HomeMy WebLinkAboutCorrespondence - 217 GRAY STREET 8/26/2015 Grant, Michele
To: Iroy @Ijrengineering.com
Subject: RE: Septic system replacement- 217 Gray St., N. Andover
Very Well,
Thank you
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email ID,&rarit@townofnortliandover.corx7
Web www.TownofNorthAndover.com
From: Luke Roy [ni i1tQJ Qg I�r�qL€c rd .coven]
Sent: Wednesday, August 26, 2015 1:58 PM
To: Grant, Michele
Subject: Septic system replacement- 217 Gray St., N. Andover
Hi Michelle,
I spoke with the installation contractor yesterday on 217 Gray Street regarding a field change to layout of the
replacement system. From our discussion he intends to install the pump chamber in somewhat different location than
shown on the approved plan...on the opposite side of the front walkway from where we proposed it. I told him that as
long as he maintained 1%slope in the pipe from the tank to the pump chamber and that the pump chamber is a
minimum of 10ft. from the foundation then I don't have any problem with the change and that we will locate and reflect
the difference on our as-built of the system.
Luke J. Roy, P.E.
OR Engineering, Inc.
234 Park Street
North Reading, MA 01864
978-664-8141
978-664-8142 fax
1
Grant, Michele
From: Sawyer, Susan
Sent: Monday,June 08, 2015 4:17 PM
To: Grant, Michele
Subject: FW: 217 Gray
From: Luke Roy [Malilt(Y.Iro 1@ rrenr ineering.com]
Vent: Monday, November 10, 2014 2:32 PM
To: Sawyer, Susan
Subject: RE: 217 Gray
Hi Susan,
Thanks for the reminder. I will try to pass on to the owner. I haven't had much direct contact with the owner as I was
brought in by the installer they were working with at the time to do the design. I will also pass on and remind about the
certification of notice.
Thanks.
Luke
Luke J. Roy, P.E.
LJR Engineering, Inc.
234 Park Street
North Reading, MA 01864
578-664-8141
578-664-8142 fax
From:Sawyer, Susan [mailto:ssaw _L@ townofnorthandover corms]
Sent: Monday, November 10, 2014 12:00 PM
To: 'Iroy @ljrengineering.com'
Subject: RE: 217 Gray
Good afternoon Luke,
I don't know if your client is planning on installing this year, but this is just a reminder in case you know that they are
planning on it. Our last permit goes out 11/15 and it must be in the ground by Nov. 30. 1 don't believe I have their email,
so if you are aware, please let therm know. I hate to see people miss deadlines,they did not know were there.
Thank you,
Susan
PS did we get the certification of notice? I don't recall off hand.
From: Luke Roy [fflailta�lrrp-) enging rin�.gc?r r]
Sent: Thursday, October 09, 2014 1:48 PM
To: Sawyer, Susan
Subject: RE: 217 Gray
Grant, Michele
From: Luke Roy <lroy @IJrengineering.com>
Sent: Wednesday, June 10, 2015 3:48 PM
To: Grant, Michele
Subject: RE: 217 Gray
Hi Michele,
Thanks for forwarding.
-Would you prefer a revised design plan showing the conventional replacement area?
-1 have a copy of my old infiltrator training card and cert. which I can scan and email
-1 sent the owner the certification form again to try to have it signed.
Luke J. Roy, P.E.
OR Engineering, Inc.
234 Fork Street
North Reading, MA 01864
978-664-8141
978-664-8142 fax
From: Grant, Michele [mailto:MGrant to riofnortliandove:r.corriI
Sent:Tuesday,June 09, 2015 9:25 AM
To: 'Iroy @ljrengineering.com'
Subject: FW: 217 Gray
Good Morning Luke,
Please see the requirements listed below. When you submit the necessary paperwork, I can then issue a permit to the
installer.
Best Regards,
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover,MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgrant(ztownofnorthan dove r,com
Web www.'TownofNorthAndover.coni
1
Grant, Michele
To: James H.Currier
Subject: RE: 217 Gray street North Andover
Hi Karen,
No, we do not.There were some questions about the design that Jay had.
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email 2ML�l.!:t( townofnorthandover.com Web www.Tow�,iofNorthAndover.com
-----Original Message-----
From:James H.Currier [mailt.Q111Lurrler @cornc st.net]
Sent: Monday, March 23, 2015 12:10 PM
To: Grant, Michele
Subject: RE: 217 Gray street North Andover
Hi Michele,
Jay would like to know if you have a list of"vacuum test companies" we can contact.
Thanks,
Karen
J's Septic & Drain
131 Forest Street
MIDDLETON, MA 01949
978-774-6685
-----Original Message-----
From: Grant, Michele [rnai Ito:rY)a tt town of north andover.com]
Sent: Monday, March 23, 2015 11:34 AM
To: 'jhcurrier @comcast.net'
Subject: 217 Gray street North Andover
Good Morning,
1
Attached please find the Approval Letter for 217 Gray st. Also, please put all design questions in writing to our
office.
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St ( Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email mgr nt tc wnofnorthandover.com Web www.TownofNorthAndover.corr7
-----Original Message-----
From:Dgre
S
.jy@tow_rfnortharidover.com [Mai lto:r�c>repl tov_anofi�orthandover.cono]
Sent: Monday, March 23, 2015 11:43 AM
To: Grant, Michele
Subject: Message from "ComDev-Health-Ricoh"
This E-mail was sent from "ComDev-Health-Ricoh" (Aficio MP C3002).
Scan Date: 03.23.2015 11:43:01 (-0400)
Queries to: norep townofnorthandover.com
z
0
0
North Andover Health Department
Community Development Division
October 9, 2014
Paul Miller
217 Gray Street
North Andover, MA 01845
Re: Subsurface Sewage Disposal System Plan for 217 Gray Street, Map107D Lot 112
Dear Mr. Miller:
The proposed wastewater system design plan for the above site dated August 14, 2014 with a
final revision date September 23, 2014 and received on October 2, 2014 has been approved.
The design has been approved for use in the construction of a replacement onsite septic system
for a 4-bedroom(max 9-room) home. This plan is generally good for 3-years from the date of
approval however, as this is for a repair system, this is reduced to 2- years.
The plan received the following local upgrade approval.
1) To allow the use of a sieve analysis in lieu of a pert test
2) The allow the use of a single deep hole test rather than two as required by code. .
During this time, a licensed septic system installer must obtain a permit and complete this work,
and a.Certificate of Compliance be endorsed by the installer, designer and the Town of North
Andover, In the event an imminent health problem, such as sewage backup into the dwelling is
occurring, the North Andover Board of Health may reduce the time period for which this plan is
valid.
Of special note, this system approval allows the use of existing septic sand, which has been sieve
tested by a MA State certified laboratory. With this approval will require an additional inspection
by the
This approval is also subject to the following conditions:
1, Please keep the attached DEP Form 9b for your records (attached)
Page 1 of 3
North Andover Health Department, 1600 Osgood Street, Shute 2035
North Andover, MA 01845 Phone: 978,688.9540 Fax: 978,688.8476
°17 Oray Street October 9, 2014
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.
4. BEFORE a Disposal Works Construction permit is given the below must be
complied with. A letter of acknowledgement must be submitted with the owners
signature.
Since the (Infiltrator Chambers, Cultec Chambers, Eljen) system is proposed as an alternative
soil absorption system the "Standard Conditions for Alternative Soil Absorption Systems with
General Use Certification and/or Approved for Remedial Use" will apply. Please provide the
following as required by the approval conditions
Section II(7):
e) The record drawings, approved by the LAA, must clearly indicate an area for the best feasible
replacement system that could be installed in the event that the proposed Alternative Soil
Absorption System fails or it is determined that it is not capable of providing equivalent
envirom-nental protection;
Section II(18):
a) proof that the Designer has satisfactorily completed any required training by the
Company for the design and installation of the Technology;
C) certification by the Designer that the design conforms to the Approval, any Company
Design Guidance, and 310 CMR 15.000; and
d) a certification, signed by the Owner of record for the property to be served by the
Technology, stating that the property Owner:
i. has been provided a copy of the Title 5 I/A technology Approval, the Owner's Manual,
and the Operation and Maintenance Manual, and the Owner agrees to comply with all terms and
conditions;
ii. for Systems installed under a Remedial Use Approval, the owner agrees to fulfill his
responsibilities to provide written notification of the Approval to any new Owner, as required by
310 CMR 15.287(5);
iii. if the design does not provide for the use of garbage grinders, the restriction is understood
and accepted; and
iv. whether or not covered by a warranty,the System Owner understands the requirement to
repair, replace, modify or take any other action as required by the Department or the LAA, if the
Page 2 of 3
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9510 Fax: 978.688.8476
217 (gray Street October 9, 2014
Department or the LAA determines the System to be failing to protect public health and safety
and the environment, as defined in 310 CMR 15.303.
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
SX1,
. Sr, S/RS
ublic Health Director
Encl. Form 9B
Local Installers List
cc: Luke Roy, LJR Engineering Inc.
File
Page 3 of 3
North Andover Health Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476
Commonwealth of Massachusetts
Town of North Andover
Local Upgrade Approval
Form 9
c
DEP has provided this form for use by local Boards of Health if they choose to do so.
The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided
to the system owner.
A. Facility Information
Important:When
filling out forms 1. Facility Name and Address
on the computer,
use only the tab Paul Miller
key to move your Name
cursor-do not 217 Gray Street
use the return Street Address
key.
North Andover MA 01845
G City/Town State Zip Code
2. Owner Name and Address (if different from above):
Name Street Address
City/Town State
Zip Code Telephone Number
3. Type of Facility(check all that apply):
x Residential ❑ Institutional ❑ Commercial ❑ School
4. Design flow per 310 CMR 15.203: 440
gpd
5. System Designer: Luke Roy Name XPE [:]RS
234 Park Street North Reading MA 01864
Address City/Town State,ZIP
B. Approval
1. Local Upgrade Approval is granted for:
❑ Reduction in setback(s)—specify:
❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction
217 Gray Street Local Upgrade Approval* Page 1 of 2
Commonwealth of Massachusetts
v
Town of North Andover
Local Upgrade r
Form 9
'GSM
B. Approval (continued)
❑ Reduction in separation between the SAS and high groundwater:
Separation reduction ft
Percolation rate min./inch
Depth to groundwater ft
❑ Relocation of water supply well (explain):
❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater
® Use of only one deep hole in proposed disposal area
® Use of a sieve analysis as a substitute for a perc test
List local variances granted not requiring DEP approval per 310 CMR 15.412(4):
List variances granted requiring DEP approval:
North Andover Health Dept
Approving Authority
Susan Sawyer October 7, 2014
Print or Type Name and Title kinatUTe Date
217 Gray Street Local Upgrade Approval* Page 2 of 2
Susan,
in cases of"riew construction" with use of the iniltrator charnbers we have had to show a feasible replacement area for
a co rive ritiona I systern—bUt never done on a replacement design such as this. Not a problern if we have to add,
We haven't been involved in obtaining certification from the Owner as required by the conditions you reference. Do you
know is there a standard form for this oarti�ficetion/ackno\w|edGemen1?
Luke J. Roy, P.E.
L/R Engineering, Inc.
234 Park Street
North Reading, 8&402864
978-664-8141 X
978-664-8242/ox |
/
From: Sawyer, Susan |
�
Sent:Thursday, October O9, IO1413OPK4
/m:
Subject: 217Gray �
Luke,
Sorry about the confusing messages today. I was ready to approve this and then noted that you were using infiltrators.
Did you follow the standards conditions requirements?Specifically the highlights.
Susan
Since the (Infiltrator Chambers, Cu|tecChambem, EUen) system is proposed as an alternative soil absorption system the
"Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for
Remedial Use" will apply. Please provide the following as required by the approval conditions
Section 11/7\:
e)The record drawings, approved by the LAA, must clearly indicate an area for the best feasible replacement system �
that could be installed in the event that the proposed Alternative Soil Absorption System fails or it is determined that it �
|
ia not capable nf providing equivalent environmental protection;
�
Section 11(18):
~Ja\ proof that the Designer has satisfactorily completed any required training by the Company for the design and '
installation of the Technology;
c) certification by the Designer that the design conforms to the Approval, any Company Design Guidance, and 310
CMR15.UUO; and
d) a certification, signed by the Owner of record for the property to be served by the Technology,stating that the
property Owner:
i. has been provided a copy of the Title 5 I/A technology Approval,the Owner's Manual,and the Operation and
Maintenance Manual, and the Owner agrees to comply with all terms and conditions;
ii for Systems installed under a Remedial Use Approval,the owner agrees to fulfill his responsibilities to provide
written notification of the Approval to any new Owner,as required by 310 CMR 15.287(5);
iii. if the design does not provide for the use of garbage grinders,the restriction is understood and accepted; and
whether or not covered m/a warranty,the System Owner understands the requirement no repair, replace, �
Vrtek� anymtherac�|onasne�uiredbyLheDep�rtmentorth� LAA, iftheD�p�rLmentoriheLAAd�t�rmlneath�
modify �
System to be failing to protect public health and safety and the environment,as defined in 310 CIVIR 15.303.
�-.
2
Owner's Certification for 217 Gray Street, North Andover, MA
I,Paul Miller,owner of record of 217 Gray Street,North Andover,MA,hereby certify the following:
L 1 have been provided a copy of the Title 5 I/A technology Approval,the Owner's Manual,and the
Operation and Maintenance Manual,and the agree to comply with all terms and conditions;
ii. I agree to fulfill my responsibilities to provide written notification of the Approval to any new
Owner,as required by 310 CMR 15.287(5);
iii. The design does not provide for the use of garbage grinders,the restriction is understood and
accepted;
iv. Whether or not covered by a warranty,I understand the requirement to repair,replace,modify
or take any other action as required by the Department or the LAA,if the Department or the LAA
determines the System to be failing to protect public health and safety and the environment,as
defined in 310 CMR 15.303.
wledged:
Paul Miller
- a
01v
L/ R
r It a. ncr 7., q
I ,rtsnau.mr avnpkhd the rcquireA t u b proFm f .1
I�fl(t XIOR I:xlwlc eholnbcr sy,tna fnt rv1 s1(a wasl 1 In11�a�/t f I'
t 1�1a11 h1e INFILTR.ITUA°'chv1 h:r rysl�n a>I apple r 71 i; 91
�t I rn f)EI Il ns.al I:ttr f r I.`;EILTR.ITUR druullielA1 hN1 ht tG: ,rl
I 1 t f Ih h-the Ia1e.,t rcvtvion of tl tl C\I I c e1lvnb:r .�11 HILr
'.rtit<11t I:A anA i?su:d 11,5 291h Aay et\larch 20nI.�0°f 7111.$mill,pP13 7hi,
D ' ® cenif-121 .NA Ili?
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SYSTEMS INC R 1r.1I„a11,ea
D Environmental Onsite Wastewater Solutions”
D
Luke Wav
D O'Neill Associates a
D has satisfactorily completed the required training program for the installation of the INFILTRATOR®
leaching chamber system for on-site wastewater disposal applications. You are hereby certified to
D install the INFILTRATORO chamber system as set forth by the Massachusetts DEP approval letter for 4
INFILTRATORO drainfield chambers. All other guidelines as set forth by the latest revision of 310 CMR
D 4
15.00 of Title 5 will apply.This certificate was sealed and issued this 29th day of 911arch, 2004.
Certification No. 11,41144
D Lee Verbridge Q
Atlantic Regional Manager
LJR Engineering, in . �,� L � o o V n
Civil Engineers Land Surveyors IC,-G V MEn G G,3LR�I�I��[.�.��Ll1..0
234 Park Street
North Reading, MA 01664
DAr1_ d !LI JOB)Qq_ 0 J
(976) 664.8141 Fax (978) 664-8142 A V I E1111-IONS xw y e r'
TO RE:N ®rr1�h_�-0d0v (0j p6pj • 2'-17 voL V
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WE ARE SENDING YOU Attached ❑ Under separate cover via the following items:
❑ Shop drawings Mq Prints ❑ flans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order ❑ ---__—.--
COPIES DATE NO. DESCRIPTION
���°°D
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xiwmxuxew�mmwumummwuxxo xwmawwwwwwwomsmwwiwwwwnmrww�mmmmw mmowxmiwuuwmuvm� mwuwmrmuwmwuwwmmsrux�nuxw�wwuwwxwmwwmmuwwuv.®wm�vnWUVUnmrwumwoumvuovu uuevwmwmwmw
ymw�mww��m� t� W
THESE ARE TRANSMITTED as checked below: wryhulwrc')x 4 4ryp tl
f�o approval Ci Approved as subrnitted El k Resubmit --------copies w
'for approval
Lk?'For your use ❑ Approved as noted ❑ Submit---_copies for distribution
❑ As requested ❑ Returned for corrections ❑ Return— corrected prints
❑ For review and comment: ❑ ---------- --_..__...-.....----...........
- -
❑ FOR LIDS DUE _-- -.----...._— ❑ PRINTS RETURNED)AFTER LOAN TO US
REMARKS-
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COPY TO �r
SIGNED:
If enclosures are not as noted,kindly notify us at once.
North Andover Health Department
(ommunity Development Division
September 23, 2014
Luke Roy, P.E.
LJR Engineering, Inc.
234 Park Street
North Reading, MA 01864
Re: Subsurface Sewage Disposal System Plan for 217 Gray Street(Map 107D,Lot 112)
Dear Mr. Roy:
The proposed wastewater system design plan for the above site dated August 14, 2014 and
received on September 2, 2014 has been reviewed. Unfortunately, the plan cannot be approved
until the following items are corrected. The specific section in Title 5: 310 CMR 1.5.000, or
North Andover regulation that is not met by this design follows each item.
/I. Please show any wetland resource areas within 150' of the proposed system or provide a
statement indicating none exist (NA 3.2)
7Please provide a pump performance curve (3 10 CMR 15.220(4)(x)).
3. Please indicate if a weep hole is proposed in the force main within the pump chamber to
allow the effluent to drain back after the pump turns off.
V/4. Please indicate the size and materials of the manhole covers above the septic tank and
/ pump chamber.
u'5. Please specify the required annual maintenance for the effluent filter (3 10 CMR
15.227(7).
6. Please explain how the 82.8% of sand was determined from the sieve analysis of the soil
sample. It is not clear from the sieve analysis report.
Since the existing septic tank and pump chamber are proposed to remain in place, the
health department shall require them to be tested for watertightness. Please explain the
proposed method in order to demonstrate that the existing tanks are watertight.
Page 1 of 2
North Andover I-lcalth Department, 1600 Osgood. Street, Suite 2035,
Norµtli Andover°, MA 01.845 Phone: 978.688.9540 Fax: 978.688.8476
Please feel free to contact the office with any questions you may have. We look forward to
working with you to obtain a wastewater treatment and dispersal system which will be in
compliance with all regulations and assure protection of public health and the environment of
North Andover.
Sincerely, f
Susan Sawyer, RE, S/RS
P bllc Health 1 irec �r
cc: Paul Miller
File
Page 2 of 2
North Andover Health. Department, 1600 Osgood Street, Suite 2035,
North Andover, MA 01 84.5 Phone: 97 .688.9540 lax: 97 .688,8476
e•
TOWN OF NORTH ANDOVER
Office of COMMUNITY D VIi LOPMENT AND SERVICES
HEALTH DEPARTMENT ,
1600 OSGOOD STREET; SMITE 2035
NOWI"II ANllOVER, MASSACHUSt.,'TTS 01.845
978.688.9540 —Phone
Susan Y. Sawyer,Rh;IIS/RS 978.688.8476- FAX
Public Health Director E-MAIL: healthdel2t((i,townofiiortliandovec.eom
WEBSITE: http://www.towrzofnortlhandover.com
SEPTIC PLAN SUBMITTAL FORM � ")
"'T"a U el!
Date of Submission: + H YkNDOVE
C P
I.,
H`A�.°r� o- r
Site Location: -21 -7 6 ✓6L q e.,freef
Engineer: L , o G )'A ��i►�I ��o r�C.
New Plans? Yes J $225/Plan Check# (includes l" submission and one re-
review only)
Revised Plans?Yes $75/Plan Check#
Site Evaluation Forms Included? Yes ,/ No
Local Upgrade Form Included? Yes `°� No
Telephone#: gig "6 6 q — ,� j q I Fax#:
E-mail:_1 10 0 0— ur e v,9 11 o e eno`nl , cok^
Homeowner
Name: 9ct U M 0 le, v,
OFFICE USE ONLY
When the subtnig'on is complete (including check):
Date stamp plans and letter
_ Complete and attach Receipt
Copy File; Forward to Consultant
Enter on Log Sheet and Database
Commonwealth of Massachusetts
City/Town of Koith
Form Application for Local Upgrade Approval
` DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
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
15.404(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 15.415.
NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of
a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved
capacity of an on-site system constructed in accor ode or 310 CMR 15.000.
..
A. Facility Information
Important: LCHE-1311 ""' Vf when filling out 1. Facility Name and Address: F NORVH AN bf�J�V P
forms on the computer,use 0 V (l j'1 tely DEPAI C"r' ENT
only the tab key Name
to move your
cursor-do not p r ess
Street Address
use the return e,,
key, f`'0 4+ 0 trl �11/�iV – (A PV a t �H
- ----- --- -----
f v" City/Town State Zip Code
2. Owner Name and Address (if different from above):
Name — Street Address - —
City/Town State
Zip Code Telephone Number
3. Type of Facility(check all that apply):
d Residential ❑ Institutional ❑ Commercial ❑ School
4, Describe Facility:
5. Type of Existing System:
❑ Privy ❑ Cesspool(s) [ Conventional ❑ Other(describe below):
6. Type of soil absorption system (trenches, chambers, leach field, pits, etc):
t5form9a.doc•rev.7/06 Application for Local Upgrade pp pg Approval* Page 1 of 4
Commonwealth of Massachusetts
City/Town of "dav-t t
Form 9 Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
A. Facility Information (continued)
7. Design Flow per 310 CM 15.203: JJ
Design flow of existing system: gpd Ll �Ll�
Design flow of proposed upgraded system 4 q
gpd
Design flow of facility: gpd L4 L4 0
B. Proposed Upgrade of System
1. Proposed upgrade is(check one):
[ Voluntary ❑ 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:
Go�s�vyc�-I v� o� n6w St4s cf yy vt&Kq
sf-txv,d a-ed rvt. l tf�Lhr cho.m!"s
3. Local Upgrade Approval is requested for(check all that apply):
❑ Reduction in setback(s)—describe reductions:
❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction
❑ Reduction in separation between the SAS and high groundwater:
Separation reduction ft
Percolation rate
min./inch
Depth to groundwater ft.
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 2 of 4
Commonwealth of Massachusetts
City/Town of NoyVk mad Wr
Form 9 - Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
B. Proposed Upgrade of System (continued)
❑ Relocation of water supply well (explain):
❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater
Q Use of only one deep hole in proposed disposal area
[1� Use of a sieve analysis as a substitute for a perc test
❑ 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)(h)(1). The soil evaluator must be a
member or agent of the local approving authority.
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:
>EX i s f f vt A S(k CO vv S l'at-w}—S ® 10 c6c h`" o� �x►s �+;�� s�s�Gy',� ,
P-tj p rOX I w.t'1y fa 6W
2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible:
_ A, s S+ 6,VC1, tsCy.S 6 S 6 &J , b Fhtr VA- 4t/s�S
t,v,ar ,tic1 t,ef red ves �Q ,
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 3 of 4
Commonwealth of Massachusetts
City/Town of Noft+
Form 9A ® Application for Local Upgrade Approval
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use.
C. Explanation (continued)
3. A shared system is not feasible:
N a ab��i--W s un� ✓aG�r 1'�-!Y
4. Connection to a public sewer is not feasible:
00 Sew-,e Y
5. The Application for Local Upgrade Approval must be accompanied by all of the following(check the
appropriate boxes):
[j Application for Disposal System Construction Permit
[� Complete plans and specifications
[� 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."
Su c?Hv (hed 1,t*,v of avI-hm 7atta�
Facility Owner's Signature Date
Print Name
l.y Ke 9.. RD y a 12-1 1 k
Name of Preparer L Date o "
Preparer's address City/Town y
Mn OtMLI —116 ILI
State/ZIP Code Telephone
t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 4 of 4
June 30,2014
To: Town of North Andover
Re: Simard Construction-Septic 217 Gray St.
Please use this letter as authorization for Simard Construction to perform whatever service is necessary
on my property at 217 Gray St. North Andover,including testing, permits and excavation concerning my
septic system. If there are any questions,please call me at 978-697-5203.
a k u,
Paul E. Miller
Spol
Particle Size Distribution Report
o00
100 I
I I 1 I I I 1 I I 1 I I I
I I I I I I I I 1 I I I I
I I I I 1 I I I 1 I I I I
90
I I I I I I I 1 I I I I I
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80
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Z 50
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I 1 I I I 1 I 1 I I I I I 1
W 40
I I I 1 I I 1 I I 1 I I I
I I 1 I I 1 I I I I I I I I
I I I I 1 I I I I I I I 1
30
I 1 I I I I I 1 I 1 I I
I I I I I I I i I I I I I
I I I 1 I I I I I 1 I 1 I I
I I I 1 I I 1 I I I I 1 I 1
20
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10
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0
100 10 1 0.1 0.01 0.001
GRAIN SIZE-mm.
%+3" %Gravel %Sand %Fines
Coarse Fine Coarse Medium Fine Silt Clay
0.0 1 6.2 14.3 8.3 22.7 1 31.3 17.2
SIEVE PERCENT SPEC.` PASS? Material Description
SIZE FINER PERCENT (X=NO) F-M SAND,SOME GRAVEL,LITTLE SILT
1.5" 100.0
P, 96.6
3/4" 93.8
3/8" 86.8 Atterberg Limits
#4 79.5 PL= NP LL= NV P1= NP
#10 71.2 Coefficients
#20 59.8 Dgp= 12.9890 D85= 8.0182 D60= 0.8602
#40 48.5 D50= 0.4608 D30= 0.1777 D15=
#50 41.2 D10= Cu= Cc=
#100 26.8
#200 17.2 Classification
USCS= SM AASHTO= A-1-b
Remarks
(no specification provided)
Source of Sample: ON SITE,EXISTING
Sample Number:926 Date: 8/01/2014
UTS OF MASSACHUSETTS, INC. Client: LJR ENGINEERING,INC.
5 Richardson Lane Project: 217 GRAY STREET,NORTH ANDOVER,MA
Stoneham, MA 02180 Project No: Figure
'>eetfic saha Flo , I
Particle Size Distribution Report
_ o00
100 T-.. -'STATE ENVIRONMENTAL CODE TITLE V SEPTIC SAND GRADATION REQUIREMENTS
I I I I I I I
I I
90
80
70 "
w 80
LL
Z 50
1 I
W
1 J I A
LI 40
IZ I 1 9 a
I 1 I I I I I I I i1 f I I
30
1 I I I I I I I I I 1 f�l I I
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20
10
1 I I I I I I I 1 I f !
O
100 10 1 0.1 0.01 0.001
GRAIN SIZE-mm.
%+311 %Gravel %Sand %Fines
Coarse Fine Coarse Medium Fine Silt Clay
0.0 0.0 0.0 7.1 54.7 34.8 3.4
SIEVE PERCENT SPEC." PASS? Material Description
SIZE FINER PERCENT (X=NO) SEPTIC SAND
#4 100.0 100.0
#10 92.9
#20 71.1 Atterber g Limits
#50 21.1 10.0- 100.0 PL= LL= P1=
#100 6.6 0.0-20.0 Coefficients
#200 3.4 0.0-5.0 D90= 1.6762 D85= 1.3272 D60= 0.6558
D50= 0.5335 D30= 0.3632 D15= 0.2509
D1 0= 0.2000 Cu= 3.28 Cc= 1.01
Classification
USCS= SP AASHTO=
Remarks
100%OF THE MATERIAL PASSED THE 3/4"SIEVE.3.8%
BY WEIGHT OF THE SAMPLE RETAINED ON THE NOA
SIEVE.
STATE ENVIRONMENTAL CODE TITLE V SEPTIC SAND GRADATION REQUIREMENTS
Source of Sample: ON SITE,TITLE V SAND
Sample Number: 925 Date: 8/01/2014
UTS OF MASSACHUSETTS, INC. Client: LJR ENGINEERING,INC.
5 Richardson Lane Project: 217 GRAY STREET,NORTH ANDOVER,MA
Stoneham, MA 02180 Project No: Figure
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