HomeMy WebLinkAboutCertificate of Compliance - 314 REA STREET 3/25/2002 Tc) �tt of , tl (` 't Atidover �'4ra��
Wfice of the Health De tm".t
t,
..Ott t t n Development ae Street
rvices Division
North Andover, saac csctts i t 1845
mulra Sum `I"elophoale(978) 688-9540
public t fCrcl01 Difector Fax( 78)018-
TOWN Or NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
03/25/02
This is to certify that
the individual subsurface disposal system
constructed () or repaired (X)
by
Mike Reilly
at
311 Rea Street
has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the
North Andover Board of Health regulations,
The Issuance of this certificate shall not be construed as a guarantee that the system will function
satisfactorily.
Arian J. L G e
Board of Health Inspector
k� d4 k1" a?N%/ �'"}:3✓aW, � -? a 13011 C7YN0688-°33,3 CRFALT11698.9540 Pt.ANNI"N t fii-x.533
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The u dersigned hereby certify that the Sewage Disposal System ( ) constructed;
( repaired:
by
located at
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit # , dated with an approved design
flow of gallons per day. The materials used were in conformance with those
specified an the approved plan; the system was installed in accordance with the provisions
of 310 CN4R 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: ,
�
Engineer Representative
Final inspection date:
Engineer Repres ntative
Installer: . Lic.#: Date:
Design Engineer: Date: .
,
of
AS-BUILT C i CKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
INCLUDING-REE-PiVE""
TIES TO haT LINES & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES &PERC
° TESTS
DISPOSAL ELEVATIONS OF <> �
SAL SYSTEM
f ,... TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WITHIN 150' OF SYSTEM
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
_I o o'2- AJ
AS-BUILT CHE CKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATIONS & DIMENSIONS OF SYSTEM,
/ A14.
�✓ 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
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
o_
k d�•yi
i
N&M Job number 1770/
TOWN OF NORTH ANDOVER
INSPECTION CHECKLIST FOR SEPTIC SYSTEMS
Site: Final Date:
Installers i..... Tel:,
Date Yes No Initials
A. Bottom of Bed
1. Excavation to proper depth
2. With trenches,sides of excavation are beneath B horizon
3. Edge of excavation specified distance from foundation, etc.
Comments: (Use back of sheet for diagrams.)
B. Retaining Wall
1. Wall height and Width as specified
2. Waterproofed'
3. Watj mnimum 10'to leaching facility
4. Wall meets specifications of plan
comments:
C. Building Sewer
1. Pipe diameter minimum 4" A,,
2. Schedule 40 pipe
3. Inlet to tank cemented
4. Slope minimum 0.01 or 1/81,per foot minimum
5. Pipe properly set on compact firm base
6. Pipe laid on continuous grade in straight line
7. Cleanouts precede all change in alignment and grade
8. Manholes at any 90'change
9. 10' minimum offset to water line
Comments:
D. Septic Tank
1. Level
2. 1,500 gal minimum
3. Gas baffle present on outlet
4. Manhole to w/in 6"of grade
5. Manholes over center and each tee
6. 3-20"manholes
7. Outlet line cemented
8. 2"--3"drop from inlet to outlet
9. Pipe set
10. Compact base with 6"of/"crushed stone under tank
It. Tank is watertight
--
. Tees 12"off side of tank
N&M Job number 1770/ "
Comments: Date Yes No Initials
E. Pump Chamber
1. If separate from tank,compact,base with 6"of 3/4"stone underneath
2. Minimum 2"pipe to d-,box if gravity system
3. 20"access manhole'
4. Tank level
5. Watertight-, �`"`
6. Tank size agrees with plan specification
7. Manhole to grade
8. y,Check valve and bleeder hole present -
9:' Alarm in building on separate'circuit
' 10. Alarm functions
11. Manual operating switch
12. Pump delivers liquid"to d-box —`
Comments: ;
I
F. Distribution Box
1. D-box level
2. Minimum 0.1 T'(2")drop from inlet to outlet
3. Minimum 6"sump
4. Outlet pipes show equal distribution
5. Compact base with 6"of stone benea#h box
6. Box is watertight
7. All lines cemented with hydraulic cement
8. Schedule 40 pipe
9. First 2' from.box laid level
Comore is
s r
ao-
3.,
G. Soil Absorption system
1. All stone double-washed—3/a"—1
-pea stone
Bucket test done? %/ s,
2. Minimum 2"of pea stone above distribution lines
3. Minimum 6"stone beneath pipe .R--
4. Distribution lines capped or connected together
5. Toe of slope stops minimum 5' from edge of property;
5a. if not, then Swale.
Comments:
N&M Job number 1770/
Date Yes No Initials
H. Leach Trenches
I. Minimum 2 trenches y�
2. Length of trenches agrees plan. (Max. length 1001)
3. Width of trenches a -mss with plan Minimum 2';maximarn'=4'. yY
4. Vent present if> feet or specified
5. Minimum Oi ance between trenches 10'
6. Pipe s e minimum 0.005 or 6"per r�
7. Depth of trenches below outlet invert minimum of 6".
8.--Vi�es set on stable base.
Comments:
I. Leach Field
1. Maximum length of field 100'
2. Pipe slope minimum 0.005 or 6"per 100'
3. Separation between pipes 6'maximum
4. Pipes connected"at end&vent end raised w
5. Separation between adjacent fields 10'minimum
6. Pipes set on stable base
7. Maximum 4' separation from edge of field to first line
8. Minimum two distribution lines
Comments:
�
J. Leaching Pits
1. Minimum inlet pipe 4"
2. Pits of concrete
3. Sidewall between 12"and 48"wide
4. Access manholpsori each pit
5. Pipes cemented with hydraulic cement
6 �
Comments:
K. Final Grade
1. Slope over soil absorption system minimum 0.02
2. All system components covered by at least 9"soil
3. Cover soil free of stones larger than 6"
4. Grading slopes away from dwelling
5. No areas over system that may pond
6. Grading meets 3:1 slope
7. Minimum of 9"of fill graded over system