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Home My WebLink AboutCertificate of Compliance - 980 FOREST STREET 5/19/2009 NORTH 69 -y oL O �n N � * L C. ebb ORA COCNI<Nl WKN`y1 SSACHUS��y PUBLIC HEALTH DEPARTMENT Community Development Division CrEX2IFIC, rrE O F COqV1 '�E '1'�IA�� As of: .May 19, 2009 This is to certify that the individuaCsubsurface disposal system received a S.A9ISTF.AC'7ORTINSITEC IONof the: Full System Repair of the SuhsuMace Sewage DisposafSystem Dy� John Soucy .fit: 980 Forest Street flap 105.(D; Parref79 North,Andover, M,4 01845 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. ,.ISu.�dn 7 Sawyer Pu6lic Yfealth Director 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8416 Web www.townofnorthandover.com �9d$W�'1P pry W�ap°p P(BUC HEALTH I')Et' Rt fltt' (:okninoanity Uewelopmew Divisioi,i TOWN OF NORTH ANDOVER SEPTIC DISPOSAL SYSTEM—INSTALLATION CE TIFICATION �.. RECEIVED .E�D The undersigned hereby certify that the Sewage Disposal System constructed;O repaired; By: c, G... C 1A (Print Name) �:' (�:r i r d OVE R Located at: (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 G0 > 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 1.5.000,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: 1 � r Engineer Representative(Signature) And—Prirat Name u Final Construction Inspection Date: �rr Engineer Representative(Signature) And—Print Name „ Installer: 41d,"'' (Signature) Date: W-) 1 t J Ar Print Name .�„ w. (Signature) rd— Enginer: , �_. ... Date: R� P.N — — �— � . And—Print Name 1600 Osgood Street, Noah Andover, Massachusetts 01845 Phone ` a6 . , 4 Fog 978.688.8476 Web http://www.townofnorthondoverncorn AS-BUILT CHECKLIST LOT NUMBER, STREET NAME " ASSESSORS MAP & PARCEL NUMBER e�- LOT LINES &LOCATION OF DWELLINGS r LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING-RESERVE.-_ TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA " LOCATIONS OF DEEP HOLES &PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION w LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK& D-BOX f ORIGINAL STAMP & SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW , i.°` LOCATION& ELEVATIONS OF BENCHMARK USED 'TOWN OFNOP.111 ANDOVE.R Office of COMMUNITY DEVELOPMENTAND SERVI(".'ES HEAL311 DEPARTMENT 0100 1600 OSGOOD STREE'l' Building 2-36 NORTH ANDOVE.R, MASS�'CH USETTS 0, 845 ` 0 C Aj Susan Y. Sawyer, REHS/RS ❑ 978.688.9540 Phone Public I lealth Director 978.6883 �8476 --FAX 49 QNSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: �-5V, MAP: I o�� I') LOT: 7 INSTALLER:` DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: 3/5 /C)1.5? INSPECTIONS TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPE TIO : DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS ❑Existing septic tank properly abandoned ❑lnternal plumbing all to one building sewer ❑Topography not appreciably altered Comments: SEPTIC TANK Bottom of tank hole has 6" stone base F-1 Weep hole plugged J C, 1500 gallon tank has been installed w �� . �.�° '.� �❑ H-10loading M-0rl6Iifhic "ntrUct'ibm 'Y Water tightness Qf-tA k-h5s been-n-a chieved .4— (Visual or Vacuum Test or Water held for 24hrs) 1P Inlet tee installed, centered under access port ❑ Outlet tee (gas baffle or effluent filter) installed, centered under access port ❑ 24" inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present F-1 Hydraulic cement around inlet & outlet Wastewater System Documentation-Feb 2006 Pagel 46 TOWN OIFNORTH ANDOVER kOO Office of COMM UNITY DEVEL,OPMENTAND SERVICES HEAL141 DEPARTMENT' 1.6f)tJ OSGOOD STRIA,"T; Building 2-36 NORTH ANDOVER, MASSAC11LJSt`1TTS 01845 & C SUSall Y. Sawyer, REJ IS/RS 978,688.9540 Phone Public Health Director 978,688,8476 FAX Comments: PUMP CHAMBER ❑',"6ottorn of tank hole has 6" stone base F-1 Weep hole plugged F-1/Combo Tank installed. Size: 1000 gallon Pump Chamber installed H-1.Q Ioad"irt M6nolithi-c,2onstruction) ❑ `hr6t-tee installed, centered under access port F-1 Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working F-1 Separate on/off floats F-1 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 F-1 Hydraulic cement around inlet & outlet Comments: ry 21 ADVANCED TREATMENT TECHNOLOGY ❑ Type of treatment device: ❑ Installed per manufacturers requirements F-1 All components working in accordance with manufacturer's requirements Comments: Wastewater System Documentation—Feb 2006 Page 2 of 6 °t OWN OF NOR I'll ANDOVER R7§1 -1, Office of COMMUNITY DEVELMMEN'r ANT) SERVICES � HEM.,,al DEPAWIMENY too V 1600 OSGOOD s,rRL,.F1]'; Building 2-36 NOR441 ANDOVE'R, MASSACI 1L)SE'ri-s 0 1845 "2 .11 U Susan Y, Sawyer, R 95 EFIS/RS 978.688,540 -Phone Public Health Director 978A8.8476 - FAX D-BOX F-1 Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) F-1 Hydraulic cement around inlet & outlets F-1 Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM� Sattom of SAS excavated down to 0_61 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 F-1 Retaining wall (boulder/ concrete /timber/ block) F-1 Final cover as per plan Comments: Wastewater System Documentation—Feb 2006 Page 3 of 6 TOWN OF NORTH ANDOVER. Office of COMMUNITY DEVE1,OkIMENTAND SERVICES paa HEAL,"M DEPARTMENT 1600 OSGOOD STUu,"r; Building 2-36 % NORTH ANDOVER, MASSACHUSETTS 01845 C�4 Susan Y. Sawyer, RH IS/RS 978,688.9540 1"l one PUbfic I lealth Director 978.688.8476 FAX PRESSURE DISTRIBUTION F-I -- inch manifold F-I laterals installed with end sweeps size: material: ❑ Squirt test ft in height F-I Equal distribution to all laterals F-I orifice size inch as per plan Comments: CONTROLPANEL F-I Alarm & Pump are on separate circuits F-I Alarm sounds when float is tripped ❑ Location of control panel: F-I Rated for exterior if placed outside Comments: Wastewater System Documentation—Feb 2006 Page 4 of 6 TOWN GF' NOR'I'H ANDOVER Office of COMM U N 117Y DEVE1,0111M ENTA N 1) SE RV ICES HEAL71-1 DEPAR'll"'MENT 40 1600 0SG(.)0J.") STREET; Building 2-36 6 NMI]I AN DOVH, MASSACI IUSETTS 01 4.> SLISMI Y. Sawyer, Rl"FIS/RS, 978,688.9540 Phone Public Health Director 978.688.8476- F'AX CRITICAL SETBACK DISTANCES Mark those distances checked in the field against the design plan and regulatory setback Tank SAS Sewer F-1 Property line 10 10 ❑ Cellar wall 10 20 ❑ Inground pool 10 20 F-1 Slab foundation 10 10 ❑ Deck, on footings, etc 5 10 -- F-1 Waterline 10 10 101 ❑ Private drinking well 75 1002 50 F-1 Irrigation well 75 100 ❑ Surface Water 25 50 F-1 Bordering Vegetated Wetland Salt Marsh, Inland/Coastal Bank 3 75 100 F-1 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 F-1 Reservoirs 400 400 F-1 Drains (wat. supply/trib.) 50 100 ❑ Drains (intercept g.w.) 25 50 F-1 Drains (Other)Foun(li-ition 10(5) 20(10) F-1 Drywells 20 25 ' Suction line 222(2) 2 100 feet is a rnininlUni 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 Wastewater System Documentation-Feb 2006 Page 5 of 6 TOWN (,)F NORTH ANI)OVER ICY R Office of COMMUNITY tit VE1..,01'MEivr AND SERVICES HEA1,1"H DETARI'MENT 1600 OSGOOD STREET, Building 2--36 NORTH ANDOVE'R, MASSACHUSE"TTS 01845 U SLIKM Y. Sawyer, REHYRS 78.6 .95 40- Phone Public Health Director 97&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 6 of 6