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HomeMy WebLinkAboutBuilding Permit #Exception - 1312 SALEM STREET 6/8/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: INITORTANT:Applicant must complet6 all items on this page LOCATION I Z Sr<,IeAMK StVtAj -- ,, i` Print PROPERTY OWNER �Akdv.Z J = L"r Print MAP NO: 1 aro A PARCEL: GA ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential `.zNew Building ❑ One family 0 Addition ❑Two or more family ❑ Industrial —[].Alteration No. of units: ❑Commercial ❑ Repair, replacement XrAssessory Bldg {Others _❑ Demolition ❑ Other _ ® Sept c," �ItWelli tOQF goclpl ® W le ids (j Water „shed D st ct�—� �; DESCZlPTION OF WORK TO DEP RIiO' 1,D: (Ideittlifi gatfon ease Type or Flint Clearly) OWNER: Name: J Phone• Address: 1�1�- S I t�Vh � Y�,e : �v.Y ►tri 4yytiy� ; MA' CONTRACTOR Name: �J �%UJI.IL` Phone: Address: Supervisor's Construction License: Exp. Date: i Home Improvement License: Exp. Date: ARCHITECT/ENGINEER � ' Phone: i Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ 110'� FEE: 7(� Check No.: Receipt No.: NOTE: Persons contrac ng e�' tered contractors do not have access to the guaranty fund .wR, t-�2' .s.T. �. .+f-f .�!''t➢ws+Fi:i..4b; Signature of Agent/Owner. .- Signature of contractor rxe - - - - t vl `,,._Q Permit No#: Date Received <OC NIcwlwKw y1' Date Issued: gcHus���y IMPORTANT: Applicant must complete all items on this page LOCATION _.5�(e /Vu, Pnnt PROPERTY OWNER',11A, + M�_'L¢. Pnnt 100 Year Structure lyes MAF i 'FARDEL O1f�o- ZONING DISTRICT Historic,Qistrict yes _ Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential , New Building ,-One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement X'Assessory Bldg A�/�1 ke ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain 0.Wetlands Water/Sewer ❑ Watershed District DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly (.- �,"-r Aa7x OWNER: Name: �r© -1 Phone: �7y kd cW Address: 131 '.2- �J A,-J.-4� AAA, Contractor Name. 't DS Phone: ZZs tel( Address,- .7®--Sn �tYv 4 w-m-!:1 i �14T Supervisor's Construdtion IL 0-U3 10-3ca Exp. Date: ®J-(G'1_S Home Irn,provementiLicense: _I 1_9'Zoq. ^_ Exp. Date; 0 1 ARCHITECT/ENGINEER Phone: Address: Reg. No._ ��`��`� FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $_ 7g 1FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _ a �re, Signature- of contractor s - Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL, Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools Well ❑ Tobacco Sales ❑ Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on SkinaWre 1 COMMENTS HEALTH Reviewed on L :,91inature COMMENTS ! � Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receiptsubmifted yes Planning Board'Decision: Comments Conservation Decision: Comments Water& Sewer Connection/sig nature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS IIS Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE"OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On W`2s�_Pignature_± L i �-- COMMENTS �� C� �� r�� u�f� d , �� � �'� e0 CONSERVATION Reviewed on Signature COMMENTS 12 P("HEALTH Reviewed on Signature COMMENTS c=, S 4--- Z711� oning Board of Appeals: Variance, Petition No: Zoning Decision/receipt Jmitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: - Located 384 Osgood Street ;FIRE DEPARTMENT - Temp Dumpster on site yes no - - - -- - - Located at 124,Main Street Fire'Department signature/date COMMENTS QOWN OF NORTH ANDOVER Q RTN Oast�au iaa ti0 Office of COMMUNITY DEVELOPMENT AND SERVICES o? 4. .REALTH DEPARTMENT 400 OSGOOD STREET �. Mm�- • NORTH ANDOVER, MASSACHUSETTS 01845 "SS+CNUgg� 978.688.9540 -- Phone Susan Y. Sawyer, REHS/RS 978.688.8476--FAX Public Health Director E-MAIL: healthde tr townofnorthandover.com WEBSITE: http://www.townofnoi-tiiandovei-.com December 14,2005 Gay E.Neilson 1312 Salem Street North Andover, MA 01845 Dear Ms.Neilson: Please note that the Health Department considers that your property is in the building process,and will grant the Health Department portion of the sign-off for the Building application with the knowledge that any outstanding work will be taken care of. We are in receipt of your letter via e-mail referencing the outstanding septic system final grading which will be completed in the spring,as weather permits. Ms.Michele Grant,Health Inspector will sign- off on your building application tomorrow. Sincerel,y? S l an Y. Sawyer Public Health Director Cc: ➢ File ➢ New England Engineering �I Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@miliriverconsulting.com] Sent: Wednesday, December 14, 2005 3:27 PM To: amcbrearty@millriverconsulting.com; Lisa Kozel LeVasseur; DelleChiaie, Pamela; Sawyer, Susan Subject: 1312 Salem Street Inspection report for 1312 Salem Street is attached. All was generally satisfactory with construction however the pipe from the pump chamber to the SAS had frozen solid. Therefore we could not test the system operation. This will need to be checked at a future date by you or by us. The pipe was left exposed, not backfilled, and it went down way below freezing the night before. I am concerned that the pipe between these two components is essentially dead flat and may freeze up again some day even when the soil cover material is on top. I expressed this to the installer and suggested he may wish to insulate the pipe. He said he checked with the designer and the designer indicated he was not concerned with freeze-up once it would be backfilled. Dan Daniel Ottenheimer,President Mill River Consulting, Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultina.com dano a millriverconsulting.com I 12/14/2005 Page 1 of 2 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, December 14, 2005 1:50 PM , To: Sawyer, Susan; Grant, Michele Subject: FW: Subsurface Disposal Plan for 1312 Salem Street, Map 106A Lot 160 -----Original Message----- From: Gay Neilson [mailto:theneilsons@comcast.net] Sent: Wednesday, December 14, 2005 1:39 PM To: DelleChiaie, Pamela Cc: SoucySewer@aol.com; Alan Jenney Subject: Subsurface Disposal Plan for 1312 Salem Street, Map 106A Lot 160 (/` 1312 Salem Street North Andover, MA 01845 December 14, 2005 Susan Sawyer, Public Health Director Town of North Andover Re: Subsurface Disposal Plan for 1312 Salem Street, Map 106A Lot 160 Dear Ms Sawyer, Thank you for your continued assistance with our septic system installation. Due to the time of year, and the cold and snowy conditions we have decided to wait until spring to complete the finish grading, loaming, fertilizing and seeding. I understand that a final Certificate of Compliance cannot be issued until this work is completed. I will ensure that this work will be done as early in the spring as the weather will allow. We have a building project, (an enclosed porch), that we would like to proceed with this winter. In fact, it would be far better to complete the porch before we seed the lawn! I would like to request that some form of conditional approval be granted for the septic installation so that a Building Permit may be issued. Please contact me if you need any other information, and again thanks to you and all parties involved for your continued support in this project. Sincerely, Gay E. Neilson 978 685-9415 theneilsons@comcast.net i i 12/14/2005 TOWN OF NORTH ANDOVER r Office of COMMUNITY DEVELOPNIEN-PAND SERVICES HEALTH DEPARTM�;NT 27 CHARIFES STREET 'SORT" i,t,NDOVER. ','.I,�"')'-; ' HUSETTS01845 "CH Susan Y. Smvyer 978.688.9540—Phone Public Health Director 978.688.9542—.FAX November 22, 2005 Gay Neilson 1312 Salem Street North Andover,MA 01845 Re: Subsurface Disposal plan for 1312 Salem Street,Map 106A Lot 160 Dear Homeowner, As you are aware,due to problems with ledge identified within the boundaries of the septic system during installation,the previously approved plan had to be revised.New England Engineering submitted the revision dated November 17,2005. At a regularly scheduled Board of Health meeting,held on November 19, 2005,the BOH heard t a request in regard to your property. The following local upgrade requests were approved: 1) The offset distance between the leach bed and a property line from 10 feet required by Title 5,section 15.211 (1)to 3 feet. 2) A reduction in over dig offset from 5 feet required by Title 5,section 15.255(5)to 3 feet This super-cedes the previous upgrade approval noted in the approval letter. All other conditions outlined in the first letter remain in force.Please refer to that letter for details. Please be advised that this ledge problem was identified,new plans submitted and resolved in a matter of days, which is an extremely quick span of time. It is noted that there was good cooperation by all parties,and because of this,it allowed the to process to proceed efficiently. Thank you for your part and cooperation in this matter. Please remember that if you have not already done so,a signed maintenance agreement must be submitted prior to the issuance of a Certificate of Compliance will be issued by the Health Department. Also,the property owner must submit the attached DEP Form 9b to the appropriate Regional Office of the Department of Environmental Protection at 205B Lowell St. Wilmington,MA 01887. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you might have. YSincer y, . Sawyer,REH S/RS Public Health Director cc: New England Engineering Encl.DEP form 9b commonwealth _ Massachusetts C ity/Town of No r4 ti AAd o ve r• o Local Upgrade Approval NOV 18 Z"05 Form 9B TOWN(j� tri ANDOVER HEALTH DEPARIM ENT DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information Important: When filling out 1. Facility Name and Address forms on the computer, use Gay Neilson only the tab key Name to move your 1312 Salem Street cursor-do not Street Address use the return key. North Andover MA 01845 City/Town State Zip Code rib 2. Owner Name and Address (if different from above): (same) Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 gpd 5. System_Designer: Benjamin C. Osgood, Jr. ® PE ❑ RS Name 60 Beechwood Drive North Andover MA, 01845 Address City/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for: ® Reduction in setback(s)—specify: 1. Reduction in offset distance between the leach bed and a property line from 10 feet required by Title 5, Section 15.211(1) to 3 feet. 2. Reduction in overdig from 5 feet required by Title 5, Section 15.255(5) to 3 feet. ❑ Reduction in SAS area of up to 25%: - SAS size,sq.ft. %reduction Form 913 Second-1312 Salem Street North Andover•rev.5/02 Local Upgrade Approval, Page 1 of I rw 20fCommonwealMassachusetts C ity/Town of /Uo r4\ A v\d Z•re r a o Local Upgrade Approval Form 9B �M B. Approval (continued) ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft. Percolation rate min./inch -- Depth to groundwater ft ❑ Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: Al I C) Approving Authorit Print or Type Name and TitI6 Wig—natu�re � Date Form 9B Second-1312 Salem Street North Andover•rev.5/02 Local Upgrade Approval,Page 2 c l A CD Robin Carr 1300 Salem Street North Andover, MA 01845 RecavED November 18, 2005 NOV 18 2005 TOWN OF N_ ! North Andover Board of health 400 Osgood Street North Andover, MA 01845 Re: 1312 Salem Street,North Andover, MA Septic System Design Dear Members: Please accept this letter as confirmation of the following: 1. Robin and Paul Carr are the owners of the property at 1300 Salem Street,North Andover and are direct abutters of the property owned by Gay and Paul Neilson at 1312 Salem Street. 2. We have been informed that the Neilson's would like to construct a septic system 3 feet from the property line which separates 1312 Salem from our property. 3. We understand the Board of health is required to hold a hearing to approve the reduced setback to 3 feet from the required 10 foot setback and that we are required 10 days prior to the hearing. 4. We understand that the Board of Health is going to hold a hearing regarding this matter on Saturday November 19, 2005 at the town hall 2nd floor meeting room and we waive the requirement that we be notified 10 days in advance of this hearing. 5. We have no objection to the placement of the septic system at 1312 Salem Street 3 feet from our property line. Robin Carr CD COMMONWEALTH OF MASSACHUSETTS Essex County A,'dR-A Dated: November 18,2005 Then personally appeared the above named Robin Carr and acknowledged the foregoing instrument to be the free act and deed of Robin Carr before Me. I cam. Grimm Notary Public My commission expires: 2,1,7 966 q DONNA M.WEDGE NOTARY PUBLIC commoxwEAITH OF MASSA 12� Mr� Aug. ' i RECEIVED NOV 1 18 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT tf 0 0 TOWN OF NORTH ANDOVER of NOR*N , Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ~ 400 OSGOOD STREET '♦o �'' NORTH ANDOVER. MASSACHUSETTS 01845 CHUs�t Susan Y. SaNAyer,RENS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX October 14, 2005 Gay Neilson 1312 Salem Street North Andover, MA 01845 Re: Subsurface Sewage Disposal System Plan for 1312 Salem Street, Map 106A, Lot 160 Dear Ms. Neilson: The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on your behalf by New England Engineering Services dated August 19, 2005, final revision date October 12, 2005 received by this office on October 13, 2005. This approval generally is valid for three years from the date of this letter and during this time a licensed septic system installer must obtain a permit and complete this work, and a Certificate of Compliance must be endorsed by the installer, designer and the Town of North Andover. The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. 1) The 4-bedroom(9-room maximum) design has been approved for use in the construction of a replacement onsite septic system. It includes a local upgrade to the MA DEP regulations that allows a reduction of the leach area from the foundation, from 20 feet to 13 feet. This approval is subject to the following conditions: 1. This parcel has variable depth to shallow bedrock throughout.Additional testing of the eastern side of the system will be conducted upon installation. The installer must inform the Health Department and engineer at the time of excavation of the tank. If it is found that the soils are different in this location,the engineer will make changes to the plan or as needed onsite adjustments approved by the Health Department. 2. This plan calls for the use of the "B" layer of soil. The septic installer must follow the plan carefully to ensure compliance to the code. The installer must pay particular attention to the soils so that the required depth to bedrock is adhered to. If too much soil is removed the installation will be stopped to determine the proper course of action. Bottom of bed depths will likely vary from 8 inches to 60 inches. Q 0 3. The attached DEP Form 9b must be submitted to the appropriate Regional Office of the Department of Environmental Protection at One Winter Street, Boston MA by the property owner. 4. This system utilizes alternative technology that requires perpetual maintenance. Please provide a maintenance agreement for the MicroFast treatment unit and the pressure distribution system as required for a minimum of two years. 5. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). 6. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincere ,f an Y. Sawyer, REH S Public Health Director cc: Ben Osgood Jr., New England Engineering File ♦; 0 0 Commonwealthpf Ma ch setts C ity/Town of I�VDA oJP r a a Local Upgrade Approval Form 913 DEP has provided this form for use by local Boards of Health if they choose to do so. The Local Upgrade Approval is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of the Local Upgrade Approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. A. Facility Information Important: When filling out 1. Facility Name and Address forms on the computer,use Gay Neilson only the tab key Name to move your 1312 Salem Street cursor-do not Street Address use the return key. North Andover MA 01845 CitylTown State Zip Code 2. Owner Name and Address-(if different from above): (same) 2AP1 Name Street Address Cityrrown State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 gpd 5. System Designer: Benjamin C. Osgood, Jr. ® PE ❑ RS Name 60 Beechwood Drive North Andover MA, 01845 Address City/Town State,ZIP B. Approval 1. Local Upgrade Approval is granted for: ® Reduction in setback(s)—specify: Reduction in offset distance between the leach bed and a foundation wall from 20 feet required by Title 5, Section 15.211(1) to 13 feet. Reduction in SAS area of up to 25%: sas size,sq.ft. %reduction Form 913-1312 Salem Street North Andover•rev.5/02 Local Upgrade Approval, Page 1 of 2 o Commonwealth of Massachusetts City/Town of NoA A,ndo%)er Local Upgrade Approval Form 9B B. Approval (continued) ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min./inch Depth to groundwater ❑ Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): List variances granted requiring DEP approval: w i3a -Approving Authority Print or Type Name and Titl SnatureDate Form 9B-1312 Salem Street North Andover•rev.5/02 Local Upgrade Approval* Page 2 of 2 TOWN OF NORTH ANDOVER Q, NCRTH Office of COMMUNITY DEVELOPMENT AND SERVICES o • HEALTH DEPARTMENT 400 OSGOOD STREET "�S',,�o�•*�tg• NORTH ANDOVER, MASSACHUSETTS 01845 CHuse 978.688.9540-Phone Susan Y. Sawyer,R.EHS/RS 978.688.8476—FAX Public Health Director E-MAIL:healthdept@townofnorthandover.com WE.BSIT.E:http://www.townofnorthandover.com September 14,2005 Benjamin Osgood,P.E. New England Engineering Services,Inc. 60 Beechwood Drive North Andover,MA 01845 Re: 1312 Salem Street,Map 106A,Lot 160 Dear Mr.Osgood: The proposed septic system design plan for the above site dated August 19,2005 and received on August 23,2005 has been reviewed. Unfortunately,it cannot be approved until the following items are corrected. Each item is followed by the specific section in Title 5: 310 CMR 15.000 or North Andover regulations which are not met by this design. 1. The parcel has variable depth to shallow bedrock throughout. Additional soil testing should be provided at the eastern side of the soil absorption system to determine the conditions in this area. 2. Wetland resource areas appear to be present on the parcel and should be identified on the site plan. 3. Indications should be provided as to the reason for selecting and proposing to utilize this area of the site which does not comply with state and local standards for the soil absorption stem when it appears P Y rP Y pp other locations on the 3.7 acre site might be more suitable. 4. Please indicate the designed distal head squirt height on the design plan for easy reference. 5. Please cite the DEP Policy number for requesting to utilize the B soil horizon. Additionally,while not a reason for disapproval,you may wish to consider the following: A. The design calls for 34 chambers where only 26.64 chambers are required.The design flow calculations are based on 2.83 sq.ft./LF where 4.72 sq.ft./LF is allowed for the standard Infiltrator-brand chamber. B. Since fewer chambers are actually required,a 25%reduction in area is no longer needed. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Sincere san Y. Sawyer,REHS/R Public Health Director cc: Owner File RECEIVED Commonwealth of Massachusetts North Andover, Massachusetts AUG 15 2013 System Pumpinm Record TOWN OF NORTH ANDOVER HEALTH DEPARTMENT System Owner & Address: Debbie Hoover 1317 Salem Street North Andover, MA 01845 Location of system: Rear yard Date of Pumping: July 25, 2013 Type of system: Septic Tank Gallons Pumped: 1000 gallons System pumped by: Service Pumping& Drain Co.,Inc. 5 Hallberg Park North Reading,Ma License#: BHP-2013-0098,0100,0765,0096,0097,0099,0101 Contents transferred to: Greater Lawrence Sanitary District Date: July-25; 2Q'f3 Pumping Technician: JN This is PROPRIETARY and CONFIDENTIAL information that may be used only by the Board of Health for regulatory purposes Town of North AAd4over HEALTH DEPARTMENT 27 Charles Street rim North Andover,MA 01845 2005 978.688.9540 AUG healthdep ownofnorthandover.com TOWN OF NORTH ANDOVER HEALTH DEPARTMENT SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: U-q dDD,S- SITE LOCATION: /�/a7 �� ? .\ T" /UD>�G1y [JIrP✓ ENGINEER: D� �'• �'t� NEW PLANS: YES V $225.00/Plan ao?$- Check#: (Includes 1s` E{ and one Re-Review Only) REVISED PLANS: YES $75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: S NO Telephone#: L j j g Fax It: E-mail: nee-7g,&49- -" -earn.- HOMEOWNER NAME: OFFICE USE ONLY When the submission is complete (including check): 1. ✓ Date stamp plans and letter. 2. :Zcolwlete and attach Receipt 3. t� Copy File; Forward to Consultant 4. Enter on Log Sheet and Database 0 NEW ENGLAND ENGINEERING SERVICES INC August 20, 2005 Susan Sawyer North Andover Board of Health C "'QED 400 Osgood Street North Andover, MA 01845 AUG 2 3 2005 TOREALT H DEPAFtTMf°TER Re: 1312 Salem Street, North Andover, MA Septic System Design Plan Submittal Dear Ms. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. 2. (2) Copies of the Form 11 Soil Evaluator Sheets. 3. (2) Copies of the Form 12-Percolation Test Sheets. 4. (2) Copies of the Sewage Pump Calculations j5. (2) Copies of the Local Upgrade Approval letter requesting placement on the agenda at next Board of Health meeting. 6. (2) Copies of the Form 9A-Request for Local Upgrade Approval. 7. (2) Copies of the Form 913- Local Upgrade Approval 8. (2) Copies of the Infiltrator DEP Approval 9. (2) Copies of the Micro-Fast System DEP approval. 10. (2) Copies of the Micro-Fast System Maintenance Agreement (Draft Copy). 11. 2) Copies of the Infiltrator Letter of e Clarification.Slope( p P 12. (1) Copy of the Septic System Submittal Form. 13. Check for the Town approval fees. Please contact this office with any questions or concerns. Sincerely, ­–I—L -A— Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 TOWN OF NORTH ANDOVER o�NORTN Office of COMMUNITY DEVELOPMENT AND SERVICES F HEALTH DEPARTMENT 400 OSGOOD STREET 0 �.� �•l� NORTH ANDOVER, MASSACHUSETTS 01845 Ss�c•ono 5�t Susan Y.Sawyer,REHS/RS 978.688.9540—Phone978.688.8476—FAX Public Health Director E-MAIL:healthdeptktownofnorthandover.com t WEBSITE:hn://www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM RECEIVED Date of Submission: g ao0 NOV 18 2005 Site Location: 13 S�I,em S+net4, TOWN NORTH ANDOVER HEALLTT H DEPARTMENT Engineer: AJew Ee\ rv�c New Plans? Yes $225/Plan Check# (includes 1St submission and one re- review only) Revised Plans? Yes_,X $75/Plan Check# 7& Site Evaluation Forms Included? Yes No X Local Upgrade Form Included? Yes X No Telephone 4:L978) G&, - 1768 Fax#:�q 7 gl 6 8 5- 10�►� E-mail: Yleesev►a lit/ Homeowner Name: Gay A)e sorb OFFICE USE ONLY When the submi ion is complete (including check): ➢ — Date stamp plans and letter ➢ Complete and attach Receipt ➢ Copy File, Forward to Consultant I ➢ Enter on Log Sheet and Database Q Q NEW ENGLAND ENGINEERING SERVICES INC November 18, 2005 RECEIVED Susan Sawyer North Andover Board of Health NOV 1, 8 2005 400 Osgood Street North Andover, MA 01845 TOWN O H NORTH AER DEPARTMENT Re: 1312 Salem Street,North Andover,MA Septic System Design Plan Re-Submittal Dear Ms. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. This is in response to the current status of the installation with respect to ledge and PP p p g bedrock found in the proposed system location. Additional field testing was performed by Benjamin C. Osgood, Jr., P.E., and witnessed by Michelle Grant,North Andover Board of Health, on 11/15/05. It has been concluded that a replacement system can be installed in close proximity to the previously approved design plan (last revised on 10/12/05). Changes to the previously approved plan are as follows: 1. Local Upgrade Approval Required. New Local Upgrade Approvals are required for this revised design plan. The Local Upgrade Approval seeks a reduction in offset distance between a leach bed and a property line from 10 feet to 3 feet. Also, a reduction in overdig offset from 5 feet to 3 feet. Supporting documentation regarding this request is enclosed. 2. Addition of Special Design Note. A special provision is indicated in the notes section on sheet 1, and states that the property line must be staked by a professional land surveyor to insure accuracy of the property line. 3. Leach Bed Infiltrator Configuration. The new configuration of Infiltrator chambers is proposed to be 3 rows x 14 chambers. The effective leach area is 792.96 square feet which exceeds the minimum area required of 785.71 square feet. This is calculated in the design data section on sheet 1. It is also graphically depicted on sheet 1 and sheet 2. 4. Segmental Block Retaining Wall. A segmental block retaining wall is proposed. The top of the wall shall be less than 2 feet in height above grade. This can be found in the Infiltrator End Detail on sheet 2. 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 RECEIVED N 0 V 18 2005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 5. Revised Pipe Lengths of Force Main, Manifold, and Discharge Laterals. a. Force main length was extended from 21 feet to 26 feet. Calculations have been revised in the dosing notes (sheet 2) and pressure distribution spreadsheet(separate handout). This is graphically depicted in the plan view(sheet 1) and the system profile (sheet 2). b. Manifold has been reduced in length. Calculations have been revised in the dosing notes (sheet 2) and pressure distribution spreadsheet(separate handout). This is graphically depicted in the plan view(sheet 1) and the pipe layout detail (sheet 2). c. Discharge laterals were extended to 56 feet. Calculations have been revised in the dosing notes (sheet 2) and pressure distribution spreadsheet(separate handout). This is graphically depicted in the plan view(sheet 1),the pipe layout detail (sheet 2), and the system profile (sheet 2). 6. Orifice Spacing. The required spacing of the orifices has been adjusted for optimum pump efficiency and to meet the pressure distribution guidelines of Title 5. Calculations have been revised in the pressure distribution spreadsheet (separate handout), and in the pipe layout detail (sheet 2). 7. Hydromatic SP40 (4/10 hp) Pump. A new system curve was developed, however,the Hydromatic SP40 pump shall still be specified. Calculations have been revised in the pump notes (sheet 2), dosing notes (sheet 2) and the pressure distribution spreadsheet. 8. Elevations. No changes have been made with respect to the elevations of the foundation invert,tanks, distribution box, ESHGW, bottom of bed, or breakout. These changes are reflected in the plan entitled, "Proposed Subsurface Sewage Disposal System, 1312 Salem Street,North Andover, MA,Assessors Map 106A, Lot 160,"dated August 19, 2005, revised to November 17, 2005. Enclosed are the following documents for review. 1. (3) Copies of the Revised Septic Design Plan 2. (2) Copies of Pressure Distribution Calculations 3. Letter of Request to be placed on the Board's November 19th 2005 meeting agenda. 4. Form 9A—Request for Local Upgrade Approval 5. Form 9B—Local Upgrade Approval i Please contact this office with any questions or concerns. Sincerely, I Thomas Hector Project Engineer 0 0 NEW ENGLAND ENGINEERING SERVICES INC November 18, 2005 Susan Sawyer RECEIVED North Andover Board of Health 400 Osgood Street NOV 1:8 2005 North Andover, MA 01845 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Re: 1312 Salem Street,North Andover,MA Local Upgrade Approval Request Dear Ms. Sawyer, The purpose of this letter is to request that the above referenced property be included in the upcoming Board of Health meeting agenda on November 19, 2005 to discuss the following Local Upgrade Approval request: Local Upgrade Approvals Required 1. Reduction in offset distance between the leach bed and a property line from 10 feet required by Title 5, Section 15.211(1)to 3 feet. 2. Reduction in overdig from 5 feet required by Title 5, Section 15.255(5)to 3 feet. If you have any questions or comments, please do not hesitate to contact this office. Sincerely, Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 00 NEW ENGLAND ENGINEERING G NEERIN G SERVICE S INC 1',` Y Fes�i-+ i• .2.c4, �.... ,;:ay Proeli Locatdbri 31 S 4LEM 5TJ2EET NQR7N AND©1fER,MA OW;J - y ;J DESIGN FLOW(in gallons/day)? 440 Elevation of the PUMP OFF SWITCH,in feet? 93.4 Elevation of the upper LATERAL,in feet? 97.55 DELIVERY PIPE distance,from pump to manifold,in feet? 26 G t�r D DELIVERY PIPE diameter,in inches(if not 2"-use 2"min)? 3 p Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) 4 �1 IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)?. yes YES How many orifices in the MANIFOLD? 0 n00G MANIFOLD ORIFICE diameter,in inches(if not 5/16") 0 0.3125 MANIFOLD DIAMETER(if not 2"-use 2"min)? 4 4 TOTAL LENGTH OF MANIFOLD8 TH ANDOVER Does How any MANIFOLD LATERALS7 o FIELD after dose(yes or no).' no 3 �� C ENT Pumping Pumping chamber weep hole size(usually.25") 0.25 USE 0 IF FORCE MAIN DOES NOT DRAIN PROGRAM WILL CALCULATE UP TO 26 LATERALS ANDbP TO 50 ORIFICES PER LATERAL Your HIGHEST elevation lateral MUST be LATERAL 1: (first orifice from lateral 1/2 of orifice spacing) Lateral 1: Lateral 2: Lateral 3: Length of each LATERAL,in feet? 56 56 56 Diameter of each LATERAL,in inches(1.5 min)? 1.5 1.5 1.5 Elevation of each LATERAL,in feet? 97.55 97.55 97.55 Number of ORIFICES per lateral 16 16 16 Distance from Manifold to closest Orifice,in feet 1.75 1.375 1.375 ORIFICE SPACING,in feet 3.5 3.5 3.5 Diameter of ORIFICES,in inches?(D) 0.25 0.25 0.25 Square feet of leachfield per laterals(can ignore) Maximum number of orifices in any one lateral 16 Minimum lateral diameter 1.5 �. FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(DdA2.63)))A1.85) PRESSURE CALCULATIONS(using orifice dischage equation Q=11.79 DA2 hdA.5 Lateral l: Lateral 2: Lateral 3: LATERAL DISCHAGE(first approximation) 23.58 23.58 23.58 MANIFOLD ORIFICE DISCHARGE 0.00 TOTAL SYSTEM DISCHAGE(first approximation) 70.74 TOTAL DISCHARGE PER LATERAL 23.74 23.74 23.74 DISCHARGE PER SQUARE FOOT OF LEACHFIELD #DIV/01 #DIV/0! #DIV/01 ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.50 1.50 1.50 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.47 1.47 1.47 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 1.8% 1.8% 1.8% 0.0% 0.0% MAXIMUM DISCHARGE LATERAL 23.74 MINIMUM DISCHARGE LATERAL 23.74 MAXIMUM DISCHARGE PER SQUARE FOOT #DIV/0! MINIMUM DISCHARGE PER SQUARE FOOT #DIV/0! %DIFFERENCE DISCHARGE for SYSTEM by orifice #REF! as percent of maximum orifice in system %DIFFERENCE DISCHARGE for SYSTEM by laterals 0.0%as percent of maximum lateral in system %DIFFERENCE DISCHARGE for SYSTEM by square feet as percent of maximum square foot in system WEEP HOLE DISCHARGE(usually a 1/4"weep hole) 1.98 weep hole= 0.25 inch VOID VOLUME IN DELIVERY PIPE 9.55 VOID VOLUME IN MANIFOLD 5.22 VOID VOLUME IN EACH LATERAL 5.14 5.14 5.14 TOTAL LATERAL VOID VOLUME 15.42 MINIMUM DOSE VOLUME(based on void volume) 77.11 to 154.21 MIN ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole,usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting headloss) TOTAL HEAD LOSS IN EACH LATERAL 1.10 1.09 1.09 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM 1.10 MANIFOLD HEADLOSS(center-fed unless manifold design) 0.06 DELIVERY PIPE HEADLOSS 0.33 w/delivery 3 inch diameter FITTING LOSS(headloss'.15) 0.60 add extra head if fittings are more than absolute minimum DISTAL PRESSURE HEAD 4.00 STATIC HEAD(OFF-SWITCH TO HIGH LATERAL/MANIFOLD) 4.15 HEADLOSS PUMP TO WEEPHOLE(assume T run) 0.04 PUMP MUST BE ABLE TO PASS SOLIDS AT 73.19 G.P.M 10.28 FEET OF HEAD or After OTIS(network losses=1.3'distal head) 73.19 G.P.M. 13.76 FEET OF HEAD 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(9 78)685-1099 I Q NEW ENGLAND ENGINEERING SERVICES INC DESIGN FLOW(in gallonslday)? 440 Elevation of the PUMP OFF SWITCH,in feet? 93.4 Elevation of the upper LATERAL,in feet? 97.55 DELIVERY PIPE distance,from pump to manifold,in feet? 26 RECEIVED DELIVERY PIPE diameter,in inches(if not 2"-use 2"min)? 3 Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) 4 IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)? yes YES How many orifices in the MANIFOLD? 0 NOV 1' 8 2005 MANIFOLD ORIFICE diameter,in inches(K not 51161 0 0.3125 MANIFOLD DIAMETER(if not 2"-use 2"min)? 4 4 TOTAL LENGTH OF MANIFOLD 8 TOWN OF NORTH ANDOVER Does MANIFOLD drain to FIELD after dose(yes or no)? no HEALTH DEPARTMENT How many LATERALS? 3 Pumping chamber weep hole size(usually.25") 0.25 USE 0 IF FORCE MAIN DOES NOT DRAIN PROGRAM WILL CALCULATE UP TO 26 LATERALS AND UP TO 50 ORIFICES PER LATERAL Your HIGHEST elevation lateral MUST be LATERAL 1: (first orifice from lateral 1/2 of orifice spacing) Lateral 1: Lateral 2: Lateral 3: Length of each LATERAL,in feet? 56 56 56 Diameter of each LATERAL,in inches(LS"min)? 1.5 1.5 1.5 Elevation of each LATERAL,in feet? 97.55 97.55 97.55 Number of ORIFICES per lateral 16 16 16 Distance from Manifold to closest Orifice,in feet 1.75 1.375 1.375 ORIFICE SPACING,in feet 3.5 3.5 3.5 Diameter of ORIFICES,in inches?(D) 0.25 0.25 0.25 Square feet of leachfield per laterals(can ignore) Maximum number of orifices in any one lateral 16 Minimum lateral diameter 1.5 FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(Dd"2.63)))"1.85) PRESSURE CALCULATIONS(using orifice dischage equation Q=11.79 D"2 hd".5 Lateral l: Lateral 2: Lateral 3: LATERAL DISCHAGE(first approximation) 23.58 23.58 23.58 MANIFOLD ORIFICE DISCHARGE 0.00 TOTAL SYSTEM DISCHAGE(first approximation) 70.74 TOTAL DISCHARGE PER LATERAL 23.74 23.74 23.74 DISCHARGE PER SQUARE FOOT OF LEACHFIELD #DIV/01 #DIV/O! #DIV/0! ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.50 1.50 1.50 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.47 1.47 1.47 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 1.8% 1.8% 1.8% 0.0% 0.0% MAXIMUM DISCHARGE LATERAL 23.74 MINIMUM DISCHARGE LATERAL 23.74 MAXIMUM DISCHARGE PER SQUARE FOOT #DIV/01 MINIMUM DISCHARGE PER SQUARE FOOT #DIV/0! %DIFFERENCE DISCHARGE for SYSTEM by orifice #REF1 as percent of maximum orifice in system •DIFFERENCE DISCHARGE for SYSTEM by laterals 0.0%as percent of maximum lateral in system %DIFFERENCE DISCHARGE for SYSTEM by square feet as percent of maximum square foot in system WEEP HOLE DISCHARGE(usually a 1/4"weep hole) 1.98 weep hole= 0.25 inch VOID VOLUME IN DELIVERY PIPE 9.55 VOID VOLUME IN MANIFOLD 5.22 VOID VOLUME IN EACH LATERAL 5.14 5.14 5.14 TOTAL LATERAL VOID VOLUME 15.42 MINIMUM DOSE VOLUME(based on void volume) 77.11 to 154.21 MIN ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole,usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting headloss) TOTAL HEAD LOSS IN EACH LATERAL 1.10 1.09 1.09 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM 1.10 MANIFOLD HEADLOSS(center-fed unless manifold design) 0.06 DELIVERY PIPE HEADLOSS 0.33 w/delivery 3 inch diameter FITTING LOSS(headloss'.15) 0.60 add extra head if fittings are more than absolute minimum DISTAL PRESSURE HEAD 4.00 STATIC HEAD(OFF-SWITCH TO HIGH LATERAL/MANIFOLD) 4.15 HEADLOSS PUMP TO WEEPHOLE(assume 3'run) 0.04 PUMP MUST BE ABLE TO PASS SOLIDS AT 73.19 G.P.M 10.28 FEET OF HEAD or After OTIS(network losses=1.3'distal head) 73.19 G.P.M. 13.76 FEET OF HEAD 60 BEECHWOOD DRIVE-.NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 NEW ENGLAND ENGINEERING SERVICES INC October 13, 2005 Susan Sawyer Res North Andover Board of Health OCT 13 2005 400 Osgood Street North Andover, MA 01845 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Re: 1312 Salem Street, North Andover, MA Septic System Design Plan Re-Submittal Dear Ms. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. This is in response to your letter dated September 14, 2005 regarding the septic design plan review for the above referenced property. The issues have been addressed as follows: 1. Additional Soil Testing. Additional testing to the eastern side of the SAS was restricted due to the fact that the site had variable depth to shallow bedrock. In addition, testing could not be performed near the existing (flooded and failed) leach area or system components, in fear that disruption to the current system could create an emergency situation. If the Board of Health feels that testing is needed in this area, it would have to be done prior to the construction of the field. 2. Wetland Resource Areas Present. It was determined in the field, the day of soil testing, that any wetland resource area was well over 150 feet from the proposed test pit location and proposed leaching facility location. This was determined by Benjamin C. Osgood, Jr. and Andrew McBrearty of Mill River Consulting. 3. Determination of Site Location. The decision for the proposed site location was determined through the process of elimination. Other areas on the property were wooded with outcrops, which is typical for this area. Also, with wetland resource areas present, we wanted to keep a maximum distance to those areas. Testing was not performed in other areas because no other suitable areas were found as determined by Benjamin C. Osgood, Jr. and Andrew McBrearty of Mill River Consulting. 4. Distal Head Squirt Height. This figure is now located in theDesign Data section on sheet 1, and is also indicated in the Pipe Layout Detail on sheet 2. 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 Q Q 5. Cite DEP Policy Number. This has been addressed and is included in the Special Design Note on sheet 1. Additionally, changes to the design data have been made with respect to the 25% reduction the leach field. Under the original design plan (dated August 19, 2005), a 25%reduction in leach field size had been sought. Due to a revised interpretation of the MicroFAST system approval by DEP, the use of the infiltrator size reduction approval by DEP can be combined with the reduced soil depth requirement of the MicroFAST system. This revised design plan has been adjusted accordingly, and a 25% reduction in leach field size is no longer needed. On another note, the Infiltrator Chamber model has been changed from the original design plan. It has been brought to our attention that the Infiltrator-Standard Chamber is no longer available. The replacement product is the Infiltrator-Quick4 Standard Chamber. Details of this new chamber are shown in the Infiltrator Detail on sheet 2. We have also included the DEP approval- Modified Certification for General Use for the Quick4 Standard chamber. Enclosed are the following documents for review and approval. 1. (3) Copies of the Revised Septic Design Plan 2. (2) Copies of Pressure Distribution Calculations 3. (2) Copies of Modified Certification for General Use-Infiltrator Systems, Inc. Please contact this office with any questions or concerns. Sincerely, 1 Thomas Hector Project Engineer 0 0 NEW ENGLAND ENGINEERING SERVICES P INC PRESSI RE°DISTR1S`U7lON DESIGN-'SPREADSHEET Prop6rty,1,ocat16n 131;2.SALEM,STREETNOR,TWANDOVER,'Mk: October 10,2005 DESIGN FLOW(in gallons/day)? 440 Elevation of the PUMP OFF SWITCH,in feet? 93.4 Elevation of the upper LATERAL,in feet? 97.38 DELIVERY PIPE distance,from pump to manifold,in feet? 21 DELIVERY PIPE diameter,in inches(if not 2"--use 2"min)? 3 Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) 4 IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)? yes YES How many orifices in the MANIFOLD? 0 MANIFOLD ORIFICE diameter,in inches(if not 5/16") 0 0.3125 MANIFOLD DIAMETER(if not 2"--use 2"min)? 4 4 1 0 1." .v. � TOTAL LENGTH OF MANIFOLD 11 Does MANIFOLD drain to FIELD after dose(yes or no)? no How many LATERALS? 4 Pumping chamber weep hole size(usually.25") L 0.25 USE 0 IF FORCE MAIN DOES NOT DRAIN (1 y PROGRAM WILL CALCULATE UP TO 26 LATERALS AND UP TO 50 ORIFICES PER LATERAL OCT p I J 2005 Your HIGHEST elevation lateral MUST be LATERAL 1: TOWN 0- (first orifice from lateral 1/2 of orifice spacing) Lateral 1: Lateral 2: Lateral 3: Lateral 4: HEAL) ORTH ANDOVER Length of each LATERAL,in feet? 44 44 44 44, H DEPARTMENT Diameter of each LATERAL,in inches(1.5"min)? 1.5 1.5 1.5 1.5 Elevation of each LATERAL,in feet? 97.38 97.38 97.38 97.38 Number of ORIFICES per lateral 12 12 12 12. Distance from Manifold to closest Orifice,in feet 1.375 1.375 1.375 1.3751 ORIFICE SPACING,in feet 3.5 3.5 3.5 3.5, Diameter of ORIFICES,in inches?(D) 0.25 0.25 0.25 0.25 Square feet of leachfield per laterals(can ignore) Maximum number of orifices in any one lateral 14 Minimum lateral diameter 1.5 FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(Dd^2.63)))^1.85) PRESSURE CALCULATIONS(using orifice uischage equation Q=11.79 D^2 hd^.5 Lateral l: Lateral 2: Lateral 3: Lateral 4: LATERAL DISCHAGE(first approximation) 17.69 17.69 17.69 1769 MANIFOLD ORIFICE DISCHARGE 0.00 TOTAL SYSTEM DISCHAGE(first approximation) 70.74 TOTAL DISCHARGE PER LATERAL 17.75 17.75 17.75 17.75 DISCHARGE PER SQUARE FOOT OF LEACHFIELD #DIV/0! #DIV/0! #DIV/0! #DIV/0! ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.49 1.49 1.49 1.49 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.47 1.47 1.47 1.47 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 1,0% 1.0% 1.0% 1.0% 0.0% MAXIMUM DISCHARGE LATERAL 17.75 MINIMUM DISCHARGE LATERAL 17.75 MAXIMUM DISCHARGE PER SQUARE FOOT #DIV/0! MINIMUM DISCHARGE PER SQUARE FOOT #DIV/0! %DIFFERENCE DISCHARGE for SYSTEM by orifice #REF! as percent of maximum orifice in system •DIFFERENCE DISCHARGE for SYSTEM by laterals 0.0% as percent of maximum lateral in system •DIFFERENCE DISCHARGE for SYSTEM by square feet as percent of maximum square foot in system WEEP HOLE DISCHARGE(usually a 1/4"weep hole) 1.86 weep hole= 0.25 inch VOID VOLUME IN DELIVERY PIPE 7.71 VOID VOLUME IN MANIFOLD 718 VOID VOLUME IN EACH LATERAL 4.04 4.04 4.04 4.04 000 TOTAL LATERAL VOID VOLUME 16.16 MINIMUM DOSE VOLUME(based on void volume) 80.78 to 161.56 MIN ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole,usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting headloss) TOTAL HEAD LOSS IN EACH LATERAL 0.50 0.50 0.50 0.50 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM 0.50 MANIFOLD HEADLOSS(center-fed unless manifold design) 0.03 DELIVERY PIPE HEADLOSS 0.26 w/delivery 3 inch diameter FITTING LOSS(headloss'.15) 0.60 add extra head if fittings are more than absolute minimum DISTAL PRESSURE HEAD 4.00 STATIC HEAD(OFF-SWITCH TO HIGH LATERAL/MANIFOLD) 3.98 HEADLOSS PUMP TO WEEPHOLE(assume 3'run) 0.04 PUMP MUST BE ABLE TO PASS SOLIDS AT 72.87 G.P.M 9.41 FEET OF HEAD or After OTIS(network losses=1.3'distal head) 72.87 G.P.M. 13.52 FEET OF HEAD 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645- FAX(978)685-1099 Q 0 NEW ENGLAND ENGINEERING SERVICES INC F -4 PREOREID STRIBUTiON DESIGN SPREADSHEET ti Property Location 1312 SALEM STREET NQRTH ANDOVER MA DESIGN FLOW(in gallons/day)? 440 Elevation of the PUMP OFF SWITCH,in feet? 93.4 Elevation of the upper LATERAL,in feet? 97.38 DELIVERY PIPE distance,from pump to manifold,in feet? 21 DELIVERY PIPE diameter,in inches(if not 2"--use 2"min)? 3 Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) 4 IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)? Uno YES How many orifices in the MANIFOLD? MANIFOLD ORIFICE diameter,in inches(if not 5/16") 0.3125 MANIFOLD DIAMETER(if not 2"--use 2"min)? 4 TOTAL LENGTH OF MANIFOLD Does MANIFOLD drain to FIELD after dose(yes or no)?How many LATERALS?Pumping chamber weep hole size(usually.25") USE 0 IF FORCE MAIN DOES NOT DRAIN PROGRAM WILL CALCULATE UP TO 26 LATERALS AND UP TO 50 ORIFICES PER LATERAL L Your HIGHEST elevation lateral MUST be LATERAL 1: (first orifice from lateral 1/2 of orifice spacing) Lateral 1 Lateral 2: Lateral 3: Lateral 4: Length of each LATERAL,in feet? 44 44 44 44, Diameter of each LATERAL,in inches(1.5"min)? 1.5 1.5 1.5 1.5= Elevation of each LATERAL,in feet? 97.38 97.38 97.38 97.38= Number of ORIFICES per lateral 12 12 12 12< Distance from Manifold to closest Orifice,in feet 1.375 1.375 1.375 1.3751 ORIFICE SPACING,in feet 3.5 3.5 3.5 3.51. Diameter of ORIFICES,in inches?(D) 0.25 0.25 0.25 0.251 Square feet of leachfield per laterals(can ignore) Maximum number of orifices in any one lateral 14 Minimum lateral diameter 1.5 FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(Dd^2.63)))^1.85) PRESSURE CALCULATIONS(using orifice dischage equation Q=11.79 D^2 hd^.5 Lateral l: Lateral 2: Lateral 3: Lateral 4: LATERAL DISCHAGE(first approximation) 17.69 17.69 17.69 17.69 MANIFOLD ORIFICE DISCHARGE 0.00 TOTAL SYSTEM DISCHAGE(first approximation) 70.74 TOTAL DISCHARGE PER LATERAL 17.75 17.75 17.75 17.75 DISCHARGE PER SQUARE FOOT OF LEACHFIELD #DIV/0! #DIV/0! #DIV/0! #DIV/01 ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.49 1.49 1.49 1.49 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.47 1.47 1.47 1.47 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 1.0% 1.0% 1.0% 1.0% 0.0% MAXIMUM DISCHARGE LATERAL 17.75 MINIMUM DISCHARGE LATERAL 17.75 MAXIMUM DISCHARGE PER SQUARE FOOT #DIV/0! MINIMUM DISCHARGE PER SQUARE FOOT #DIV/O! %DIFFERENCE DISCHARGE for SYSTEM by orifice #REF! as percent of maximum orifice in system %DIFFERENCE DISCHARGE for SYSTEM by laterals 0.0%as percent of maximum lateral in system %DIFFERENCE DISCHARGE for SYSTEM by square feet as percent of maximum square foot in system WEEP HOLE DISCHARGE(usually a 1/4"weep hole) 1.86 weep hole= 0.25 inch VOID VOLUME IN DELIVERY PIPE 7.71 VOID VOLUME IN MANIFOLD 7.18 VOID VOLUME IN EACH LATERAL 4.04 4.04 4.04 4.04 0.00 TOTAL LATERAL VOID VOLUME 16.16 MINIMUM DOSE VOLUME(based on void volume) 80.78 to 161.56 MIN ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole,usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting headloss) TOTAL HEAD LOSS IN EACH LATERAL 0.50 0.50 0.50 0.50 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM 0.50 MANIFOLD HEADLOSS(center-fed unless manifold design) 0.03 DELIVERY PIPE HEADLOSS 0.26 w/delivery 3 inch diameter FITTING LOSS(headloss`.15) 0.60 add extra head if fittings are more than absolute minimum DISTAL PRESSURE HEAD 4.00 STATIC HEAD(OFF-SWITCH TO HIGH LATERAUMANIFOLD) 3.98 HEADLOSS PUMP TO WEEPHOLE(assume 3'run) 0.04 PUMP MUST BE ABLE TO PASS SOLIDS AT 72.87 G.P.M 9.41 FEET OF HEAD or After OTIS(network losses=1.3'distal head) 72.87 G.P.M. 13.52 FEET OF HEAD 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 0 Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Friday, September 16, 2005 7:56 AM To: amcbrearty@miliriverconsulting.com; Lisa Kozel LeVasseur; DelleChiaie, Pamela; Sawyer, Susan Subject: 1312 Salem Street plan review Plan review attached. You'll see the soils are seriously marginal at this site and we do not feel it appropriate to base the design for the SAS in an area where a large section of what is beneath the SAS is unknown. Due to the variable depth to ledge, I would not advocate that this soil testing occur at the time of installation but rather that it is documented prior to final plan approval. Dan I Daniel Ottenheimer,President Mill River Consulting,Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting c-om dpno@millriverconsultina.com 11/22/2005 0 Commonwealth 'f Massachusetts R '� '- EC City/Town of A)oA�\ AAcl over a W Form 9A - Application for Local Upgrade Alismowl TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 5.404(1), is not feasible. 310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer,use Gay Neilson only the tab key Name to move your 1312 Salem Street cursor-do not use the return Street Address key. North Andover MA 01845 City/Town State Zip Code 2. Owner Name and Address (if different from above): same as above 'e"A1 Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Installation of new residential subsurface sewage disposal system. 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other(describe below): Current residential sewage disposal system is in failure. Form 9A Second LUA-1312 Salem Street North Andover•rev.5/02 Application for Local Upgrade Approval* Page 1 of 4 1 Q Commonwealth of Massachusetts Cityrrown of W Form 9A - Application for Local Upgrade Approval G H SVOy`' I DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): Leach field 7. Design Flow per 310 CMR 15.203: Design flow of existing system: ptlknown Design flow of proposed upgraded system 440 gpd Design flow of facility: 440 gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): ® Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: Replacement of leaching facility and components. 3. Local Upgrade Approval is requested for(check all that apply): ® Reduction in setback(s)—describe reductions: 1. Reduction in offset distance between the leach bed and a property line from 10 feet required by Title 5, Section 15.211(1)to 3 feet. 2. Reduction in overdig from 5 feet required by Title 5, Section 15.255(5)to 3 feet. ❑ Reduction in SAS area of up to 25%: reduction a SAS size,sq.ft. /o ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min./inch Depth to groundwater Form 9A Second LUA-1312 Salem Street North Andover•rev.5/02 Application for Local Upgrade Approval, Page 2 of 4 0 Commonwealth of Massachusetts City/Town of /Jor4 , AvNAove r- Form 9A - Application for Local Upgrade Approval M yv9 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the p fY Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(i)(1). The soil evaluator must be a member or agent of the local approving authority. : High groundwater evaluation determined b 9 Y Andrew McBrearty 6/8/05 Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: No other location available on the lot for the system size required. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: A 1500 gallon Micro Fast Septic tank is included in the design. Form 9A Second LUA-1312 Salem Street North Andover•rev.5/02 Application for Local Upgrade Approval* Page 3 of 4 Commonwealth of Massachusetts City/Town of JJot�ti Ar dower a L w Fora 9A - Application for Local Upgrade Approval LSM Sv DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: No available system in the vacinity. 4. Connection to a public sewer is not feasible: Town sewer is not in the area of the property. 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit ❑ Complete plans and specifications ❑ Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." Cc 11/17/05 Facilit wner's Signature V Date Benjamin C. Osgood, Jr., P.E. (Agent for owner) New England Engineering Services 11/17/05 9 9 Name of Preparer Date 60 Beechwood Drive North Andover Preparer's address City/Town MA 01810 978-686-1768 State/ZIP Code Telephone Form 9A Second LUA-1312 Salem Street North Andover•rev.5/02 Application for Local Upgrade Approval, Page 4 of 4 l ,per \ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 JANE SWIFT RSC E!VED BOB DURANb Governor Secretary AUG 2 3 2005 IAUREN A.LISS Commissioner TOWN OF NORTH ANDOVER HEALTH DEPARTMENT APPROVAL FOR REMEDIAL USE Pursuant to Title, 310 CMR 15.00 Name and Address of Applicant: Bio-Microbics, Inc, 8450 Cole Parkway Shawnee,KS 66227 Trade name of technology and model: MicroFAST Treatment System Models MicroFAST 0.5, 0.9, 1.5, 3.0, 4.5 and 9.0;HighStrengthFAST Treatment System Models HighStrengthFAST 1.0, 1.5, 3.0, 4.5 and 9.0 and N'itriFAST Treatment System Models NitriFAST 0.5, 1.0, 1.5, 3.0, 4.5 and 9.0 (hereinafter called the"System"). Schematic drawings of each model are attached and are a part of this Approval. Date of Application: March 16, 2001 Transmittal Number: W 019013 Date of Issuance: August 13, 2001 Expiration date:te. Auiu st 13 2006 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Approval for Remedial Use to: Bio-Microbics, Inc., 8450 Cole Parkway, Shawnee, KS 66227 (hereinafter "the Company"), approving the System described herein for Remedial Use in the Commonwealth of Massachusetts. Sale and use of the System are conditioned on compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000. Glenn Haas,Acting Assistant Commissioner Date Bureau of Resource Protection Department of Environmental of Protection This information is available in alternate format by calling our ADA Coordinator at(617)5746872. DEP on the World Wide Web: httpJhvww.state.ma.usldep I'$ Printed on Recycled Paoer Bio-A icrobics Remedial Use Approval A icroFAST,HighStrengthFAST and NitriFAST I. Purpose 1. The purpose of this approval is to allow use of the System in Massachusetts, on a Remedial Use basis. 2. With the necessary permits and approvals required by 310 CMR 15.000, this Approval for Remedial Use authorizes the use and installation of the System in Massachusetts. 3. The System may only be installed on facilities that meet the criteria of 310 CMR 15.284(2). 4. This Remedial Use Approval authorizes the a use of the System where the local approving authorityfinds that the System is for upgrade of a failed, failing or nonconforming system and the design flow for the facility is less than 10,000 gallonspe r day ( GPD) and there is no increase in design flow to be served by the system. H. Design Standards 1. The FAST treatment system(Fixed Activated Sludge Treatment),Models MicroFAST 0.5, 0.75, 0.9,and 1.5, lEghStrengthFAST 1.0 and 1.5,NitriFAST 0.5, 0.75, 0.9 and 1.5 all consist of a single tank having a primary settling zone and an aerobic biological zone. Solids are trapped in the primary zone where they settle. In the aerobic zone,the bacteria colony attaches itself to the surface of a submerged media bed and feeds on the sewage as it circulates. Models MicroFAST,I ighStrengthFAST and NitriFAST 3.0, 4.5 and 9.0 consist of a standard Title 5 septic tank for settling solids and a second tank with the submerged media for aerobic treatment. 2. Models MicroFAST 0.5, 0.75 and 0.9. lEghStrengthFAST 1.0,NitriFAST 0.5, 0.75 and 0.9 shall be installed in the second compartment of a two compartment septic tank with a total liquid capacity of at least 1,500 gallons. Models MicroFAST,I-EghStrengthFAST and NitriFAST 1.5 shall be installed in the second compartment of a 3000 gallon tank. The two compartment septic tank shall be installed between the building sewer and the pump chamber of a standard Title 5 system constructed in accordance with 310 CMR 15.100- 15.279, subject to the provisions of this Approval. MicroFAST,lEghStrengthFAST and NitriFAST Models 3.0, 4.5 and 9.0 shall be installed between a septic tank designed in accordance with 310 CMR 15.223 and the pump chamber of a SAS. 3. The System is approved for use at facilities with a maximum design flow up to 10,000 GPD. 4. The System may be used in soils with a percolation rate of up to 90 min.fmch. For soils with a percolation rate of 60 to 90 min./inch, the effluent loading rate shall be 0.15 GPD/ sq. ft. 5. Pressure distribution designed in accordance with Department guidelines is required for all installations of the System. Pave 2 of R ` � I O Bio-Microbics Remedial Use Approval MicroFA,.ST,HighStrengthFAST and NitriFAST III. Allowable Soil Absorption System Design 1. Reduction of the Required Soil Absorption System Size - An Applicant is eligible for up to a 50 percent reduction in the area of the soil absorption system required by 310 CMR 15.242, where all the following is met. Accordingly, in approving design and installation of the System by a particular Applicant, the local approving authority may allow up to a 50 percent reduction in the area of the soil absorption system required by 310 CMR 15.242,provided that all of the following conditions are met: A. No reduction in the required separation(four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. B. No reduction in the required four feet of naturally occurring pervious material is allowed unless the Applicant has demonstrated that the four foot requirement cannot be met wWwhere on the site,that easements to adjacent property on which a system in compliance with the four foot requirement could be installed have been requested but cannot be obtained, and that a shared system is not feasible. Any such reduction must first be approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. C. Where full compliance with all of the minimum setback distances in 310 CMR 15.211 is not feasible, the local approving authority may allow a reduction under a local upgrade approval in accordance with 310 CMR 15.405 (1)(a),(b),(f),(g),and(h). D. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, even taking into account provisions for local upgrade approval as described above, then pursuant to 310 CMR 15.410,the applicant first must obtain variance(s)from the local approving authority and then approval of the Department. 2. Reduction of the Required Separation Distance to I i hg_Groundwater Elevation-An applicant is eligible for a reduction in separation.(four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch) between the bottom of the stone underlying the SAS and the high groundwater elevation, where all of the following conditions are met. Accordingly, in approving design and installation of the System by a particular Applicant, the local approving authority may allow a reduction in the required separation (four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation,provided that all of the following conditions are met: A. A minimum two foot separation(in soils with a recorded percolation rate of more than two minutes per inch) or a minimum three foot separation(in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation is maintained. Pape.3 of R 0 Bio-Microbics Remedial Use Approval MicroFAST,HighStrengthFAST and NitriFAST B. No reduction in the required SAS size is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. C. No reduction in the required four feet of naturally occurring pervious material is allowed unless the Applicant has demonstrated that the four foot requirement cannot be met anywhere on the site,that easements to adjacent property on which a system in compliance with the four foot requirement could be installed have been requested but cannot be obtained, and that a shared system is not feasible. Any such reduction must first be approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. D. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, the local approving authority may allow a reduction under a local upgrade approval in accordance with 310 CMR 15.405 (1)(a), (b),(f), (g),and(h). E. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, even taking into account provisions for local upgrade approval as described above, then pursuant to 310 CMR 15.410,the applicant first must obtain variances)from the local approving authority and then approval of the Department. 3. Reduction of the Requirement for Four Feet of Naturally Occurring Pervious Material An Applicant is eligible for a reduction in the required four feet of naturally occurring pervious material in an area of no less than two feet of naturally occurring pervious material,where all of the following conditions are met. Accordingly, in approving design and installation of the System by a particular Applicant, the local approving authority may allow a reduction in the required four feet of naturally occurring pervious material in an area with no less than two feet of naturally occurring pervious material,provided that all of the following conditions are met: A. The Applicant has demonstrated that the four foot requirement cannot be met anywhere on the site, and that easements to adjacent property on which a system in compliance with the four foot requirement could be installed have been requested but cannot be obtained, and .. that a shared system is not feasible. B. No reduction in the required SAS size is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. C. No reduction in the required separation (four feet in soils with a recorded percolation rate of more than two minutes per inch or five feet in soils with a recorded percolation rate of two minutes or less per inch)between the bottom of the stone underlying the SAS and the high groundwater elevation is allowed unless such a reduction is first approved by the local approving authority and then approved by the Department pursuant to 310 CMR 15.284. D. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is Pave:4 of 8 0 Bio-Microbics Remedial Use Approval Mi.roFAST,HighStrengthFAST and NitriFAST not feasible, the local approving authority may allow a reduction under a local upgrade approval in accordance with 310 CMR 15.405 (1)(a),(b),(0,(g),and(h). E. Where full compliance with all of the minimum set back distances in 310 CMR 15.211 is not feasible, even taking into account provisions for local upgrade approval as described above, then pursuant to 310 CMR 15.410, the applicant first must obtain variance(s) from the local approving authority and then approval of the Department. IV. General Conditions 1. All provisions of 310 CMR 15.000 are applicable to the use of this System,the owner and the Company,except those that specifically have been varied by the terms of this Approval. 2. Any required sample analysis shall be conducted by an independent U.S. EPA or DEP approved testing laboratory,or a DEP approved independent university laboratory. It shall be a violation of this Approval to falsify any data collected pursuant to an approved testing plan,to omit any required data or to fail to submit any report required by such plan. 3. The facility served by the System and the System itself shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 4. In accordance with applicable law, the Department and the local approving authority may require the owner of the System to cease operation of the System and/or to take any other action as it deems necessary to protect public health,safety,welfare and the environment. 5. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least equivalent to that of a sewer system Accordingly,no System shall be installed,upgraded or expanded,if it is feasible to connect the facility to a sanitary sewer,unless as allowed by 310 CMR 15.004. 6. Design and installation shall be in strict conformance with the Co approved Company's DEP app o ed plans and specifications,310 CMR 15.000 and this Approval. V. Conditions Applicable to the System Owner 1. The System is approved for the treatment and disposal of sanitary sewage only. Any wastes that are non-sanitary sewage generated or used at the facility served by the System shall not be introduced into the System and d shall be lawfiilly disposed. 2. Effluent discharge concentrations shall meet or exceed secondary treatment standards of 30 mg/L biochemical oxygen demand (BODS) and 30 mg/L total suspended solids (TSS). The effluent pH shall not vary more than 0.5 standard units from the influent water supply. 3. Operation and Maintenance Agreement: A. Throughout its life, the Owner of the System shall have the System properly operated and maintained in accordance with Company's and designer's operation and maintenance requirements and this Approval and be under an operation and maintenance agreement(O&M). No O&M agreement shall be for less than one year. B. No System shall be used until an O&M agreement is submitted to the approving Ploo5ofR Bio-Microbics Remedial Use Approval MicroFAST,HighStrengthFAST and NitriFAST authority which: a. provides for the contracting of a person or firm competent in providing services consistent with the System's specifications and the operation and maintenance requirements specified by the designer and those specified by the Department; b. contains procedures for notification to the local approving authority and the Department within five days of a System failure, malfunction or alarm event and for corrective measures to be taken immediately; and c. Provides the name of the operator, which must be a Massachusetts certified operator as required by 257 CMR 2.00 that will operate and monitor the System. The owner of the System shall at all times have the System properly operated and maintained, at a minimum every three months and every time there is an alarm event. The local approving authority and the Department shall be notified, in writing,within seven days every time the operator or operators are changed. 4. The owner shall fiunish the Department any information, which the Department may request regarding the System,within 21 days of the date of receipt of that request. 5. Within 30 days of the approving authority's issuance of the Certificate of Compliance for the system,the owner shall submit a copy of the Certificate of Compliance to the Department. 6. By January 314 of each year for the previous year, the System owner shall submit to the Department and the local approving authority an O&M checklist and a technology checklist, completed by the System operator for each inspection performed during the previous calendar year. Copies of the checklists are attached to this approval. 7. The owner of the System shall record in the appropriate registry of deeds a notice that discloses the existence of this Remedial Use approved alternative system. A copy of the book and page number of the recording must be provided to the local approving authority and the Department prior to the issuance of the Certificate of Compliance. S. The owner of the System shall provide a copy of this Approval, prior to the signing of a purchase and sale agreement for the facility served by the System or any portion thereof;to the proposed new owner. 9. Effluent from a system serving a facility with a design flow of less than 2000 GPD shall be monitored quarterly. Both influent and effluent from a system serving a facility with a design flow 2000 GPD to 10,000 GPD shall be monitored monthly. At a minimum, the following parameters shall be monitored: pH, BODS, and TSS. All monitoring and operation and maintenance data shall be submitted to the local approving authority and the Department by January 314 of each year for the previous calendar year. After one year of monitoring and reporting and at the written request of the owner, the Department may reduce the monitoring and reporting requirements. 10. When sanitary sewer connection becomes feasible,within 60 days of such feasibility,the owner of the System shall obtain necessary permits and connect the facility served by the System to the sewer, shall abandon the System in compliance with 310 CMR 15.354, unless a later time is allowed, in writing, by the local approving authority, and shall in writing notify the Department of the abandonment. Page.6ofIt Bio-Microbics Remedial Use Approval MicroFAST,HigbStrengthFAST and NitriFAST VI. Conditions Applicable to the Company 1. By January 3 1 d of each year,the Company shall submit to the Department, a report, signed b a corporate officer,general partner or Company owner that contains information on the System, for the previous calendar year. The report shall state:the number of units of the System sold for use in Massachusetts including the installation date and date of start-up during the previous year;the address of each installed System, the owner's name and address,the type of use(e.g. residential, commercial, school, institutional) and the design flow; and for all Systems installed since the date of issuance of this Approval, all known failures, malfunctions, and corrective actions taken and the address of each such event. 2. The Company shall notify the Director of the Watershed Permitting Program at least 30 days in advance of the proposed transfer of ownership of the technology for which this Approval is issued Said notification shall include the name and address of the proposed new owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership,responsibility,coverage and liability between them. All provisions of this Approval applicable to the Company shall be applicable to successors and assigns of the Company,unless the Department determines otherwise. 3. The Company shall furnish the Department any information that the Department requests regarding the System,within 21 days of the date of receipt of that request. 4 Prior to its sale of the System, the Company shall provide the purchaser with a copy of this Approval. In any contract for distribution or sale of the System,the Company shall require the distributor or seller to provide the purchaser of the System, prior to any sale of the System, with a copy of this Approval. 5 If the Company wishes to continue this Approval after its a�ita Uon date the Company shall for and obtain a renewal of this Approval.applypp al. The Company shall submit a renewal application at least 180 days before the expiration date of this Approval, unless written permission for a later date has been granted in writing by the Department. VII. Reporting P g 1. All notices and documents required to be submitted to the Department by this Approval shall be submitted to: Director Watershed Permitting Program Department of Environmental Protection One Winter Street-6th floor Boston,Massachusetts 02108 VIII. Rights of the Department Pope 7ofa Bio-Microbics Remedial Use Approval MicroFAST,HighStrengthFAST and NitriFAST 1. The Department may suspend, modify or revoke this Approval for cause, including, but not limited to, non-compliance with the terms of this Approval, non-payment of the annual compliance assurance fee, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to this Approval and/or the System against the owner, or operator of the System and/or the Company. IX. Expiration Date 1. Notwithstanding the expiration date of this Approval,any System sold and installed prior to the expiration date of this Approval, and approved, installed and maintained in compliance with this Approval (as it may be modified) and 310 CMR 15.000, may remain in use unless the Department, the local approving authority, or a court requires the System to be modified or removed,or requires discharges to the System to cease. W019013 Remedial Bio-Microbics 8-13 Combined Paup8of8 0 0 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 RECEIVED MITT ROMNEY ELLEN ROY HERZFELDER Governor AUG 2 3 2005 Secretary EERRY tiF.aM EDWARD P.KUNCE Lieutenant Governor Acting Commissioner TOWN OF NORTH A� JOVLR HEALTH DEPAR) y,tti; MODIFIED CERTIFICATION FOR GENERAL USE Pursuant to Title 5,310 CMR 15.000 Name and Address of Applicant: Infiltrator Systems,Inc. P.O.Box 768 6 Business Park Road Old Saybrook,CT 06475 Trade name of technology and model:High Capacity Chamber,Standard Chamber,Infiltrator 3050 (Storm Tech SC-740)and Equalizer 24 and 36 (hereinafter the"System"). Transmittal Number: W023699 Date of Issuance: February 21,2003 Date of Expiration: February 21,2008 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Certification to: Infiltrator Systems,Inc.,P.O. Box 768, 6 Business Park Road,Old Saybrook,CT 06475(hereinafter"the Company"),for General Use of the System described herein. Sale and use of the System are conditioned on and subject to compliance by the Company and the System owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000. Glenn Haas,Director Date Division of Watershed Management Department of Environmental Protection Tbb bdormatlen b avabble to atternate fam*L Call Aprei McCabe,ADA Coordinator at 1.617-55t:117L TDD Ser Ace-1-800.298-2207. DEP on the World Wide Web: httpJMrnw.niass.gov/dep () Prir Red on Recycled Paper O O Infiltrator Modified Certification for General Use Page 2 of 8 I. Purpose 1. The purpose of this Certification is to allow use of the System in Massachusetts, on a General Use basis. 2. With the necessary permits and approvals required by 310 CMR 15.000, this Certification authorizes the use of the System in Massachusetts. I The System may be installed on all facilities where a system in compliance with 310 CMR 15.000 exists on site or could be built and for which a site evaluation in compliance with 310 CMR 15.000 has been approvedby the local approving authority,or by DEP if DEP approval is required by 310 CMR 15.000. II. Design Standards 1. The models listed below are covered under this Certification. Dimensions Invert Model W x L x H Height Inches Inches Equalizer 24 15 x 100 x 11 6 Equalizer 36 22 x 100 x 13.5 6 Standard Chamber 34 x 75 x 12 6.5 Infiltrator 3050 or 51 x 85.4 x 30 24 StormTech SC-740 High Capacity Chamber 34 x 75 x 16 11 2. The System is an open-bottom leachingunit molded from polyolefin resin It can Po Y be installed withoutate or distribution aggreg b pipe as an absorption trench in accordance with the requirements in 310 CMR 15.251. 3. The use of aggregate as specified in 310 CMR 15.247 is not necessary with the System when installed as a trench,bed or field. 4. The minimum separation between any two trenches shall be as specified in 310 CMR 15.251. 5. For new construction, the applicant can size the System in a trench configuration without aggregate, using the effective leaching areas presented in the following table. No System shall be designed and constructed with a soil absorption system area of less than 400 square feet. i O Q Infiltrator Modified Certification for General Use Page 3 of 8 Effective Effective Model Leachings Leaching2 Area Area SF/LF SF/LF Equalizer 24 3.75 NA Equalizer 36 4.73 NA Standard Chamber 6.53 NA Infiltrator 3050 or NA 8.2 StormTech SC-740 lhgh Capacity Chamber 7.79 NA 1. Effective leaching area is equal to 1.67 times the bottom width plus two x invert. 2. Effective leaching area is equal to 1.0 times the bottom width plus two x invert. 6. Systems shall be sized in accordance with the following table for new construction in DEP designated nitrogen limited areas as defined in 310 CMR 15.214 and 15.215. The effective leaching area, as shown in the following table, shall be used for any System installed in a Department designated Nitrogen Sensitive Area or for any System that is installed for new construction where a private drinking water supply well is proposed to serve the facility, as defined in 310 CMR 15.214 (2) and for which a variance to the minimum setback distance of 100 feet has been granted. Effective Model Leaching' Area SF/LF Equalizer 24 2.3 Equalizer 36 2.8 Standard Chamber 4.0 Infiltrator 3050 and 8.2 Storm Tech SC-740 ffigh Capacity Chamber 4.5 1. Effective leaching area is equal to 1.0 times the bottom width plus two x invert. 7. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in item 5 above or additional reductions in soil absorption leaching area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. The effective leaching areas presented in item 6 above shall be used for remedial sites located in Department designated Zone II or IWPA when the facility is to be brought into full compliance in accordance with 310 CMR 15.404. 0 0 Infiltrator Modified Certification for General Use Page 4 of 8 8. In accordance with 310 CMR 15.240 (6) absorption trenches should be used whenever possible. When the System is installed for new construction without aggregate in a bed or field configuration, as defined in 310 CMR 15.252, the System shall be designed using the effective leaching area for the bottom width presented in the following table. Chambers shall be spaced a minimum of six inches apart(edge-to-edge)when used in a bed configuration No system shall be designed and constructed with a leaching area of less than 400 square feet. The effective leaching area shall only be equal to the bottom width for any System installed in a Department designated Nitrogen Sensitive Area or for any System that is installed for new construction where a private drinking water supply 1 well is proposed to serve the facility, as defined in 310 CMR 15.214 2 and for which a variance to the minimum setback distance of 100 feet has been granted Effective Model Leaching' Area SF/LF Equalizer 24 2.08 Equalizer 36 3.05 Standard Chamber 4.72 Infiltrator 3050 or 4.25 StormTech SC-740 High Capacity Chamber 4.72 1. Effective Leaching area is equal to 1.67 times bottom width only. 2. Effective leaching area for Infiltrator 3050 or StormTech SC-740 is equal to 1.0 times the bottom width 9. The System, when installed in a bed or field configuration without aggregate on remedial sites, shall utilize the effective leaching areas presented in item 8 above or additional reductions in soil absorption system area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 10. The System, when installed as specified in 310 CMR 15.253: Pits, Galleries, or Chambers, shall have an aggregate base and/or be surrounded by aggregate and shall be sized as specified in 310 CMR 15.253 (1) (a) and (b). Effective depth can be increased up to two feet with the corresponding addition of up to 14 inches of base aggregate. Bottom width can be increased by two to eight SF/LF with the corresponding addition of one to four feet of aggregate per side. I 0 0 Wittrator Modified Certification for General Use Page 5 of 8 11. The requirement that Chambers installed in trench configuration as specified in 310 CMR 15.253(6) be provided with inlets at intervals not to exceed 20 feet is not applicable to the System III. General Conditions 1. The provisions of 310 CMR 15.000 are applicable to the use of the System, P app Y m, except those that specifically have been varied by the terms of this Certification. 2. The facility served by the System, and the System itself, shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 3. In accordance with applicable law, the Department and the local approving authority may require the owner of the System to cease use of the System and/or to take any other action as it deems necessary to protect public health, safety, welfare or the environment. I 4. The Department has not determined that the performance of the System will provide a level of protection to the environment that is at least equivalent to that of a sewer. Accordingly,no new System shall be constructed,and no System shall be upgraded or expanded, if it is feasible to connect the facility to a sanitary sewer,unless allowed pursuant to 310 CMR 15.004. 5. Design,installation and use of the System shall be in strict conformance with the Company's DEP approved plans and specifications and 310 CMR 15.000,subject to this Certification. IV. Conditions Applicable to the System Owner 1. The System is approved for the treatment and disposal of sanitary sewage only. Any wastes that are non-sanitary sewage generated or used at the facility served by the System shall not be introduced into the on-site sewage disposal system and shall be lawfully disposed of. 2. For new construction, the owner initially shall size a soil absorption system in accordance with 310 CMR 15.242 to demonstrate that a conventional Title 5 soil adsorption system using aggregate, including a reserve area, can be installed on the site. The owner may than size the soil absorption system for the System. The total area required for the aggregate system, which may include the area designated for the System, and a reserve area shall be preserved and the owner shall ensure that no permanent structures or other structures are constructed on that area and that the area is not disturbed in any manner that will render it unusable for future installation of a conventional Title 5 soil absorption system 3. The owner of the System shall at all times properly operate and maintain the on- site sewage disposal system. 0 0 Infiltrator Modred Certification for General Use Page 6 of 8 4. The owner shall furnish the Department any information that the Department requests regarding the operation and performance of the System, within 21 days of the date of receipt of that request. 5. No owner shall authorize or allow the installation of the System other than by a person trained by the Company to install the System. V. Conditions Applicable to the Company 1. By January 31st of each year, the Company shall submit to the Department a report, signed by a corporate officer, general partner, or Company owner that contains information on the System for the previous calendar year. The report shall state known failures, malfunctions, and corrective actionsen for talc o the System as well as the date and address of each event. 2. The Company shall notify the Department's Director of Watershed Permitting at least 30 days in advance of any proposed transfer of ownership of the technology for which this Certification is issued. Said notification shall include the name and address of the proposed new owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership, responsibility, coverage and liability between them All provisions of this Certification applicable to the Company shall. be applicable to successors and assigns of the Company,unless the Department determines otherwise. 3. The Company shall famish the Department any information that the Department requests regarding the System, within 21 days of the date of receipt of that request. 4. Prior to any sale of the System, the Company shall provide the purchaser with a copy of this Certification. In any contract for distribution or sale of the System, the Company shall require the distributor or seller to provide the purchaser of the System,prior to any sale of the System,with a copy of this Certification. 5. If the Company wishes to continue this Certification after its expiration date, the Company shall apply for and obtain a renewal of this Certification. The Company shall submit a renewal application at least 180 days before the expiration date of this Certification, unless written permission for a later date has been granted by the Department. 6. The Company shall prepare an installation manual specifically detailing procedures for installation of its System. The Company shall institute and maintain a training program in the proper installation of its System in accordance with the manual and provide a training course at least annually for prospective installers. The Company shall certify that installers have passed the Company's training qualifications, maintain a list of certified installers, submit a copy to the 0 0 Infiltrator Modified Certification for General Use Page 7 of 8 Department, and update the list annually. Updated lists shall be forwarded to the Department. 7. The Company shall not sell the System to installers unless they are trained to install these Systems by the Company. VI. Conditions Applicable to Installers of the System 1. Each Installer shall install the System in accordance with Company training on the installation of the System and the conditions of this Certification. 2. No Installer shall install the System unless the Installer has been trained by the Company on installation of the System VII. Reporting 1. All submittals of notices and documents to the Department required by this Certification shall be submitted to: Director Watershed Permitting Program Department of Environmental Protection One Winter Street-6th floor Boston,Massachusetts 02108 VIII. Rights of the Department 1. The Department may suspend, modify or revoke this Certification for cause, including, but not limited to,non-compliance with the terms of this Certification, non-payment of an annual compliance assurance fee, for obtaining the Certification by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Certification, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to this Certification, the System, the owner, or operator of the System and the Company: IX. Expiration Date 1. Notwithstanding the expiration date of this Certification, any System installed prior to the expiration date of this Certification, and approved, installed and maintained in compliance with this Certification (as it may be modified)and 310 CMR 15.000, may remain in use unless the Department, the local approving authority, or a court requires the System to be modified or removed, or requires discharges to the System to cease. a Infiltrator Modified Certification for General Use Page 8 of 8 W 023699InfiiL Reduced Size-Jan.2003SHC June 2,2005 Infiltrator Systems Inc. (ISI)has been working to clarify some of the installation details with regard to mounds in fill in accordance with the Massachusetts Title 5.The MA regulations,Title 5,require that the 15 foot breakout elevation to grade be measured from the top edge of the SAS.For the Infiltrator mound system,the Massachusetts Department of Environmental Protection agrees that the top edge of the SAS would be the bottom outside edge of the chamber unit as shown in the attached drawing. Additionally, since only bottom area is credited in all bed systems,the fill around the upper portion of the chamber can be either naturally occurring pervious material or Title 5 fill. See the enclosed drawing for all details on the mound system. The aforementioned drawing should be considered an addendum to ISI's Massachusetts Design and Installation Manual dated May 2003. If you have any questions, please contact your local Infiltrator Systems representative. We thank you for your partnership with our company and look forward to working with you in the future with your onsite wastewater treatment needs. Regards, Jim Healy District Manager Infiltrator Systems,Inc. (866) 511-6066 cc: Steve Corr, MA DEP TYPICAL MASSACHUSETTS MOUND DETAIL WITH INFIL I 10A NOT TO SCALE) CHAMBERS ESTABLISH VEGETATIVE COVER STANDARD CHAMBER(TYP.) MIN.COVER PER CODE FINISHED GRADE •• 'ak C' ''":�iY K' •i'Z.,.," .i+i�r'-7!�;'ie 3 P. `. ,i jj%ji% 3 ij/fj jjj jj jj j jj/jj j j •/j/ �/j/% / %—%•—� � —/ _— —/ /— — 4 — — —— — — -— — — — DEPTH PER DESIGN SHADING KEY TOPSOIL CAP COVER MATERIAL PER TITLE 5 SPEC OR NATURALLY OCCURING PERVIOUS MATERIAL •�. 1 FILL MATERIAL PER TITLE 5 SPEC ® TOP SOIL LAYER (TO BE REMOVED) INFILTRATOR SYSTEMS,INC. 6 BUISNESS PARK ROAD TYPICAL MASSACHUSETTS P.O.BOX 768 MOUND DETAIL WITH OLD SAYBROOK,CT 06475 INFILTRATOR SYSTEMS PFI'(800)221-4436 CHAMBERS FX.(860)577-7001 W W W.INFILTRATORSYSTEMS.COM Scale NOT TO SCALE Checked DFH Date 05/04/2005 ACA) No.M�ou—)ESIGN_15FT-OFFSET Sheet 1 Of 1 Drawn By: BCP f �"" FO 11-- SOIL EVALUATOR FORM AUG 2 3 2005 Page I of 3 TOHEALTM DEPTA RTM ANDOVER No. ' I —T��r _ Date: Commonwealth of Massachusetts Massachusetts Soil Suitability Assessment for On site Sewage Di sposal Performed By: 76mdu..... .................................... Date: c Witnessed By: r.e.w...A....... � t—im Ad&-a 1 3 1X So&e Ztrl.Cl oww's Wme. lot `TAy o Address,aid AJor-6\ Avtgover T 3 , l is Salervt Str�At l Jor+v\ Avlc6ver, MA 01s4S ew construction ❑ Repair 918 4.13 5-_ 91�IS- Office Review Published Soil Survey Available: No ❑ Yes Year Published �.�. ?.�...... Publication Scale i �µ G. j�- Soil Map Unit C, Drainage Class LJQll....... Soil Limi ions .......RI.N.kj....Pe.f.vo .................................. j Surficial Geologic Report Available: No Yes F1 Year Publishedn....,.. Publication Scale . .......-.. Geologic Material (Map Unit) ....................................... Landform . ............................................................................................. �..... Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Within 500 year flood boundary No ❑Yes ❑ Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ....... ... Wetlands Conservancy Program Map (map unit) �,(..-X:.................................._---.....:..........._._......__._. -Current Water Resource Conditions(USGS): Month Ph Range :Above Normal ormal ❑Belcw Normal ❑ Other References Reviewed: DEP APPROVED EOFNJ-12/07195 Y 0 ;FOR1Vi 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. 131a Jam' 4 over On-site Review Deep Hole Number TIVI :: Date:.0:$/(7 ' 1 Time:..��.D....a Weather Location (identify on site plan) ReAr,,,:,: ." ..:..:,... 0 Land Use :.:... 4.5...x...a . : a.�.::..:....: Slope t%) ...:- :. o. Surface Stones ..::... . ..: Vegetation :, a.......:::.:..:...:.:.::.:..::..... _,...............................:....:.:._.. ............ Landform .::.::.. ..... :.::. ..:. Position on landscape (sketch on the back) To. :.: sip ..e......... Distances from: Open Water Body j-.00.:.... feet wa Drainage o.0 9 y.3:::. .,:. feet Possible:Wet'Area :BOO....:.: feet Property Line .:.:Q::.,,.::. feet - Drinking Water Well >,..,.I,,,T .:..,. feet Other ...... ....,.:, .. ,. ,,,,. DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravel) Di s0 - JfoZk S L IoYR �sYR/6 s- 6 S o t - O a s AA 1 l 5Y rve s° o �- 7 toy co L. 0 D ria 6 5� s MINIMUM OF 2 HOLES RE(IUIRED A EVERY PROPOSED DISPOSAL AREA Parent Material(geologic) OWL 1 � `� De pthtoBedrock: Wo Depth to Groundwater: 'Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Gr76) ound Water: - DEP APPROVED FORM-12/07/95 2 ;FO%N1 II - SOIL EVALUATOR FORNI Page 2 of 3 Location Address or Lot No. 0121 eq ieJ,,, On-site Review beep Hole Number Date•,.b/,:.. �S Time .: ,.�.: Weather Location (identify on site plan) .15W7_. : Land Use ::. . S.l...:f~il 'lat�..:,.....::. Slope M) ..:M/o.. Surface Stones...?J.:..:: ::....:..:.. ............ Vegetation .,!��:r..!'aSS..::...:.:..:.::::.:: .....:.::..: .::.:.w_::,.,. .:::::.,.:.,.:.: x Landform cirr� n: Position on landscape (sketch on the back) Distances from: ; Open Water Body :.: ,,., feet Drainage wa 9 Y- �.� feet Possible'.Wq Area :, �..:., feet Property Line .. . ..:.,..,.. feet Drinking Water Well>'.1S , feet Other DEEP OBSERVATION HOLE LOG* Depth from* Soil Horizon Soil Texture Soil color Soil D.� Surface.(Iriches) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,Consistency, % Gravel) cc a/a _ ? 1oYRa �narV, o sl3 . 10°l0 C��•v. 75YK Obprvej MINIMUM OF 2 HOLES REGURRM-EVE t, Parent Material(geologic) 4t dq" ��,�•. DepthtoBedrock: 50. Death to Groundwater: 'Stai.nding Water in the Hole: '� Weeping from Pit Face.: -- Estimated Seasonal High Ground Water: DEP APPROVED FOAM-12/07/95 i ;FORM -. - SOIL EVALUATOR F ORM Page 2 of 3 Location Address or Lot [1o. 3 ens �r�n ''aver . On-site Review Deep Hole Number l:P3,1, Date:... is , Time:.:::. . :•0....a Weather plan) Location (identify on site Land Use � Slope (%) ..:1:: ... Surface Stones...~::/x:.:.:.::.:.. .:::::.::::.... .:... Vegetation :,:�t'cw.,_,,_ . ....:.::.::..... Landform :.:.............:..v,... .............. Position on landscape (sketch on the back) Distances from: OpenWater . .Oy ...::.: :.., feet Drainage way-� .,:. feet Possible:Wet'Area `{t?O _. ` .. feet Property Line .:..::.�.:;.,:.:.: feet Drinking Water Well lSD feet Other ....�: . ....: :.....�. .,«..... DEEP OBSERVAT 10 N HOLE E LO G Depth from Soil Horizon Soil Texture Soil color Surface(Inches) WS.DA) Soil , (Munselq Mottling (Structure,Stones, Other Boulders,Consistency, k Gravel ) sY o L a Civ ao /0 79 .s MINIMUM OF 21101 !7 8 Parent Material 1 eolo i cl t DePthtoBedrock: Death to Groundwater: Standing Water in the Hole: ---+ Estimated Seasonal High Ground Water. fl Weeping from Pit Face: —" DEP APPROVED FORM-12/07/95 - ;FORM SOIL EVALUATOR FORNI Page 2 of 3 Location Address or Lot No. On-site ' Review Deep Hole Number .. ' oSS 0 DO Weather Time:.:., ..+..::...:. a►r �s Location (identif n site Ian q y e p ) . :....��! gW::.: . .. ..wN.v�:..,,:.,. Land Use 1, . �1, ,� Slope M `::Co.. Surface Stones Vegetation . '/ t,�S...:.......:.:..:.:.::..,...:::. Landform "Aa6u.1v :..... ...:..... .. Position on landscape (sketch on the back) Distances from: Open Water Body :.y0,„?,;,.., feet Drainage way-30-0., feet Possible'.We Area `I'Q!�......, feet Property Line .:��,..:....,, feet Drinking Water Well� a.�w feet Other DEEP OBSERVATION HOLE LOGr Depth from Soil Horizon $oil Texture Soil Color $o•,! . G,u Surface.(Incfies) (USDA) (Munsell) er Mottling (Structure,Stones,Boulders,Consistency, Gravell 5 [;,. I DYR 6 /Vont ` res oZ 0% 1017 ObServej & MINIMUM OF 2 HOLES R Parent Material(geologic) Depthto8edrock:_ypTf7Y Depth to Groundwater: 'Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: 4574g h DEP APPROVED FORM-12/07/95 i Q Q .FOR'Vi I1 : SOIL F,�'ALUATOR FORM " Page 2 of 3 Location Address or Lot No. e r On-site . Review Deep Hole Number Date::-6.8 Time•.:., ��:.:.:::. Weather A�T Location (identify o site plan) :...,:a ... at' . . ...... ......... Land Use '��.. .,Sc . Slope (%) la.. Surface Stones r, Vegetation .�T!'r�,�s,::::...:.:...:::..::.,.:::.:..._.:. ::...w::.. ...... .......... ..... Landform.— Position on landscape (sketch on the back) •.:�..a ::. .. .:�a� ...:.....::..:::::::.:.::.:::.. ..:::-...:.....,.::.:.::.:.::::.::...: : :::...... :;.:. :.::.:. Distances from: Open Water Body ; ..;,., feet Drainage way.-30-9— feet Possible'Wq'Area :,0P.::; feetProperty Line .:�. ..:...:., feet - -Drinking Water Well>--W : feet Other , DEEP OBSERVATION HOLE LOG• Depth from- Soil Horizon Soil TextureSoli Color „oil Surface.06ches) (USDA) (Munsell Mottling (Structure,Stones,Boulders,Consistency, 0/9 Gravel O 1 l� V , J: SY an*. 7 06WWL tY PROPOSED DISPOSAL AREA f t Parent Material(geolo ic) '�� 9 ` Oe thto8e �� ofA � �` Brock: P �t� Depth tc Groundwater: "Standing Water in the Hole: Weeping from Pit Face: Il Estimated Seasonal High Gibund Water. DEP APPROVED FORM-MOMS FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.. 131a 54lelm Determination for Seasonal High Water Table Method Used: El Depth observed standing in observation hole..............:..:. inches ❑l Depth weeping from side of observation hole ................... inches N Dep.th.to soil mottles ..::.........:::.:.. inches ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor ................... Adjusted ground water level ........................................................ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in pil areas observed throughout the area proposed for the soil absorption system? o _ If not, what is the depth of naturally occurring pervious material? Certification certify that on 9 d`l` (date) I have. passed the soil evaluator_examination approved by the De a ment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date 8 1? c S DEP APPROVED FORM-12/07195 CD Commonwealth of Massachusetts a(Onn--site City/Town of Mo4h "over W ED Percolation Test 2005 ° Form 12 �M TM TER Percolation test results must be submitted with the Soil Suitability Asse Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important: When filling out A. Site Information forms on the computer,use Gay Neilson only the tab key Owner Name to move your 1312 Salem Street cursor-do not Street Address or Lot# use the return key. North Andover MA 01845 _ City/Town State Zip Code rah __ (978) 685-9415 ntact P Coerson(if different from Owner) Telephone Number rerum B. Test Results 6/8/05 10:00 7/12/05 8:00 Date Time Date Time Observation Hole# PT1 PT1 B Depth of Perc 81"/17" 57/18" Start Pre-Soak 99-56 8:07 End Pre-Soak 10:11 8:25 Time at 12" 10:11 8:25 Time at 9" 10:41 time at 10.5" 8:54 Time at 6° 9:27 Time (9"-6") - 33 MIN. Rate (Min./Inch) =--- 11 MIN. PER INCH Test Passed: ❑ Test Passed: Test Failed: ® Test Failed: ❑ Thomas K. Hector Test Performed By: -- _ Andrew McBrearty, Mill River Witnessed By: -- Comments: t5form12.doc•06/03 Perc Test•Page 1 of 1 i k t i I I { r� � r �s Q 0\1 cV �)7�v z(v J61 S ��.Ol .• �'7� ��� I.zJitas � '1Rn�/� %Y�Q� H, L�' �L j`V 1�1 �.j .:�cj. a CD NEW f E ENGLAND ENGINEERING SERVICES INC PRESSURE6ISTRISl1TION'DE�I�N SpRFAnSHKFT Property_Location 1312 SALEM STREET NORTH ANDOVER MA #o DESIGN FLOW(in gallons/day)? 440 Elevation of the PUMP OFF SWITCH,in feet? 93.45 Elevation of the upper LATERAL,in feet? 97.55 DELIVERY PIPE distance,from pump to manifold,in feet? 39 RECEIVED DELIVERY PIPE diameter,in inches(if not 2"--use 2"min)? 3 Design DISTAL PRESSURE,in feet(if not 2.5)?(hd) 4.5 IS MANIFOLD CENTER-FED&SYMETRICAL(yes or no)? Uno YES AUG 3 2005 How many orifices in the MANIFOLD? MANIFOLD ORIFICE diameter,in inches(if not 5/16") 0.3125 MANIFOLD DIAMETER(if not 2"--use 2"min)? 4 TOWN OF NORTH ANDOVER Does MAN FO D drainTOTAL LENGTH OF MANIFOLD FIEOLD after dose Gres or no)? HEALTH DEPARTMENT How many LATERALS?Pumping chamber weep hole size(usually.25") USE 0 IF FORCE MAIN DOES NOT DRAIN PROGRAM WILL CALCULATE UP TO 26 LATERALS AND UP TO 50 ORIFICES PER LATERAL Your HIGHEST elevation lateral MUST be LATERAL 1: (first orifice from lateral 1/2 of orifice spacing) Lateral 1: Lateral 2 Lateral 3 Lateral 4: Length of each LATERAL,in feet? 53.13; 53 53 13F 53.13 Diameter of each LATERAL,in inches(1.5"min)? 1.5' 1.5% 1.5'' 1.5 Elevation of each LATERAL,in feet? 97.55 97.55 97.55 97.55 Number of ORIFICES per lateral 12 124 124 12 Distance from Manifold to closest Orifice,in feet 1.94`; 1.94a 1.94+ 1.94 ORIFICE SPACING,in feet 4.5 4.5§ 4.51 4.5 Diameter of ORIFICES,in inches?(D) 0.25 0.25' 0.25' 0.25 Square feet of leachfield per laterals(can ignore) Maximum number of orifices in any one lateral 14 Minimum lateral diameter 1.5 A0, l7LTSy amts .� FRICTION CALCULATIONS(using Hazen Williams friction ft=Ld((3.55Qm/Ch(Dd^2.63)))^1.85) PRESSURE CALCULATIONS(using orifice dischage equation Q=11.79 D^2 hd^.5 Lateral 1: Lateral 2: Lateral 3: Lateral 4: LATERAL DISCHAGE(first approximation) 18.76 18.76 18.76 18.76 MANIFOLD ORIFICE DISCHARGE 0.00 TOTAL SYSTEM DISCHAGE(first approximation) 75.03 TOTAL DISCHARGE PER LATERAL 18.85 18.85 18.85 18.85 DISCHARGE PER SQUARE FOOT OF LEACHFIELD #DIV/0! #DIV/0! #DIV/0! #DIV/0! ORIFICE MAXIMUM DISCHARGE BY LATERAL 1.58 1.58 1.58 1.58 ORIFICE MINIMUM DISCHARGE BY LATERAL 1.56 1.56 1.56 1.56 ORIFICE%DIFFERENCE DISCHARGE within LATERAL 1.3% 1.3% 1.3% 1.3% 0.0% MAXIMUM DISCHARGE LATERAL 18.85 MINIMUM DISCHARGE LATERAL 18.85 MAXIMUM DISCHARGE PER SQUARE FOOT #DIV/01 MINIMUM DISCHARGE PER SQUARE FOOT #DIV/0! •DIFFERENCE DISCHARGE for SYSTEM by orifice #REF! as percent of maximum orifice in system •DIFFERENCE DISCHARGE for SYSTEM by laterals 0.0%as percent of maximum lateral in system •DIFFERENCE DISCHARGE for SYSTEM by square feet as percent of maximum square foot in system WEEP HOLE DISCHARGE(usually a 1/4"weep hole) 2.03 weep hole= 0.25 inch VOID VOLUME IN DELIVERY PIPE 14.32 VOID VOLUME IN MANIFOLD 7.18 VOID VOLUME IN EACH LATERAL 4.88 4.88 4.88 4.88 0.00 TOTAL LATERAL VOID VOLUME 19.51 MINIMUM DOSE VOLUME(based on void volume) 97.54 to 195.08 MIN ACTUAL MINIMUM IS BASED ON DAILY DESIGN FLOW (weep hole,usually 1/4",not counted for dose,effluent is repumped during process and not counted for friction,except as fitting headloss) TOTAL HEAD LOSS IN EACH LATERAL 0.72 0.72 0.72 0.72 MAXIMUM TOTAL LATERAL HEADLOSS IN SYSTEM 0.72 MANIFOLD HEADLOSS(center-fed unless manifold design) 0.04 DELIVERY PIPE HEADLOSS 0.54 w/delivery 3 inch diameter FITTING LOSS(headloss*.15) 0.68 add extra head if fittings are more than absolute minimum DISTAL PRESSURE HEAD 4.50 STATIC HEAD(OFF-SWITCH TO HIGH LATERAL/MANIFOLD) 4.10 HEADLOSS PUMP TO WEEPHOLE(assume 3'run) 0.04 PUMP MUST BE ABLE TO PASS SOLIDS AT 77.42 G.P M 10.62 FEET OF HEAD or After OTIS(network losses=1.3*distal head) 77.42 G.P.M. 15.08 FEET OF HEAD 60 BEECHWOOD DRIVE-NORTH ANDOVER, MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 0 p NEW ENGLAND ENGINEERING SERVICES INC August 22, 2005 AUG 2 3 2005 Susan Sawyer TOWN OF NOR-1 riL,,,) 'En HEALTH DErAR-4,,,4ENT North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 1312 Salem Street, North Andover, MA Local Upgrade Approval Request Dear Ms. Sawyer, The purpose of this letter is to request that the above referenced property be included on the p Y October 2005 Board of Health meeting agenda to discuss the following local upgrade approval requests: Local Upgrade Approval Required 1. Allow reduction in offset distance between the leach bed and a foundation wall from 20 feet required by Title 5, section 15.211(1) to 13 feet. 2. Allow a 25% reduction in leach area from 785.71 square feet required 589.29 square feet. If you have any questions or comments, please do not hesitate to contact this office. Sincerely, Thomas Hector Project Engineer 60 BEECHWOOD DRIVE-NORTH ANDOVER,MA 01845-(978)686-1768-(888)359-7645-FAX(978)685-1099 I r Q 0 BOARD OF HEALTH 0 NORTH ANDOVER,MASS. 01845LHEALTH:DEPARTM]ENT EIVE 978-688-9540 �! APPLICATION FOR SOIL TESTS 20 y{ TH AN DATE: �" MAP&PARCEL: I t o�A � 0 LOCATION OF SOIL TESTS: OWNER: PAUL� G� �I� 1L S 0 N TEL.NO.: 9 754065 ADDRESS: I ENGINEER: Kke,t,0 gk;(T(4U6 TEL.NO.: CERTIFIEDSOILEVALUATOR: F-2�rt l(&J (-. 09 -y i) ✓it? Z77-MWW K G1it C-7V?- Intended use of land: Residential Subdivision mgle Family Home Commerciale Is This: Repair testing _ Undeveloped lot testing Upgrade for addition T In the Lake Cochichewick Watershed. Yes No THE FOLLOWING MUST BE INCLUDED WrM THIS FORM: 1. Proof of land ownership(Tax bill,deed,or letter from owner permitting tests) 2. Plot plan 3. Fee of$425.00 per lot for new construction. This covers the minimum two deep holes.and two percolation tests required for each disposal area. Fee of$360.00 per lot for rrMairs or up rg ades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below Th' ine N.A.Conservation Commission Approval. . Date Received: Check Amount: Check Date: V\,QuI<161 V UDI N A 6rl oLt4l U s � r n YCERPRED FOUNDATION PLAN LOCATED IN . Qoo--rH Aameusp SCALE.'/"= DATE•' Z Z S.L.G/LES R.L.S. LAWRENCE a NORTH ANDOVER . oa000eo, o r oc, ( oQ o�s o • A LST 5 DWK- r � JI L sAk d S >r A4g $w urr- � a s , L oT 7 \ I 157.2?• ►61,92 iv 3L t X51,67 ear � Is,I.s t I' Q a / CERT/FY THAT THE OFFSETS SHOWN ARE FOR THE USE OF IPA ,114 OF 1 OFFSETS SHOWN THE BU/L D/NG INSPECTOR ONL Y B SUCH. CONFORM TO THE USE /S FOR DETERMINATION OFZON/NG ^ 0. 1:2 z ZONING B Y L AW OF CONFORM/TY OR NON CONFORM/TY �` Ne ger�+ A.j DoyERWHEN TAKEN. •7 i 9`'4- r _ r I U t Al1 t t.. �r';r i:�l�l�,i�"`•��, i.,�l� �..,1�'�l i..f�h�`,,,1k/� �� ��.,�✓d���..� � ---- -----'--- �- _ ___ ... ._-- - ... --- ... .._ _ .- - - I a G y i. ..w, �p D. y� y t f 3Ja - --- - I,� r fi IjL —=-n - --- - ` �",' t✓, _ r YkI l .aT(, td` 41i 44—: I TI r I I d 11' i r r I f 1 11 ii 4 II jGf y/cur/ I I a Commonwealth of Massachusetts tREC"71ED City/Town of NOr4k 7 "Ac>�ver u Form 9A - Application for Local U raddGlp9 TOWN OF NORTH ANDOVER ^M HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but he information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 5.404(1), is not feasible. 310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Title 5 Permitting Program, upon issuance by the local approving authority and before commencement of construction. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved roved 9 PP capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address: forms on the computer,use Gay Neilson only the tab key Name to move your 1312 Salem Street cursor-do not use the return Street Address key. North Andover MA 01845 Cityrrown State Zip Code " 2. Owner Name and Address (if different from above): same as above Name Street Address City/Town State Zip Code Telephone Number 3. Type of Facility (check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Installation of new residential subsurface sewage disposal system 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other(describe below): Current residential sewage disposal system is in failure. Form 9A-1312 Salem Street North Andover•rev. 5/02 Application for Local Upgrade Approval* Page 1 of 4 0 Commonwealth of Massachusetts City/Town of Nor+h Avvdover r` 141Form 9A - Application for Local Upgrade Approval l 1M Sve y`v DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): Leach field 7. Design Flow per 310 CMR 15.203: Design flow of existing system:em. Unknown gpd Design flow of proposed upgraded system 440 gpd Design flow of facility: 440 gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): ® Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: Replacement of leaching facility and components 3. Local Upgrade Approval is requested for(check all that apply): ® Reduction in setback(s)—describe reductions: 1. Request for reduction in offset distance between the leach bed and a foundation wall from 20 feet required by Title 5 Section 15.211(1) to 13 feet ® Reduction in SAS area of up to 25%: 589.29 25% SAS size,sq.ft. %reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft. Percolation rate min./inch Depth to groundwater ft. Form 9A-1312 Salem Street North Andover•rev.5/02 Application for local Upgrade Approval* Page 2 of 4 Commonwealt4 of Massac usetts City/Town of ,Alamo► �-�over m Form 9A — Application for Local Upgrade Approval a M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of system (continued) ❑ Relocation of water supply well (explain): ❑. Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the ere required separation eparation between the bottom of the soil absorption stem and h p y the high groundwater elevation an Approved Soil pp Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(i)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Andrew McBrearty 6/8/05 Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: No other location available on the lot for the system size required. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: A 1500 gallon Micro Fast Septic tank is included in the design. Form 9A-1312 Salem Street North Andover•rev.5/02 Application for Local Upgrade Approval*pp pg pp al Page 3 of 4 .� O Commonwealth pf Massachusetts City/Town of r+ t /+Ado,je,_ Form 9A - Application for Local Upgrade Approval pg pp 4M SV � DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) i 3. A shared system is not feasible: No available system in the vacinity. 4. Connection to a public sewer is not feasible: Town sewer is not in the area of the property. 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ❑ Application for Disposal System Construction Permit ❑ Complete plans and specifications ❑ Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." ac'2D8/22/05 aci' Owner's Signature ate Benjamin C. Osgood, r., P.E. (Agent for owner) New England Engineering Services 8/22/05 Name of Preparer Date 60 Beechwood Drive North Andover Preparer's address City/Town MA 978-686-1768 State/ZIP Code Telephone Form 9A-1312 Salem Street North Andover•rev.5/02 Application for Local Upgrade Approval* Page 4 of 4 COMMONWEALTH OF MASSACHUSETTS Z EXECUTIVE OFFICE OF ENVIRONMENTAL:AFFAIRS r , DEPARTMENT OF ENVIRONMENTAL PROTECTION l i yt V v 4 R f7 y TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION [TOWNN EIVED Property Address: /3/Z4 S,+t9,, i Sr - .va2 rH A NDS 2E� 2 5 200 Owner's Name: Air��«,N 5 Owner's Address: RTH AIvuOVER EPARTMENT Date of Inspection: �� n t { Name of Inspector: (please print) RiZ1AA.1 /7,4letil/'� Company Name: ,vo�Lrt/�q S T r�l/t//iZOoLMif icii/{ Mailing Address: w a s -,oow T 7- AM AM 0/ 2.3 Telephone Number: 77 E-71, /, -s yo T-Cc CERTIFICATION STATEMENT 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 Conditionally Passes Needs Further Evaluation by the Local Approving Authority ails Inspector's Signature: ......• Date: yV /© ds 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 DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ""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. Title 5 Inspection Form 6/15/2000 page I `tRage 2 of I1 .OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: xy£./4.SD,rte Date of Inspection: If 14 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A � A. System Passes: 6� I have not found anKinformation which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304.rexist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: l/One;or,more system components as described in.the"Conditional Pass"section need to be replaced or . repaired:The system, upon completonlof.the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined.(Y N N)in the for the following statemedis. If not determined"please f explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not).is strucfur lly, unsound,exhibits substantial infiltration or exfiltration or tank failure;is,iminent. System will pass inspection if.the existing tank is replackd,with a complying septic tank4as`.apprc ved by the Board of Health. *A metal septic tank will*pass inspection if/it-i§structurally sound,not leaking and if a Certificate of Compliance indicating that the tankLis less7hari 20 years old is available. ND explain: 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;Msettled oyneven distribution box. Systern willpass.inspection if(with_: approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: 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): A. broken pipe(s)are replaced ,. obstruction is removed ND.explain: 7"),- { Page�. tf � OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property'Address: /?2: %.,4 C_ rrvt .'saT Ng Owner:. Date of Inspection: S""'. 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 31.0 CMR 15.303(1)(b)that the system isnot 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 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: `r � The system has a septic tank and soil absorption system(SAS).and^the SAS.is within 100 feet of x surface water supply or tributary. to a surface water supply. The system has aseptic tank and SAS and the SAS is within a Zone 1 of a public water Fsupply. The system has a septictank and SA54nd the SAS is within 50 feet of a private water supply well. The system has aseptic 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 coliform bacteria and volatile.organic compounds indicates that the well is free from pollution from that facility and the presence,.ofAmmonia_nitcogen.ansd nitrate nitrggen s,equal_toorless than S ppm;:prbvided that-no other-= -� failure criteria are triggered.A copy of the analysis must be attached to this form: 3. Other: 3 . Page 4 of 11 ► ( 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: /3/'2. S7" Owner: /f /G S ooh! Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup 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 , Static liquid level-inithe distrinutiSn box abuv�e outlet�invert°2iue�.to an overloaded of clogged'ySAS�or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than '/Z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number —:74 r� 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. r Any portion of a cesspool or privy is within a Zone 1 of a public well. tiAny 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 asses if the well water analysis, l PPY P q tY Y • • ] Y P y � , Performed at a DEP certified laboratory,for coliform bacteria and volatile organic compommds Y. indicates that the well is free from pollution from that facility 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.] es/Ido)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{large.syst .m�the systenitniustserve`a facility witti�a d'esign flow'of1,6060 6&_i0 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply 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 Il 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. 4 a � � Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST r . ,. : Property Address: L = er-M 57 Owner: AS14 e," Date of Inspection:.. 3 7/ge 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 compon�nts,pumped out in the,previous two weeks'': . - _, i r 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 available note as N/A) t of Was the facility or dwelling inspected for signs of sewage back up? . *. 'r Was the.site inspected for signs of break out? ... — 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? 4. The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no 1 &1' Existing 'information. For example,a planatthe Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] f.. 5 ' . Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: -/. /z S Le L7 ,tlO;rL a'r-/ Av .. Owner: Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): . Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):-- Number of current residents: Does residence have a garbage grinder(yes or no): / Is laundry on a separate sewage system(yes or no): /1/ [if yes separate inspection required] Laundry system inspected(yes pr no A1,4 Seasonal use: (yes or no) _ ,t, Water meter readings, if available(1 st 2 years usage(gpd)) Sump Pump(yes or no): IV Last date of occupancy: 6 f14Aery COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on.310 CMR 15.203):_ gpd Basis of design flow(seats/persons/sgft,etc.): E. Grease trap present,(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: > Last date of occupancy/use: . d d , OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): r' If yes, volume pumped: ,�00 gallons--How was quantity pumped determined? /14.dT,6 I till C„_ t) Reason for pumping: 17,41 S4 /rlr /c.G-TSG/(.J T�VPEF SYSTE c tank,distribution box,soil absorption system Single cesspool —Overflow cesspool. Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy.of the DEP approval . Other(describe): . Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): //, 6 Page 7 of 11 t OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddress: /?,/2. r/9 CM moi" Owner:. IyL14 OILI Date of Inspection: T/ sb BUILDING SEWER(locate on site plan) Depth below grade: / e, ,irc a,o Materials of construction:Lust iron _�-'40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): 4.ca, e' 0 7`7 d SEPTIC TANK:_(locate on site plan) Depth below grade:. /Z Material of construction:_rete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) ! Dimensions: /,.,'X Sludge depth: �� '/.., Distance from top of sludge to bottom of outlet tee or baffle: Y ` Scum thickness: r' :Z'S rt. .h Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: 'F%ff-14 en'35 Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP:_(locate onsite plan) t Depth below grade`_ Material of construction:_concrete_metal_fiberglass 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: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related.to outlet invert,evidence of leakage,etc.): d, t 7 � Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) k, Property Address: a Owner` Date of Inspection: TIGHT or HOLDING TANK: tank must be pum ed at time of ins ection locate P p )( on site plan) Depth below grade: Material of construction: concrete metal fiberglassAolyethylene other(explain): Dimensions: Capacity: 'gallons Design Flow:-.. . . i % galldhs/days d , • } . 5 , Alarm present(yes or no): t Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: '(if present must be_opened)(locate on site plan) Depth of liquid.level above outlet invert: /i1✓.�/ ? 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.): 7'Cl.. ' PUMP CHAMBER: Al ocate on site plan) Pumps in working order(yes or no): .Alarms in working order(yes or no): Comments(note condition of pump chamber, condition rof pumps and appurteances,etc)� M, 8 w " Page9of11 ® s OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: ��%2.. SA4.rAl t Owner: N4./40• lI i.: Date of Inspection: ' SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type i 4 leaching pits,number: - leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: z U X y p ' overflow cesspool,number: 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.): i ?i 0.A. CESSPOOLS:, cesspool must be pumped as part of inspect ion)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer r Dimensions of cesspool: Materials of construction: t Indication of groundwater inflow(yes or no.): Comments(note condition of soil,signs of hydraulic failure,l,level of�ponding,Condition of yegetation,a'c:) :;w",-'-4-,f, x PRIVY: locate on site plan) Materials f construction: Dimensions: Depth of solids.- Comments olids:Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 e ' Page 10 of i 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM'INFORMATION(continued) a Property Address: %2_ St4t i' .✓ *. tN # � Owner: Date of Inspection: hs o SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. F M E 10 01 Page 111 of 11 ti--;r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Addss: /3/2- ;11 4�',-vi "7" Owner: WJE"14 JAJ Date of Inspection: 3 SITE EXAM , Slope 6 — 1 Surface water ya p Check cellar s NU Puri,P Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: L.-Of t ined from system design plans on record-If checked,date of design plan reviewed: . 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: You must describe how you established the high ground water elevation: o Z I 9 AiL-,i) AS /30 Tom' 1a�1�1 +'i/�✓6 l l CERT!F/ED FOUNDATION PLAN LOCATED IN . ��2TH Q�.rDeu� SCALE.7"=A.:.. feA, i z z S.L.G/LES R.L.S. L AWRENCE a NORTH ANDOVER r,) ,a i 3,•7 Ac rsrEs t � ! • �q s� tia Son'� :� Sh31es L oT 'j -41rt � '• t57.iq� 15'1.92 q�l 3G.'t y, 01.1.7 our o yy r :Q t / CERTIFY THAT THE OFFSETS SHOWN ARE FOR THE USE OF � y?�`" ° '' OFFSETS SHOWN THE BUILDING INSPECTOR ONL Y, 8 SUCH S.G1 !•C�` � �F CONFORM TO THE USE IS FOR DETERMINATION OFZONINGo. i .s:72 }s ZONING B Y L A W OF' CONFORMITY OR NON CONFORMITY �-J01vTµ Ajr>ooek-- WHEN TAKEN. ► , .. �� A irOUNDATIO AN Y LOCATED //V' r.loQ-r-H /h�e�J� SCALE./,,__ :.. DATE' Z z G/LES R.L.S. to(rs�gs IIIAJos. L AWRENCE"Q'NOR TH ANDOVER e 40 4% . 0 op , �tr''�Aop� �Qoq�04 . S (:ID-T- 5 N S L est. 1 B l'BS r .� • Vi .. ZSR. �s a �. " IS1•(.T'e�1' Stti � a ♦ L oTXfo QlAf - / CERT/FY�hrAT TH OFFSETS SHOWN ARE'.FOR THE USE;OF OFFSE� WOM'D/NG INSPECTOR ONL Y„ CONfO � LISA /S"FOR DETER f { . ~� M/NATION OFZOIVING ZON/NG}�Y �4WF > , c ONFORM/rY OR NON CONFOfi tifl�Y v HE rAKEN