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PUBLIC HEALTH DEPARTMENT
Community Development Division
QNSITE WASTEWATER SYSTEM T TI
LOCATION INFORMATION
ADDRESS: 506 Boston Street MAP: 107D LOT: 79
INSTALLER: Peter Breen
DESIGNER: Greg Hochmuth
PLAN DATE: 12/10/08
BOH APPROVAL DATE ON PLAN: 1/28/09
INSPECTIONS
TANK INSPECTION: 9 I) M
DATE OF BED BOTTOM INSPECTION:
DATE OF FINAL CONSTRUCTION INSPECTION: 9/10/09
DATE OF FINAL GRADE INSPECTION:
SITE CONDITIONS
N/A 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
N/A Cleanouts per plan
JZ Bottom of tank hole has 6" stone base
❑ Weep hole plugged
® 1500 gallon tank has been installed
H-10 loading mono construction
® Water tightness of tank has been achieved by
Visual testing
® Inlet tee installed, centered under access port
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townotnorthn,rtdover.corn
Inspection Form June 2008
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PUBLIC HEALTH DEPARTMENT
Community Development Division
® Outlet tee installed, centered under access port
(effluent filter)
® 24" inch cover to final grade installed over outlet
access port
® Hydraulic cement around inlet & outlet
Comments:
PUMP CHAMBER
Bottom of tank hole has 6" stone base
❑ Weep hole plugged
® 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" cover at final grade installed over pump access
port
® Water tightness of tank has been achieved by
Visual 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 & kitchen
Comments:
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.66$.9540 Fax 976.68$.8476 Web wwwv tawnotnortl�nndover_om
Inspection Form June 2008
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PUBLIC HEALTH DEPARTMENT
Community Development Division
DISTRIBUTION-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:
OIL ABSORPTION SYSTEM (General)
El Bottom of SAS excavated down to 6 in into 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
N/A Retaining wall (boulder/ concrete /timber/ block)
❑ Final cover as per plan
Comments:
SOIL ABSORPTION SYSTEM (Gravel-less Chambers)
Brand and Model of Chamber: Standard Quick 4
Infiltrator Chambers
® Number of chambers per row: 9
® Number of rows (trenches): 3
Comments: 27 Chambers total
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fox 978.688.8476 Web wwwW.towaofnorthondovr r.carn
Inspection Form June 2008
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PUBLIC HEALTH DEPARTMENT
Community Development Division
BM = 91.90' BM 91.90'
HR = 1.52' HR = 6.86'
HI = 93.42' HI = 98.76'
SYSTEM ELEVATIONS
ROD ELEVATION AS-BLT INVERT ELEV DESIGN INVERT ELEV
Benchmark
Buildin Sewer OUT
Septic Tank IN 5.84 87.23 87.27
Septic Tank OUT 6.04 87.03 87.02
Pump Chamber IN 6.06 87.01 87.00
Pump Chamber OUT 6.49 86.76 86.75
Distribution Box IN 1.25 97.34 97.32
Distribution Box OUT 1.28 97.13 97.15
Lateral 1 TOP 1.47
Lateral 1 INVERT 96.94 97.06
Lateral 2 TOP 2.34
Lateral 2 INVERT 96.07 96.06
Lateral 3 TOP 3.85
Lateral 3 INVERT 94.56 94.56
BED BOTTOM LAT 1 96.3
BED BOTTOM LAT 2 95.4
BED BOTTOM LAT 31 93.9
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978,688.9540 Fax 978.688.8476 Web www.towrnafnorth and over,corn
Inspedion Form June 2008
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PUBLIC HEALTH DEPARTMENT
(ommunity Development Division
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 10 101
® 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 1.00
• 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).
s 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
1600 Osgood Street,North Andover,Mossochusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web Aww.towroLi or hhtindover.tnnl
Inspection Form June 2008