HomeMy WebLinkAboutCertificate of Compliance - 58 OAKES DRIVE 6/17/2003 Town of North Andover are kI
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Office of'the Health Department .
Community Development an e ices Division
27 Charles Street
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North Andover,Massachusetts 01845 US�$
Heidi Griffin Telephone(978)688-9540
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Fax (978)688-9542
TOWN OF NORTH ANDOVER ��-
BOARD OF HEALTH „
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE
June 17, 2003
This is to certify that
the individual subsurface disposal system
constructed. ( ) or repaired (X)
by
Mike Reilly
at
58 Oakes Drive
has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the
North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will function
satisfactoril
Jonath arkey
Ch ` ,North Andover Board of Health
BOARD OF APPEALS 688-9541 f UILDING 688-9545 CONISERV"iVI'ION 688-9530 HEALri-I 688-9540 PLANNING 688.-95;5
TOWN'OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System ( )'constructed;
i) repaired;
located at F=1) r`:)A-K ty.,�. i"���.« � A,i
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit# ,plan dated , 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.
Bed inspection date:
Engineer Representative
Final inspection date: 2 1 U..
Engineer Representative
Installer: / r Lic.#:
Date:
Engineer: Date: 416
TANGARD
ri
' 'VV
CHECKLIST FOR NORTH ANDOVER
SEPTIC SYSTEM PLANS
Job
The following is a checklist that incorporates all Title 5 and local regulations for septic plans.
Name of Applicant: of Designer: /V 5
Plan Date: Z 2! ,Q Revision Date: Date of Review:
Property Address: � 'S �JJ E� e Map: �� Lot: e.�
BOH Reviewer:�/ Type of Plan(new or upgrade): U _
Number of Bedrooms in Assessor's Records: gpd)Garbage Disposal Allowed: 6
General Information: N.A.=North Andover Septic Regulations Other numbers refer to Title 5
OK Problem N/A
Street number and map/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 8.021
Name&address of record owner&applicant- NA 8.02k
Name&address of designer-NA 8.021
L/ Holder and location of all easements-220(4)(b)
Date plan drawn&any revision date- NA 8.02m
All dwellings and buildings,existing and proposed-220(4)(c)
1✓ Location of all existing or proposed impervious areas-220(4)(d)
All distances on site plan—NA 8.03a-e
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) (Not to scale)
North arrow-220(4)(g)
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)
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
v Cross section of leaching facility-NA 8.02w (Not to scale)
Location of benchmark(s)within 50-75 feet of facility-220(4)(q)
Note listing all variance requests with proper citations-220(4)(p)
/' Local upgrade approval request form submitted-403(1)
2
Original R.S./P.E. stamp, signature&date-220(1)&(2)
P.E.,discipline specified within stamp. MGL C. 112 s. 81M
vI sfc. supplies(w/in 400'), pub. wells(w/in 250'),pvt. wells(w/in 150')-220(4)(
Location of watercourses, wetlands,wells, etc. w/in 150'of system—NA 8.02r
Wetland disclaimer—NA 8.02s
RLS plan reference&certification required(prop line setbacks)-220(3)
l/ Plan contains designer's certification statement
Use approvals/standards checked for I/A system-DEP does.,
<� Pere rate>30 MPI-not allowed for new,LUA for upgrade-245(1)&('3)
Perc rate > 60 MPI-must use modifred tight tank or UA technology-245(4)
i Proposed system qualifies as "shared" system-002(definitions)
L Flow is over 2,000 gpd-No R.S. allowed-220(1)
4 Design flow was set in accordance with code-203
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
r Foundation drain present with elevation—NA 8.02y
On-site Soil and Groundwater Review
OK� Problem N/A
Proper deep observation hole logs on plan-220(4)(h)
All deep holes and peres shown,including aborted tests—NA 8.02n
Soil evaluation forms submitted within 60 days of field work-018(2)
Proper percolation test log-220(4)(i)
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 perc testing(one in each disposal area, 3 in prim. >2,000 gpd)- 104(4)
r/ Deep hole testing conducted within two years—NA 7.05
Hole Identification Numbers:
l
�
ground elevation el.
�
acceptable soil el.
Leach facility invert el. 0 -5
ground water el. 7
refusal el. r °
bottom of leach facility el. �Q J
thickness of acceptable soil 6, 17 5
before&after soil R&R /
separation to groundwater [�
separation to refusal j �f
soil class
2
3
perc rate
loading rate
septic tank below g.w. table (yes or no)
pump tank below g.w. table (yes or no)
l.f in fill -255(l)
Setback Distances(Given in feet) 15.21 1
YES /O Is the lot in the Lake Cochiewick Watershed? NA 6.00&5.02
OK Problem N/A
Septic Tank Leach Facility
Property line 10 10
i� Cellar wall 10 20
-'� Inground pool 10 20
Slab foundation 10 10
Deck, on footings,etc. 5 10
Waterline 10 10
Private drinking well 75 100
Irrigation well 75 100
i/ Wetlands 75 100
V Public well 400 400
Wetlands bordering surface 150 150
water Supply or trib.
(in Watershed)
l� Trib. To Surface Water supply 325 325
Reservoirs 400 400
+� Tributaries to reservoirs 200 200
r� Drains(wat. supply/crib.) 50 100
`J Drains(intercept g.w.) 25 50
Foundation drains 10 20
Drains (Other) 5 10
Drywells 20 25
y Downhill slope 15'to 3:1 slope
3
4
w/o barrier
Building Sewer
OK Problem N/A,,, e` ` Y
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
t — Watertight joints specified-222(3)&(4)
t Pipe laid on compact,fin base-222(5)
1 ' 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)
/ 4 Manhole at any 90 degree alignment c-hange-222(8)
Invert elevation at building: , b
/ Invert elevation at septic tank:
Length of run /
pe: b , 6/P,`l (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)
No structures above tank—(228(3)
Tank can accommodate both primary&reserve—NA 9.04
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)
�—° 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)
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)
t/ Gas baffle installed on outlet-227(4)
Access manhole cover above center of tank&each tee(except 2 compart)
j 228(2)
3-20" manholes-228(2)
1 childproof,24"riser/manhole w/in 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<=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(1)(c)
Buoyancy calcs.required if tank at or below water table-221(8)
Tank is watertight-221 (1)
V 9" of cover over tank(minimum)-228(1)
H- 10 loading(min.)-H-20 if traffic-226(3)
Top of tank<=36" below grade-221(7)
67 All pumping to tank(if applies)in accordance with-229
7 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 design 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 m 9
Inlet elevation: [l
Outlet elevation: Ill
1/ 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: 10 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)
Top of box<=36" below grade-221(7)
V, Buoyancy calculations required if box is at or below water table-221(8)
Pump Chamber(Check here if not present: )
OK Problem N/A
Volume specified: a 220(4)(r)
Pump on elevation- y`7 220(4)(x)
Pump off elevation: 220(4)(r)
1 Alarm on elevation: 220(4)(r)
i` 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)
5
6
24 hour storage capacity above pump on elevation-231(2)
Number of pumps: 2 if system serves>2 dwelling units-231(6)
Capacity of pump(s)- '/Q gpm @ 'TDH-220(4)(r)
Pump can pass 1 1/4 "solids(minimum)-231(7)
Pump controls specified-220(4)(r)
v 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/
50%larger if garbage disposal-240(4)
Trenches to be used whenever possible-240(6)
No vehicle or imperv. area above l.f. unless unavoidable-240(7);NA 13.02
Vented if under impervious cover-241 (1)
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)
Reserve area provided(new construction)-248(1)
v Reserve 4' from primary leach area—NA 9.04
4'(5'if pere rate<=2 MPI)separation to g.w.-212(a)&(b)
V 4'(down to T with variance or I/A-upgrades only)of natural soil under I.f.
�7_, GW separation is adjusted to highest existing grade if facility cuts into a hillside
Pipe slope minimum of 0.005 -251(9)
/ 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)
L/ Surface&subsurface drainage away from l.f. -240(1 1)&245(5)
LIfi 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)
Impermeable barrier if<3:1 slope or< 15 feet to—3:lslope-255(2)
Impermeable barrier/retaining wall poured concrete—NA 9.02
UZ Retaining wall stamped by P.E. -255(2)(b)
Top of retaining wall>=top of peastone elevation-255(2)(f)
v'�J 10'offset from edge of leach facility to edge of ret. wall-255(2)(g)
✓ Pere test(s)done in most restrictive layer- 104(2)
Pere 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
6
7
—�! Leach lines capped, vented,or connected together-251(9)
✓ Pressure dosing guidance followed if pressure distribution-254(2)(c),
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
Number of trenches:
Minimum of 2 trenches-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.): -25 1 (1)(a)
Trenches are vented(when>50')-251 (11)
Trenches follow contour lines-251(2)
Trench spacing 3 times effective width or depth minimum-251 (1)(d)
In fill or reserve between trenches, 10' min. -NA 14.01& 14.03
Available leach area given(Min. 500 s.f.)-NA 9.01(2)
Bottom=L x W x# = s.f.
Sidewall=L x D x# x 2= 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)
Trench depth of 3/4" to 1 1/2" double washed stone-247(1)
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 2 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" Cl 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: )
O Problem N/A
Number of fields: (need dosing chamber if> 1,231 (1))
7
8
Length(100' ax.): �� -252(2)(b)
Width: Z5
Total area:L x W = UA h 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: °, 5
Effective area=total area l 3 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)
r-' 2"of 1/8"-1/2" 2x washed peastone.-247(2)
Final Grading
OK Problem N/A
Slope over leach area minimum of 0.02 feet/foot—240(10)
Grading shall divert drainage away from leach area—240(l 1)
Grading slopes away from dwelling
5/24/01
8