HomeMy WebLinkAboutCertificate of Compliance - 63 HAY MEADOW ROAD 6/6/2014 �� n �aOilriUk d
PUBLIC HEALTH DEPARTMENT
Town of Forth Andover
Community Development Division
CERTIFICATE OF
COMPLIANCE
As of: 6/6/201. 4
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Repair of D-Box
By-, Todd Bateson
At
63 Hay Meadow Road
Map 104.B Lot 0097
ort�, Andover, MA 01845
T A .issuance of this c t is to shall no be construed as a guarantee that the system will function satisfactorily.
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Michele Grant K_-J/
Public Health Agent
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 fax 978.688.8476 Web www.townofnorthandover.corn
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North Andover Health Department
Community Development Division
QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 63 Hay Meadow Rd. MAP: 104.13 LOT: 0097
INSTALLER: Todd Bateson
DESIGNER:
PLAN DATE:
BOH APPROVAL DATE ON PLAN:
INSPECTIONS
TANK INSPECTION: D-box 6/6/14
DATE OF BED BOTTOM INSPECTION:
DATE OF FINAL CONSTRUCTION INSPECTION:
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:
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
❑ 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
E:1 Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
F-1 Bottom of tank hole has 6" stone base
❑ Weep hole plugged
❑ 1500 gallon Pump Chamber installed
❑ H-10 loading
❑ Monolithic tank construction
F-1 Inlet tee installed, centered under access port
❑ Pump(s) installed on stable base
❑ Alarm float working
❑ Pump On/Off floats working
F-1 Separate on/off floats
❑ Drain hole in pressure line
❑ cover at final grade installed over pump
access port
❑ Watertightness of tank has been achieved by
testing
❑ Hydraulic cement around inlet & outlet
Comments:
CONTROL PANEL
❑ Alarm & Pump are on separate circuits
❑ Alarm sounds when float is tripped
❑ Location of control panel: basement
F-1 Alarm signal located inside: basement
Comments:
DISTRIBUTION-BOX Installed on stable stone base
F� H-20 D-Box
F-1 Inlet tee (if pumped or >0.08'/foot)
",,-'Hydraulic cement around inlet & outlets
Fj Observed even distribution
Speed levelers provided (not required)
Schedule 40 PVC Pipe
Comments: