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HomeMy WebLinkAboutTitle V Inspection Report - 142 BERRY STREET 11/20/2017 FILE# .A ncl 11 1 4 17 r RECENED I/ / TITLE V INSPECTION )j*1 ANDOVERTOWN OF NCDean G. Luscomb II & Sons P.O. Box 135 Jf Middleton, MA 0 1949 978-774-4065 Licensed Plumber # 20285 ON FORM QUkS7RFACE SEWAGE T�ISPOSAL sYSTEM INSI'ECTI PROPERTY OARS NAIUIE_..V�. PROPERTY ADDRESS DATE OF INSPECTION `'v._2 ,. ... i NAMEOF INSPECTOR 1 (DUALITY IS NUMBER ONE TO US r 1 3 RECEIVED Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments [)EPARIMV'tT 142 Berry Street ------- Property Address Keith Tho son TV--- -- I--,------,--. _ --- —11............ Owner Owner's Name information is required for North Andover MA 01845 November 14, 2017 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: When filling out A. General Information forms on the computer,use 1 Inspector: only the tab key to move your Dean G. Luscomb 11 cursor-do not Name of Inspector ...................... use the return key. Dean G. Luscomb 11 & Sons Company Name 288 Maple Street Company Address MiddletonMA 01949 reran City/Town State Zip Code 978-774-4065 51848 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 16.000). The system: Passes ❑ Conditionally Passes F-1 Fails D Needs Further Evaluation by the Local Approving Authority November 14, 2017 sp tor's Signature 4, 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 1 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .u' 142 Berry Street Property Address Keith Thompson OwnerOwner`s Name information is North Andover MA 01845 November 14, 2017 required for __. __.___--------.___-- _..__ __... every page, Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Ched 111B,C,D or E/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: El 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 Compliance indicating that the tank is less than 20 years old is available. I [] Y [ N ❑ ND (Explain below): .............. I i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 Berry Street Property Address Keith Thompson_ ------------- Owner Owner's Name information is required for North Andover MA 01845 November 14, 2017 every page. City/Town 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.): El 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): El broken pipe(s)are replaced El Y R N 0 ND (Explain below): ❑ obstruction is removed F1 Y El N F ND (Explain below): distribution box is leveled or replaced F1 Y El N El ND (Explain below): ............. ❑ .......... ........... The system required pumping more than 4 times a year due to broken or obstructed pipe($). The system will pass inspection if(with approval of the Board of Health): F-1 broken pipe(s)are replaced El Y F-1 N F] ND (Explain below): E-1 obstruction is removed El Y El ND M ND (Explain below): C) Further Evaluation is Required by the Board of Health: F-1 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: E] 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 151ns-313 Title 5 Official inspection Form:Subsurface Sewage Disposat System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 Berry Street Property Address Keith Thompson Owner Owner's Name information is required for North Andover MA 01845 November 14, 2017 every page. Cityfrown 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: 0 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. 0 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. n 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: A Yes No Backup of sewage into facility or system component due to overloaded or El 0 clogged SAS or cesspool El 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less El E than 1/2 day flow 15ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System�Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 142 Berry Street Property Address — Keith Thompson Owner Owner's Name information is North Andover MA 01845 November 14, 2017 required for _ _ ...._..__.__._._ every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No 0 ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: CJ ® 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. ❑ ® 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 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 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) rge Systems: To be considered a large system the system must serve a facility with a de ' n flow of 10,000 gpd to 15,000 gpd. For large sy .ms, you must indicate either"yes"or"no" to each of the following jn-�ddition to the questions in Sec ' D. I Yes No Q ❑ the system is hin 400 - of a surface drinking water supply © © the syste Thin 20 t of a tributary to a surface drinking water supply to system is located in a nitrog ensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II o ublic water supply well If yoCa ha swered "yes" to any question in Section E the system nsidered a significant threat, or answered "yes" in Section D above the large system has failed. The o or operator of any large system considered a significant threat under Section E or failed under Section II upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 15ins 3113 Title 5 Oficial Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 'Y 142 Berry Street Property Address Keith Thompson �...._ __...�...._.__..__�.__. _....._......_ -- .- ---...__..__,..---.__ Owner Owner's Name information is North Andover MA 01845 November 14, 2017 required for —.._.._-� _._..... _._ ._..__ .�...------__-- ' every page. City/Town State Zip Code 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 i ❑ ® Were any of the system components pumped out in the previous two weeks? J ❑ Has the system received normal flows in the previous two week period? EJ this 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 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? ® n Were all system components, excluding the SAS, located on site? Z ❑ 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: ® ❑ 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)] I D. System Information Residential Flow Conditions: Number of bedrooms(design): - — Number of bedrooms (actual): 3 330 Bpd _._.. DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): t 15ins•3113 Title 5 Official Inspection Form: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 142 Berry Street Property Address Keith Thompson Owner Owner's Name information is required for North Andover MA 01845 No 14, 2017 .......... every page. City/Town State Zip Code Date of Inspection D. System Information Description: owner and town ------------ 2 Number of current residents: Does residence have a garbage grinder? El Yes 0 No Is laundry on a separate sewage system? (Include laundry system inspection El Yes 0 No information in this report.) Laundry system inspected? El Yes 0 No Seasonal use? El Yes F] No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? Yes ❑ No current Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of ablishment: Design flow(base 10 CMR 15.203): Gallons per day gpdr— Basis of design flow(seats/perso ft, etc.): Grease trap present? ❑ Yes Q No Industrial waste holding tank pre El Yes El No Non-sanitary was charged to the Title 5 system? El Yes El No Water-meter readings, if available: tains-3M Title 5 Official Inspection Form:Subsurface Sewage Disposal System�'Page 7 of 17 ^ . . ' Commonwealth of Massachusetts T°tNe 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 142Ber Street Property Address Keith Thom son Owner Owner's Name information is required for North MA 01845 November 14, 2017 every page. nityfTown State Zip Code Date ofInspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe ------ General Infornmahpn Pumping Records: Source ofinformation: Last pumped_1 U � � Was system pumped anpart ofthe inspection? 0 Yes [l No 1�OO gallons If yes, volume � ' QoUnns bv measurements How was quantity pumped determined? Reason for pumping: hea |id Type of System: Septic tank, distribution box, soil absorption system El Single cesspool El Overflow cesspool Fl Privy El Shared system (yes or no) (if yes, attach previous inspection records, if any) Fl Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to beobtained from system owner) and ecopy oflatest inspection ofthe I/Asystem bysystem operator under contract El Tight tank. Attach a copy of the [)EP approval, 0 Other(describe): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 Berry Street Property Address Keith Thompson Owner bwner's Name information is required for North Andover MA 01845 November 14, 2017 every page, CityfFown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: System is from 1984 -33 years old. Were sewage odors detected when arriving at the site? El Yes 0 No Building Sewer(locate on site plan): 24" Depth below grade: feet Material of construction: 0 cast iron F] 40 PVC F-1 other(explain): Distance from private water supply well or suction line: —--------- feet Comments (on condition of joints, venting, evidence of leakage, etc.): Main line and joints are in good condition. ------------- Septic Tank (locate on site plan): Depth below grade: 14" feet Material of construction: M concrete El metal ❑ fiberglass ❑ polyethylene El other(explain) Precast rectangular concrete- 1500 gallons If tank is m`e1Trftt--age;_.. Is age mff4" t ""a­C–e I�icate7of Compliance? (attach a—copy of­ceMi ZNo Dimensions: 5'x 5' x 10' - 1500 gallons Sludge depth: 611 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 Berry Street Property Address Keith Thompson Owner -6.Owner's Name ........—----- information is required for North Andover MA 01845 November 14, 2017 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) 30" Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of Scum to top of outlet tee or baffle 411 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? by_measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank and baffle are in very good shape. The solids are heavy and do require pumping at this time. The liquid lis running at it's correct working heigth. --—-------- ase Trap(locate on site plan): Depth belo rade: —----- feet Material of constructs ❑ concrete El metal R fiberglass F-1_poly6fh-y1`e`ne [I other(explain): ............... Dimensions: Scum thickness .............. Distance froMPP (scum to top of outlet tee or baffle -6 " Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date ....... 15ins-3113 Title 5 Official Inspection Fowl:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 Berry Street Property Address Keith Thompson Owner Owner's Name ------------- .......-- information is required for North Andover MA 01845 November 14, 2017 every page. City/Town State Zip Code Date of Inspection 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.): ---------------- -—---------------- Ti ht or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth low grade: Material of c, ,n or "o"U epth\b%low g Material of c ❑ concrete ❑ metal n fiberglass El polyet17 n other(explain): ------------ Dimensions: Capacity: ga ns 4,,a,,enZ�— Design Flow: gallons per day Alarm present: F1 Yes n No Alarm level: X n Yes El No A*m in working order: Date of last pumping: Date Comments (condition oflalgrm and float switches, etc.): -----------—--------- Attach copy of current pumping contract(required), Is copy attached? 0 Yes El No 15ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 Berry Street Property Address Keith Thompson Owner Owner's Name information is required for North Andover MA 01845 November 14, 2017 every page. Cityrrown 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 Zero 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.): The d-box is 20"x 20" and is 26" belowgrade. The d-box is in very good shape. .......... ......................................... -----------------___------------- Pump_Chamber(locate on site plan): Pumps in working El Yes El No* Alarms in working order: No* Comments (note condition of pump chamber, condi i umps 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: SAS was located by asbuilt and d-box to vent location. 15ins-3113 Title 5 Official trispection 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 142 Berry Street Property Address Keith Thompson Owner Owner's Name --------- information is required for North Andover MA 01845 November 14, 2017 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: p leaching pits number: 2 shallow qs ❑ leaching chambers number: El leaching galleries number: El leaching trenches number, length: - Cl leaching fields number, dimensions: El overflow cesspool number: El innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS is in good condition. There are no signs of ponding or breakout. ----------- —------------- —--------- . Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number configuration --.--_..._ Depth-top of liquid to i invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of Gn ruction .......... Indication of groundwater inflow ❑ Yes ❑ t5ins 3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Farre _ M1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 142 BerP�rr Street Property Address �� Keith Thomason Owner Owner's dame information is North Andover MA 011845 November 14 2017 required for , _...__. every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont,) Cbrmm,ents (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc,): P ivy (locate on site plan): Materials onstruction: - - - Dimensions - — -'' Depth of solids Comments (note condition of soil, signs of is failure, level of ponding, condition of vegetation, etc.): I I t5ins 3113 Title 5 Official 9nspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts e 5 Official Inspection Form Subsu Sewage Disposal System Form Not for Voluntary Assessments 142_Per _Street Property Address Keith Tpqmpson er Owner's Name infor tion is North Andover r require November 14, 2017 every page. CityfTown State Zip Con----_.Pate of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties­io`---- 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 1Y azrq IV' 444/0m /i iv r 43 P�El- P��S Alv Pz 2- t5ins-3113 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts - w Title 5 Official Inspection Form - a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .°' 142 Berry Street Property Address Keith Thompson Owner Owner's Name information is North Andover MA 01845 November 14 2017 requiredfor __..,-_--....._....._, _._._......_.__.- -------______ ------------...--.__.-. every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 1 Site Exam: JJ / ® Check Slope " /Ul l"1" ® Surfacewater ® Check cellar aAolo )PG4044P t I ® Shallow wells ltle, Estimated depth to high ground water: 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: Sept 1984 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Sketch only. ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database-explain: i i You must describe how you established the high ground water elevation: The basement is 6' below grade/ .. - -_ t 4 I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3113 Tittle 5 Official tnspection Form Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 142 gf�n Street Property Address Keith Thompson .......... ......... Owner Owner's Name information is required for North Andover MA 01845 November 14, 2017 every page. City/Town State- Zip Code bate 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 Z System Information— Estimated depth to high groundwater Z 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 Nov, 14, 2017 10:430 No. 2424 P. 1 ,,dwd Gard gemealed m 1111412017 10:87:24 AM by Orr HaNan Page I Town of North Andover Tax Map # 210-106,D-0039-0000,0 Parcel Id 17799 142 BERRY STREET KEITH THOMPSON 142 BERRY STREET NORTH ANDOVER, MA 01845 class 101 Single Family Property Type 1 Realdentlal Zoning2 1 Residential Zomng3 1 Residential Size Total 1 Acres FY 2018 UB Mailing Index Name/Address Type Loan Number Activelinaol, From Until KEITH THOMPSON Owner 142 BERRY STREET NORTH ANDOVER,MA 01845 HOUGHTON,RITA Previous Customer Inactive 1/5/2009 142 BERRY STREET N.ANDOVER,MA 01845 UB AeCoqat Maim. �� 6 Account No Cycle Occupant Name Active/Inactive Bldg Id,13410.0-142 BERRY STREET Last Billing Date 9/12/2017 2100055 02 Cycle 02 Active /0 UB Servioes Malnt. Account No,2100055 Service Code Rate Charge MultipllarlUsers / MtSCFEEADMIN FEE 0,63518 7.82 1/ WTR WATER 01 ALL METER SIZE UB Meter Maintenance Account No.2100055 Serial No Status Location Brand Type Size YTD Doris 32945548 a Active HH#142 b Badger w Water 0,63 0,03 467 Date Reading code Consumption Posted Dale Variance 11/1/2017 534 aActual 16 -32% 8/112017 519 a Actual 22 9/2012017 52% 5/1/2017 497 a Actual 14 6/26/2017 3% 2/1/2017 483 a Actual 14 3/14/2017 -18% 11/1/2016 469 a Actual 17 12/19/2016 •33% 8/112416 452 a Actual 25 9/21/2016 22% 5/3/2016 427 sActual 21 6/2112016 13% 2/1/2016 406 a Actual 19 3/2812016 11°fa 10/30/2015 357 a Actual —16 12/30/2015 -211% 81312015 371 a Actual 21 9/14/2015 105% 5/4/2015 360 aActual 10 6/22/2015 -6% 2/4/2015 340 a Actual 11 3/20/2015 36% 11/4/2014 329 aActual 8 12/1512014 53016 8/612014 321 a Actual 5 9111/2514 29% 5/12/2014 319 a Actual 8 6/12/2014 28% 2/3/2014 308 aActual 6 3/17/2014 11% 11/1/2013 302 a Actual 5 12124/2413 -20% 8/9/2013 297 aActual 7 9/1612013 44% 511/2013 294 a Actual 11 6118!2413 -11% 2/4/2013 279 aAclual 14 3/13/2013 0% 10/30/2012 265 a Actual 13 12(1312512 211/0 8/112012 252 aActual 13 9/2612012 6% 5/112012 239 a Actual 12 6120/2012 -6% 2/1/2012 227 a Actual 13 3/14/2012 26% i1/1/2011 215 aActual 10 12115/2011 -55% 8/412011 204 aActual 23 9114/2011 110% i