HomeMy WebLinkAboutCertificate of Compliance - 54 LONG PASTURE ROAD 12/10/2004 Town of North Andover
Office c of the Health Department
Community ev o i nt and Services i i io
400 OSGOOD STREET
cINU
Susan Y. Sawyer, ICE S/PAZ 978.688.9540-Phone
Public Health Director 978.688,9542- Fax
CERTITICATE OE I fC
As cif
December 10, 2004
This is to certify that
the individuaf subsurface disposaf system
repaired" — Tuff System
6y
Leo Virneffi
at
5 (Lot J) 0n asture
%orth,4ndover, M.,4 01845
has been instalfed in accordance with the provisions of Title V of the State Sanitary Code and
with the,1-Arorth Andover Ooard of Yfeafth regufations.
The Issuance of this certificate shall not be construed as a guarantee that the system wiff
function satisfactm fy.
Susan T Sawyer
Public Wealth Director
lrCbARD OF F4L'{'L ALS 688-9541 BUIL IAN6 688-9545 CONtit3RVA C'ION 688-9530 Ld&',AIXH 698-9540 PLANNING 688-9535
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTE
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System constructed;
( ) repaired;
by
located at
was installed in con �� "
form�nce with the North And ver Board of Health approved plan,
rr r ,
System Design Permit#-2t)/
,plan dated /V' %r ,/'f j, , with a design flow
Of'57"?) 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
CVIR 15.000, Title S 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.
Bed inspection date:
Engineer Representative
Final inspection date:
Engineer Representative
r, ,
Installer: ',�� �,„ �, /
Lie.#: Date:
f
Engineer: A Date:
e
�,N
AS-BUILT CHECKLIST
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 150' 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
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
Yes NO Initials,,
A. Bottom of Bed F'
1. Excavation to proper depth 1. /
2. With trenches,sides of excavation are beneath B horizon
3. Edge of excavation specified distance from foundation,etc.
Comments:
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: f
C. Building Sewer
1. Pipe diameter minimum 4"
2. Schedule 40 pipe
3. Watertight joints
4. Inlet to tank cemented
5. Slope minimum 0.01 or 1/8"per foot minimum ,
6. Pipe properly set on compact firm base
7. Pipe laid on continuous grade in straight line
8. Cleanouts precede all change in alignment and grade .-
9. Manholes at any 90 change
10. 10' minimum offset to water line
Comments:
D. Septic Tank
1. Level -s/3
2. 1,500 gal minimum
3. Gas baffle present on outlet `
4. Manhole to grade
5. Manholes over center and each tee
6. 3-20"manholes
7. Inlet tee minimum 12"under invert
8. Outlet tee minimum 14"under invert
9. Outlet line cemented
10. Air space 3"above tees
11. 2"-3"drop from inlet to outlet
12. Pipe set
13. Compact base with 6"of'/4"crushed stone under tank
14. Tank is watertight
Comments:
Yes NO
E. Pump Chamber
1. If separate from tank,compact base with 6"of/4"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
8. Check valve and bleeder hole present
9. Alarm in building on separate circuit
10. Alarm functions
11. Manual operating switch
12. Pump delivers liquid to d-box
Comments:
F. Distribution Box
1. D-box level
2. Minimum 0.1T'(2")drop from inlet to outlet
3. Minimum 6"sump : ..,
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
Comments:
G. Soil Absorption system
1. All stone double-washed-'/4"- 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. Grading meets 3:1 slope
6. Minimum of 9"of fill graded over system
7. Toe of slope stops minimum 5' from edge of property; if not,then swale.
Comments:
H. Leach Trenches
1. Minimum 2 trenches
2. Length of trenches agree with plan. (Max. length 100') t �"
3. Width of trenches agree with plan-Minimum 2%maximum-4'.
4. Vent present if<50 feet or specified
5. Distance between trenches minimum 4' and maximum of 6'
6. Minimum distance between trenches 10'
7. Pipe slope minimum 0.005 or 6"per 100'
8. Depth of trenches below outlet invert minimum of 6". °"'"
Yes NO
9. Pipes set on stable base.
Comments:
I. Leach Field
1. Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6"per 100'
3. Separation between pipe 6'maximum
4. Pipes connected at end
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
9. Maximum perc rate 20 mpi
Comments:
I Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between 12"and 48"wide
4. Access manholes on each pit
5. Pipes cemented with hydraulic cement
Comments:
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