HomeMy WebLinkAboutMiscellaneous - 353 BOXFORD STREET 11/20/2001 INSTALLATION CERT11TICATION
The !1T�C1prSi�f e� herelbv Cvrt-;Fy tl-,,T t.-.e Sv;vage Disposal SVSte a {X) C�IiST-uc--�;
1
l
repaired;
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located at /366 J4 1-11 5�
was insta:led in ccn c=ance -r,,rith the North A-adover;hoard of HeLth approved plan:.,
S��stem Desi�r Pe. t dated with an approved desig-r!
fEcvv of ° ;;c,ns der day, The materials used were in conformance with those
sQeciEed on the approved plan; 'Lhta� 5y"s e.T was insmEed in accordance with tie prmrisicns
of 310 C1vl, 15,000, Title 5 a;,d local regulations, and tree Anal grading arr°ees
subs-,=-sally with the approyea plan„ All wcri is accurately represented an the A-s-1 uiit
w ich l,as berm vu�r.�tted to the Bcarci cf Hea.lt .
Bed inspe=icr.
date:
R e se tat:ve
Final I nspeC,ion Date:
*En ,'.heer Repr°s4enialiv�.7r'
11
d`
�.�.,. date:
Desi ;n Emmneer- ` c"r / Dare: 1t11
CHECKLIST FOR NORTH ANDOVER
SEPTIC SYSTEM PLANS
The following is a checklist that incorporates all Title 5 and local regulations for septic plans.
Name of Applicant: ']1 � & C /l Name of Designer: (�,AC1,7 j"�JA1 e!M; 6<-�Y")n6
Plan Date: / , �� Revision Date: Date of Review:
Property Address: 4) -z, Map: Lot: l
BOH Reviewer: _ r J Type of Plan(new or upgrade):
g�
Number of Bedrooms in Assessor' s Records: /V/f gpd)Garbage Disposal Allowed: /V o
General Information: N.A. =North Andover Septic Regulations Other numbers refer to Title 5
OK,f Problem N/A
t Street number an_ ma /lot 220(4)(u)
Maximum scale of 1 '=40'for plot plan-220(4)
Maximum scale of 1 "=20'for profile and component details-220(4)
Legal boundaries of the facility being served-220(4)(a)
Names of abutters from recent tax map- NA 8.02j
Number of bedrooms, design calcs., -NA 8.02i
Name&address of record owner&applicant- NA 8.02k
�f Name&address of designer-NA 8.021
Holder and location of all easements-220(4)(b)
L� Date plan drawn&any revision date- NA 8.02m
All dwellings and buildings, existing and proposed-220(4)(c)
/ Location of all existing or proposed impervious areas-220(4)(d)
All distances on site plan-NA 8.03 a-c
Elevation of proposed driveway-NA 8.02t
Location and elevation of foundation drain.-NA 8.02y
\ , Location and dimensions of the system incl. reserve(new const.)-220(4)(e)
Limits of excavation of leach area on site plan-NA 8.02z
Locus plan-220(4)(t)
�u+ Ob North arrow-220(4)(g)
ti Existing and proposed contours-220(4)(g)
Locations and logs of deep holes-220(4)(h)
Locations and logs of percolation tests-220(4)(i)
Date(s)of soil testing-220(4)(h)&(i)
L� Existing grade elevation of each deep hole-220(4)(h)
Elevation of percolation tests-N.A. 8.02n
Name of approving authority representative-220(4)(h)&(i)
Name of soil evaluator-220(4)0)
Soil logs and perc test logs match BOH records
Locations of waterlines, drains, and subsurface utilities-220(4)(m)
Observed and adjusted g.w. elevation in the vicinity of the system-220(4)(n)
Complete profile of the system to scale-220(4)(o),NA 8.02c
r,! Cross section of leaching facility-NA 8.02w
Location of benchmark(s)within 50-75 feet of facility-220(4)(q)
ice - Note listing all variance requests with proper citations-220(4)(p)
L - Local upgrade approval request form submitted-403(7)
Original R.S./P.E. stamp, signature&date-220(l)&(2)
2
i
If.P.E., discipline specified within stamp. MGL C. 112 s. 81M
sfc. supplies(w/in 400'),pub. wells(w/in 250'), pvt. wells(w/in 150')-220(4)(
Location of watercourses, wetlands,wells, etc. Win 150'of system—NA 8.02r
m Wetland disclaimer—NA 8.02s
Land surveyor plan reference required(property line setbacks)-220(3)
Plan contains designer's certification statement
Use approvals/standards checked for UA system-DEP docs.,
„ - Perc rate b MPI-not allowed for new,LUA for upgrade-245(1)&('3)
Perc rate 60 MPI-must use modified tight tarok or IIA technology-245(4)
Proposed system qualifies as shared system-002(definitions)
�...... Flow is over 2,000 gpd-No R.S. allowed-220(1)
Design flow was set in accordance with code-203
P., Existing system location and note on proper abandonment-354
Leaching facility at least 1' above Base Flood elevation—NA 9.05
-° All piping Sch 40 minimum—NA 10.01
Basement floor minimum 1' above groundwater elevation—NA 5.04
Foundation drain present with elevation—NA 8,02y
On-site Soil and Groundwater Review
OK Problem N/A
Proper deep observation hole logs an plan-220(4)(h)
All deep holes and peres shown, including aborted tests—NA 8.02n
t... Soil evaluation farms submitted within 60 days of field work-018(2)
t Proper percolation test log-220(4)(1)
Ample deep observation holes in primary disposal area(minimum 2)- 102(2)
Ample deep observation holes in secondary disposal area(minimum 2)- 102(2)
Ample pert testing(one in each disposal area, 3 in prim. >2,000 gpd)- 104(4)
Deep hole testing conducted within two years—NA 7.05 ,.. o o t g
Hole Identification Numbers:
ground elevation el.
p
acce table soil el.
Leach facility invert el.
ground water el.
F
refusal el. `° �.�. T e;
bottom of leach facility el. :�. (m,) '( t / ' Lw • ....
thickness of acceptable sail
before&after sail R&R
separation to groundwater
separation to refusal ! � ,
soil class '
pert rate ''' fw"'i
3
loading rate 7"-/
septic tank below g.w.table (yes or no)
pump tank below g.w. table (yes or no)
].f in fill -255(l)
Setback Distances(Given in feet) 15.21 1
OK Problem N/A
Is the lot in the Lake Cochiewick Watershed? NA 6.00& 5.02
Septic Tank Leach Facility
" Property line 10 10
l Cellar wall 10 20
Inground pool 10 20
a. Slab foundation 10 10
Deck,on footings, etc. 5 10
1/" Waterline 10 10
p Private drinking well 75 100
w ,.. Irrigation well 75 1.00
Wetlands 75 100
Public well 400 400
t.. Wetlands bordering surface 150 150
water Supply or trib.
(in Watershed)
Trib. To Surface Water supply 325 325
Reservoirs 400 400
' Tributaries to reservoirs 200 200
Loo Drains(wat. supply/trib.) 50 100
Drains(intercept g.w.) 25 50
Foundation drains 10 20
Drains(Other) 5 10
, ',— Drywells 20 25
Downhill slope 15'to 3:1 slope
w/o barrier
4
Building Sewer
OK Problem N/A
Grease trap required for certain uses(check 230 for details)
1/ Pipe diameter listed(4" minimum)-222(1)
Pipe schedule listed-222(3)
Pipe cast iron or Sch 40 PVC—NA 11.02
Watertight joints specified-222(3)&(4)
Pipe laid on compact,fin base-222(5)
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)
j Manhole at any 90 degree alignment chapge-222(8)
Invert elevation at building: J :f" —
Invert elevation at tic tank:t C,.
Length of run: r
Slope: x 0 (minimum of 0.01 -0.02 desired)-222(6)
10'offset to private well or suction line-222(2)
Septic Tank
OK Problem N/A
Tank is accessible-228(3)
t� Tank can accommodate both primary&reserve—NA 9.04
sue;: 200%of flow(required&provided given. 1500 min.)-220(4)(f)&223)(1)(a)
+ 2-3" drop from inlet to outlet-227(5)
Minimum of 4'liquid depth-223(2)
.ts.. 3"air space above tees/baffles(minimum)-227(4)
9"air space above flow line(minimum)-227(4)
Tees are,not to be replaced by baffles-227(1)
✓
tx 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)
Access manhole cover above center of tank&each tee(except 2 compart)
228(2)
3-20"manholes-228(2)
1 childproof, 24"riser/manhole to final grade if<1000gpd-228(2)
�f Inlet and outlet tees on center line-227(l)
Soil compaction below tank specified(if soil is non-native)-221(2)
6" of<=3/4"stone beneath tank specified-221(2)&22 8(1)
If> 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)
Buoyancy calcs. required if tank at or below water table-221(8)
Tank is watertight-221 (1)
9"of cover over tank(minimum)-228(l)
H- 1 0 loading(min.)-H-20 if traffic-226(3)
Top of tank<=36"below grade-221(7)
All pumping to tank(if applies)in accordance with-229
ate' Tank is set to keep old system in service during install if possible
4
5
Tight Tank(Check here if not present:
OK Problem N/A
500%of deisgn flow or 2000 gallons provided—260(2)(a)
3-20"manholes—228(2)
Soil compaction below tank specified(if soil non-native)—221(2)
6"of<=3/4"stone beneath tank specified—221(2)&228(1)
Buoyancy calcs.Required if tank at or below water table—221(8)
Tank is watertight—221(1)
9"of cover over tank specified(minimum)—228(1)
H-10 loading(min.)—H-20 if traffic—226(3)
Top of tank<=36"below grade—221(7)
All pumping to tank(if applies)in accordance with—229
AN alarm set at 3/5 tank capacity—260(2)(c)
Min. 1-24"frame w/cover at finished grade—228(2)(f)
Year round access for pumping—228(2)(g)
Distribution Box(Check here if not present: )
OK Problem N/A
Inlet elevation:
Outlet elevation:
s 0.17'drop from inlet to outlet(minimum)-232(3)(b)
6" sump(minimum)-232(3)(e)
All outlets at same elevation-232(3)(b)
Outlet pipes laid level for first 2 ft. -232(3)(c)
�✓ Pipe Sch 40-NA 10.01
Number of outlets: (�j _ Number of laterals:
Size of outlets: "
Inlet baffle/tee min. 1" over outlet invert for all d-boxes-232(3)(a),
Soil compaction below distribution box specified(if soil is non-native)-221(2)
6"of stone beneath distribution box specified-221(2)
Box is watertight-221 (1)
L7 Top of box<=36"below grade-221(7)
L-- Buoyancy calculations required if box is at or below water table-221(8)
Pump Chamber(Check here if not present: t•�' )
OK Problem N/A
Volume specified: 220(4)(r)
Pump on elevation- 220(4)(r)
Pump off elevation: 220(4)(r)
Alarm on elevation: 220(4)(r)
Number of cycles per day-220(4)(r)(also 254(1)(d)if gravity from d-box)
Minimum 2" delivery line to d-box if gravity-254(1)(c)
Pressure dosed l.f. if flow>=2,000 gpd-254(1)(a)&254(2)(a)
Cycles per day is consistent with chamber volume-23 1
Volume calculations include flowback volume-2') 1(2)
24 hour storage capacity above pump on elevation-231(2)
Number of pumps: 2 if system serves>2 dwelling units-231(6)
S
6
Capacity of pump(s)- gpm @ 'TDH-220(4)(r)
Pump can pass 1 1/4 "solids(minimum)-231(7)
Pump controls specified-220(4)(r)
Alarm equipment specified-231(2)
Alarm is in building and powered on separate circuit from pump-2') 1(9)
Pump sequence correct(off-lead on-lag on-alan-n on)-231(8)
Pump performance curves included-220(4)(r)
Manual operating switch-NA 12.01
Check valve,bleeder hole-NA 12.01
1 childproof, 24"riser/manhole to final grade-2'31(5),
Soil compaction beneath pump chamber specified(if soil is non-native)-221(2)
6"of<=3/4"stone beneath chmbr. specified-221(2)&228(1),
Buoyancy calculations if chamber is at or below water table-221(8)@
9" of cover over chamber(minimum)-228(1)
H- 10 loading(min.)-H-20 if traffic-226(')),
Chamber is watertight-221 (1)
Top of chamber<=36"below grade-221(7)
Leaching Facility(general-complete for all designs)
OK Problem N/A
50%larger if garbage disposal-240(4)
Trenches to be used whenever possible-240(6)
-'` No vehicle access or imperv. area above l.f unless unavoidable-240(7)
Vented if under impervious cover-241 (1)
e Vented through same pipes as distribution system-241 (1)(a)
Vent protected from precipitation/animal entry-241 (1)(b)
�- Vent is placed beyond traffic or impervious area-24 1 (1)(c)
All lines connected to vent if bed or trenches-241(1)(d)
9" cover over peastone-240(9)
1.f Reserve area provided(new construction)-248(1)
Reserve 4' from primary leach area-NA 9.04
4'C5fif perc rate<=2 MPI)separation to g.w.-212(a)&(b)
4'(down to T with variance or I/A-upgrades only)of natural soil under l.f. l
cam' GW separation is adjusted to highest existing grade if facility cuts into a hillside (±
Pipe slope minimum of 0.005 -251(9) j; oC it N-
Require 5'removal and replacement if in fill-255(5)
Top of leach facility<=36" below grade-221(7)
Final grade over l.f. minimum 0.02 ft/ft-240(10)
Surface&subsurface drainage away from l.f -240(1 1)&245(5)
-� Minimum design flow 440 gpd without deed restriction-NA 13.01
-'" 3:1 slope where grading required-255(2)
Toe of fill slope stops 5'from property line or swale installed-255(2)
I Impermeable barrier if<3:1 slope or< 15 feet to-3:1 slope-255(2)
Impermeable barrier/retaining wall poured concrete-NA 9.02
✓� Retaining wall stamped by P.E. -255(2)(b)
Top of retaining wall>=top of peastone elevation-255(2)(f)
10'offset from edge of leach facility to edge of ret.wall-255(2)(g)
Perc test(s)done in most restrictive layer- 104(2)
Perc test 4' below leaching elevation-NA 7.06
Design flow listed and required/provided leach area given-220(4)(f)
Leach pipes SCH40 PVC-NA 10.01
Leach pipes minimum 4" diameter except for dosed system-NA 14.04
_ Leach lines capped,vented,or connected together-251(9)
Pressure dosing guidance followed if pressure distribution-254(2)(c),
7
Pressure dosing required over 2,000 gpd or with I/A remedial use-231(1)
Leaching Trenches(Check here if not present: )
OK Problem N/A
t/ Number of trenches: -
Minimum of 2 trenches-NA 9.01(2) r
Depth of trenches(max eff. 2'): 1 -247(l)
VIX Width of trenches(2'min., 4'max.): -251 (1)(b)
Length of trenches(100'max.): -25 1 (1)(a)
Trenches are vented(when>50')-251 (11)
Trenches follow contour lines-251(2)
L-� Trench spacing 3 times effective width or depth-251 (1)(d)
V,/' In fill or reserve between trenches, 10' min. -NA 14.01& 14.03
t.' Available leach area given(Min. 500 s.f.)-NA 9.01(2)
Bottom=L �, 6 x W % x#�__ ��6 s.f.
Sidewall=L Zj` x D f ` x# - -2S x 2= s.f.
Effective leach area given .
Loading factor:
P' Effective area=total area (7 66 s.f. x LTAR: 71 _ (/-/ g/day
Effective area is>=design flow of facility being served
2"of 1/8"- 1/2"2x washed peastone.-247(2)
Trench depth of 3/4"to 1 1/2" double washed stone-247(l)
Leaching 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'): -253(1)(a)
Available leach area given
Bottom=L x W x#of systems- s.f.
Sidewall=L+W x D x 2 x#of systems= s.f.
Total area=bottom +sidewall = 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
Minimum of pits at least 13'X16'-NA 9.01(3)
Distribution for galleries/chmbrs. in trench config. -pipe every 20'-253(6)
Distribution for galleries/chmbrs. in bed config.-ea.pipe serves<=40 s.f.-253(6)
Spacing-2 times the effective width or depth(the greater)-253(1)(c)
2"of 1/8"- 1 /2" 2x washed peastone.-247(2)
3/4"to 1 1/2"double washed stone-247(1)
Each pit has at least one 20"access cover. 24" CI to grade over 2,000 gpd
-253(3)
Surrounding aggregate thickness between 1'(min.)and 4'(max.)-253(1)(b)
Vents, if necessary, extend under covers of pit(s)-241 (e)
Leach Fields(Check here if not present:
OK Problem N/A
Number of fields: (need dosing chamber if> 1,231 (1))
Length(100'max.): -252(2)(b)
Width:
7
8
Total area:L x W s. f.
Minimum 900 square feet-NA 9.01(1)
Distribution lines connected with solid pipe—NA 15.01
Effective leach area given
Loading factor:
Effective area=total area s.f x LTAR = g/dav
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(2)(e)
10'minimum separation between adjacent leach fields-252(2)(f)
Between 6"and 12" of 3/4- 1 1/2" stone beneath field-252(2)(g)&247(2)
2"of 1/8"-1/2"2x washed peastone.-247(2)
8/28/98
R
AS-BUILT CHE C + CKILIST
LOT NUMBER STREET NAME
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
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 CE 1
CENTER OF
TANK & D-BOX
ORIGINAL STAMP & SIGNATURE 61A'14 ' ;
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
LOCATION& ELEVATIONS OF BENCHMARK USED