Loading...
HomeMy WebLinkAboutCorrespondence - 141 STONECLEAVE ROAD 3/2/2005 Town of North Andover HEALTH DEPARTMENT 27 Charles Street North Andover, MA 01845 978.688.9544 � healthde I&ImVnO northandover:cone R E C E � ? 4 SEPTIC PLAN SUBMITTAL FO �(V O ORI H M4r�r VIIj��:�i� (DATE OF SUBMISSION: V2 SITE LOCATION: 1� I ENGINEER: I C%72,0,lu j6 NEW PL,A NS: YES 5p .00/plan Check 4, cludes,�-4m''-"gyp and one Re-Review Only) REVISED I'IA S: 'YES S 75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: AVES NO LOCAL UPGRADE FORM INCLUDED:_ rYES NO : Lir�7 7' SIFax#: Telephone# E-mail:Ll HOMEOWNER NAME: C ( 1 4 OFFICE i1SE ONLY Olsen the submission is complete(including check): 1. °°°° °Date stamp plans and letter 2. -111' omplete and attach Receipt 3. Copy File;Forward to Consultant 4. Enter on Log Sheet and Database Locction: n owner's Nnm4: &u LLL Map/Parcel: °°°I~ - • I 609 Address: Installer: Telk_kj?_r� New Repair Wedands>, ltd Zone II Soll Symbol SoU Rtme�wy j Soil Qss f- Deep Observation Hole Logs Elevation Depth Soil Horizon Soll Tadure Soil Color Soil Mottling. % Gravel,Stones,etc Z uk>%V-A, ,,x,.k W ra.tJ►� L� �/1.7�t� Parent hiaterial.rt I i t Depth to Badncl`_SuadIag Water in the Hela4�Siieepin=fro ta?U Fan E0GWa t L, FJA 4-4oIvtf-rOIN4Lrp N►� 6 PatetttMaterW- 1 L Depthta8e�lnek°° StuaWt=�faterhttiuHola, tYeepin=[ran?itFaee ��"ES8G1Yt ��i Date Percolation Tests Observation Hole 9 Depth of Pere Start Pre-soil: Time at 12't Time at 9" Time at 6" Time(9"-6')_ ' •Rate Min/Inch Performed BV Witnessed$s� � J Massachusetts Department of Environmental Protection ILL: Bureau of Resource Protection —Wastewater Management Program Form 9A ® Application for Local Upgrade Approval Required by 310 CMR 15.403(1) Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd,where full compliance, as defined in 310 CMR 5.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. ` NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of anew design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of a septic system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: 1. Facility When filling out Name and Address forms on the ��Ll t computer,use only the tab key Name!� !n to move your 1411 1 �N GL��.✓ 1�--CA cu or-do not us?the return Streett�Address �' s? key. F��7 e TL-� f,Q�D 11�F7i ���7�' _r J City State Zip Code �Q 2. Owner Name and Address: o f`` 6 Na a e � Street Address R� PAN City `�� Zip © } Telephone Number 3. Type of Facility(check all that apply): 2/Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: �► L �-I &O l n cofz 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) Conventional ❑ Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): .�I e >� t5form9a•rev.5/02 Application for Local Upgrade Approval*Page 1 of 4 lY Massachusetts Department of Environmental Protection Bureau of Resource Protection —Wastewater Management Program I I Form 9 ® Application for Local Upgrade Approval Required by 310 CMR 15.403(1) A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: i Design flow of existing system: gpd Design flow of proposed upgraded system gpd Design flow of facility gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): �oluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: VJtL 3. Local Upgrade Approval is requested for: ❑ Reduction in setback(s)—describe reductions: ❑ Percolation rate for 30 to 60 min./inch: min./inch ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction eduction in separation between the SAS and high groundwater: Separation reduction ft, Percolation rate min./Inch Depth to groundwater ❑ Relocation of water supply well (explain): t5form9a•rev.5/02 Application for Local Upgrade Approval-Page 2 of 4 I I - a Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wastewater Management Program Form 9A ® Application for Local Upgrade Approval Required by 310 CMR 15.403(1) ❑ Other requirements of 310 CMR 15.000 that cannot be met.—describe and specify sections of the Code: 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 groundwater elevation pursuant to 310 CMR 15.405(1)(i)(1). The soil evaluator must be a member or agent of the local approving authority. I High groundwater evaluation determined by: / Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: It 1. .16�1 iu5 L L n 1A 16 d L-W- X44&0 ILLE Ex 6F- FK7-LU �►z�i h�6 _ C � r1Ab(k-0G AN0 t2feA ►o AG e I55 toE5• 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: /�,M. 3. A shared system is not feasible: /;t[,4 , 4, Connection to a public sewer is not feasible: I t5form9a•rev.5102 Application for Local upgrade Approval*Page 3 of 4 I Massachusetts Department of Environmental Protection Bureau of Resource Protection —Wastewater Management Program Form 9 ® Application for Local Upgrade Approval Required by 310 CMR 15.403(1) 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit Complete plans and specifications 9/site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. 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 deliberate violations." �Fa/cl Ity Owner's Signetu�, Date Yi7 0 t?�4 � U LU S Print Name Name of Preparer Date r2A YX kks)001/ Preparer's address ci y/Town !"v r�l© q� ) State/ZIP NOTE: 310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Division of Watershed Management, upon issuance by the local approving authority and before,commencement of construction. t5form9a•rev.5/02 Application for Local Upgrade Approval,Page 4 of 4 TOWN OFN011TH A,NI)OVIKIZ 'ES Office of COMNWNYTY DEVELOPMENTAND SERVK 1-1EALT11 DEPARTMENT 400 OSGOOD STREET NOWHI ANDOVI.?11 ., MASSA(tJ (JS F]"I'S 01845 V71i.6W9540 Phone Susati Y. Sawyer, REHYRS 9711 688.9542 --FAX Public Flealth Director F'--MAIL: health( ar le !haodovei%corn .. .......... W F 13 SITL":...h ttp--LNK tciNvtiofiio�-ttiaiiclovet-.coiti .......... ..... March 23, 2005 Anthony Donato, P.E. Merrimack Engineering Services 66 Park Street Andover, MA 01810 Re: Proposed Septic Design for 141 Stoneeleave Road, Map 104B, Lot 136 Dear Mr. Donato: The proposed septic system design plans for the above site dated February 23, 2005 have been reviewed. Unfortunately, the plans cannot be fully reviewed until a proper percolation test has been completed. The test data submitted includes a percolation test from August 1977, which predates current design standards. The town representative, Andy McBrearty, noted that Mr. Dufresne had left the site prior to having a discussion regarding the inability of completing a perc test and proposal for using old test data. Due to the lack of information, the representative took a soil sample, which was provided to the excavator operator. It is not known if the sample is in Mr. Dufresne's possession at this time. Following a review of the old file information for lots on this street, the soil logs on the proposed plan, site information from the town representative and in consideration of the time that has passed since 1977, and this office has determined that an additional pere test must be conducted on this site. It is highly probable that this soil may prove to be other than a 5 min per inch soil. Therefore, according to the North Andover regulation found below, it is requested that you please reschedule a percolation test for this site or provide sieve analysis results from the sample taken by the town representative. North Andover subsurface jKLtent regulation — 7.08 The results of Percolation Tests shall not expire. Percolation Tests should be marked clearly in the field so as to eliminate confusion as to the location of such tests in the event such tests will be used far design at a much later date. The Board of Health representative may require the area previously tested to be reperced if there is some question (is to the results, elevation or location of previous tests. In addition, a quick review indicates this design contains a requested reduction to the groundwater from the bottom of the soil absorption system. In order to avoid problems with this design plan when it is re-submitted,please be advised that this does not achieve the goal of full compliance as sought by Title 5 of the Massachusetts Environmental Code. As stated in section Page 2 March 23, 2005 To:Bill Dufresne, Merrimack Engineering Re: 141 Stonecleave Road 15.405(1) the request for a reduction to groundwater depth should be the last option to be considered in a series of setback or other reductions, and is only to be considered when full compliance cannot be provided. Justification has not been provided that this site cannot achieve full compliance with the design standards in Title 5. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of Andover. Sincerely_ Susan Y. Sawyer Public Health Director Cc: ➢ Homeowner ➢ File North Andover-Septic System Design Plan Review Checklist (Rev.Jan 28, 2004) The following checklist incorporates Title S and local regulations for septic plans. Property Address: i V / Map:/tam a Lot: Name of Applicant: Name of Designer: Plan Date: " Revision Date: z-1 Date received:at BOH �� e� at MRC VC3 MRC Staff Reviewer: Date of Review: Type of Plan: ❑new upgrade Number of Bedrooms in Assessor's Records: Number of Bedrooms in Design:— - - ( gpd) Garbage Disposal Allowed: ey s/no General Information:NA:=North Andover Design Standards Other numbers refer to Title 5 ❑ yes -no Is the lot in the Lake Cochichewick Watershed? NA 6.00(requires Alt.Treatment) OK Problem N/A Street number and map/lot-220(4)(u) Names of abutters from recent tax map—NA 8.02j Name&address of record owner&applicant—NA 8.02k Name&address of designer—NA8.021 p~ ° Date plan drawn&any revision date—NA 8.02m Location and elevation of foundation drain(or note)—NA 8.02y Maximum scale of 1"=20'for profile and component details-220(4) Locus plan-220(4)(t) (Not to scale) Date(s)of soil testing-220(4)(h)&(i) Name of approving authority representative-220(4xh)&(i) Name&esdifiestion numbet of soil evaluator-220(4)(j) Complete profile of the system to scale-220(4xo),NA 8.02c V Cross section of leaching facility—NA 8.02w(Not to scale) 'f a Note listing all variance requests with proper citations-220(4)(p) Local upgrade approval request form submitted&noted on plan-403(1) Original R.SJP.E.stamp,signature&date—220(1)&(2) Surface supplies(w/in 400'),pub wells(w/in 400'),pvt.wells(w/in 100')-220(4)(k) ; Wetland disclaimer(no wetland w/in 100')—NA 8.02s RLS plan reference&certification(if property line setback variance)-220(3) Use approvals/standards checked for I/A system—DEP dots. } System is in Nitrogen Sensitive Area?-215 Loading rate<=440gpd/acm(new construction)-214 Perc rate>30 MPI—check loading rate(differs w&w/o pressure dist)242(1)&(2) -" Perc rate >60 MPI-must use modified tight tank or 11A technology-245(4) Proposed system qualifies as"shared"system—002(definitions) Flow is over 2,000 gpd—No R.S.allowed—220(1) Number of bedrooms with design talcs—NA 8.021 6 Minimum 4 bedroom design without deed restriction—NA 1.05,NA 13.01 Design flow was set in accordance with code—203 Leaching facility at least 1' above Base Flood elevation—NA 9.05 All piping Sch 40 minimum—NA 10.01 Basement floor 1' minimum above groundwater elevation(new const)NA 5.04 Site Plan: Page I North Andover-Septic System Design Plan Review Checklist (Rev.Jan 28, 2004) OK Problem N/A Maximum scale of 1"=40' for plot plan-220(4) Holder and location of all easements-220(4)(b) All dwellings and buildings,existing and proposed-220(4)(c) Location of all existing or proposed impervious areas-220(4)(d) Elevation of proposed driveway—NA 8.02t Legal boundaries of the facility being served-220(4)(a) Location and dimensions of the system(incl.reserve area for new const.)-220(4)(e) All distances on site plan(ST&SAS to dwelling&property lines)—NA 8.03 a-c Limits of excavation of leach area on site plan—NA 8.02z North arrow-220(4)(g) Existing and proposed contours-220(4)(g) _ILL Locations and logs of deep holes-220(4)(h) Locations and logs of percolation tests-220(4)(i) Locations of waterlines,drains,and subsurface utilities-220(4)(m) _ Location of benchmark(s)within 50-75 feet of facility-220(4)(q) Location of watercourses or wetlands w/in 150'of system—NA 8.02r Existing system location and note on proper abandonment—354 Setback Distances(given in feet) 15.211 (NA 5.02) OK Problem N/A Septic Tank Leach Facility Sewer Property line 10 10 -- - Cellar wall 10 20 -- a - Inground pool 10 20 -- U...- Slab foundation 10 10 Deck,on footings,etc 5 i0 -- nom'° Waterline 10 10 10� Private drinking we112 7538 1003 50 ... Irrigation well 7540 100 2-S Surface Water 25 50 _.., Bordering Vegetated Wetland , Saft Marsh,Inland/Coastal Bank' 7523 10039 Wetlands bordering surface water Supply or trib.(in Watershed) 15023 15038 Trib to Surface Water supply 325 298 325 X08 Public well 400 400 Interim Wellhead Prot.Area not>440 g/ac/d(new const.only— 15.214) Reservoirs 400 400 Drains(wat.supply/trib.) 50 100 Drains(intercept g.w.) 25 50 Drains(Other)Foundation 10(5) 20(10) Drywells 2040 25 Downhill slope or barrier wall -- 15' to 3:1 slope w/o barrier Suction line 222(2) 'New constriction allowed up to 440 gallons/day/acre when on a private well pursuant to 15.214(2). 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 4 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 Page 2 i North Andover-Septic System Design Plan Review Checklist (Rev. Jan 28, 2004) Local Upgrade AQproval Hierareby: fill Note that the goal jar a septic system design is FULL compliance wherever feasible as sel forth in 310 CMR 15.404(1). Where compliance is not possible,allowed to reduce setback to following(405)w/o abutter notification unless properry line or neighboring private water supply setback(with "a"the first preference,and'T'being LAST preference:) a) property line but not w/in 10'of another SAS-need survey if w/in 5' b) cellar wall,pool,or slab c) Place leach area in soil between 30 and 60 MPl(n.a.if filed after 1/1//04) d) Up to 25%reduction in size of SAS e) Relocate private well if septic system failed because of this criteria f) Setbacks to BVW's g) Setbacks to surface waters,salt marsh,inland and coastal banks,vend pools,leaching CH's,dry wells,or surface or subsurface drains not leading to water supplies h) Setback to water lines,private wells(not<501),water supplies and tribs.and drains leading to the same(not<100') i) Reduce required separation to g w.(BON must set GW,3 or 4'only(depending on pert rate),<2000 gpd flow,no increase in flow or square footage,no reduction to SAS size,setbacks to wells,BVW's,wetlands,sfc.waters,salt marsh,coastal bank,vernal pool, water line,wader supplies or tribsJdrains). Building Sewer OK Problem N/A Grease trap required for certain uses(check 230 for details) _ Pipe diameter listed(4"minimum)-222(1) Pipe schedule listed-222(3) �.. Pipe cast iron or Sch 40 PVC—NA 11.02 F Watertight joints specified-222(3)&(4),NA 11.02 Pipe laid on compact,firm base-222(5) V° Pipe laid on continuous grade in straight line-222(7) Cleanouts precede all changes in alignment and grade-222(8) Cleanout provided every 100 feet—222(8) Manhole at any 90 degree alignment change—222(8) =- ' Invert elevation at building: Invert elevation at septic tank: i Length of run: 4 'a- — Slope: (minimum of 0.01 -0.02 desired)-222(6) Page 3 North Andover-Septic System Design Plan Review Checklist (Rev.Jan 2$, 2004) No tank allowed in a velocity zone or on a coastal beach, barrier beach dune, or in a regulated floodway(213) ggggtsc Tsok: septic tank below g,w.table '10-yes ❑no 0 assumed OK Problem NIA r Tank is accessible-228(3) 223(lxa) 200%of flow(required&provided given, 1500 min.)-220(4)(f)&, 2 11(min)-3"(max)drop from inlet to outlet-227(5) Minimum of 4' liquid depth-223(2) 3"air space above tees/baffles(minimum)-227(4) 9"air space above flow line(minimum)-227(4) V Tees are not to be replaced by baffles-227(1) Tees extend 6"above flow line-227(1) Inlet tee extends 10"below flow line(minimum)-227(6) Outlet tee extends 14"below flow line(more for deeper tanks)-227(6) Gas baffle installed on outlet-227(4) Effluent filter Brand and model approved by DEP Filter type/name noted on manhole covers. Riser placed over filter Filter maintenance schedule specified Access manhole cover above center of tank&each tee(except 2 compact)-228(2) 1y1, 3-20"manholes-228(2) 1 Childproof 20"riser/manhole Win 6"of final grade if<1000gpd-228(2) 2 childproof 20"risers over inlet&outlet tees Win 6"of final grade if>1000gpd-228(2) Inlet and outlet tees on center line-227(1) Soil compaction below tank specified(if soil is non-native)-221(2) 6"of<--I%"stone beneath tank specified-221(2)&228(1) —y lf> 1,000 gpd AND not a single fam.dwell.must be 2 tks or 2 comp.—223(1)(b) If plan specifies disposal must be 2 tanks in series or 2 compart.tank-223(l)(c) R- Buoyancy calcs.required if tank at or below water table-221(8) - Notation as to tank watertightness—221(1) 9"of cover over tank(minimum)-228(1) Top of tank<=36"below grade-221(7) H-10 loading(min.)-H-20 if traffic-226(3) All pumping to tank(if applies)in accordance with—229 No tight tank allowed in a velocity zone or on a coastal beach, barrier beach, dune, or in a regulated floodway ",(Check here if not present: )tank below g.w.table ❑yes ❑no ❑assume OK Problem N/A 500%of design flow or 2000 gallons provided—260(2xa) 3-20"manholes-228(2) Soil compaction below tank specified(if soil is non-native)-221(2) 6"of<=I''/z"stone beneath tank specified-221(2)&228(1) Buoyancy talcs,required if tank at or below water table-221(8) Notation,as to tank watertightness—221(1) 9"of eovei,over tank(minimum)-228(1) Top of tank<1 63,6"below grade-221(7) H.10 loading .:),-H-20 if traffic-226(3) All pumping to tank(ifpplies)in accordance with-229 A/V alarm set at 3/5 tank c4 acity—260(2)(b) Alarm signal to locus manned�4 hours per day if deemed necessary—260(2)(c) Tank is set to keep old system in Rrvice during install if possible Min. 1-24"frame w/cover at finished,grade—260(2xf) Year round access for pumping—260(2)(9) Page 4 North Andover-Septic System Design Plan Review Checklist (Rev.Jan 28, 2004) Odor control provided if required—260(2)(k) Distribution Box(Check here if not present: ) OK Problem N/A Inlet elevation: Outlet elevation: 0.17'drop from inlet to outlet(minimum)-232(3)(b) 6"sump(minimum)-232(3xe) All outlets at same elevation(notation)-232(3)(b) Outlet pipes laid level for fast 2 ft.(notation)-232(3)(c) Inlet baffle/tee mim I"over outlet invert for all d-boxes when pumped or steep slope(>.08)-232(3xa) Soil compaction below distribution box specified(if soil is non-native)-221(2) 6"of<= I '/P stone beneath distribution box specified-221(2) Box is watertight(notation)-221(1) Top of box<=36"below grade-221(7) Puma Chamber(Check here if not present: )pump tank below g.w.table 0 yes 0 no 0 assume OK Problem N/A .,.. Volume specified: 't `-/'o -220(4)(r) a Pump on elevation: / -220(4)(r) Pump off elevation: -220(4)(r) Alarm on elevation: i; 22000 - Number of cycles per day correct(4 doses/day,CL I soil)-220(4)(r),254(1)5 Minimum 2"delivery line to d-box if gravity-254(1)(c) Cycles per day is consistent with chamber volume-231(3) Volume calculations include flowback volume-231(2) 24 hour storage capacity above pump on elevation-231(2) r 2 pumps if system serves>2 dwelling units-231(6) 3 Pump can pass 1 W solids(minimum)-231(7) Pump controls specified-220(4)(r) Alarm equipment specified-23 l(2) Alarm is in building and powered on separate circuit from pump-231(9) Pump sequence correct(off-lead on-lag on-alarm on)-231(8) Pump performance curves included-220(4)(r) Pump can provide flow needed against calculated head-220(4)(r) -' Manual operating switch—NA 12.01 Check valve,bleeder hole—NA 12.01 1 childproof,24"riser/manhole to w/in 6"of final grade-231(5) Soil compaction beneath pump chamber specified(if soil is non-native)-221(2) 6"of<—I%"(114"in N.A spec)stone beneath chamber.specified-221(2)&228(1) r Buoyancy calculations if chamber is at or below water table-221(8) Chamber is watertight(notation)-221(1) 9"of cover over chamber(minimum)-228(l) 771" Top of chamber<=36"below grade-221(7) 11-10 loading(min.)-H-20 if traffic(notation)-226(3) s Encourage more than I cycle per day. Page 5 North Andover-Septic System Design Plan Review Checklist (Rev. Jan 28, 2004) O■-site Soil sad Groundwater eview OK Problem N/A �,- Proper deep observation hole logs on plan-220(4)(h) Deep hole testing conducted within two years—NA 7.05 All deep holes and peecs shown,including aborted tests—NA 8.02n ,;. Soil evaluation forms I 1&12 submitted within 60 days of field work-018(2) Existing grade elevation of each deep hole-220(4xh) Elevation of percolation tests—NA 8.02n ti . _ Proper percolation test log-220(4)(i) Soil logs and perc test logs match BOH records Ample deep observation holes in primary disposal area(minimum 2)- 102(2) `a Ample deep observation holes in secondary disposal area(minimum 2)-1002(2) Ample perc testing(one in each disposal area,3 in prim.>2,000 gpd)- ( ) perc test(s)done in most restrictive layer- 104(2) Observed and adjusted g.w.elevation in the vicinity of the system-220(4)(n) 1 Bob soil class perc rate loading rate(LTAR)- Leaebin Fac lily Lteneral complete for all designs except tight tanks OK Problem N/A SAS size calcs provided 220(4xf),NA 8.02i 500/6 larger if garbage disposal-240(4) SAS size>°required size Trenches to be used whenever possible 240(6) — No vehicle access or impery area above I.f.—NA 13.02 le assess area above hfi w"dess Unavoidable-440(7) de i ipmie"SeOM 241(t) A Vented through same pipes as distribution system-241(1)(a) Vent protected from precipitatiordanimal entry-241(1)(b) Vent is placed beyond traffic or impervious area-241(1)(c) All lines connected to vent-241(1)(d) 9"cover over peastone-240(9) Reserve area provided(new construction)-248(1) .. GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005-251(9) Excavation extends 6"into natural soil—NA 9.02 y, Fill material specs provided—255(3) Top of leach facility<=36"below grade-221(7) Final grade over l.f.minimum 0.02 ft/ft-240(10) r„y Surface&subsurface drainage away from 11-240(11)&245(5) Grading slopes away from dwelling Leaching Facility(continued) 3/8"-5/8"orifices specified(gravity system)-251(8) Toe of fill slope stops 5'from property line or swale installed-255(2) 3:1 slope where grading required-255(2) Page 6 North Andover-Septic System Design Plan Review Checklist (Rev.Jan 28, 2004) Impermeable barrier if<3:1 slope or<15 feet to 3:1 slope-255(2) Impermeable barr ier/retaining wall poured concrete—NA 9.02 Retaining wall stamped by P.E.-255(2)(b) Top of retaining wall/barrier>=top of peastone elevation(breakout)-255(2)(f) 10'offset from edge of leach facility to edge of ret.wall-255(2)(g) Leach pipes S40-25 1(1} ,NA 10.01 1 Leach pipes minimum 4"diameter-264k7*, NA 14.04 Pressure dosing guidance followed if pressure distribution-254(2)(c) Orifice spacing<5' Dose volume 5x— Iox void volume of leach lines Pump volume includes Dose Vol.+Drainback Vol. Squirt height on plan(min 2.51). Pressure required over 2,000 gpd or with llA remedial use—231(1) Critical design paranmeler calculations ,N,,. Test Pit Numbers: 1 -, elevation at grade ! ` a. top acceptable soil el. b. bottom acceptable soil el. c. naturally occurring soil depth(b-a) ❑yes ❑ no >4' natural soil? 240(1) ❑ if NO,variance(repair&I/A)415(1) a. ground water el. E b. bottom of leach facility el. -r E c. separation to groundwater(b-a) eyes ❑ no >4' (5' in sands)ground water sep?-212(a)&(b) a. top acceptable soil el. b. breakout el. eyes ❑ no 5'overdig required?—255(1) yes ❑ no if"yes"specs for fill provided? Page 7 North Andover-Septic Syslem Design Plan Review ChecIdist (Rev.Jan 28, 2004) Leach Fields(Check here if not present: ) OK Problem N/A Number of fields: Q (need dosing chamber if>1)-231(1)) Length(100' max.): Y n -252(2)(b) Width: Total area:L x W s.f. Minimum 900 square feet(new construction only)NA 9.01(1) Effective leach area given total of s.f. Loading factor. Effective area=total area 9,0 s.f.x LTAR e — s 9/day 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(2xe) Reserve 4' from primary leach area-NA 9.04 10' minimum separation between adjacent leach fields-252(2)(f) Between 6"and 12"of 3/4- 1 1/2"stone beneath field-252(2xg)&247(2) Ends of distribution lines tied together with solid pipe--251(9),NA 15.01 2"of 1/8"-1/2"2x washed peastone-247(2) Lea bieg Treaches(Check here if not present: ) OK Problem N/A Number of trenches: (minimum 2)—NA 9.01(2) Depth of trenches(max eff.2'): ' .247(l) Width of trenches(2'min.,4' max.): ' -251(1)(b) Length of trenches(100' max.): ' -251(1)(a) Minimum 500 square feet(new construction only)NA 9.01(1) Trenches are vented(when>50')-251(11) Trenches follow contour lines-251(2) Trench spacing 3 times effective width or depth-251(1)(d),NA 14.01 Trench spacing>10' if in fill—NA 14.01 Available leach area given Bottom=L x W x # = s.f. Sidewall=L x D x# x2= 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) 3/4"to 1'/Z"double washed stone from bottom of SAS to dist. lines-247(1) Leacbing Pits(Check here if not present: ) OK Problem N/A #of pits/pit systems: (dosing chamber if>1,231(1)) Dimensions of each pit or system:L W D_ Depth of pits(max eff.2')DE: ` -253(I)(a) Available leach area given Bottom=L x W x#of systems= s.f. Page 8 is S stem Design plan Review Checklist (Rev.Jan 28, 2004) North Andover-Sept y x DE x 2 _x#of systems= s.f. Sidewall=L+W = s.f. Total area=bottom +sidewall Effective leach area given Loading factor: s.f.x LTAR = g/day Effective area=total area 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 onfig. pipe every 20'40 s.f.-253(6) Distribution for galleries/chmbrs.in bed c o g p pe Spacing-2 times the effective width or depth(the greater)-253(1)(c) 2"of 1/8"-1/2"2x washed peastone-247(2)9 EDS 700.3.2(J) 3/4"to 1 1/2"double washed stone-247(l) Each pit has at least one 20"access cover,24"Cl to grade over 2,000 gpd 253(3) Surrounding aggregate thickness between 1' (min.)and 4' (max.)-2530)(b) Vents,if necessary,extend under covers of pit(s)-241(e) App ovals ed' Health Department,no LUA Health Department,w/LUA Board of Health,local regulation variance Board of Health,w/LUA Board of Health,Title 5 variance DEP,Title 5 variance DEP,holding tank Notice of Intent forms from Cons.Comm. Other: _Draft maintenance agreement w'thMethod and frequenccytof removal specified—260(2)(d) Location and method of content removal—260(2)(e) Deed Restriction regarding#bedrooms Draft maintenance Agreement(Pressure Distribution delivery to SAS requires this) _Proper License w/class 2 WWTP operator for Advanced treatment Licensed installer or hauler(or above)for simple Press.Dist. _Minimum 2-year term _ Quarterly scheduled maintenance Check pressure distribution if part of design Page 9 1 FORM U - VERIFICATION FORM f' INSTRUCTIONS : This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state lava, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: c' �`� 1 ' Phone LOCATION: Assessor' s Map Number Parcel Subdivision Lot(s) Street St . Number 4 ************************Official Use Only************************ j�- RECOMMENDATIONS� OF TOWN AGENTS : � Date Approved i r Conse`rvat14� Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-I-Tealth Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date i" i. . / 1 r G v I i / L, / I i t t l� '14 { i I i / Cam. 2 c INN r W ELL DATABASE NEL yL71 L. LOCAT 0N: DAT : D EP it OF W—ELL. : . =F-OF WH=L: DF,== b. DUG c UI lKNG _.. QEW �rtLEE �Ii�Cr Rcc"E,. ` r -..._ _ �(,, �.•�'(.^i,.,-k--��,...�,..y,C��r,,,.�.,,,1 �,:`�i"���.4....,,�G�� �r':...-lam .... - - I, 12 � o A.Gv OF W .L.: WE=D R.iI.L.4:;1L - rJEIL PF vff �: W'.= LO.CAZi021: rN L PFR:` DA DEPTr OF 'LT.: T`L L OF rry a.. D LED b. DuG c. Lei ilu`iO7rl i . -_-'.,•-�="fir,. . TY°E OF WA=-R BE.4=\, G ROCK. �rIA'I A2iA.LYS?S DATE: ?G i LA 1 G A. 1ESc: `j UGH L�.0N: Y N OT�� CONTA-HD, (ANTS: Y `+ Town of North Andover Office of the Health Department Community Development and Services Divis 27 Charles Street 4 North Andover,Massachusetts 01845 cau http://www.towiiofnorthandover.com Susan Y.Sawyer,REHS/RS e-mail: healthcle t @toNN7 wtofiiortlia�i ovei <k>I�� P (978)688-9540 Public Health Director F (978) 688-9542 INFORMATI®let REQUEST Health Department Please use this form if the Health Director is unavailable to provide immediate assistance. Please fill out this form in its entirety to ensure an accurate'),and prompt response. All requests', for information will be handled as soon as possible, j % CONTACT INFf)Rl!!IATION '\a Date: n Name. r q Phone number: Fax number: Address: ., INQUIRY -Property in question: (Please include as much information as possible) „ 4 Subject: ' k � � (� p p qy ' t,+"�4� u� �. 1�{ Yry' �fi.f M b c 1„✓/,, "C J"t=y k U• � �E. d � r�,'4,.. � �f�,p..k N h� ''�F' i�q �, ” rtf f 1 { NC @L n 1 e'& j Gr w � Thank you for your interest and inquiry. BOARD OF APPEALS 688-9541 BUILDING 688-9.545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 T'O ✓N OF NORITI ANDOVEM RT Office of COMMUNITY DEM, -,0111VIENT /01) S11"IM(TS HEALTH DEPARI'MENT 400 OSGOOD STR.U. ET NORTH ANDOVER, MASSACHUSETTS 0 1845 Susan Y. Smycr, REVIS/RS 978.688.9,5-TF) -- Plione PUblic Ficall1i Director 978,68)3,9542 .--FAX April 19,2005 Scott and Vonda Paulus 14tStonecleave Road North Andover,MA 01845 Re:Proposed Septic Design for 141 Stonecleave Road,Map 104B,Lot 136 Dear Mr. And Mrs.Paulus: The North Andover Board of Health has completed the review of the septic system design plans,for the above referenced property,submitted on your behalf by Merrimack Engineering Services dated February 23,2005,final revision date of April 11,2005 and received by this office on April 11,2005. The design has been approved for use in the construction of an upgrade onsite septic system. Generally,a new plan approval is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work,and a Certificate of Compliance must be endorsed by the installer,designer and the Town of North Andover. The time period,for which this plan is valid,is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. This approval is subject to the following conditions: 1. The proposed location of the new septic tank and new pump tank must be rive(5)feet from the existing concrete supports that support the porch. This is a requirement of the local regulations. Without adhering to this distance,the integrity of the porch may be in jeopardy. The plan does not indicate the distance. The installer must verify the distance.N any of the supports are within rive feet of the tanks the installer must contact the engineer for appropriate action or alteration to the plan to correct the problem. 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation,the originally issued Disposal System Construction Permit is void,installation shall stop,and the applicant shall reapply for a new Disposal Systems Construction Permit(3 10 CMR 15.020(1)). 3. It is the responsibility of the applicant and/or the applicant's septic system designer,septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission,Zoning Board,Planning Board, Building Inspector,Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements, Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system,which will be in compliance with all regulations and assure protection of public health and the environment of Andover. Sincere � S Sawyer,REHS Public Health Director cc: Anthony Donato,Merrimack Eng. File