HomeMy WebLinkAboutCertificate of Compliance - 32 OLYMPIC LANE 6/22/2016 e
PUBLIC HEALTH DEPARTMENT
Town of North Andover
Community Development Division
CEIRUIFICATE
As of® 6/22/16
This is to certify that the individual subsurface disposal system received a
SATISFACTORY INSPECTION of the:
Repair Full
On-Site s System
By: Todd Bateson
Ate
32 Olympic iane
Map 106B Lot 109
North Andover, MA 01845
;a ance of thi rtific to shall not be construed as a guarantee that the system will function satisfactorily.
Xrian J. aGrasse, CENT
Director of Public Health
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9540 Fax 978.688.8476 Web www.townof north andover.corn
PUBUC HEALTH DEPARTMENT
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TOWN OF NORTH AN DOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby 1 y that the the 4Sewage Disposal Systemi const ructed
repaired; ell
Y
IZYBy
(Print,N ame) -
Located at: t
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan, originally dated
and last revised on ,with a design flow of
f
V � 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.
Bottom of Bed:Inspection Date: "
l4°' i ��. 1 �+7 Engin a presentati�c(Signature)
And-Print Name
Final Construction Inspection Date:
� " ��„�c . Engi cer epresentCv
f' ( '� � e..(nature)
And-Print Name
Installer: � '^ �, w (Signature) Date
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And Q�5 , tV''
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.� ot
ame
:
Engineer:_ ff ,�°”" _(Signature) ;. Date V,
And - Print Name
1600 Osgood Street, Notch Andover, Massachusetts 01845
Phone 978.688.9540 Fax 978.,6 88.8476 e htip://wwim.northaiidoverma.gov
•
North Over Health Department
Community and Economic Development Division
QNSITE WASTEWATER SYSTEM N T CTI N NOTES
LOCATION INFORMATION
ADDRESS: 32 Olympic Lane MAP: 106.13 LOT: 0109
INSTALLER: Todd Bateson
DESIGNER: Jack Sullivan
PLAN DATE: 12/1/15, revised 3/31/16
BOH APPROVAL DATE ON PLAN: 4/24/16
INSPECTIONS
TANK INSPECTION: 5/25/16
DATE OF BED BOTTOM INSPECTION: 5/25/16
DATE OF FINAL CONSTRUCTION INSPECTION: 6/2/16
DATE OF FINAL GRADE INSPECTION: o P,) K
SITE CONDITIONS
N/A Contractor reports any changes to design plan
X Existing septic tank properly abandoned
® Internal plumbing all to one building sewer
® Topography not appreciably altered
Comments:
SEPTIC TANK
X Building sewer in continuous grade, on
compacted firm base
X Cleanouts per plan
X Bottom of tank hole has 6" stone base
X Weep hole plugged
X 1500 gallon tank has been installed
H-10 loading
X Monolithic tank construction
X Water tightness of tank has been achieved by
visual testing
X Inlet tee installed, centered under access port
X Outlet tee installed, centered under access port
(gas baffle/effluent filter)
® 24" inch cover to finish grade installed over
outlet access port
X Neoprene boots around inlet & outlet
Comments: rubber gaskets in place
DISTRIBUTION-BOX
® Installed on stable stone base
® H-20 D-Box
N/A Inlet tee (if pumped or >0.08'/foot)
® Hydraulic cement around inlet & outlets
® Observed even distribution
® Speed levelers provided (not required)
® Schedule 40 PVC Pipe
SOIL ADSORPTION SYSTEM (Gravel-less Chambers)
® Brand and Model of Chamber: Standard Quick
4 Low Profile Infiltrator Chambers
® Number of chambers per row: 13
® Number of rows (trenches): 9
Comments: Total Chambers = 117
FINAL GRADE
Loamed
Seeded
Cover per plan
Comments:
DOCUMENTS NEEDED
Certification of Installation Form submitted
By engineer and signed and dated by
Engineer and installer
As-Built Plan
BM = 104.85
HR = 3.42
HI = 108.30
SYSTEM ELEVATIONS
ROD AS-BLT INVERT DESIGN INVERT
ELEVATION ELEV ELEV
Benchmark
Building Sewer OUT 6.59 101.36 100.9
Septic Tank IN 6.67 101.28 100.58
Septic Tank OUT 6.92 101.03 100.33
Distribution Box IN 8.74 99.21 99.22
Distribution Box OUT 8.92 99.03 99.05
Lateral 1-9 TOP 9.00
Lateral 1-9 INVERT 98.95 98.95
Top of Chamber
Bottom of Bed/Chamber 9.60 98.70 98.70
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.) 50 100
® 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