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HomeMy WebLinkAboutCertificate of Compliance - 139 OLYMPIC LANE 3/31/2004 Off ice of tlie lleaftfi De partinent Developinent and Services Division � "')usan Y, Saawl ycr nw" C:Nc � h;c:; 978 688,9540 - f1iot�e TOWN CAE NORTH ANDOVER BOARD OF HEALTH CERTIFICATE CAE COMPLIANCE DATE OF COMPLIANCE March 31, 2004 This is to certify that the individual subsurface disposal system constructed ( ) or repaired (X) by John Soucy at 139 Olympic Lane North Andover, MA 01845 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 satisfactorily. Susan Y.Sawyer,REHS/RS a Public Health Director �3R IG�bC)p' E'&°llRhN ;k�,a'y"'ill RMV,11A1"+I6689.9545 G`(' 1°JaVd�ViVR��f�dr � `�:w rJi NNV.M:G"RB088-9,540 1'LArMlYw1NG088,-9+35 TO 'OF NORTH ANDOVER SEWAGE DISPOSAL, SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( )constructed; O repaired; by " located at y p r p^+4µ P a Y 1 fi 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: Engineer Representative Installer: Lic.#: Date: Engineer: tt�HAR Date: -4 TANGARD Ss �fC1 t . r Gv kPY'�pr P 'its .g ........,... . .. .. ... �� ..... .................... ........­... . ..... NEW E114(:"JL,,,.AND EIIAGINEERING SERVICES ... �.ov.o. . .... March 25, 2004 a. North Andover Board of Health C F f 'q. � � �TI 27 Charles Street � 0 �" IN North Andover, MA 01 845 Re: 139 Olympic Lane, As-Built Plan --e / 42,e7 w, r� Dear Board of Health, This letter is written to inform you we are submitting an As-Built Plan and Installation Certification for the above referenced property. Enclosed are (3) copies of the As-Built Plan and an Installation Certification. Please contact this office with any questions or concerns. Sincerer, Thomas Hec o , EIT New England Engineering Services, Inc. Rio fEE,GI IWOC:D DRIVE-NORTH ANDOVER, MA 01845-(978)686-1766 (888)359-7645- FAX(973)N 85.11199 Page I of I DelleChiaie, Pamela From: Dan Oftenheimer[info@miliriverconsulting.com] Sent: Monday, December 08, 2003 1:36 PM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 139 Olympic Lane I leidi, Nian anci Parn, Alkx,Jied pkease find the Lx)ttorn of L-.)(..,d and flinal construdion irq� .)ecfion report for, ffie sepfic-,,, system ['Duili cd, '139 Olyrnpic Larie by Jd-in Soucy. No probI(-.-:,rns were encountered wilh 1 h septic- systern corisfrudion, Dan Daniel 01tenheirner, President Mill River Consuffing Septic S✓stern AA(.jn(.jgerrlE?nt Services 5 Blackburn Center Gloucester, MA 0193(")-2259 978-282--0014 or J-8,00-377-3044 fax: 978-282-00,12 12/8/2003 KILL RIVER CONSULTING Septic System Management Services TOWN OF NORTH ANDOVER SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 139 Olympic Lane MAP: LOT: INSTALLER: John Soucy DESIGNER: New England Engineering Services PLAN DATE: 06/24/03 BOH APPROVAL DATE ON PLAN: 11/12/03 DATE OF BED BOTTOM INSPECTION: 11/26/03 DATE OF FINAL CONSTRUCTION INSPECTION: 12/04/03 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE X GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1,500 LOADING OF SEPTIC TANK = same tank used GALLON PUMP CHAMBER = n/a LOADING OF PUMP CHAMBER = n/a TYPE OF SAS = field DIMENSIONS AND DETAILS OF SAS: 20' x 45' field with 4 laterals SITE CONDITIONS Inspections Existing septic tank properly abandoned Internal plumbing all to one building sewer Topography not appreciably altered Comments: Existing tank re-used. 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282. 0014 a r t o0rr i d l..r. 1.1e r.c ,,.�r�.°u I tj rig ........ Page 1. of 3 KILL RIVER CONSULTING Septic System Management Services SEPTIC TAN Bottom of tank hole has 6" stone base ❑ Weep hole plugged gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) Inlet tee installed, over access port FAI Outlet tee (gas baffle or effluent filter) installed, over access port El inch cover to within 6" of final grade installed over one access port, must be over outlet of tank.if effluent filter is present El Hydraulic cement around inlet & outlet Comments: Existing tank re-used. Inlet and outlet tees installed. Tank appeared watertight based on holding of wastewater upon inspection. ®-BOX El Installed on stable stone base ❑ Inlet tee (if pumped or >0.0$'/foot) Hydraulic cement around inlet & outlets Observed even distribution El Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to C soil layer, as provided on plan x Size of SAS excavated as per plan Title 5 sand installed, if specified on plan 3/4-11/2" double washed stone installed x 1/8-1/2" (peastone) double washed stone installed X laterals installed and ends connected to header (and vented if impervious material above) Orifices @ 5 & 7 o'clock positions 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 tall free 1.800.377.3044 978.282. 0014 c~om Page 2 of 3 MILL RIVER CONSULTING Septic System Management Services El Elevations of laterals installed as on approved plan El Final cover as per plan Comments: Potable water supply line from street to house was not as shown on design plan. Pipe was rerouted around soil absorption system with slight modification in location of soil absorption system. Waterline location to be depicted on as-built plan. SYSTEM ELEVATIONS Benchmark: 100.00 Rod at Benchmark: 3.36 Height of Instrument: 103.36 INVERT ON DESIGN PLAN ELEV a(7 TOP OF PIPE INVERT ELEVATION Septic Tank IN 97.39 97.84 97.51 Septic Tank OUT 97.14 97.44 97.11 Distribution Box IN 96.92 97.36 97.03 Distribution Box OUT 96.75 97.16 96.83 Lateral HIGH 96.70 97.08 96.75 Lateral LOW 96.47 96.86 96.53 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282. 0014 j n f'oOrl2 l .:. CYC t. : l C s no,a.°OM �. .. Page 3 of 3 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:�� , /� L, ;Name of Designer: Plan Date: �.' , t a' Revision.Date: Dace of Review: Ij Property Address: ��� ��/ "'`t`d° ti Map: l��f�.� ../ ,y Lot: BOH Reviewer: 'Type of Plan (new or upgrade): Number of Bedrooms:—, gpd) Garbage Disposal Allowed: 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 Holdernd location of all casements-220(4)(b) D,W 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 8.03a-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 8.022 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 bole-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 t � Locations of waterlines,drains,and subsurface utilities-220(4)(m) t"I", Observed and adjusted g.w. elevation in the vicinity of the system-220(4)(n) L Complete profile of the system to scale-220(4)(o),NA 8.02c Cross section of leaching facility-NA 8.02w (Not to scale) r Location of benchrnark(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. otao , signature&(late 220(U&(2) f.D, discipline specified within stamp. MG[C. 112 x. 8 I dt. supplies(x/in4001,pub, wells (w/in 250),pvL wells(w/in 150') 220(4)( —Z _ ___� Location of watercourses, wetlands, wells,etc. w/in |50'ofmyatem—NA8.U3r Wetland disclaimer—0AQ82o KLS plan reference&certification required (prop line setbacks)-220(3) | Plan contains designer's certification xtun:moot � Use approvals/standards checked for l/\system DBPdncu.. � Pere rate>3OMPI not allowed for new,IJJA for upgrade-245(|)&c('3) ~ Por rate > 60A0PI /nox/use moJijixJ tight tank vrQ4technology 245(4) Proposed system qualifies uo "xbarod" system-O02(dnOuiiioxx) Flow ia over 2,000gyd NoR.S. allowed 220(|) Design flow was set ioaccordance with code 202 Existing system location and note oo proper abandonment 354 Leaching Csoiii/y at|coat |' above Doao Flood olcvuhnn—N'4 9.05 All piping Scb48odoimum—NA |0.Ol Basement floor minimum |' above groundwater elevation—NA5O4 � Foundation drain prouoo/with elevation—NA8.U2y | On-site Soil and Groundwater Review � � OK Problem N/A Proper deep observation hole logs on plan'22U(4)(b) � --___— ___ All deep bo|uo and pores shown, including aborted<euu—NA 8.02n — ___. Soil evaluation forms submitted within 6O days of field work 018(2) Proper percolation test log 220(4)(i) Ample deep o600cvudon holes in primary disposal area(minimum 2)' 102(2) Ample deep observation holes in secondary disposal area(minimum 2)- 102(2) Ample pom testing(one io each disposal area,3iuprim.>2.00Ogpd) 104(4) Deep hole testing conducted within two years—NA7.05 Hole Identification Numbers: ` ground elevation el. acceptable soil el. Leach fnoilitv invert el. C ! \ | 01round water el. refusal el, / bottom of]each facility el. 7 C/ thickness u[acceptable soil before&after soil &&K ' r� separation to groundwater x//�L� uxpumdon to refusal soil class � 3 pert rate loading rate _ septic tank below g.w. table _ '� i (yes or no) 17ump tank below gm. table i / (yes or no) If ill fill % -255(l) Setback Distances (Given in feet) 15.21 1 YES NO Is the lot in the Lake Coehiewick Watershed? NA 6.00&5.02 OIL Problem N/A Septic Tank Leach I+acility Property line 10 10 i Cellar wall 10 20 Inground pool 10 20 Slab foundation 10 10 Deck,on footings,etc. 5 10 Waterline 1.0 10 Private drinking well 75 100 Irrigation well 75 100 „' ✓ Wetlands 75 190_ Public wel'1 400 400 Wetlands bordering surface 150 150 water Supply or trio. (in Watershed) Trib.To Surface Water supply 325 325 ..._ ✓ Reservoirs 400 400 ° Tributaries to reservoirs 200 200 Drains(wat. supply/Crib.) 50 100 Drains(intercept g.w.) 25 50 Foundation drains 1.0 20 _- Drains(Other) 5 10 Drywells 20 25 Downhill slope 15'to 3:1 slope 3 4 w/o'barrier Building Sewer OK Problem N/A Grease trap required for certain uses(check 230 for details) Pipe diameter listed (4"minimum)-222(l) Pipe"schedule listed- 222(3) _ Pipe cast''irlo,n or Sch 40 PVC–NA 1.1.02 Watertight j'oiI s 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) Cleanorrt provided every 100 feet-222(8) . Manhole at any 90 degree alignment change-222(8) Invert elevation at building: Invert elevation at septic tank: Length of run: Slope: (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'fine(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) 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 w/in 6" of final grade if<I000gpd-228(2) Inlet and outlet tees on center line-227(1) Soil compaction below tank specified(if sail is non-native)-221(2) 6" of<=3/4"stone beneath tank specified-221(2)&22 8(l) If> 1,000 gpd AND not a single fain. dwell. must be 2 tks or 2 comp. -223(l)(b) If plan specifies disposal must be 2 tanks in series or compart. tank-223(1)(c) Buoyancy calcs.required if tank at or below water table-221(8) Tank is watertight-221 (1) 9" of cover over tank(minima n)-228(1) _ 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 Tank is set to keep old system in service during install il'possible 4 5 Tlht Dank (Check here if not present: ) Old 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 cafes. 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. 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) 1, Outlet pipes laid level for first 2 ft. - 232(3)(c) iF Pipe Sch 40-NA 10.0 1,,, Number of outlets: Number of laterals: Size of outlets: Inlet baffle/tee min. V over outlet invert for all d-boxes-232(3)(a), _ Soil compaction below distribution box specified(if soil is non-native)-221(2) d; 6" of stone'beneath distribution box specified-221(2) Box is watertight-221 (1) 9� Top of box<=36" below grade-221(7) 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: 220(4)(x) 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) Minionam 2" delivery line to d-box if gravity-254(l)(c) Pressure dosed l.f. if flow>=2,000 gpd -254(l)(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-23 1(2) Number of pumps: 2 if system serves>2 dwelling units-23](6) Capacity of punllr(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 1101 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) OIL,Problem N/A V, 50%larger if garbage disposal-240(4) _ T-enclies 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(l) _ Reserve 4' from primary leach area—NA 9.04 4'(5'if perc rate<=2 MPI) separation to g.w. -212(x) &(b) 4'(down to 2'with variance or IIA-upgrades only)of natural soil under I.f. GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005-25](9) Require 5'removal and replacement if in fill-255(5) Top of leach facility<=36" below grade-221(7) Final grade over Lf.minimum 0.02 ft/ft-240(1 0) Surface&subsurface drainage away from l.f. -240(l 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) 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)(t) _-- 10'offset from edge of]each facility to edge of ret. wall-255(2)(g) Pere test(s)clone in most restrictive layer- 104(2) Pere test 4' below leaching elevation—NA 7.06 Design now 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-25 1(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& 1.4.03 Available]each area given(Min. 500 s.f.)-NA 9.01(2) Bottom=L x W x# — s.f. Sidewall=L x x# x2= s. f. Effective]each 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(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 2 pits at least 13'X16'—NA 9.01(3) Distribution for galleries/chmbrs.in trench config. -pipe every 20'-253(6) Distribution for gal leries/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(l) _. 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 closing chamber if> 1, 231 (0) 7 8 Length(100'"max.): e% v"_ -252 (2)(b) Width: Total area: L °� x W � ,'� ��' ' �,4 = � a S.f. Minimum 900 square feet-NA 9.01(1) Distribution lines connected with solid pipe—NA 15.01 Effective leach area giver Loading factor: Effective area=total area � s.f x LTAR -�, = R" � l g/dav Effective area is>=design flow of facility being served Minimum of two distribution lines-252(2)(a) '7 Cline separation (max.)-252(2)(d) r� 4'maxirnurn 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) Final Grading OK problem N/A r f i Slope over leach area minimum of 0.02 feet/foot—240(10) Grading shall divert drainage away from leach area—240(l 1) 77' Grading slopes away from dwelling //V0 i i a, d f pf p G n 5/24/01 8