HomeMy WebLinkAboutTitle V Inspection Report - 1116 SALEM STREET 11/1/2005 C OMMONWEALTH OF MASS C;IILTs `I s
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
a
y a DEPARTMENT oF ENVIRONMENTAL PROTECTION
w
s
TITLE 5
OFFICIAL INSPECTION FO -NOT FOR VOLUNTARY ASSESSMENTS
SUBSU !ACE SEWAGE DISPOSAL, SYSTEM FORM
PART A
CERTIFICATION
Property Address:_1116 Salem Street
_North Andover
Owner's Name: Andre Farrah-
Owner's Address: 1116 Salem Street
North Andover,11&01845_ "
Date of Inspection:_11/l/2005q RECEIVED
Naive of Inspector: Neil J.IBateson
Company Name: Bateson Enterprises Inc.— "°i
Mailing Address:_111 Ar°gilla Road® .t.t„)v vtq of �, �����H N�y���rER
—Andover,) Ma.01810 ..�._..HEALTH DEPARTMENT
�n�m�
'Telephone Number: 978 475-4786_
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
Passes
Conditionally Passes
Needs Farther Evaluation by the Local Approving Authority
F } s� «_ _
Inspector's Sir� ttrrea -
M ,....a Date: _II1/1/2p�5_
'flue system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority,
Notes and Comments:
****"Phis report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address bow the system will perform in the future under the same or different
conditions of use.
Page 2 of I 1
OFFICIAL INSPECTION FORM -e NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE; DISPOSAL SYSTEM INSPECTION FORM
PART
CERTIFICATION (continued)
Property Address: 1116 Salem Street_
North Andover
Owner: Farrah
_ —
Date of Inspection: 11/1/2005_
Inspection.Summary: Check A,B,C,D or /ALWAYS complete all of Section D
A. System Passes:
_ _X I have not found any information which indicates that any of the failure criteria
described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to
be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of
Health,will pass.Answer yes,no or not determined(`,N,ND)in the for the following statements. If"not
determined"please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether
metal or not)is structurally unsound,exhibits substantial infiltration or extiltration or tank failure is imminent.
System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the
distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System
will pass inspection if(with approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
_ The system required pumping more than 4 times a year due to broken or
obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
Page 3 of 11
OFFICIAL. INSPECTION FORM ® ICI®T FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:—116 Salem Street_
Ttorth Andover
—
Owner:_1+arrah_
Date of Inspection:_11/1/2005_
C. Further Evaluation is Required by the Board of health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing;to protect public health,safety or the enviromnent.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
_ Cesspool or privy is within 50 feet of a surface water
_ Cesspool or privy is within 50 feet of a bordering;vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and:public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well".Method used to determine distance
**This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
3. Other
Page 4 of 11
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYS'T'EM INSPECTION FOR
PART A
CERTIFICATION (continued)
Property Address: 1116 Salem Street_
_North Andover
Owner:_1+arrah Andover-
Owner:
of inspection:_11/l/2005
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
_ No Backup of sewage into facility or system corntnonent due to overloaded or°clogged SAS or cesspool
—No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
No- Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
No Liquid depth in cesspool is less than 6"below invert or available volume is''/z day flow.
—No Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
_ _No Any portion of the SAS,cesspool or privy is below high ground water elevation.
No Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
—water supply.
No Any portion of a cesspool or privy is within a Zone 1 of a public well.
—No Any portion of a cesspool or privy is within 50 feet of a private water supply well.
—_No— Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliforrn bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered.A copy of the analysis must be attached to this form.]
No_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described
in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to
determine what will be necessary to correct the failure
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,1010 gpd to 15,000
gird.
You must indicate either"yes"or"no"to each of the following:
(Tire following criteria apply to large systems in addition to the criteria above)
yes no
_ the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system has failed.The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
1.5.304.The system owner should contact the appropriate regional office of the Department.
Page 5 of 11
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PANT
CHECKLIST
Property Address: 1116 Salem Street_
North Andover
Owner: Farrah_
Date of unspection:_11/1/2005__
Check if the following have been done.You mast indicate"yes"or"no"as to each of the following:
Yes No
_Yes_ _ Pumping information was provided by the owner,occupant,or Board of Health
No Were any of the system components pumped out in the previous two weeks'?
_Yes_ ` Has the system received normal flows in the previous two week period'?
No Have large volumes of water been introduced to the system recently or as part of this inspection ."
_Yes_ _ Were as built plans of the system obtained and examined?Town did not(nave,engineer did.
_Yes — Was the facility or dwelling inspected for signs of sewage back up'?
Yes Was the site inspected for signs of break out
_Yes_ _ Were all system components,excluding the SAS,located on site'?
Yes _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the
condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of
scum ?
_Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the
proper maintenance of subsurface sewage disposal systems 7
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
Yes— Existing information.
_Yes_ �_ Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of
distance is unacceptable) [3 10 CMR 15.302(3)(b)]
Page 6 of I I
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART O
SYSTEM INFORMATION
Property Address: 1116 Salem Str°eet
North Andover
Owner: Farrah
_ ® Andover-
Owner:
of Inspection:_11/1/2005_
I+'LOW CONDITIONS
DII IONS
,SID AL,
Number of bedrooms(design):mil_ Number of bedrooms(actual):_3–
DESIGN flow based on 310 CMR 15.203 440
Number of current residents:
Does residence have a garbage grinder(yes or no):_No
Is laundry on a separate sewage system(yes or no):_No
Laundry system inspected(yes or no):
Seasonal use: (yes or no):_No
Water meter reading:_Yes_
Sump pump(yes or no):_Yes
Last date of occupancy:_Current
CD EIICIA IIS'I ,
Type of establishment:_
Design flow(based on 31.0 CMR 15.203):___ggpd
Basis of design flow(seats/persons/sgff,etc.):
Grease trap present(yes or no):_.__
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
Last date of occupancy/use:
O'I ,Pt(describe):
GENE,RAL MORMATION
Pumping Records
Source of information:_Pumped two years ago,owner_
Was system pumped as part of the inspection(yes or no):_'des_
If yes,volume pumped:_1500_gallons--How was quantity pumped determined?_Measured tank
Reason for pumping: _Inspect tank&baffles_
TYPE OF SYSTEM
X Septic tank,distribution box,soil absorption system
_ vSingle cesspool_Overflow cesspool
Privy
_Shared system(yes or no)(if yes,attach previous inspection records,if any)
_Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
—Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components, date installed(if known)and source of information:_7 years old, 11/19/1995,
as built plan_
Were sewage odors detected when arriving at the site(yes or no):_NC
Page 7 of I I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMEN'rs
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 1116 Salem Street_
North Andover
Owner: Farrah
Date of Inspections 11/1/2005
BUILDING SEWS,R—X— (locate on site plan)
Depth below grade:—28"
Materials of construction: —X—cast iron —X 40 PVC other
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage, etc.) _A"Cast iron thru wall.4"PVC in house,
no leaks visible
SEPTIC TANKS:
Depth below grade:_10"
Material of construction: X concrete metal fiberglass polyethylene
___,othcr(explain)-----
If tank is metal list age:_ Is age confirmed by Certificate of Compliance(yes or no):_(attacli a copy of
certificate)
Dimensions:101 x 51 x 4'—
Sludge depth: 211
Distance from top of sludge to bottom of outlet tee or baffle:—25—
Scum thickness:—3"—
Distance from top of scum to top of outlet tee or baffle:_$""_
Distance from bottom of scum to bottom of outlet tee or baffle: 1811
How were dimensions determined:Tape Measure—
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc._Pumped septic tank.Inlet tee ok.Outlet tee ok.Depth of
liquid at outlet invert.No evidence of leakage.—
GREASE TRAP:_(locate on site plan)
Depth below grade:_
Material of construction:—concrete—metal_fiberglass___polyethylene—other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:_
Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT'S
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1116 Salem Street—
North Andover
—
Owner: Farrah
Date of inspection—: 11/l/2005
TIGHT or HOLDE4G TANK:_(tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:_
Material of construction:—concrete—metal—fiberglass____polyethylene_other(explain):
Dimensions:
Capacity:_ gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BO S:
Depth of liquid level above outlet invert: —0—
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):—D-box level&distribution equal.No evidence of leakage. No evidence of
carryover._
PUMP CHAMBER:—X—(locate on site plan)
Pump in working order(yes or no):—Yes_
Alarm in working order(yes or no):_Yes_
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):—Pump cycled on then
off.Alarm has visual& audible
Page 9 of 11
O FFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address 1116 Salem Street_
�North Andover
Owner: Farrah
Hate of Inspection:
_
_11/1/2005_
SOIL ABSORPTION SYSTEM(SAS): X_(locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,member:_
leaching chambers,number:
leaching galleries,number:
leaching trenches,number,length: _
_X_ leaching field,number,dimensions:_1 field 20'x 45'_
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level ofponding,damp soil,condition of vegetation,
etc.):_Soil ok.Vegetation ok.No sign of podding to surface
CESSPOOLS:
Number and configuration: _
Depth—top of liquid to inlet invert:
Depth of sludge layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments(note condition of soil, signs of hydraulic failure,level of podding,condition of vegetation,etc.):
P (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure,level of podding,condition of vegetation,etc.):
Page 10 of I
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
T'AR'T' C
SYSTEM INFORMATION (continued)
Property Address:_1116 Salem Street,
North Andover
Owner: Farrah
_ �+
Date of inspection:_1.1/l/2005_
S10'T CH OF SEWAGE DISPOSAL YS'I7M
Provide a sketch 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.
Driveway
House
A to 8epticTank=15'3x'
A to Pump Tank=19'®11
A to ID-Box=.521811 d
B to Septic'T'ank=341711
B to Pump Tank=31141'
B to TD-Box=481199 Porch
Shed
Septic Tank
Puxnp Tank
D-Box
Page 11 of 1 l
OFFICIAL INSPECTION I+'OR —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address 11.16 Salem Street a
_North Andover
—
Owner:_Farrah_
Late of Inspection:_11/l/2005_
SITE EXAM
Slope
Surface water
Cheek cellar
Shallow wells
Estimated depth to ground water _3'_
Please indicate(check)all methods used to determine the high ground water elevation:
_ Obtained from system design plans on record-If checked, date of design plan reviewed:_12/19/1997_
® Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local board of Health-explain:_
_Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation: As per design plan-
����P ° i
.� �, �
a
��
�,
4^Y !L
"g�'r„,� ^L ^b � ro ur w 4w 4w ..w 4w 4w 4w cw wrr 49 4w 4w wv 4w 49 4w ;a "
w aw 4w ww ww 4w .„r 4w 4w 4w tiA 4w bw bw bw rar �bw
„ � �. vrr 4w 4w.rr x
�'
i
4w 4w h 4w .sr.:w bw ur 4^w aw 4w � bw bw b^v
� 4 bw 4Y
� • 1.9 w 4w
66
4
41M 4w 49 4w 4J11 p 49 4w L9 49 4V 4w 49 4^I 4w 4w 49
W b w b:Y Y 4w 4w 4w 4w ti b 1 bw 4
4 4w 41 W"1 6C1 Ww
� �" ''Op /
l ��� � � v o1���/Pd1��l�� �
� Ytai
i 1 I �''����r�� � `w�
it 1 V j �� + } � 4w rxr q w bw kn
r�„ ✓' �
l "4w
�d (� �
� Ji � �i '17 Jii r rl e����
Vu I I✓ � � �fy 1, &Y � 11.9 4 � w w 4w
�o l 0, l Gr�������� i'���'�� i���1���,�r���'/,,�U Yw WY^ 4 4'YI
�� i � r g�
1 y plG ��r�1a�� r rj✓✓ ��iJ�%����
�� ���'��� /��� �j�/ �/�� rw . bw« bw 4w
J I it��y�,��,����y�� � � F
! �l�i�ryl�y14n/������ f�+ � �'� i�
� �� �'�l/�✓�/ an�f�l�>j�1 iii/ . 4w a 4w xw . 49
1��VV jd��,�1"r��✓ ° ✓ ✓ � �, � «
i'� l y+��/� r��'�'>�J V J IG/�' w 4w w�+r 4w bw �� 4w « 4w 4w
it
U yy/`6lPa�� ,l ,//
rj � /fir lV'� t�C//✓ y���� N �iF�
i; � I' i d�/yir /ri'�ii l�l�l�e/��/l�.
J i F � � �1�����������
� � y�l/G ���/�l'%ff i r���/!�ili�� �/l�� m sw bw uw a 4w 4w q 4w rrw w w wv ti 4w bw cw ew
wl",( r � � /��/yy'��%fit��f i��i r1�it��%���r�/my.y�li9l% 4w e„r wrw 4w cn 49 w .:v 49� � aw w 4w u� 4w 4w wer,
f°'` % l/G7y�/1����Y91Y1�4%//�)��yfl�i�lO�J/5G
�w; �✓ k� ,r'i�/���1�/ �� J/�l�(/�flr wtl� /i � W» e� 4w 4w 4A s �n wn nw w www «.�w..9 ww 4w 4, 4w �v
� r�P i✓ it✓'i��lyi/N�d�y/����ii��>�l' ������f 4//i��
� i r ��;�i/ /1�j1�,/� � it/f r �I �N✓�`"y���^Iyl
"I / �✓ll / 1 1f �� ��/lr/ �Il
f,,,�„ rl "�� �//�hyj�� � "�1�r/fi �����j+��ipL
Il, it Rio�/ y /�! �J( /r�/ /!��
I%�fr� ip��r��/ij`d j���n��, ����//����'��l/I"�j�� �4w bw ww
Yj ��/' JI �r>ty✓F���Zi�/rr,l��li�hol.���7"/0"�9��������r����l/��I bw
i/�� i�i�/ ✓6;?' 1i�% %�����Jf����y0�1�i�i�/�f�r�N� '��� bw 4w 4w 4 4w bw 4w b9
„1 �/ y � �T/J r`ff�,�i�t�� ��jf��/%�Fj✓ l�� ��� uv 4w a� 4w a9 ua 4w.
P N ,rc' i�v��l rii ii�r� �i iii x ri 4�
/✓ ��yj�ryyl�r��yp����j �✓1i
V� �1 ��/��✓� ���veld/���iyd���� �G� " 4w i,/�:Re�
1 .. .. n ..
Irk i .1 � �✓/���/i,���/r/�/` ���f9�r/�
'>i1�yF����p%r°/ll ��lr��i'y���/%% / i�ti/��� �.w . � �P"1_.
✓� r �N/ n� >>i 14lii�itfirN� � + ry mild ! 110 1...!
r" �� Wfif�Y 4�/%�i�.����lr�l�b� � ii, 1� "` a rw : M 4w cw
' � � f�,d�l�Fw,l't it �l�"//x//����'���ff���l� V r,,?y�v�� �� �l���r r/��ir�U� .....�...... .. .� .. . ii nom.
� ��� "� r � � i� r ,i ✓-
�i ✓y� � ,fy ! ( �� � / ✓
r�,�� �/I � vz , �iril�l/� //✓ rr �l//�jiGrY�l
b
� o lie
o, ki � iit/ia�/� ✓"�y✓i/ �i1
��,�ir i i0/l�0��i fj��'y�J) ����� �'
V✓�9�i� ' i F/ /'�'�rr� iriifi� sU����5�lll, ri�� '
I��'/i ' � ���"7�� ✓��'� ,y 'J �' lit��a" ,
/l o✓i l in��/U9� /Ji�i✓y/ �i D ��
o i y �l�i✓�/f�/fir Ff r��l��✓�✓�r�r1���' v V
J i"d� l�r a i i/d / J i
/����f��/����//�%iy���i� �ri����f0��/�0��� � n
a"l' r'r /r��j/� > >r�ll 9 / �1
�✓� �rr
,, �
,,. jl,
1
1 �,
r��
��,� '�1'�, rM, �aN.r�;r,l a�lr�,�,J�,v:.k�. rva, ,;'9�:,.h";yi,�'.:u,,M'��YHa,4 rt. lu.,. r, „, ,� .' J�h �i'l.x, ,.,.u.,�,�e l'Y,�.. wVJ'„ e,rr''�'� i�e,,:'d�N�. l�e,,u, VGYrYi,�,/„JJ✓�k,�A�G✓d. '��'�� ,,o,� 'd,�A(LV. I�u,, '.
Summary RreGord Card generated on 11/1/2005 11:22:03 AM by Dame E3wclay Pogo I
Town of North Andover
Tax Map ,# 210-106.A--0045-0000.0
1116 SALEM STREET
FARRAH, ANDRE & KATHLEEN
1116 SALEM STREET
N. ANDOVER, NIA
01845
iss 101 Single Family Property Type 1 Residential
e Total 0.54 Acres
2006
3 Mailing Index
me/Address Type Loan Number Active/Inact. From Until
RRAH, ANDRE & KATHLEEN Payer
16 SALEM STREET
ANDOVER, MA
345
t Account Maim.
:ount No Cycle Occupant Name Active/Inactive
3 Id. 3442.0- 1 1 16 SALEM ST Last Billing Date 10/6/2005
;0390 03 Cycle 03 Active
Services Maint.
✓ice Code Rate Charge Multiplier/Users
CFEE ADMIN FEE 0.63 5/8 7.82 1/
R WATER 01 ALL METER SIZE 67.80 /1
Meter Maintenance
al No Status Location Brand Type Size YTD Cons
36013 a Active ERT METE METE w Water 0.63 0.63 0
Date Reading Code Consumption Posted Date Variance
9/12/2005 621 a Actual 20 10/14/2005 -51%
6/7/2005 601 a Actual 35 7/15/2005 62%
3/15/2005 566 m Manual estimate 25 4/5/2005 _25%
12/8/2004 541 a Actual 29 1/14/2005 _3%
9/15/2004 512 a Actual 35 10/8/2004 -8%
6/9/2004 477 a Actual 21 7/30/2004 15%
4/16/2004 456 a Actual 43 5/17/2004 0%
12/11/2003 413 n New Meter 0 12/11/2003 0%
O: (9 78) 4754786
786
Fax: (978) 475-54-51
BATESON E INC.
Excavating-Water.& Sewer Lines-Septic Systems &Pumping Service
111 A°gilla.Road Andover, Mass. 0181.0
Title 5 Inspection Report
Property Address.- 1116 Salem Street, North Andover
Owner.- Farrah
Date of Inspection-, 11/1/2005
My report contained herein does not constitute a guarantee of fixture usage and the functionality of the existing
c system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any fiarther
ition of your current septic system.
Neil J. Eateson
Bateson Enterprises, Inc.