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HomeMy WebLinkAboutTitle V Inspection Report - 259 GRANVILLE LANE 11/15/1996 V ` J �6 nr;afn;N da it y r ''� ,,.0 n5tl � Jntn a,ant ar w u..'a r 7 K LA I-IELD 16f-er fable, Septic Complimice, November 25, 1996 North Andover Board of Health 146 Main Street North Andover,MA 01845 Attn: Sandra Starr Re: Sanitary Disposal System Inspection 259 Granville Lane - Dennis O'Keefe Dear Ms. Starr: In accordance with the Commonwealth of Massachusetts, Department of Enviroiunental Protection, State Enviroivnental Code (Title V), 310 CMR 15.301, paragraph 7, please find attached a "Subsurface Sewage Disposal System Inspection Form" for your records. If you have any questions regarding this report or any of its contents, please do not hesitate to contact this office. We thank you, in advance, for your continued cooperation in these matters. Very truly yours, SEA'S . CO LIANC ,,INC. loo m oe Paul Cardone Certified Septic Inspector Attachment N,Andlet.sam • SYSTEM IN Pt;t.;FOR SOIL EVALtJA'FOR M tt ONMENTAL ENGINEER 447 041 Boston Rd, 11.E Route 1., t'opsfi old, MA 01983 3 Tel (50 3) 887-E3586 Fax (508) 887-3480 E--Vent '� y Y Yd n. Ueano '"rw- �' SEPTIGTA K LEAcHNELU Water Table Septic Compliance, Inc. affilliate of Thomas E. Neve Assoc., Inc. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Address of Owner: Dennis O'Keefe (if different) Date of Inspection: November 15, 1996 Name of Inspector: Paul Cardone Company Name, Septic Compliance,Inc. Address and 447 Old Boston Road,Topsfield,MA 01983 Telephone Number: (508)887-8586 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: XX Passes Conditionally Passes Needs further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: November 19, 1996 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. I • SYSTEM INSPECTORS • • SOIL EVALUATORS • • ENVIRONMENTAL ENGINEERS 447 Old Boston Rd., US Route 1,Topsfield, MA 01983 Tel (508) 887-8586 Fax (508) 887-3480 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 259 Granville Ln.No. Andover,Ma.01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 INSPECTION SUMMARY: Check A,B,C,or D: A) SYSTEM PASSES: XX I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes,no, or not determined(Y,N, or ND). Describe basis of determination in all instances. If"not determined",explain why. The septic tank is metal,cracked,structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four 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 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 259 Granville Ln.No.Andover,Ma.01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 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 the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS THE BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND 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 APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. The system has a septic tank and soil absorption system and is within 100 feet to a surface supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Owner: Dennis O'Keefe Date of Inspection: November 156, 1996 D) SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contact to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface water due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s) Number of Times Pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 D) SYSTEM FAILS(continued) Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exists: 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). The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 259 Granville Ln.No.Andover,Ma.91845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 Check if the following have been done: Y Pumping information was requested of the owner,occupant,and Board of Health. Y None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. N/A Asbuilt plans have been obtained and examined. Note if they are not available with N/A. Y The facility or dwelling was inspected for signs of sewage back-up. Y The system does not receive non-sanitary or industrial waste flow. Y The site was inspected for signs of breakout. Y All system components,excluding the Soil Absorption System,have been located on the site. Y The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. Y The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. Y The facility owner land occupants(if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System. 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 259 Granville Ln.No.Andover,Ma.01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 FLOW CONDITIONS RESIDENTIAL Design flow: 550 gallons Number of bedrooms: 5 Number of current residents: 3 Garbage grinder(yes or no): no Laundry connected to system(yes or no): yes Seasonal use(yes or no): no Water meter readings,if available: Last date of occupancy: occupied C O MMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present(yes or no): Industrial Waste Holding Tank present(yes or no): Non-sanitary waste discharged to the Title V system(yes or no). Water meter readings, if available: Last date of occupancy: OTHER(Describe): Last date of occupancy: 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 GENERAL INFORMATION PUMPING RECORDS and source of information: According to owner system is pumped every two or three years. System pumped as part of inspection(yes or no): yes If yes,volume pumped: 1500 gallons Reason for pumping: To check baffles,to check tank for leaks,to check structural integrity of the tank. TYPE OF SYSTEM XX Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or not) [If yes,attach previous inspection records,if any] Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: 14 years of age 1982 owner The house was built in 1982. The system was never replaced. Sewage odors detected when arriving at the site(yes or no): no SEPTIC TANK: yes (locate on site plan) Depth below grade: Tank itself is down 4'cover is brought up to grade. Material of construction: x concrete metal FRP Other(explain) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 Dimensions: 10'6"x 6'4"x 5'4" Sludge Depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: P 10" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 5" Distance from bottom of scum to bottom of outlet tee or baffle: 1,9" Comments: (recommendations for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,etc.) We recommend tank be pumped be once per year,baffles in very good condition, level good,structural integrity good,no evidence of leaks. GREASE TRAP: none (locate on site plan) Depth below grade: Material of construction: Concrete Metal FRP 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: 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 Comments: (Recommendations for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,etc.) TIGHT OR HOLDING TANK: none (locate on site plan) Depth below grade: Material of construction: Concrete Metal FRP Other(explain): Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (Condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: yes-down 5' (Locate on site plan) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 259 Granville Ln.No.Andover,Ma.01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 Depth of liquid level above outlet invert: none equal Comments: (Note if level and distribution is equal evidence of solids carryover,evidence of leakage into or out of box,etc.) level is good box level no signs of carryover no leaks apparent. PUMP CHAMBER: none/gravity (Locate on site plan) Pumps in working order(yes or no): Comments: (Note condition of pump chamber, condition of pumps and appurtenances, etc.) SOIL ABSORPTION SYSTEM(SAS): yes (Locate on site plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present, explain: 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 259 Granville Ln.No.Andover,Ma. 01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 Type: Leaching pits,number: Leaching chambers,number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: 1-field 20'x 40' Overflow cesspool,number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) normal none none green grass CESSPOOLS: none (Locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: Inflow(cesspool must be pumped as part of inspection): 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 259 Granville Ln.No.Andover,Ma.01845 Owner: Dennis O'Keefe Date of Inspection: November 15, 1996 Comments(Note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: none (Locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(Note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 13 SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least two permanent references, landmarks or benchmarks. Locate all wells within 100'. fr�o..li � CiaiL;G .StQli�i'r.F.cS �-3cn f'✓J y n DEPTH TO GROUNDWATER Depth to groundwater: TV no water observed feet Method of determination or approximation: Being a registered soil evaluator,seeing that I had to dig down 5'to the d-box,I continued down another 2'6". That is as far as my machine would go. I observed no groundwater. 14 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector Paul Cardone Company Septic Compliance,Inc. Address 447 Boston Road,Topsfield,MA 01983 (508)887-8586 Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and maintenance of on-site sewage disposal systems. Check one: I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15.303. Any failure criteria not evaluated are as stated in the XX FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15.303. The basis for this determination is provided in the FAILURE CRITERIA section of this form. Inspector's Signature: tf 2�2� f Date: November 19, 1996 Copies to: Board of Health Buyer(if applicable)Approving authority: