HomeMy WebLinkAboutApplication - 14 PURITAN AVENUE 8/13/1997 Town of North Andover, Massachusetts Form No.a
NORTH BOARD OF HEALTH
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DESIGN APPROVAL FOR
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�9SSACHL15E SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
• Applicant I A Test No.
Site Location - I A
Reference Plans and Specs-
ENGINEER DES GN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
CHAIRMAN,BOARD OF HEALTH
: Fee Site System Permit No. 94
SEPTIC PLAN SUBMITTALS
LOCATION: ` y
NEW PLANS: YES $60.00/Plan
REVISED PLANS: YES $25.00/Plan
DATE: ;�ZV-12 -7
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DESIGN ENGINEER:
When the submission is all in place, route to the Health Secretary
PLAN REVIEW CHECKLIST
ADDRESS ,� y l / �r p "" ✓'
.��/` .,.. ���,�..°�,��,�a��� �l�<�� ENGINEER
9ENERAL
3 COPIES °' STAMP LOCUS " NORTH ARROW_ ',„mow.. SCALE
CONTOURS /,--' PROFILE r .' .” (Sc) SECTION - BENCHMARK SOIL &
PERCS ELEVATIONS WETS. DISCLAIMER
WELLS & WETS
WATERSHED? ,j °> DRIVEWAY WATER LINE FDN DRAIN _"� M&P� �_ r
SCH40 ��,�°.. TESTS CURRENT" �.""�""- SOIL EVAL
SEPTIC 'DANK
��,�f'ro
MIN 1500G l�"''-. . 17 INVERT DROP GARB. GRINDER A") (2 comps +200)
10 ' TO FDN . MANHOLE _" r ELEV '' GW # COMPS._Z_ GB
D-BCC
SIZE # LINES FIRST 2 ' LEVEL STATEMENT
INLET / ,l3 7 ,Z Z (2° OR . :L7 FT) TEE REQ'D? ,/l/
LEACHING �'"
MIN 440 GPD? t RESERVE AREA t.-,., 4 ' FROM PRIMARY? / o 2% SLOPE
100 ' TO WETLANDS f 100 ' TO WELLS 4 To S .H.GW (5 ' >2M/IN)
20 ' TO FND & INTRCPTR DRAINS "" 400 ' TO SURFACE H2O SUPT
4 ' PERM„ SOIL BELOW FACILITY rm .... MIN 12" COVER ° FILL? ,w (15 ' )
BREAKQUT MET'
TRENCHES
MIN 440 Upd SLOPE (min .005 or 6 11/1001 ) SIDEWALL DIST. 3K EFF,
W OR D (MIN 6 )_L"'
RESERVE BETWEEN TRENCHES? IN FILL? "" "" MUST
BE 10 ' MIN. "� 4" PEA STONE? " VENT? ( >3 ' COVER; LINES >501 )
BoT
1 SIDE F�__= 1,,,<, , LDNG , ., = TOT '- i J ' '°
Town of or°th Andover f NORTp
OFFICE OF ?°,�'``� a 9ti0L
COMMUNITY DEVELOPMENT AND SERVICES
30 School Street
4
North Andover, Massachusetts 01845 �,9°
M J. SCOTT North
'rector
September 15, 1997
Merrimack Engineering
66 Park Street
Andover, MA 0 18 10
Re: Lot #13 Puritan Ave.
To Whom it May Concern:
This is to inform you that the proposed plans for the site referenced above have been
approved.
If you have any questions, please do not hesitate to call the Board of Health Office at the
number below.
Sincerely,
Sandra Starr, R.S.
Health Administrator
SS/cjp
cc: A. Cormier
CONSERVATION 688-9530 HEALTH 688-9540 PLAN 4G 688-9535
FORM 11 - SOIL EVALUATOR FORA1
Page 1
No. ............. Date... :_ ..............
.
Commonwealth Of Massachusetts
WoeT A Awtovez, Massachusetts
Soil Suitabil i asses e t r On®site Sewage Disposal
Performed By: ....W-I-U-t.A..t° 1.......D.U....... . .S..W—el ........................ 6k4..-`
Witnessed By, ... '.:U. .{ _.. .. UI I :... ......... .
..............................................................................................................................................j.................... /
Location Address or Owner's Name. A,C a �u 1 2� ( AWp��«'„
Lot X L ,-C t3 Elul(Z(-rA tj AV E.. Address,and �3 1. ALI: yE Z— POND
Telephone b Y� p� py, /7 g
I�,lb IZ`rj4 / KjDoV9IZ. A.
New Construction (I� Repair ❑
Office Review
Published Soil Survey Available: No ❑ Yes IJ�
t-'.iSVyv Soil Ma Unit ...��. ?..,. G2
Year Published .�. .�... Publication Scale . z16 v ;,f*; ,e- )ffaec.Taa1/
Drainage Class ........ Soil Limitations ..... Y ............................................... ...................................H0(-L(s
Surficial Geologic Report Available: No ❑ Yes ❑
Year Published .... ...... Publication Scale
GeologicMaterial (Map Unit) ........`. ......................................................................................................................................
Landfor.m .....................................................................................................................,.........................................,.............................................
.
Flood Insurance Rate Map: *' Z o-(g o (o 13 6° q
Above 500 year flood boundary No ❑ Yes
Within 500 year flood boundary Na Yes ❑
Within 100 year flood boundary Not Yes ❑
Wetland Area:
National Wetland Inventory Map (map unit) .............. .W......9.tTrz-....... i. T 1.°.1��......
Wetlands Conservancy Program Map (map unit) ........ ........ ....... ......................
Current Water Resource Conditions (USGS): Month J'v4. /
Range ; Above Normal ❑ Normal Below Normal
AS,s0 05D
Other References Reviewed; V 6 S 6 P`y
FORM It - SOIL EVALUATOR FORM
Page 2
On-site Review
�
Deep Hole Nunnber '/.A-Z . Dato��v!-�l�-ql Tinne:'R,.r\, VVoothar
Location (identify on site plan) -' -_-^ .--------------------------------------------'
Land Use Slope -ZP-. Surface Stones -.��A.W^�'
Vegetation ........C40A.R9 .----------------------------------------------------------------
kJ��
Landformn --'.==��/�..............................................................................................................................................................................................................
Position on landscape (sketch on the back) S0��-'i>
........................................................................................................
Distances from:
Open Water Body - feet Drainage vvay-Z�Z.t feet
Possible Wet Area ]00.:t. feet Property Lino 17' feet
Drinking Water Well /oot Othar ----....------'
DEEP OBSERVATION HOLE LOG
Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other
(Inches) (USDA) (Munsell) (Structure, Stones, Boulders,
Consistency, % Gravel)
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Parent Material (geo|ogiu) -. --.7-/-{°L----------------' Depth toBedrock: ----
Depth to Groundwater: `~ ° ���'' �4
Standing Water in the Hole: / Weeping from Pb Face:
/
Estimated Seasonal High Ground Water: �=.
'
FORM 11 ® SOIL EVALUATOR FORM
Page 3
Determination for Seasonal High Water Table
Method Used:
❑ Depth observed standing in observation hole.......`. inches
❑ Depth weeping from side of observation hole ...........: .... inches
Ef Depth to soil mottles 9 1y0 inches
❑ Ground water adjustment feet
Index Well Number ...' ".. Reading Date .........:::....... Index well level ...................
Adjustment factor ......... ... Adjusted ground water level .................. .......................
......
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas
observed throughout the area proposed for the soil absorption system? �ZE—ZC
If not, what is the depth of naturally occurring pervious material?
Certification
I certify that on I have passed the examination approved by the
Department of Environmental Protection and that the above analysis was
performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017.
Signature( Date �'
FORRZ 12 - PERCOLATION TEST
COMMONWEALTH OF MASSACHUSETTS
LLoM Ak'wvt=2 , Massachusetts
Percolation Test
Date: _772`97.. Time: .....�:J-ft.................
Observation Hole #
Depth of Perc
Ste•'-+-2a -7
Start Pre-soak 12 4 3 ( 2 : Z(t3
End Pre-soak t Z: SS 3
Time at 12"
Time at 9" l 11 l 3 I
Time at 6" ( ; 3
Time (9"-6") z O �-�i 3 3 t ►�c
Rate Min./Inch l l h, k'J 10
Site Passed LEI Site Failed ❑ -
............................................................................................................
Performed By: CAS 601)( )—A
Witnessed By: !�L) SA 0 F6 VD
Comments: __. ..................... ............... ._ ...__...... ........................_............................... ..__.... ..............