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Home My WebLink AboutInspection - 296 RALEIGH TAVERN LANE 7/7/2015 aw PUBLIC NEU'rli lttt5e"l"MENT colvrwrrarrlty hvelopntena R)ivislnrr TOWN OF NORTH ANDOVER RECEIVED SEPTIC;DISPOSAL SYSTEM—INSTALLATION N C ERTIFIC'ATION The undersigned hereby certify that the Sewage Disposal System( )constructed;( )repaired; BY _ — d..li.AU F1:71 fJAR1M I'J (Print Name) i i Located at:,--- IX 166"1 (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated A! "" ,�g L+_and last revised oil_ ° °� with a design flow of °�'Y4 gallons per day. The materials used were in conformance with those specified oil the approved plan;the system was installed in accordance with the provisions of 310.C;MR 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: M ,�. Engineer° el��°seen .�tive(Siguatu�°e) And–Print Name Final Construction Inspection late: t" I Engineer Representative(Signature) i L"L-' 00 11_11�2 And–Print Name J� u ;installer. � ��' J (Signature) Date. And–pan t Name En iner, 01W0114 Date; ;; , , VUomwil And–Print Name 1600 Osgoo d Street, North Andaver, Massachusetts 01845 ilone 978.688.`t540 �Fttx 978.688.8476 Web isrtlii�:f�wwa "°tr w��ri��o�..ii�r�pm��urwarr"ttr�r� Town of North Andover — Se t�vstem - AS-BUILT CHECKLIST 1) v 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) 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) Ties to all tank openings,d-box,and leach area from dwelling or Permanent Structure 7) --L—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 8) Locations of Wells,Drains,Wetland Resource Areas within 150 feet of system 9) Location of water,gas,electric lines,cable,control panel (if applicable) 10) 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) North Arrow 15) `'" Location&Elevation of Benchmark used 16) STATEMENT ON PLAN (NA 5.3) a. "I certify the locations, elevations, ties, cover material;exposed component covers etc., shown on this as-huiltsuhstantiallyagvee witli the appr~ovedplan and have determined that the hreak out cle nations,if applicable,have been rnet." Signature of Designer Date b. "If a STUCTURAL WALL IS PRESENT(NA 4.9)a Letter or statenierzt on the as-built indicating the wall- was or was note constructed in accordance with the intended design andany manufacturer's specifications." Signature of Designer Date As of:Monday,July 20,2015 • North Andover Health Department Community and Economic Development Division UNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 296 Raleigh Tavern Lane MAP: 106C LOT: 112 INSTALLER: Todd Bateson DESIGNER: Merrimack Engineering PLAN DATE: 12/4/14 BOH APPROVAL DATE ON PLAN: 4/23/15 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION:6/17/15 DATE OF FINAL CONSTRUCTION INSPECTION: 6/24/15 DATE OF FINAL GRADE INSPECTION: t" l SITE CONDITIONS N/A Contractor reports any changes to design plan ® Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ® Cleanouts per plan X Bottom of tank hole has 6" stone base X Weep hole plugged X 1500 gallon tank has been installed H-10 loading X Monolithic tank construction ® Water tightness of tank has been achieved by visual testing X Inlet tee installed, centered under access port F71 Outlet tee installed, centered under access port (effluent filter) ® 24" inch cover to within 6" of finish grade installed over one access port X Neoprene boots around inlet & outlet Comments: 7426 PUMP CHAMBER X Bottom of tank hole has 6" stone base ® Weep hole plugged X 1500 gallon Pump Chamber installed X H-10 loading X Monolithic tank construction X 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 ® Neoprene boots around inlet & outlet Comments: CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement ® Alarm signal located inside: basement Comments: 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 N/A Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: SOIL ABSORPTION SYSTEM (General) X Bottom of SAS excavated down to C soil layer, as provided on plan X 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: 74'x26 w field SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Low Profile Infiltrator Chambers ® Number of chambers per row: 16 ® Number of rows (trenches): 6 Comments: Total Chambers = 96 FINAL GRADE Loamed Seeded Cover per plan Comments: DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer �As-Built Plan BM = 154.50 HR = 4.76 HI = 159.26 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 5.49 153.42 153.4 Septic Tank IN 5.98 152.93 153.00 Septic Tank OUT 6.20 152.71 152.75 Pump Chamber IN 6.24 15167 152.70 (2") Pump Chamber OUT 6.70 152.39 ----- (2") Distribution Box IN 4.57 154.52 154.50 Distribution Box OUT 4.58 154.33 154.33 Lateral 1 TOP 4.60 Lateral 1 INVERT 154.31 154.28 Lateral 2 TOP 4.61 Lateral 2 INVERT 154.30 154.28 Lateral 3 TOP 4.62 Lateral 3 INVERT 1 54.29 154.28 Lateral 4 TOP 4.62 Lateral 4 INVERT 154.29 154.28 Lateral 5 TOP 4.61 Lateral 5 INVERT 154.30 154.28 Lateral 6 TOP 4.60 Lateral 6 INVERT 154.31 154.28 Top of Chamber 4.60 154.66 154.67 Bottom of Bed/Chamber 5.25 154.01 154.00 CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ® Property line 1.0 10 -- ® Cellar wall 10 20 -- ® Inground pool 10 20 -- ® Slab foundation 10 10 -- ® Deck, on footings, etc 5 10 -- ® Waterline 10 10 10' ® Private drinking well 75 1002 50 ® Irrigation well 75 100 ® Surface Water 25 50 ® Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Bank 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)Foundation 10(5) 20(10) ® Drywells 20 25 Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 1032, 10.54,and 10.30,respectively,pursuant to 15.211(3),also by NA wetland bylaws