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HomeMy Public PortalAboutBOH3.2.22packetQI Tn� 0 Board of Health Penny Holeman Annette Graczewski Joe Ford Jeannie Kampas Kimberley Croclker 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 March 2,2022 at 7:OOPM Purs u ant to Cha pter 20 of the Acts of 2021, this rn eeting wi 11 �e cond u cted via remote mea ns, i n accord an. -e with ap pl Ica b le law. This mea ns th at members of the public body may access thIs meeting via virtual means. No in-person attendance of members ofthe public will be permitted, and pu blic particl pati on I n any pub] ic hea ri ng cond uc ted d u ring this me eting sha 11 b e by re mote m ea ns on ly. M e mbers of th e p ubl Ic who wl5h to access th e meeting rn ay d o so in the fo llowIng m anne r: Phone: Call (301)715-8592 or (312)626-6799. Webinar ID: 820 4394 4509 Passcode� 979174 To r" u int to speak: Press * 9 and wait to be recognized. Zoom Webinar. https://usD2WCb.zoom.us�/820431344509?pwd=MytpM2kvUExKbUlRSOhmMOlZb3dQZ?O Passccde: 979174 To request to spea k: Tap Zoo rn "Ra ise Ha nd', t h en wait to be recognized. W hen req uIred by law of a Howe d by the Chai r, p e rso ns wi-5 hi ng to prov! d e p u In lic comm ent a r oth e Fwl-re pa rtic! pate Ti n th e meeti ng, m ay d o so by accessing the meeting remotely, as noted above. Additionally, the meeting will be broadcast live, In real time, via Live broadcast (Brewster G overn m e nt TV Cha nne 118), Livestreorm f0vestream. bre ws ter -ma. gov) or Vid ea re co rd i ng (tv.b rewster-ma.gov) L Call to Order 2. Chairmar�s announcements 3. Citizens forum: Members of the public may address the Board of Health on matters not on the meeting agenda for a maximum 3-5 minutes at the Chair's discretion. Under Open Meeting Law, the Board of Health is -unable to reply but may add items presented to a future agenda 4. Covid update 5. J.M. O'Reilly & Associates Inc. - Title 5 and Local variance requests for 56 Underpass Road 6. Open Meeting Law complaint -William Jennings -February 16, 2022 meeting - discussion of complaint and possible vote to authorize response thereto 7. Discuss holding in person/hybrid meetings 8. Consent agenda: a. 120 Run Hill Road - Leaching Facility Setback Regtdation variance 9. Liaison Reports 10. Matters not reasonably anticipated by the Chair 11. Items for next agenda 12. Next meeting: March 16, 2022 13. Informational items: a. Montl-dy report for Ocean Edge b. Monthly report for Pleasant Bay Health & Living Center C. Monthly report for Maplewood d. Monthly report for Serenity at Brewster (formally Wingate) e. Monthly report for Cape Cod Sea Camps 14. Adjournment Date Posted: Date Revised, 2/24/2022 Recei4� by Tow'�"L6 Clerk: VI -1 A M\HeffithWH Agendas and Minutes and Remote SchedulewOH Agendas\March222a.docx 4aT6.M. O�REILLY & ASSOCIATES INC. pD J DV/1 C PROFESSIONAL ENGINEERING, LAND SURVEYING & ENVIRONMEN- D �f Site Development • Property Line • Subdivision • Sanitary • Land Court • Environmf February 16, 2022 Brewster Board of Health 2198 Main Street Brewster, MA 02631 RE: Title 5 Variances Brewster Veterinary 56 Underpass Road, Brewster, MA Assessor's Map 78, Parcel 116 Dear Board Members, I V E D Pefti5n& 6 2022 "7WAhN HEALTH MI=NT On behalf of our clients, The Brewster Veterinary Hospital, J.M. O'REILLY & ASSOCIATES, INC. is submitting Site & Sewage Disposal Design Plan (Site Plan and the existing floor plans along with the Variance Application. The Variances requested are as follows: 310 CMR 15.221— Depth to Svstem 1. System to be greater than 36 inches below grade — 60" provided 24" variance requested Local Brewster Regulations 2. Soil Absorption System (SAS) and Reserve Area is not 100 feet from Edge of Wetland 61' provided 39; variance requested The existing sewage system was installed in late 1980's and was intended to serve a proposed office building with garage. The original use of the building was a landscape design company with landscaping operations. Soon after the landscape use ended, in 1994, the building was used as a veterinarian's clinic (Dr. Morgan). The veterinarian clinic was purchased in June 2018 by the Brewster Veterinary Hospital group (Dr. Kaser & Dr. Burns). The facility started doingthe laundry in house in 2019 and 2020, instead of using an independent cleaning service. Also, with the ongoing pandemic, the cleaning sanitizing activities increased substantially within the facility. The additional loading on the 35 -year-old system caused the system to back up and reach a state of failure. The system was pumped several times during the summer and fall and needs to be replaced. 1573 MAIN STREET, P.O. Box 1773, BREWSTER, MA 02631 • PHONE: (5oS) 896-66oI • FAX: (508) 896-6602 W W W. JMOR EI LLYAS SOC. COM Prior to the pandemic, the Brewster Veterinary Hospital began evaluating the existing operations of the facility and potential improvements to space allocations to bring the facility into compliance with the industry standards for veterinarian hospitals. The owners are continuing to evaluate the facility and are in the process of developing proposed improvements. Also, in 2020, once the pandemic started, the owners made minor improvements to the building to treat and see the animals within the parking areas in the front portions of the property. One example of the changes made to the building in 2020, was the elimination of an exam roam to create more internal spaceforsocial distancing between staff members and between staff and customers. An exterior pass-through window was also installed to allow staff to interact with customers without having to enter the building. The site plan does show the potential future additions to the existing building. The owners are currently working with Catalyst Architects in the development of potential additions to the building footprint so as to bring the facility into compliance with the industries' standards for a veterinarian hospital. J.M. O'REILLY &ASSOCIATES, INC. do not see the potential additions as an expansion of use or potential flow to trigger a "New Construction" activity under Title 5. The Board will note under the design flow we have identified both the existing floor space for both the first and second floors, along with a placeholder for the potential increases in floor space. The proposed addition areas have not been fully vetted and are not definitive. As discussed with the Health Director, the design flow based on Office Use (75 gpd per 1,000 sf) was the suitable flow value for the facility. The average daily water usage for the facility in 2021 was found to be x.25 GPD. (Note: The water flow for 2039 and 2020 was 285 gpd and 428 gpd, respectively). The site plan shows the existing sewage system being replaced with a new Title 5 sewage system. The system includes two septic tanks and distribution box and a 45'x12.83'x2' leaching galley. The existing system is proposed to be removed and the new system installed in the same general location. The unsuitable soils, along with eh contaminated soils from the system, will be removed and be replaced with clean "Title 5" septic sand. The proposed SAS is positioned to balance the distances between the bordering vegetated wetland, to the south, and the isolated wetland to the north. The regional groundwater map shows the groundwater flowing in a northerly direction, towards the isolated wetland. The isolated wetland is supported by the tight soils of the area and does not represent the true groundwater table. In October 2021, the parcel was before the Conservation Commission for un -authorized alteration of land with the Buffer Zones. The Commission approved the restoration plan for the up -permitted activities and have reviewed the wetland resource. The Conservation Agent has been asked to review the wetland lines with the Health Department to verify the location of the wetlands boundaries to allow the Board to take action of the application. The project is scheduled to be heard by the Commission for an amendment to the approvals to include the installation of the sewage system. The application also includes a Nitrogen Loading computation sheet for the design flow of 500 gpd. The average Nitrogen loading for the parcel is below the 5 ppm, refer to the calculation sheet The proposed system is compliant with the Title 5 and the local regulations, with the exception to the depth requirement of the system and the setback distances to the wetland resources on and adjacent to the parcel. J.M. O'REILLY & ASSOCIATES, INC., will be present at the public (virtual) hearing dated March 2, 2022 to review the project in detail and answer any questions the Board may have. Please contact our office if you need any additional information at this time. Very truly yours, J.M. O'REILLY & ASSOCIATES, INC. John M. O'Reilly, P.h., P,L.S, Principal CC: Client =war TOWN of BREWSTER OrricE❑F 2198 MAIN STREET HEALTii DEPARTMENT s "s BREWSTER, MA 02631 °r = - A PHONE: (508) 896-3701 EXT 1120 FAX: (508) 896.4538 BRHEALTH a BREWSTER-MA.GOV WWW. BREW STEP,-MA.GOV Received: .27'K -'aid: (0/06/d Application for Board of Health Variances Abutter Deadline: o?"2 -,2 Z ❑lB-House Local Upgrade Approval Wubliic Hearing Date: 2/1612022 SUBJECT PROPERTY ADDRESS: 56 Underpass Road Map: 78 LC Plan: Parcel: 116 Book: 31355 Page. 47 LC Certificate: Lot: 116 Name of Applicant: William Kase r, Trustee; 56 Underpass Road Realty Trust (Brewster Veterinary Hospital) Mailing Address: 56 Underpass Road Telephone # 508-896-2540 Email: slopes@brewstervethospital.com Owner(s) of Record : Same Mailing Address: Design Engineer/Sanitarian: John M. O'Reilly, P.E., P.L.S. Mailing Address: 1573 Main St., P.O. Box 1773, Brewster, MA 02631 Telephone #: 508-896-6601 Firm/Company Name: J.M. O'Reilly & Associates, Inc. Email address: joreill imoreillyassvc.com Signature:—` New Construction ❑ Voluntary Upgrade ❑ Add ition/Alterat ion 10 Failed system ❑ Rea l Estate Transfer ❑ Design flour of existing system: 392 gpd (2-27-1992 determination) Design flow of proposed System: 500 gpd (based on Omce Space) Total sewage Flow of site: 50D spa (Proposed) Conservation Commission approval required: yes W no ❑ Order of Conditions/Det, Of Applicability attached ❑ eer Reason for failure: overloaded leaching facility Total lot size (sf): 1.87 ac Date of ConCom hearing: 10/26/2021 & 3-8-2022 List of all Variances from State and Local cedes (add sheets if needed) TITLE 5 Sec. #: Description of Variance(s) 310 CMR 15.221 1.) System to be greater than 36" below grade - 60" provided 24" variance requested Depth to System Brewster Reg. #: Description of Variance(s) Setback to Wetland S.A.S. is not 100 feet from Wetland (8VW & Isolated Wetland): 131 feet provided (39 foot variance requested) Approved by: Health Department Date: N:1HealtMBOH regsllnHouse Septic Local Upgrade Approval 20191Varianceapplication FINAL NONFILLABLE FORM 12.18.19.docx RESIDENTIAL NITROGEN LOADING CALCULATIONS - PROPOSED (6 BR) Office 500 GPD Brester Vet - Underpass Road Impervious Surfaces: Roof Area: 3050 sf Paving Area: 18405 sf Lot Size: 81,457 ft: Natural Area: 13125 sf Lawn Area: 1,000 sf Title V Flow: 500 gpd; 2021 water usage=125 gpd WASTEWATER Title V 6,665 sf Office 75 4pd x 3.785 = 1,892.50 L/d 35 mg = 66237.5 mgld 1,000 5f gal T Actual is based on the 2021 water usage times 200% 250 gpd Water Usage (200%) 250 gal x 3.785 x 1 = 946.3 Lid x 35 mg = 33120.5 mgld gal 2 L IMPERVIOUS SURFACES Roof 3,050 40 in ft 28.32 L 1 yr = 788,8 Lld 0.75 mg = 591.6 mgld yr 12 in ft' 365 d L Paving 18,405 40 in ft 28.32 L 1 yr = 4760.1 Lid 1.5 mg - 7,140.1 mgld yr 12 in ft' 365 d L LAWN 1,000 3 lbs 1 yr 454,000 0.25 = 932.9 mgld 1,000 ftlyr 365 d I6 NATURAL 81,457 - 22,455 = 59,002 59,002 1.42 28.32 L 1 yr = 6,500.6 Lld yr ft' 365 d SUMMARY Title V Flow 66,237.5 + 591.6164384 + 7140.1 + 932.9 mg 74,902.1 mg = 5.37 ppm 1892.5 + 788.8 + 4760.1 + 6500.6 L 13942.0 L Actual 33,120.5 + 591.6 + 7140.1 + 932.9 mg = 41,785.1 mg= 3.22 ppm 946.3 + 788.8 + 4760.1 + 6500.6 L 12995.8 L Final Calculation ppm 4.29 CERTIFIED MAIL RETURN RECIEPT REQUESTED BREWSTER BOARD OF HEALTH PUBLIC HEARING NOTICE Date: 2116/2022 Re: 56 Underpass Road Map: 78 Lot: 1166 Subject Address Dear Abutter: A public hearing has been scheduled for the Brewster Board of Health to take action on an application for variances from the regulations of the Massachusetts Department of Environmental Protection, Title 5, and/or the Town of Brewster Regulations for Subsurface Disposal of Sewage. The following variances are requested: List of all variances from State and Town Codes Title 5, Sec. # Description of variance(s) 310 CMR 15.221 1.) System to be greater than 36" below grade - 60" provided 24" variance requested Brewster Reg. # Description of variance(s) Setback to Wetland Sail Absorption System (SAS) is not 100 feet from Edge of VVetland - 61' provided 39' variance requested Said hearing will be held at the Brewster Town Offices, 2198 Main Street, Brewster, on 3/2/2022 at 7:00 p.m. V 651 ble- V'1 YlUcL l hewlA� The application and plans are available for review at the Brewster Health Department, Brewster Town Offices, 2198 Main Street, Brewster, MA, Monday through Friday (excluding holidays) from 8:30 a.m. to 4:04 p.m. Sincerely, J.M. O'Reilly & Associates, Inc. Applicant/Representative CC: Brewster Health Department N;\Health\BOH regsUnHouse Septic Local Upgrade Approval 2019\Pubiichearingabutternotification NONFtLLABLE FORM 12.11.19.docx Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02531-1898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 brh ea 1 th (@breNvster- m a. gov W W W,BREW STER-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 Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Board of Health Meeting Date: March 2, 2022 Project Location: 56 Underpass Road Map & Parcel: 781116 Owner's Name & Address: William Kaser, Trustee 56 Underpass Road Realty Trust 56 Underpass Road Brewster, MA 02631 Applicant: same as above Date Requested: February 16, 2022 Title 5 Variance Request: Yes® No El Board of Health Variance Request: Yes® No❑ 100' Wetland Setback Other: Yes ❑ No ❑ 1. Outside Zone II and Town Water 2. In ESA— existing building and septic system and lot within 100' of wetlands 3. Existing septic system in hydraulic failure Health Director's Comments and Recommendations: The property consists of an existing commercial building (Brewster Veterinary Hospital) with a 1986 Title 5 septic system consisting of a 1000 gal septic tank, distribution box, and a leach pit originally designed for office space and garage. The property borders an isolated wetland (perched) to the north and the southerly and westerly bordering vegetated wetland of the Considine Ditch drainage system. The existing leach facility is approximately 70'+1- from the closest edge of the wetlands. The current septic system in failure and has been subject to frequent pumpings to avoid sewage overflow and backups into the facility. The applicant is proposing to upgrade of the failed system to accommodate the existing use and a future proposed addition to bring the facility into compliance with industry standards. The proposed septic N:1Health\BOH Meeting NoteslBOH hearing Notes156 Underpass Rd M78P116 AgendaNariance Action item Form 02.17.2022.dwx system will consist of two septic tanks (15 00 gal and 1000 gal), distribution box, and leaching facility comprised of leach chambers with stone. 2. Title 5: Maximum Feasible Compliance, a. 2' variance request, proposed leach facility to be 5' below grade Town of Brewster: b. 39' variance request, proposed leach facility to be 61' from the closest edge of wetland per Leach Facility Set Back Regulation (5) 3, Approval with the following reasons: a. Pre-existing commercial business with a hydraulically failed septic system requiring frequent pumpings. b. The proposed leach facility is located to the maximum extent possible away from the wetlands surrounding the property. The Conservation Commission has approved the location of the wetland edge as shown on the plan. c. The proposed septic system is in compliance with the 1995 Title 5 Code including a 6.2' separation between the leach facility and adjusted groundwater. The proposed septic capacity will adequately accommodate the existing commercial use based on a review of water usage records and the type of use. N:1Health\BOH Meeting No=\BOH HearingNotesl56 Underpass Rd M78P116 Agenda. Variance Action item Form 02.17.2022.doex Amy von Hone From: Noelle Aguiar Sent: Monday, February 14, 2022 2:03 PM To: John O'Reilly Cc: Amy von Hone; Sherrie McCullough; Aiyson Konkol Subject: RE: Brewster Vet Hospital - failed sewage system Attachments: Site Plan -Restoration Plantings Brewster Veterinary NOI 56 Underpass Rd 10072021.pdf; Brewster Veterinary Hospital SE 9-1906 Order of Conditions.pdf Afternoon, The attached site plan was submitted for a planting project on the site, as well as the permit issued for this project. The Commission and I have reviewed the wetlands on-site and approved the plan of record. Kind Regards, Noelle Aguiar M. S. Oceanography and Coastal Sciences Conservation Administrator Town of Brewster 1657 Main Street Brewster, MA 02631 nagular@brewster-ma.gov (548) 896-4546 ext. 4242 Beginning July 6th, Brewster Town Offices will be open to the public Tuesday, Wednesday, and Thursday from 8.30 to 4:00pm. Residents and visitors are urged to continue to access town services remotely if passible. Phone messages and email communications will continue to be answered promptly. Thank you for your understanding and cooperation. For the latest updates on Town services, please visit www.brewster-ma.c From: John O'Reilly <joreilly@jmoreillyassoc.com> Sent: Monday, February 14, 2022 2:00 PM To: Noelle Aguiar <naguiar@brewster-ma.gov> Cc: Amy von Hone ravonhone@brewster-ma.gova; Sherrie McCullough <smccullough @brewster-ma.gov>; Alyson Konkol <akonkol@jmoreillyassoc.com> Subject: Brewster Vet Hospital - failed sewage system Noelle, I am in the process of filing the sewage system plan to the BOH for the Brewster Vet Hosp. for variances to replace the failing septic system. I am planning on filing the paperwork with the health department this Wednesday for a meeting on the 211 of March. I will also be filing the plan with your commission, this week, to amend the orders of conditions for the issue from this summer, hopefully to be heard on the 8th of March.. I am hoping, when asked by the health department, you can attest to the health department that the Commission has reviewed the wetland resources, from the previous application to the commission, and the BOH can act on the variances accordingly. Typically, the BOH wants to have the commission review and approve the wetland locations prior to the BOH reviewing the plans. I have copied both Amy and Sherrie on this email for the purposes of full disclosure. d `.bajsmaJB'p�j w adeys ale) suuisrn eeayp� yW ssedJapun 9 c ,� .:•{ I e4!d SO H Iue ll lJa}an Ja1sM0.18 O X ijit /w, SJoua-Nl am7]�a�]N�rV�-ytl�' ��I z Y IIS ! V as Y 7s d 0 u r a6 ys ages SMISFn WeM yw `jalsMaag `pd ssed.japun gg elILSOj lJe4lJBB/J8SM01 z o z r�!r ss ouua�ui ax�asiy iS� gay p W 0 u r OPEN MEETING LAW COMPLAINT FORM Office of the Attorney General One Ashburton Place Boston, MA 02108 oDDO Please note that all fields are required unless otherwise noted. Your Contact Information: First Name: William Last Name: Jennings Address: 34 Thousand oaks Drive City: Brewster State: MA Zip Code: 0263 1 Phone Number: 774-286-9493 Ext. Email: willlam.j.jenningsgmail.com organization or Media Affiliation (if any): Are you filing the complaint in your capacity as an individual, representative of an organization, or media? (For statistical purposes only) 0 Individual F1 Organization ❑ Media Public Body that is the subject of this complaint: * City/Town ❑ County ❑ Regional/District E] state Name vfPublic Body (including city/ Town Of Brewster/Board of Health town, county or region, if applicable): _ Specific person(s), if any, you allege committed the violation: Date of alleged violation: Page 02/16/22 Description of alleged violation: Describe the alleged violation that this complaint is about. If you believe the alleged violation was intentional, please say so and include the reasons supporting your belief. NoteJhls text field has a maximum of 3060 characters. The Town of Brewster contlnuea to hold Public Meetings virtually over Zoom and not in person. For the Hoard of Health Meeting, held on February 16, 2022, the Board opened the meethg and when it came time for Citizens Forum, the agenda stated "To request to speak: Tap Zoom " Raise Hand " , then wait to be recognized" Before the meeting the Chairperson was told that there were members of the public logged into the meeting, Follwing the agenda's Instruction, I clicked on the "Raise Hand" icon and waited to be called on. The chairperson, perhaps unaware how the software worked, did not acknowledge the public and passed on the Citizens Forum moving onto the next item on the agenda without calling on the public. I was awaiting to speak and become frustrated that I followed Instructions as stated on the Agenda and was ignored. Thankfully, i emailed the department email address on the Town's website and a town employee responded and she got back to me to tell me that they would let the Board know. She did so and thankfully I was allowed to speak. However, that was after a small discussion amongst the Board and town staff about whether my "raised hand" was done in a timely manner. Mind you however, there is no description on the Agenda about when the "raised hand" is to occur. However, I imagine that there were others that felt my frustration that the Board Chair was unable to acknowledge the publlc and perhaps logged off and were not given the opportunity to speak. If the Board met in person, this never would have happened. There is no reason why this Board cannot be meeting In person, There are numerous boards that meet in person throughout our local area. What action do you want the public body to take In response to your complaint? Note: This text field has a maximum of 509 characters, 1 j 1 feel it is approriate that the Board Chair be properly trained to acknoweldge the public during citizens forum before the next scheduled meeting of March 2, 2022. 2] The Agenda should be Improved to let the public know exactly when the timing of the "raised hand" should occur. The updated guidance of June 21, 2021 states "meeting notice must clearly specify how the public may access the meeting, whether in-person, remote or both". The Board of Health In Brewster has Palled In this regard. 3) The order allowing in person meeting expires at the end of March, it Is my hope that this Board begins to meet before that. The Board's failure to meet a simple task as listenting to the puN[c; virtually makes it clear that it is titre for this Board to begin meeting in person again, so the public is given its right to speak at Public Meeting. If this Board met in peeson, none of this would have happened. Review, sign, and submit your complaint i. Disclosure of Your complaint. Public Record. Under most circumstances, your complaint, and any documents submitted with your complaint, Is considered a public record and will be available to any member of the public upon request. Publication to Website. As part of the Open Data Initiative, the AGO will publish to its website certain Information regarding your complaint, including your name and the name of the public body. The AGO will not publish your contact Informatfon. II. Consulting With a Prit+ateAttorney_. The AGO cannot give you legal advice and Is notable lobe your private attorney, but represents the public interest. If you have any questions concerning your individual legal rights or responsibilities you should contact a private attorney. 111. Submit Your Complaint to the Public Body, The complaint must be filed first with the public body. If you have any questions, please contact the Division of Open Government by calling (617) 963-2540 or by email to openmeeting@5tate.ma.us. By signing below, I acknowled a th�t l have read and and correct to the be of my10 [edge. Signed: Page 2 understood the provisions above and certify that the information I have provided is true Date: February 17, 2022 For Use Ry Public Body Far Use ByAGD pate Received by Public Body: Date Received byAGO, ji) The Commonwealth of Massachusetts Office of the Attorney General One Ashburton Place Boston, Massachusetts 02108 OPEN MEETING LAW COMPLAINT FORM Instructions for completing the Open Meeting Law Complaint Form The Attorney General's Division of Open Government interprets and enforces the Open Meeting Law, Chapter 30A of the Massachusetts General Laws, Sections 18-25. Below is the procedure for filing and responding t4 an Open Meeting Law complaint. Instructions for flling a complaint: o Fill out the attached two-page form completely. Sign and date the second page. File the complaint with the public body within 30 days of the alleged violation. If the violation was not reasonably discoverable at the time it occurred, you must file the complaint within 30 days of the date the violation was reasonably discoverable. A violation that occurs during an open session of a meeting is reasonably discoverable on the date of the meeting, o To file the complaint: o For a local or municipal public body, you must submit a copy of the complaintto the chair of the public body AND to the municipal clerk. o For all other public bodies, you must submit a copy of the complaint to the chair of the public body. o Complaints maybe filed by mail, by email, or by hand. Please retain a copy for your records. o If the public body does not respond within 14 business days and does not request an extension to respond, contact the Division for further assistance. Instructions for a public body that receives a complaint: ❑ The chair must disseminate the complainttothe members of the public body. o The public body must meetto reviewthe complaint within 14 business days (usually 20-22 calendardays). o Afterreview, but within 14 business days, the public body must respond tothe complaint in writing and must send the complainant a response and a description of any action the public batty has taken to address the allegations in the complaint. Atthe same time, the body must send the Attorney General a copy of the complaint anda copy of the response. The public body may delegate this responsibility to an individual member of the public body, its counsel, or a staff member, but only after the public body has met to review the complaint. o If a public body requires more time to review the complaint and respond, it may request an extension of time for good cause by contacting the Divisfon of Open Government. once the public body has responded to the complaint: o If you are not satisfied with the public body's response to your complaint, you may file a copy of the complaint with the Division by mail, by email, or by hand, but only once you have waited for 30 days after filing the complaint with the public body. Mail may be sent to: The Division of Open Government, Office of the Attorney General, One Ashburton Place - 201h Floor, Boston, MA 02708, Emails may be sent to: openmeeting@state.ma.us. o When you file your complalntwith the Division, please includethe complaint form and all documentation relevant tothe alleged violation. You maywish to attach a cover letter explaining whythe public body's response does not adequately address your complaint. o The Division will not review complaints filed with us more than 90 days after the violation, unlesswe granted an extension tothe public body or you can demonstrate good cause forthe delay. if you have questions concerning the Open Meeting Law complaint process, we encourage you to contact the Division of Open Government by phone at (617) 963-2540 or by email at gpenmeeting@state.ma.us. Board of Health Penny Holeman Annette GraczewAi Joe Ford Jeannie Kampas Kimberley Crocker Pearson Health Director Amy von Bone Assistant Health Director Sherrie McCullough Senior Department Assistant 'I'ammi Mason Town of Brewster Board of Health 2198 Main St., Brewster, MA 02631 bi-he-,ilth@brewstei--ma.gov (508) 896-3701 BOARD DE HEALTH MEETING AGENDA 2198 Main Street February 16, 2022 at 7:OOPM Pursuant to Chapter 20 of the Acts of 2 02 1, this meating will be conducted via remote means, In accordance with appIIcabte law. This means that members of the public hotly may access this meeting Yla virtual means, No in-person attendance of members of the publlcwill be permitted, and publicpartkipatlon In any public hea ring con ducte d during thds meeting shall be by remote means only, Members of the public who wish to access the meeting may do so In the following manner: Phone; Call (301)715-8592 or (312)626.5799. Webinarto: 820 4394 4509 Passcade:979174 To request to speak: Press *9 and wait to be recognized. Zoom Webinarr htt s: ws02Web.-400m.0 82043944599] wd=M t 2kvUExKbU1R50hmM012b3d x09 Passcode:979174 To request to speak: Tap Zoom "Raise Hand", then wait to be recognized. When required by law or allowed by the ChWr, persons wishing to provide public comment or otherwise participate In the meeting, may do so by accessing the meeting remotely, as noted above. Additionally, the meeting will be broadcast live, In real time, via Live broadcast (Brewster Government 1V Channel 18), Lives tream filvestrearn.brews ter-ma.govf or Video recording (tv.brewster-ma.gov) 1. Call to Order 2. Chairman s announcements 3. Citizens forum 4. Covid update 5, Discuss and possibly approve final draft of Nitrogen Loading Regulations (including Town Counsel edits) 6. Discuss/comment on BOH 2021 Town Deport 7. Review & approve minutes from 11/15/21; 12/1/21 S. Liaison Reports 9. Matters not reasonably anticipated by the Chair 10. Items for next agenda 11. Next meeting: March 2, 2022 12, Informational items: a, Monthly report Ocean Edge b. Article- "Effectiveness of Face Mask or Respirator Use in Indoor Public Settings for Prevention of SARS-CoV-2 Infection c, Monthly report for Pleasant Bay Health & Living Cenet d. Monthly report for Maplewood e. Monthly report for Serenity of Brewster (formally Wingate) f. Monthly reports for King's Landing (Oct, Nov & Dec) g. Montl-tly report for Cape Cod Sea Camps h. Groundwater Discharge Annaul Report for 2021- Cape Cod Sea Camps i, Article from CCT rel Nitrogen in groundwater 13. Adjournment Date Posted: Date Revised: Received by Town Clerk: 2/11/2022 Ilfileserverl61rdocuments$1lmasonlDesktoplAgenda tcmplate.doex Town of Brewster 2198 Main Street Brewster, MA 02631-1898 Phone: (508) 896-3701 Fax: (508) 896-8089 MEMORANDUM Office of: Select Board Town Administrator TO: Select Board FROM: Peter Lombardi, Town Administrator & Donna Kalinick, Assistant Town Administrator RE: Upcoming Meeting Schedule & Format for Town Committees DATE: February 10, 2022 We are recommending that the Board continue the committee meeting format that has been in place since June 2021 through to the end of March 2022, Although the recent surge of CGVID cases in Brewster and the County has seemed to stabilize, we should continue to be vigilant through the winter months. Current state provisions allow for the continuance of remote and hybrid meetings through April 15, 2022; however, the State legislature is proposing an extension of this provision until July 15. This latest Iegislative solution is pending approval by Governor Baker. We will have to revisit this issue at our second meeting in March to determine whether we need to continue this approach into spring. The Board of Health will have revisited their mask requirement in Town buildings by that date. The following are a list of committee meeting provisions that we currently have in place. • In-person/hybrid meetings can be held in Room A or Room B. The hybrid option has been installed Room B and both rooms are now fully operational. • In-person attendance will be limited to board/committee members and staff only through March. Attendance is limited to 6 people in order to allow for social distancing. • Public attendance will continue to be through Zoom webinar through March 3, 2022. • In-person attendees will be required to follow either the mask mandate or mask advisory in town buildings; rooms are equipped with air purifiers and are cleaned between meetings. • Committee members and/or staff can person. opt to participate remotely instead of in - There are currently no committees who are meeting in person. We have been able to effectively manage the committee schedule during this time frame. MUNICIPAL ]OBS MUNICIPAL MARKETPLACE CONTACT U5 NEWSLETTER SIGN UP f W in SEARCH MEMBERS ADVOCACY NEWS RESOURCES EVENTS ABOUT MMA FEB MUNICIPAL GOVERNMENT 14 Gov. Baker signs COVID bill with public meet11 d _2022 provisions Home —> News --.). Municipal Government On Feb. 12, Gov. Charlie Baker signed a $101 million bill supplementing certain fiscal 2022 appropriations in response to the current phase of the COVI❑-19 public health emergency and extending certain authorizations related to public meetings. W 1� The law extends pandernic- Grcveland residents attend their Town Meeting in spring 2020. related authorizations related to public board and town meetings that either had expired or were due to expire soon. The following options are now available through July 15: • Remote option for public bodies: The law extends authorization for virtual public meetings, first enacted at the beginning of the pandemic in April 2020. • Open town meeting quorums: The law allows select boards, in consultation with their town moderator, to lower the quorum requirement for open town meetings to not less than 10% of the existing quorum level. The quorum provision includes a seven --day notification requirement before any select board vote. • Remote representative town meetings: The law allows representative town meetings to have the option to meet remotely, if approved by the select board and town moderator, as well as the town meeting when it meets. These extensions were priorities for the MMA in early 2022. In terms of funding, the law includes $50 million for the expansion of COVID testing and $25 million to procure high-quality masks for students and faculty in elementary and secondary public school districts, early childhood centers, congregate care facilities, and home health care workers. It also includes $25 million for the COVID-19 Massachusetts Emergency Paid Sick Leave Fund and $1 million for a public awareness campaign regarding unemployment benefit overpayments. The law also sets the state primary date for Sept. 5, 2022. Following negotiations between the House and Senate, the Legislature had sent a final bill H. 4345} to the governor on Feb. 3. Written by Jackie Lavender Bird, Senior Legislative AnolVst News Categories ECONOMIC AND COMMUNITY DEVELOPMENT LABOR AND PERSONNEL LOCAL AID AND FINANCE MUNICIPAL GOVERNMENT MUNICIPAL SERVICES PUBLIC WORKS, ENERGY AND UTILITIES February 23, 2022 Lorraine C. Harvey, as Trustee The LCH Realty Trust 4119106 120 Run Hill Road Brewster, MA 02631 Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02631-1898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896.4538 brheaIthrt Brewster-ma.gov W W W.BRE WSTER-MA.GOV Health Department Amy L. von Hone, R.S., C.H.R. Director Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Re: 120 Run Hill Road — Septic System In- House Variance Request Approval Dear Ms. Harvey: The Health Department has reviewed your variance request and hereby approves the existing leaching chambers to remain less than 300 feet from Lower Mill 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, RS Assistant Health Director cc: File N:1Hea1th\BOH Decision Lettefs%Septic Variance In -House Decisions\Real Estale Transfer Approvals1120 Run Hill Road Approval 02.23.2022.doe "go VoEws 0 M r w T� 0 y - Town of Brewster 2198 MAIN STREET BREWSTER, MASSACHUSETTS 02631-1898 PHONE: 508.896.3701 EXT. 1120 FAX: 508.896,4538 brhealtb@—brewster-ma.gov WWW.BREWSTER-MA.GOV AGENDA ACTION ITEM FORM BOH Variance Agenda Item F-1 In -House Local Upgrade Approval M Other: 300' variance request to Lower Mil I Pond 0 Health Department Amy L. von Hone, R.S., C.H.O. Director Board of Health Meeting Date: March 2, 2022 Project Location: 120 Run Hill Road Map & Parcel: 35/34 Owner's Name & Address: Lorraine C. Harvey, as Trustee The LCH Realty Trust 4/19/06 120 Run Hill Road Brewster, MA 02631 Sherrie McCullough, R.S. Assistant Director Tammi Mason Senior Department Assistant Applicant: Lorraine C. Harvey, Trustee Date Requested: February 10, 2022 Title 5 Variance Request: Yes El No M Board of Health Variance Request: Yes[] NoM300'Pond Setback Other: Yes 0 No El 1. In ESA— existing dwelling and septic system within 300'of Lower Mill Pond Assistant Health Director's Recommendation: Approve with following comments and conditions 1. The existing property consists of an existing 4 -bedroom dwelling serviced by a 1997 Title 5 septic system and town water. The lot is approximately 71,400 sf. and is outside Title 5 Zone II and DCPC restrictions but subject to local ESA restrictions. 2. Per the engineered plan on file, the leach chamber system (4 Infiltrator chambers with 4 'of stone) are approximately 193' fi-om. the edge of Lower Mill Pond. The leach facility is located parallel to the closest edge of the pond. 3. A Title 5 Septic lnspection Report dated January 19, 2022, indicated the system is properly functioning and the leach facility is greater than 5'above ground water. 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. N:\HealtW30H Decision LetterMeptic Vari ance I n-Hoiise Doe i s ions\Real Estate Trans &r Approvals\ 120 Lower Mi I I Pond Road Action Item S ummary 02.23.2022.docx n 0 V I 0 m r� 10, A v � n ❑ v vo am nz -vr - car f�--"amoN z z C 'n0(nm w omNaT�1 fan7�rm NrmiiO�NN Z a -rl m r L7 U) V) 9 N Q m�m N n n N a O 6igb �aF❑ m ❑ N z a � 0 m o r a 2 a,im ^C] v N m A w ro C~n N r p o p Z 0 v, o n c c 'v 0 0$� c-i� vvov L o v e -n -nix cI� ir00 O m 1-ng00 yAy�77 r gmm 0 z� 0-06 C 1 Y T m o m M m� O m m r z 0DEDa:>0:Er� m � A a:, in QTrNyc O mz� umi x r N m r x � r 'v o'voo 000 vcnov0000 N�>-ncm>Nc y aa")c ❑❑zzrzzzrz-1 c�azvaD�00m �NO�mCl cizm� O(n N u c> v0,3 c v �b v❑�❑n�zn s a{a ms m n2 v Y ❑ Z c z 0 fO m Lo df N� m N N rn 66 0 o A 4 4 ro `� a v G A� Nrn Lv 0 o O m m W v i raj a N W m n w W Z N- W - Oi+v1 rppl� i. -C.1 �am�nm 0 ao zz ,-moi 0 n i fia] h zA� z m C, a'noom m 0 m r m fli ro m m V N 00 A N W aaaaao� vm=0Ylm0 N z C w � W m O o m m w a m Xa A d Z: a r r> 0 m r O P d W i 2 6 m r c a[n a 1 z2: m Nadi oc r vv c wQ�m n n C1 N C] z y�y c {� w O i s m N N 3 00 y O y y u 0 m L 0 o z m ou as w 00 P f'r � an 0 0 a s 2 CCC n h N y { d o m A �n1b z 0o L]m m inn m [Wil � n z b .� m r r va � r o a v m vT w �w r � O o 0 co -h ou C M n roam m n v Cl) z o a z o M a M 1 X rF o n m m D z Ti �wm w Q1 � W -b `C AW N, 0 p�MN�n is -t- m o g 611 [�] F---!6a' A 0W -1 N fV N 00 � + OP Town of Brewster OFIR E or: BOARD OF 1IFA.1,TH P >a BREWSTER, MASSACHUSETTS 02631-1898 508 §96-370193,1 '�F2i� E D FEB 10 2022 BREWSTER k1EALTH DF-PA,RTnn�NT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM APPENDIX BREWSTER REGULATION Map Lot 3q Property Address: 120 Run Hill Rd Other Address: Name of Inspector: Darrell Stone Company Name, Address, and Phone Number: Cape Cod Septic Inspection (5081-240-2500 PO Box 1466, East Harwich MA 02645 Date of Inspection: 1119122 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 grade. 5 _ C) Further Evaluation is required by the Board of Health —10, � - /k O ]42- 0 f ] X The leaching facility or facilities are located within 300 feet of a _ or lake.- >z 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. _ 5' j5 �hJn uoJ' /k The Brewster Health Department has reviewed and accepted this report based on the information contained therein. This inspection reflects the present condition of the Sanitary System and is not any guarantee as to the life or future condition of said system. L ul � ' ') )� a Jd3 /a�Q- �- Date Approving Authority Please be advised of ADDITIONAL BOARD OF HEALTH REGULATIONS: 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. All underground tanks must be registered with Board of Health and are subject to testing requirements. Commonwealth of Massachusetts Title 5 Official Insp ' Subsurface Sewage Disposal System For 120 Run Hill Rd. 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 �oq A ection Form m - Not for Voluntary Assessments z 22-6 30-6 3 ',? "/- V Property Address 4 7. g-,/ z5.. Lorraine C. Harvey Trust Owner Owner's Name information is required for every Brewster, Ma 02631 1/19122 page. CitylTown State 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 �oq tVnsp-doc • rev. 712812018 Title 5 Ofrclal Inspection Form Subswfaca Sewage disposal System • Page 16 of 18 A B z 22-6 30-6 3 ',? "/- V Z5' -la 4 7. g-,/ z5.. 5 tVnsp-doc • rev. 712812018 Title 5 Ofrclal Inspection Form Subswfaca Sewage disposal System • Page 16 of 18 TOWN OF BREWSTER ADDENDUM TO DEP SEPTIC INSPECTION REPORT Inspection Location 120 Run Hill Rd Map & Parcel 5. Is there a 4' separation (1978 code) or a 5' separation (1995 code) Yes X No between the bottom of the S.A.S. and adjusted groundwater? TOP OF FOUNDATION 6. Town Water�_X} or Private Well ( ) Distance from nearest septic system component: 10'+ 7. Wetlands or surface water within 100' of septic system? Yes No Y Distance from nearest septic system component: 100'+ 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?) �1 Septic tank inlet Yes Septic tank outlet Yes Pump chamber inlet n/a D -box inlet if pumped system nla Grease trap inlet nla Grease trap outlet nla 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 port on S.A.S. (1995 code) Yes 2 January -19,2022 Bryan Webb (via email) Ocean Edge Resort 2907 Main Street Brewster, MA 02631 RE: Ocean Edge Resort Wastewater Treatment Facility Monthly Operations Report — December 2921 Dear Mr. Webb: Weston& Sampson 55 Walkers Brook Woe, Sdte 100, Reading, MA 01867 Tel: 978,532.19oo Enclosed please find the Monthly Operations Reporting Package for the Ocean Edge Resort wastewater treatment facility (WVVTF) located at 832 Village Drive in Brewster, MA. Weston & Sampson Services, Inc, would like to note the following: • All regulated effluent parameters of samples collected throughout the month were reported to be within their respective permissible limits. ■ 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. t James R. Tringale Compliance Coordinator cc: Brewster Board of Health (via email) FR Mahony Associates (via email) westonan ds am pso n. cam Offices ices in: MA, CT, NH, Vi, NY, NJ, PA, SC & FL Massachusetts Department of Environmental Protection .1 tiaEP TI - eransaconCopy 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: 1339137 Document: Groundwater Discharge Monitoring Report Forms Size of File: 1027.19K Status of Transaction: submitted Date and Time Created: 2/1812022:12.35.41 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. �J Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. W1115D Ilk rf7xn Massachusetts Department of Environmental Protection 1633 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit DAILY LOG SHEET 2. Tax Identification Number 2021 DEC DAILY 3. Sampling Month & Frequency A. Facility Information 1. Facility name, address: ]OCEAN EDGE CONFERENCE CTR a. Name JROUTE 6A b. Street Address BREWSTER MA C, City d. State 2. Contact information: 2631 e. Zip Code JAMES R. TRINGALE a. Name of Facility Contact Person 9785321900 JWSSCampliance@wseinc.com b. Telephuroe Number c. e-mail address 3. Sampling information: 1 211 /2021 JONSITE MEASUREMENTS a. Date Sampled (mmlddlyyyy) b. laboratory Name CHRIS VIGNEAU c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency J Daily Log Sheet - 2021 Dec Daily J 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 033 -- Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit l 2. Tax identification Number DAILY LOG SHEET 2021 DEC DAILY Ll� 3. Sampling Month & Frequency C. Daily Readings/Analysis Information Date Effluent Reuse Irrigation Turbidity Influent pH Effluent Chlorine UV Flow GPD Flaw GPD Flow GPD pH Residual Intensity [mgll) C/o) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 2378 I j 7.18 4898) 7.59 4898 7.08 9017 7.08 7.65 5919 7.10 7.13 7.71 5382 2272 � 7.14 7.64 3969 3969 7.18 7.61 4853 4653 4fi53 J 7.07 7.59 2370 2370 7.04 7.12 3910 7.79 2346 7.07 7.62 3604 7.06 7.57 4694 4694 7,04 7.09 7.61 7.58 3058 3207 7.13 7.66 3504 2500 7.11 7.73 2500 2500 2500 7.08 7.57 4389 7.04 7.81 5717 7.09 7.71 7.69 10919 7.16 gdpols.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1633 j fR Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number _ Groundwater Permit '' MONITORING WELL DATA REPORT 2. Tax identification Number 2021 DEC MONTHLY 1 3. Sampling Month & Frequency A. Facility Information Impartant:INhen 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 fiA do not use the return key. b. Street Address BREWSTER IMA 102631 ryy C. City d. State e. Zip Code lk AV 2. Contact information: rem #Alj JAMES R. TRINGALE a. Name of Facility Contact Person 9785321900 WSSCompl'ance@wseinc.com b. Telephone Number c. a -mall address 3. Sampling information: 112/16/2021 ONSITE MEASUREMENTS a. Date Sampled (mmlddlyyyy) b. Laboratory Name CHRIS VIGNEAU c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2021 Dec Monthly Ail forms for submittal have been completed. 2. r This is the last selection. 3. r- Delete the selected form. T gdpd€s 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection i Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT 1633 1. Permit Number 2. Tax Identification Number [2{721 DEG MONTHLY 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "0", balow detection limit, less than (<) value, or not detected, enter "N D" ■ TNTC = too numerous to count. (Fecal results only) • NS =Not Sampled • DRY = Not enough water in well to sample. ParameterlContaminant DG2 DG3 DG4 DG5 UG1 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 PH 6.80 J 16.60 6.40 6.50 6.50 s.U. STATIC WATER LEVEL 143.1 j 47.9 41.3 FEET SPECIFIC CONDUCTANCEf 46� 290 380 1440 _ _ I320 UMHO&C Well #: 6 mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data far 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. Q 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 DEC MONTHLY 3. Sampling Month & Frequency 1. Facility name, address: OCEAN EDGE CONFERENCE CTR a. Name ROUTE 6A b. Street Address BREWSTER IMA 102631 C. City I State e. Zip Code 2. Contact information: ES R. TRINGALE a. Name of Facility Contact Person 785321900 IWSSCPmpliance@wselnc.COm b. Telepl*ne Number c. s -mail address 3. Sampling information: 112/16/2021 Ri ANA TI CAL a. Date Sampled [mmlddfyyyy] b. Labaratory Name WARiDUS ANALYSTS c. Analysis Performed By (Name) B. Farm Selection 1. Please select Forza Type and Sampling Month & Frequency Discharge Monitoring Report - 2021 Dec 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 Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1633 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit fVumber Ll Groundwater Permit 2. Tax identification Number' DISCHARGE MONITORING REPORT 2029 DEC MONTHLY 3. Sampling Month & Frequency D. Contaminant Analysis Information • For "0", below detection limit, less than {<} value, or not detected, enter "ND" • TNTC = too numerous to count. (Fecal results only) • NS = Not Sampled 1. Parameter/Contaminant 2. Influent 3. Effluent 4. Effluent Method Units Detection limit BODr60 �7 10 MGI - TSS 170 1 4A 2.0 MG/L TOTAL SOLIDS 440 MG/L AMMONIA -N MG/L NITRATE -N ND I ❑.050 MG/L —_ TOTAL NITROGEN(NO3+NO2+TKN) MOIL OIL & GREASE 14.60 � 10.50 MG/L — infeffrp-blank+doe • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report - Page 1 of 1 lmpodtant: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. r Massachusetts Department of Environmental Protection B33 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number Facility Information EDGE CONFERENCE CTR a. Name JROUTE 6A b. Street Address BREWSTER JIVIA � 92631 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 res ponslbla for gathering the Information, the Information submitted is, to the hest of my knowledge and belief, true, accurate and ccmplete. I am aware that the are significant penalties fcr submitting false intarmation, including the possibility of fine and imprisonment for knowing vioiations." MARIANNA COOMBS 1/27/2022 a. Signature b, Date (mmlddlyyyy) gdpols 2015-09-16.dcc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 R.I. ANALYTICAL Specialists in Environmental Services LABORATORY REPORT WSS Inc.dba Weston & Sampson Date Received: Attn: Chris Vigneau Date Reported: 55 Walkers Brook Drive P.O. Number Suite 100 Reading, MA 01867 Work Order #: 2112-21630 Project Name: PROJECT# 25364 OCEAN EDGE RESORT - MONTHLY 12/16/2021 12/28/2021 Page 1 of 2 Enclosed are the analytical results and Chain of Custody for your project referenced above. The sample(s) were analyzed by our Warwick, RI laboratory unless noted otherwise. When applicable subcontracted results are noted and subcontracted reports are enclosed in their entirety. All samples were analyzed within the established guidelines of US EPA approved methods with all requirements met, unless otherwise noted at the end of a given sample's analytical results or in a case narrative. The Detection Limit is defined as the lowest level that can be reliably achieved during routine laboratory conditions. These results only pertain to the samples submitted for this Work Order # and this report shall not be reproduced except in its entirety. We certify that the following results are true and accurate to the best of our knowledge. If you have questions or need further assistance, please contact our Customer Service Department. Approved by: Krzysztof Trafalski Laboratory Director Laboratory Certification Numbers (as appiicable to sample's origin state): Warwick RI * RI LAI00033, MA M-RIO15, CT PII.0508 Page 2 of 2 R.I. Analytical Laboratories, Inc. Laboratory Report WSS Lnc.dba Weston & Sampson Work Order #: 2112-21630 Project Name: PROJECT# 25364 OCEAN EDGE RESORT - MONTHLY Sample Number: 001 Sample Description: INFLUENT Sample Type: COMPOSITE Sample Date 1 Time - 12116/2021 (a) 05:30 Sample Number: 003 Sample Description: EFFLUENT Sample Type: GRAB Sample Date 1 Time: 12/16/2021 Q 06:00 SAMPLE DET. DATErHME PARAMETER RESULTS LIMIT UNITS METHOD ANALYZED ANALYST Oil & Grease Gravimetic 0.60 0.50 mgll EPA 1664A 12/22/2021 7.00 EMM SAMPLE DET. DATLYTIME PARAMETER RESULTS LIMIT [AMTS METHOD ANALYZED ANALYST BODS 60 60 mgll SM5210B 21 cd 12/17/2021 12:26 LKB Total Suspended Solids 70 2.0 mg'l SM2540D 2011 12/20/2021 15:26 JM.T3 Total Solids 440 to m911 SM2540B 18-21ed 12/16/2021 22:45 TP Ammonia (as N) 5.8 0.20 mg11 EPA 350.1 12/21/2021 12:16 JMD Sample Number: 002 Sample Description: EFFLUENT Sample Type : COMPOSITE Sample Date 1 Time : 12/16/2021 Q 05:45 SAMPLE DET. DATEITIME PARAMETER RESULTS LIMIT UNITS METHOD ANALYZED ANALYST BVD 5 27 10 m911 SM52108 2led 12117/2021 12:11 Ly -B Total Suspcnded Solids CO 2.0 mgll SM2540D 2011 12/20/2021 15.26 JMD Nitrite (as N) 0.11 0.050 mg/1 EPA 300.0 12/17/2021 1414 KPG Nitrate (as N) e0A50 0.050 nw)l EPA 300.0 12/1712021 M24 KPG TKN (as N) 0.99 0.50 met SM4500NOrg-D 18-21ed 12/20/2021 13:00 JMD Sample Number: 003 Sample Description: EFFLUENT Sample Type: GRAB Sample Date 1 Time: 12/16/2021 Q 06:00 SAMPLE DET. DATErHME PARAMETER RESULTS LIMIT UNITS METHOD ANALYZED ANALYST Oil & Grease Gravimetic 0.60 0.50 mgll EPA 1664A 12/22/2021 7.00 EMM U 0 r Q 2 � 0 a c � 0 d a � F z p d r� �•C [] d v � � E m t�Jpaj uuorloo leaa=l M ob cn CD y 3 o b 00 ti = n z .sle}ew a a 1.30 P041OW - SOon GL th990 esewo v Ilo - Eno W r_ c t3 8184d 904d IElol " d'1 e}e4dso4d 041JO - d•0 A N se U060 IN eguauauab- CHN x ueBMIIN 14ePIObl lelol-NN1. � ■`m� vl 00 a d7 uop polso ua6o.4IN Ielol - Nl o N co o ai N se ueBOAIN WAN N - EoN Hd� a N se uaBOAIN 81YI N - zoN .�maC spHo5 Egiol - Si co c� 4%d ;L?L CO SPIIoS PopuadsnS - SSl Of 0) U SPI JOS penlassl❑ Mol- Sal pugwac zo IMILU9400yg - a09 + apoo X14 d apo uopumosazd {� a acU.L W s-totgquo;3 ;o # Q- aaisoduio- ao qui- as r C It, a M b u M CD W ` > y j C-11 VL r aq�; � Z f .� D�� IL o �j da , n L4 L-1 `� w-Amw Q 00 � N Vn 000 U 0 r Q 2 � 0 a c � 0 d a � F z p d r� �•C [] d v � � E m M ob cn CD y 3 o b 00 ti = n z a a GL W r_ c t3 -� A 0 � ■`m� vl 00 a d7 o N co o ai Hd� a .�maC co c� 4%d ;L?L CO Lo Of 0) U U 0 r Q 2 � 0 a c � CL E d a � F z p a. Z 0 [] d _ O � � � E m M z w z.2 z C) = n Z ^� � r VZ Massachusetts Department of Environmental Protection - eDEP Transaction Copy I 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: 1347378 Document: Groundwater Discharge Monitoring Report Forms Size of File: 1029.16K Status of Transaction: In Process Date and Time Created: 211812022:10.18:59 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 746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit Ll- 2, Tax iidentification Number DAILY LOG SHEET2022JAN DAILY [2 -- 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer, use ]PLEASANT BAY HEALTH GTR only the tap key to a. Name move your cursor- 383 SOUTH ORLEANS ROAD do not use the return key. b. Street Address BREWSTER IMA 102531 c. City d. State e. Zip Code 2. Contact information: m AA4 IJOSEPH SMITH a. Name of Facility Contact Person 7742125005 'smith@NSUWater.com b. Telephone Number c, a -mail address 3. Sampling information: 1/1/2022 NOT APPLICABLE a. Cate Sampled (rrfrnlddfyyyy) b. Labceatory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Daily Log Sheet - 2022 Jan Daily T- 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 Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Massachusetts Department of Environmental Protection 1746 j Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DAILY LOG SHEET 2022 JAN DAILY 3. Sampling Month & Frequency C. Daily Readings/Analysis Information Effluent Reuse Irrigation Turbidity Influent pH Flow GPD Flow GPD Flow GPD Effluent Chlorine UV pH Residual Intensity (mgll) C/0 gdpols.doc • rev. 09/15/15 Groundwater Permit Daily Lag 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 DISCHARGE MONITORING REPORT 2022 JAN MONTHLY L1. 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address: the computer, use IPLEASANT SAY 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 102631 ldtf c. City d. State e. Zip Code lk 2. Contact information: r JOSEPH SMITH a. Name ad Facility Contact Person 7742125005 ssmith@NSUWater.com b. Telephone Number c. a -mall address 3. Sampling information: 1!512022 ALPHA ANALYTI CAL a. tate Sampled lmmlddryyyyj. 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 - 2022 Jan Monthly All forms for submittal have leen completed. 2. r- This is the last selection. 3.- 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 746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT - 2022 JAN MONTHLY E 3. Sampling Month & Frequency D. Contaminant Analysis Information ■ For "0", below detection limit, less than value, or not detected, enter "ND" • TNTC = too numerous to count. (Fecal results only) • NS = Not Sampled 1. Parameter/Contaminant Units 1300 McIL TSS MGIL TOTAL_ SOLIDS MGIL AMMONIA -N MG1L NITRATE -N McIL TOTAL NITROGEN(NO3+NO2+TKN) MG1L OIL. & GREASE MG+L FECAL COLIFORM 1100 NIL CHLORIDE MGIL 2. Influent 3. Effluent 4, Effluent Method Detection limit 1200 -- z.5 _. 1 12,0 - - - ---- --� 48 ND 320 2$0 I 10 12.4 -� 7.5 1 0.10 7.50 ND ND 45—_ fnfeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report - Page 1 of 1 Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. ►kuru Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT A. Facility Information 1. Facility name, address: PLEASANT BAY HEALTH CTR a. Name 383 SOUTH ORLEANS ROAD b. Street Address BREWSTER IMA C. City d. State 2. Contact information: 74fi 1. Permit Number I 2. Tax identification Number 2022 JAN MONTHLY 3. Sampling Month & Frequency 02831 e. Zip Code JOSEPH SMITH a. Name of Facility Contact Person 7742125005 ljsmith@NSUWater.com b. Telephone Number c. e-mail address 3. Sampling information: 1/4/2022 INOT APPLICABLE a. Date Sampled (mmlddryyyy) b, laboratory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampiing Month & Frequency Monitoring Well Data Report - 2022 Jan Monthly T r- All forms for submittal have been completed. 2. This is the last selection. 3. r Delete the selected form. gdpols 2015-09-15.doc • rev. 09115115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection J746 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT 2022 JAN MONTHLY Ll 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "D", below detection limit, less than (a) value, or not detected, enter "ND" < • TNTC = too numerous to count. (Fecal results only) • N5 =Not Sampled • DRY = Not enough water in well to sample. ParameterlContaminant DG -1 DG -2 CG -4 UG -1 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 7.12 7.1 7.4Q 7.4$ S.U. STATIC WATER LEVEL 10 70 r1D.6T 21.44 9.68 FEE•f SPECIFIC CONDUCTANCE 1g6 211,$ 268.4 1 86.7 u>urHOSC 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. r Massachusetts Department of Environmental Protection 1746 Bureau of Resource Protection - Groundwater discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number Facility Information T BAY HEALTH CTR a. Name 383 SOUTH ORLEANS ROAD b. Street Address BREWSTER MA 21331 C. City d. State e. Zip Code Certification "1 certify under penalty of law that this document and all attachments were prepared under my direction or supervislon 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 In form atlon. the information submitted is, to the best of my knowledge and belief, true, accurate and complete. I am aware that the are slgniflcant penalties for submitting false Information, Including the possibility of fine and Imprisonment for knowing violations' SAMANTHA FARRENKOPF 2/18/2022 a. Signature Renortin Comments b, Date (mm1ddlyyyy) BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (BEA) HAS COMPLETED THE JANUARY 2022 MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE AMPHIDROME WASTEWATER TREATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 115122. LABORATORY RESULTS REPORTED ALL PARAMETERS WITHIN DISCHARGE PERMIT LIMITATIONS. EFFLUENT PH WAS REPORTED WITHIN THE 6.5-8.5 RANGE TH ROUGHOUT 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 57 GPD, 21,594 GPD AND 8,768 GPD, RESPECTIVELY. gdpols 2015-09-15.dvc • rev. 09/15/15 Groundwater Permit • Page 1 of 1 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: SFARRENKOPF Transaction ID: 1347284 Document: Groundwater Discharge Monitoring Report Forms Size of File: 1032.a8K Status of Transaction: in Process Date and Time Created: 2117/2022:2:05:49 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. rad ra►urr Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DAILY LOG SHEET A. Facility Information 1, Facility name, address: MAPLEWOO❑ AT BREWSTER a. Name 951 1. Permit Number 2. Tax identification Number 2022 JAN DAILY 3. Sampling Month & Frequency 1820 HARWICH ROAD b. Street Address B RE WSTER IMA 102631 C' City d. State e. Zip Code 2. Contact information; JOSEPH SMITH a. Name of Facility Contact Person 7742125005 'smith@NSUWater.com b. Telephone Number c. e-mail address 3. Sampling information: 111!2022 INOT APPLICABLE a. date Sampled (mmlddlyyyy) b. Laboratory Name BEA NSU PERSONNEL c. Analysis Performed By (Name) B. Form Selection I. Please select Form Type and Sampling Month & Frequency Daily Log Sheet - 2022 Jan Daily ' r Ail forms for submittal have been completed. 2. l- This is the last selection. 3. r- Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15115 Groundwater Permit Daily Log Sheet - Page 1 of 1 Massachusetts Department of Environmental Protection 951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DAILY LOG SHEET 2022 JAN 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) (°Io} 1 5480 _f z 5480 J 3 5459 6.8 7.3 4 5848 J 6.8 7.4 5 5912 6.8 7.2 6 4688 7 4884 6.9 7.2 $ 4884 9 4884 �� 10 6595 6.9 7.0 11 4629 6.8 7.1 12 4990 fi.9 7.1 13 4021 6.9 7.1 14 4705 6.$ 7.2 J 15 4705 _� I 16 4705 17 4970 �� 6.9 7.3 18 4908 6.4 fi.3 19 4586 J fi.2 6.2 20 5304 6.6 21 4697 6.3 6.9 22 4697 _ J 23 4697 24 5046 6.6 6.6 25 4650 6.7 6.7 26 4933 6.$ 6.7 27 4667 6.9 7.1 4� 28 4707 6.7 7.1 29 4707 30 31 rr024 7.1 gdpols.doc • rev. 09/15/15 Groundwater Permit Dally Log Sheet • Page 1 of 1 Important:When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. r�0 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater discharge Program Groundwater Permit DISCHARGE MONITORING REPORT A. Facility Information 1. Permit Number 2. Tax identification Number 2022 JAN MONTHLY 3. Sampling Month & Frequency Facility name, address: MAPLEWOOD AT BREWSTER a. Name 820 HARWICH ROAD h. Street Address BREWSTER IMA IG2631 c. City d. State e. zip Code 2. Contact information: JOSEPH SMITH a. Name of facility Contact Person 17742125005 h. Telephone Number 3. Sampling information: 1/1812022 a. Date Sampled (mmlddlyyyy) ALPHA ANALYTICAL PERSONNEL c. Analysis Performed By (Name) B. Form Selection )smith@NSUWater.com c. e-mail address ALPHA ANALYTICAL h. Laboeatory Name 1. Please select Form Type and Sampling Month & Frequency i Discharge Monitoring Report - 2022 Jan Monthly r All forms for submittal have been completed. 2. This is the last selection. 3. r Delete the selected form. V gdpdIs 2015-09-15.doc • rev. 09/15/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 1651 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification dumber DISCHARGE MONITORING REPORT 12022 JAN 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) • NS = Not Sampled 1. ParameterlContaminant Units 1300 MGIL T55 MGL TOTAL SOLIDS MG1L AMMONIA -N IOG'L NITRATE -N MGIL TOTAL NITROGEN(NO3+NO2+TKN) WIL OIL & GREASE= MGL 2. influent 3. Effluent 760 x270 60 1330 4, Effluent Method Detection limit 17.96 I Fano IND 1440. -. I i nfeffrp -bl ank. d c c • 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 ret<m Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit MONITORING WELL DATA REPORT A. Facility Information 951 —1 1. Permit Number 2. Tax identification Number 2022 JAN MONTHLY 3. Sampling Month & Frequency 1. 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 77421250005 jjsrnith@NSUWater.com b. Telephone Number c. e-mail address 3. Sampling information: 1/27/2022 INOT APPLICABLE a, Date Sampled (mmlddlyyyy) b. LabDratosy Name BEA NSU PERSONNEL c. Analysls Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2022 Jan Monthly T- All forms for submittal have been completed. 2. Iv_ This is the last selection. 3. F Delete the selected form. gdpols 2015-09-15.doc • rev. 09/15115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number MONITORING WELL DATA REPORT --- — 2022 JAN MONTHLY 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "0", below detection limit, less than (-z�) 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. Parameter/Contaminant MW -1 NIW2 MW -3 MW -4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: S 5.92 5.88 [6.42 6.12 S.U. STATIC WATER LEVEL. [31.52 31.80 31.74 1 132.10 FEET SPECIFIC CONDUCTANCE 1104 948.5 382.2 194.0 UNIHOSIC mwdgwp-blank.doc • rev. 09!15115 Monitoring Well Data for Groundwater Permit • Page 1 of 1 accordance with a system designed to assure that qualified personnel props rly gather and evaluate the informatlon submitted Based on my inquiry of the person or persons who manage the system, or those persons directly respansibde for gathering the 6A I rertm information, the information submitted is, to the best of my knowledge and belief, true, accurate and complete. 1 am aware that the are significant penalties for submitting false information, including the possiNlity of fine and imprisonment for knowing violations.' SAMANTHA FARRENKOPF 2/1712022 Any person signing a. Signature b. Date [mmfddlyyyy] a document under 314 CMR 5.14(1) or (11 shall make the Reporting Package Comments following BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (BEA) HAS COMPLETED THE JANUARY 2022 certification MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE BIOCLERE WASTEWATER REATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 1/18122. ABORATORY RESULTS REPORTED BOD AND TSS GREATER THAN DISCHARGE PERMIT IMITS. SUBSEQUENT RESAMPLING COMPLETED ON 213122 FOR ANALYSIS OF BOD AND SS REPORTED CONCENTRATIONS OF 10 MGIL AND 26 MG/L, RESPECTIVELY. EFFLUENT PH /AS REPORTED BELOW THE 6.5 LIMIT TWICE DURING THE MONTH. FLOW VOLUME IEASUREMENTS WERE ASSESSED DURING THE MONTH FROM THE SYSTEM'S EFFLUENT LOW METER. DAILY FLOW REMAINED WITHIN THE 19,800 -GPD LIMITATION THROUGHOUT HE MONTH. THE MINIMUM, MAXIMUM AND AVERAGE GPD FLOWS REPORTED OVER THE OURSE OF THE MONTH WERE 4,012 GPD, 6,595 GPD AND 4,973 GPD, RESPECTIVELY. If you are filing electronic -ally and want to attach additional comments, select the check box. r gdpols 2015-09-15.doc • rev. 09/15115 Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection 951 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Ll Groundwater Permit 2. Tax identification Number Facility Information important:When MAPLEWOOD AT BREWSTER filling out forms on the computer, use a. Nares only the tab key to 820 HARWICH ROAD move your cursor - b. Street Address do not use the IBREWSTER IMA 102631 return key, c. City d. State e. zip Code 4:1 Certification "1 certify under penalty of law that this dcrument and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel props rly gather and evaluate the informatlon submitted Based on my inquiry of the person or persons who manage the system, or those persons directly respansibde for gathering the 6A I rertm information, the information submitted is, to the best of my knowledge and belief, true, accurate and complete. 1 am aware that the are significant penalties for submitting false information, including the possiNlity of fine and imprisonment for knowing violations.' SAMANTHA FARRENKOPF 2/1712022 Any person signing a. Signature b. Date [mmfddlyyyy] a document under 314 CMR 5.14(1) or (11 shall make the Reporting Package Comments following BENNETT ENVIRONMENTAL ASSOCIATES, LLC. (BEA) HAS COMPLETED THE JANUARY 2022 certification MONTHLY INFLUENT AND EFFLUENT SAMPLING OF THE BIOCLERE WASTEWATER REATMENT SYSTEM. MONTHLY WASTEWATER SAMPLING WAS COMPLETED ON 1/18122. ABORATORY RESULTS REPORTED BOD AND TSS GREATER THAN DISCHARGE PERMIT IMITS. SUBSEQUENT RESAMPLING COMPLETED ON 213122 FOR ANALYSIS OF BOD AND SS REPORTED CONCENTRATIONS OF 10 MGIL AND 26 MG/L, RESPECTIVELY. EFFLUENT PH /AS REPORTED BELOW THE 6.5 LIMIT TWICE DURING THE MONTH. FLOW VOLUME IEASUREMENTS WERE ASSESSED DURING THE MONTH FROM THE SYSTEM'S EFFLUENT LOW METER. DAILY FLOW REMAINED WITHIN THE 19,800 -GPD LIMITATION THROUGHOUT HE MONTH. THE MINIMUM, MAXIMUM AND AVERAGE GPD FLOWS REPORTED OVER THE OURSE OF THE MONTH WERE 4,012 GPD, 6,595 GPD AND 4,973 GPD, RESPECTIVELY. If you are filing electronic -ally and want to attach additional comments, select the check box. r gdpols 2015-09-15.doc • rev. 09/15115 Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection �- eDEP Transaction Copy I Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: EBELAIR Transaction ID: 1341905 Document: Groundwater Discharge Monitoring Report Forms Size of File: 2760.76K Status of Transaction: Submitted Date and Time Created: 2/1812022:3:22:49 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 1699 Bureau of resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT 2022 JAN MONTHLY Ll 3, Sampling Month & Frequency A. Facility Information lmportant:When filling out forms on 1. 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. 6. Street Address BREWSTER IMA 102631 vfs:] c. City d. State e. Zip Code IL Ar 2. Contact information: r DAVID FELDMAN a. Name of Facility Contact Person 7817079527 dfeldman@wingateheaithcare.com 6. Tef--phcne Number c. a -mall address 3. Sampling information: 1/14/2022 JR1 ANALYTICAL a. date Sampled (mmlddlyyyy) 6. Laboratcvy Name NICOLE SKYLESON c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Discharge Monitoring Report - 2022 Jan Monthly r All forms for submittal have been completed. 2.— 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 Protection599 Ll" Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT 2022 JAN MONTHLY 3. Sampling NtonlFi & 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 Samples! 1. Parameter/Contaminant 2. Influent 3. Effluent 4, Effluent Method Units Detection limit BOD MGL TSS 9,0 ND 2.0 MG/L -� TOTAL SOLIDS ~3 230 I NIG& AMMONIA -N 1.2 MG+L NITRATE -N5,7 - f 0.050 Mc1q- TOTAL NITROGEN(NO3+NO2+TKN) 15.8 f 0.50 MC -JL OIL& GREASE IND h9G,L infeffrp-bdank.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 2022 ANNUAL Ll 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on I. 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 BREWSTER MA 102631 VG:l C. city d. State S. Zip Code 2. Contact information: rP DAVID FELDMAN a. Name of Facility Contact Person 7817079527 feldman@wingatehealthcare.com b. Telephone Number c. a -mall address 3. Sampling information: 111'1412022 IRI ANALYTICAL a. Date Sampled (mrrtlddryyyy) 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 - 2022 Annual )- All forms for submittal have been completed. 2. r- This is the last selection. 3. F Delete the selected form. gdpols 2015-09-15.dec • rev. 09115115 Groundwater Permit Daily Log Sheet • 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 1.2022 ANN UAL 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 2. Influent 3. Effluent 4. Effluent Method Units Detection limit TOTAL. PHOSPHORUS ASP MGIL ORTHOPHOSPHATE I . �a.020 _ J MGL infeffrp-blank.doc • rev. 09115/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection 599 I Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number - Groundwater Permit 2. Tax o-dentification Number DISCHARGE MONITORING REPORT 2022 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 {a} value, or not detected, enter "ND' • NS =Not Sampled 1. ParameterlContaminant 2. Influent 3. Effluent 4. Effluent Method Units Detection limit ACETONE--- UGL BENZENE ND i f 1.0 UGL 1,1 DICHLOROETHANF Nb 1.0 UGIL 1,2 DICHLOROETHANE ND 1 0 - UGI 1,1 DICHLOROETHYLENE ND I 1.0 UGIL CIS-1,2-DICHLOROFTHYLENE N❑ 1,0 UGIL TRANS 1,2 DICHLOROETHYLFNF ND ,0 UGIL ETHYL BENZENE ND 1.0 UGIL METHYLENECHLORIDE ND 1,0 UGL TOLUENE ND 1.0 UG/L O -XYLENE ND 1 0 J UGIL PIM XYLENE IND 1.0 UGIL CARBON TETRACHLORIDE ND 1.D UGIL CHLOROFORM ND 1 0 UG1L 2.9UTANONE (MEI{] N❑ - 1.0 -- l UGIL infeffrp-blank.doc • rev. 09115/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection 1599 is Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Nurn6er Groundwater Permit 2. Tax identification Number DISCHARGE MONITORING REPORT 2022 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 t<j value, or not detected, enter "ND" • NS =Not Sampled 1. ParameterlContaminant Units 4-METHYL-2-PENTANONE (MiBK) L) - o! -TRICHLOROETHYLENE UGIL TETRACHLOROETHYLENE UGIL 1,1,1 TRICHLOROETHANE UG/L VINYLCHLORIDE UGIL STYRENE UGI CHLOROHENZENE UG/L METHYL TERTIARY 13UTYL ETHER uG2 CHLOROETHANE uCO- 1,2-DICHLOROPROPANE UGIT. DIB ROM OCH LOROMETHAN E UGIL. 1,1,2-TRIGHLOROETHANE UGIT 2-CHLOROETHYLVINYL ETHER UG- BROMODICHLOROMETHANE UG- BROMOFORM UG1L 2. Influent 3. Effluent 4. Effluent Method Detection limit ND--- �ND 1.0 NI -_ 1 1.0 NDr1.0 � ND - ND IND 1 IND ND ND ND -- - - I -_ ND ND ND infeffrp•blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Massachusetts Department of Environmental Protection bgg Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit - 2. Tax identification Number DISCHARGE MONITORING REPORT 2022 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 (<) vaiue, or not detected, enter "N D" • NS =Not Sampled 1. Parameter/Contaminant Units 1,1,2,2 -TETRACHLOROETHANE UGI. CHLOROMETHANE UGOL 13ROMOMETHANE UGOt_ CARBONDISULFIDE UGAL 2kIEXANON£ UGt, ACROLEIN LJGIL ACRYLONITRILE UGL TRANS -I,3 -D ICH LO ROPROP E NE UGIL CIS -1,3 -DI CH LO ROP ROP E N E UG1 2, Influent 3. Effluent 4. Effluent Method Detection limit IND Na 1.a IND 1.0 ND 1.0 NE) ND - I -ND - -J IND ND —._..� Infeffrp-blankAoc • rev. 09!15115 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 Important:When filling out farms on the computer, use only the tab key to move your cursor - do not use the return key. Irk lk t*0 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Groundwater Discharge Program Groundwater Permit DAILY LOG SHEET A. Facility Information Facility name, address: gREWSTER MANOR a. Name HARWICH ROAD 599 1. Permit Number 2. Tax identification ;dumber 2022 JAN DAILY 3. Sampling Month & Frequency b. Street Address BREWSTER IMA 102631 c. City d. State e, Zip Code 2. Contact information: DAVID FELDMAN a. Name of Fad lity Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Wx-bBr c. e-mail address 3. Sampling information: 11/31/2022 WH ITEWATER a. Data Sampled (mmlddlyyyy) b. Laboratory Name DOUG MURPHY c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Daily Lag Sheet - 2022 Jan Daily F ! All forms for submittal have been completed. 2. rThis is the last selection. 3. F Delete the selected form. gdpdIs 2015-09-15.doc • rev. 09/15115 Groundwater Permit Daily Lcg Sheet • 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 DAILY LOG SHEET 2fl22 JAN DAILY i 1 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.) 9 2403 z 3465 3 9973 7.4 3.8 4 1916 7 3.8 3320 I 7.1 3.7 6 2799 �� 6.9 3.2 7 4509 � 7 3.7 $ 1733 9 2203 10 2141 6.7 3.5 11 2315 7 3.3 12 2250 7.1 3.9 13 2376 7.2 3.3 14 4065 7.1 3.4 15 1946 16 2566 17 4216 7.2 3.1 18 2053 J 7.3 J 3.1 19 2368 �] 7.4 2.9 202767 7.4 3.2 21 91942 7.5 3.1 22 2166 23 1746 24 2556 7.5 2.5 25 2076 7.4 12.4 26 1841 7.4 2.6 27 2003 [7=.3 � 2.328 1848 .3 2,1 29 2326 F=1 30 2191 31 2157 7.4 gdpols.doc • rev. 09115115 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection _ Groundwater Discharge Program 1. Permit Number . Groundwater Permit MONITORING WELL DATA REPORT 2. Tax identification Number 2022 JAN MONTHLY 3. Sampling Month & Frequency A. Facility Information Impartant:when filling out forms on 1. Facility name, address: the computer, 'use 113REWSTER MANOR only the tab key to a. Naas move your cursor - 873 HARWICH ROAD do not use the return key. b. Street Address BREWSTER IMA 102631 try C. City d. State e. Zip Code lk Ar 2. Contact information: + DAVID FELDMAN a. Narve of Facility Contact Person 7817079527 dfeldman@wingatehealthcare,com b. Telephone Number c. e-mail address 3. Sampling information: 1/19/2022 1WHITEWATER a. pate Sampled (mmfddlyyyy) 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 - 2022 Jan Monthly T- 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. 09115/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 599 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number MONITORING WELL. DATA REPORT - 2022 JAN MONTHLY Ll` J 3. Sampling Nivnth &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. Parameter/Contaminant MW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 6.2 —__I 5.1 B.4 16.6— S.U. 66---S.U. STATIC WATER LEVEL. 58.66 .78 -- 51.54 n9 ---- - FEET SPECIFIC CONDUCTANCE 13x2 146 j 275 ___I 1133 UMFIOW mwdgwp-bdankAac • rev. 09115115 Monitoring Well Data for Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection 1,599 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit MONITORING WELL DATA REPORT 2.Taxidentification Number 2022 QUARTERLY 1 L11- 3. Sampling Month & Frequency A. Facility Information Important:When filling out forms on 1. Facility name, address the computer, use only the tab key to ]BREWSTER MANOR a. Name move your cursor - 873 HARWICH ROAD do not use the return key. b. Street Address BREWSTER IMA 102631 WQ C, City d. State a. Zip Cc -de 2. Contact information: qram.A� DAVID EELDMAN a. Name of Facility Contact Person 7817079527 feldman@wingatehealthcare.com b. Telephone Number c. a -mall address 3. Sampling information: 1/19/2022 IRI ANALYTICAL a. Date Sampled (mmlddlyyyy) b. Laboratory Name NICOLE SKYLESON c. Analysis Performed By (Name) B. Form Selection t. Ptease select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2022 Quarterly 1 rr All forms for submittal have been completed. 2. r This is the last selection. 3. T- Delete the selected farm. gdpols 2015-09-15.doc • rev. 09115/15 Groundwater Permit Daily Log Sheet • Page 1 of 1 Massachusetts Department of Environmental Protection 599 Bureau of Resource Protection - Groundwater Discharge Program 1. Permlt Number Groundwater Permit ! 2, Tax identification Number MONITORING WELL DATA REPORT 2022 QUARTERLY 1 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 MW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 MTRATE-N 0.61 0.60 0.62 htGiL TOTAL NITROGEN(NO3+NO2+TK �fiD f 0.61 - - J n.64 --� 0.62 MG- mwdgwp-blank.doc • rev. 09/15115 Monitoring Well Data for Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection 1599 y� L1 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2, Tax identification Number MONITORING WELL DATA REPORT f ' �', � 2022 ANNUAL 3. Sampling Month & Frequency A. Facility Information Important:when fllling 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 102631 C. City d. State e. Zip Code 2. Contact information: f4 6AV1D FELDMAN a. Nana. of Facility Contact Person 7817079527 dfeldman@wingatehealthcare.com b. Telephone Number 3. Sampling information: c. e-mail address 1/19/2022 IRI ANALYTICAL a. Date Sampled (mmlddfyyyy) b. Laboratory Name NICOLE SKYLESON c. Analysis Performed By (Name) B. Form Selection 1. Please select Form Type and Sampling Month & Frequency Monitoring Well Data Report - 2022 Annual F All forms for submittal have been completed. 2. r This is the last selection, 3. r- Delete the selected form. gdpols 2015-09-15.dac • rev. 09/15115 Groundwater Permit Daily Log Sheet - Page 1 of 1 Massachusetts Department of Environmental Protection599 J Bureau of Resource Protection _ Groundwater Discharge Program 1. Permit Number Groundwater Permit MONITORING WELL DATA REPORT 2. Tax identification Number 2022 ANNUAL 3. Sampling Month & Frequency C. Contaminant Analysis Information • For "Q 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 MW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 TOTAL PHOSPHORUS ASP I0 13 0.111 �65 �ND mat ORTHO PHOSPHATE—p - p ND ND ND MG/L mwdgwp-blank.doic • 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 MONITORING WELL DATA REPORT D. VOC Analysis Information 599 I 1. Permit Number 2. Tax identification Number 2022 ANNUAL 3. Sampling Month -& Frequency • If VOCs are present, please indicate the amounts of the individual compounds in pg/I. • For " 0", below detection limit, less than {<} value, or not detected, enter "ND" • NS =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 ACETONE[ ND ND - —_] N❑ UGIL BENZENE ND [ND NID UWL 1,1 DICHLOROET14ANE ND I1Pa J ND ND UGL 1,2 DICHLOROETHANE ND ND ND ND UG4- 1,1 DICHLOROETHYLENE ND ND I IND I ND UGIL CIS -1,2 OICHLOROETHYLENE r[} ND ND ND UGA. TRANS 1,2 ❑ICHLOROETH YLENE `ND ND ND ND LCti I ETHYL BENZENE NDND ND ND UGL METHYLEN ECH LORI DE ND IIND ND ND UG& TOLUENE ND IND ND UGIL OXYLENE IND ND ND ND UGIL I PIM XYLENE IND NQ ND N❑ UGI. CARBON TETRACHLORIDE IND ND UGIL CHLOROFORM ND ND NO ND UGL Well #: 5 Well #: B 2-BUTANONE (MEK) ND ND I NDND UGIL mwdgwp-blank.doc • rev. 09/15/15 Monitoring Well Data for Groundwater Permit • Page 1 of 1 Massachusetts Department of Environmental Protection 1599 - Bureau of Resource Protection - Groundwater Discharge Program i. Permit Number Groundwater Permit - - -- MONITORING WELL DATA REPORT 2. Tax 6dentification Number 2022 ANNUAL Ll 3. Sampling Month & Frequency D. VOC Analysis Information • If VOCs are present, please indicate the amounts of the individual compounds in pwI. • For "0", below detection limit, less than (<) value, or not detected, enter "ND" • NS = Not Sampled ■ DRY = Not enough water in well to sample. Parameter/Contaminant MW9 MW2 VIW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 Well #: 5 Well #: 6 4-METHYL-2-PENTANONE(MIEK rND l ND f ND ND UGL TRICHLOROETHYLENE ND ND IND NQ UGR TFTRACHLOROETHYLENE Np� ND ND J ND UGIL 1,1,1 TRICHLOROETHANE ND ND --- ND ! ND D U A- - —J V1NYLCHLORIDE ND ND ND Nl7 UG4- STYRENE IlgD T - — ND _-. I ND INQ UG,L CHLOROBENZENE ND FLD ND I IND UGC METHYL TERTIARY BUTYL ETHE IND ND NQ ND UGIL CHLOROETHANE NDNQ ND ND UGIL 1,2-DICHLOROPROPANE ND ND IND ND UGIL —� DIBROMOCHLOROMETHANE�ND I IND_ ND ND UG4- - — 1,1,2-TRICHLOROETHANE ND IND--- IND IND UGrL — 2 CHLOROETHYLVINYLFTHERN� ND ND f ND UG'L BROMODICHLOROMETHANE FD ND ND ND UG- BROMnFpRMfN❑ D— INDND UGL 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 MONITORING WELL DATA REPORT D. VOC Analysis Information 1599-- -_—_ 1. Permit Number 2. Tax identification Number 12022 ANNUAL f 3. Sampling Month & Frequency • 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 • DRY = Not enough water in well to sample. ParameterlContaminant MW1 MW2 MW3 MW4 Units Well #: 1 Well #: 2 Well #: 3 Well #: 4 1,1,2,2 TETRACHLCROETHANE NU - - - ND- ND ND UG/L CHLOROMETHANE ND _l IND_ ND- NO UG- BROMOMETHANE ND IINQ ND I IND UGIL CARBONDISULFIDE FND�] Nf} ND FD UGL 2-HEXANONE Nb I No ND Na lV3n. ACROLEIN IND J IND I IND UGL ACRYLONITRILE ND ND ND ND UGA. TRANS-I,3-DICHLOROPROPENE' ND �ND - ND ND UG,t_ cls-1,3-DICHL0R0PROPENE ND IND_-_ j IND ND UGIL Well #: 5 Well #: 6 mwdgwp-btanUoc • 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 comments, select the check box. r Massachusetts Department of Environmental Protection 5gg Bureau of Resource Protect Eon _ Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number Facility Information JBREWSTER MANOR a. Name 873 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 all attachments were prepared under my direction or supervisEon 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 informaticm, 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 impflsonmant for knowing yiolati0ns' ELIZABETH BELAIR 2/18/2022 a. Signature b. Date (mmlddlyyyy) gdpols 2015-09-15.doc • rev. 09/15/15 Groundwater Permit - Page 1 of 1 COASTAL engineering co. TECHNICAL SERVICES 260 Cranberry Highway Orleans, MA 02653 508.255.5511 P 508.255.6700 F Orleans I Sandwich I Nantucket coastalengineeringc om pa ny.com V E D FEB 14 2022 f3Ri"wS-r T L7FPf;17'i"M -N T To: Brewster Town Hall Date: Board of Health Department 2198 Main St Via: Brewster, MA 02631 Subject: Cape Cad Sea Camps 3057 Main Street Brewster, MA GWDP 977-0 ❑ Plans [—] Copy of Letter Specifications We are sending the following items: 02/10/2022 MITTAL Project No. C1684S.02 ®1st Class Mail OPick up DCertified OFed Ex ® Other Copies Date No. Description 1 1212021 C16845.02 Daily Log Sheet (Not field-tested — Camp is Closed) 1 1212021 C16845.02 Monthly Discharge Monitor Report (Not sampled — Camp is Closed) 1 02/10/2022 016845.02 eDEP Electronic Receipt These are transmitted as checked below: Ofor approval ®for your use [:]as requested Qfor review 6 comment Remarks: Enclosed are the recent monthly reporting forms for the system at the above referenced location under GWDP 977-0, The laundry mat has been shut down since the camp has been closed. No flow or pH was able to be recorded and the distribution box was not sampled. Please do not hesitate to contact us if you have any questions or comments, JGSIacc Cc: plombard i[olbrEwster-ma.gov By: John G. Schnaible, R.S. NOTE: if enclosures are not as noted, please contact us at [508] 255-6511 Orleans I Sandwich I Nantucket Q:100C1CI6800116845,021iransmittals12022-01-27 Transmittal (GWDP 2021).doc Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 24 21 22 23 24 25 26 27 28 29 30 31 Massachusetts Department of Environmental Protection 1977 Bureau of Resource Protection - Groundwater Discharge Program 1. Permit Number Groundwater Permit 2. Tax identification Number DAILY LOG SHEET 2021 DEC DAILY 3. Sampling Month & Frequency C. Daily Readings/Analysis Information Effluent Reuse Irrigation Turbidity Influent pH Flow GPD Flow GPD Flow GPD NS N5 NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS NS N5 NS NS NS NS NS NS NS Effluent Chlorine UV PH Residual Intensity (mg/1) {°Io) 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 MONITORING WELL DATA REPORT C. Contaminant Analysis Information 977 1. Permit Number 2. Tax identification Number 2021 DEC MONTHLY 3. Sampling Month & Frequency * 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. Parameter/Contaminant LAUNDRYEFFL Units Well #: 1 Well #: 2 Well #; 3 Well #: 4 TSS NS MGIL OIL & GREASE NS MGL FOAMING AGENTS (MBAs) NS MG)t Well #: 5 Well #: 6 C 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 D. Contaminant Analysis Information • For on, below detection limit, less than t<j value, or not detected, enter "N D' • TNTC = too numerous to count. (Fecal results only) • NS =Not Sampled 1. ParameterlContaminant Units BOD MG1L TSS MGIL NrrftATE-N MGL TOTAL NITROGEN(NO3+NO2+TKN) MG1 977 _ 1. Permit Number 2. Tax identification Number 12021 ANNUAL 3, Sampling Month & Frequency 2. Influent 3. Effluent NS 4. Effluent Method Detection limit N5 �� N5 1. NS __..._ N5 NS NS NS infeffrp-blank.doc • rev. 09/15/15 Groundwater Permit Discharge Monitoring Report • Page 1 of 1 2/10/22,1:22 PM RT Mass©EP's Online Filing System Receipt eDEP - MassDEP's OnlineRing System MassDEP Nome I Contact I Privacy PoNcy lJsemaMe:CASDMR Nickname: COASTAL26D Farms Signature Receipt Summary/Receipt print receipt I F-E-x—it—] Your submission is complete. Thank you for using DEP's online reporting system. You can select "My eDEP" to see a list of your transactions, DEP Transaction ID: 1341201 Date and Time Submitted: 2/10/2022 1:18:16 PM Other Email : DEP Transaction ID: 1341201 Date and Time Submitted: 2/10/2022 1:18:16 PM Other Email : DEP Transaction ID: 1341201 Date and Time Submitted: 2/10/2022 1:18:16 PM Other Email : DEP Transaction ID: 1341201 Date and Time Submitted: 2/10/2022 1:18:16 PM Other Email : Form Name: Groundwater Discharge Monitoring Report Forms Facility Information: Tax Identification Number: 043070847 location: 3057 MAIN STREET Address: BREWSTER ZIP: 02631 Daily Log Sheet(2021 DEC DAILY) Form Name: Groundwater Discharge Monitoring Report Forms Facility Information: Tax Identification Number: 043070847 location: 3057 MAIN STREET Address: BREWSTER ZIP: 02631 Monitoring Well Data Report(l - 2021 Dec Monthly) Farm Name: Groundwater Discharge Monitoring Report Forms Facility Information: Tax Identification Number: 043070847 https://edep.dep.mass.gov/eDEP/Pages/PrintReceipt.aspx 1/2 2110/22, 1'22 PM location: 3057 MAIN STREET Address: BREWSTER ZIP: 02631 Discharge Monitoring Report(1 - 2021 Annual) Form Name: Comments eDEP - MassDEP's OnlineFiling System My eDEP MassDEP Horne I contact I Privacy Policy blassDEP's Online Filing System ver.15.21.0.0@ 2019 MassDEP https://edep.dep.mass.ovIeDEP/Pages/PrintRer,eipt.aspx 212