HomeMy WebLinkAboutTitle V Inspection Report - 338 SALEM STREET 4/2/2014 Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form Not for Voluntary Assessments
338 Salem Street V
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is
required for North Andover MA 01845 4/2/2014
every page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: A. General Information
When filling out
forms on the
computer, use 1 Inspector: i"V 014
only the tab key
to move your -Neil J. Bateson
cursor-do not Name of Inspector
----------------
use the return
key. Bateson Enterprises Inc.
001� Company Name
111 AM:flla..Roa"d
Company Address
Andover MA 01810
---------- .......
City/Town State Zip Code
978-475-4786 S115
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
❑ Passes El Conditionally Passes Z Fails
F-1 Needs Further Evaluation by the Local Approving Authority
4/2/2014
l4pegor'i7sig nature V Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DER The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-3713 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
xt 338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is
required for North Andover MA 01845 4/2!2014
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E 1 always complete all of Section D
A) System Passes:
❑ I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
u Compliance indicating that the tank is less than 20 years old is available.
d
El Y ❑ N ❑ ND (Explain below):
15ins•3113 Title 5 Official Inspection Form:Subsurrace Sewage Disposal System•Page 2 of 17
j
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Las Heros
Owner Owner's Name
information is
required for North Andover MA 01845 4/2/2014
-�-
every page. cilyfrown State Zip Code Date of inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ns•W13 Title 6 official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
= Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owners Name
information is
required for North Andover MA 01845 4/2/2014
every page. Cityf Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
® ElBackup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
El ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
El ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/z day flow
t5ins•3113 Title 6 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
0 I
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
vK 338 Salem Street _
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 412/2014
required for
everypage. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
El ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well,
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal collform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
® ❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a targe system the system must serve a facility with a
design flow of 10,000 gpd to 115,000 gpd.
ij
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ Elthe system is within 400 feet of a surface drinking water supply
El ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (interim Wellhead Protection
Area— IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins•3113 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
Tale 5 Official Inspection Form
b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is
required for North Andover MA 01845 412/2014
every page. Cityrrown State Zip Cade Date of Inspection
C. Checklist
Check if the following have been done.You must indicate"yes" or"no"as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
Were as built plans of the system obtained and examined? (If they were not
0
❑ ® available note as NIA)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
u
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® E) Existing information. For example, a plan at the Board of Health.
® ElDetermined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
y
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): NIA Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): NIA
t5ios•3113 Title 5 Official Inspection Fort:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form»Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is
required for North Andover MA 01845 4/2/2014
every page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 2
Does residence have a garbage grinder? ® Yes ❑ No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ❑ No
Seasonaluse? ❑ Yes ® No
Water meter readings, if available (last 2 years usage(gpd)): Yes
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: oatBrent
Commercial/industrial Flow Conditions:
0
Type of Establishment:
9
Design flow(based on 310 CMR 15.203):
Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
is
151ns•3/13 T111e 5 Official Inspection Form:Subsurface Sewage Otsposal System•Page 7 of 17
3
i
"r
r.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
Y 338 Salem Street _
Property Address
Suzan De-Los Heros _
Owner Owner's Name
information is
required for North Andover MA 01845 4/2/2014
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records.
Source of information: Never pumped, owner
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
L1Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ lnnovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the 1/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
15ins•3113 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
= Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owners!Name
information is
required for North Andover MA 01845 4/2/2014
every page. CityfTown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
Original to house, owner
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: feet
Material of construction:
® cast iron ❑ 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
4" Cast iron through wall, 4"bast iron in house. No leaks visible.
Septic Tank(locate on site plan):
Depth below grade: f et
Material of construction:
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
9
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 8 x 4
8"
Sludge depth:
t51ns 3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
i
Commonwealth of Massachusetts
up
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 4/2/2014
required for
every page. CitylTown State Zip Code Date of inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle NIA
Scum thickness
2"
Distance from top of scum to top of outlet tee or baffle NIA
Distance from bottom of scum to bottom of outlet tee or baffle NIA= Outlet baffle corroded off
How were dimensions determined? Tape Measure
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Inlet baffle corroded off. Outlet baffle corroded off. Depth of liquid at outlet invert. No evidence of
leakage.
i
B Grease Trap(locate on site plan):
i
Depth below grade: teat
Material of construction:
El concrete ❑ metal ❑ fiberglass El polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
z Date of last pumping: Date
t5ins•3113 Tills 5 Official Inspection Form;Subsurface Sewage Disposal System Page 10 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal Systems Form -Not for Voluntary Assessments
r 338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 4/2/2014
required for
State Zip Code Date of Inspection
every page. Cityrrown
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal Elfiberglass Elpolyethylene ❑ other(explain):
3
3
9
Dimensions:
Capacity:
gallons
d Design Flow:
gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
Page ii of 17
Wins•3113 Title 5 Of ficial Inspaclion Form:Subsurface Sewage Disposal System
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
t
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 412!2014
required for
every page. City[Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D-box level &distribution not equal. Evidence of heavy carryover, outlet baffle off in
septic tank.Evidence of leakage. D-box badly corroded. D-box cover cracked.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t&ns•3113 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 412!2014
required for
every page. City/town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length:
4 trenches 30'
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Typetname of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Soil ok. Vegetation ok. No sign of ponding to surface. Camera leach pipes, liquid above leach
Wes. Signs of hydraulic failure. Heavy solids in pipes. Couple of the trenches pipes collapsed
�l
u
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Tale 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
Y
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 4/2/2014
required for
every page. City[Town State Zip Code Date of Inspection
D. System information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
a
9i
15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is North Andover MA 01845 4/2/2094
required for -
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
tID
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= �0tl
t5ins•3/13 Title 5 Offtciel Inspection Form:Subsurface Sewage Disposal System•Pago 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is
required for North Andover MA 01845 4/2/2014
every page. Cityrrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 1.5 to 3
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers- (attach documentation)
® Accessed USGS database-explain:
Essex County Soil Map
You must describe how you established the high ground water elevation:
' Essex County Soil Map, Sheet#30, Woodbridge Soil, Water 1.5'to 3' Deep.
9
3
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
i.
Mris•311.3 Title 5 Official Inspection Farm!Subsurface Sewage Disposal System•Page 16 of 17
r
Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
a
338 Salem Street
Property Address
Suzan De-Los Heros
Owner Owner's Name
information is
required for North Andover MA 01845 4/2/2014
every page. CitylTown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information— Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
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Summary Record Card generated on 3126!2414 1:18:23 PM t y Maureen McAuley Page 1
Town of North Andover
Tax Map # 210- 37.8-0055-0000.0
Parcel Id 14809
338 SALEM STREET
DE-LOS HEROS
338 SALEM STREET
N. ANDOVER, MA
0'1845
Class 101 Single Family Property Type 1 Residential
Zoning2 1 Residential Zoning3 1 Residential
Size Total 0.84 Acres
FY 2014
UB Mailing Index
Name/Address Type Loan N imber Activelinact. From Until
DE-LOS HERDS Payor
338 SALEM STREET
N.ANDOVER,MA
01845
UB Account Maint.
Account No Cycle Occupant Nana Activellnactive
Bldg Id. 16048.0-338 SALEM STREET Last Billing Date 1/7/2014
3160105 03 Cycle 03 Active
UB Services Maint.
Account No. 3160105
Service Code Rate Charge Multiplier/Users
MISCFEE ADMIN FEE 0.63 518 7.82 11
WTR WATER 01 ALL METER SIZE 41.80 11
UB Meter Maintenance
Account No. 3160105
Serial No Status Location Brand Type Size YTD Cons
16335955 a Active 00 METE METE w Water 0.63 0.63 278
Date Reading Code Consumption Posted Date Variance
3/5/2014 923 a Actual 10 -10%
12/4/2013 913 a Actual 11 1/17/2014 22%
9/5/2013 902 a Actual 9 10/15/2013 2%
6/7/2013 893 a Actual 9 7/24/2013 29%
3/7/2013 884 a Actual 7 4/22/2013 37%
12/5/2012 877 a Actual 5 1/9/2013 1%
9/6/2012 872 a Actual 5 10/15/2012 -15%
6/7/2012 867 a Actual 6 7/16/2012 -4%
3/6/2012 861 a Actual 6 4/14/2012 -13%
12/8/2011 855 a Actual 7 1/17/2012 -36%
9/9/2011 848 a Actual 12 10/13/2011 -43%
6/2/2011 836 a Actual 19 7/20/2011 31%
3/4/2011 817 a Actual 14 4/13/2011 91%
12/7/2010 803 a Actual 8 1/121/2011 -73%
9/3/2010 795 a Actual 29 10/15/2010 301%
6/2/2010 766 a Actual 7 7/15/2010 0%
3/4/2010 759 a Actual 7 4/14/2010 -40%
12/4/2009 752 a Actual 12 1/12/2010 -38%
9/2/2009 740 a Actual 19 10/15/2009 14%
6/2/2009 721 a Actual 16 7/20/2009 21%
3!612009 705 a Actual 14 4/29/2009 -44%
12/3/2008 691 a Actual 24 1/20/2009 24%
9/4/2008 667 a Actual 20 10/10/2008 61%
6/3/2008 647 a Actual 12 7/16/2008 52%
3/5/2008 635 a Actual 8 4/11/2008 -18%
12/5/2007 627 a Actual 9 1/22/2008 -17%
9/12/2007 618 a Actual 12 10/12/2007 23%
6/11/2007 606 a Actual 10 7/20/2007 22%
3/8/2007 596 a Actual 8 4/16/2007 -23%
epi
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