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Home My WebLink AboutCertificate of Compliance - 858 JOHNSON STREET 5/19/2014 mi • PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division CERTIFICATE ""'W Cu"'MPLIANCE As of.- 5/19/201 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: On-Site Complete Repair and Construction of an Disposal By: all • At: 858 Johnson Street Map 107A Lot 45 North Andover, i The uance of this c'e ate %all not, e construed as a guarantee that the system will function satisfactorily. k ,, i 4111ch a Grant Public health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnortliandover.coni %$AC PUBLIC HEALTH DEPARTMENT Con7munity Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System(_onstructed;( )repaired; By: (Print Name) Located at: 241,4 s o/ (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated. , a 4 ,_°� ` - and last revised on &ml ; " with a design flow of 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. Bottom of Bed Inspection Date: Engineer Representative(Signature) And—Print Name Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name Installer. 11. ' � � ;,..��` (Signature) Date; And—Print Name Engines I' .' °° ignature) Date; And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 'Web http;//www.townofnorthandover.com i North Andover Health Department Community Development Division QNSITE WASTEWATER Y T M CONSTRUCTION NOTE LOCATION INFORMATION ADDRESS: 858 Johnson St. MAP: 107A LOT: 0045 INSTALLER: Bill Hall DESIGNER:0" i .F� ❑ ` PLAN DATE: BOH APPROVAL DA�E ON PLAN: c..,;6 V INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: 10/11/13 DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION; SITE CONDITIONS Contractor reports any changes to design plan E fank"'properly,-abandort d"." .°" ❑ Intem al plumbing a�l1�o one�building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK Building sewer in continuous grade, on � compacted firm base Cleanouts per plan 4/AT Bottom of tank hole has 6" stone base Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading Monolithic tank construction 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/effluent filter) ❑ inch cover to within 6" of finish grade installed over one access port Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Pottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 156Q gallon Pump Chamber installed ❑ H-1 b\loading ❑ Monolithic tank construction ❑ Inlet tee"Apstalled, centered under access port ❑ Pump(s) installed on stable base F-1 Alarm float working ❑ Pump On/Off'floats working F-1 Separate on/o' ff`floats ❑ Drain hole in pressure line ❑ cover at final, rade installed over pump access port F-1 Water tightness of tank as been achieved by testing ❑ Hydraulic cement around inlet & outlet Comments: CONTROL PANEL ❑ Alarm &\Pump are on separate circuits ❑ Alarm souMs when float is tripped ❑ Location of cntrol panel: basement F-1 'Alarm signal lo�ted inside: basement Comments: DISTRIBUTION-BOX Installed on stable stone base H-20 D-Box Inlet tee (if pumped or >0.08'/foot) " Hydraulic cement around inlet & outlets Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTE (General) El Bottom of SAS excavated down to C soil layer, as provided on plan Size of SAS excavated as per plan t � - " � ' ❑ 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)04 ❑ Final cover as per plan Comments: ) ( ., SOIL ABSORPTION SYSTEM, (Gravel-less Chambers) Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ❑ Number of chambers per row: ✓ . ❑ Number of rows (trenches): 4 Comments: Total Chambers FINAL GRADE Loamed Seeded Cover per plan Comments: DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer As-Built Plan BM = HR = HI = SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 TOP Lateral 1 INVERT Lateral 2 TOP Lateral 2 INVERT Lateral 3 TOP Lateral 3 INVERT Lateral 4 TOP Lateral 4 INVERT Lateral 5 TOP Lateral 5 INVERT Lateral 6 TOP Lateral 6 INVERT Top of Chamber Bottom of Bed/Chamber SKETCH PLAN 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 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