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Home My WebLink AboutCertificate of Compliance - 305 BOSTON STREET 6/28/2012 o . • SFTRLRD]eyc e • PUBLIC HEALTH DEPARTMENT Town of North Andover Community Development Division i iCte ® C lip c As of Lune , This is to certify that a SA IS-.SNORT INSIPECIIOX Was completedfor the: On-Site Wastewater s y e WY: Wlrwm a at: 305 Ooston Street Parcel ID :210/107.D-0005®0000.0 ,p 5W 01845 The Issuance of this certificate shaff not be construed as a guarantee that the On Site Sewage 1D. isposafSystem wifffunction satzsfactorify. Susan,I�Y. Sawyer, RE961U (Pu6fic Yfeafth lOirector 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com # ... :w��, �1V-N( N :I Ir�fl� t xW � I P 6 E" PUBLIC HEALTH DEPARTMENT Communify Development Division TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM— INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System( "constructed;( )repaired; ( 4 a y'-- - (Print Name) Located at: -- — (Installation.Address) ,M---_ __- Was installed in conformance with the North Andover Board of Health approved plan,originally dated and last revised on 2//,3 ).�`�� 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. C1vIR 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. Bottom of Bed Inspection Date: Engineer Representative(Signature) And–Print Name Final Construction Inspection Date: Engineer Representative(Signature) And–Print.Name Installer: ��:. . """ .� � (Signature) Dake: And- Print Name Enginer. i nature) Dat�e:� �a And -Print Name 1600 Osgood Street, North Andover, Massachusetts 01845 _ Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com AS-BUILT CHECKLIST All changes to the design plan have been reflected on the as-built Is of suitable scale;(one inch=40 feet or fewer for plot plans and one inch=20 or fewer for details of system components) Lot number, Street Name,Assessors Map and Parcel Number Lot Lines and Location of Dwellings served by the system Locations&Dimensions of system,including reselve(if applicable) &. Ties to dwelling or Permanent Structure&Wells . a.From Septic Tank f i b.From Leach Area Ties to Lot Lines from leach area Locations of Deep Holes&Peres .° ... r ' Elevations of Disposal System f', Top of Foundation Elevation r Locations of Wells,Drains,Watercourses within 15Q ' °" " = Location of water,gas,electric lines,cable Distances from Corners of House to Center of Tank&D-Box - Location of Structures within 6 Inches of Finished Grade Original Stamp&Signature t y asements which could impact the system. r., r of an e. � Location and holder Impervious Areas Dvewa s,etc r^" North Arrow .4 Location&Elevations of Benchmark used... r STATEMENT ON PLAN(NA 5.3) , "1 certify the locations, elevations, ties, cQve material; exposed component covers etc, shown on this as-built ,ww *substantially agree with the appr9vedfilan and have determined that the break out elevations, if applicable, have Signature of Designer Date or, if a STUCTURAL WALL ZS PRESENT(NA 4.9)Letter or statement on the as-built indicating the wall was, or was not, constructed in accordance with the intended design and any manufacturer's specifications Signature of Designer Date As of:Wednesday,April 27,2011 µ North Andover Health Department Community Development Division QNSITE WASTEWATER SYSTEM T UCTI NOTES ADDRESS-LOCATION INFORMATION MAP: LOT: INSTALLER: ✓" DESIGNER: PLAN DATE: BON APPROVAL DATE ON PLAN: INSPECTIONS t TANK INSPECTION: DATE OF ❑ " F " DATE OF FBINABOTOTOMRUCTION INSPECTION: �n. � ..::�.: °.....,... ECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑ Contractor reports any changes to design plan ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK ❑ Building sewer in continuous grade, on compacted firm base ❑ Cleanouts per plan ❑' Bottom of tank hole has 6" stone base ❑ W cle plugged ❑ gallon tank has been installed loading Monolithic tank construction ❑ Water tightness of tank has been achieved by testing 0 Inlet tee installed, centered under access port ❑ Outlet tee installed, centered under access port (gas baffle/effluent filter) ❑ inch cover to within 6" of final grade installed over one access port ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed ❑ loading ❑ Monolithic tank 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 ❑ cover at final grade installed over pump access port ❑ Water tightness of tank has been achieved by testing ❑ Hydraulic cement around inlet & outlet Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: basement ❑ Alarm signal located inside: basement Comments: DISTRIBUTION-BOX ❑ Installed on stable stone base ❑ H-20 D-Box ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: IL. ABSORPTION SYSTE (General) Bottom of SAS excavated down to C soil layer, as provided on plan Size of SAS excavated as per plan Title 5 sand installed, if specified on plan ❑ 40 Mil HDPE barrier installed ❑ Laterals installed and ends connected to header (and vented if impervious material above) ❑ Elevations of laterals and chambers installed as on approved plan ❑ Retaining wall (boulder/ concrete/timber/ block) ❑ Final cover as per plan Comments: ,V < ��" tF, ., a �. .:�Na .,�, . y, � � , et,,,,L,,�.... 6,t " ' SOIL ABSORPTION SYSTEM (Gravel-less Chambers) ❑ Brand and Model of Chamber: Standard Quick 4 Infiltrator Chambers ❑ Number of chambers per row: ❑ Number of rows (trenches): Comments: Total Chambers BM = HR = HI = SYSTEM ELEVATIONS ROD AS-BLT INVERT DESIGN INVERT ELEVATION ELEV ELEV Benchmark Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN Distribution Box OUT Lateral 1 TOP Lateral 1 INVERT Lateral 2 TOP Lateral 2 INVERT Lateral 3 TOP Lateral 3 INVERT Lateral 4 TOP Lateral 4 INVERT Lateral 5 TOP Lateral 5 INVERT Lateral 6 TOP Lateral INVERT Top of Chamber Bottom of Bed/Chamber SKETCH PLAN 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 -- ® Waterline 10 10 10' ® 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 1 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 15.211(3),also by NA wetland bylaws