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Home My WebLink AboutCertificate of Compliance - 57 LONG PASTURE ROAD 11/14/2008 ea p PUBLIC WEALTH DEPARTMENT Town of North Andover Community Developrnent Division Ar November 14, 2008 This is to certify that the individuafsu6surface disposal system received a SA` I-ScF., TORMS1xEMOX of the; ®Instadation of an individuaf On-Site Sewage DiTosa(System y: �Ryan Greenwkh .57L n Pasture,_&ad. _q& ,L;ot5 210/1 WA-021 C-(.)(lt 0.0 ,p XX 01845 The issuance of this certificate shaft not be construed as a guarantee that the system wifffunction satisfactorily. ,Susan 'Y'' awyet, Wislqu ft6CzcY eafth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978,688.9540 Fox 978.688.8476 Weh www.townofnorthandover.com 'TOWN OF NORTH ANDOVER 00RT" Office of COMMUNITY REVEL OPMEINT ,AND SERVICES HEALTH DEPARTMENT I. `( 'Gy 4M OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 "'7340Husaaa� 978.688,9540—Phone Susan Y.Sawyer, REHS/RS 978.688.8476–FAX Public Health Director E-MAIL: healthdept,iiatownofnorthandover.com WEBSITE: http:"'.'wvvw.townofriorthandover.com TOWN OF NORTH ANDOVER 1 SEPTIC DISPOSAL SYSTEM - INS'TALLA'TION CERT'IFICAT'ION The undersigned hereby certify that the Sewage Disposal System ('°"'i constructed; ( ) repaired; (Print flame) located at )... 7 4 (Insta ation Address) was tnstal Andover ✓o Health approved plan, originally dated ' e to conformance and lasttRev Revised A� �.Board o�� . /,� /�� wtth a design flow of m � : 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 CMR 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. Bed inspection date: Engineer Representative(Signature) And-Print Name Final inspection date: 41LZZ, �– Enginee Representative(Signature) And-Print Name sv.:�ONPo ..NW1Ybai., ,�"amp' HCO /h. ..rNIPN�Vf' ',f 0r. .,.vPti. �SINSS• ., Installer: H,,„ -. .�u -.�° , .. (Signature) Date. ✓''� --- '`Y,9 i"J 6 wb,y i f I And- Print Name — - Engin�.er �: Signature) ., 1 And-Pridt Name Vhs , a SACHU PUBLIC HEALTH DEPARTMENT Community Development Division QNSITE WASTEWATER Y CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 57 Long Pasture Road MAP: 106A LOT: 216 INSTALLER: Ryan Greenwich DESIGNER: Philip Christiansen PLAN DATE: 11/18/96 Rev. 10/27/08 BOH APPROVAL DATE ON PLAN: 10/27/08 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 11/19/08 DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ® Contractor reports any changes to design plan ❑ Existing septic tank properly abandoned ® Internal plumbing all to one building sewer ® Topography not appreciably altered Comments: New system, no tank abandoned SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base ❑ Cleanouts per plan ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ® 1500 gallon tank has been installed H-10 loading 2-piece construction ❑ Water tightness of tank has been achieved by testing 1600 Osgood Street,North Andover,Massachusetts 01845 Rhone 978.688.9540 Fax 978.688.8476 Web www.townofnor11mndover.com Inspection Form Jane 2008 o °r � a.eww a ' ``.. '.. saeares e°cwitw "�' SA us PUBLIC HEALTH DEPARTMENT Community Development Division ® Inlet tee installed, centered under access pork ® Outlet tee installed, centered under access pork (effluent filter) ❑ inch cover to within 6" of final grade installed over one access port, must be to grade and over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet Comments: Needs hydraulic cement DISTRIBUTION-BOX ® Installed on stable stone base ❑ Inlet tee (if pumped or >0,08'/foot) ❑ Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) Comments: Baffle wall in d-box, needs hydraulic cement SOIL ABSORPTION SYSTEM (General) ❑ Bottom of SAS excavated down to 6 in into C soil layer, as provided on plan ❑ Size of SAS excavated as per plan ® 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: 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688,9540 Fax 978,688.8476 Web www,tawiiofnnrthundover, Inspection Form June 2008 OR1 � 6 tl Va' T$y yygg _ 9 i " t lli PUBLIC HEALTH DEPARTMENT Community Development Division SOIL ABSORPTION SYSTEM (gavel-leas Chambers) ® Brand and Model of Chamber: Infiltrator Chambers ® Number of chambers per row: 9 ® Number of rows (trenches): 6 Comments: SYSTEM ELEVATIONS AS—BLT INVERT ELEV. DESIGN INVERT ELEV. Benchmark 151.72 Building Sewer OUT 153.07 153.10 Septic Tank IN 152.88 152.90 Septic Tank OUT 152.73 152.65 Distribution Box IN 152.63 152.54 Distribution Box OUT 152.47 152.37 Lateral 1 INVERT 152.44 152.3 Lateral 2 INVERT 152.44 152.37 Lateral 3 INVERT 152.44 152.37 Lateral 4 INVERT 152.44 152.37 Lateral 5 INVERT 152.44 152.37 Lateral 6 INVERT 152.44 152.37 BED BOTTOM ELEV. 151.62 151.70 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978,688.9540 Fax 978.688.8476 Web www.town0northandover.coni Inspection Form June 2008 M ttoRTF1 �.s%-e0 $6 4, SAC� Cm5t1;IC pY0 Wm4 me�1' US PUBLIC HEALTH DEPARTMENT Community Development Division 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 Bank3 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 r 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 1600 Osgood Street,North Andover,Mossu iusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www.townalnorthundover com Inspection Form June 2008 TOWN OF NORTH M0115 Mylh--s +Offce of COMM UNITY DEVELOPEN"r AND SERV1(..'ES HEAL"11-1 DEPARTMEN'T 1600 OSGOOD STRE'E'T; BUilding 2--36 NORTH ANDOVER, MASSAC71-1USE.1"I'S 01845 SUSall Y, Sawyer, REFIS/RS 978.68&9540- Phone Public Flealth Director 9M688.8476 F'AX QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 5-7 011%a 1 (0 1 "AP: LOT: INSTALLER: 74, DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: y ❑F ;4 DATE OF BED BOTTOM INSPECTION: leg x � " 41 , � DATE OF FINAL CONSTRUCTION INSPECTION: 64"L Vfa/ /-0d/Y DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANK Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Watertightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port E:1 Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present F-1 Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page I of 6 TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOMENTAND SERV1(-'E.S HEALN11 DEPART'MENI' t 600 OSGOOD STREt.,T� Building 2-36 NORTH ANDOVEIR, MASSACHUSETTS 01845 SUSaf) Y. Sawyer, REHS/RS 978.688.9540 Phone PUblic Health Director 978MU476-FAX Comments: PUMP CHAMBER Bottom of tank hole has 6" stone base Weep hole plugged Combo Tank installed. Size: F-1\\l 11 000 gallon Pump Chamber installed H-10 loading \Monolithic construction) F-1 i'r let tee installed, centered under access port ❑ Pump(s) installed on stable base F-1 Ala°rm float working ❑ Pum,�On/Off floats working ❑ S epa t e on/off floats I ❑-1 Drain h le in pressure line ❑ 24" inch over to within 6" of final grade installed over ,c pump acc ss port a F-1 Water tight ess of tank has been achieved Visual testing F-1 Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY F-1 Type of treatment device: F-1 Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 TOWN OU' NOR"M ANDOVER I �'S Office of COMMUNITY DEVELMMENTAND SERVICE, U1EA1.3`H DEPARTMENT' 1600 OSGOOD s'rREET', Building 236 4 1 4 V NORTH ANDOVER, MASSACHUSETTS 011<1._` 1 Susart Y. Sawyer, REHS/RS 97&688.9540 Phone Public Health Director 978.688.8476 FAX D-BOX Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) F-1 Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: Cl/ SOIL ABSORPTION SYSTEM /" Bottom of SAS excavated down to soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan F-1 3/4-1 1/2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header F-1 Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan F-1 Elevations of laterals installed as on approved plan ❑ 40 Mil HIDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) F-1 Final cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 TOWN OF NORTI-I ANDOVER 0-T 4, Office of COMMUNITY DEVELOPMENTAND SERVICf"S HEALTH DEPAR,rMENT 1600 OSGOOD STREET; Building 2-36 NO R'141 ANDOV[�.'R, MASS ACHUSEF-rs 0 1845 U Susan Y. Sawyer, REIIS/RS 978.6M9540 Phone Public I lealth Director 978,688,8476 - FAX PRESSURE DISTRIBUTION F-I -- inch manifold F-I laterals installed with end sweeps size: material: ❑ Squirt test ft in height F-I Equal distribution to all laterals F-I orifice size inch as per plan Comments: CONTROL PANEL F-I Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped F-I Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OF NOR'1'11 ANI)OVER Office of C,0MMUNrrY DEVELOPMENTAND SERVICES 1-1EALTH DEPARTMEW 1600 OSGOOD STREET, Building 2-36 NORTI I AN DOV El , MA S SA(,,,I I U S l""FFS 01845 S cm) Susan Y. Sawyer, REHS/RS 978.613£ 9540 - Phone Public health Director 97&68&8476 FAX 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 -- F-1 Waterline 10 10 101 ❑ Private drinking well 75 1001 50 F-1 Irrigation well 75 100 F-1 Surface Water 25 50 ❑ Bordering Vegetated Wetland Salt Marsh, Inland/Coastal Bank 3 75 100 F-1 Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 F-1 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 1 Suction line 222(2) 2 100 feet is a inininiurn acceptable distance and no variance is allowed for a lesser distance(NA 5.02). '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 Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER 40..4TH 7 Office (A COMMUNITY DEVE1,011MENT' AND SERVICES 0 HEALI'll DEPARTMENT 600 OSGOOD STRELX; Building 2-36 W.)RTH ANDOVER, MASSACI I USET'I'S 01845 ss Susan Y. Sawyer, R IS/RS 978.68 8,9540 Phone Public Health Director 978.68&8476 SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6 of 6