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PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: 10/17/2014
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Construction Complete
On-Site Sewage Disposal System
By:
Matthew Manning
At:
35 Stanton Way Lot 1
Map 61 Lot 116
North Andover, MA 01845
The Issuance�a#'this certificate
shall not be construed as a guarantee that the system will function satisfactorily.
Susan S wyer �°° -�
.r
Public Health A e "/
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fox 978.688.8476 Web www.townofnorthandover.com
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PUBLIC HEALTH DEPARTMENT
Community Development Division
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM— INSTALLATION CERTIFICATION R EI E
eby certify that the Sewage Dis p osal S y stem" constructed; repaired;
The undersigned her
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(Print Name) �'i tt"i DEPART
1"�W rorm� wumwwmuw
Located at:
(Installation Address)
was installed in conformance with the North Andover Board of Health approved plan,originally dated
" e 7_ " / and last revised oil with a design flow of
gallons per day. The materials used were in confornance with those specified oil the
approved plan;the system was installed in accordance with the provisions of 310. CiO 1 5.000,'Title 5 and local
y:
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 tied inspection D
ate
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Engineer Representative(Signature)
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And—Print Name
Final Construction Inspection Date: -- _
Engineer Representative(Signature)
And—Print Name
Instailer. � `" "` " (Signature)
Date; ��' t
And—Print Name
(Signature) Date:
Enginer;_
And—Print Name
1600 Osgood Street, north Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.cotrt
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North Andover Health Department
Community Development Division
QNSITE WASTEWATER SYSTEM CONSTRUCTION NO
ADDRESS: Lot 1 Stanton Way MAP: LOT: Lot 1
INSTALLER: Matthew Manning
DESIGNER: Christiansen & Sergi Inc.
PLAN DATE: 2/20/14
BOH APPROVAL DATE ON PLAN: 3/28/14
INSPECTIONS
TANK INSPECTION:
DATE OF BED BOTTOM INSPECTION:9/9/14
DATE OF FINAL CONSTRUCTION INSPECTION- 9/115/14
DATE OF FINAL GRADE INSPECTION:
ADDITIONAL INSPECTIONS or SOIL COLLE TI
Type: Date:
Type: Date:
Type: Date:
SITE CONDITIONS
® Contractor reports any changes to design plan
N/A 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
N/A Cleanouts per plan
X Bottom of tank hole has 6" stone base
® Weep hole plugged
® 1500 gallon tank has been installed
H-10 loading
® Monolithic tank construction
F71 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)
® 24" inch cover to within 6" of finish grade
installed over one access port
® Hydraulic cement around inlet & outlet
Comments:
DISTRIBUTION-BOX
® Installed on stable stone base
® H-20 D-Box
N/A 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
N/A 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
N/A Retaining wall (boulder/ concrete /timber/ block)
❑ Final cover as per plan
Comments:
SOIL ABSORPTION SYSTEM (Presby)
® Brand and Model of Presby: Standard Enviro-
Septic
® Number of Enviro-Septic pipes per row: 3
F71 Number of rows (trenches): 7
Comments: Total Enviro-Septic pipes = 21
FINAL GRADE
Q, Loamed
Seeded
Cover per plan
Comments:
DOCUMENT'S NEEDED
P Certification of Installation Form submitted
By engineer and signed and dated by
Engineer and installer
As-Built Plan
BM = 112.31
HR = 6.06
HI = 118.37
SYSTEM ELEVATIONS
ROD AS-BLT INVERT DESIGN INVERT
ELEVATION ELEV ELEV
Benchmark
Building Sewer OUT 2.55 115.47 115.43
Septic Tank IN 2.84 115.18 115.19
Septic Tank OUT 3.15 114.87 114.94
Distribution Box IN 3.25 114.77 114.82
Distribution Box OUT 3.40 114.62 114.65
Lateral 1 TOP 3.59
Lateral 1 INVERT 114.43 114.48
Top of Pipe 3.56 / 3.53 114.81/114.84 114.90
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 10 101
® 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, 10.32, 10.54,and 10.30,respectively,pursuant to 15.211(3), also by NA
wetland bylaws