021 Feb Monthly r All forms for submittal have been completed, 2.SO- This is the last selection, I- 3. — Delete the selected form. gdpols 2615-09-15.doc • rev. 09/15115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Ll Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT 2021 FEB MONTHLY 3, Sampling Monlh & Frequency C. Contaminant Analysis Information • For "0", below detection limit, less than (<) value, or riot detected, enter "ND" ` • TNTC = too numerous to count. (Fecal results only) • NS =Not Sampled • DRY = Not enough water in well to sample. ParameterlContaminant OG -1 DG -2 DG -4 UG -1 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 PH 5.81 6.80 6.69 6.27 s.0 STATIC WATER LEVEL 11.71 11.71 11.$2 12.16 FEET SPECIFIC CONDUCTANCE 234.5 213.9 357.7 129A UMHosfc mwdgwp-blank.doc • rev. 09115/15 Monitoring Well Data for Groundwater Permit • Page 1 of 1 ill Important: When filling out forms on the computer, use only the tab key to move your cursor do not use the return key. Any person signing a document under 314 CMR 5.14(1) or (2) shall make the following certification If you are filing eiectronic-ally and want to attach additional comments, select the check box. F - Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit Facility Information [PLEASANT BAY HEALTH CTR a. Name 1383 SOUTH ORLEANS ROAD b. Street Address JBREWSTER C' City 745 1. Permit Number 2. Tax identification Number IMA 102831 d. State e. Zip Code Certification "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of tha person or persons who manage the system, or those persons directly responsible for gathering the informatlon, the information submitted is, to the best of my knowledge and belief, true, accurate and complete. I am aware that the are significant Penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations." �MANTHA FARRENKOPF 1319!2021 a. Signature Reporting Package Comments 6, date (mm/dd/yyyy) BENNETT ENVIRONMENTAL ASSOCIATI=S, LLC. (BEA) HAS COMPLETED THE FEBRUARY 2021 MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE AMPHIDROME WASTEWATER TREATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 21312021. LABORATORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT LIMITATIONS. EFFLUENT PH WAS REPORTED WITHIN THE 8.5-8.5 RANGE THROUGHOUT THE MONTH, FLOW VOLUME MEASUREMENTS WERE ASSESSED DURING THE MONTH FROM THE SYSTEM'S EFFLUENT FLOW METER. DAILY FLOW REMAINED WITHIN THE 26,500 -GPD LIMITATION THROUGHOUT THE MONTH. THE MINIMUM, MAXIMUM AND AVERAGE GPD FLOWS REPORTED OVER THE COURSE OF THE MONTH WERE 8,717 GPD, 22,507 GPD AND 15,079 GPD, RESPECTIVELY. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit • Page 1 of 1