HomeMy WebLinkAboutCertificate of Compliance - 796 WINTER STREET 8/21/2001 1
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TOWN OP NORTH ANDOVER SEWAGE, DISPOSAL S�' S` E,iM
I-STALLA-HO`N CERTII=I(:ATION 5
The undersismed here;-,y ceriifv that the S,2,xaLc Disposal System i.
located aI ------
was installed in cOntermance with the North Arn-lo-%er Board of He^dth approved plan,
Svstem Design Pe^r t —dated � I �. I �0� _. with an approved de--I,�n
low of gallons per day The mate a!s,used were in conformance %%--it`t those
specified on the approved plan; the system was installed in accordar.ce ,,.ith the provisions
of 310 CMR 15.000, Title 5 and local regulations, and the meal Qradip.g agrees
substantially with the approved plan. .-ail work is accurate,.v represented ;)r. the ?s-built
.which has been submitted to the Board cL ziealth
Bed inspection dat-,: -
Engineer R Arta,:n:ative
Final ;nspect:on cater ►�i♦---
Encn'nee: Rzprese^tat:.e
Lnstaller: - m. Date: ---
P AS
Design Engin �eer: _ _ Date: ----
. o RICHA
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C N w
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TANGARD C4
A�®,rPCQIS F Vk'jc
F` �ONAL ECG\
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AS-BUILT C IST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
INCLUDING RESERVE
TIES TO LOT LINES & DWELLING, WELLS
a, FROM SEPTIC TANK.
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES &PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WITHIN 1 S0' OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
_ DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK &D-BOX
ORIGINAL STAMP & SIGNATURE
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
LOCATION &ELEVATIONS OF BENCHMARK USED
N&M Job number 1.770/
TOWN OF NORTH ANDOVER
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
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Site: � �, f .. � ; ' :: '" Final Date:
Installer: Tel:
Date Yes No Initials
A. Bottom of iced
1. Excavation to proper depth
2. With trenches, sides of excavation are beneath B horizon e _
3. Edge of excavation specified distance from foundation,etc. ,.
Comments: (Use back of sheet for diagrams.)
B. Retaining Wall
1. Wall height and width as specified
2. Waterproofed _
3. Wall minimum 10'to leaching facility
4. Wall meets specifications of plan —
Comments:
C. Building Sewer
1. Pipe diameter minimum 4" --_--
2. Schedule 40 pipe
3. Inlet to tank cemented
4. Slope minimum 0.01 or 1/81" er foot minimum
5. Pipe properly act firm base
6. Pipe lad on continues grade m straight ht line
gr
7. Cleanouts preced ll change in alignment and grade
8. Manholes at a. 90°change --
9. 10'minunurn'atlset to water line .........
Comments:
- _
D. Septic Tank
1. Level 71-� (,�-��
2. 1,500 gal minimum 4
3. Gas baffle present on outlet f
4. Manhole to w/in 6"of grade ;,m
5. Manholes over center and each tee
6_ 3-20"mprrlioles
77. Outjeffine cemented
8. ?
.0. drop from inlet to.,outet
9 Pipe set
Compact base with 6 of/a cru
shed stone under
"
11 Tank is watertight
., - .
12. fees 12;,rs' 'side of tank --�-„
a..
N &M Job number 1770/
Comments: Date Yes No Initials
E. Pump Chamber ✓ d°X
1. If separate from tank,compact base
with 6"of/a°stone underneath
2. Minimum 2
pipe to d-box if gravity system
3. 20"access manhole
4. Tank level
5. Watertight
6. Tank size agrees with plan specification
7. Manhole to grade „w-
m
8. Check valve and bleeder hole present
9. Alarm in building on separate circuit
10. Alarm fiinctions yo —
11. Manual operating switch — o 0"
12. Pump delivers liquid to d-box
Conimen ts:
F. Distribution Box
1. D-box level �
2. Minimum 0.17"(2")drop fi•om inlet to outlet. °" "
3. Minimum 6"sump , ,n_
4. Outlet pipes show equal distribution —
5. Compact base with 6"of stone beneath box
6. Box is watertight
7. All lines cemented with hydraulic cement
8. Schedule 40 pipe
9. First 2' from box laid level
Comments: P
0V
G. Soil Absorption system � V
1. All stone double-washed 3/n"— 1 '/z"
-pea stone
Bucket test done? — —
_ .
2. Minimum 2"of pea stone above distribution lines —
3. Minimum 6"stone beneath pipe --
4. Distribution lines capped or connected together ,.
5. Toe of slope stops minimum 5' from edge of property; —
,,_- ..
Sa, if not, then Swale. — —
Comments: —
. �d
N&M Job number 1770/
Date Yes No Initials
H. Leach Trenches
1. Minimum 2 trenches
2. Length of trenches�a ee with plan. (Max. length 100')
3. net".w
Width p esters f>50 feet or specified
'mom° 'u -4
with plan-Minimum 2';
5. Mm urti"
4. Vent r
distance between trenches 10'
6. > "e slope minimum 0.005 or 6"p ,T60' -
7. Depth of trenches below outletwinvert minimum of 6".
8. Pipes set on stabl"b ser-
Comments: � --
L Leach Field
1. Maximum length of field 100' '
2. Pipe slope minimum 0.005 or 6"per 100'
3. Separation between pipes 6'maximum
4. Pipes connected at end&vent end raised
5. Separation between adjacent fields 10'minimum
6. Pipes set on stable base
7. Maximum 4' separation from edge of field to first line
8. Minimum two distribution lines
Comments:
J. Leaching Pits — — — —
1. Minimum inlet pipe 4" .
2. Pits of concrete .,....,..... ,,,...�.�,,....•
3. d S .. n
• � etw�e"•� 12"and 48"wide
11 b ,,, n
r e Ce whole on each pit „mm-
5.4. Access
cemW.�m....,.. --
6. cement
p hydraulic. -
Comments� mente with r
�-
K. Final Grade
1. Slope over soil absorption system minimum 0.02
2. All system components covered by at least 9"soil
3. Cover soil free of stones larger than 6" ?— --
4. Grading slopes away from dwelling
5. No areas over system that may pond
6. Grading meets 3:1 slope — ----
7. Minimum of 9" of fill graded over system
s
CHECKLIST FOR NORTH ANDOVER
SEPTIC SYSTEM PLANS
N&M Job 1770/ ��� 2
The following is a checklist that incorporates all Title S and local regulations for septic plans.
Name of Applicant: Z:/4 ,q"�i I" Name of Designer;
Plan Date: Revision Date: Date of Review:
7 M�.
°'°^ r �' � ,_ .. Map: �°�' y
Property Address. � � ° � " P' Lot:
BOH Reviewer: Type of Plan(new orrupgrade)
Number of Bedrooms imAssessor"°5Records: gpd)Garbage Disposal Allowed:
General Information: N.A.=North Andover Septic Regulations Other numbers refer to Title 5
OK Problem N/A
Street number and map/lot-220(4)(u)
� Maximum scale of 1 "=40'for plot plan-220(4)
Maximum scale of 1 "=20'for profile and component details-220(4)
Legal boundaries of the facility being served.-220(4)(a)
Names of abutters from recent tax map- NA 8.02j
Number of bedrooms,design calcs.,-NA 8.02i
Name&address of record owner&applicant- NA 8.02k
Name&address of designer-NA 8.021
Holder and location of all easements-220(4)(b)
Date plan drawn&any revision date- NA 8.02m
/ All dwellings and buildings,existing and proposed-220(4)(c)
Location of all existing or proposed impervious areas-220(4)(d)
All distances on site plan—NA 8.03a-c
Elevation of proposed driveway-NA 8.02t
Location and elevation of foundation drain-NA 8.02y
Location and dimensions of the system incl.reserve(new const.)-220(4)(e)
Limits of excavation of leach area on site plan-NA 8.02z
Locus plan-220(4)(t) (Not to scale)
North arrow-220(4)(g)
Existing and proposed contours-220(4)(g)
-- Locations and logs of deep holes-220(4)(h)
Locations and logs of percolation tests-220(4)(i)
Date(s)of soil testing-220(4)(h)&(i)
- Existing grade elevation of each deep hole-220(4)(h)
� Elevation of percolation tests—N.A. 8.02n
Name of approving authority representative-220(4)(h) &(i)
Name of soil evaluator-220(4)0)
Soil logs and perc test logs match BOH records
Locations of waterlines,drains,and subsurface utilities-220(4)(m)
Observed and adjusted g.w.elevation in the vicinity of the system-220(4)(n)
Complete profile of the system to scale-220(4)(o),NA 8.02c
Cross section of leaching facility-NA 8.02w (Not to scale)
Location of benchmark(s)within 50-75 feet of facility-220(4)(q)
Note listing all variance requests with proper citations-220(4)(p
Local upgrade approval request form submitted-403(1)
Original R.S./P.E. stamp, signature&date-220(1)&(2)
If P.E.,discipline specified within stamp. MGL C. 112 s. 81M
sfc. supplies(w/in 400'),pub.wells(w/in 250'),pvt.wells(w/in 150')-220(4)(
Location of watercourses,wetlands,wells,etc.Win 150'of system—NA 8.02r
Wetland disclaimer—NA 8.02s
RLS plan reference&certification required(prop line setbacks)-220(3)
u _ Plan contains designer's certification statement
Use approvals/standards checked for I/A system-DEP does.,
2
p Perc rate>30 NIPI-not allowed for new,LUA for upgrade-245(1)&(13)
Perc rate>60 MPI-must use modified tight tank or IIA technology-245(4)
Proposed system qualifies as "shared" system-002(definitions)
Flow is over 2,000 gpd-No R.S. allowed-220(1)
Design flow was set in accordance with code-203
Existing system location and note on proper abandonment-354
6-"`°` Leaching facility at least 1' above Base Flood elevation-NA 9.05
All p�P g i in Sch 40 minimum-NA 10.01
Basement floor minimum 1' above groundwater elevation-NA 5.04
_ Foundation drain present with elevation-NA 8.02y
On-site Soil and Groundwater Review
OK Problem N/A
Proper deep observation hole logs on plan-220(4)(h)
All deep holes and peres shown,including aborted tests-NA 8.02n
Soil evaluation forms submitted within 60 days of field work-018(2)
Proper percolation test log-220(4)(i)
Ample deep observation holes in primary disposal area(minimum 2)- 102(2)
Ample deep observation holes in secondary disposal area(minimum 2)- 102(2)
Ample perc testing(one in each disposal area,3 in prim.>2,000 gpd)- 104(4)
a Deep hole testing conducted within two years-NA 7.05
Hole Identification Numbers:
ground elevation el.
acceptable soil el. '"„
Leach facilitv invert el. `""
ground water el. "
refusal el.
bottom of leach facility el. 3"
thickness of acceptable soil
before&after soil R&R
separation to groundwater "° `` + °~ "
separation to refusal �.
soil class ) °mr
perc rate p:7
loading rate
y
septic tank below g.w. table
es or no
pump tank below g.w. table ��o �° ('Yes, )
1
f in filler no of
Setback Distances(Given in feet) 15.21 1
YES NO Is the lot in the Lake Cochiewick Watershed? NA 6.00&5.02
OK Problem N/A
Septic Tank Leach Facility
Property line 10 10
Cellar wall 10 20
2
3
Inground pool 10 20
Slab foundation 10 10
Deck,on footings,etc. 5 10
Waterline 10 10
Private drinking well 75 100
Irrigation well 75 100
Wetlands 75 100
Public well 400 400
Wetlands bordering surface 150 150
water Supply or trio. (in Watershed)
Trib.To Surface Water supply 325 325
Reservoirs 400 400
Tributaries to reservoirs 200 200
-- Drains(wat. supply/trio.) 50 100
Drains(intercept g.w.) 25 50
Foundation drains 10 20
Drains(Other) 5 10
Drywells 20 25
- „ Downhill slope 15'to 3:1 slope
w/o barrier
Building Sewer
OK Problem N/A
Grease trap required for certain uses(check 230 for details)
Pipe diameter listed(4" minimum)-222(l)listed-222(3)
Pipe Pipe cast don or 5 h 40 PVC—NA 11.02
Watertight joints specified-222(3)&(4)
Pipe laid on compact,fjn- base-222(5)
Pipe laid on conti,pu06s grade in straight line-222(7)@
Cleanouts prpe6de all changes in alignment and grade-222(8)
Cleanout provided every 100 feet-222(8)
Manhole at any 90 degree alignment change-222(8)
,"-Invert elevation at building:
Invert elevation at septic tank:
Length of run:
Slope: (minimum of 0.01 -0.02 desired)-222(6)
10'offset to private well or suction line-222(2)
3
4
Septic Tank
OK Problem N/A -
Tank is accessible-228(3)
No structures above tank–(228(3)
Tank can accommodate both primary&reserve–NA 9.04
200%of flow(required&provided given. 1500 min.)-220(4)(f)&223)(1)(a)
2-3" drop from inlet to outlet-227(5)
Minimum of 4'liquid depth-223(2)
3"air space above tees/baffles(minimum)-227(4)
9"air space above flow line (minimum)-227(4)
Tees are not to be replaced by baffles-227(1)
Tees extend 6" above flow line-227(1)
Inlet tee extends 10"below flow.line(minimum)-227(6)
Outlet tee extends 14" below flow line(more for deeper tanks)-227(6)
Gas baffle installed on outlet-227(4)
Access manhole cover above center of tank&each tee(except 2 compart)228(2)
3-20"manholes-228(2)
1 childproof,24"riser/manhole w/in 6"of final grade if<1000gpd-228(2)
Inlet and outlet tees on center line-227(1)
Soil compaction below tank specified(if soil is non-native)-221(2)
6"of<=3/4"stone beneath tank specified-221(2)&22 8(1)
If> 1,000 gpd AND not a single fam.dwell. must be 2 tks or 2 comp.-223(1)(b)
If plan specifies disposal must be 2 tanks in series or 2 compart. tank-223(1)(c)
Buoyancy calcs.required if tank at or below water table-221(8)
Tank is watertight-221 (1)
9"of cover over tank(minimum) -228(1)
H- 10 loading(min.)-H-20 if traffic-226(3)
Top of tank<=36" below grade-221(7)
All pumping to tank(if applies)in accordance with-229
Tank is set to keep old system in service during install if possible
Distribution Box(Check here if not present: )
OK Problem N/A
Inlet elevation:
Outlet elevation:
0.17'drop from inlet to outlet(minimum)-232(3)(b)
6"sump(minimum)-232(3)(e)
All outlets at same elevation-232(3)(b)
` Outlet pipes laid level for first 2 ft.-232(3)(c)
Pipe Sch 40-NA 10.01
r
Number of outlets: Number of laterals:
Size of outlets:
�' – Inlet baffle/tee min. 1" over outlet invert for all d-boxes-232(3)(a),
Soil compaction below distribution box specified(if soil is non-native)-221(2)
6"of stone beneath distribution box specified-221(2)
—. Box is watertight-221 (1)
Top of box<=36"below grade-221(7)
Buoyancy calculations required if box is at or below water table-221(8)
Pump Chamber(Check here if not present: )
OK Problem N/A
Volume specified: 220(4)(r)
Pump on elevation- 220(4)(r)
- Pump off elevation: 220(4)(x)
Alarm on elevation: 220(4)(r)
Number of cycles per day-220(4)(r)(also 254(1)(d) if gravity from d-box)
Minimum 2" delivery line to d-box if gravity-254(1)(c)
4
5
Pressure dosed 11 if flow>=2,000 gpd-254(1)(a)&254(2)(a)
/ Cycles per day is consistent with chamber volume-23 1
Volume calculations include flowback volume-2') 1(2)
24 hour storage capacity above pump on elevation-231(2)
Number of pumps: 2 if system serves>2 dwelling units-231(6)
Capacity of pump(s)- gpm @ 'TDH-220(4)(r)
Pump can pass 1 1/4 "solids(minimum)-231(7)
Pump controls specified-220(4)(r)
Alarm equipment specified-231(2)
Alarm is in building and powered on separate circuit from pump-2') 1(9)
Pump sequence correct(off-lead on-lag on-alan-n on)-231(8)
Pump performance curves included-220(4)(r)
Manual operating switch-NA 12.01
Check valve,bleeder hole-NA 12.01
1 childproof,24"riser/manhole to final grade-2'31(5),
Soil compaction beneath pump chamber specified(if soil is non-native)-221(2)
6"of<=3/4"stone beneath chmbr.specified-221(2)&228(1),
Buoyancy calculations if chamber is at or below water table-221(8)@
9" of cover over chamber(minimum)-228(1)
H- 10 loading(min.)-H-20 if traffic-226(')),
Chamber is watertight-221 (1)
Top of chamber<=36"below grade-221(7)
Leaching Facility(general-complete for all designs)
OK Problem N/A
50%larger if garbage disposal-240(4)
��•� Trenches to be used whenever possible-240(6)
No vehicle or imperv. area above 11 unless unavoidable-240(7);NA 13.02
Vented if under impervious cover-241 (1)
Vented through same pipes as distribution system-241 (1)(a)
Vent protected from precipitation/animal entry-241. (1)(b)
Vent is placed beyond traffic or impervious area-24 1 (1)(c)
All lines connected to vent if bed or trenches-241(l)(d)
� 9" cover over peastone-240(9)
Reserve area provided(new construction)-248(1)
4" Reserve 4' from primary leach area—NA 9.04
4'(5'if perc rate<=2 MPI) separation to g.w.-212(a) &(b)
4'(down to 2'with variance or I/A-upgrades only)of natural soil under l.f.
GW separation is adjusted to highest existing grade if facility cuts into a hillside
�'. Pipe slope minimum of 0.005-251(9)
Require 5'removal and replacement if in fill-255(5)
Top of leach facility<=36"below,grade-221(7)
Final grade over l.f.minimum 0.02 ft/ft-240(10)
Surface&subsurface drainage away from l.f. -240(1 1)&245(5)
-- Minimum design flow 440 gpd without deed restriction—NA 13.01
3:1 slope where grading required-255(2)
Toe of fill slope stops 5'from property line or swale installed-255(2)
" t Impermeable barrier if<3:1 slope or< 15 feet to—3:lslope-255(2)
Impermeable barrier/retaining wall poured concrete—NA 9.02
Retaining wall stamped by P.E.-255(2)(b)
Top of retaining wall>=top of peastone elevation-255(2)(f)
10'offset from edge of leach facility to edge of ret. wall'255(2)(g)
v Perc test(s)done in most restrictive layer- 104(2)
U Perc test 4' below leaching elevation—NA 7.,06
Design flow listed and required/provided leach area given-220(4)(f)
Leach pipes SCH40 PVC—NA 10.01
Leach mini
es r mum 4'diameter except for dosed system—NA 14.04
p�p minimum
Leach lines capped,vented,9�connected together-251(9)
r Pressure dosing guidance followed if pressure distribution-254(2)(c),
Pressure dosing required over 2,000 gpd or with I/A remedial use-231(1)
5
6
Leachin&'Trenches(Check here if not present: )
OK Problem N/A
Number of trenches:
Minimum of I trenches-NA 9.01(2)
Depth offtenches(max eff.2'): -247(l)
Width`of trenches(2'min.,4'max.): -251 (1)(b)
Length of trenches(100'max.): -25 1 (1)(a)
"Trenches are vented(when>50')-251 (11)
Trenches follow contour lines-251(2)
Trench spacing 3 times effective width or depth minimum-251 (1)(d)
In fill or reserve between trenches, 10'min.-NA 14.0,1&"14.03
Available leach area given(Min.500 s.f.)-NA 9,01 2)
Bottom=L x W 'x# = s.f.
Sidewall=L x D x# x 2= s.f.
Effective leach area given
are ,.
° Loadin g factor:
Effective area=total a s.f.x LTAR = g/day
Effective area is>-design flow of facility being served
2"of 1/8"- 1/2",„2x washed peastone.-247(2)
Trench depth,of 3/4" to 1 1/2"double washed stone-247(1)
Leach Fields(Check here if not present: )
OK Problem N/A
Number of fields:
(need dosing chamber if> 1,231 (1))
Length(100'max.); "° '" � -252(2)(b)
Width: '°'
Total area:L x W = �� � � s. f.
Minimum 900 square feet-NA 9.01(1)
Distribution lines connected with solid pipe–NA 15.01
Effective leach area given
—,t Loading factor:
Effective area=total area s.f x LTAR g/dav
Effective area is>=design flow of facility being served
Minimum of two distribution lines-252(2)(a)
6'line separation(max.)-252(2)(d)
4'maximum separation from edge of field to line-252(2)(e)
m R
° 10"minimum separation between adjacent leach fields-252(2)(f)
_ Between 6" and 12" of 3/4- 1 1/2"stone beneath field-252(2)(g)&247(2)
2"of 1/8"-1/2"2x washed peastone.-247(2)
Final Grading
OK Problem N/A
Slope over leach area minimum of 0.02 feet/foot–240(10)
Grading shall divert drainage away from leach area–240(11)
Grading slopes away from dwelling
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