HomeMy WebLinkAboutCorrespondence - 82 RALEIGH TAVERN LANE 11/5/1997 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
c�
DATE: ,1� 7 7 CURRENT INSTALLER'S LICENSE#
LOCATION:
LICENSED INSTALL R:
A
SIGNATURE: TELEPHONE#
CHECK
REPAIR: NEW CONSTRUCTION:
s�c
IF NEW CONSTRUCTION, PLEASE ATTACH OUNDATION AS-BUILT.
Administrative Use Only
$75.00 Fee Attached? Yes ✓"rf No
Foundation As-built? Yes No m�
Floor plans on file? Yes No
Approval _ Date: r _�;
LOCATION: '!'i 12 1.e CA 14 �/
NEW PLANS: $125.00/Plan
REVISED PLANS: AYES $ 60.00/Plan
mw OF bO t�� l00�lf� l
SITE EVALUATION FORMS INCLUDED:
NO BOARD OF�9E�+1� E-4
DATE:
DESIGN ENGINEER: 0194 tk 1 C(C
DATE TO CONSULTANT:
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
When the submission is all in place, route to the Health Secretary.
I
SEPTIC PLAN SUBMITTAL FORM
LOCATION: 82 'Raleigh Tavern Rd
NEW PLANS: YES $125.00/Plan !7 ;
REVISED PLANS: YES $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: YES NO
DATE: ..-.
DESIGN ENGINEER:
DATE TO CONSULTANT:
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
When the submission is all in place, route to the Health Secretary.
Town of ort Andover p%ORT1� e
OFFICE OF
��Oryttt !O 16�rOL
COMMUNITY DEVELOPMENT VICES a A
27 Charles Street 9
� Q�A� 0-�PPy(y
North Andover, Massachusetts 01845 q i1
s T. USES
WILLIAM J. SCOTT
Director
(978)688-9531 Fax (978)688-9542
February 2, 1999
William Dufresne
Merrimack Engineering
66 Park Street
Andover,MA 01810
RE: 82 Raleigh Tavern Lane
Dear Mr. Dufresne:
This is to inform you that the proposed plans for the repair of the septic system
located at 82 Raleigh Tavern Lane,North Andover, have been disapproved for the
following reasons:
1. Details of impervious barrier along sideline of street lacking details, such as bottom
elevation,top elevation, etc.
2. Six inch stone base required under d-box, septic tank and pump chamber. (3 10 CMR
15.221(2) and 15.228(1))
3. Force main not designated minimum 2-inch diameter. (3 10 CMR 254(1)(c)).
4. Baffle in d-box missing. Proposed tee in Profile missing specifications. (3 10 CMR
15, 232(3)(a)).
5. Toe of the slope must be at least 5' from the property line. (310 CMR 15.255(2))
If you have any questions, please feel free to contact the office at the number below.
Sincerely,
d-, 4' 2%�>
Sandra Starr,R.S.
Health Administrator
Cc: A. DenBoggende
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Feb-02-99 10: 14A Paul D. Tuv-bide, PE/PL5 508-465-0313 P .O2
February 2, 1999
_
i C'andra Starr
I wT. th A"Anuzr Rnard nf'Mealth administrator
rim m �rr�� .Y,e«,it.,T'PFrpinnment and Services
yea - -�
dv u�isvv: a+�.
J-.401 till"iuuVv,,
1 It le V review 101®d I%_Wct8iY a Va,Lt arr.:oa
I� Dear Sandra,
Enclosed find the"Checklist for North Andover Septic System darts foe the dbvve-
mentioned site. The following is a list of all the 'Problem' areas and aeiiciencles roz
Fnaineering has found.
r
Tt, A r,lccae 2n ,mnrat"In"S irarrtPr along the sideline of the street. There is
t, < . .1®®.,,n ah=*csrn,md to nlpeo the)'bottom; how
f 1[cY csclate VL grata UC"lcadi koaavcc -r --- =- -.---- r
I e a P__ t,, ae..,e.<o,l 'r't,®.1 neren�s' eltrtt�lrl fnEln�,y the�FP
t.lObv io (Fie 810JUDU bulljiuuu LU`.3ica`v`w isiL arils).
,.»% u.A v,��... 4m cvnth®ter mat PriAiC
"l7uidance an 1JiiL5iitrllil,l i aSit3Y�C tiilf�JiiutEG� �FV p ia•-ate �:- =
l s A.-ivat file apply lYi uerrturisii atoms ills „�t.�ti
maybe aliowed, provided ,a�e�a��,r.�...ro.,•e,ro��r.
f , � -
authority that the material is impervious, is desigle.d to e-uut,cct Wtittuc�a =tr
f integrity of the material being affected, adequate prOvlsians Dave been lri®tic►o
ensure its support and to prevent puncture during installation."
Aa 6-inch stone base is required under a d-box, septic tank, and pump chamber
?7117) and 229(1) A note in the Profile states: "Septic tank, pump tank&d-box
elall h,*ept lPVel nn„ndistitrhed native sail or 6"-3/ minus crushed stone beneath.
tp__h s q,4Aa.11 Alen tt,p AMA for nttmn chamber and septic tank show a 6"
_
—in" s}aneiilri qhr%a,in nil these nrPaq that a 6" stone base
.—A eee rnn -linmhPr w;fhmlt PXrentlnn-
Y5 rb"�1+11I Gi.Y Y3�1,�,,,,L,1�a,°TitSis, thaw ac>sz�. au `✓us.+.Ya vvw�••�,+�• �-_-
® the torte am is designed as a c-%a inch Pipe, slut OW,r€quirerncz.i i.�Avr��-81: 1
ro
pipe 254(1)(c). ("This roust be changed in numerous places on We Plain.)
® A baffle is required in the d-box because of the dosed system. A proposed tee is
shown in the d-box in the Profile detail but no specifications for its construction are
shown. it should be designed as per 310 CMR 15.232(3)(a).
The to-of slope r'u'st be 5' f Om the nronerty line 255(2). The slope appears to go
ri6,a !..4 e •ne of the street.
It to utic>sideliaa. �,a ,.._�
,.n m �rn� at_..a P Q.. F9" d i/R tv !/ ;-ch stone is to be
3 iO C.[�i[C 24!t^)State CUM cull a ti„ii6Ll UMA �
e e L-A °TL.. ..I- 1 n Fi�v�A 1rcllAs of stone
"I lit 1, placed on the top of the 1each4i9 ved. l„6 picas,des Igra caal� a%ia
.-_ rte„ A m - in. .,F nt z
and a layer of untreated building palter o�leii [art 5ie?ft�. tei� a iu�„mss erg axvli�
. e e e L_�� mL.Aa,. •,.
Cnl('IRICC I IIP appears to be allowed (a"minimum of 2 inches' wOul' atlaw ” ilYlr11C3j. ,tut is i°ais
CIUUIIYLL Ill{IU regulation that I could find that allows untreated building paper over the stofic(this
was allowed in older regulations of Title 5 and Article 11), and therefore 1 would
Ovit ., n�Pr� recommend that the building paper be removed.
Land Surveyors
Opte Ham¢Sire- tf you have any questions or comments please feet free to contact roe.
Newburyport,MA
01950
(i�iyj<fv5-o53a �iiy��i�ly
Carlton A. Brown,PE/PLS
6
PAGE 1 OF 5
Commonwealth of Massachusetts
North Reading, Massachusetts
Application for Local U_pw ade Approval
Title 5, 310 CMR 15.000
DEP Approved form required by 310 CMR 15.403(1)
To be submitted to Local Approving Authority/Board of Health: For the upgrade of a failed or
nonconforming system with a design flow of <10,000 gpd, where full compliance, as defined in
310 CMR 15.404(1), is not feasible.
i
To be submitted to DEP: For the upgrade of a failed or nonconforming system with a design flow
of 10,000 up to 15,000 gpd and/or for upgrade of a state or federal facility, where full
compliance, as defined in 310 CMR 15.404(1), is not feasible.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the
addition of new design now to a cesspool or privy or the addition of new design flow above the
existing approved capacity of a system constructed in accordance with either the 1978 Code or 310
CMR 15.000.
1) Facility/system owner
Name v £ t' kyyV— OIL)
Address &12AI
Phone #
Address of facility �YLa.LE
2) Applicant'(if different from above)
Name A
Address
Phone #
3) Type of facili
_ estdential _commercial _ school
institutional
(Specify)
DEP APPROVED FORM-12/07195
PAGE 2 OF 5
4) Type of existing system system
____privy cesspool(s) y
Other (describe)
Type of soil absorption system (trenches, chambers, pits,etc.)
5) Design flow based on 310 CMR 15.203
a) Design flow of existing system gpd
Approved? __yes approval ate j
no why?
I
b) Design flow of proposed upgraded system �c7gpd
c) Design flow of facility gpd
6) Proposed upgrde of existing system is
a ✓Voluntary
Required by order, letter, etc. (attach copy)
Required following inspection required by 310 CMR 15.301 (provide date(date)
inspection form was submitted to the approving authority) (date)
b) .Describe the proposed upgrade to the system
I. FI;' r?
c) Which of the following are applicable to the proposed upgrade?
fig, Reduction of setback(s) (list setbacks to be reduced with proposed setback distances)
AIA, Percolation rate of 30-60 minutes per.inch (state actual pert rate)
DEP APPROVED FORM•12/07/95
PAGE 3 OF 5
ALL Up to 25% reduction in subsurface disposal area design requirements (state required
& proposed size)
./ Relocation of water supply well (identify well, describe relocation)
t�T I o6 e:w_ grm u j" L
hAI *E 11C CV TW 0E *
k2 COOL-) rWy S`t�ii Er'I Cow,.�ar�t�T
Reduction of required separation between bottom of SAS & high groundwater
(specify proposed reduction & perc rate) 4' 4-v -3 �
Ivol Other requirements of 310 CMR 15.000 that cannot be met (specify sections of the
Code)
System upgrades that cannot be performed in accordance with 310 CMR 15.404 &
15.405, or in full compliance with the requirements of 310-CMR 15.000, require a
variance pursuant to 310 CMR 15.410-15.417.
7) If the proposed upgrade involves.a reduction in the required separation between the bottom
of the soil absorption system-and the.high groundwater elevation, an Approved Soil
Evaluator must determine the.high ground water elevation pursuant to 310 CMR
15.405(1)(i)(1). The evaluator must be a member or agent of the local approving authority:
Distance from soil absorption system to high groundwater
feet
As determined by:
Evaluator's name 6 L.t_ 00 G
Evaluator's signature
Date of evaluation 7 -
DEP APPROVED FORM•1210719S
PAGE 4 OF 5
8) Notice to Abutters
No application for upgrade approval in which the setback from property lines or a
private water supply well is reduced shall be complete until the applicant has
notified all abutters whose property or well is affected by certified mail at least ten
days before the Board of Health meeting at which the upgrade approval will be on
the agenda. Such notice shall include the date, time and place where the upgrade
approval will be discussed.
If the Department is the approving authority, then such notice to abutters must be
completed prior to the date of submission of the application to the Department.
The notices to abutters shall include a copy of the completed application form and
shall reference the standards set forth in 310 CMR 15.402 through 15.405.
List of affected Abutters:
Abutter Name Date notified
Address
Abutter Name Date notified
Address
Abutter Name Date notified
Address
Abutter Name Date notified
Address
9) Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible (each
section must be completed):
a) an upgraded system in full compliance with 310 CMR 15.000 is not feasible:
A O TOCGS Or- -Afr �"°�e�T7 Cos i 77
b) an alternative system approved pursuant to 310 CMR 15.283-15.288 is not feasible:
DEP APPROVED FORM.12107195
PAGE 5 OF 5
c) a shared system is not feasible:
d) connection to a sewer is not feasible:
10) An application for a disposal system construction permit, including all required attachments
(e.g. plans & specifications, site evaluation forms), must accompany this application. Is the
DSCP application attached? _yes_no
11) Certification
"I, the facility owner, certify under penalty of law that this document and all
attachments, to the best of my knowledge and belief, are true, accurate, and
complete. I am aware that there may be significant consequences for submitting
false information, including, but not limited to, penalties or fine and/or
imprisonment for knowing violations."
i
i
i
Facility owner's signature Date
Print Name
Name of preparer Date
Telephone # & address of preparer Dlb�n
NOTE: Title 5, 310 CMR 15.403(4), requires,the system owner or operator to submit to the
Department a copy of the local upgrade approval upon issuance by the Board of Health and prior
to commencement of construction.
DEP APPROVED FORM-12107195
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS LAND SURVEYORS PLANNERS
66 PARK STREET-ANDOVER,MASSACHUSETTS 01810•TEL(978)475-3555,373-5721 - FAX(978)475-1448« E-MAIL,merreng @aol,com
February 8, 1999 _.
r r f
x
Ms. Sandra Starr, R.S.
Health Administrator
.�
27 Charles Street
North Andover, MA 01845
RE: 82 Raleigh Tavern Lane
Dear Ms. Starr:
We are in receipt of your review letter dated February 2, 1999 for the sewage disposal system
upgrade plan for the above referenced site.
Enclosed herewith are three (3) copies of the revised plans. Items 1-4 inclusive have been
addressed and shown on the revised plans. Item 5 is with regard to the side slope being within
5' of a property line. The toe of the proposed fill is within 1' of the right-of-way line of
Raleigh Tavern Lane. There is, however, a 10' (approximate) grass shoulder between the
bottom of slope and the paved way which provides an area twice that required by Title 5 to
dissipate any potential run-off associated with the raised system. Additionally, there is an
existing catch basin down gradient of the slope which will collect any run-off before entering
the roadway or any abutting properties.
In addition to this slope requirement, we are requesting a local upgrade approval to allow the
system to be 3.0' above the estimated seasonal water table. This L.U.A. will help minimize
both the cost of the repair and the adverse aesthetic affects the upgrade will have on the
property.
We appreciate your consideration of these matters and look forward to discussing them in
greater detail with the Board during the meeting on February 24, 1999.
Very truly yours,
MERRIMACK ENGINEERING SERVICES
William Dufresne
Project Manager
cd
Enclosure
cc: Mary&Anton DenBoggende
MEIN IMAC K ENGINEERING ERVIC;E , INC.
PROFESSIONAL ENGINEERS 0 LANG)SURVEYORS 0. PLANNERS
66 PARK STREET-ANDOVER,MASSACHUSETTS 01810•TEL(978)475-3555,373-5721 •EAX(978)475-1448>E-MAIL:merreng@aoi,com
February 18, 1999
B R) e
f
Ms. Sandra Starr, R.S.
Health Administrator
27 Charles Street
North Andover, MA 01845
RE: 82 Raleigh Tavern Lane
Dear Ms. Starr:
We are in receipt of your review letter dated February 2, 1999. for the sewage disposal system
upgrade plan for the above referenced site.
Enclosed herewith are three (3) copies of the revised plans. Items 1-4 inclusive have been
addressed and shown on the revised plans. Item 5 is with regard to the side slope being within
5' of a property line. The toe of the proposed fill is within 1' of the right-of-way line of
Raleigh Tavern Lane. There is, however, a 10' (approximate) grass shoulder between the
bottom of slope and the paved way which provides an area twice that required by Title 5 to
dissipate any potential run-off associated with the raised system. Additionally, there is an
existing catch basin down gradient of the slope which will collect any run-off before entering
the roadway or any abutting properties.
In addition to this, we are requesting a variance from your regulations to allow the following:
• The S.A.S, to be 80' from wetlands (100' required).
• Side slopes to be 10' and 20 ML Geomembrane (15' is required).
• Geomembrane (concrete is required).
• Local upgrade allowing the S.A.S, to be 3' from the E.S.W.T.
These variances and upgrades will help maximize environmental protection while minimizing
the cost and adverse aesthetic impacts on the property.
Ms. Sandra Starr, R.S.
February 18, 1999
Page 2
We appreciate your consideration of these matters and look forward to discussing them in
greater detail with the Board at their February Meeting.
Very truly yours,
MERRIMACK ENGINEERING SERVICES
William Dufresne
Project Manager
cd
Enclosure
cc: Mary & Anton DenBoggende
MERRIMACK ENGINEERING SERVICES,INC. 4 66 PARK STREET a ANDOVER,MASSACHUSETTS 01810
SEPTIC PLAN SUBMITTAL FORM
LOCATION:
NEW PLANS: YES $125.00/Plan
REVISED PLANS: YES $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: YES NO
DATE: --V/ 7Z�
DESIGN ENGINEER:
ti
DATE TO CONSULTANT:
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
When the submission is all in place, route to the Health Secretary.
Town of North Andover, Massachusetts F°'"' °•2
e a°R*ti BOARD OF HEALTH
19 V
p
DESIGN APPROVAL FOR
SSA�HUS SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
A licant P"-)HPZ� /9N Goa) d&i, 3, 6C��-k,-)1 ;
pp � �_ Test NO.
Site Location ZI?A-6
Reference Plans and Specs. /m ne-k- D0,c;ec5 U,6
ENGINEER DESIGN DA E
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 HEATH
Fee s Site System Permit No. /c>G
Town of ort Andover *
4 {,
OFFICE OF '6 °G
CO MMUNITY DEVELOPMENT AND SERVICES 4 ;.
u »
27 Charles Street `
M' a4q 4
•n, Y�y^y
North Andover, Massachusetts 01845 �` �S�j�
WILLIAM J. SCO'I"I'
Director
(978) 688-0531 Fax (978) 688-9542
March 10, 1999
Anton& Mary DenBoggende
82 Raleigh Tavern Lane
North Andover, MA 01.845
RE: 82 Raleigh Tavelxl Lane—variances
Dear Mr. & Mrs. Den.Boggende:
This is to inform you that at their meeting of March 9, 1999, the North Andover Board of
Health granted variances to sections 5.02 and 9.02 of the Town of North Andover Minima n
Requirements for the Subsurface Disposal of Sanitary Sewage to permit the installation of a leach
area 80' from wetlands, and to permit a Geomembrane to be installed instead of a concrete wall.
In addition, under local upgrade approvals (3 10 CMR 15,405), the Board ofHealtll approved a
waiver request to allow the side slope to be adjusted to 1.0' with a geomembrane installation, and
granted the request for the system to be 3 feet to groundwater instead of feet.
Please note that with the latter variance, depth to groundwater, there can be no increase of
flow to the system, nor can there be an increase in the square footage of the building. In.addition,
these variances are granted with the requirement that within 6 months the existing toilets in the
house that are not low-flush toilets be replaced with 1.6 gallon toilets. Please notify the Board of
Health for an inspection when they have been replaced.
If you have any questions, feel free to call the Health Office at the number below.
Sincerely,
Sandra Stan", R.S.
Health Administrator
Cc: W. Dufresne
File
BOARD OF APPEALS 698-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: CURRENT INSTALLER'S LICENSE#
LOCATION:
LICENSED
SIGNATURE: TELEPHONEM
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
$75.00 Fee Attached? Yes No
Foundation As-Built? Yes No
Floor Plans? Yes No
Approval Date:�
-4/4
Town of North Andover, Massachusetts Form No. 3
BOARD OF HEALTH
t NORTH 1 \
° `` " 19 � f
�.rL
o A
* 7 DISPOSAL WORKS CONSTRUCTION PERMIT
�4SSACHUS��5
Applicant
NAME ADDRESS TELEPHONE
Site Locations— l ,1 ;
: Permission is hereby granted to Construct ( ) or Repair ( an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. JC'�
CHAIRMAN, BOARD OF HEALTH
Fee ,_ D.W.C. No. L
Town of North Andover 01 T
i�eo
OM- CE OF y4, ,,,�00�
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
WILLIAM J. SCOTT SACwuse
Director
(978)688-9531 Fax (978) 688-9542
March 29, 1999
Maly DenBoggende
92 Raleigh Tavern Lane
North Andover, MA 01345
RE: sprinkling system
Dear Mrs. Den.Boggende:
This letter comes in response to your questions of whether a sprinkler system can be
installed oil your septic system leach area. Although we often observe during field work on failed
septic systems that a number of homeowners do install sprinkler systems over their leach areas,
we strongly recommend against this practice. The sprinkler system over the leach area could
introduce a significant amount of excess water into your septic system. This could result in a
system failure. For this reason the Board of Health opposes the installation of sprinkler systems
over leach areas.
Sincerely,
Sandra Starr, R.S.
Health Administrator
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEAL'rII 68$--9540 PLANNING 6188-9535
Town of North Andover NoRTa
OFFICE OF =Ott e o ti0 L
COMMUNITY E LOP ENT AND SERVICES p
27 Charles Street o $
North Andover,Massachusetts 01845 '�9ssACFHUS��Ry
WILLIAM J. SCOTT
Director
(978)688-9531 Fax(978)688-9542
October 8, 1999
Anton&Mary DenBonggende
82 Raleigh Tavern Lane
North Andover, MA 01845
RE: low-flush toilets
Dear Mr. And,Mrs. DenBonggende:
This correspondence is in regards to the recent repair of your septic system at 82 Raleigh
Tavern Lane. As you may recall, the Board of Health members voted to grant variances
to the regulations for the construction of your system with the additional requirement of
the installation of low-flush toilets within six months. I have attached a copy of the
original letter for your convenience.
To date, we have not had a request for an inspection of your premises. A final letter of
compliance can not be issued until this requirement is met. Please contact this office as
soon as possible so that we may discuss this issue. Thank you for your cooperation in this
matter.
Sincerely,
usan Ford f
Health Inspector
cc: file
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Town of North Andover, Massachusetts Form No.3 .
NORTH
BOARD OF HEALTH
. t 1 � /
o t .o ao .�'//za 1/ ._19
• H A
DISPOSAL WORKS CONSTRUCTION PERMIT
• SACHUSE
Applicant
NAME ADDRESS �` TELEPHONE
Site Location 2 �—1 �'
i-
Permission is hereby granted to Construct ( ) or Repair ( an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval'S.S. No.
g p Y y4
CHAIRMAN, BOARD OF HEALTH
L
Fee 7J D.W.C. No.
,.
,.3ul --2 -9 08:20A Paul D. "T'urbide, FEE/PL 508-465-0313 P.02
CHECKLIST FOR NORTH ANDOVER
SEPTIC SYSTEM PLANS
The ibilowing is a checklist that incorporates all Title 5 and local regulations for septic plans
'dame of Applicant t`�rr�,J k VIALf,� EName of Designer Ff Et�•�(27, (20���I��
Plan Date Ail-1- --q 21� Revision Date. Date of Review
Property address LE J&W - L )J,&Q. flap: ® Lot. J D�
BOH Rev;ewer Type of Plan(new or upgrade): ULKrV,=
Number of Bedrooms in Assessor' s Records: gpd)Garbage Disposal .-,flowed W
General Information: N A. =North Andover Septic Regulations Other numbers rel"er to T"ile
OK, Problem N/A
Street number and map/lot-220(4)(u)
Maximum scale of 1 "-40' for plot plan-220(4)
Maximum scale of t "=20'for profile and component details -220(4)
Legal boundaries of the facility being served -220(4)(a)
Names of abutters from recent tax map- NA 8.02j V
Number of bedrooms,design calcs., -NA 8.021 , Pi
Name& address of record owner&applicant - NA 3 02k
,j dame& address of designer-NA 8 021
T- - Holder and location of all easements- 220(4)(b)
Date plan drawn& any revision date - NA 3.02m
All dwellings and buildings, existing and proposed-220(4)(c)
;/, Location of all existing or proposed impervious areas-220(4)(d)
All distances on site plan-NA 8,03a-c
Elevation of proposed driveway-NA 8"02t
Location and elevation of foundation drain - NA 8 02y
Locadon and dimensions of the system Incl. reserve(new const ) sa0(t1te;
Limits of excavation of leach area on site plan - NA 8 02z
Locus plan-220(4)(t)
North arrow-220(4)(g)
�_ Existing and proposed contours-220(4)(g)
Locations and logs of deep holes 220(4)(h)
Locations and logs of percolation tests - 220(4)(i)
T
Date(s)of soil testing-220(4)(h)&(i)
Existing grade elevation of each deep hole-220(4)(h)
,f Elevation of percolation tests--N.A. 8.02n
Name o(approving authority representative-22U(4)(h)&(i)
Name of soil evaluator-220(4)0)
Soil logs and perc test logs match BOH records
f � Locations of waterlines,drains, and subsurface utilities- 2?o(4)(mJ
Observed and adjusted g"w, elevation in the vicinity ofthe system - 2^-1)(-,11n)
IT Complete profile of the system to scale-220(4)(o),NA 8 02c
Cross section of leaching facility -NA 8 02w
Location ofbenchmark(s)within 50.75 feet of facility • '_201;)(gl
dote listing all valiance requests with proper citations - 22-W-1)(PI
Luna/upgrade approval request/form.vibinmeJ, - 40317,
J�-- Original R.S lP E. stamp, signature& date- 220(1) & (2,
Jul-22-98 O8r21A Paul D. Turbide, PE/PLS 508-465-0313 P.O3
I/ sfc. supplies(w/in 400'), pub. wells(w/in 250'), pvt. wells(wiin 15D,@) • 220(4)(
Locarion of watercourses, wetlands,wells,etc. w/in 150'of system-NA 8 02r
Weiland disclaimer-NA 8 02s
—� ✓ Land surveyor plan reference required(property line setbacks)- 220(3)
Plan contains designer's certification statement
./ U-se approvals/standards checked for VA system-DEP docs.,
Perc rate>30M21-not allowed for new, LUA for upgrade-245(l)&('3)
Perc rare> 60 UPI-must use modified right rank or I A technology-245('a)
Proposed system qualifies as"shared" system-002(definitions)
Flow is over 2,000,pd-No R.S. allowed -220(1)
Design now was set in accordance with code-203
Existing system location and note on proper abandonment - 600 3 1 (n, 354
Leaching facility at least V above Base Flood elevation-NA 9 0;
B piping Sch 40 minimum -NA 10.01
Basement floor minimum 1' above groundwater elevation-NA 5 04
01j-site Soil tend Groundwater Review
OK Problem NSA
_ Proper deep observation hole logs on plan-220(4)(h)
Soil evaluation forms submitted within 60 days of field work-0 l 8(2)
Proper percolation test log• 220(4)(i)
Ample deep observation holes in primary disposal area(minimum 21) l0?t?;
7f ,ample deep observation holes in secondary disposal area(minimum ?) :0?(
Ample perc testing(one in each disposal area,3 in prim.> 2,000 gpd)- 104(4)
Hole Identification Numbers:
ground elevation e!
acceptable ieil el
Leach facility inven el
ground water el
refusal el
bonorn orleach iacil.ty el
rhtcknuss oracceptable soil
betbre&after soil R&R
separation to groundwater
separation to rerusal
soil class
perc rate T-
loacing rate —
septic:ank below g- fable (yes or no)
pump tap 'Wwiv w (?Ole _ (yes or no)
1 t in til! _ 2550)
Jul -22-98 08:21A Paul D. Turbide, PE/PLS 508-465-0313 P.04
Setback Distances(Given in feet) 15 21
OK Problem N/A
is the lot in the Lake Cochiewick Watershed') NA b 00& 5 02
Septic Tank Leach Facility
Property line 10 10
Cellar wall 10 20
J (nground pool 10 `6
,J Slab foundation 10 10
Deck on footings, etc 5 10
Waterline 10 10
Private drinking well 75 100
Imgation well 75 100
Wetlands 75 l00
Public well 400 400
Wetlands bordering surface 150 150
water Supply or Crib.
(in Watershed)
/
V Trib 7o Surface Water supply 335 3--25
Reservoirs 400 400
^� Tributaries to reservoirs 200 200
Drams(wat. supply/mb 7 50 t00
Drains(intercept g.w.) 25 50
_ Foundation drains 10 20
Drains(Other) 5 0
Drvwells 20
Downnill slope I S to 1 1 slope
wio bamer
Jul-22-98 08:21A Paul D. Turbide, PE/PLS 508-465-0313 P.05
Building Sewer
OK Problem N"
Grease trap required for certain uses (check 230 for details)
Pipe diameter listed(4"minimum)-222(1)
- Pipe schedule listed- 222(1)
Pipe cast iron or Sch 40 PVC-NA 11.02
_ Watertight joints specified-222(3)&(4)
Pipe laid on compact, fin base•222(5)
Pipe laid on continuous grade in straight line- 111(7)@
Cleanouts precede alt changes in alignment and grade-222(8)
Cleanout provided every 100 feet.222(g)
Manhole at any 90 degree alignment change-222(8)
_ Invert elevation at building:
Invert elevation at septic tank:
Length of run:
Slope: (minimum of 0.01 -0.02 desired) -223(6)
t0' offset to private well or suction line-222(2)
Septic Tank
OK/ Probicm \IA
Tank is accessible- 228(7)
Tank can accommodate both primary&reserve-NA 9.04
200%of flow(required& provided given, 1500 min.)-220(14)(()& 2:3)(1)(a)
2-3" drop from inlet to outlet-227(5)
:`tinimum of 4' liquid depth-223(2)
3"air space above tees/baffles(minimum)-227(4)
Vair space above flow line(minimum)• 227(4)
7 Tees are not to be replaced by baffles-227(1)
Tees extend 6" above flow line-327(1)
Inlet tee extends 10"below now line(minimum)-227(6)
_ Outlet tee extends 14" below now line(more for deeper tanks) - 227(6)
Gas baffle installed on outlet- 227(4)
Recess manhole cover above center of tank&each tee(except 2 compare)
228(2)
3-20" manholes-228(2)
I childproof, 24" riser/manhole to final grade if<1000gpd• 328(3)
Inlet and outlet tees on center line-227(1)
Soil compaction below tank specified(if soil is non-native)-221(2)
6" of<=314"stone beneath tank specified -221(2)&22 8(l)
If> 1,000 gpd AND not a single fam.dwell. must be 2 tks or 2 comp 22i 111br
If plan specifies disposal must be 2 tanks in series or 2 cornpart tank __.(1)(t)
7 Buoyancy talcs. required if tank at or below water table-221(8)
Tank is watertight-221 (1)
9" of cover over tank(minimum)-2280)
_ H- 1 0 loading(min.) -H-20 iftraffic-226(3)
Top of tank<=36" below grade -221(7)
r ,sJI pumping to tank (if applies)in accordance with -229
_ Tank is set to keep old system in service during install if possible
_CiVltt tl[Ik iCheck here it not present-
Jul-22-98 08:22A Paul D. Turbide, PE/PLS 508-465-0313 P.06
Distribution Box(Check here if not present:
OK �'roblem NIA
�/ Inlet elevation:
Outlet elevation:
0.1 T drop from inlet to outlet(minimum)-232(3)(b)
6" sump(minimum)-232(3)(e)
All outlets at same elevation-232(3)(b)
Outlet pipes laid level for first 2 ft.-232(3)(c)
Pipe -NA 10,01
Number er of f outlets; Number of laterals;
Size of outlets:
Inlet baffleAee min. 1"over outlet invert for all d-boxes- 232(3)(a),
Soil compaction below distribution box specified(if soil is non-native) -921(2)
6" of stone beneath distribution box specified-221(2)
Box is watertight-221 (1)
Top of box<=36" below grade-221(7)
Buoyancy calculations required if box is at or below water cable -212 10)
Pump Chamber(Check here if not present:
OK Problem N/A
Volume specified: 220(4)(x)
�+ J Pump on elevation - _220(4)(x)
Pump off elevation: 220(4)(r)
Alarm on elevation: ^, 220(4)(r)
Number of cycles per day-220(4)(r)(also 254(1)(d)if gravity from d-box)
Minimum 2" delivery line to d-box if gravity-254(1)(c)
Pressure dosed Lr. if flow>=2,000 gpd•254(1)(a)&254(2)(a)
/ Cycles per day is consistent with chamber volume-23 1
Volume calculations include Elowback volume• _'} 1(2)
24 hour storage capacity above pump on elevation-231(2)
._ .
Number of pumps: 2 if system serves>2 dwelling units-231(6)
_ Capacity of pump(s)- gpm @ TDH 220(4)(x)
Pump can pass 1 1/4"solids(minimum)-23 1(7)
Pump controls specified -220(4Xr)
alarm equipment specified.231(2)
Alarm is in building and powered on separate circuit from pump - 2') I(9)
Pump sequence correct(off-lead on-lag on-alan-n on)- 231(8)
Pump performance curves included-220(4)(r)
Manual
het al operating switch- N 12.
✓� Check valve,bleeder hole-NA 12.01
.� 1 childproof, 24" riser/manhole to final grade• 2'31(5),
Soil compaction beneath pump chamber specified (if soil is non-mit i.e) - " :(2
_ 6"of<=3!4"stone beneath chmbr.specified - 22 1(2)&2 2_3(1),
Buoyancy calculations if chamber is at or below water table- 221(8kii
9" of cover over chamber(minimum) •228(1)
H- 10 loading(min)-H•20 if traffic-226(')),
Chamber is watertight-221 (I)
—✓ _� i op of chamber<=36" below grade• 221(7)
Jul-22_98 08s22A Paul 0- Turbide, PE/PLS 508-465-0313 P.07
Leachin LFacili[v(general - complete for all designs)
OK Problem NiA/
50%larger if garbage disposal-240(4)
Trenches to be used whenever possible-240(6)
No vehicle access or imperv. area above 11 unless unavoidable- 240(7)
Vented if under impervious cover-241 (1)
Vented through same pipes as distribution system-241 (t)(a)
Vent protected from precipitation/animal entry-241 (1)(b)
Vent is placed beyond traffic or impervious area-24 1 (1)(c)
All lines connected to vent if bed or trenches• 24l(1)(d)
9"cover over peasione-240(9)
Reserve area provided(new construction)-248(1)
Reserve 4' from primary leach area-NA 9.04
(S'if perc rate <=2 MPI)separation to g,w. -212(a)&(b)
4' (down to 2' with variance or I/A-upgrades only)of natural soil under i.t.
G'YV separation is adjusted to highest existing grade if facility cuts into a hil,side
Pipe slope minimum of 0.005 -251(9)
Require 5'removal and replacement if in fill-255(5)
Top of leach facility<=36"below grade-221(7)
J Final grade over It minimum 0.02 ft/ft-240(1 0)
Surface& subsurface drainage away from U. -2400 1)& 245(5)
3/8"-5/8"orifices specified(gravity system)-25 10)
Minimum design flow 440;pd without deed restriction-NA 13.01
3:1 slope where grading required -255(2)
Tot of fill slope stops 5'from property line or swale installed -255(2)
/ Impermeable barrier if<3:1 slope or< 15 feet to-3:lslope-255(2)
Impermeable barrier/retaining wall poured concrete-yA 9.02
Retaining wall stamped by P.E.-255(2)(b)
Top of retaining wall >=top of peastone elevation- 255(2)(f)
10'offset from edge of leach facility to edge of ret.wall - 255(2)(g)
_ Perc tests)done in most restrictive layer- 104(2)
Perc test 4' below leaching elevation -NA 7.06
_ Design flow listed and required/provided leach area given - 230(4)(t)
Leach pipes SCH40 PVC-NA 10.01 j
Leach pipes minimum 4"diameter except for dosed system-NA 14.04
Leach lines capped,vented, or connected together-251(9)
Pressure dosing guidance followed if pressure distribution- 254(2)(c ),
—� Pressure dosing required over 2,000 gpd or with I/A remedial use-231(i)
1 ,eacbino Trenches(Check here ifnot present' )
OK Problem NiA
Number of trenches:
` Minimum of 2 trenches-NA 9.01(2)
Depth of trenches(max eff.2'): -247(l)
Width of trenches(2' min.,4'max.): -251 (10)
r� Length of trenches(100'max.)' 25 1 (1)(3)
Trenches are vented(when> 50')-251 (11)
` Trenches follow contour lines- 251(2)
Trench spacing 3 times effective width or depth -251 (1)(d)
In till or reserve between trenches, 10' min. -NA 14.01& 14.03
Available leach area given(Arfin. 500 s.f)-NA 9 0 I(2)
Jul -22-98 08:24A Paul D. Turbide, PE/PLS 508-4.65-0313 P.08
Bottom =L x W X#_ = s.f
Sidewall =L x D x# x 2 = s f
Effective leach area given
Loading factor.
Effective area=total area s,f x LTAR = g/day
Effective area is>=design flow of facility being served
2"of 1/8"- 1/2"2x washed peastone.-247(2)
_ Trench depth of 3/4" to 1 1/2"double washed stone-247(1)
Ledchina Pits(Check here if not present-
OK Problem N/A
#ofpits/pit systems (dosing chamber if>I,231 (1))
Dimensions of each pit or system L W D
Depth of pits (max eff. 2'): - 253(1)(a)
Available leach area given
bottom- L x W x#of systems= s.f.
Sidewall= L x D x#of systems= s.f.
_ Total area=bottom + sidewall s.t'.
Effective leach area given
Loading factor:
Effective area=total area s.f. x LTAR =^_g/day
T Effective area is>=design flow of facility being served
Minimum of 2 pits at least 13'X16'-NA 9.01(3)
Distribution for galleries/chmbrs. in trench contig. - pipe every 20'-253(6)
Distribution for galleries/chmbrs, in bed config.-ea.pipe serves<=40 s f-253(6)
Spacing- 2 times the effective width or depth(the greater) -233(I)(c)
2"of 1/8"- 1 /2° 2x washed peastone.-247(2)
_ 3i4" to 1 1/2"double washed stone-247())
Each pit has at least one 20"access cover. 24"CI to grade over 2,000 gpd
-253(3)
Surrounding aggregate thickness between f'(rein.)and 4'(max.) -253(l)(b)
Vents, if necessary,extend under covers of pit(s)-241 (e)
Leach Fields(Check here if not present: )
0K Problem N/A
Number of fields: (need dosing chamber if> I,231 (1),
Length(100'max.): -252(2)(b)
Width:
_ Total area: L x W s. C,
T Minimum 900 square feet -NA 9.01(1)
Distribution lines connected with solid pipe-NA 15 01
Effective leach area given
Loading factor:
Effective area= total area s.fx LTAR grdat
Effective area is >= design flow of facility being served
Minimum of two distribution lines-252(2)(a)
6'line separation(max,)- 252(2)(d)
4'maximum separation from edge of field to line- 252(2)(e)
10'minimum separation between adjacent leach fields - 252(2)(t)
Between 6" and 12" of 3/4 - 1 1/2" stone beneath field -252(2)(g)& 2-47i_;
��
of 118"-1/2" 2x washed peastone.-247(3)