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BOH10621packet
E W rri F� o o c' ►- : _ .. 'HCaHpDRASF'� Jill it i t i',i Board of Health Penny Holeman Annette Graczewski Jae Ford Jeannie Karnpas Kimberley Crocker Pearson 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 BOARD OF HEALTH MEETING AGENDA 2198 Main Street October 6, 2021, at 7:DOPM Pursuant to Chapter 20 of the Acts of 2021, this meeting will be conducted in person and via remote means, in accordance with applicable law. Thls means that members of the public body may access this meeting in person, or via virtual means. is person attendance will be at the meeting location listed above, and it is possible that any or all members of the public body may attend remotely. No in-person attendance of members of the public will be permitted, and public participation in any public hearingconducted during this meetingshalI be by remote means only. Members of the public who wish to access the meeting may do so in the fol low] rig manner: Phone: Call (307.)715-8592 or (312)625-6799. Webinar 10: 820 43944509 Passcode: 979174 To request to speak: Press *9 and wait to be recognized. Zoom Webinar. httusO2Web.zoom.us 82043944509? Pwd=M m 2 kvU ExKb Q I R50h rn M0iZb3d0.Zz09 Passcode: 979174 To request to speak: Tap Zoom "Raise Hand", then wait to he recognized. When required by law or allowed by the Chair, persons wishing to provide public comment or otherwise participate in the meeting, may do so by accessing the meeting remotely, as noted aboae. Ad d itio n ai ly, the meeting wlli be broadcast live, in real time, via live broadcast (Brewster GovernmentTV Channel 18), livestream {rivestream.Brewster-ma.govj or Video recording (tv.brewster-ma.gov) 1. Call to Order 2. Chairman's announcements 3. Citizen's forum 4. 185 Brook Trail Road - request to keep cesspools for an addition 5. Discuss and vote on Select Board recommendation to require face coverings at November Special Town Meeting 6. Consent agenda: ■ 268 Slough Road - 300' setback variance for septic system upgrade ■ 49 Canoe Pond Drive - 300' setback variance for real estate transfer 7. Introduction the the Harold D. Craft Step Ladder Theory of Groups- Chair Holeman 8. Minutes from 9/1/2021 9. Liaison Reports 10. Matters not reasonably anticipated by the Chair 11. Next meeting: October 20, 2021 72. Informational items: a. Monthly report for King's Landing b, Monthly report for Wingate c. Monthly report for Ocean Edge d. Letter from DEP re; Brewster Water PFAS6 e. Monthly report Wingate f. Monthly report for Pleasant Say Health & Living Center g. Monthly report for Maplewood h. Monthly report for 17 Russell's Path i. Brewster Recycling Guide j. Article --- E -Cigarette Use among Middle & High School Students, National Youth Tobacco Survey, United States, 2021 13. Adjournment ii-' Date Posted: Date Revised: Reeef4d byj own Clerk: 10/01/2021 f,� 4ay llfileserver161rdocuments$Itmason\DesktoplAgenda template. docx September 28, 2021 Amy von Hone, Health Director Brewster Health Department & Board of Health 2198 Main Street Brewster, MA 02631 Re- Cesspools at 185 Bxook Trail Road Dear Ms. Von Hone and Board of Health Committee Members, RECEIVED =,SEP3 BRFWSTE-R i1EALTH DEPARTMENT We are acting as agent fox the homeowners, Paul and Eileen Meehan, of 185 Brook Trail Road, Brewster. Our clients would life to add a 14' x 18' family room addition in place of an existing deck. We are requesting that the Board of Health consider waiving the upgrade of our client's two existing cesspools. We do not believe the system is contributing to pollution of the ground water or areas designated as wetlands. The homeowner would also like to note that while the cesspools are 50 years old, for 40 years the house was a second residence and not lived in full time. As you consider and research this situation, please let us know if we can answer any questions or provide additional documents. Thank you for your time. Sincerely, George Davis President, George Davis, Inc. DESIGN 4 BUILD : RENOVATE 33 NORTH MAIN STREET, SOUTH YARMOUTH, MASSACHUSETTS D2664 506-394-0832 508-394-5460 FAX GeorgeDavislnc.com Permit To be completed by Applicant: Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02631-1898 PHONE: 508.895.3701 EXT. 1120 PAX: 508.896.4538 brhealth(rr�hrewster-ma. ao� WWW.BREWSTER-MA.GOV BUILDING WAIVER SIGN OFF SHEET Health Department Amy L. von Hone, R.S,, C,H2O. Director . IY Tammi Nfiason BREWSTER ri�ALTH DEPARTMENT Building Site Location �t - [��(' l_.i� �t ( -C1t J -- - Map -d L--parcel-11— Proposed Improvement: Zone Il: Y IN Town or Well water: f (xl F� Appl Addy icant: to / rd, 7 Phone #: - rLQatL a Date Filed: **If you would like e-mail notification of sign off, please provide e-mail address: r!! Owner Name: (([�.� L G t' f� i? d� G�rGI�-- _ Phone: Owuer Address: RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements for Septage Disposal and other Public Health Activities. Please submit one (1) copies of plan, to include: (1) Site plan showing existing buildings, water line location and septic System location; 'y. (2) Floor plan labeling ALL rooms within building (all existing and proposed) Note: Floor plans are not required for decks, sheds, windows, roofing; (3) If necessary, Title 5 application signed by licensed installer with fee (4) If review is fdr a DWCP application, 3 sets of site plans are required) Reviewed by: PLEASE NOTE Czg� Poi Lr,5(q*y� i.c,(_ds 4-� tbc_ u�pd�_d __. ION m YK'oaVApq [&3vvq ®lsmmg 0 _ n__r+a Resew+a-E pA Plil90-10 9� $ ) } § °° -gul' e9 . ©mewuool e ¥lnlB d * E LU r -yam -yes----- � II bl 1 I� ) �(� [I L / I -I E� !I iI Q. I ll k! I ! I I \}� §\ \k d) �eo8 /§{/ Atf J »=2E 23±° () &/ Wt w N E D N 00 tl- v m n j; ;�E O Z Z a O 4 w j = w w Q Yi N W w o_ F Z Z N N w w ¢ r Q a W N w w q ¢ ❑ tot O ❑ w w n P F C7 ¢ z a S W 2 lu IN L] ❑ J 7 S7 l[j U ¢w wm �� a � to C>0 ~ JJ y N ui �Jn c3 a 7 0 1 N aZ Z p F iuj m o 7 w UJ ❑ o firm JwL7aJ JQZ❑ M m v �n a S o P � V w ou ereppi ni N [V L�-A aQ»a q ❑ O r w w 7 P C7 ¢ z a S J N L] ❑ J 7 S7 0 IL ED LL1 z a � a 17L LVLI ❑ 0 2 N G y N ❑w1-¢Uxw0 aQ»a q w w r 0 w v v ry C7 ¢ L] ❑ J LU U 0 IL ED LL1 z X T a 17L LVLI ❑ � w I F !O X17 W N m O Y 0 Y 01 h C/ fel m �4P�[i uin M N1�a] w u]NM N o U_ cd ai ai RN T iL iL N N r N m p' m m m rn mnco ra V ❑ 2 rLW iL T W Z z 6 w 0 p Z SYN❑� ali¢QpN M i w a ❑ CD ' ua 2 Z J J z I7}LLX m io Q N N m 07@7 W N ¢ < < m 0 0 0 O O P C 6 � W A i z F o a w m p sr J J LL O ¢ C) ¢ ❑ ar��J rad �� a 2 2 6 �NQ=O}rL7 n 1- 1- ❑ m 4� b W LLI SL' ❑ w ¢ 3 W ❑ Lu [Y IFJ w ¢ ❑ ❑NC�' ❑ Z 0 C 0il.22 U7 ❑ C) IL W o� P a 0000nv$o0 r 69 0 0 LU Z¢ w N LL ¢ Q 6 W Lu F w ❑ u7 Q F w aZrn J F W m o -,d' U W [W9WF~ F a Z O O J F ❑ Q O� ¢ y mLL m o — y PARCEL 30 PARCEL 2q 2Ai.qO' z Q D E z � 3 eF 0. wW}Y zuiuraW rw {Y kO zt�� S m W w a 7 p lL }z i}UQ R Fu I—(L p 4fl�2lu tl1 WN[ , _tLi 'T N wn�n 0 0 w o W wq ` r �+ z co 111 .... Q — y PARCEL 30 PARCEL 2q 2Ai.qO' z D E z iu m u�3�4u 0. wW}Y zuiuraW z"S0 w'0 n kO zt�� S m F m m, }z i}UQ R Fu I—(L p 4fl�2lu tl1 } :f , _tLi 'T N wn�n kO zt�� 44 U m m R Fu I—(L p 4fl�2lu tl1 , wn�n wq ` r �+ o�- QO o 0. Q w p` 0. tis •9� i M 65.93' q /+ BR�p� I W F � � o s Z o � The Commonwealth of Massachusetts � , . TOWN ���^^` BRE,,^^TER l����l�T� ��l� TTT����,�� "^`^^��°�� ^^�� ^^^�^^����^ No, �for Permission to Install a Cesspool or �Septic.�o Tank /�Date . To the Board of Health: " The undersigned hereby applies for a permit according to the following apnuif1umdoom: l. Owner's DTamum ... fx.L,��........ ...�^�.�.A..V.............. .......................... ......... ..................................... ............. 2. Owner's Address Cr-12A9.A......... 5 ..�-S ......................... 3. Location of Lot -Street ....... %.oL1J4/\----. JX.g�a.. 4^ Distance from nearest DnveDbog —'—�.,a.x6........................... ............ .—................. ......................................... 5. Distance from side Doe ---...—..—.-----..~..--.------------.~—...—..--. 8. Distance from rear }boe —..-9 xP-..'.—..--.--------.------------.---.....--.---' 7. Dia',aooe from front line ..... .......... .............. ............ ...... .......................................................................... � /� x 0` IDistancefromfromvwell ..—..^.w^..m—/---------.—.............................................................................................. 9. Size of Cesspool - depth -diameter ����°�^'�.----------------------......----., 10. Depth below inlet pipe .............. ..................... ..—...... ........................................................................................ %3. Material ofcover .~......... »«..C... ............................................................_--._.--....... _ — 13, Capacity u�ae�t� too� in —^--^--^^^----^~^^^^^^^^^^~—^'----'------.~....... 24, Draw sketch of property, hoose well & cesspool or septic tank, any existing cesspools or septic tanks. � f � �e+op . Y P 0 Y 'sown of Brewster Brewster, Massachusetts 02631.1898 QFFiCE� OF; BOARD OF MALTH UPGRADING OF SUBSTANDARD ONSITE SEWAGE DISPOSAL SYSTEMS REGULATION PURPOSE: The possible contaminatIon_of the sole source aquifer by substandard onsite sewage disposal systems presents a serious threat to drinking water affecting public health. This possible contamination also poses a threat to areas -designated as wetlands affecting the environment and public health. This regulation is adopted pursuant to the power of the Board of Health conferred by Chapter 111, Section 31, of the General La -,,7s. (1) if the inspection of an onsite sewage disposal system occurring as the result of: (a) a pending real estate transfer; (b) an application for a building permit which increases habitable space; (c) a complaint received by the Board of Health or its agents; (d) the Board of Health's continual survey by its agents of areas of critical concern (areas near wetlands, ponds and the shore line) ; (e) the Inspection and maintenance Program required as a condition of funding for the Tri --town Sewage Treatment Plant; or (f) three or more pumpings within an eighteen month period ----- determines that a substandard system is in use, paragraph (3a) or (3b) shall apply. (2) For the purpos6 of this regulation: (a) a STANDARD ONSITE SEWAGE DISPOSAL SYSTEM is defined as a septic system consisting of a septic tank discharging its effluent to a suitable subsurface sewage disposal area conforming to 310 CMR 15.00, the State Environmental Code, Title 5, Minimum Requirements for the_Subsurface Disposal of Sanitary Sewage and the Town of Brewster Regulations; (b) a SUBSTANDARD ONSITE SEWAGE DISPOSAL SYSTEM is defined as one not conforming to the definition found in paragraph (2)(a). (3)(a) Onsite sewage disposal systems consisting of one cesspool shall be upgraded to meet the definition of paragraph (2)(a): (b) Onsite sewage disposal systems consisting of two or more cesspools shall be upgraded to meet the definition of paragraph (2)(a) unless the Board of Health, or its agents, determine that the system is not contributing to pollution of the ground water or areas designated as wetlands. (4) Anyone_ ordered to upgrade a substandard onsite sewage disposal. UPGRADING OF SUBSTANDARD ONSITE SEWAGE DISPOSAL SYSTEMS REGULATION system shall have the right to petition in writing the Board of Health fora waiver of the order. The petition must be received by the Board df Health within seven (7) days of the ordered upgrade. The Board of Health shall consider the petition at its next regularly scheduled Board meeting after receipt of the petition. The sole criterion for the Board of Health granting a waiver from an order imposed under paragraph ( 3) (a ) or ( 3) (b ) shall be proof of financial hardship of the recipient(s) of such order provided, however, that the Board of Health may consider the severity of the -threat to the public health posed by the substandard system in deciding whether to grant a waiver from its order to upgrade the system. This regulation takes effect on the date following publication. ADOPTED: November 1, 1988 AMENDED: October 16, 1990 EFFECTIVE: Upon publication � r v G Jo M. Mulkey, Chairman Alyce L,a . Favreau, Vice -Chairman ndon C. Guy, Member -At -Large BREWSTER BOARD OF HEALTH C)' -n 0L_" Ct_U1' 3&)l Cole, Town Clerk ^� PAGE 2 OF 2 Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02631-1998 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 hihealth &breGvster-mti.gov W W W.BREW STER-MA.GOV AGENDA ITEM Health Department Amy L. von Hone, R.S., C.H.O. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant November Town Meeting Face Covering Mandate Discussion October 6, 2021 Board of Health to discuss and vote on the recommendation of the Brewster Select Board to require face coverings at the November Special Town Meeting. Discussion: 1. November 15th Town Meeting will be held indoors at the Stony Brook Elementary School. 2. The current COVID active cases in Brewster indicate we continue to experience new cases on a weekly basis consistent with the- 4th pandemic surge which started approximately mid-July 2021. 3. A consistent portion of new active cases are breakthrough cases of fully vaccinated individuals. 4. There is a limitation on booster vaccinations which are currently approved for the Pfizer vaccine only for those that are 65+ years old, immunocompromised, or at increased risk for COVID due to occupational or institutional settings. 5. A face covering mandate is consistent with the current required face coverings in all School buildings and the recommendation for face coverings inside all Town buildings. Compiled by Amy von Hone, Health Director N:1Healih\BOH Meeting Note ABOH Hearing NoteslBQH Hearing 10. 06,21 November Town Meeting Mask Mandate Discussion Vote.docx RECEIVED T"Vw" TOWN OF BR>GWSTE SEP 7 2021 OFFICE, OF 04 o Jul �y 2198 MAIN Si'RCE r EA TFi DEPARTMENT i BREWSTER MA 02631 PHONE. (508) 896-3701 EXT 1120 BREWSTER N EALTH DEPARTMENT FAX: (508) 896-4538 BRHEALTH(u7BREW STER-MA.GOV W W W.SREWSTF:R-MA.GOV Received: TINT Paid: `�7�Q Application for Board of Health Variances Abutter Deadline: 1ARIn-House Local Upgrade Approval ❑Public Hearing Date: SEPTEMBER 2, 2021 SUB.]ECT PROPERTY ADDRESS: 268 SLOUGH ROAD, DENNIS, MA DEED BK 33940 PG 258 pl y Map:11 Parcel: I I Book: 217 Page: 99 LC Certificate: LC Pian: Lot: z Name of Applicant: NORMAN A. SYLVIA JR. Mailing Address: 46 GRASSY POND ROAD, DENNIS, MA 02638 Telephone # 608-237-2304 Email: nsylvial959@gmaii.com Owner(s) of Record : NORMAN SYLVIA Mailing Address: 46 GRASSY POND ROAD Design Engineer/Sanitarian: PETER MCENTEE Firm/Company Name: ENGINEERING WORKS, INC. Mailing Address: 12 WEST CROSSFIELD ROAD, FORESTDALE, MA 02644 Telephone #: 508-477-5313 Email address: peter.mcentee@gmaii.com Signature: L �- Appllcant or Engineer New Construction ❑ Voluntary Upgrade ®Addition/Alteration M Failed system ❑ Rea l Estate Transfer ❑ Design flow of existing system: 330 GPD Reason for failure: PROXIMITY TO GROUNDWATER Design flow of proposed system: 330 GPD Total sewage flaw of site: 220 CCD Total lot size (so: 17,300+1-sf Conservation Commissfon approval required: yes EV no ❑ Order of Conditions/Det, Of Applicability attached ❑ Date of ConCom hearing: 9/14/2021 List of all Variances from State and Local codes add sheets if needed TITLE 5 Sec. #: Description of Variance(s) 15.405 (1)(a) 2' varaince, SAS to property line [front], for an 8' setback. Brewster Reg. #: Description of Variance(s) Section 3 30' variance, SAS to B.V.W„ for a 70' setback. Section 4 147' variance, SAS to Pine Pond, for a '153' setback. Section 4 13' variance, SAS to Slough Pond, for a 287' setback. Approved by: �( [' a Date:_ Health Department NAHealIMBOH regsllnHouse Septic Local Upgrade Approval 2019Warianceappiication FINAL NONFILLABLE FORM 12.18.19.doex SLIDER U LIVING RM BEDROOM T-0i KITCHEN BATHBEDROOM NT FIRST FLOOR SLIDER m z FAMILY RM m z m z UTILITY -� BASEMENT FLOOR PLAN 268 SLOUGH ROAD, BREWSTER, MA CERTIFIED MAIL RETURN RECEIPT REQUESTED BREWSTER IN-HOUSE SEPTIC LOCAL UPGRADE APPROVAL NOTICE: Date: SEPTEMBER 2, 2021 Re- 268 SLOUGH RD Map: 11 Lot: 1 Subject Address Dear Abutter: Please be advised that an application for septic local upgrade approvals from the regulations of the Massachusetts Department of Environmental Protection, Title 5 and/or the Town of Brewster Regulations for Subsurface Disposal of Sewage, has been submitted to the Brewster Health Department for approval. The following variances are requested: List of all variances from State and Town Codes The application and plans are available for review and comment at the Brewster Health Department, Brewster Town Offices, 2198 Main Street Brewster, Monday through Friday (excluding holidays) from 8:30 a.m. to 4:64 P.M. Sin r y, L App icant/Representative CC: Brewster Health Department N:1Health\BOH regs\InHouse Septic Local Upgrade Approval 2019\inhousevarianceabutternotification NONFILLABLE FORM 12.11.19.docx �Rewar TOWN OF BREWSTER, MA -3 a BOARD OF ASSESSORS Y l _ 2198 Main Street Brewster, MA 02631 Ei� rtpA� 4 Abutters List Within 65 feet of Parcel 11!1110 1113810 0 SLOUGH ROAD UG OA )ucH � OA 1111110' 268 IGH 1113710 SLOUGH. 1111010 0 PIKE POND. LAN DIN 1 Key Parcel ID Owns;, Location Mailing Streel Halling City ST YupCd/Gcun� 6552 11-10-0-E BREWSTER TOWN OF OPINE POND LANDING 2196 MAIN STREET BREWSTER MA 02631 (38.104.1) 6561 11-11-0-R FLUS MAEBELLE L 268 SLOUGH ROAD 46 GRASSY PONS] DRIVE DENNIS MA 02536 (36-104) CIO SYLVIA NORMAN A JR 6492 11-12-0-R PEACE ON PINE POND LLC 256 SLOUGH ROAD 18100 MORNING START LANE CAPE CORAL FL 33993 (38-241 6496 11-36.0-E BREWSTER CONSERVATION TRUST 0 SLOUGH ROAD 36 REO TOP ROAD BREWSTER MA 02631 (38-26-2) TRUSTEES 6493 1137-0-R GOLDSMITH ANN D 265 SLOUGH ROAD 10 STOODARD ROAD HINGHAM MA 02043 (35-25.3) 4Krftd by: r'I !amts M. Gallagher, MAA Deputy Assessor 8130/2021 Page 1 Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 0263 1-1 898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 brhealtlia,brewster-ma.gov W W W.BREW STER-MA.4OV AGENDA ACTION ITEM FORM SOH Variance Agenda Item ❑ In -House Local Upgrade Approval Other: Health Department Amy L. von Hone, R.S., C.H.O. Director Board of Health Meeting Date: October 6, 2021 Project Location: 268 Slough Road Map & Parcel: 11111 Owner's Name & Address: Norman A. Sylvia, Jr. 46 Grassy Pond Road Dennis, MA 02638 Applicant: Norman A. Sylvia, Jr., 46 Grassy Pond Road, Dennis, MA 02638 Date Requested: September 7, 2021 Title 5 Variance Request: Yes ® No ❑ Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Board of Health Variance Request: Yes ® No ❑ Wetland Setback — BVW 100'IPond 300' Other: Yes N No ❑ 1. Inside Zone IIIDCPC and existing Town water 2. In ESA — Site within 300' of Wetland (BVW and Slough Pond and Pine Pond) 3. Upgrade of failed leach facility servicing existing 2 bedroom dwelling Health Director's Recommendation: Approve with following comments and conditions 1. The existing property consists of an existing 2 bedroom dwelling serviced by town water and a failed 1972 septic tank and leach pit. The applicant proposes to upgrade the existing system to a Maximum Feasible Compliant Title 5 septic system. The proposed septic system will consist of a proposed 1500 gal septic tank, distribution box, and a 38' x 11.3' Leach Field for a maximum 3 bedroom capacity septic system (minimum design requirement per Title 5). The location of the proposed septic system accommodates the wetlands and Slough Pond and Pine Pond bordering three sides of the property at varying distances. 2. The proposed project has been reviewed and approved by the Brewster Conservation Commission on 09114121. N:\Hea1t1ffi0H Mccting Notes1130H Hearing Notes1268 Slough Road M1 IN I AgendaNariance Action Item Form 09.17202 I.dac.x 3. The lot is subject to septic flow restrictions per the Brewster Environmentally Sensitive Areas (ESA): 1 bedroom per 10,400 sf of land area and the DCPC: 5 ppm maximum total nitrogen. The existing lot is 17,300 sf which is grandfathered for the existing 2 bedroom dwelling but is undersized for any additional flow with a standard Title 5 system. 4. Map References: Cape Cod Water Resources Classification Map I, 6/18/2010 (Map referenced in approved BOH Regulation Regarding Variance Requests for On -Site Sewage Disposal System Applications): lot and septic system are located within the Freshwater Recharge Area. Septic System Buffers and Groundwater Flow Directions near Brewster's Ponds, 1/26/2016 (Map referenced in Draft BOH Regulation of Sewage Disposal Systems to Protect Surface Waters and Pond Nater Quality, 2016): the lot and septic system are located within proposed septic system setback delineated boundary. Draft regulation not currently approved by BOH. Septic system pre-existed draft regulation and map. Water -Table Map of Brewster and Harwich, 1987 (Map referenced in approved BOH Regulation Regarding Variance Requests for On -Site Sewage Disposal System Applications): septic system located downgradient of northeasterly end of Pine Pond and southwesterly of Slough Pond. 5. Due to the lot size and proximity of wetlands to the entire lot, the leach facility cannot be located any further away than as proposed. 6. The following variances are requested: Title 5: a. 2' variance, proposed 8' separation between SAS facility and property line Town of Brewster: b. 30' variance, proposed 70' separation between SAS and wetland (BVW) c. 13' variance, proposed 287' separation between SAS and Slough Pond d. 147' variance, proposed 153' separation between SAS and Pine Pond 7. Approval with the following conditions: a. Approve the septic variances as requested above with the following conditions: i. There will be no addition of the number of bedrooms in the residential structure. A copy of the BOH Approval Letter to be recorded at the Barnstable County Registry of Deeds prior to issuance of the Certificate of Compliance upon completion of the septic system installation. A copy of the recorded letter to be placed on file at the BOH. ii. Variances will expire one (1) year from the date of the BOH Approval. N:1HcalthlBOH Meeting NoteslBOH Hearing Notes1268 slough Road M i 11'11 Agenda. Variance Action Item Form 09.17.2021. docx Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 0263 1-1 89 8 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 t�rlteallh a?b�e�tister-nri.�o� W W W.BREW STER-MA.00V Health Department Amy L. von Hone, R.S., C.H.O. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Notice of Board of Health Variance Approval/Deed Restriction September 21, 2021 Norman A, Sylvia, Jr. 46 Grassy Pond Road Dennis, MA 02638 RB: 268 Slough Road, Brewster, MA Map: 11 Parcel: 111 Book: 33940 Page: 258 Lot: 2 Owner of Record: Norman A. Sylvia, Jr. Dear Mr. Sylvia: On September 21, 2021, the Brewster Health Department reviewed and approved the following variances for the septic system upgrade at the above address per engineered plans by Engineering Works, Inc. dated July 27, 2021: Title 5. 310 CMR 15.211 (Minimum Setback Distances) a. 2' variance, 8' setback between the Leach Facility and property line N o Town of Brewster: -i Leaching Facility Setback Regulation cc a. 147' variance, 153' separation between SAS and Pine Pond m b. 13' variance, 287' separation between SAS and Slough Pond G. 30' variance, 70' separation between SAS and Bordering Vegetated Wetland 10 In granting the above variance, the Health Department imposes the following Order of Conditions: 1. The property consists of an existin two (2) bedroom dwelling. No additional bedrooms allowed without further review by the Board of Heal?h and the Building Department. 2. Prior to issuance of the Certificate of Compliance, this Variance Approval Letter must be properly recorded at the Barnstable County Registry of Deeds and a recorded copy of same shall be furnished to the Brewster Health Department as proof of the recording. 3. Variances shall expire within one (1) .year of the date of this approval. Please feel free to contact me if you have any comments or questions on the above. I can be reached at the Health Department, 508-896-3701, ext. 1120. Sincerely, z/�,�� �C�P y L. von Hone, R.S., C.H.O. irector of Health cc: Engineering Works, Inc. 12 West Crossfield Road, Forestdale, MA 02644 File N:\Health\B0H aecisian Letters\SepticVariance In -House Decisions\Title 5 Brewste r Ap prova I s\26 8 5 1 a u gh Road InHcuseApprova109.2L2021.dcc 0 r _f IIII 11 I I`1 I1 IIII IIlf;llfllll` III � 11 I I I II 111 I I. k� I illllli�i i I R I� Ikilll'I i�l� 111111 I 't1��1� �:t lkil { II I.I�j � 1111111 kk1 , . 111,1 1I 1 `1114', J111111 IIIII11k I f �ih DR nom 0\p tv 0 l� -2-6 s Seo v?lam Ad Cape Cad Water Resources Classification Map I La C,us �,M Regional Policy Flan (Efnfecti Amended Effective Amended -- Effective Priroxy ResoineAreas: Wellhead Protection Ar Identirooad Wellhead Protection Areas: {zones of Department of EnvirormenW Frotedion and EC cape Cad Commission Water Resceirces SWfF, a Public Supply wells Nbllc Water Supply Well 4 Smail Volume Welis, Non -Transient Small Volume Wells, Trans$ent o "used PubIIC Water S.fpply WeR 7 Surface Water Supply Locations of pubic community surface and grou pubk nomco mmmity suprly sources. Departm and EOFA Mas5GIS 2010, and Cape Cad Comm! Potential Water Supply Potential Pubkc Water Suoly Tracts: From the' AcquisiWn Assessment Project" (PLAAP), June : Lower Cape data from the Lower Cape Water Q r Freshwater Recharge A Freshwater Recharge Area: Areas shown are th, (see reports M04-5014 and 2004-5181), the Mi the Cap` Cad Commission Water Resmaces Sta Water Ouaiity Impaired Arer - AevelopedA.reas Devc;opment such as med)am and high density unsewcred resldentlal lots less than 20,000 squ industrial areas determined from digital parcel a ]anduse: 1999. Created by Mass -Amherst Res( with ifle EDEA MassGiS projed and the Cape G Potential Plumes from Pataoa[ PYJmes from Waste Site Areas: Create the Nr Force Center for EngineerMg and tha Ili Camrrdssion Water Resources Staff. Waste Site Areas Areas that inrhxle larrdrdls, septage, and waste% determined from dlgltal parcel and assessors' dl 1999. Created by the UMass-P.aaherst Resource }n cooperation with the ECL`EA MasSGIS project t Water Ouailty Improvement Vater QuaTty Irrrpalred Areas that are located i This Map was plo&—d by the Cape lad Ia)rmaum System Npartment W the m ef[ectNa January 16, zoos, Phlrl any at nam amendments d'bct9ve]u 3, MI LNEP Poor supprr Wells, end rhe Ck- mala amffdnm6 effedae Jule 1% pratmtfon areas and aFP Piro The Cape Cad CaMmision is a d Mal Wnedfons are welmme at the cape C mnmd 91�&mpewdcD x ihis map is HluerraUve and alldeplc[ed box intended for planning Wrpus s w*F - - _J CAPE CC COMMISSIC N = o r Regional Policy Flan (Efnfecti Amended Effective Amended -- Effective Priroxy ResoineAreas: Wellhead Protection Ar Identirooad Wellhead Protection Areas: {zones of Department of EnvirormenW Frotedion and EC cape Cad Commission Water Resceirces SWfF, a Public Supply wells Nbllc Water Supply Well 4 Smail Volume Welis, Non -Transient Small Volume Wells, Trans$ent o "used PubIIC Water S.fpply WeR 7 Surface Water Supply Locations of pubic community surface and grou pubk nomco mmmity suprly sources. Departm and EOFA Mas5GIS 2010, and Cape Cad Comm! Potential Water Supply Potential Pubkc Water Suoly Tracts: From the' AcquisiWn Assessment Project" (PLAAP), June : Lower Cape data from the Lower Cape Water Q r Freshwater Recharge A Freshwater Recharge Area: Areas shown are th, (see reports M04-5014 and 2004-5181), the Mi the Cap` Cad Commission Water Resmaces Sta Water Ouaiity Impaired Arer - AevelopedA.reas Devc;opment such as med)am and high density unsewcred resldentlal lots less than 20,000 squ industrial areas determined from digital parcel a ]anduse: 1999. Created by Mass -Amherst Res( with ifle EDEA MassGiS projed and the Cape G Potential Plumes from Pataoa[ PYJmes from Waste Site Areas: Create the Nr Force Center for EngineerMg and tha Ili Camrrdssion Water Resources Staff. Waste Site Areas Areas that inrhxle larrdrdls, septage, and waste% determined from dlgltal parcel and assessors' dl 1999. Created by the UMass-P.aaherst Resource }n cooperation with the ECL`EA MasSGIS project t Water Ouailty Improvement Vater QuaTty Irrrpalred Areas that are located i This Map was plo&—d by the Cape lad Ia)rmaum System Npartment W the m ef[ectNa January 16, zoos, Phlrl any at nam amendments d'bct9ve]u 3, MI LNEP Poor supprr Wells, end rhe Ck- mala amffdnm6 effedae Jule 1% pratmtfon areas and aFP Piro The Cape Cad CaMmision is a d Mal Wnedfons are welmme at the cape C mnmd 91�&mpewdcD x ihis map is HluerraUve and alldeplc[ed box intended for planning Wrpus s w*F - - _J CAPE CC COMMISSIC Z.'elC ��]��� --5EXISTING CONTOUR x 50.98 0,98 IXISTING SPOT GRADE 1 -NF- EXISTING WATER SERIACE ]k k Ru RL'PAIR OF SEPTIC Si'STESk ONLY, d., w �GEXISTING WATER SERVICE T nf' e.rrd 0 MOM rc,rft ,nd N{f<-OVERHEAD WIRES fbkurcoddiuu.' �l7�1 �dTEST PTT leu rrJl[lin a.abr .effl.L. �.1 Brcwmcr }fen 'bbmrrt en a BENCHMARK , APP LEGEND 'grapy ��Cl •� - +I � \ `-•'�'� '" .. G\ Ic N O 7F�T •` N -,� h• l � w I z s� a.• BENCHMAR .�� ll 1 NAG. NAIL SET 34.95 PROPOSED S.A.S. 36.CB 874 ROWS OF 9 Ct 7Y �, ".•1,�:• INFILTRATOR OUICK49ARD UNITS �p LOCUS MAP � BT!FY �•_• 4, � ',` 35.21 �� �� 7.02 1` EXISTING LEACH PIT •�•, �ryy %g. .0 35"02 TO Of REMOVED SEE NOTE 11-SNEEr 2 WORK LINIT(TYP.) \ '�' VENTA. 6�. ' RECT.� j[ C' PROPOSED SEPTIC 'TANK I x ` art` `J'. ` 35.19 1500 GALLON (H-10) OR 37.27 �� x EXISTING SEP77C TAMC (TO 8E REMOVED)35.05 TOP OF TAMC EL. =36"d9 5.12 1NV.(0UT)=34.761 * +37. ' y X 3 e o 34 S � 37.5 ' 7.09 �Jc K l 081% ` 37.07 / .,• ;;'.:.:� 35.00 WF lm 3t.41 ^.5 1 34.83 #r.�.I�22 P 30✓ :�;:::,::' B' 3C5$ 34.. y0 30.82 �1l'jSTfNG� 37.08 2,5,1 of, Y T.OF 38 !32.37- 5y LOT 2 'X 30.83 ` f _ �'3t).H7 _'-_'R�=.':-;-'"�• 1w , ':GRAVEL r!-==`� x WORK IJF�AIT[IP.} 17,3fl0±5.F. @ �� DRIVEWAY: w> 30.83 -DEC• X 39.17ABOW' ,3_0.57 _ 31.15 9 8 32.36 i �• 30.80WIF fy (ic• r Irl 0 1 ~ -30-r� E 'v TO 30.84 "i WF \ 30.69 St , A 30.02 0 0 x 29.83 v�q o¢ }} SLAB f ' 3077 h jWF SOIL LOG + 29.46 x 29,66 I 30.73 DATE: JUNE 24„ 2021 } I SOIL EVALUATOR: PETER McENTEE PE(SE#1542) WITNESS: AMY VON HONE RS REALTH AGENT X 29.96 ; ELEV. TP QEEnt n+��°.aI 37.3 FILL 0. t' 30.45 33"s A 44" FF fLOAMY SAN PERC 33.3 1QYR 4/2 48_ Q WF LOAMY SAND NLAND 13 + 29.68 9 69 j ; tOYR 5/8 BANK SPIKE f , 31.3 72" TH •, x 29.9 Cl 29. '9 •, l , MED" SAND TB TR I OF Z"SY 6 6 28,75 29.43 29.65 30.0 _3� !}SH s`T4-- WAI Gw TB WF TB gg PETER T. �, 28.8 C2 REDOX = 102" 28.99 29.77 24.55 T v mcENTEE ' g'�8 TINE SAND WIF CIVIL 2.5Y 5/3 •• 29.,76 "edge o{ 855. 1B�• No- 35109 $ '. 29.47 27.7B 27.5 STG. Gw - 117" PLAN OF RECORD �a 26.3 132" STANC[NG GR011 NDSYATER, EL -27-554L GA, NORMAN ONO DREWP Pine Pond '1 l Z,'� 1 �•� REDOX AT a-23 .8 DENKS, MA 02638 WATER SURFACE, EL -28.7 I PERC RATE C2 MIN/1N. ("R" HORIZON) WETLAND MARSH WATTERSLENVIRONMENTAL PROPOSED SEPTIC SYSTEM UPGRADE PLAN FORES DALES MA 02644 268 SLOUGH ROAD, BREWSTER, MA 978--434-1228 Prepared for: Norman SyWio, 46 Grassy Pond Rd, Dennis, MA 02638 FLOOD PLAIN Dr9QNATIQ Engineering by: SCALE DRAWNFEMA FLOOD HAZARD MAP NO.: 25001001582J1' =2D' P.T.M. 180582J 80-21 21 ZONE X & 02% ANNUAL CHANCE Engineering Works, Inc. CHECKED EfT NO. PARCEL ID: 11-11-0 (12 W&sL 5 8) 477 5313kd Rood, Farestdale, MA 02644 ��N 27�21 P.T.M. 'TD# 2 NOTE: TO PREVENT BREAKOUT,7AROUNIDIVE FINISH GRADE SHALL NFOR A OISTANCE OF 15SEPTIC TANK PERIMETER OF THE S.A.INSTALL RISERS & COVERS OVER INLET &pROPOSEt] D-H0]S PROPOSEDS.A.S- OUTLET AND SET TD 6" OF FINISH GRAbE RISER INSTALL INSPECTION PORT OVER EACH ROINSTALL &WATERTIGHTCOVER SET TO 6" OF GRADE rF.G. EL=37.3* -F.G. EL.=37.1 t I EXISTING FG_ EL: 37.1 t F.G. EL =37.0*CONNECT ALL ROWS -TAN 21, GV R SA-S. L = 3't L 4' I. e'[IAA11) 1 NSPECTION PORT o -17 IN.) -17IN-)4"4 ) B S-IR Owes.) (ANIMUH®5S=CH "SCH40 PVC _ IV 6 5.3 TO 14 INV.=34.95 415' LIQUID INVERT LEVEL sr,FFLE INV.-34.59 PROPOSED RNV'=34.42 4 RQwS pF 9 OIiITS AT 4'/DNIT + 2'(ENo CAPS)= 39-Do' IL AB 10 INV.�34.7D P ❑ 05 PIC TAN 5 NV.=33.3 ESTABLISH y AVTE�C{�TAVVE5COVER 'fB NA V oR PERLC sAN6) D _J CONNECT TOSEWER 3't FROM INLET TO "'TINGETANK, INV.= 35.31 BREAKOUT TOP CF _ EL. TOP OF CHAMBER - - - CHAMBER EL.=34.90 NOTES- _ 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BOTTOM ELEV.=33.90-,u 1) INVERTS. PRIOR TO INSTALLATION. r 2.83' 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON A MECHANICALLY COMPACTED STABLE BASE ' EFFECTIVE WDTH=11.3' OR SIX INCH CRUSHED STONE BASE, AS SPECIF9D IN USE 4 ROWS OF 9-QaIC94 STANDARD WRLTRATOR CN4+ABERS 310 CMR 15.221(2), ADJUSTED GW,EL.=28.8 r ION WnH no SEPARATeEMEEN EACH Mt & HD 5TONE 3) INSTALL INLET & OUTLET TEES AS REQUIRED. STG. GT;. EL--27.5 TYPICAL C 0 E10sRN0 SUITABLE 4) GAS BAFFLE T9 BE INSTALLED ON OUTLET TEE au MATERIAL C AS MANUFACTURED BY TUF-IRE, ZABEL OR EQUAL, SEPTIC SYSTEM PROFILE SEPTIC L J 1 J 1 GIYI GENERAL NOTES: / 1- ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER- EXiS�rfNG 2. ALL (YORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS HOUSE(1268) CF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLr-ABLE LOCAL RULES AND REGULATIONS. EXCEPT AS REQUESTED BELOW: -310 CMR 15.445(1}(a}: LOCAL UPGRADE APPROVAL 1) A 2' vorinnce, SAS. to Front property line, for on 8' setback. -TOWN OF BREIYSTER LOCAL REGULATIONS 2) A 30' vor�once, S.AS. to B.V.W., for a 7D' satback �� 3) A 147' variance to 300' From pond setback, for Q 1S3' setback Pond. 8 from Pine 4) A 13' vurionce to the 300' pond setbak, for 287'i From tea'' Slavo Pond. 3. THE SELVAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR A) a . TO WSPECTiON AND APPROVAL BY THE BOARD OF HEALTH AND THE 41'�� DESIGN ZKCCONDITIONS 4. ANY CONDfDON3 ENCOUNTERED DURING CONSTRUCTION DIFFERING;- FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESK'N ENGINEER BEFORE CONSTRUCTION CONTINUES, �U% 5- ALL ELEVATIONS BIASED ON NAV83- ------r " 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OP HEALTH FOR PROPER INSPECMNS DURING CONSTRU=M. LAYOUT OUT 7. WATER SUPFtY PROMDED BY TOWN WATER SUPPLY. S.A.S. 8. THERE ARE NO POTABLE WELLS WITHIN 100 FL OF THE PROPOSED C13 PROPOSED SEPTIC SYSTEM- 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON OWNER CONTRACTOR OR AS OTHERWISE DIRECTED BY THEE APPROVINGALRHG421TIE3. 16" G���� 10. IT SHALL BE THE RESPONSIaUry OF THE CONTRACTOR TO VERIFY Q121 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REIAOVE ALL UNSUITABLE Sf/LS SIDE HEY! [91 IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE SAS. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). _ 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE IHSPECnan n '� INSPECTED BY DESXuH ENGINEER PRIOR TO BACKFILL. _ 52" vi 13. THIS ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC TOP ME34" SYSTEO COMPONENTS NOT SHOWN ON THE PLAN. 5INVERT . THIS AN IS TO BE USED FOR SEPTIC SYSTEM PLXRPGSES ONLY AND 14FL SURVEY. E.3" 48 [EFFECIh'E) P7HD S4�TDE IS NOT TD BE CONSIDERED TO BE A PROPERTY LINE 15- SITE LOCLS LIES WITHIN A STATE REGULATED ZONE Y- ND VFW 16, SITE LOCHS LIES WITHIN THE BREWSTER HEALTH DEPARTMENT 300' U P ❑ CAP POND SETBACKS FOR PINE POND AND SLOUGH POND. 17. SITE LOCUS LIES SOWN GRAfSENT FROM PINE POND- SIDE VIEY! NOMINAL CHAMBER SPECIFICATIONS _._.xx4e.n' DESIGN CRITERIA n�ILcriue av NUMBER OF BEDROOMS: 2 BEDROOMS em......._.........--..._.............I............rrs ooDL >.vexax..._.................Pts ON SOIL TEXTURAL CLASS: CLASS 1 34" DESIGN PERCOLATION RATE: C2 MIN/IN Ester rLVaM Stt Aa GPACW ITR LIYT...._.............44.4 CAL DAILY FLOW: 220 GPD QUICK 4 STANDARD INFILTRATOR CHAMBER DESIGN FLOW: 330 GPD GARBAGE GRINDER: NO - NOT PERMITTED FOR GARBAGE GRINDER INFILTRATOR CHAMBERS PROPOSED SEPTIC TANK: 15M GALLON CAPACITY LEACHING AREA REQUIRED: (330 GPD) = 445-9 SF H.T.S. .74 GPD/SF PROPOSED SEPTIC SYSTEM UPGRADE PLAN DISTRIBUTION BOX: 1 INLET, 6 CUTLETS (H-10) USE OF 9-Uuick 4 Pluu sL £ TS 268 SLOUGH ROAD, BREWSTER, MA WITH NOS TON BETWEEN MH ROW & NO ONE Prepared for: Norman Sylvia, 45 Grassy Pond Rd, Dennis, MA BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.72 SF/LF OR02638 JOB. NO, Engineermg by: 9 UNITS/ROW + 2 END CAPS/ROW = 3B.0 FT - 717 5F P.T.M.GRAIN P.T.1$0-21 21 Engineering Warks, Inc. 4 ROWS x 3fl.0' x 4.72 SF/LF DESIGN FLOW PROVIDED: 0.74(717.4 S.F.) = 530-9 d 12 West CrossFleid Road, Forestd'3%, MA 02644 DATECHECKED SHEET Nd P.T.M. of E7/27/21 NOMINAL AREA = 11.3' x 38.0' = 429.4 SF (400 SF R D) (505) 477-5313 �peway TOWN Or BRE, wsTER orrtcEOF 13EALTH DEPAItTMENT 2198 MAIN STRCCT BRE, WSTER, MA 02631 r a PHONE: (508) 896-3701 ENT 1120 "— FAx: (508) 896.4538 BRHEALTE-T a BREW TER-MA.GOV 7iA W W W.BREWSTGIt-MA.GOV Received: Paid: Application for Board of Health Variances Abutter Deadline: .oln-House Local Upgrade Approval ❑Public Hearing Date: al SUBJECT PROPERTY ADDRESS: ! t�Gi� !1� P G� •, L/� Map: -'� Parcel: •ff Book: Page: LC Certificate: LC Plan: Lot: Name of Applicant: Mailing Address: '-. La/I Telephone # Email: Owner(s) of Record : �Q 14 xi Mailing Address: 'Z ti� ry l V an ��--_ Firm/Com Name: Desiga-En neer-/Sanitarian: la Y Mailing Address: Telephone #: Email address: Signature: New Construction ❑ Voluntary Upgrade ❑Addition/Alteration ❑ Failed system ❑ Design flow of existing system: Jo Design flown of proposed system: Total sewage flow of site: Conservation Commission approval required: yes ❑ no 1 Order of Conditions/Det. Of Applicability attached ❑ Applicant or engineer Esta�ransfer ❑f. Reason for failure: Total lot size (sf): ] S Date of ConCom hearing: of all Variances from State and Local codes add sheets if tion of Variance(s) Approved by: i r VA. x— A Date: Health Department WI-le.lthTOB regsllnHouse Scptic Local Upgradc Approval 20191Vnrianceapplicati01' FINAL NONPILLABLE FORM 12.19.19.docx Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 0263 1-1 89 8 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 brh ea i th Q.brewster-m a_. Dov W W W.BREWSTER-MA.GOV AGENDA ACTION ITEM FORM BOH Variance Agenda Item ❑ In -House Local Upgrade Approval Other: Health Department Amy L. von Hone, R.S., C.H.O. Director Board of Health Meeting Date: October 6, 2021 Project Location: 49 Canoe Pond Drive Map & Parcel: 24148 Owner's Name & Address: David & Ingrid Condon 49 Canoe Pond Drive Brewster, MA 02631 Applicant: same as above Date Requested: September 22, 2021 Title 5 Variance Request: Board of Health Variance Request: Other: Yes❑ No® Yes® No❑300' Pond Setback Yes ❑ No ❑ Sherrie McCullough, R,S. Assistant Director Tammi Mason Senior Department Assistant 1. Outside Zone II and existing Town water 2. In ESA —Leaching Facility within 300' of Canoe Pond 3. Title 5 Inspection Report for a Real Estate Transfer dated September 9, 2021 Town of Brewster Variance Request: a. 70` variance, proposed 230` separation between SAS and Canoe Pond Assistant Health Director's Recommendation: Approve with following comments 1. The existing property consists of an existing 5 -bedroom dwelling serviced by town water and a 2000 Title 5 septic system consisting of a 1500 -gallon septic tank, d -box, and a 20' X 37.5' leaching field. 2. The lot is subject to septic flow restrictions per the Brewster Environmentally Sensitive Areas (ESA): 1 bedroom per 10,000 sf of land area. The existing lot is 37,318 sf which is grandfathered for the existing 5- bedroom dwelling but is undersized for any additional flow. WHealthWH Meeting Notes\BOH Hearing Notes149 canoe pond variance action item.doex 3. Per the Title 5 Inspection Report, the leaching facility is approximately 230' from the edge of Canoe Pond. The leaching facility is also located parallel to the pond shoreline and is approximately 9.5'above pond elevation. 4. Per the Water Table Map, groundwater is flowing Northwesterly, and the existing septic system is located downgradient of the pond and therefore, will not impact the pond as currently situated. 5. Map References: - Cape Cod Water Resources Classification Map 1, 611$12010 (Map referenced in approved BOH Regulation Regarding Variance Requests for On -Site Sewage Disposal System Applications): lot and septic system are not located within the Freshwater Recharge Area. Septic System Buffers and Groundwater Flow Directions near Brewster's Ponds, 1/26/2016 (Map referenced in Draft BOH Regulation of Sewage Disposal Systems to Protect Surface Waters and Pond Water Quality, 2016): the existing septic system is located outside the proposed septic system setback delineated boundary. Draft regulation not currently approved by BOH. Water -Table Map of Brewster and Harwich, 1987 (Map referenced in approved BOH Regulation Regarding Variance Requests for On -Site Sewage Disposal System Applications); septic system located downgradient of northeasterly end of Canoe Pond. 6. Due to the lot size, and proximity of the pond, and existing lot contour constraints, the leach facility is a Maximum. Feasible Compliant 1995 Title 5 septic system. NAHeaitMBOH Meeting NotesWH Hearing Notes149 canoe pond variance action item.doex `� f ` e �•� ow �! t ■ QpOW�p �- ■�.. m ; ■ lip cn Uj .40 } h r • 60 It 1.0 �► � � �i�� 4p # r ' ,. OP 00 Is r fig► r` r # ,rA 'w � � p � �� Did . � � ft i 45 ■ MP �= ` e ON .i 1- 1 1 1 � i Pill IP 10 do J + 4 ■ IL �. 1 # _ Ila • September 29 2021 David & Ingrid Condon 49 Canoe Pond Drive Brewster, MA 02031 Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02631-1898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 bi-kheaithCLb,brewster-ma. gov W W W.BRE WSTER-MA.GOV Re: 49 Canoe Pond Drive — Septic System Variance Request Approva Dear Mr. & Ms Condon: Health Department Amy L. von Hone, R.S., C.H.C. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant The Health Department has reviewed your variance request and hereby approves the existing leaching chambers to remain less than 300 feet from Canoe Pond as required by the Brewster Leaching Facility Setback Regulation. If you have any questions about the above matters, please do not hesitate to contact this office. Sincerely, Sherrie McCullough, R.S. Assistant Health Director cc: File N:1Health180F1 Decision Letters\Septic Variance In -House Decisions\Real Estate TransferApprovals149 Canoe Pond Drive approval letter.doc Town of Brewster OFFICE ❑P. BOARD OF IIF.ALTH BREWSTER, MASSACHUSETTS 02631-1898 {508} 896-37[}1 E)CT'.i120 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FHJ-1VgH APPENDIX .1.abd�❑ BREWSTER REGULATION Map 2-4 Lot Property Address: 49 Canoe Pond DrOther Address:Name of Inspector: Darrell StoneCompany Name, Address, and Phone Number: Ca a Cod Se tic !ns ection 50 a Date of Inspection: 9176121 PO Box 1466 East Harwich MA 02645 This inspection represents (Check One) X Real Estate Transfer Alteration/Addition A) System Passes B) System Conditionally Passes Septic tank covers are more than 12 inches below the finished grad RECEIVEID 5EP 22 2021 BREWSTER HEALTH C) Further Evaluation is required by the Board of Health �. - DEPARTMENT X The leaching facility or facilities are located within 300 feet of a pond or lake. Records show excessive pumping three or more times within any eighteen (18) month period for residential or commercial property; except for required grease trap maintenance for commercial property. D) System Fails (Brewster Real Estate Transfer Regulation requirements) The system is in a state of disrepair such that it cannot function as it was originally intended: The lack of a 4 food protective zone between the bottom of the system and the groundwater; Any other problem as defined by the Board of Health or its Director; The sewage disposal system consists of a single cesspool, or cesspools. The Brewster Health Department has reviewed and accepted this report based on the information contained therein- This inspection refiects the present condition of the Sanitary System and is not any guarantee as to the life or future condition of said system - Approving Authority t Date Please be advised of ADDITIONAL BOARD OF HEALTH REGULATIONS: 1. All private wells are required to be analyzed prior to approval of the Subsurface Sewage Disposal System Inspection Form, and sixty (60) days prior to transfer of property, 2. All underground tanks must be registered with Board of Health and are subject to testing requirements. Owner information is required for every page. Important: when filling out forms on the computer, use only the tab key to move your cursor - do not use the return Ivey. Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface sewage Disposal System Form - Not for Voluntary Assessments Property Address David & Ingrid Condon Owner's Name Brewster MA 92531 9116121 CitylTown State Zip Code Date of inspection w Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Aa Inspector Information Darrell Stone Name of Inspector Cape Cod Septic Inspection Company Name P.O. Box 1456 Company Address Harwich CityrTown «Fr (59$1240-2500 _. Telephone Number Bo Certification Ma 92645 State Zip Code 514995 License (dumber I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (390 CMR 15.O00); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection,- and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1- ❑ Passes 2. ❑ Conditionally�,Passes { 3. ® Needs urther Evaluation by o Approving Authority 4. ❑ Fails -- --- - --- 9117121 Inspe is Sign Date The systeFn inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. if the system has a design flow of 14,909 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP, The original form should be sent to the system owner- and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. ':insa.doC • rzy 71?2018 Tiilg 5 gfFCral lnsaecticzi Form: Subsurface Sewsve Disposal Syslefn • Papa 1 of 18 ;� Commonwealth of Massachusetts 11Y �]p Title 5 official Inspection Form V Subsurface Sewage Disposal System Forme Not for Voluntary � F� Assessme nts 49 Canoe Pond Dr Property Address - - David & Ingrid Condon Owner owner's Name information is required for every Brewster _MA 02631 9116121 page. City/Town State Zip Code Cate of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and a11 of 4 and 6. 11 j System Passes: ❑ I have not found any information which Indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2] System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for "yes", "no" or "not determined" (Y, N, ND) for the following statements. If "not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc • rev. 7!2612018 TWa 5 Official fnspaction Form: Suhsurtace Sewage disposal System - Paw 2 of 15 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon owners Name Brewster G ity/Town C. Inspection Summary (cont.) MA 02631 9115!21 state Zip code ©ate of Inspection 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipes). The system will pass inspection if (with approval of the Board of Health): ❑ broken pipes) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ Nb (Explain below): 3) Further Evaluation is Required by the Board of Health: ® Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 1+.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: '5inso.doc • rev. 71,281201a Tkde 5 Official Inspecflvn Form: Subsurface "vage Oispasal System • Page 3 cY 9B Commonwealth of Massachusetts r Title 5 Official Inspection Farm r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �— 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner Owner's !Name information Is required for every Brewster MA 02631 9116121 page. City/ rown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water- supply well-. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: The leaching facility is within 300' of a pond ` 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ © Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5 insp. doe • rev. 7126M18 Ti tl2 5 Official Inspecl ion Farm: Subsurface Sewage Disposal Syslem • Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �r y. 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner Owner's Name information for is Brewster MA 02631 9116121 required far every page City/Town State zip Code Date of Inspection C. Inspection summary (cont.) 4) System Failure Criteria Applicable to All Systems. (cont.) lYes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool 0 © Liquid depth in cesspool is less than 6" below invert or available volume is less than % day flow ❑ © Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ © Any portion of the SAS, cesspool or privy is below high ground water elevation ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is. equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system faits. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (interim Wellhead Protection Area — IWPA) or a mapped Zone II of a public water supply well :F,insp.doc •rev. T12&12818 U1 5 Oficial In9pec0n Form: Subsurface Sewage Disrasai System • Page 5 of 19 Owner information is required for every page - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon _ Owner's Name Brewster Cityrro,.vn C. Inspection Summary (cont.) MA 02531 9/16121 State Zip Code Date of Inspection If you have answered "yes" to any question In Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should ccntact the appropriate regional office of the Department. 6. You must indicate "yes" or "no" for each of the following for all inspections: fI Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ 0 Were any of the system components pumped out in the previous two weeks? ❑X ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? © ❑ Were all system components, excluding the SAS, located on site? 0 ❑ Were the septic tank manholes uncovered, opened, and the Interior of the tank Inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ❑ Was the facility owner rand occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑X ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 15insp.dac • rev Tl26126ig Title 5 Official lnspeclion Form: SuesUrface Sewage Disposal System • Page 6 Of 58 Commonwealth of Massachusetts f}- Title 5 Official Inspection Form �= Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u� 49 Canoe Pond Dr Property Address David & Ingrid Condon Ovdner Owner's Name inforequirc;dfo is Brewster MA 02531 9116/21 required for every page. CitylTown State Zip Code bate of inspection 0. System Information 1. Residential Flow Conditions: Number of bedrooms (design): ',5) Number of bedrooms (actual); DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms) Description: 5 bedroom residential dwelling Number of current residents: Does residence have a garbage grinder? Does residence have a water treatment unit? If yes, discharges to: Is laundry on a separate sewage system? (include laundry system inspection information in this report.) Laundry system inspected? Seasonal use? Water meter readings, if available {last 2 years usage (gpd)): Detail: 2020 _ 50,000 gallons - 2019 - 40,000 gallons q ❑ Yes 6 No ❑ Yes ® No ❑ Yes © No ❑ Yes ® No ❑ Yes ❑ No 131.5 gpd Sump pump? ❑ Yes ® No Last date of occupancy: current Date _- zu.coc • fay- x12512018 Title 5 Official Inspection Fo": Subsurface Sowage Disposal System - Pago 7 Of 18 cP�r Commonwealth of Massachusetts I� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner Owner's Name information is Brewster MA 02631 9116121 required for every _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercialllndustrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day {Bpd} Basis of design flow (seatslpersonslsq.fl., etc.): Grease trap present? Water treatment unit present? if yes, discharges to: Industrial waste holding tank present? Non -sanitary waste discharged to the Title 5 system? Water meter readings, if available: – — Last date of occupancyluse: pate Other (describe below): 3. Pumping Records: Source of information: Unknown Was system pumped as part of the inspection? If yes, volume pumped: How was quantity pumped determined? Reason for pumping: ganons ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes © No ,5 -so cc • ra, 'i_5=13 Title 5 Offic iai Inspection Fo nn- Subsurfaca Sawaga bi sposai System • P a g a 8 of 13 Commonwealth of Massachusetts f;x Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ., 49 Canoe Pond Dr D. System InformaCon (cont.) MA 02631 9/16121 State Zip Code date of Inspection 4. Type of System: ..1 © Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the IIA system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): Approximate age of all components, date installed (if known) and source of information: 2000 per BCI _ Were sewage odors detected when arriving at the site? 5. Building Sewer (locate on site plan): Depth below grade: Material of construction: ❑ cast iron ® 40 PVC ❑ other (explain): feet Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Apparent good condition ❑ Yes ® No - so -dos • rev. 712W20'16 Tills 5 Official lnsoecAion Form= Suhsumce sewage Disposal Svstern • Pagz 9 of 18 Property Address David & Ingrid Condon Owner Owner's Name Information is Brewster for every page City/Town D. System InformaCon (cont.) MA 02631 9/16121 State Zip Code date of Inspection 4. Type of System: ..1 © Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the IIA system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): Approximate age of all components, date installed (if known) and source of information: 2000 per BCI _ Were sewage odors detected when arriving at the site? 5. Building Sewer (locate on site plan): Depth below grade: Material of construction: ❑ cast iron ® 40 PVC ❑ other (explain): feet Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Apparent good condition ❑ Yes ® No - so -dos • rev. 712W20'16 Tills 5 Official lnsoecAion Form= Suhsumce sewage Disposal Svstern • Pagz 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1 �r 49 Canoe Pond Dr D. System Information (cont.) 6. Septic Tank (locate on site pian): Depth below grade: Material of construction: ❑ concrete ❑ metal _MA_ 0_2631 9116121 _ State Zip Code Date of Inspection 6„ ❑ fiberglass ® polyethylene ❑ other (explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: gallon Sludge depth: 6 — — Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle ❑;t f btt f t btt f tltt b"I t 1 24" 112" ✓6rt X16„ Is ance rom ❑ ❑m o scum ❑ o om o ou a ee or a e How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Normal liquid level No sign of leakage SCH 40 outlet tee eco next maintenance pumping within 1.5 years �` ," Rm Recommended maintenance pumping every 2-3 years c5p. noc - rev. 1-12812016 Ti(Ia 5 Official 3n sp action Form; Sub—fa.e Sawaga lisp osal System • Page 1❑ of 1a Property Address ©avid & Ingrid Condon Owner Owfler's Name information is Brewster required for every page. Cityrrown D. System Information (cont.) 6. Septic Tank (locate on site pian): Depth below grade: Material of construction: ❑ concrete ❑ metal _MA_ 0_2631 9116121 _ State Zip Code Date of Inspection 6„ ❑ fiberglass ® polyethylene ❑ other (explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: gallon Sludge depth: 6 — — Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle ❑;t f btt f t btt f tltt b"I t 1 24" 112" ✓6rt X16„ Is ance rom ❑ ❑m o scum ❑ o om o ou a ee or a e How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Normal liquid level No sign of leakage SCH 40 outlet tee eco next maintenance pumping within 1.5 years �` ," Rm Recommended maintenance pumping every 2-3 years c5p. noc - rev. 1-12812016 Ti(Ia 5 Official 3n sp action Form; Sub—fa.e Sawaga lisp osal System • Page 1❑ of 1a Commonwealth of Massachusetts Y P Title 5 Official Inspection Form Subsurface Sewage Disposal System f=orm a Not for Voluntary Assessments �n 49 Canoe pond Dr Property Address David & Ingrid Condon Owner Owner's Name inrarired for is reguired for every Brewster MA 02631 9116121 page. City/Town State Zip Code Date of Inspection Do System Worr motion (cont.) 7. Grease "crap (locate on site plan); Depth below grade. Material of construction: ❑ concrete ❑ metal ❑ fiberglass Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle et ❑ polyethylene ❑ other (explain): Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Hoiding rank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Dimensions: Capacity- -- gallons Design Flow: gallons per day -5!.9=_o.doc • rev. 712512018 Title 5 Ofrriai Inspection Form: Suhsixface Sewage ❑i8po5a16ystem - Page 11 of 18 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner Owner's Name information is required for every Brewster MA 02631 9116121 page, Cityliown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding 'lank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order; ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Grade to box 21" Cover 6" OK condition 4 outlets with speed levelers Normal liquid level No scum No sign of leakage t'I!No sign of failure tsins o.dcc • ray. 712V201 Title 5 Official Inspection Foran: Subsurface Seg aga Disposal System • Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Properly Address David &Ingrid Condon Owner Owner's Name information is required for every Brewster MA page• citylrown state D. System Information (cont.) 10. Pump Chamber [locate on site pian]: 02631 9116121 Zip Code Date of Inspection Pumps in worming order: ❑ Yes ❑ No* Alarms in worming order: ❑ Yes ❑ No` Comments {note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) {locate on site plan, excavation not required}; If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: ❑ overflow cesspool number: ❑ Innovative/alternative system Type/name of technology: 1, (20x37.5' , st".00c - rev. '12W20F9 7itte S Offmial [nsoection Form: SubsUrfaee Sewa Disposal System • Page 13 of 18 Commonwealth of Massachusetts y Title 5 official Inspection Form f= Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner O�vner's Name information is required for every Brewster MA 02631 9116121 page. CityrTown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 1, (20x37.5') field 04Grade to SAS 26" Clean and dry stone o sign of hydraulic failure 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth — top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): .--.so.dcc • re•r. 7,245r � 16 Yit le 5 OMCial ]nspaction Forth! Subsurface Sewage Disposal Sy stam • Page 14 of 18 Owner information is required for every page. Commonwealth of Massachuz�efts II'Ve 5 Offs ccAad DespecNon Farm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner's Name Brewster MA 02631 9/16/21 City/Town State Zip Code Date of Inspection D. System InfoFinafion (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments mote condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): :_insp.dac• ray. 712612016 Title 5 G fxiial Inspection Form: Subsurace Sewage Disposal System •Pape 150718 ;\ Commonwealth of Massachusetts TiVe 5 Offsciai 9nspecb)n Farm Subsurface Sewage Disposal System Forth - Not for Voluntary Assessments " 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner Owner's Name information is required for every Brewster MA 42631 9116121 page. Cityfrown §tate Zip Code Date of inspection D. System Information (cont.) . 14. Sketch Of Sewage Disposal System: - Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand -sketch in the area below ❑ drawing attached separately C? I �C e PCnA ca�v�� i 3 I z2- i z; -C t5inzp.doc - rev. 712 612 6 1 8 Titla 5 Oficial inspection Farm; Su 4surfaca Sa wage Disposal System • Page 56 of 18 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner's Name Brewster MA 02631 CityfTown State Zip Code M System Wolimation (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells >5 Estimated depth to high ground water: feet 9116121 Date of Inspection Please indicate all methods used to determine the high ground water elevation: © Obtained from system design plans on record _ If checked, date of design plan reviewed: 209❑ate [❑ Observed site (abutting property/observation hole within 159 feet of SAS) © Checked with local Board of Health - explain: Plan on file ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: elevations from design plan Bottom of SAS ELV. 98.9 Bottom of Test hole ELV. 87.29 GW Adjusted GW ELV, 919 Separation >5 Before filing this Inspection Report, please see Report Completeness Checklist on next page. :5in5o,oac • rev. 7/2612016 7itle 5 0ffxiai Inspection I-Qnn SubSI1raCe SEwage 0iSPoeei System • Page 17 P` 18 F Commonwealth of Massachusetts r Title 5 Official Inspection Form �. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4?> 49 Canoe Pond Dr Property Address David & Ingrid Condon Owner Qwner's Name information is required for every Brewster MA 02531 9116121 page. CitylTown State Zap Cade Date of Enspection E. (Report Completeness Checklist Complete all applicable sections of this form inclusive of: © A. Inspector Information: Complete all fields in this section. © B. Certification: Signed & Dated and 1, 2, 3, or 4 checked 0 C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed R D. System Information: For 8: Tight/Holding Tank — Pumping contract attached For 14: Sketch of Sewage Disposal System drawn an pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 15in5p-doc • rav- 7l2E1265B Title 5 official Inspection Form: Sufis urfaea Sewage Disposal system • Page 18 cf 16 TOWN OF BREWSTER ADDENDUM TO DEP SEPTIC INSPECTION REPORT Inspection Location 49 Canoe Pond Dr 1. Residential Property —Bedrooms (inct sten, sesvingromn, office) � Family Rooms 1 Living Rooms Bathrooms 3 Dining Rooms f Kitchens I Other: Sunroom, Laundry 2 Total: 14 2. Floor Plan: Show all floors including basement: Map & Parcel Commercial Property Employees Toilets Rooms with Bath Square Feet - ;. Is the septic system, as inspected, in Bill compliance with either Yes No the 1978 ( __) or 1995 (LC ) Title 5 code? if not, list deficiencies 4. Is the system in the Zone II (Water Resource Protection Yes No 2j District)? Lot size: I TOWN OF BREWSTER ADDENDUM TO DEP SEPTIC INSPECTION REPORT Inspection Location 49 Canoe Pond Dr Map & Parcel 5. Is there a 4' separation (1978 code) or a 5' separation (1995 code) Yes U No between the bottom of the S.A.S. and adjusted groundwater? TOP OF FOUNDATION 6. Town Water LX) or Private Well (�+) Distance from nearest septic system component: 101'+ 7. Wetlands or surface water within 100' of septic system? Yes No X Distance from nearest septic system component: 230'+1- 8. Groundwater flow direction NW 9. Type of pipe used in system PVC X Orangeberg Other 10 Sanitary tees or baffles in place (Yes —No —N/A?) Se tic tank inlet Yes Septic tank outlet Yes Pump chamber inlet nla D -box inlet if pumped system nla Grease trap inlet nla Grease trap outlet n/a Risers — 1978 code within 12 inches of grade on septic tank Yes Risers — 1995 code within 6 inches of grade on all components Yes One inspection potion S.A.S. (1995 code) nla 2 FI Py /A3; wren. 1/ Lon. g {i(rr L rU y� 09 1 JA � T= •: _ _ cr. i 7-]j v f, .'F.r /v C'R!f r-,7,ra !'rfr..r /ir�Y,• y Orrr.t7,�e 97.'f..' n o BOX 000�56D Gal. GAL . 5epfrc rangy LERCH I i�G FACILITY SEPTIC TRNJK PROF I L E Nei ro .00 5' � SFP I7L TAHX OVT[ii I � 1, _1 - GAS r r 1.1EXISTING '3Q-: 70 B-5 RF.hIOy're"+ '.I ALL AREAS DISTURBED BY CONSTRUCTION ARE TO BE GRADES], LOAM COVERED. AND SEEDED. .3.} UNSUITABLE SDILS ARE TO BE REMOVED F 5AROUND LEACHING AREA AND REPLACE WITH APPROVED FILL MATERIAL. X1.1 DESIGN ENGINEER TO CERTIFY SOILS RFI- BEFORE EFBEFORE SYSTEM INSTALLATION. DESIGN ENGINEER TO CERTIFY SYSTEM IF PRIOR TO BACKFILLING. peen K Bela,Y $n+h �I4u� + Famrly Sunror J c [ e P rem"9 Re vhr ter• Garoq� lF Sad _ �eiroornFayrr K�cheN Q�� Ivfn 1=/r- APPRoxrl�,rrE F'�.c�R ,tArovr coo TH OZ —Q 7� lot d � �F�,JCN n�rgrzK G) To_e c.6. f k i�U. 98.) r,ANoF- PQNn DIII u11 6f'�=A SYSTEM DESIGN Design Flow :-5' btedrooms /Ya goI/clay 50 galSept Ic Tonk : SSO go I . x 150% - 325 90 I Use 00 Gal . Tank Leaching Fac i.l I t y : deac/7 Fief BO IOfnrX 0. ?4( TOTAL i NOTE: Garbage disposal is not permitt,-d with 111is design. LQC.qTId/1Yr 3 L- Pa re e I 2.3 G a Hr ere; 37, 318 5F CDNSTRNCTION LAYOUT LL,, i 1 'n _1 t� 3rr5' 7-E5 r .�olE ",1 tc--/e^^v. 9Y7 �_ Z5 FI i Odr9v2� '7 Al'l e . mid, is sI� B �' { ;:VamY sond Med+'urw Fond PERC. TEST rI 1 C, 7. a Yee TIlne ; 12.'� 3 .rrin- 7i 33 - ! r 9 r- Y "�3 ., E1dr:dye "5YA/4 i I ,��p TE S T I,/OL E gra Ice Ll Q•_ IJ r_.,,� �. 5 y �3 IRYRF4%3 nH4� PERC. TEST rI Pe;eC r45 7- *e ,Ue,,a1fr7 ; 7,� TIlne ; 12.'� 3 .rrin- 7i 33 - �Q �P C �,mx'r�n• MArI��,M aid ., E1dr:dye "5YA/4 71— Very F+he .nd 9 CZ^2.sy(.A FIn e fJe t;.- Ice Ll in✓7P aA IJ r_.,,� �. 5 y �3 PERC. TEST rI Pe;eC r45 7- *e ,Ue,,a1fr7 ; 7,� TIlne ; 12.'� 3 .rrin- 7i r�Qf� � .7n7�ry�n. �Q �P C �,mx'r�n• 'Pale : 7111loo 71'rNe 8:30 E1dr:dye G19001VDWrgF6-oP 4991 CrroN wv le, F, d. = 10,4 F_ Iev, 53.9 KORAN ENG I NEER E NG ,INC 941 MAIN STREET. $0. HARWICH, MA 02881 432-2978 MTE PLAN � SEWAGE DISPOSAL SYSTEM FnR 011 ROBERT PAuf-mto `ot 49 CI1A10E P01VI? D1R1 VIe bREW.S;rFR MA ALLATION PROJECT ; 00 -ZO2 1 5CA L E ! ".-3O' 1 DA TE. 9ri��pd ti; STEP LADDER THEORY OF GROUPS 5 Vision Where are we going? 4 Where can we go? Goals 3 What's our task? Group identity 2 Who are we? Trust Who are you? Safety Who am I? A"big vision" (organizational for instance) could be the catalyst for a group process which then leads to the individuals growing together through the steps to understand each other, to understand the tasks needed to be accomplished, and then to create a new vision of what is possible next as a group. Any time problems occur, the group needs to revisit the earlier steps and build again - even as far as Step I (safety). The process is cyclical and depends on people and events. This is a simple yet powerful theory of group and team process including sequential series of steps that groups of 2 or more people need in order to be effective together. These steps, if you use them, will help any group be more effective. Models from Cornell University's Harold D. Craft Leadership Program Page 1 roups are formed for various reasons. Once they are formed, the individuals in the group will need to learn about each other and learn to work well together to both enjoy and succeed at their reason for being in the first place. Step 1 is creating safety - this is about who am I - the first question anyone asks is "who am I" in this group and what influence will I have. How will people treat me? Will people listen to me? Once I feel secure about who I am - that I won't be put down or ridiculed --then I am able to move into Step Z. Which is moving into "who are you" (the others in the group) and "how do you think". What are your strengths? What can you do? What resources do you bring to the group? What issues do you have? When we know more about each other, we begin to build trust, which leads to Step 3. Intimacy or Group Identity is just a way of saying that I understand you/us better and comes as a result of increasing closeness and a comfort level with each other. Once I feel safe, have built some trust, and understand who others are in the group, we can build "who are we" together. This leads us to Step 4. We can then explore what's possible, what can we do as a group, and given our skills as people in this group - when we put that all together, what can we do? Once we're secure in who we are as a group, we can deal with what we're supposed to be doing -- what's the goal or the task. We then can focus outward and look at the work to be done. Often we jump right into the goal or task without building the safety or trust or understanding our group's resources. We ignore what motivates people and what they need to be fully engaged in the task at hand - thereby making the group less effective. Finally - once we know each other, our resources, and understand what we can do as a group, we can move into Step 5. We can now look forward to the future as a group. What are our dreams as a group - where can we go, what is our new vision? At any point a group may need to stop and rebuild. For instance, if any trauma or important change happens, (a leader leaves, membership changes, or members have a serious conflict), then we often need to return to the beginning for a time. It is critical to re -build where needed - often at the safety step, but it may be trust, it may be looking at the group as a whole, People will automatically ask "am I safe in this group" because of the trauma change. It is highly predictable that, troubling events often get projected into our minds as something that could happen to us next; or that now things are different and different is change, and change may feel threatening. Truth telling grows as safety grows, and the balance between process and task is a learned "sense' of what's needed during the life of the group. Understanding the various steps is important - measuring to learn where the group is, is important. Then consciously facilitating and designing the group gatherings to address the needs for task and process is critical to ongoing effectiveness of both the individuals in the group and the group as a whole. Models from Cornell Uriiversit 's Harold D. Craft Leadershi Pro ram Page 2 Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02631-1898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 brliealth@brewster-ma.gov W W W.BREWSTER-MA.GOV Board of Health Meeting Wednesday September 1, 2021, at 7:00PM Hybrid Meeting Health Department Amy L. von Hone, R.S., C.H.Q. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Board members attending remotely: Penny Holeman, MPH, MA, MS, Chair; Jeannie Kampas, Vice Chair; Annette Graczewski, MT (ASC P) and Kimberley Crocker Pearson, MS, MD, MPH Board members absent: Joe Ford Others attending remotely: Amy von Hone, R.S., C.H.O., Health Director and Tammi Mason, Senior Department Assistant Anyone wishing to listen to the meeting can do so via Live Broadcast (Brewster Government TV Channel 18) or by Livestream at www.livestream.brewster-ma.gov or video recording (www.tv.brewster-ma.cl ) Call to order Meeting was called to order at 7:OOPM Chairman's announcements Massachusetts Department of Public Health (MDPH) tracks the number of mosquitos that test positive for West Nile Virus and Eastern Equine Encephalitis. No mosquitos, humans or animals have tested positive for West Nile Virus or Eastern Equine Encephalitis in Brewster. MDPH announced today that they had their first case of West Nile Virus in a human this year. Brewster is in a low-risk category for West Nile Virus and for Eastern Equine Encephalitis the risk remains remote. This is an important reminder to protect ourselves from mosquito bites. 3. Citizen's forum None 4. Covid update Mrs. von Hone stated that on a weekly basis, the Massachusetts Department of Public Health tracks the number of positive cases over a 2 -week period. Currently there are 21 positive cases in Brewster. There is usually between 7-9 new cases a week. There have been a few isolated clusters over the past few weeks in some of the businesses in town. Most cases are outside of the work environment. Barnstable County numbers are going down. Most of the cases are in young adults in their 20's who have not been vaccinated. There are cases in the higher age bracket (up to 70 years of age) that have been fully vaccinated and have had breakthrough cases. BOH 911/21 Minutes Page 2 Booster shots will become available on September 20, 2021, They will be available on a schedule to be released by the State and it should follow along with the same schedule as the I" round of vaccinations (as far as who can receive it first, etc.). Barnstable County department of Health and Environment will be taking the lead on the booster shots. Every Thursday the County has a Covid vaccination clinic at the Barnstable County Complex from 10AM — 2PM. You can register online at the County website, or you can walk in. Only Pizer and Mode rna vaccines have been approved as booster. J & J has not been approved yet. The vaccine rates are not moving up at a high rate, but for the most part, Brewster has done well with the vaccinations as well as the Cape in general. Mrs. von Hone stated that she met with the school nurses, and they are In the process of finalizing guidance and protocols for opening. Masks will be mandated for everyone through October 1 s4 at least. The school population would need to reach an 80% vaccination rate before the mandate would be lifted. However, Brewster only has elementary schools so until they approve a vaccine for that age group the mask mandate will have to stay in place. If you need a vaccination card replacement you can email bcinformation@barnstablecounty.orci and give them your name, date of birth, what type of vaccine you received and the date you received it and they can look up your information in the database and give you a new card. 5. Draft Water Quality Protection District zoning Bylaw Changes Mrs. von Hone stated that this is in the beginning stages. It is all part of the power point presentation that was given to the Board on nitrogen loading about a month ago. This is in anticipation of the Planning Board approving some housekeeping items in their section of the Zoning Bylaw that relates to the Water Quality Protection District (WQPD) which oversees zone II tour public drinking water wells) and the District of Critical Planning Concern (DC PC) in Town. These parts of town have stricter requirements with regards to nitrogen loading, to protect our groundwater and to protect Pleasant Bay and the nutrient overload that is taking place there. The Town is mandated to mitigate and address this with the other 3 towns that are contributing nutrient loads to Pleasant Bay. Information included in the packets was from the Town Planner as well as the proposed changes to the Zoning Bylaw as it relates to the WQPD. The Planning Board met last week and did not make any decision or conclusion and did not vote on the proposed changes. The housekeeping changes in the bylaw are to address some confusion that has been experienced on what would fall under these restrictions and how the nitrogen loading is calculated, because when the bylaw was written, it was based on the creation of the DC PC and a nitrogen loading calculation derived from a technical bulletin put out by the Cape Cod Commission (CCC). When the Town wrote the bylaw and passed it, they didn't take the parameters that were created in the CCC Technical Bulletin word for word. This caused confusion when consultants and engineers had to go through the calculation of the nitrogen on a proposed project. Mrs. van Hone highlighted the changes for the Board. One of the issues discussed was to remove the parameters on how to calculate the nitrogen loading for a particular project. It was suggested to take it out of the Zoning Bylaw and put it into a Board of Health Regulation. The Health Department currently reviews nitrogen loading calculations when reviewing a septic system installation. A couple of items that were added were a more restrictive requirement for commercial properties. The draft states that SPPM would remain for residential properties and commercial properties would go down to 3PPM. This would reduce the BOH 9/1/21 Minutes Page 3 nitrogen loading by 21%. The other addition is that if there is a project that can't meet the 5 or 3 PPM requirement, they could potentially make a payment to offset them not being able to meet the PPM. There is no draft BOH regulation yet. Mrs. Graczewski stated that she had watched the Planning Board's 8/25/21 meeting and as it was described to the members, the regulation that is being proposed for the BOH would come into play anytime there was a bylaw or regulation in Brewster that spoke to nitrogen loading requirements or thresholds. Then the regulation would describe only how the calculation is to be performed. Dr. Pearson asked about I/A technology and the offset fes. Mrs. von Hone stated that she is unsure if this would be part of this bylaw change. 6. Consent Agenda- * Pastisserie Ever After — Residential Kitchen for Cottage Foods Mrs. van Hone stated that the application was complete, everything had been checked and a final inspection had been done. Motion: Approve the consent agenda for Patiesserie Ever After Motion: Annette Graczewski Second: Kimberley Crocker Pearson Vote: Annette Graczewski —yes Action: Motion passed Jeannie Kampas — yes Kimberley Crocker Pearson -- yes Penny Holeman — yes 7. Minutes from 2/17/21; 3/17/21; 4/7/21; 5/5/21; 6/2/27; 7/7/21 & 7/27/21 Motion: Approve minutes from 2/17/21 Motion: Annette Graczewski Second: Jeannie Kampas Motion: Approve minutes from 3/17/21 Motion: Annette Graczewski Second: Jeannie Kampas Motion: Approve Minutes from 4/7/21 Motion: Annette Graczewski Second: Jeannie Kampas Motion: Approve minutes from 5/5/21 Motion: Annette Graczewski Second: Jeannie Kampas Motion: Approve minutes from 6/2/21 Motion: Annette Graczewski Second: Jeannie Kampas Motion: Approve minutes from 7/7/21 BOH 911/21 Minutes Page 4 Motion: Kimberley Crocker Pearson Second: Jeannie Kampas Motion: Approve minutes from 7/21/21 Motion: Annette Graczewski Second: Kimberley Crocker Pearson Vote: (2/17/21;3/17/21;4/17/21;5/5/21) Annette Graczewski — yes Action: Motion passed Jeannie Kampas -- yes Penny Holeman -yes Kimberley Crocker Pearson — abstain Vote: (6/2/21) Annette Graczewski — yes Action: Motion passed Jeannie Karnpas — yes Penny Holeman — yes Kimberley Crocker Pearson — yes Vote: (7/7/21) Annette Graczewski — abstain Action: Motion passed Jeannie Kampas — yes Penny Holeman — yes Kimberley Crocker Pearson — yes Vote: (7/21/21) Annette Graczewski — yes Action: Motion passed Jeannie Kampas—yes Penny Holeman — yes Kimberley Crocker Pearson — yes 8. Liaison Reports Ms. Holeman stated that the Council on Aging is talking about having a health fair and wanted to know if the BOH wanted to join them. The Board agreed to discuss this at the next meeting. Mrs. von Hone stated that she could get in touch with Denise }sego, Director of COA and see if there is anything that they would like to see. 9. Matters not reasonably anticipated by the Chair Mrs. von Hone stated Pat the Rabies vaccine baiting was very successful. The next round will be this month, All of Brewster wlII be�%aited. She stated that there was sera typing on the positive racoon and the rabies strain found closely resembles the strain that is in Plymouth County, and they surmised that this racoon was transported to the Cape. No other positives came up. 10. Next meeting: September 15, 2021 Noted Informational items were noted Meeting adjourned at 8`OOPM � 0 COASTAL engineering co. TECHNICAL SERVICES 264 cranberry Highway Orleans, MA 02653 508.255.6511 P 548.255,6700 F Orleans 1 Sandwich I Nantucket coastal en gi neerin gcom pa ny.rom 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 TRANSMITTAL Date. 09/09/2021 Project No. WBR007.00 Via: ®1st Class Mail ❑Pick up []Certified ❑Fed Ex RECEIVE❑ :SEP::172021 BRFW5TER HEAL.-rH f L tier F75pecifications ®Other , DEr'ARTM�NT ❑Plans ❑Copy o e — We are sending the following items: fate tion 7uples 0712021 g Sheet 07/28/2021rly SE Discharge Report wlLaLiaratory Test Results 07/13/2021y Monitor Weil ❑ata Report {Field-tested data) 08/31/2021lectronic Receipt These are transmitted as checked below: ❑for approval ®far your use ®as requested ❑for review G 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. Test results also indicate high levels of BOD. We will adjust the system settings and use of process control chemicals to help improve treatment of the system. The average daily flow was approximately 9,974 gpd. Additional parameters sampled: Quaternary Ammonium Compounds — 2.6 mg/L Fecal Coliform — <100 ml 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, WWTPO CC Commission Horsley Witten Group, Inc. AquaPoint.3 LLC MOTE: If enclosures are not as noted, please contact us at (508) 255-6511 0:1o0C\W1W$R\007\TRANSMITTALSWRAN SMITTAL (JULY 2021).oer - Massachusetts Department of Environmental Protection 1934 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number m .- Groundwater Permit 12. Tax identification Number DAILY LOG SHEET 2021 JUL DAILY 3. Sampling Month & Frequency C. Daily Readings/Analysis Information Date Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine UV Flow GPD Flow GPD Flow GPD pH Residual Intensity (mgll) N") 1 9820 5.73 L� J 2 10778 6.81J 3 10890 4 9178 l� 9 11340) 6 9285 _ �� 6.92 7.57�J 7 7562 6.88 8 10501 6.98 7.39 9 9262 6.93 7.42 10 11 91175 �1 1� 12 13 10645 6.98 7.46 14 9761 J 6.96 7.48 15 10888 � 6.88 7.41 16 10503 6.93 7.44 17 9600 18 10343 �. 19 10970 7.04 7.39 20 10015 6.89 7.41 21 9767 �� �� 7.01 7.46 22 9811 23 9753 7.04 7.50 [[ j 24 9518 � 6.93 25 10734 26 10610 27 8668 6,94 7.46 28 9290�- 7.03 7.48 29 10166 7.13 7.51 30 8720 7.11 7.52 31 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 D. 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 1934 1. Permit Number 2. Tax identif[cation Number 2021 JUL MDNTHLY 3. 5amp€ing Month & Frequency 1, Parameter/Contaminant 2. Influent 3, Effluent 4. Effluent Method Units Detection limit BOD f1gG� TSS MGIL TOTAL SOLIDS MG!L AMMONIA -N Mit NrrRATE-N IAGIL TOTAL NITR0GF-N(NO3+NO2+TKN) MG/L OIL & GREASE MG1L infeffrp-blank.doc - rev. 09/15115 '86 51.. 15 1147 9.5 5.0 1 430 - E 12.8 0:1 [3 - .. I 0.050 I Groundwater Permit Discharge Monitoring Report • Page 1 of 1 [Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DISCHARGE MONITORING REPORT 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 i93�4 1. Permit plumber 2. Tax identification number E2021 QUARTERLY 2 3. Sampling Month & Frequency 1. ParameterlContaminant 2. Influent 3. Effluent A. Effluent Method Detection limit units TOTAL FHO5PHORUS AS P 6.$5 0.200 MGIL ORTHO PHOSPHATE J 0.1125 MG1L ;nfnffro-blank.doc • rev. 09115/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 HA 'A -N - A LY T I CAL ANALYTICAL REPORT Lab Number: L2140805 Client: Coastal Engineering Company 260 Cranberry Highway Route 6A Orleans, MA 02653 ATTN: Chad Simmons Phone: [508] 255-6511 Project Name: KINGS LANDING BREWSTER Project Number: WBR007.00 Report Date: 08/10/21 Serial No:08102117:44 The original project reportldata 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: INA (M-MA086), NH NELAP (2064), CT (PH -0574), IL [200477], ME (MA00086), MD (348), NJ (MA935), NY (11148), NO (257001666), PA (68-03671), RI (LA000065), TX Ji 04704476), VT (VT -0935), VA (460195), USDA (Permit #P330-17-04196). Right Walkup Drive, Westborough, MA 01581-1019 508-898-9220 (Fax) 508-898-9193 800-624-9220 - www.alphalab.com Page 1 of 22 Project Name: KINGS LANDING BREWSTER Project. Number: WBR007.00 SAMPLE RESULTS Lab ID: L-2140805-01 Client ID: INFLUENT(COMPOSITE) Sample Location: 3 STATE ROAD, BREWSTER, MA Sample Depth: Matrix: Water Parameter Result Qualifier Units RL Se rial_No:08102117:44 Lab lumber: L2140805 Report Date: 08/10/21 Date Collected: 07/28/21 08:00 Date Received: 07/29/21 Field Prep: Not Specified Dilution Bate Date Analytical MDL Factor Prepared Analyzed Method Analyst General Chemistry - Westborough Lab 07/30/21 08.00 121,25408 D Sollds, Total 430 mgil . NA NA i ..... 2.5 QB103121 15;45 ......... ........... . 121, 2540D AC Solids, Total Suspended 47. rrigll 12 1 08/05/21 11:00 08105!21 22:21 121,4500NH3-BH AT Nitrogen, Ammonia 12.8 mgll mgll 0.075 1.50 5 08/09121 08:00 08109f2i 16:54 121,4500NH3-H AT Nitrogen, Total Kjeldahl 33.3 mgll 12 NA 6 07/29/2122:50 08/03/21 16:50 121,52103 JD BOD, 5 day 88. i 4fi,:i?HA Page 6 of 22 Serial No:08102117:44 Project Name: KINGS LANDING BREWSTER Lab Member: L2140805 Project Number: WBR007.00 Report Date: 08/10/21 SAMPLE RESULTS Lab ID; L2140805-02 Date Collected: 07/28/21 08:00 Client ID: EFFLUENT(COMPOSITE) Date Received: 07/29/21 Sample Location: 3 STATE ROAD, BREWSTER, MA Field Prep: Not Specified Sample Depth: Matrix: Water Dilution Date Hate Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry - Westborough Lab Solids, Total Suspended 9.5 mgll 5.0 NA 1 - 08/03121 15:45 121,2540D AC Nitrogen, Ammonia 18.2 mgil 0.750 - 10 08105!21 11:0€1 08105!21 22:33 121,4500NH3-6 AT Nitrogen, Nitrite 0.83 mg/l 0.050 1 0713a'21 05:22 44,353,2 MR Nitrogen, Nitrate 0.77 mgll 0.10 1 - 0713a'21 05:22 44,353.2 MR Nitrogen, Total Kieldahl 24.3 mgli 0.300 - 1 08/09/21 08:00 08/09/21 16:55 121,4500NH3 H AT esJD, 5 day 51. mgA 15 NA 7.5 07/29/21 22:50 0a+63121 16:50 121,521013 Page 7 of 22 Project Marne: KINGS LANDING BREWSTER Project Humber: WBR007.00 SAMPLE RESULTS Lab 1D: L2140805-03 Client 1D: POST EQ Sample Location: 3 STATE ROAD, BREWSTER, MA Sample Depth: Matrix: Water Parameter Result QLalifier Units RL General Chemistry - Westborough Lab Soria! No:08102117.44 Lab Number' L2140805 Report Date: 08/10/21 Date Collected: 07/29/21 08:00 Date Received: 07/29/21 Field Prep: Not Specified Dilution Date (late Analytical MDL Factor Prepared Analyzed Method Analyst 07/30/21 0852 44,353,2 MR Nitrogen, Nitrate 3.8 mg/1 0.10 1 ..... .. ...._. Nitrogen, Total Kjeldahl 25.8 mgt 0.600 -- 2 08/09/21 08:00 08/69/21 i , 450ONH3-H AT l��iPHA `:��. , Page 8 of 22 Serial No:08102117:44 Project Mame: KINGS LANDING BREWSTER Lab Number, L2140805 Project Number: WBR007.00 Report Date: 08/10/21 SAMPLE RESULTS Lab ID: L2140805-04 Date Collected: 07/29/21 07:45 Client ID: EFFLUENT(GRAB) Date Received: 07/29/21 Sample Location: 3 STATE ROAD, BREWSTER, MA Field Prep: Not Specified Sample Depth: Matrix: Water Page 9 of 22 Dilution Date Date Analytical Parameter Result Qualifier Units RL MDL Factor Prepared Analyzed Method Analyst General Chemistry.- Westborough Lab Phosphorus, Total 6.85 mg11 0.200 20 08/03/21 12:00 08104121 14:59 121,4500P -E MC Phosphorus, orthophosphate 6.25 T-- - mgll 0.125 - 25 - 07/30/212:28 i21,450OP-E KA Page 9 of 22 E 0 �m u. W K 0. a a 'ti .v 4 0 o� a v � E 4 i h�E2L7U r Li d' w � r Y � a EL � as v 00 rL OD O El c 2 � R o U cr a� CON � � 1 a 4 �q G C >y "`y 00. c E 0 �m u. W K 0. a a 'ti .v 4 0 o� a v � E 4 i h�E2L7U r Li w � 00 r g EL � as v 00 rL dL El E o cr CON � � 1 a 4 G N "`y 00. c wiCON p " © 0 a to CL ®�L�r W � 67 a Fm _ rA 1141, C p _ y N ry it hJ ❑.� So. C�' w 7 00 r g W� � as v 00 rL C E o cr � � } G G "`y 00. c " © 0 a to CL C�' (L 7 00 W� 9 a v 00 rL C 1.L ENVIROTECHLABORATORIES� INC. MA CERT NO.: M -MA 063 8 Jan Sebastian Drive Sandwich, JIIA 02563 (508)888-6460 1-800-339-6460 FAX (508)888-6446 6r`edtresday,, September 1, 2021 Coastal Engineering Co. Time 260 Cranberry Highl"OY Orleans, MA 02653 Pro jectllratn e: Kings Landing Cornments: Project Mumber: WBR007.0 Sampled By: Chad Simmons Lab Order Number: WW -211762 Date Received: 07/29121 Sample Tip-,5urnple Time Sample Date Camrrteitts Effluent A 10:30 0712W21 Parameters Units Test Results Reportable Limits Date Analyzed Analyst Ale (hod ❑il & Grease Grab mg1L 2.5 1.0 05114121 KB EPA 1664 auatemary Ammon€urn Compoun mg/L 2.6 0.8 03103121 RIA' HACH 8337 Fecal Coliform GFG1100ml X160 1001100m1 07/29/21 NB @ 15:00 5M 92220 All ,sawples were analyzed within rhe established guidellnes of US EPA approved ineMads with all requirements met unless otherwise noted at the end of a given sample's analytical results We certify that the folio wing results are true and aecu rate to the best of our kno}eledge. BRL=below reportable lrrarts *see attached By: RonaldJ. Saari Page 1 of 1 Laboratory Director Massachusetts Department of Environmental Protection eDEP Transaction Copy_ Here is the file you requested for your records. To retain a copy of this file you must save and/or prin R E C E 1 V E ❑ SEP 0 7 2021 Username: EBELAIR Bf_�E.wPAR HEALTHpEPAri rMENT Transaction ID: 1300453 Document: Groundwater Discharge Monitoring Report Forms Size of File: 2032.80K Status of Transaction: Submitted Date and Time Created: 8124/2021:11:14:37 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. ' WUI GQU VI IAO. VLAI L.,G I I VLGI.LIV11 - VI VLal ILI VVC LGI L 1.] kICLI tJU 1 IVy1 Lil 11 1. r GI 11l Il 1Y u 11 kuvl Groundwater Permit �: -•.. 2, Tax identification Number MONITORING WELL DATA REPORT 2021 QUARTERLY 3 3. Sampling Month & Frequency A. Facility Information Importarlt:When filling out forms on 1. Facility name, address: the computer, use BREWSTER MANOR only the tab key to a. Name move your cursor - 873 HARWICH ROAD do not use the return key. b. Street Address BREWSTER FM A 102631 VG:1 C. City d. State e. Zip Code 2. Contact information: A+ ]DAVID FELDMAN a. Name of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b, Telephone Number c. a -mall address 3. Sampling information: 1711912021 IRI ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name NICOLE SKYLESON c. Analysis Performed 6y (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 quarterly 3 ' All forms for submittal have been completed. 2, r This is the last selection. 3. Delete the selected form. gdpols 2015-09-15.doc • rev. 09115/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 `---•�yw +• • r•www•vr. 1 1•..•tuulull - UI UL,1114 YVQL�1 VIJI.•IIRIyO 1 luyl ulll C Groundwater Permit MONITORING WELL DATA REPORT fI. C. 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 • DRY = Not enough water in well to sample. 2. Tax identification Number 2021 QUARTERLY 3 3. Sampling Month & Frequency Parameter/Contaminant {WW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #. 3 Well #: 4 Well #: 5 Well #: 6 NITRATE&N 0.76 0.61 0.59 0.58 MG/ TOTAL NITROGEN[NO34NO2+Ti{ 1.34 0.61 1.23 1.24 MGI. mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data for Groundwater Permit • Page 1 of 1 L'i I UI GOU VI I%GOQ aI UV I IVLGVLIVII — V1 VMI IU VY 0IGI L IJVI IRI I10 1 IU IQ111 I. r QI IIIIL IVLIi11UCl Groundwater Permit2. Tax identification Number MONITORING WELL DATA REPORT 2021 JUL MONTHLY 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer, use JBREWSTER MANOR only the tab key to a. Name move your cursor - 873 HARWICH ROAD do not use the return key. b. Street Address f3REWSTER IMA 102631 y C. City d. State e. Zip Code 2. Contact information. RW AA DAVID FELDMAN Id a. Name of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Number c. e-mail address 3. Sampling information: 7/19/2021 1WHITEWATER a. Date Sampled (mrrdddlyyyyl) b. Laboratory Name DOUG MURPHY c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Jul Monthly ' — All forms for submittal have been completed. 2. r 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 VG1Guu VI I�CSVGIVG 1 IU[Gl�II VII UlVU114f YY RLGI VIJU1IRIL�G 1 IUL�.Igll! 1. F Vk 1 l 111 I N", I tuft MW Groundwater Permit 2, Tax identification Number MONITORING WELL DATA REPORT 2021 JUL MONTHLY 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "0", below detection limit, less than [tel value, or not detected, enter "ND" • TNTG = too numerous to count. (Fecal results only) • N5 = Not Sampled • DRY = Not enough water in well to sample. Parameter/Contaminant MW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 PH 5.9 15.8 116.1 S.U. STATIC WATER LEVEL_ 59.69 58.97 59.58 25.76 FEET SPECIFIC CONDUCTANCE 486 498 275 944 UF,t1HOM Well #: 5 Well #: 6 mwdgwp-blank.doc • rev. 09115/15 Monitoring Well data for Groundwater Permit • Page 1 of 1 L UI G,OU UI I %GOWU1 L. 1 l UIGVLI VI l - VI VUI PVVVC LUI L IQlJRl LUG I I VU1 Ci111 1. 1 [-;1I111L IYUI I ILJGI L�i Groundwater Permitlax identification Number DAILY LOG SHEET 202'1 JUL DAILY 3. Sampling Month & Frequency Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. �Q A. Facility Information 1. Facility name, address I$REWSTER MANOR a. Name 873 HARWICH ROAD b. Street Address SREWSTER IMA 102631 C. City d. State e. Zip Code 2. Contact information: DAVID FELDMAN a. Name of Facility Contact Person 7817079527 b. Telephone Number 3. Sampling information: ldfeldman@wlngatehealthcare.com c. e-mail address 7/31/2021 1WHITEWATER a. Date Sampled (mmlddlyyyy) b. Laboratory Name DOUG MURPHY c. Analysis Performed By (dame) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Daily Log Sheet - 2021 Jul Daily ' I— All forms for submittal have been completed. 2. r- This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15,doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 uurvuu vo I uo t.c o IULc�uWro — �IWUI , Jv r —H1 mill L Groundwater Permit DAILY LOG SHEET C. Daily Readings/Analysis Information Date Effluent Reuse Irrigation Turbidity Influent pH Flow GPD Flow GPD Flow GPD 1 614 2 170 3 1195 L _ 4 11208 5 183 — 6 1291 7 1299 8 260 C� 1396 10 1361 11 220 12 1199 13 1414 14 1287 15 16 1164 17 1457 �- 18 586 19 1277 _ 20 1809 21 8401 22 23 3092 24 146 25 149 26 3046 27 208 28 29 30 31 9dpo1s.doc • rev. 09/15115 I. r co n rn rvuoi 1. ur 2. Tax identification !Number 2021 JUL DAILY 3. Sampling Month & Frequency Effluent Chlorine UV pH Residual Intensity (mg/1) CQ 7.6 4.8 7.2 7 4.4 6.3 6.5 6.7 6.7 6.5 5.2 4 4.3 6 6.5 6.5 6.3 Groundwater Permit Daily Log Sheet • Page 1 of 1 lrrtportant:When filling out forms on the computer, use only the talo key to move your cursor - do not use the return key. "RM VK uur CrAU UI [%GQl II LG 1 1VlG1olIV11 - L IVUI RI YYa IGI u5�41 I 1 ,Vyr al l! Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information ,. r vr, InL rrurnuar 2. Tax identification Number 2021 JUL MONTHLY 3. Sampling Month & Frequency 1. Facility name, address: BREWSTER MANOR a. Name 873 HARWICH ROAD b. Street Address BREWSTER IMIA J02631 C. City d. Stake e. Zip Code 2. Contact information: DAVID FELDMAN a. Name of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Number 3. Sampling information: c, e-mail address 7/20/2021 IRI ANALYTICAL. a. Date Sampled (mrNddlyyyy) b. Laboratory Name NICOLE SKYLESON c. Analysis Performed By (Name) S. Form Selection 1. Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Jul Monthly ' J_ All forms for submittal have been completed. 2. r This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 ' Groundwater Permitu uYYUc Tax identification Number DISCHARGE MONITORING REPORT 2021 JUL 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. ParameterJContaminant 2. Influent 3. Effluent .4. Effluent Method Units Detection limit Boo 9.2 ND 3.0 MG/L TSS 9.0 ND 2.0 MG1L �— TOTAL SOLIDS 210 MG& AMMONIA -N 11.4 MG& NITRATE -N $.1 0,050 PAGIL TOTAL NITROGEN(NO3+NO2+TKN) MGA - OIL & GREASE ND 0.50 MG(L infeffrp-blank.doc • rev. 09115115 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. Q sk wul coo UI ixG u1 uU 1 IULGUUI l - V1 UI.I1 Ill YYCILG1 LJIJL�l IM ljG 1 IWljP CII 11 Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information 1. ral nut rrulnuar 2. Tax identification Number 2021 ANNUAL $. Sampling Month & Frequency 1. Facility name, address: BREWSTER MANOR a. Name 873 HARWICH ROAD b. Street Address BREWSTER MA 102631 C. City d. State e. Zip Code 2. Contact information: DAVID FELDMAN a. Name of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Number 3. Sampling information: c. e-mail address 7120!2021 IRI ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name NICOLE SKYLESON c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Annual �- All forms for submittal have been completed. 2. r This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 . —�a�.aw — .%--Ui 1 IVLGI�NVII" V'Vu11U VV G kc v1—iu1 �... 1-yi ul,l I. UOI I I IR II Ul lI UW1 MW Li Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT 2021 gNNUAL 3. Sampiing Month & Frequency D. Contaminant Analysis Information ■ For "0", below detection limit, less than (<) value, or not detected, enter "ND' • TNTC = too numerous to taunt. (Fecal results only) • NS = Not Sampled 1. ParameterlContaminant Units TOTAL PHOSPHORUS AS P MGfL ORTHO PHOSPHATE MGL 2. Influent 3. Effluent 0.40 0.32 Q. Effluent Method Detection limit 0.010 f 0.020 infeffrp-blank.doc • rev. 09/15115 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 L'i LJLAI GQU VI 1 %G Uk4 U 1 1 VLQVLIVI I - VI VUJ IVVWC LGl L kQ] 11C 1lU. G 1 I Vy l 0111 1. r GI 11111 i'1 UI I tUCI Groundwater PermitDISCHARGE MONITORING REPORTTax idenfificatian Number 2021 ANNUAL 3. Sampling Month & Frequency E. VOC Analysis Information • If VOCs are present, please indicate the amounts of the individual compounds in Pg/1. • For "0', below detection limit, less than (<) value, or not detected, enter "ND" • NS =Not Sampled 1. Parameter/Contaminant Units ACETONE UGIL BENZENE UGIL 1,1 DICHLOROETHANE UGIL 1,2 EXCHLOROETHANE UGL 1,1 DICHLOROETHYLENE UG L CIS -1, 2 -DIC H LOROET HY LE N E UGIL TRANS 1,2 DICHLOROETHYLENE UGIL ETHYL BENZENE U&- METHYLENECHLORIDE UGIL TOLUENE UGA. 0 -XYLENE UGIL P)M XYLENE UGIL CARBON TETRACHLORIDE UGIL CHLOROFORM UGJL 2-BUTANONE (MEK) UGIL 2. Influent 3. Effluent 4. Effluent Method Detection limit it[S N5 NS NS NS J NS I NS NS I NS NS NS NS NS NS NS A NS I NS NS N5 771 NS NS NS NS NS I NS NS infeffrp-blank.doc • rev. 09/15115 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 ui..,I GQU VI IIG JVViLG I 1VlGl+ll Vll — LJI V%aI IU YYy IGi V[J U[ICilyG 1 IVP AIII 1. !- VII IIF% 1Viii![VVI Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT 2021 ANNUAL �'. 3. Sampling Month & Frequency E. VOC Analysis Information • If VOCs are present, please indicate the amounts of the individual compounds in pgll. • For "0', below detection limit, less than (<) value, or not detected, enter "N❑" • NS =Not Sampled 'i. Parameter/Contaminant Units 4-METHYL-2-PENTANONE (MIBK) UGIL TRICHLOROETHYLENE UGIL TETRACHLOROETHYLENE UGIL 1,1,1 TRICHLOROETHANE UGIT. VINYLCHLORIDE UGIL STYRENE UGIL CHLOROBENZENE UGC. METHYL TERTIARY BUTYL ETHER ML. CHLOROETHANE UGIL 1,2-DICHLOROPROPANE UG/L DIB ROM OC H LO ROMETHANE UGIL 1,1,2 -TRI CH LORD ETHAN E UGIL 2-CHLOROETHYLVINYL ETHER UGIL B RO M ODIC H LO ROMET HANE UGIL BROMOFORM UGIL 2. Influent 3. Effluent 4. Effluent Method Detection limit NS NS FNS -NIS � NS I NS NS NS NS NS NS NS NS NS NS NS NS 1 NS NS NS NS NS NS NS NS NS INS _I NS NS NS infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit discharge Monitoring Report • Page 1 of 1 L'i L U1 UOU VI 1XGOVWIII 1 IULG%�LIUII - V1 VUI RfYYPLCI V1041kQ1 yc 1 iVkJl Elf[1 1. r OI 1111% INUki WCI Groundwater PermitDISCHARGE MONITORING REPORT 2• Tax identification Number 2021 ANNUAL 3. Sampling Month & Frequency E. VOC Analysis Information • If VOCs are present, please indicate the amounts of the individual compounds in pg/l. • For "0", below detection limit, less than (<) value, or not detected, enter "ND" • NS =Not Sampled 1. ParameterlContaminant Units 1,1,2,2 -TETRACHLOROETHANE UGIL CHLOROMETHANE UGIL BROfMOMETHANE UG& CARBONDISULFIDE UGL 2-HEXANONE UGIL ACROLEIN UGIL ACRYLONITRILE UGIL TRAN 5-1, 3-D I C H LOROP ROA E N E UG& CIS -1,3 -DI C HLO ROP RO PE NE UGIL 2. Influent 3. Effluent 4. Effluent Method Detection limit NS NS N5 NS NS NS NS NS I NS NS NS NS NS NS NS NS NS NS infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 L lmportant:wher, filling out farms 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 electronic -ally and want to attach additional comments, select the check box. V"j GAU VI I %GQ] UI VG 1 I UIG VLI VI I - Ll1 VMI IU VY 0 LGI 1011 LUG I k U.1 Q 11 1. F G11111L 1V Ul I1Vcj Groundwater Permit 2. Tax identification Number Facility Information REWSTER MANOR a. Name 873 HARWICH ROAD b. Street Address BREWSTER IMA 102631 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." ELIZABETH BELAIR 8/24/2021 a. Signature b. Date (mmld(ilyyyy) gdpd[s 2015-09-15.doc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 August 34, 2021 Bryan Webb (via email) Ocean Edge Resort 2907 Main Street Brewster, MA 02631 RE: Ocean Edge Resort Wastewater Treatment Facility Monthly Operations Report — July 2021 Dear Mr. Webb: Weston @Sampson" 55 Walkers Brook Drive, B+.nte 100, Readirg, PAA 01851 Tel, 978.532.180 Enclosed please find the monthly Operations Reporting Package for the Ocean Edge Resort wastewater treatment facility (WWTF) located at 832 Village Drive in Brewster, MA. Weston & Sampson Services, Inc. would like to note the following: • Monthly TSS of effluent sample collected on July 14 was reported to be 46 mg/L, which is over the maximum permissible limit of 30 mg/L, An additional sample was collected on July 30, and results were reported to be in compliance with permit limits. • Monthly Total Nitrogen of the July 14 effluent sample was reported to be 16.3 mg/L. The maximum permissible limit is 10 mg/L. The result of the recollected sample was reported to be 16.3 mg/L,,which is also over the maximum limit. • The elevated results are likely due to a high level of grease in the grease trap that carried over to the Amphidrome filter. The filters have since been replaced, and extra Amphidrome backwash cleaning cycles have been introduced to remove any excess grease buildup. • All other regulated effluent parameters of samples collected throughout the month were reported to be within their respective permissible limits. • quarterly effluent and monitoring well samples were collected this month. • Data was filed with MassDEP electronically, via eDEP. A copy of the transaction is included in this package. If you have any questions or concerns regarding this report, or the wastewater treatment facility, please feel free to contact me at wsscompliance@wseinc.com. Regards, WESTON & SAMPSON SERVICES, INC. James R. Tringale Compliance Coordinator cc: Brewster Board of Health (via email) FR Mahony Associates (via email) westonandsampson.cm ofrnes h: MA, CT, NH, VT, NY, NJ, PA, SC & FL LlMassachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: WSSINC Transaction ID: 1302988 Document: Groundwater Discharge Monitoring Report Forms Size of File: 1612.60K Status of Transaction: submitted Date and Time Created: 911012021:1:23:04 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Important:when filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Q Grp Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DAILY LOG SHEET A. Facility Information 1. Facility name, address: OCEAN EDGE CONFERENCE CTR a. Name 633 j 1. Permit Number 2. Tax identification Number 2021 JUL DAILY 3. Sampling Month & Frequency IROUTE 6A b, Street Address BREWSTER IMA 02631 G. City d. State e. zap Code 2. Contact information: AMES R. TRINGALE a. Name of Facility Contact Person 9785321900 b. Telephone Number 3. Sampling information: WSSCompliance@wseinc.com c. e-mail address 711!2021 JONSITE MEASUREMENTS a. Date Sampled (mrnlddlyyyy) b. Laboratory Name CHRIS VIGNEAU c. Analysis Perforated By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Daily Log Sheet - 2021 Jul Daily J - All forms for submittal have been completed. 2.- This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 633 Bureau of Resource ProtectiDn - Groundwater Discharge Program 1, Permit Number M1 Groundwater Permit 2, Tax identification Number DAILY LOG SHEET 2fl21 Jl1t DAILY 3, Sampling Month 0& Frequency C. Daily Readings/Analysis Information Date Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine UV Flaw GPD Flow GPD Flow GPD pH Residual Intensity (mg11) {°Im} 1 15125 �� 7.02 7.46�- 2 13113 I� 3 13113 4 13113 5 13113 7.00 7.38 B 22589 , J 6.97 7.44 7 18217 7.03 7.37 $ 15461 7.00 17335 10 17335 11 17335 7.Ofi 7.38 12 17329 7.01 7.35 13 .14555 7.00 7.31 14 18647 7.04 7.37 15 15832 f �I 16 15832 7.09 7.46 17 15709 18 15709 7.04 7.38 J �� 19 18425 6.97 7.40 20 16739 7.00 7.44 21 20245 7.07 7.39 22 9580 7.02 7.36 23 18482 24 18482 25 1$482 7.00 7.43 _ J 28 15556 6.98 7.35 27 15823 7.05 7.42 28 17327 � 7.12 F74 44 771 29 16875 7.07 8 30 17$25F=1 31 17825 gdpols.dor, • rev. 09115/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Important:When filling out forms on the computer, u s e only the tab key to move your cursor - do not use the return key. rob lk Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT A. Facility Information 1. Facility name, address: OCEAN EDGE CONFERENCE CTR a. Name ROUTE 6A b. Street Address BREWSTER MA C, Gky d. State 2. Contact information: 633 1. Permit Number 2. Tax identification Number 2021 JUL MONTHLY 3. Sampling Month & Frequency 102631 e. Zip Code JAMES R. TRINGALE a. Name of Facility Contact Person 9785321900 WSSCompliance@vseinc.com b. Telephone Number c. e-mail address I Sampling information: 7/14/2021 JONSITE MEASUREMENTS a. Date Sampled (mmlddlyyyy) b. Laboratory Name CHRIS VIGNEAU G. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Jul Monthly r All forms for submittal have been completed. 2. % This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 633 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number L11 Groundwater Permit 2.7ax identification Number MONITORING WELL DATA REPORT 2021 JUL MONTHLY 3, Sampling Month & Frequency C. Contaminant Analysis Information • For "0", below detection limit, less than (a) value, or not detected, enter "ND" • TNTC = too numerous to count. (Fecal results only) ■ NS = Not Sampled • DRY = Not enough water in well to sample. ParameterlContaminant DG2 DG3 DG4 DG5 O01 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 PIS 6.40 6.20 6.10 6.10 6.So S.U. STATIC WATER LEVEL 46,3 4$,0 42.547.3 40.6 FEET SPECIFIC CONIX.ICTANCE 400 360 590 250 2 =3 D UVH SIC mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data for GrauTrdwater Permit • Page 1 of 1 Lei Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. tdE :] reYrm Massachusetts Department of Environmental Protection Bureau of Resource Protection _ Groundwater Discharge Program Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information 633 1. Permit Number 2. Tax Identification Number 2021 JIJL MONTHLY 3, Sampling Month & Frequency 1. Facility name, address: OCEAN EDGE CONFERENCE GTR a. Name ROUTE 6A b. Street Address BREWSTER MA 102631 C, City d. State e. Zip Code 2. Contact information: JAMES R. TRINGALE a. Name of Facility Contact Person 9785321900 IWSSCompliarice@wseinc.com L Telephone Number c. e-mail address 3. Sampling information: 711412021 IRI ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name VARIOUS ANALYSTS c. Analysis Performed By [Name] B. Form Selection Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Jul Monthly TJ r- All forms for submittal have been completed. 2, i This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09115115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 833 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit D 2. Tax identification Number DISCHARGE MONITORING REPORT 2021 JUL MONTHLY 3. Sampling Month & Frequency D. Contaminant Analysis Information • For V', 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 Units BOD MIuIL TSS MGIL TOTAL SOLIDS MGIL AMMONIA -N MGt- NITRATE-N MM TOTAL NITR0GEN(NO3+Na2+TKN) lvr- IL OIL & GREASE NfGIL 2. Influent 3, Effluent 250 2 390 780 38 4. Effluent Method Detection limit 1❑ 2+0 0.68 4.050 F16.28 ND 0.50 i nfeff rp- b la n k. d ac • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information lmportant:When filling out forms on 1. Facility name, address: the computer, use ]OCEAN EDGE CONFERENCE CTR only the tab key to a. Name move your cursor - ROUTE 6A do not use the return key. h. Street Address BREWSTER MA 4:1 C. City d. State 2. Contact information: R AIIJAMES R. TRiNGALE 633 1. Permit Number 2. Tax identification Number 2021 QUARTERLY 3 3. Sampling Month & Frequency 02631 e. Zip CcsSe a. Name of Fad Ilty Contact Person 9785321900 WSSCompliance@wseinc. cam b. Telephone Number c. e-mail address 3. Sampling information: 7/14/2621 JR1 ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name VARIOUS ANALYSTS c. Malysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 [Quarterly 3 ' 1- All forms for submittal have been completed. 2. F This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1633 Bureau of Resource Protection - Groundwater Discharge Program 1. permit Number _ Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT 12021 quARiERLY 3 3. Sampling Month & Frequency D. Contaminant Analysis Information • For '0", below detection limit, less than (a) value, or not detected, enter "ND' • TNTC = too numerous to count, (Fecal results only) • NS = Not Sampled 1, ParameterlContaminant 2. Influent 3. Effluent 4. Effluent Method Units Detection limit TOTAL PHOSPHORUS AS P 44 ` 10.010 l MG.+L ORTHO PHOSPHATE 7,0 ] 0.020 Mia L i n feffrp-bl ank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection 633 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number oll Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT 2021 QUARTERLY 3 3. Sampling Month &Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer, use JOCEAN EDGE CONFERENCE CTR only the tab key to a. Name move your cursor - ROUTE 6A do riot use the return key. b. Street Address BREWSTER MA 02fi31 VQ C. City d. State e. Zip Code 2. Contact information: JAMES R. TRINGALE a. Name of Facility Contact Person 9785321900 b. Telephone Number 3. Sampling information: WSSCom piiance@wseinc.corn c. e-mail address J7/1412021 JR1 ANALYTICAL a. Data Sampled (mm/ddlyyyy) b. laboratory Name VARIOUS ANALYSTS c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Quarterly 3 ' All forms for submittal have been completed. 2. r This is the last selection. 3. F' Delete the selected form. gdpdis 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Lag Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT 633 1. Permit number 2. Tax identification Number 2021 QUARTERLY 3 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "ff", below detection limit, less than (<) value, or not detected, enter "ND" • TNTC = too numerous to count. (Fecal results only) • N5 =Not Sampled • DRY = Not enough water in well to sample. Parameter/Contaminant DG2 D03 DC -4 DG5 UGI Units Well A 1 Well 4: 2 Well #: 3 Well 4: 4 Well #: 5 NITRATE -N 6.7 3.3 1.7 F5.62.7 TOTAL NITROGEN{NO3+NO2+Ti{ 6 91 3.3 1.75.fi I`•7�_� MCIL TOTAL PHOSPHORUS ASP 0.78 fi,244O.v4 0.33 0.31 MG& ORTHO PHOSPHATE 0 fi$1 ND ND ND ND Nei Well #: 6 C mwdgwp-blank.doc • rev. 09/15/15 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 1633 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number Facility Information [OCEAN EDGE CONFERENCE GTR a. Name ROUTE 6A b. Street Address BREWSTER IMA 102631 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 penaltles for submitting false information, including the posslbility of fine and Imprisonment For knowing vidatians IAARIANNA COOMBS 8/30/2021 a. Signature b. date (mmfddfyyyy) rting Package Comments MONTHLY TSS OF EFFLUENT SAMPLE COLLECTED ON JULY 14 WAS REPORTED TO BE 46 MGIL, WHICH IS OVER THE MAXIMUM PERMISSIBLE LIMIT OF 30 MG/L. AN ADDITIONAL SAMPLE WAS COLLECTED ON JULY 30, AND RESULTS WERE REPORTED TO BE IN COMPLIANCE WITH PERMIT LIMITS. IONTHLY TOTAL NITROGEN OF THE JULY 14 EFFLUENT SAMPLE WAS REPORTED TO BE 6.3 MG/L. THE MAXIMUM PERMISSIBLE LIMIT IS 10 MGIL. THE RESULT OF THE :ECOLLECTED SAMPLE WAS REPORTED TO BE 16.3 MG/L, WHICH IS ALSO OVER THE 1AXIMUM LIMIT. THE ELEVATED RESULTS ARE LIKELY DUE TO A HIGH LEVEL OF GREASE IN THE GREASE r TRAP THAT CARRIED OVER TO THE AMPHIDROME FILTER. THE FILTERS HAVE SINCE BEEN REPLACED, AND EXTRA AMPHIDROME BACKWASH CLEANING CYCLES HAVE BEEN INTRODUCED TO REMOVE ANY EXCESS GREASE BUILDUP. gdpols 2015-09-15.doc - rev. 09/15/15 Groundwater Permit • Page 1 of 1 Commonwealth of Massachusetts 041 executive Office of Enargy & Env ironrhen'tal Affairs Department of Environmental Protection Southeast: Regional Office .20 Rivarside Drive. Lakeville MA 02547.508-046-2700 Charles D. Baker Kathleen A. Theoharides Governor Seoretary Karya E. Polito Made 5uuberg UeUtenant Governor Commissioner Mr. Paul Anderson, Superintendent Brewster Water Department 165 Commerce Park Road Brewster, MA 02531 Dear Mr, Anderson: September 27, 2021 RE: BREW STER = Public Water Supply Brewster Water Department PWS IDA: 4041000 Water Quality Initial Monitoring PFAS6 The Massachusetts Department of Environmental Protection (MassDEP) has received your PFAS Initial Monitoring Waiver Application. The PFAS laboratory testing results for the first two quarters of monitoring were below the applicable Minimum Reporting Levels (Not Detected) and the Brewster Water Depatflnent has determined that there is no known or suspected PFAS contamination in the vicinity of the PWS and its sources. Therefore, the Brewster Water Department qualifies for a waiver of the third and ' fourth quarters of PFAS Initial Monitoring, pursuant to 310 CMR. 22.070(5)(c). This waiver is for the following locations: 10000; 10005, 10006, 10060. As a community system serving over 3,300 customers, the Brewster Water Department will be required to complete routine PFAS monitoring of two quarters in one year during the next 3 -year Compliance Period (2023•-2025). Please note that the signature on this cover letter indicates formal issuance of the attached document. If you have any questions regarding this matter, please contact Bill Schwartz at (508) 946-2818 or wiliiam.schwartz@mass,gov. . Sincerely, Qy- ' `�- Jim McLaughlin, Chief Drirtking Water Program Bureau of Water Resources Y:IDWPIA3-chivel,SERO1Brewster4041000-Mater Quality -2421-49-27 ec: Paul Anderson, panderson@brewster-ma.gov Brewster Board of Health, tmyAiDn(j!Lrewster-mag❑ This Information Is available In alternate format. Contant Web all e Watera-Ekanem, Dlrectorof AlvereltylC4vll Rights at 617.292-6754. TTY# MassRefay Service i-800.439-2370 MassDEP Website: mvw.mass.gavldep Printed on Recycled Paper Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: DDELAIR Transaction ID: 1306750 Document: Groundwater Discharge Monitoring Report Forms Size of File: 714.07K Status of Transaction: Submitted Date and Time Created: 9/2012021:9:20:43 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to 'Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection 1599 i, Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT 2021 AUG MONTHLY 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on ] . Facility name, address: the computer, use IBREWSTER MANOR only the tab key to a. Name move your cursor - 873 HARWICH ROAD do not use the return key. b. Street Address B REWSTER IMA 102631 app c. City d. State e. Zip Code 2, Contact information: JMVP #Aj DAVID FELDMAN a. Name of Facility Contact Person 7817079527 dfeldman@vingatehealthcare.com b. Telephone Number 3. Sampling information: c. a -mall address 8/24/2021 RI ANALYTICAL a. Date Sampled [mmlddlyyyy] b- Laboratcry Name DOUG MURPHY c. Analysis Performed By [Name] B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Aug Monthly 2-1 - All forms for submittal have been completed. 2, r This is the last selection. 3, r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 5gg Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT ---- -- — ---- - 12021 AUG MONTHLY 3. Sampling Month & Frequency C. 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 • DRY = Not enough water in well to sample. Para meteT/Contaminant FAW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 PH I5.7 15.6 5.9_..- -- 5.9 s.u. STATIC WATER LEVEL 59.73 - �58.98 I f 59.67 FEET SPECIFIC CONDUCTANCE X14 211 l2 403 135 -� ;--_ I� -- -� UMHOSIC mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data for Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information important:When filling out forms on 1. Facility name, address: the computer, use JBREWSTER MANOR only the tab key to a. Name move your cursor- 873 HARWICH ROAD do not use the return key. b. Street Address BREWSTER IMA c. City I State lk Ar 2. Contact information: + DAVID PELDMAN 1. Permit Number 2. Tax identification Number 2021 AUG MONTHLY 3.5ampling Month & Frequency 02631 e. Zip Code a. Name of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Nurnter c. e-mail address 3. Sampling information: 8/31/2021 a. Date Sampled (mmlddlyyyy) NICOLE SKYLESON c. Analysis Performed By (Name) B. Form Selection RI ANALYTICAL b. Laboratory Name 1. Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Aug Monthly .J r All farms for submittal have been completed. 2.- This is the last selection. 3. F Delete the selected form. gdpdts 2015-09-15.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 1 of 1 Massachusetts Department of Environmental Protection 1599 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT Zp -- AUG MDNTHLY 3. Sampling Month &Frequency D. Contaminant Analysis Information • For "fl", 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 8 - MG1L. TSS 489 J NS NS _ Mc-�L _. TOTAL SOLIDS 690 MGL AMMONIA -N r� g MGh- NITRATE-N MaL TOTAL NITROGEN(NO3+NO2+TKN) NS NS MGIL OIL & GREASE NS INS -� MGL infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Important:When filling out forms on the computer, u s e 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 It you are filing electronic -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 Information REWSTER MANOR a. Name 873 HARWICH ROAD 599 1. Permit Number 2. Tax identification Number b. Street Address BREWSTER UA 102631 c. City d. State e. Zip Code Certification "I certify under penalty of law that this document and all attachments were prepared urrier my direction or supervision In accordance wlth a system designed to assure that quallfled 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:' ELIZABETH BELAIR 9/17/2021 a. Signature b. Date (mmlddly)yy] ;porting Package Comments .ANT DID NOT DISCHARGE FOR AUGUST 2021. 39,900 GALLONS WERE PUMPED OFFSITE HILE METAL REHAB. WAS BEING PERFORMED IN THE PLANT. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 Massachusetts department of Environmental Protection eaEP Transaction copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: SFARRENKOPF Transaction ID: 1308473 Document: Groundwater Discharge Monitoring Report Forms Size of File: 1028.94K Status of Transaction: In Process Date and Time Created: 9/1412021:1:24:14 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DAILY LOG SHEET A. Facility Information Important: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 - 383 SOUTH ORLEANS ROAD do not use the return key. b. Street Address f BREWSTER MA Idd C. City d. State 2. Contact information: ren JOSEPH SMITH 746 1. Permit Number 2. Tax Identification Number 2021 AUG DAILY 3. Sampling Month & Frequency 02631 e. Zip Ccde a. Name of Facility Contact Person 7742125005 ljsmith@NSUWater.com b. Telephone Number c. e-mail address 3, Sampling information: 8/1/2021 INOTAPPLICABLE a. pate Sampled (mmlddlyyyy) b. Laboaatory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Daily Log Sheet - 2021 Aug Daily J r All forms for submittal have been completed. 2. r This is the last selection. 3.- Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number _ Groundwater Permit 2. Tax identification Number DAILY LOG SHEET 2021 AUG DAILY IL =I 3. Sampling Month & Frequency C. Daily Readings/Analysis Information Date Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine Uv Flow GPD Flow GPD Flow GPD pH Residual intensity (ingll) (ON 1 9244 2 2005 7.0 74.3 310278 7.2 J 69.2 4 8067 I 7.1 74.0 5 7288 6.8 69.3 6 905 7.0 J� 66.6 7 9055 8 9055 9 6627 7.0 61.6 10 7523 6.8 61.7 11 8948 6.8 61.7 12 6335 7.2 68,8 13 7938 7.4 74.4 14 7938 15 i i i J i 1 16 9351 7.5 66.7 17 8303 7.2 74.6 18 2734 7,1 =66.8 19 7120 7.1 69.2 2a 9888 62.1 21 22 9888 23 11213 8.5 6.8 66.6 24 8355 _ 6.9 64.2 25 4898 6.9 86.5 26 $468 7.0 65.8 27 7321 6.9 !J 62.4 28 7321 29 7321 30 8836 7.0 88.5 31 8748 7.0 74.3 gdpols.doc • rev. 09/15115 Groundwater Permit Daily Lag Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program ' Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information Important:When filling out forms on I. Facility name, address: the computer, use JPLEASANT BAY HEALTH CTR only the tab key to a. Name move your cursor- 383 SOUTH ORLEANS ROAD do not use the return key. b. Street Address BREWSTER IMA 1#1fAb G. City d. State Ilk At 2. Contact information: MIT AJOSEPH SMITH 746 I 1, Permit Number 2. Tax identification Number 2021 AUG MONTHLY f 3, Sampling Month & Frequency 02631 e. Zip Code a. Name of Facility Contact Person 7742/25405 ljsm[th@NSUWater.com b. Telephone Number c. e-mail address 3. Sampling information: 8/26/2021 ALPHA ANALYTICAL a. Date Sampled {mrnlddly)yy] b. Laboratory Name ALPHA ANALYTICAL PERSONNEL c. Analysis Performed By [Name] B, Form Selection Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Aug Monthly .J All forms for submittal have been completed. 2.- This is the last selection, 3. l- Delete the selected form. gdpdis 2015-09-15.doc • rev. 09115/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identiflcativn Number DISCHARGE MONITORING REPORT 2021 AUG MONTHLY Ll` 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) • N5 = Not Sampled 1. Parameter/Contaminant Units BOD MGi TSS MG/L TOTAL SOLIDS MGR. AMMONIA -N MGL NiTRATE•N VIGIL TOTAL NITROGEN(NO3+NO2+TKN) MG?L OIL & GREASE MGIL FECAL. COLIFORM /100 ML CHLORDF MCA - 2. Influent 3. Effluent 4. Effluent Method Detection limit 320 2.6 1 12.0 110 ND 1540 300 10 1 Vic 3.3 0.10 - -� 7.49 ND 15 63 0.450 40 Infeffrp-blank.doc • rev. 09/15115 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. rad rerun Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit N40NITORING WELL. DATA REPORT A. Facility Information 746 1. Permit Number 2. Tax identification Number 2021 AUG MONTHLY 3. sampling Month & Frequency 1. Facility name, address: PLEASANT BAY HEALTH CTR a. Name 383 SOUTH ORLEANS ROAD b. Street Address BREWSTER MA 102631 C' City 2. Contact information: JOSEPH SMITH a. Name of Facility Contact Person 7742125005 b. TOepkne Number 3. Sampling information: d. State a. Zip Code tsmith@NSUWater.com c. e-mail address 18/20/2021 NOT APPLICABLE a. Cate Sam�ad [mmldd(yM) b. Laboratory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Aug Monthly 'J r All forms for submittal have been completed. 2. This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.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 MONITORING WELL DATA REPORT 746 1. Permit Number 2. Tax identification Number 2021 AUG MGNTHLY 3. Sampling Month & Frequency C. 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 ■ DRY = Not enough water in well to sample. ParameterlContaminant DG -1 DG -2 DG4 UG -1 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 PH 5.81 6.40 1 IDRY 5.71 S.U. STATIC WATER LEVEL g8 3.87 DRY 5.41 FEET SPECIFIC CONDUCTANCE 42.3 51.4 QRY 88.7 UmHoac Well #: 5 Well #: 6 mwdgwp-blank.doc • rev. 09/15/15 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(1) or (2) shall make the following certification If you are filing electronic -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 Information (PLEASANT BAY HEALTH CTR a. Name 383 SOUTH ORLEANS ROAD 745 _ 1, Permit Number 2. Tax identification Number b, Street Address BREWSTER IMA 102631 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 aocordonce 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 veho manage the system, or those persons directly responsible for gathering the lnformation, the information submitted is, to the best of my knowiedge and belief, true, accurate and complete. I am aware that the are sig nIficant penalties for submitting false information, including the possibility of fine and lm prisonment for knowing violations SAMANTHA FARRENKOPF 9114/2021 a. Signature olrtine P Comments b. Date (mmlddlyyyyj BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (BEA) HAS COMPLETED THE AUGUST 2021 MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE AMPHIDROME WASTEWATER TREATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 8126!21. LABORATORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT LIMITATIONS. PH WAS REPORTED WITHIN THE 6.5-8.5 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 2,005 GPD, 11,213 GPD AND 7,965 GPD, RESPECTIVELY. gdpols 2015-09-15.doc • rev, 09/15115 Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: sFARRENKOPF Transaction ID: 1311925 Document: Groundwater Discharge Monitoring Report Forms Size of File: 1031.91 K Status of Transaction: in Process Date and Time Created: 9127/2021:4:18:29 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. VQ Lw-AA� Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DAILY LOG SHEET A. Facility Information 951 1. Permit Number 2. Tax identification Number 2021 AUG DAILY 3. Sampling Month & Frequency Facility name, address: MAPLEWOOD AT BREWSTER a. Name 820 HARWICH ROAD b. Street Address BREWSTER IMA 102631 C. City d. State e. Zip Code 2. Contact information: OSEPH SMITH a. Name of Facility Contact Person 7742125005 hsmith@NSUWater.com b. Telephone NurrPwE-�r c. a -mall address 3. Sampling information: 18/1/2021 a- Date Sampled (mmlddlyyyy) SEA NSU PERSONNEL c. Analysis Performed By {Name} B. Form Selection NOT APPLICABLE b. Laboratory Name 1. Please select Form Type and Sampling Month & Frequency Daily Log Sheet - 2021 Aug Daily rr All forms for submittal have been completed. 2, r- This is the last selection, 3. r- Delete the selected form. gdpols 2015-09-15.doc - rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1951 Bureau of Resource Protection - Groundwater Discharge Program 1, Permit Number Groundwater Permit - - Z Tax identification Number DAILY LOG SHEET 2021 AUG DAILY21- ---- - 3. Sampling -Month & Frequency C. Daily Readings/Analysis Information Date Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine UV Flow GPD Flow GPD Flow GPD pH Residual Intensity (mgfl) {°Io} 1 5007 2 76627 6.8 7.2 3 $175 6.8 7.1 4 4606 J ^� 6.8 7.1 771$ �� 6.8 7.3 5 73Q1 6.8 7.3 7 8 7301 e 74'19 _� 8 -8 7.2 10 6092 6.9 7.1 11 91 94 I 6.8 7.2 12 7319 6.8 7.2 13 65D2 6.8 7.1 14 6502 15 6502 _� i 16 5675 6.8 7.1 17 8898 F7.2] 18 5757 �J 6.$ 19 7433 fi.8 7.3 20 ----] FA 5988 6.8 21 5988 22 5988 23 8822 �� 6.8 7.2 24 5810 6.8 7.2 25 7537 �f 6.9 7.2 25 5778 6.9 7.D 27 6926 6.7 8.1 I - 28 6926 29 6926 30 6559 F6:7 31 5529 16.8 7.0 gdpols.doc • rev. 09115/15 Groundwater Permit pally Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT [2a 21 AUG MONTHLY 3. Sampling Month & Frequency A. Facility Information tmportant:When filling out farms on 1. Facility name, address: the computer, use IMAPLEWOOD AT BREWSTER only the tab key to a. Name move your cursor - 820 HARWICH ROAD do not use the return key. b. Street Address B RE WSTER IMA 102631 C. City d. State e. Zip Code 2. Contact information: RMT #Alj IJOSEPH SMITH a. Name of Fadlity Contact Person 7742125005 JjsmithQNSUWaterLC0M b. Telephone Number c. e-mail address 3. Sampling information; 8/19/2021 ALPHA ANALYTICAL a. pate Sampled (mmlddlyyyy) b. Laboratory Name ALPHA ANALYTICAL PERSONNEL c. Analysis Performed By [Name] B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Aug Monthly ' - All forms for submittal have been completed. 2. i- This is the last selection. 3, r Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page I of 1 Massachusetts Department of Environmental Protection 951 _ Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number . Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT —� • '+, 2021 AUG 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) • N5 =Not Sampled 9. ParameterlContaminant 2. Influent 3. Effluent 4. Effluent Method Units Detection limit sO° I200 MG/L TSS ��� 27 � ,0 l MG1- TOTAL SOLIDS Q0 MG/L AMh9ONIA-N 123.6 M.GIL NITRATE -N I .... 10.10 Ph"�IL TOTAL NITROGEN(NO3+NO2+TKN) Vol 0.750 Mcg OIL &GREASE IND 1 14.0 MGIL infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection 1951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT '�, 2021 AUG MONTHLY 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer, use IMAPLEWOOD AT BREWSTER only the tab key to a. Nara: move your cursor - 820 HARWICH ROAD do not use the return key. h. Street Address BREWSTER JMA 102631 Q c, City d. State e. Zip Ccde 2, Contact information: r� JOSEPH SMITH a. Name of Facility Contact Person 7742125005 ljsmith@NSUWater.com b. Telephone Number c. e-mail address 3. Sampling information: 8/30/2021 NOT APPLICABLE a. Date Sampled (mmlddlyyyy) b. Laboratory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Aug Monthly - All forms for submittal have been completed. 2. r This is the last selection. 3, r Delete the selected form. V gdpols 2015-09-15.doc • rev. 09/15/15 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 Number MONITORING WELL DATA REPORT 2021 AUG MONTHLY 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "0", below detection limit, less than {<} value, or not detected, enter "ND" • TNTC = too numerous to count. (Fecal results only) • N5 =Not Sampled ■ DRY = Not enough water in well to sample. ParameterlContaminant MW -1 MW -2 MW -3 MW -4 Units Well #: 1 Well M 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 PHF5.53____6.02 6.41 6.31 S.U. STATIC WATER LEVEL 13.75 1 1.08 10.68 11.72 FEET SPECIFIC CONDUCTANCE 18 2 250.3313.1 107.5 UMHOS C mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data for Groundwater Permit • Page 1 of 1 lmportant: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 electronic -ally and want to attach additional commentst select the check box. F' Massachusetts Department of Environmental Protection 1951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. lax identification Number Information PLEWOOD AT BREWSTER a. Name 820 HARWICH ROAD b. Street Address BREWSTER MA 102631 C' City d. State e. Zip Code Certification `I certify under penalty of law that this document and ail attachments were prepared under my direcdion or suparvision 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 possiUllty of fine and imprisonment for knowing violations.` SAMANTHA FARRENKOPF 19127/2021 a. Signature rtin Comments b. Date (mmlddlyyyy) BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (BEA) HAS COMPLETED THE AUGUST 2021 MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE BIOCLERE WASTEWATER TREATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 8/19121. LABORATORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT LIMITS. EFFLUENT PH WAS REPORTED WITHIN THE 6.5 TO 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 19,800 -GPD LIMITATION THROUGHOUT THE MONTH. THE MINIMUM, MAXIMUM AND AVERAGE GPD FLOWS REPORTED OVER THE COURSE OF THE MONTH WERE 4,606 GPD, 9,194 GPD AND 6,843 GPD, RESPECTIVELY. gdip ols 2015-09-15,doc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 BENNETT ENVIRONMENTAL ASSOCIATES, LLC. A NATURAL SYSTEMS UTILITIES COMPANY LICENSED SITE PROFESSIONALS * ENVIRONMENTAL SCIENTISTS * GEOLOGISTS * ENGINEERS 1573 Main Street, Brewster, MA 02631 * 508-896-1706 —Fax 508-896-5109 * www.bennett-ea.com LETTER OF TRANSMITTAL TO: Massachusetts Department of Environmental Protection Attention: Title 5 Program 1 Winter Street - 6th Floor Boston, MA 02108 SHIPPING METHOD: Regular Mail ❑ Pick Up Priority 1 Mail ❑ Hand Deliver ❑ Express Mail ❑ Other ❑ Certified Mail 0 Green Card/RR 0 COPIES DATE 1 DEP A {Octob 1 eptiT 1 1112/20 Alpha 1 418121 Alpha For review and comment: ❑ REMARKS: Please find enclosed the DEP Ins operation and maintenance condi questions or require additional inf DATE: 8121121 ::= REGARDING: Middleton Residence 17 Russell's Path Brewster, MA 02631 DESCRIPTION aproved Inspection and O&M Form for Title 5 IIA Treatment :r 2020, Apnl 2021) :ch inspection form (October 2020, April 2021) knalytical Laboratory report knalytical Laboratory report JOS NUMBER: r7777:1 s For approval: ❑ As requested: For your use: Cj on and O&M Forms, Waterloo Biofilter inspection forms, and laboratory results for during the reporting period for the above referenced property. if you have any tion, please contact us at your earliest convenience. Thank you. cc: Brewster Board of Health (via email] Noreen and Joseph Middleton, Property Owners (via email] FROM: Samantha Farrenkopf, Innovative Alternative Program Supervisor If enclosures are not as noted, kindly notify us at Duct important: When filling out forms on the computer, use only the tab key to move your cursor -do not use the return key. rtl Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 IIA Treatment and Disposal Systems A. Installation Noreen & Joseph Middleton mrter 17 Russell's Path Facility Street Address Brewster 02631 City Zip Mailing address of owner, if different: 85 Elm Street street AddresslPo Box: Milton MA City State 617 549 - 2274 ext. 'telephone Number Q. Authorized Service Provider 02186 DO Bennett Environmental Associates, LLC O&M Fkm 1573 Main Street Street Address 02631 Brewster MA Zip city State Zip (508} 896 -1706 ext. 1140 Telephone Number Jose h Smith 12529 Certified operator Name Certification Number C. Facility/SysteM Information Clearwater Industries Waterloo Biofiiter DEP IQ Manufacturer IQ Madel Number Unknown 612212005 installation Date Start of Operation Approval Type: ❑ General ® Provisional ❑ Piloting ❑ Remedial Seasonal Residence — used less than 6 mo./year: ® Yes ❑ No D. Operating Information 10/26/20 Inspection Date Sludge Qepth {to b® checked yearly} 511120 Previous Inspectlan Date Pumping Recommended ❑ Yes ® No Page 1 of 3 t5aiom.doc • rev. 04-11-13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems E. Field Testing Field Inspection: Calor: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other (specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pH 7.31 SU— no 5 m9/L TurbAity 4.85 NTU 6 to -a- 2 or greater 40 or Gess Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ❑ Influent M Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: 9Pd — Parameters sampled: ❑ pH M BOD ❑ CBOD ® TSS ❑ TN ® Other (list below) Nitrate Nitrite TKN other 1 Other 2 other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and monitoring event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. t5aiom.doc • rev. 04-11-13 Page 2 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. Operator Signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use — by January 315t of each year for the previous calendar year Piloting Use -within 45 days of inspection date Provisional Use — by March 31"' of each year for the previous 12 months General Use — by September 301" of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program One Winter Street, 5th Floor Boston, MA 02108 t5aoom.doc • rev- 04-11-13 Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A Treatment and Disposal Systems A. Installation Important: When Noreen & Joseph Middleton filling outforms Owner on the computer, use only the tab 17 Russell's Path key to move your Facility Street Address cursor - do not Brewster 02831 use the return city Zip key. Mailing address of owner, if different: 85 Elm Street StreetAddresslPO Box: Milton MA 02186 city state Zip 817) 549 - 2274 ext. Telephone Number B. Authorized Service Provider Bennett Environmental Associates, LLC O&M Firm 1573 Main Street Street Address Brewster MA 02631 City State Zip (508) 896 -1706 ext. 1140 Telephone Number Joseph Smith 12529 Certified Operator Name Certification Number C. Facility/System information Clearwater IndustriesWaterloo Biofiiter DEP 1D Manufacturer ID Model Number Unknown 8!22!2005 lnstallaWn Date Start of Operation Approval Type: ❑ General ® Provisional ❑ Piloting ❑ Remedial Seasonal Residence -- used less than 6 mo./year: ® Yes ❑ No D. Operating Information 411121 Inspection Date 1" sludge, 0" scum Sludge Depth (to be checked yearly) t5alorn.doc - rev. 04-11-13 10/26/20 Previous Inspection Date Pumping Recommended ❑ Yes ® No Page 1 of 3 Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection - Title 5 DEP Approved inspection and O&MForm for Title 5 IIA Treatment and Disposal Systems E. Field Testing Field Inspection: Color: ❑ gray ❑ brown ® clear ❑ turbid ❑ Other (specify): Odor: ® musty ❑ earthy ❑ moldy ❑ offensive ❑ turbid Effluent Solids: ® no ❑ some pHSU DO 5 mgit- Turbidity 5.21 NTU B to 9 2 or greater 40 or less Should a Remedial or General Use system fail the Field Testing, effluent samples shall be collected per Standard Methods and analyzed for BOD and TSS. F. Sampling Information Samples Taken: ® Influent ® Effluent Commercial systems or systems with a design flow of 2000 gpd and greater, and General Use nitrogen reducing systems: g—pd- Parameters sampled: ❑ pH ® BOD ❑ CBOD ® TSS ❑ TN M Other (list below) Nitrate _ Nitrite TKN Other 1 Other 2 Other 3 G. Inspection and Maintenance Description of any maintenance performed since previous inspection & during this inspection: Conduct an operation and monitoring event. Collect effluent samples for field testing and laboratory analysis. Notes and Comments: All mechanical components of the system are operating correctly. Effluent quality passed field testing parameters. Field effluent pH not recorded at time of inspection. t5aiom.doe - rev. 04-11-13 Page 2 of 3 Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection - Title 5 DEP Approved Inspection and O&M Form for Title 5 IIA Treatment and Disposal Systems H. Certification I certify: I have inspected the sewage treatment and disposal system at the address above, have conducted the required Field Testing and/or sample collection in accordance with Standard Methods, have completed this report and the attached technology operation and maintenance checklist, and the information reported is true, accurate, and complete as of the time of the inspection. I am a Massachusetts certified operator in accordance with 257 CMR 2.00. r Operator signature Date System owner must submit this report, technology O&M checklist, and any required sampling results to the local board of health as follows for each inspection performed: Remedial Use -- by January 31st of each year for the previous calendar year Piloting Use - within 45 days of inspection date Provisional Use — by March 31th of each year for the previous 12 months General Use -- by September 30't' of each year for the previous 12 months Send to: Department of Environmental Protection Attention: Title 5 Program one Winter Street, 5th Floor Boston, MA 02108 t5alOMADc • rev. 04-11-13 Page 3 of 3 W2412020 Permitlnspections Barnstable County Septic Management Program Samantha Farrenkopf - Bennett Environmental Associates, LLC Main Submit My Clients My Reports Help ligmIr: pectjoRs s Submit Inspection Go Back T Search Results Permit Details Permit Number Address Ovonar Name Startup Date Inspection Details Component Inspect on Date* (p t 6 f Za Inspection Time c 0 i0perater Name* ]� Operator License Number* BREIW-Rus017-Wat 17 Russells Path, Brewster Joseph and Noreen fuliddWon 08/22/2005 — select Component — i I v Fleid Testing Color C( eqr o Odor Alp D A01- —select — v5— Effluent Solids N ❑ 5 t Seleri �% d pH rO Dissolved Oxygen (D -O) j (� 0. 3 1 Turbidity CI , rs- �-- - ! -� i nn {� � d Settleable Sol Ids L Site Conditions Seasonal Residence-8slect— Alr Temperature 5 6 Weather Gon6tians Operating Information `�[J Sludge Depth Scum Layer Thickness i Pumping Recommended? Soil Absorption System Observations Signs of breakout? Ad .-Select—+► Depth of Pending L SAS Ponding Above Invert E - Soleal - y Maintenance Issues Any apparent violations of the approval? I No V1, Any cleaning or lubrication performed? hnps:tlseptic.barnstablecountyhealth.orglappfpernGt inspectionelsubtnit 1:07 pm start Cher 112 8/24/2020 PermKinspectfons - 4;,,o 1D 1�a A Ps f o� ��� 1P tO ,ySea Mips:llsepolc.harnstahlecountyhealth.orglapplpermlt InspectlonslsubMt 212 Mo *' I Any adp stments of control settings? G Nc I Any testing of pumps, switches cr alarms? [Pia v Any equipment failures? { No _V Any parts repisced? TtJo V Any further recommended ccrrective acilons? (No v j Inspection Completion Was this inspection fully completed?* f YBs vJ .7 Other Comments Inspection Details You must select a component above to complete this Inspection. - 4;,,o 1D 1�a A Ps f o� ��� 1P tO ,ySea Mips:llsepolc.harnstahlecountyhealth.orglapplpermlt InspectlonslsubMt 212 e 6124l202b �q Permitlnspectionsle {. ah (CountySeptic Managemt.rit F-.- Samantha Farrenkopf - Bennett Environmental Associates, LLC 1:07 pm Main Submit My Clients My Reports Help Fiontie' inspections Submit inspection Search Results start Over Go Back Perrt�it befalls Permit Number BREW Ruso17-Wat Address 17 Russells Path, Brewster Owner Name Joseph and Noreen Middleton Startup Date 08122/2005 Inspection Details Component - select Component - Inspection Date* y'�'� t' June - 24 2020 Y Inspection Time* I6. (%r 7 + : 07 pm Operator Name* "3—'rV'gfR Operator License Number* Tesiinci � �� Field Calor — Select Odor --Select Y P61 ._0 � a Effluent Solids — Select — v jjd c' ` ti 00"- 0"Dissolved pH (OL_ F0 c i DissolvedOxygen (D.0) y i u r C3 j �u e Cd o C Turbidity q Settleable Solids Site Gandl'lions � -- Seasonal Residence �� 5 - Select - v Air Temperature Weather Conditions t L� Operating Information Sludge Depth Scum Layer Thickness Ott Pumping Recommended? �` No " Sail Absorption System 013servations Signs of breakout? j i Select - Depth of Ponding tl Q)3V SAS Ponding Above Invert -Select -- y Wiaintenance issues Any apparent violations of the approval? No (3e e r-7 e- Any cleaning or lubrication performed? f' https:llseptic.barnstsbEecountyhesith.orglapplpermit Inspectlonslsubmit )_0 Q 712 6/24/2020 Permitlnspections Other Comzrrents inspection Details You must select a component above to complete this inspection. cd C,�m6e* https;llseptic.barnstabiecountyheatth.Grglapp/pe rmit_inap echo ns/suhm[It 212 No Any adjustments of control settings? I'- v !`+�CC Any testira3 of pumps, switches or alarms? No •• (� , f Any equipment faihures? No ,• ' ! ,S7- 3 AVL Any parts replaced? No - Any further recommended corrective actions? No . Inspection Completinn, Was this inspection fully completed?* Yes v Lf Other Comzrrents inspection Details You must select a component above to complete this inspection. cd C,�m6e* https;llseptic.barnstabiecountyheatth.Grglapp/pe rmit_inap echo ns/suhm[It 212 BREWSTER RECYCLING GUIDE (NEW OCT. 2021) WHER IT COEE I r MAT - X 0 a❑ � a 0 m U U LN J ur J Z ❑. Cho C Z 0 z ui EL V)ZM X 00 Z Z W _ ❑0 �a Qm 0- 0 UN a W 0. as aZ a METAL PLASTIC GLASS Ij NEWSPRINT CARDBOARD AND OTHER PAPER RECYCLETHESE ■ Steel, tin & metal food cans • Aluminum pie plates & trays ■ Deposit & non -deposit drink cans • Plastic bottles, jars, jugs & tubs larger than 3 inches, such as ■ Milk, water, soda & juice bottles • Big butter & yogurt tubs • Shampoo & conditioner bottles • Laundry, bleach & softener bottles ■ Clear & colored beverage bottles, deposit and non -deposit Food & sauce jars ■ Clean and dry Sunday inserts only OK • All clean cardboard must be recycled • Magazines & catalogs • Junk mail, envelopes • Books & phone books • Office & computer paper • Paper shopping bags ■ Cereal, cracker & other food boxes • See more info on reverse * Put in yellow PAYT bag Rev:092821 INSTRUCTIONS • Empty, rinse trays clean • Labels OK • Empty, rinse cans clean • Empty, rinse plastic clean • Caps OK only if onlattached to bottle! • Remove spray top from spray bottles & put in trash • Empty, rinse glass clean ■ Remove any capsllidsicorks ■ Neck rings/labels OK • Put on table • Do not tie ■ Do not put in bags of any kind ■ Put in opening of designated newsprint bin • Flatten, fold, or break down cardboard, if able • Place loose paper in paper grocery bags • Remove plastic liner from cereal & other food boxes ■ Non -container metal in the commingled compactor. (Note #3) • Plastic envelopes, film & bags; take to grocery stores or dispose witrash* • Small (less than 3") plastic single serve containers like mini yogurts, snack packs, etc.* + Foam packaging & peanuts. (Note #4) ■ Empty motor oil andlor chemical containers* • Water hoses* • Broken glass* • Auto glass, mirrors & windows** • Ceramic plates & cookware* Light bulbs* (see over for more info) ■ No capsllids/corks* • No ties* • No strings* • No plastic or paper bags (reuse, recycle or dispose of properly) ■ Food -soiled cardboard* • Excessively dirty or wet boxes* • Shredded paper' ■ Food -soiled paper anything* • To go containers* • Paper towels* • Tissues* ■ Diapers* • Cereallfood box liners* ** Put in Construction & Demolition (C&D) box Visit ReeveleSmartMA.om for additional recycling information RECYCLABLE PAPER CCEPTING ORGANICS Booklets We'll take all inedible food waste including fruits, Books: soft cover only vegetables, meats, dairy products, table scraps, Boxes: all sizes, flattened eggshells, coffee grinds, etc. if it was previously any Brochures: including glossy kind of food or drink, we can take it. Calendars: wall type, spiral okay . NO LARGE bones such as ham, beef, lamb Cardboard: all corrugated & paperboard ■ NO PLASTIC containers, wraps or bags of any Catalogs type or size. Colored, construction and kraft paper Cover, card stock, index cards Home composting is still a great way to recycle your Envelopes: all, including windows except as below organics and even more environmentally friendly! Fax paper File folders HOUSEHOLD BATTERIES Flyers Glossy paper & packaging ALL batteries, except auto, are accepted for Greeting cards recycling at the Brewster Recycling Center. Check Lottery tickets with friendly attendant for bin location. Mail LIGHTBULBS Newspaper, KEEP SEPARATE Notebooks, spiral okay Packing paper Incandescent light bulbs and LED bulbs Paper bags, handles okay are trash for your yellow PAYT bag. Phone books Fluorescent tubes & bulbs are handed Sticky notes to the attendant. Tubes only from towel & toilet paper TEXTILES NON -RECYCLABLE "PAPER" FIBER Clean and dry CLOTHING, SHEETS, LINENS, TOWELS Carbon paper should be recycled using the on-site donation boxes, Diapers local thrift shops, or some local animal/wildlife rescue Any envelopes with bubble wrap/plastic liner shelters. Food soiled paper & cardboard Label backings & sheets of labels FEE ITEMS Paper cups and/or paper plates Paper towels, napkins, and tissues Many items are recyclable that are not listed on this Photographs guide. Generally, bulky waste, including furniture and Shredded paper large toys, yard cleanup materials, trimmings, scrap Take-out food containers metal, electronics, auto tires and fluids are recycled, Thermal receipts but require a fee. Please visit https:llbrewster- Tyvek® mailing envelopes ma.gov/recycling-center-fees for a complete list. Waxed paper andlor waxed cardboard Wrappers, candy/food HAZARDOUS WASTE Wrapping paper The County hosts multiple yearly Hazardous Waste *PAPER NOTE: Metal spirals, paper clips, window Collection Days; check it out yearly. Barnstable envelopes, staples can remain with paper items County's Hazardous Waste 2021 Collection Schedule - listed, but should be minimized & removed if easy. Barnstable County: Barnstable County 1. Deposit bottles can be donated at the Brewster Scouting shed, if open, or taken to a Redemptlon Center. 2. If unsure where to place an item, ask a friendly Recycling Center attendant. 3. See attendants for small, non -container metal items like empty aerosol cans, empty paint cans, coat hangers, cooking pots/pans, etc. They will direct you accordingly. 4. Unused, small foam pieces including meat trays, go in the yellow PAYT bag; larger, bulky, foam packaging pieces can he tossed into trash receptacle loose. When in doubt, check it out at https://recyclesmartma.org/results-materials/#. You may need to throw it out! Morbidity and Mortality Weekly Report Notes from the Field E -Cigarette Use Among Middle and High School Students -- National Youth Tobacco Survey, United States, 2821 Eunice Park -Lee, PhD 1; Chunfeng Ren, PhD1; Michael D. Sawdey, PhD 1; Andrea S. Gentzke, Ph 132; Monica Cornelius, PhD'; Ahmed]amal, MBBS2; Karen A. Cullen, PhD' Since 2014, e -cigarettes have been the most commonly used tobacco product among U.S. youths (1). In 2020, an estimated 3.6 million (13.1%) U.S. middle and high school students reported using e -cigarettes within the past 30 days (current use); more than 80% of current users reported fla- vored e -cigarette use (2). Whereas the most commonly used device type in 2019 and 2020 was apref lied pod or cartridge,* disposable e -cigarette use increased significantly during this time among youths who currently used e -cigarettes in middle school (from 3.0% to 15.2%) and high school (from 2.4% to 26,5%) (.3). CDC and the Food and Drug Administration (FDA) analyzed nationally representative data from the 2421 National Youth Tobacco Survey (NYTS), a school-based, crass -sectional, self-administered survey of U.S. middle school (grades 6-8) and high school (grades 9-12) students conducted during January 18 -May 21, 2021 (20,413 students from 279 schools; overall response rate = 44.6%),t Because of the ongo- ing COVID-19 pandemic, data were collected online to allow participation of eligible students in remote learning se€tings.§ Current e -cigarette use was assessed overall, by frequency of use, device type, flavors, and usual brand. Weighted prevalence *There are a variety of differenr types of e-cigarerte devices that are currently available, Disposable e-rigarettes tome prefilled with e -liquid, and the entire device is designed to be discarded after a single use. Other devices have "pods" or "cartridges" that hold the e -liquid. Some pods or cartridges come pre -filled with e -liquid and are replaced after use, while others can be refilled by the user. Tank or mod -type devices can also be refilled by users, but are also usually customizable, allowing the user to change the. temperature or vol rage, nicotine concentrations, and add accessories to enhance the user experience. t The final sample consisted of 508 schools, 279 (54.9%) of which participated, among 25,149 students, 20,413 (81.2%) students participated. The overall responsc rate (44.64'x) is the product of the sehool-level and student -level participation rates. https://www.cdc.gov/tobacco/dat2k-statisticslsurveys/nyrs/ index.htm §Because of state and local CO'VID-19 protocols (e.g., distance or hybrid learning, restrictive travel, or visitor access), the 2021 NYTS data collection was Transitioned from an in-person, tablet -based administration to a fully online administration. Eligible students could participate in classrooms, at home, or in some other remote learning environment. Overall, 50.8% of students who compleTed rhe 2021 NYTS reported completing the survey in a school building or classroom and 49.2% at home or at some other place. Because of these differences in data collection procedures, the 2021 NYTS estimates should not be compared wirh previous NYTS survey waves that were primarily conducted on schooi campuses. estimates and population totals were calculated. This study was reviewed and approved by the CDC IRB,'* In 2421, 11.3% of high school students (1.72 million) and 2.8% (320,000) of middle school students reported current e -cigarette use (Table). Among current e -cigarette users, 43.6% of high school students and 17.2% of middle school students reported using e -cigarettes on X20 of the past 30 days; daily use was 27.6% among current highschool e -cigarette users and 8.3% among current middle school e -cigarette users. Among both middle and high school current e -cigarette users, the most commonly used device type was disposables, followed by pre - filled or refillable pods or cartridges and tanks or mod systems. Among high school current e -cigarette users, 26.1 % reported that their usual brand was Puff Sar, followed by Vuse (10.8%), SMOK (9.6%), JUUL (5.7%), and Suorin (2.3%). Among middle school current users, 30.30 reported that their usual brand was Puff Bar, and 12.5% reported JUUL. Notably, 15.6% of high school users and 19.3% of middle school users reported not knowing the e -cigarette brand they usually used. Among current youth e -cigarette users overall, 84.7% used flavored e -cigarettes, including 85.8% of high school users and 79.2% of middle school users. Among all current flavored e -cigarette users, the most commonly used flavor types among both middle and high school students were fruit, followed by candy, desserts, or other sweets; mint; and menthol. When examined by device type used, the most com- monly used flavor types among current flavored disposable e -cigarette users were fruit (78.7%, 760,000); candy, desserts, or other sweets (34.3%; 330,000); mint (30.10/x; 290,000); and menthol (21.5%; 200,000). The most commonly used flavor types among current flavored pod or cartridge users were fruit (57.9%; 270,000); menthol (46.3%; 210,000); mint (30.7%0; 140,000); and candy, desserts, or other sweets (28.2%; 130,000). The most commonly used flavor types among cur- rent flavored tanks or mod systems users were fruit (70.9%; 100,000); candy, desserts, or other sweets (51.2%; 70,000); mint (34.5°/x; 50,000); and menthol (24.7°/x; 30,000), Among current flavored e -cigarette users, fruit was the most commonly reported flavor type overall, by school level, and across all e -cigarette devices. The 2021 NYTS was fully conducted amid the global COVID-19 pandemic, during which time eligible students could participate in the survey in classrooms, at flame, or I Weighted population estimates were rounded down to the nearest 10,400 stuAems. '* 45 C.F.R. part 46; 21 C.F.R. part 56. US Department of Health and Human 5erviceslCenters for Disease Control and Prevention MMWR 1 October 1, 2021 1 Vol. 70 1 Na. 39 1387 Morbidity and Mortality Weekly Report at some other place. Differences in tobacco use estimates by locationit might be due to potential underreporting of tobacco use behaviors or other unmeasured characteristics among youths participating outside of the classroom. Thus, estimates from the 2021 NYTS should not be compared with previous NYTS survey waves that were primarily conducted on school campuses, Approximately 2.06 million youths were estimated to be current e -cigarette users in 2021. Use of tobacco products by youths in any form, including e -cigarettes, is unsafe. Most e -cigarettes contain nicotine, and nicotine exposure during adolescence can harm the developing brain (5), Ongoing efforts to address youth e -cigarette use, including FDA's prioritized enforcement against certain unauthorized flavored, cartridge - based e -cigarettes in 2020, are critical (4). As the tobacco prod- uct landscape continues to evolve, sustained implementation of comprehensive tobacco control and prevention strategies at the national, state, and local levels, coupled with FDA regula- tion, can reduce and prevent tobacco product initiation and use among youths (5). f t Youths who reported participating in tiro 2021 NYTS in a school building or classroom reported a higher prevalence of e -cigarette use compared with youths participating at home or at some other place; 15.0% of high school students who took the survey in a school building or classroom reported currently using e -cigarettes compared with 8.1 % of those who took the survey at home or at some ather place (p -A001). Corresponding author; Eunice Park -Lee, Eunice.l'ark-Lee@Fda.lihs.gov, 301-837-7342. ICenter for Tobacco Products, Fond and Drug Administration, Silver Spring, Maryland; 2Clffice on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. All authors have completed and submitted the International Committee of Medical]ournai Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed. References 1. Arrazola RA, Singh T, Corey CG, et al. Tobacco use among noddle and high school students—United States, 2011-2004. MMWRMorb Mortal Wkly Rep 2015;64:381-5. PMID:25879896 2. Wang TW, NefLJ, Park -Lee E, Ren C, Cullen KA, King BA. E -cigarette use among middle and high school students—United States, 2026. MMWR Morb Mortal Wkly Rep 2020;69:1310-2. PMID:32941408 https:lldoi.org/10.155851mmwr mm6937e1 3. WangTW, Gentzke AS, Neff l.J, er A. Disposable e -cigarette use among U.S. youth—an emerging public health challenge. N Engl J Med 2021;384:1573-6. PMID:33725431 htrps:/ldoi.org/10.1056/ NEJMr.2033943 4. Center for Tobacco Products. Enforcement priorities for electronic nicotine delivery systems (ENDS) and other deemed products on the market without premarket authorization (revised). Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2020, https:llww%vfda.gov/media/133880/download 5. CDC. E -cigarette use among youth and young adults. A report of the surgeon general. Atlanta, GA; US Department of Health and Human Services, CDC, Office on Smoking and Health; 2016. https:lle-cigarettes. surgeongeneral,govldocumenrs12016 SGR–Full–Report non-508.pdf US Department of Health and Human ServiceslCenters for Disease Control and Prevention MMWR 1 October 1, 2021 1 Vol. 70 1 No. 39 1399