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Home My WebLink AboutCertificate of Compliance - 83 OLYMPIC LANE 7/25/2006 %AoRri4 O ORATED C HU5�t PUBLIC HEALTH DEPARTMENT (ommunity Development Division C TI(F IC.A`�j �' �l<'�IA. As of: ,Vuly 25, 2006 ,This is to certify that the individual subsurface d4osal system was repaired with a Septic Tank Replacement 6y: ,john Soucy At: 83 Olympic Lane `North fl ndover. XA O 1 R4S The issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. Susan T Sawyer, ICE TS/RR ,Pu6lic ifealth(Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com TOWN OF NORTH ANDOVER a"°aTM�H Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET , _ p ppAnp✓PN'M1' NORTH ANDOVER, MASSACHUSETTS 01845 ACHWU , I�Q 3' 2 00(N' 978.688.9540-Phone OWN Sasan Y.Sawyer,R HS/RS 978.688.8476-FAX Ii li%U►r r E-MAIL:healthdept @townofnorthandover.com i t i � ,Di WEBSITE:hgp://www.townofnorthandover.com TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM - INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( ) constructed; W repaired; by J,>Vx vi (6 0r (Print Name) located at 0 > (Installation Address) was installed in conf rmance with the North Andover Board of Health approved plan, originally dated and last Revised on ,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: I Engineer Representative(Signature) And-Print Name Final inspection date: / o- (-.:;' Engineer Represen ative(Signature) And-Print Name Installer JA (Signature) Date:—'7 ' 16-0 And-Print Name Engineer: - (Signature) Date: 7 �- CA- And-Print Na TOWN OF NORTH ANDOVER 11E,Ai..,,n1 D1�13,XRIMEN"I' 4 400 0SGOOD SIR1.11-1,11" NORTH ANDOVI.-I'R, NIASSACHUSFAI'S 0 1845 OW SLISMI Y. Sawyer, REIIS/RS 978.688.9540 Phone Public Health Director 9'78.688.8,176 FAX QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: MAP: LOT: INSTALLER: DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION; DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned ❑Internal plumbing all to one building sewer ETopography not appreciably altered'- Comments: eql I'Z SEPTIC TANK ........... .................. Bb' tt0 M"oft a-ink''hole has 6" stone base eephcile,,�lugged (1500 gallon tank has been installed H-1' a "- Tlba�ding&' Monolithic construction ❑ 'Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) Inlet tee installed, centered under access port Outlet tee as baffle or effluent filter) installed, centered .err access port ❑ 24" inch cover to within 6" of final grade installed over ihtone access port, must be over outlet of tank if effluent � filter is present Hydraulic cement around inlet & outlet �v t Feb 2006 System Documentation Page I of 6 A TOWN OF NORTH ANDOVER F �aORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 0 .- A 4 F a i v 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 9SSACHUSESA� Susan Y. Sawyer, REHS/RS 978.688.940—Phone Public Health Director 978.688.8176—FAX Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ Combo Tank installed. Size: ❑ 1000 gallon Pump Chamber installed H-10 loading Monolithic construction) ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ 24" inch cover to within 6" of final grade installed over pump access port ❑ Water tightness of tank has been achieved Visual testing ❑ Hydraulic cement around inlet & outlet Comments: ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements ❑ All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 TOWN OF NORTH ANDOVER F NORTH � Office of COMMUNITY DEVELOPINIENT AND SERVICES 4,�� ® 0 ' ' P AL's DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �gSsACHUgetay Susan Y, Sawycr, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX D-BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM' ❑ Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ Laterals installed and ends connected to header ❑ Laterals vented if impervious material above ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel-less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER HrH 1 1 1 1 ~ ,Z.ob SaD eD��rO Office of CONIi� UNI T°Y DEVEL.OPNIENT AND SERVICES 0 HEALTH DEPARTMENT TENT a 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 ?r�ss""° .�gy US Susan Susan Y. Sawyer, REHS!RS 978.688.940—Phone Public Health Director 978.688.8476—FAX PRESSURE DISTRIBUTION ❑ -- inch manifold laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN OF NORTH ANDOVER o�"O oT" q Office of COMMUNITY DEVELOPMENT AND SERVICES ,r� "`'` `�°�0 0 p HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 �'�ss „5es�� Susan Y. Sawyer, REHS/RS 978.688.9540—Phone Public Health Director 978.688.8476—FAX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer ❑ Property line 10 10 -- ❑ Cellar wall 10 20 -- ❑ Inground pool 10 20 -- ❑ Slab foundation 10 10 -- ❑ Deck, on footings, etc 5 10 -- F-1 Waterline 10 10 101 ❑ Private drinking well 75 1002 50 ❑ Irrigation well 75 100 ❑ Surface Water 25 50 ❑ Bordering Vegetated Wetland , Salt Marsh, Inland/Coastal Bank3 75 100 ❑ Wetlands bordering surface water supply or trib. (in Watershed) 150 150 ❑ Trib. to surface water supply 325 325 ❑ Public well 400 400 ❑ Interim Wellhead Prot. Area ❑ Reservoirs 400 400 ❑ Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 ❑ Drains (Other)Foundation 10(5) 20(10) ❑ Drywells 20 25 r Suction line 222(2) 2 100 feet is a minimum acceptable distance and no variance is allowed for a lesser distance(NA 5.02). 3 As defined in 310 CMR 10.55, 10.32, 10.54,and 10.30,respectively,pursuant to 15.21 l(3),also by NA wetland bylaws Wastewater System Documentation—Feb 2006 Page 5 of 6 TOWN OF NORTH ANDOVER N0 TH Office ofCOi MUNITY DEVELOPMENT AND SERVICES 0 HE AL,T11 DEPikR'I ME i'I p 400 OSGOOD STREET � i NORTH ANDOVER, MASSACHUSETTS 01845 'r�ss""°"•kg�e geHUs Susan Y. Sawyer, REHS/RS 978.688.940—Phone Public I-lealth Director 978.688.8476—FAX SYSTEM ELEVATIONS INVERT ON DESIGN PLAN FIELD INVERT ELEV. Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Wastewater System Documentation—Feb 2006 Page 6of6