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Home My WebLink AboutCertificate of Compliance - 326 FOREST STREET 8/22/2014 s ' • �tiCFLED.1 .• • e PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division COMPLIANCE Installation: 8/22/14 (Final grade inspection on 4/23/15) This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Repair Complete S On-Site Sewage Disposal By: John Butt At: North 326 Forest Street Map 106A Lot 13 v , MA 01845 The I psi'ance of this certificate,fall not be construed as a guarantee that the system will function satisfactorily. Michele Grant Public Health Agent 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com ,pmt tiWS o ( PUBLIC HEALTH DEPARTMENT Community Developmonf Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL. SYSTEM-INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System(/constructed;( )repaired; By: Jai o �Aj (Print Name) Located at: � rU �°0i�' (Installation Address) Was installed in conformance with the North Andover Board of Health approved plan,originally dated t _ and last revised on— with a design flow of 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. Bottom of lied Inspection Date: Pont - Engineer Representative(Signature) f And—Print Name — Final Construction Inspection Date: Engineer Representative(Signature) And—Print Name Installer: 441 (Signature) Date: And—Print Name Enginer: 11 1;4171,04! e l 1 (Signature) Date: And—Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 97 .6 8.9540 Fox 978.688.8476 Web littl)://www.towitofnortliondover.com Blackburn, Lisa From: Isaac Rowe <irowe @millriverconsulting.com> Sent: Friday, August 22, 2014 3:44 PM To: Blackburn, Lisa; Sawyer, Susan Cc: 'Pam Lally'; 'Isaac Rowe' Subject: RE: 326 Forest Street Attachments: 326 Forest St -final inspection form.doc Susan, Attached is the final inspection form for the above referenced property. Everyt[dng looked and all risers/manhole covers were in place. John did a great job and had all components exposed and ready for inspection. I hope he does more work in town. Let me know if you have any questions. Thanks, Isaac M. Rowe, R.S. Project Manager MITI River Consulting 6 Sargent Street Gloucester, MA 01930-2719 Phone: 978-282-0014 exta804 Fax: 978-282-1318 irowe a rrAlriverconsultincl.corn www.milirivercons2lting.com From: Blackburn, Lisa [mai Ito:LBlackb urn()tow[ro_`north nclover.coni] Sent: Thursday, August 21, 2014 10:28 AM To: Dan Ottenheimer; Isaac Rowe; Pam Lally Subject: 326 Forest Street Good Morning, Please contact John Butt„ 978-81.5-3754 for hinal c:onstrucUon inspection at 326 Forest St. Thank you, Lisa Blackburn Health Department Town of North Andover 1600 Osgood Street,Suite 2035 North Andover, MA 01845 Phone 978-688-9540 Fax 978-688-8476 Email llackburn(«)townofno tlandover.corn Web www.TownofNorthAndover.com 1 North Andover Health Department Community Development Division QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 326 Forest St. MAP: 106A LOT: 13 INSTALLER: John Butt DESIGNER: Merrimack Engineering PLAN DATE: 6/25/14 BOH APPROVAL DATE ON PLAN: 7/28/14 INSPECTIONS TANK INSPECTION: 8/11/14 DATE OF BED BOTTOM INSPECTION:8/14/14 DATE OF FINAL CONSTRUCTION INSPECTION: 8/22/14 DATE OF FINAL GRADE INSPECTION: � �r SITE CONDITIONS - Ok'd by B.D. X Contractor reports any changes to design plan X Existing septic tank properly abandoned X Internal plumbing all to one building sewer X Topography not appreciably altered Comments: SEPTIC TANK ® Building sewer in continuous grade, on compacted firm base N/A Cleanouts per plan X 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 (effluent filter) ® 24" inch cover to within finish grade installed over outlet access port ® Neoprene boots around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ® Weep hole plugged ® 1000 gallon Pump Chamber installed ® H-10 loading ® Monolithic tank 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" cover at final grade installed over pump access port ® Water tightness of tank has been achieved by Visual testing ® Neoprene boots around inlet & outlet Comments: CONTROL PANEL ® Alarm & Pump are on separate circuits ® Alarm sounds when float is tripped ® Location of control panel: basement ® Alarm signal located inside: basement Comments: DISTRIBUTION-BOX ® Installed on stable stone base ® H-20 D-Box ® Inlet tee (if pumped or >0.08'/foot) ® Hydraulic cement around inlet & outlets ® Observed even distribution ® Speed levelers provided (not required) ® Schedule 40 PVC Pipe Comments: SOIL ABSORPTION SYSTEM (General) X Bottom of SAS excavated down to C soil layer, as provided on plan X Size of SAS excavated as per plan X Title 5 sand installed, if specified on plan ® 40 Mil HDPE barrier installed ® Laterals installed and ends connected to header (and vented if impervious material above) ® Elevations of laterals and chambers installed as on approved plan N/A Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: 51x48 SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ® Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers Low Profile ❑ Number of chambers per row: 10 ❑ Number of rows (trenches): 4 Comments: Total Chambers = 40 FINAL GRADE R ,r Loamed MY` ','Seeded Cover per plan Comments: DOCUMENTS NEEDED Certification of Installation Form submitted By engineer and signed and dated by Engineer and installer As-Built Plan BM = 100.00 HR = 2.82 HI = 102.82 SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT 5.05 97.42 97.5 Septic Tank IN 5.44 97.03 97.00 Septic Tank OUT 5.69 96.78 96.75 Pump Chamber IN 5.75 96.72 96.70 (2") Pump Chamber OUT 5.62 97.03 ------ (2') Distribution Box IN 3.90 98.75 98.70 Distribution Box OUT 3.90 98.57 98.53 Lateral 1 TOP 4.02 Lateral 1 INVERT 98.45 98.48 Lateral 2 TOP 4.02 Lateral 2 INVERT 98.45 98.48 Lateral 3 TOP 4.01 Lateral 3 INVERT 98.46 98.48 Lateral 4 TOP 4.00 Lateral 4 INVERT 98.47 98.48 Top of Chamber 98.87 98.87 Bottom of Bed/Chamber 4.62 98.20 98.20 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 Tovm of. North Andover — Septic Svstem - AS-BUILT CHECKLIST 1) All changes to the design plan have been reflected on the as-built 2) Is of suitable scale; (one inch = 40 feet or fewer for plot plans and one inch = 20 or fewer for details of system components) 3) Lot number,Street Name,Assessors Map and Parcel Number 4) Lot Lines and Location of Dwellings served by the system 5) Locations,Elevations and Dimensions of system,including reserve (if applicable) 6) Ties to dwelling or Permanent Structure&Wells . a. From Septic Tank& rstribut ion (D) Box �) _ w b. From Leach Area 7) /Ties to Lot Lines from leach area 8) Locations of Deep Holes &Peres 9) Top of Foundation Elevation 10) Locations of Wells,Drains,Watercourses within 150 feet of system 11) Location of water,gas,electric lines,cable 12) Location of Structures within 6 Inches of Finished Grade 13) Original Stamp&Signature 14) Location and holder of any easements which could impact the system 15) Impervious Areas;Driveways,etc 16) North Arrow 17) Location &Elevations of Benchmark used 18) STATEMENT ON PLAN (NA 5.3) a. I cez trfy the elcmtzons, ties, cover maternal;exposed component covers etc,,showy ozr ' this as-built substantially rtgr ee with the approved plan and haiTc deteimined that the hreak out clevations,if applicable,have been met." Signature of Designer Date b. "If a STUCTURAL WALL IS PRESEAT(NA 4.9)a better or statement on the as-built indicating tale wall- was, or was not constructed in accoz dance with the intended desi i and any manufacturer's Speczfzcatiblm" Signature of Designer Date As of:Tuesday,July 30,2013