HomeMy WebLinkAboutCertificate of Compliance - 114 REA STREET 4/26/2007 FORTH..
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PUBLIC HEALTH DEPARTMENT
Community Development Division
E II E OT COMPLIAXCE,
It
rd � 2007
Ot i s is to certify that the disposaf system. received a
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f
John Soucy
Atl�
114 Rea Street
Xorth yndover, 9YA 01845
The Issuance of this certificate shaf not he co-ustrued as a guarantee that the system wiff
fulnctiott satisfactorily.
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Tuhfic`hafth (Director
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townofnoi-thandover.com
µ f •. � l..w TOWN OF NORTH ANDOVER
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Office of COMMUNITY DEVELOPMENT AND SERVICES
DO 14 2006
HEALTH DEPARTMENT
/ 420 4ft OSGOOD STREET
NORTH ANDOVER, MASSACHUSETTS 01845
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�u: �:h � . � �I��ENc . . 978.68$.9540-Phone
Susan Y.Sawyer,REHS/RS 978.688.8476-FAX
Public Health Director E-MAIL: healthdept@townofnorthandover.corn
WEBSITE:hLtp://www.townofilorthandover.com
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM: ® INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System ( ) constructed; (c)-it"paired;
by
(Print Name)
S'located at I Q f �C�. oc)b lid-c,°�
(Installation Address)
was installed in conformance with the North Andover Board of Health approved plan, originally
dated w t& )�_, ?X End last Revised on ', � (�(,� , with a design flow of
17
r` 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: IZ-7-()( _
E, gineer Representative(Signature)
And-Print Name
Final inspection date: / I t- , ,- cD ,02
Engineer Representa6e(Signature)
And-Print Name
r
Installer: f ctv —(Signature) Date: L t
And Print a
Al IJ
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Engineer: _ (Signature) Date: 11.2-1, (, _
And Flame
AS-BUILT CHECKLIST
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LOT NUMBER, STREET NAME
°w..."... ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
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
r TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM
m.
LOCATION OF WATER, GAS,ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK &D-BOX
ORIGINAL STAMP & SIGNATURE
r IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
LOCATION &ELEVATIONS OF BENCHMARK USED
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ONIT°E WASTEWATER SYSTEM CONSTRUCTION NOTES
LOCATION INFORMATION
ADDRESS: 114 Rea Street MAP: 98A LOT: 8
INSTALLER: John Soucy
DESIGNER: NE Engineering
PLAN DATE:6/18/06
BON APPROVAL DATE ON PLAN: 10/25/06
INSPECTIONS
TANK INSPECTION:
DATE OF BED BOTTOM INSPECTION: 11/8/06 S. Sawyer
DATE OF FINAL CONSTRUCTION INSPECTION: 12/1/06
DATE OF FINAL GRADE INSPECTION: (;6Tt�pa j
SITE CONDITIONS
Existing septic tank properly abandoned
Internal plumbing all to one building sewer
Z Topography not appreciably altered
Comments:
SEPTIC TANK
❑ Bottom of tank hole has 6" stone base
® Weep hole plugged
Tank has been installed
® 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
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24" inch cover to within 6" of final grade installed over
one access port, must be over nutlet of tank if effluent
filter is present
Hydraulic cement around inlet & outlet
Comments: 2100 gallon "Clear Solution" tank Model 250 ST3. 12/1/06 Did not see
bottom of hole, installer told to move forward hole caving in.
PUMP CHAMBER
❑ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
® Combo Tank installed
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
Z 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:
SOIL ABSORPTION SYSTEM (General)
® 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)
❑ Final cover as per plan
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Comments: Retaining wall not yet built. Squirt test results showed 14"A 8" squirt height.
This is typically less than the recommended pressure suggested for keeping orifices
clean. May need more than typical maintenance of the pressure distribution system.
12/1/06
IL ABSORPTION SYSTEM (Gravel-less Chambers)
®
Brand and Model of Chamber Infiltrator Quick 4
® dumber of chambers per row 8
® Number of rows (trenches) 4
❑ Laterals installed and ends connected to header (and
vented if impervious material above)
® Elevations of laterals and chambers installed as on
approved plan
Comments:
CANT QL PAN L
® Alarm & Pump are on separate circuits
® Alarm sounds when float is tripped
Location of control panel in garage
❑ Rated for exterior if placed outside
Alarm signal located inside
Comments:
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SYSTEM ELEVATIONS
INVERT IN FIELD PLAN INVERT ELEV.
Benchmark 100.00
Building Sewer OUT 101.93 101.92
Septic Tank IN 100.56 101.50
Septic Tank/Pump 100.40 101.25
OUT
Lateral 1 INV 103.65 103.64
Lateral 1 TOP
Lateral 2 INV 103.64 103.64
Lateral 2 TOP
Lateral 3 INV 103.63 103.64
Lateral 3 TOP
Lateral 4 INV 103.64 103.64
Lateral 4 TOP
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CRITICAL SETBACK DISTANPES
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
Cl Bordering Vegetated Wetland ,
Salt Marsh,Inland/Coastal Bank' 75 100
❑ Wetlands bordering surface
water supply or trio. (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)FotLrtdadon 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 IOTA wetland
bylaws
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