HomeMy WebLinkAboutMiscellaneous - 31 GRAY STREET 2/18/2016 g TOWN O F NORTH ANIItV EA � I °kOaRa YN
pOffice Wg CO.vi i),I J A g� ryry)E'V'grgg P9RENT AND SERVICES �
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HEALTH DE PAR,r ENT "
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400 OSG001) S'TREE'T �
NOR"I'H ANI)OVER, IkIASSACIIUSE'l'TS 01845
RCWUS�
Susan Y. Sawyer, RE1 IS,RS 978.688.9540- Phone
PUblic Health Director 978.688.8476- FAX
SEPTIC SYSTEM
CONSTRUCTION N � 'E
LOCATION INFORMATION "
INSTALLER. y LOT:_
ADDRESS MAP:
.. _,s _
. :
DESIGNER: °•-
PLAN DATE:
BOH APPROVAL DATE ON PLAN:
INSPECTIONS
TANK INSPECTION:
DATE OF BED BOTTOM OM INSPECTION:
DATE OF FINAI. CONSTRUCTION INSPECTION: ,!
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DATE OF FINAL GRADE INSPECTION:
SELECT SYSTEM TYPE
1. GRAVITY DISTRIBUTION...Ll
2. PRESSURE DISTRIBUTION...Ll
3. PRESSURE DOSING...Ll
4. HOLDING TANK...Ll
5. ADVANCED TREATMENT...El
6. OTHER...® PUMP SYSTEM
COMPONENT SUMMARY FROM PLAN
1. GALLON TANK =
2. LOADING OF SEPTIC TANK =
3. GALLON PUMP CHAMBER =
4. LOADING OF PUMP CHAMBER =
5. TYPE OF SAS =
6. DIMENSIONS AND DETAILS OF SAS:
Comments:
Page I of 4
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TOWN OF NORTH ANDOVER II � IAORTw
Office of CO,'NU IUNITY DEVCLOP� ENT AND SERVICES ��°b{"" ,a a4,4��
HEALTH DEPARTMENT
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400 OSGOOD STREET
NORM ANDOVER, MASSACHIJSEi IS 01845 &s�""'`°�`�
ACNUSk
SUSM1 Y. Sawyer REHS/RS 97$.688.9540— Pli me
11iiblic Health Director 978.688.8476 FAX
BITE CONDITIONS
1. Existing septic tank properly abandoned,.,
2, Internal plumbing all to one building sewer...Ll
3. Topography not appreciably altered...LI
SEPTIC TANK
1. Bottom of tank hole has 6" stone base..,
2. Weep hole plugged..,LJ
3. Tank has been installed (H-20) Tank Size: 1,500 2-piece ...® - H-40
4. Water tightness of tank has been achieved (Visual)...
5. Inlet tee installed,under access port...J
6. Outlet tee (gas baffle or effluent filter) installed,under access port...U
7. Cover to within 6" of final grade installed over one access port,must be over outlet of tank
if effluent filter is present - Inches of Tank...Ll
8. Hydraulic cement around inlet& outlet...
****Comments:
PUMP CHAMBER—n/a
1. Bottom of tank hole has 6" stone base...L1
2. Weep hole plugged...LJ
3. Pump Chamber Installed_Combo tank Gallons; (H-20) (Monolithic)
4. Inlet tee installed,under access port...L
5. Pump(s) installed on stable base...
6. Alarm Float Working...LJ
7. Pump On/Off Float Working...LJ
8. Total # of Floats..
9. Drain hole in pressure line...LI
10. Cover to within 6" of final grade installed over one access port...LJ
11. Water tightness of tank has been achieved—Visual or Vacuum Test or Water held for 24
hours (circle)
12. Hydraulic cement around inlet& outlet...
Comments:
Page 2 of 4
Ol'I'lee o1'COMMUNITY :�d0��.'�'�-I Ai'ILIOVEl�. � �or�riw
Y 1! EVFLOPIVIENT AND SERVICES
HEALTH DEPARTMENT
400 OS(.00D STREE,r
?,OW11 I ANDOVU: , VIASSACIIUSE;'l"I"S 01845 ��� s�etiuse�a�
Susan Y. Sawyer, REI-MRS 978.688.0540—Plime
11tiblic Ilealth Director 978.688.8476— FAX
D-BOX
1. Installed on stable stone base... f'r
2.3. Hydraulic cement pumped
drauli(cem�e tearound inlet& outlets U
tlets ..® ..,
4. Observed even distribution... -' 1
5. Speed levelers provided (not required)...f -
.
Comments:
SOIL ABSORPTION SYSTEM N.di
1. Bottom of SAS excavated down to C Soil Layer, as provided on plan...0
2. Size of SAS excavated as per plan...Ll
3. Title 5 sand installed,if specified on plan...D
4. 3/4-1 1/2" double washed stone installed. ..
5. 1/8-1/2" (peastone) double washed stone installed
6. Laterals installed and ends connected to header (and vented if impervious material above)
7. Gravel-less disposal systems: type, number and location as per plan.........
8. Elevations of laterals installed as on approved plan...
9. 40 Mil HDPE barriers installed...❑
10. Retaining wall (boulder / concrete / timber / block) ...
11. Final cover as per plan ...
*****Comments: *****
CONTROL PANEL
1. alarm.& Pump are on separate circuits...LJ
2. Alarm sounds when float is tripped......EJ
3. Location of control panel:
4. Rated for exterior if placed outside...U
Comments: �
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Page 3 of 4
TOWN OF NORTH ANDOVER � �a�T �
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
400 OSGOOD S'T'REET �'`u '�V
NORTr-r ANi DOVER, 1\4ASSACIJUSETTS 01845 �'�ss �WUS�s��
Sl1S,111 Y. Sawyer REI-M RS 978.688.9540-- Phone
Public Health Director- 978.688.8476—FAX
SYSTEM ELEVATIONS
1. Benchmark:
2. Rod at Benchmark:
3. Height of Instrument:
INVERT ON DESIGN INVERT
PLAN ELEVATION
Building Sewer OUT 199.96 199.65
Septic Tank IN 199.75 199.24
Se tic Tank OUT 199.50 198.98
Distribution Box IN 208.95
D-Box OUT Manifold 208.73
Lateral 1 HIGH 208.80 209.16
Lateral 1 Inv 208.71 208.69
Lateral 2 HIGH 207.20 207.54
Lateral 2 Inv 207.11 207.09
Lateral 3 HIGH 205.60 205.99
Lateral 3 Inv 205.51 205.53
Page 4 of 4