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Home My WebLink AboutCertificate of Compliance - 93 RALEIGH TAVERN LANE 10/5/2007 1 o Arm i l + .. cn<rricana u a,� PUBLIC EALT H DEPARTMENT l Community Development Division � `- , As f. cto6er 5, 2007 This is to certify that the individuafsubsurface disposaf system received a S,3T1S1FAC`I0RT1XSITECT10Xof the: Tuffy RepairedrSeptic System �y• Robert Daigle .fit: 93 &Ie' ,gar Tavem Lane . Tarcef 116 North Andover, W3 01845 The Issuance of this certificate shaff not 6e construed as a guarantee that the system wiff function satisfactorify. Susan 7 Sawyer Pu6fic Ifeafth(Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fox 978.688.8476 Web www.townolnorthandover.com TOWN OF NG7""Tq ANDOVER ,�oarW Office of COMMUNITY DEVELOPMENT AND SERVICES Ot` 4E6 °gyp°L HEALTH DEPARTMENT 1600 OSGOOD STREET;Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 CH ACH1190 Susan Y. Sawyer,REHS/RS 978.688.9540 Phone Public Health Director 978.688.8476—FAX ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS:INSTALLER: e g.. MAP: LOT: DESIGNER: ~` PLAN DATE: BOH APPROVAL DATE ON PLAN: 1r/d INSPECTIONS r' " DATE OF BED TANK INSPECTION. ,, 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 to Weep hole p g ❑ 1500 anon . ,�. .... ._ H-10 to adinc ❑ Water tightn (Visual or V< ❑ Inlet tee inst ❑ Outlet tee (g _._._..._.��._. ..�.w_.__�.._�_ . ..� m. . v. centered uni ❑ 24" inch cov r one access it filter is preen ❑ Hydraulic cement around inlet & outlet Wastewater System Documentation—Feb 2006 Page 1 of 6 TOWN OF NOR,�I frl AINDOVER °F ,,ORi„q Office of COMMUNITY DEVELOPMENT AND SERVICES HE, DEPARTMENT 1600 OSGOOD STREET; Building 2-36 NORTH ANDOVER,MASSACHUSETTS 01845 SAC"use Susan Y. Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX D-BOX ❑ 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 SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 %2" 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 FORTH D 16 O t to D SOCNI[M�WKp ^' A04AT/D %VS CHug PUBLIC HEALTH DEPARTMENT Community Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INF RMATION ADDRESS: M , OT: / 4 C INSTALLER: � _., " DESIGNER: ok PLAN DATE: BOH APPROVAL DATE ON PLAN: 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 ❑ 1500 gallon tank has been installed H-10 loading Monolithic construction ❑ Watertightness 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 1 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688,8476 Web www.towoofnorthandover,com i i Of NORTH 9 1% 16 4 NO /- 01. 1' a 07p 11 ' ea" ya/ O'p COCM CK♦WKN 1 T ��SSAC HUS�� PUBLIC HEALTH DEPARTMENT Community Development Division ❑ 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 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: DISTRIBUTION-BOX ❑ 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: 2 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com NORTH 4`110 / 4 69 O COCMK\WKM 1\ ArID CH S ��y PUBLIC HEALTH DEPARTMENT Community Development Division SOIL ABSORPTION SYSTE eneral) Bottom of SAS excavated down to 6 in into C soil �� layer, as provided on plan Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan �� ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/concrete /timber/ block) i ❑ Final cover as per plan Comments: SOIL ABSORPTION SYSTEM (Gravel-less Chambers ❑ Brand and Model of Chamber Infiltrator Quick 4 ❑ Number of chambers per row 9 ❑ Number of rows (trenches) 3 ❑ Laterals installed and ends connected to header (and vented if impervious material above) ❑ Elevations of laterals and chambers installed as on approved 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 ❑ Alarm signal located inside Comments: 3 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofoorthandover.com t%O R TFr ®�44Lt.D I �6461oL O �y n ®yb yy T COCNC IWKM 1 T 440 ��SSACHUS�� PUBLIC HEALTH DEPARTMENT (ommunity Development Division SYSTEM ELEVATIONS INVERT INFIELD PLAN INVERT 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 INV Lateral 1 TOP Lateral 2 INV Lateral 2 TOP Lateral 3 INV Lateral 3 TOP Lateral 4 INV Lateral 4 TOP 4 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com O f^ C'0- oyy {t A COC MIC�WKN`y1` 471 #0F ��SSAC HUS��S PUBLIC HEALTH DEPARTMENT Community Development Division 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 5 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com AS-BUILT CBECKLIST W LOT r rv� NUMBER, STREET NAME � d ti.., ASSESSORS MAP & PARCEL NUMBER LOT LINES &LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE C.. - 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 Cr' 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 F � ��p �� ,�� ^' 1 3 ,��. �... ! r. � �, r: (/ 1,. i �.i /% � � �� / n l r d„ /' m.,wrd ��.m a ! i A.i u ° .oe �, 1 R) I /�� ., �,,�,; ,� ,a,, �� ' i �,, , �r %` �% 1% .�,- // /,,; � �. ��,��, '%, +� W ` �%ri �� ', i�V� lid i n �. � �� ,�. ,, �, ,.,� 3 Z„ FINAL GRADE INSPEC'T'ION 0 Date: Y!" ; Address: cj-' LOAMED? t °SEEDED? t ® COVER PER PLAN? Other: t �Lc �, —�L rf, lj ,J l r; f s ± � c o } i �f y. /I l � c INS J-e-1 ��