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Home My WebLink AboutMiscellaneous - 168 GRAY STREET 11/12/2007 TOWN OF NORTH ANDOVER TN '6D 4o Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 CHUS 978.688.9540-Phone Susan Y.Sawyer, REHS/RS 978,688,8476-FAX Public Health Director E-MAIL: healthdept(Atownofnorthandovei-.com WEBSITE: hqp://www,towtiofnorthandovei-.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM ® INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System "Wst&ructed1- repaired; WD by (Print Name) Nogov z�'P'zJ� / located at 168 Gray Street Lot 14 T7 r; (Installation Address) was installed in conformance with the North Andover Board of Health approved plan, originally dated 9/28/04 and last Revised on 10/13/05 with a design flow of 550 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: 10/30/07 Engineer Represeritative(Signature) James H. MacDowel And..Print Name_ Final inspection date: 12/5/06 (system) 9/26/07 final grade) Engi ect'Representative(Sig ature) James H. MacDoiqe'll And-Print Name /Z S:� (Signature) z ],or. Date: Installer: AAAAA,4 And- Print Name y It Date: 10123/07 Engineer: i nature) Clayton A. Morin And-Print Name 4 dhjn(A 6- TD�jq h& Professional Land Surveyors & Civil Engineers December 7, 2007 ESSEX SURVEY SERVICE 1958- 1986 OSBORN PALMER 1911 - 1970 BRADFORD&WEED 1885- 1972 Ms. Susan Y. Sawyer, Public Health Director Town of North Andover Office of Community Development & Services Health Department 1600 Osgood Street, Building 20 Suite 2-36 North Andover, MA. 01845 C RE: F13877 RE - LOT 14 168 GRAY ST. N. ANDOVER, MA. TOWr4 OF I H,A�'Qr.)OVER ��EAE'TH DEPAR,FIVEr'14 Dear Susan: ......—.1-1-1-- Accompanying this letter are two prints of the As-Built Septic System Plan for the referenced lot, revised as follows: I. Test hole locations have been added to the plan; 2. A benchmark (top of foundation) has been noted; 3. Leach and reserve area dimensions have been added; 4. The nearest distances from the various septic system components to the property lines have been added to the plan. If there are any questions or if further information is needed, please do not hesitate to call. Very truly yours, mes H. MacDowell J TAA_ _ HM:aIv Enclosure CC: Ms. Patty Schuler 104 LOWELL STREET PEABODY, MASS. 01960 TELEPHONE: 978-531-8121 FAX: 978-531-5920 Y AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ✓' ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS .L 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 TOWN OF NORTH AN DOVER Office of COMMUNITY DEVELOPMENT AND SERVICES } a.Apwkrw❑ HEALM DEPAR,rMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 V N1 ORTH ANDOVER, NIAS S AC 11 U S ET'rs 01845 cnus SINAI) Y. Sawycr, REJIS/RS 978.688.9540 -Phone I'Liblic Health f)irector 978.688.8476—FAX QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: MAP:le,, LOT: INSTALLER: C-1.). J, DESIGNER: PLAN DATE: BOH APPROVAL DATE ON/'PLAN: 7 INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: 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 F-1 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port F-1 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 ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page I of 6 TOWN OF NORTH ANDOVER T#j � O "e ,^y NO Office of COMMUNITY DEVELOPMENT AND SERVICES 0� �o HEALTH DEPARTMENT � ;� 1600 OSGOOD STREET; BUI1LDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 SSgctiuses Susan Y. Sawyer. REHSiRS 978.688.9540—Phone Public Health Director 978.688.8476—FAX Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2of6 OF OR"M ANDOVER COMMUN DEVELOPNIEN'r AND SERVICES 0 HEAUTH DEPARYMEN'r ' 1600 OSGOOD S'f REET; BUILDING 20; SUITE 2-36 'A V NORTH ANDOVER, MASSACHUSETTS 01845 SACIlus Susan Y. Sawyer, REFIS/16 978.688.9540--Phone I'LibliC Heath DiNdOl' 978.688.8176-17AX D-BOX F-1 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: SOIL ABSORPTION SYST M Bottom of SAS excavated down to L,,soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed 1/8-1/2" (peastone) double washed stone installed Laterals installed and ends connected to header Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Wastewater System Documentation-Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER 4 NORTH� Office ®f COMINIUNITY DEVELOPMENT AND SERVICES 0:0`�., . HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 ��$t NORTH ANDOVER, MASSACHUSETTS 01845 �9SSACHUS�Rty Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OIL NORTH ANDOVER e�No RTFI � Office of CONINIUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT' ® ` p 1600 OSGOOD STREET; BUILDING 20; SMITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 4SSACHUSE� Susan Y. Sawyer, REHS/RS 978.6889540—Phone Public Health Director 978.688.8476—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 -- ❑ 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 1 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 Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUI'T'E 2-36 NORTH ANDOVER, MASSACHUSETTS 01845 "SACHUSk` Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476 -FAX 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