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HomeMy WebLinkAboutMiscellaneous - 1 Bannan Drive (2).vvn . AN[; idAB B` 10" HEAiT TOWN OF NORTH ANDOVEF NOV --4 2002 SYSTEM PUMPING Ri,:COR.D �I'lM OWNER & ADDRESS SYSTEM LOCATION /A l (example: lefe front o(house) "I E OF PUIYIPINC:JQ_ .-p __ QUANTITY PUMPED C,1,L :.�S1'O0L: N0 YES SEPTIC TANK: NO✓ YES �. ATURE OF SERVICE: ROUTINE EMERGENCY .iii>FRV..\T10NS: GOOD CONDITION FULL TO COVET; HFAVY CREASE BAFFLES IN PLAC1' ROOTS LEACHFIELD RUNIOACK... EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER Oj�HER (EXPL.AIN) ,1 .> I LM PUM1'CD BY: il 'i,I-I ENTS: u -' I f:'NTI TRANSFERRED TO: 9A 1,17�y -5� XCA I M �iJ JY ,I" ,fl i L4 9 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD I 1 AIMIZ A,-z- Air. E'ER/ B{ 07 HEAL.T NOV - 4 2002 ,0 �T[M OWNER & ADDRESS ' SYSTEM LOCATION `(ex2mple; left front of house) nvg/ 64, U 0 E OF PUMPINC: /0-/6-6-1_ QUANTITY PUMPED .�)SPUUL: NU YESP ✓ SE TIC TANK: NO YES i a1 URE OF SERVICE: ROUTINE EMERCENCY .)1i.�FRV:\T10NS: GOOD CONDITION FULL TO COVED _ HEAVY CREASE BAFFLES IN FLACK' ROOTS LEACHFIELD RUN13ACK.. EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER Oj�HER (EXPLAIN) l � >1 .� I LM PUMPED BY: ��'/' lr l ��(� /'7- �-j) M FNTS: U'� 1 I:'N'1'� TJf ANSFEIZIZED '1'0: 9A {A. It, (S { 0 ;Location cZ 23A 11)NA AJ No. Date Allq TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ 41 4L Building/Frame Permit Fee $ Foundation Permit Fee $ CHU Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ A- 4U-LXtrCC-,- Building Inspector 1283 5/14/98 08:44 25. 00 pAID Div. Public Works k1ocation --- I No. j Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ 41 Building/Frame Permit Fee $ Foundation Permit Fee $ CHUS Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector W14/98 06:44 m j 25. 00 pAzt; Div. Public Works Q N N w z W C w d (1) N H X O C Q 'r \ r C \\vr C a O — z cx W � C 3� � z -x � ` O w O .., LL C 8C n W A z x viV1 y W C_ m _ ii 5 ^ I UJ ZZ V)f jit Z U �7 u 7 r N W Z Z z wZ LU Y Y y < L_ L C ` �I <Z. CI N_ C r. r Z C r /Q r Z r_ r 7 n s �Z < Cc LU LU _ = w J 7 W � < W ^ 3 ^ Z�a� z LQ i M dl m 9 m A N I z z W OC z 1 N Z z ca W H uj Z \' iut m C L N < CZ rn o. 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CO) C 3144 Z10103dSNl ONIOiIno ),8 03A1303d 1N3YU2fVd30 TdId IIM3d AVM3MR10 SN01103NN00 631VM213M3S - SN2iOM 01�8nd S1N3NYd00 09139r92j 3140 03AMJddd 31b'0 H11t13H-2M03dSNl 011d3S 03103('3Zl 3140 03AMJddV 3144 H1-1d3H 210103dSNl 000 S1N3NN00 03103f 3b 31d0 � 03AOZlddV 31VO b3NNd�d NMO1 S1N3WW00 03103f 36 3140 03n06ddV 3140 Z101V�J1SINIWOd NOliVA83SN00 :S1N30d NMOL 30 SNOUVCIN3WW00321 �1�N0 3Sn -------- ,,�,•! ..... - fit; ♦!-F� ! !! 838WnN '1S 133b1S (S)I01 NOIS1A108nS 1302lVd JagwnN deN s)ossassy :N011`d001 3NOHd 1N`d0llddd ----.N01103S SIH1 1n0 S��1j 1Nd01�ddd.�!ll------•••!••1►�►- --. sluawai!nbai jo algeoildde Aue ql!m aoue!ldwoo woaj Jaunnopuel Jo/pue lueoildde aUl analIaJ lou saop SIUl 'paulelgo uaaq aneq uollolpsljnf 6u!neq sluawpedaQ pue spieo9 wojl sl!wjad/slenadde tiessaoau ile leu) /�!Jan 01 pasn sl wjol s!y1 :SN0110n2IiSN1 MO© 3S -V31321 1m - n moi 7 TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units ... or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: Address of Work Owner Name: Date of Permit Application: I hereby certify that: Est. Cost -4.50d` Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. 4IS—D Job under $1,000 Date 0 �3 CY Building not owner -occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL C. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: AL�-' Date Owner N e n �01 0 7 } BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 059991 Birthdate: 10/17/1959 Expires: 10/17/2000 Tr. no: 3455 Restricted To: 00 RONALD K JOHNSON 329 WEST SUTTON RD SUTTON, MA 01590 Administrator 0 O 0 m O Town of North Andover Health Department Location: Date: e��Ij (Indicate Address, , if Residential, or Name- qf'Business) Check #: Type of Permit or License: (Circle) > Animal $ > Dumpster $ > Food Service - Type. $ > Funeral Directors $ > Massage Establishment $ > Massage Practice $ > Offal (Septic) Hauler $ > Recreational Camp $ > SEPTIC PERMITS: Ll Septic - Soil Testing $ El Septic - Design Approval Ll Septic Disposal Works Construction (DWO $ Ll Septic Disposal Works Installers (DW[) $ > Sun tanning $ > SwimmingPool $ > Tobacco $ > Tras4lSolid Waste Hauler $_ > Well Construction > OTHER- (Indicate)- *00 1486 Health Agent Initials White -Applicant Yellow -Health Pink -Treasurer COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 22 Barman Drive _ North Andover_ Owner's Name: _Mike Egan_ Owner's Address: 22 Barman Drive _ North Andover, MA 01845_ Date of Inspection: 3/23/2006_ Name of Inspector: Neil J. Bateson Company Name: Bateson Enterprises Inc._ Mailing Address: _111 Argilla Road_ _Andover, Ma. 01810_ Telephone Number: _( 978 ) 4754786_ REGI APR U 3 2006 TOWN OF NORTH ANDOVER HEAD DEPARTMENT 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 4mll, s Inspector's Signature:Date: —3/23/2006_ 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. Page 2 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 22 Barman Drive_ _ North Andover — Owner: _ Egan_ Date of Inspection: 323/2006 Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If "not determined" please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. 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, settled or uneven distribution box. System will pass 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): broken pipe(s) are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _22 Bannan Drive- - North Andover— Owner: Egan_ Date of Inspection: 383/2006 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds 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. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 22 Bannan Drive _ _ North Andover_ Owner: Egan_ Date of Inspection: 3/23/2006 D. System Failure Criteria applicable to all systems: You must indicate "yes" or `no" to each of the following for all inspections: _Yes_ _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _Yes_ _No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool No Liquid depth in cesspool is less than 6" below invert or available volume is 1/2 day flow. No— Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ _No Any portion of the SAS, cesspool or privy is below high ground water elevation. —No Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. No Any portion of a cesspool or privy is within a Zone 1 of a public well. _ _No_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ _No_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds 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 he attached to this form.] _Yes_ (Yes/No) 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 system the system must serve a facility with a design flow of 10,000 gpd to 15,000 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 it 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. Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 22 Bannan Drive _ _ North Andover _ Owner: _Egan _ Date of Inspection: 3/23/2006 Check if the following have been done. You most indicate "yes" or "no" as to each of the following: Yes No _Yes _ Pumping information was provided by the owner, occupant, or Board of Health No Were any of the system components pumped out in the previous two weeks ? _Yes_ _ Has the system received normal flows in the previous two week period ? No Have large volumes of water been introduced to the system recently or as part of this inspection ? Yes_ , Were as built plans of the system obtained and examined? _Yes_ , Was the facility or dwelling inspected for signs of sewage back up ? Yes Was the site inspected for signs of break out ? Yes_ _ Were all system components, excluding the SAS, located on site ? _Yes_ _ 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 ? _Yes_ _ Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes no _Yes_ _ Existing information. _Yes_ _ 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)] Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 22 Bannan Drive_ _ North Andover – Owner: _Egan _ Date of Inspection: 383/2006_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): _R 4_ Number of bedrooms (actual): _4_ DESIGN flow based on 310 CM15.203 _N/A Number of current residents: _4 Does residence have a garbage grinder (yes or no): No Is laundry on a separate sewage system (yes or no): No Laundry system inspected (yes or no): _ Seasonal use: (yes or no): _No_ Water meter reading: Yes_ Sump pump (yes or no): _No_ Last date of occupancy: — Current-COMMERCIAL/INDUSTRIAL Type of establishment: Design flow (based on 310 CMR 15.203): _gpd Basis of design flow (seats/persons/sgft,etc.): _ 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: OTHER (describe): GENERAL INFORMATION Pumping Records Source of information: Pumped five years ago, owner _ Was system pumped as part of the inspection (yes or no): _Yes_ If yes, volume pumped: _1000_ gallons -- How was quantity pumped determined? _Measured tank Reason for pumping: _Inspect tank & tee_ TYPE OF SYSTEM X Septic 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: _Septic tank original, D - Box & pits 19 years old, 8/31/1987, as built plan _ Were sewage odors detected when arriving at the site (yes or no): No Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22 Bannan Drive_ _ North Andover _ Owner: Egan_ Date of Inspection: 3/23/2006_ BUII.DING SEWER _ X _ (locate on site plan) Depth below grade: _24" Materials of construction: _X_ cast iron _40 PVC _other Distance from private water supply well or suction line: Comments (on condition of joints, venting, evidence of leakage, etc.) 4" Cast iron thru wall. 3" PVC in house, no leaks visible SEPTIC TANKS: X Depth below grade: _12" Material of construction: X concrete _ 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: 7' x 5' x 4'— Sludge '_Sludge depth 16"_ Distance from top of sludge to bottom of outlet tee or baffle: _16" _ Scum thickness: _12" Distance from top of scum to top of outlet tee or baffle: _8" Distance from bottom of scum to bottom of outlet tee or baffle: 4" How were dimensions determined: _Tape Measure _ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc. _ Pumped septic tank. Inlet baffle ok. Outlet baffle ok. Liquid level at outlet invert. No evidence of tank leaking. GREASE TRAP: _(locate on site plan) 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.): Page 8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22 Bannan Drive_ _ North Andover - Owner: _Egan_ Date of Inspection: 3/23/2006 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present (yes or no): Alarm level: Alarm in working order (yes or no): Date of last pumping: Comments (condition of alarm and float switches, etc.): DISTRIBUTION BOX: _X_ Depth below grade _24"_ Depth of liquid level above outlet invert: _1"_ Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.):_D-box level & distribution equal. Evidence of carryover. No evidence of leakage. Liquid above outlet inverts. Pumped d -box liquid ran back from pits._ PUMP CHAMBER: _ (locate on site plan) Pump in working order (yes or no): — Alarm in working order (yes or no): — Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _22 Bannan Drive_ _ North Andover _ Owner: Egan_ Date of Inspection: 3/23/2006 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, excavation not required) If SAS not located explain why: Type _X_ leaching pits, number: _3 leaching chambers, number: _ leaching galleries, number: leaching trenches, number, length: leaching field, number, dimensions: overflow cesspool, number: innovative/alternative system Typetname of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): _ Soil oL Vegetation oL No sign of ponding to surface. Camera inside of pits thru outlets in d -box, liquid above all inverts of pits. _ CESSPOOLS: Number and configuration: _ _ Depth – top of liquid to inlet invert: Depth of sludge layer: — Depth of scum layer: _ Dimensions of cesspool: _ Materials of construction: Indication of groundwater inflow (yes or no): _ Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): _ PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Page 10 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _22 Bannan Drive_ _ North Andover_ Owner: _Egan_ Date of Inspection: 3/23/2006 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. EIC Page 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22 Barman Drive _ _ North Andover_ Owner: _Egan _ Date of Inspection: 3/23/2006_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water _ No water found _ Please indicate (check) all methods used to determine the high ground water elevation: X Obtained from system design plans on record - If checked, date of design plan reviewed: _10/11/1973_ 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: Test pit info on old design plan_ / Summary Record Card gene4ated on, 3/2.3/2006 1:56:08 PM by Elaine Barclay ' Town of North Andover Tax Map # 210-038.0-0003-0000.0 22 BANNAN DRIVE EGAN, MICHAEL & NANCY 22 BANNAN DRIVE N. ANDOVER, MA 01845 Page 1 Class 101 Single Family Property Type 1 Residential Size Total 0.69 Acres FY 2006 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until EGAN, MICHAEL & NANCY Payor 22 BANNAN DRIVE N. ANDOVER, MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 16100.0 - 22 BANNAN DRIVE Last Billing Date 1/10/2006 3160142 03 Cycle 03 Active UB Services Maint. Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1 / WTR WATER 01 ALL METER SIZE 124.84 /1 UB Meter Maintenance Serial No Status Location Brand Type Size YTD Cons 99885620 a Active ERT HH METE METE w Water 0.63 0.63 0 Date Reading Code Consumption Posted Date Variance 3/22/2006 582 a Actual 28 -12% 12/15/2005 554 a Actual 31 1/17/2006 -26% 9/12/2005 523 a Actual 43 10/14/2005 77% 6/8/2005 480 a Actual 24 7/15/2005 2% 3/5/2005 456 m Manual estimate 22 4/5/2005 -7% 12/6/2004 434 a Actual 22 1/14/2005 -25% 9/14/2004 412 a Actual 36 10/8/2004 -59% 6/4/2004 376 a Actual 44 7./30/2004 71% 4/14/2004 332 a Actual 66 5/17/2004 0% 12/5/2003 266 n New Meter 0 12/5/2003 0% . H Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 22 Bannan Drive, North Andover Owner: Egan Date of Inspection: 3/23/2006 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. ' t - Bateson Enterprises, Inc.