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HomeMy WebLinkAboutInstallation Report - 1353 SALEM STREET 4/28/2015 a PUBRAC O A1,111 KPARTMENT u, f,�r�ti�7udef0y Dcv�lad�w�4�nG tliai5i+rrE i 1h'.���GC{I��.�'l f't Y!r�.l"�i 'I'CyWN OF NORTH ANDOVER SEPTIC DISPOSAL SYS'T'EM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( )constructed;( )repaired; By: 0 1 (Print Name) Located at: I (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan, originally dated and last revised on - I•" with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan;the system was installed in accordance with the provisions of 310.CMR 15.000,Title 5 and local regulations,and the final grading agrees substantially with the approved plan.All work is accurately represented on the As-built which has been submitted to the Board of Health. Bottom of Bed Inspection Date: Engineer Representative(Signature) And—Print Name Final Construction Inspection Dater VJ Engineer Representative(Signature) And—Print Name Installers �° (Signature) Date: (11) q�; And—Print Name Engineer: °�� � °a ��� ✓ s �d��.(Signature) Date: lo'! 1 Ian( °, And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978,,688.9540 Fao 978.688,,8476 el: http:J/www.towno ttortltandovor.com a � a"') Town of North Andover — Se °c S Ie - S ITT CHECKLIST 1) __I/All changes to the design plan have been reflected and noted on the as-built plan 2) As-built plan has a suitable scale; (1 inch = 40 feet or fewer for plot plans) 3) w Street Address,Assessor's Map and Lot Number 4) Lot Lines and Location of Dwellings served by the system 5) ✓ Locations,Elevations and Dimensions of As-built system components,including reserve (if applicable) 6) `LTies to all tank openings,d-box,and leach area from dwelling or Permanent Structure 7) Setback distances are shown on the as-built plan from system components to: Subsurface,interceptor&foundation drains Catch basins Property lines Dwellings or other structures Private water supply or irrigation wells Watercourses or wetlands ¢ �GU B) I Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system �`�' �`°��`�` j j/, 9) Vl/ Location of water,gas,electric lines,caale,control panel,Of applicable) 10) I Location of Structures within 6 Inches of Finished Grade 11) Original Stamp&Signature 12) ^✓ Location and holder of any easements which could impact the system 13) Impervious Areas;Driveways,etc 14) J North Arrow 15) Location&Elevation of Benchmark used 16) —Z—STATEMENT ON PLAN (NA 5.3) a. "I certify the locations,elevations, ties,cover material;exposed component covets etc., shown on tlris as-built stibstatztiallyagtec with the approved plan andhave determined that the break out elevations,if applicable,have been met." Signature of Designer Date b. "Ifa STUCTURAL WALL IS PRESENT(NA 4.9)a Letter or statement on the as-built indicating the wall was or was not,constructed in accot Glance with the intended design and an v mamrfacturer's specifications." Signature of Designer Date As of:Tuesday,March 17,2015 • North Andover Health Departnient Community and Economic Development Division QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 1353 Salem St. MAP: 106.A LOT: 0138 INSTALLER: John Butt DESIGNER: Merrimack Engineering PLAN DATE: 4/28/15 revised 5/21/15 BOH APPROVAL DATE ON PLAN: 06/15/15 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: 7/23/15 DATE OF FINAL CONSTRUCTION INSPECTION: 7/29/15 DATE OF FINAL GRADE INSPECTION: P � SITE CONDITIONS ❑ Contractor reports any changes to design plan Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: 7/29 — existing septic tank not yet abandoned, will do so upon completion of backfilling SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ® Cleanouts per plan Bottom of tank hole has 6" stone base f Weep hole plugged ® 1500 gallon tank has been installed H-10 loading ® Monolithic tank construction ® Water tightness of tank has been achieved by visual testing ® Inlet tee installed, centered under access port ® Outlet tee installed, centered under access port (gas baffle/effluent filter) ® 24" inch cover to within 6" of finish grade installed over one access port ❑ Hydraulic cement around inlet & outlet Comments: Boots on tank penetrations PUMP CHAMBER Bottom of tank hole has 6" stone base Weep hole plugged ® 1000 gallon Pump Chamber installed ® H-10 loading ® Monolithic tank construction ® Inlet tee installed, centered under access port ® Pump(s) installed on stable base ® Alarm float working ® Pump On/Off floats working ® Separate on/off floats ® Drain hole in pressure line ® 24" cover at final grade installed over pump access port ® Water tightness of tank has been achieved by visual testing ❑ Hydraulic cement around inlet & outlet Comments: Boots on tank penetrations CONTROLPANEL ❑ Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement ® Alarm signal located inside: basement Comments: Could not physically access basement but heard alarm from outside DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ® Observed even distribution ❑ Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: 7/29 — contractor to place hydraulic cement around pipe penetrations, engineer contacted regarding inlet elbow inhibiting drainback SOIL ABSORPTION SYSTEM (General) X Bottom of SAS excavated down to C soil layer, as provided on plan ® Size of SAS excavated as per plan X Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: 28Lx17W, 37Lx27W overdig SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ❑ Number of chambers per row: 7 ❑ Number of rows (trenches): 6 Comments: Total Chambers = 42 FINAL GRADE Loamed Seeded �`- Cover per plan Comments: DOCUMENTS NEEDED jU Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer As-Built Plan BM = HR = HI = SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 94,32 94.65 Septic Tank IN 93.71 94.25 Septic Tank OUT 93.41 94.00 Pump Chamber IN 93.72 93.95 Pump Chamber OUT Distribution Box IN 95.35 95.30 Distribution Box OUT 95.35 95.13 Lateral 1 TOP Lateral 1 INVERT 95.09 95.08 Lateral 2 TOP Lateral 2 INVERT 95.09 95.08 Lateral 3 TOP Lateral 3 INVERT 95.08 95.08 Lateral 4 TOP Lateral 4 INVERT 95.08 95.08 Lateral 5 TOP Lateral 5 INVERT 95.09 95.08 Lateral 6 TOP Lateral 6 INVERT 95.09 95.08 Top of Chamber Bottom of Bed/Chamber 94.80 94.80 SKETCH FLAN CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 10 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- ® Waterline 10 10 for ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Bank3 75 100 ® Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ® Trib. to surface water supply 325 325 ® Public well 400 400 ® Interim Wellhead Prot. Area ® Reservoirs 400 400 ® Drains (wat. supply/trib.) 50 100 ® Drains (intercept g.w.) 25 50 ® Drains (Other)Foun(Cation 10(5) 20(10) ® Drywells 20 25 1 Suction line 222(2) 2 1.00 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 1.0.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws lU ,n 5 /t lip T % wk �")�, , u+c! +I r,�; u t o rl p "a n, + � t [ ^4J:µ` � rF i, r�°,a""�✓t ,-ry'�� 'j vod �" °IIYI �w�• �. 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This will be done by 12:00 Thursday 8/6/2015 Thank You Tyler Munroe i