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Miscellaneous - 10 JERAD PLACE 4/30/2018 (4)
I 0 88 b� m ND cp �r O r O CJ � m 0 w Aj - t ` r~� � � �. -� t �.l �� a�;XJr�'/_'�"1,,yt�yy .. ,��->,i,. � � "'�`C7'k; ���+F'1 ,w %'r(• �ir,V i ., �� - �,�,�Y� �'1 i s � r•i ..� �1�� �q }� 7�-t YL rr �r'`""�Y•S�/' � A�_p��,,�t�'r/ yrr 7ry4 .'. ���,.Y�ty��`l`r�'i'iYir'� ,r - • .. "( � �I y � i..•.�c ,�it`;. ♦��c�.3� �; �� `. � � � H -t, � y i...�p, x aj' �r ,�`µ��b-�'' ��r` ;� L, ' �," /+S �,. rx r r ��dr� ' � MAP # LOT -,#h PARCEL # .`" STREET �OIV$TRUCTI.O.N_APPROV ., , . HAS PLAN REVIEW FEE.BEEN PAID? YES NO PLAN APPROVAL: DATE �, /97 APP. BY_AJ_Aa�b _ DESIGNER: ,/i`�I%� PLAN DA -TE: 4116 CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMhT- DRILLER-___.____-_-_.____ WELL TESTS: CHEMICAL DATE APPROVED._-____ BACTERIA I DATE E1PPRUVED BACTERIA II DATE APPROVED COMMENTS: FORM U APPROVAL: APPROVAL i'U ISSUEYES NO .. DATE ISSUED BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID WELL CONSTRUCTION APPROVAL SEPTIC SYSTEM CONSTRUCTION APPROVAL OTHER ANY VARIANCE NEEDED FINAL BOARD OF HEALTH APPROVAL: YES NO YES NO YES NO YES NU YES NO - 1 - $EPTZ �LS—Z M�NSIA�t..f3T�QLl y XYr 1i -1. , r^ _.' \ 1. >-,.' J ;..'•• 1. .'I ir.� f 'A �tt 1 � 1 � . ISTHE INSTALLER LICENSED? + `�+ YES - NO �x' Fl i TYPE aIOF 1 CONSTRUCTION . �' NEW REPAIR " NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW NO CONDITIONS OF.. APPROVAL YES NO (FROM . FORM U) + ISSUANCE OF PERMIT ES NO DWC PERMIT, N0. ' . INSTALLER: T /1i/1-5 ' `BEGINJNSPECTION YES NO: - • -.: -'::EXCAVATION , INSPECTION: :NEEDED: PASSED .�, BYt :-`•;CONSTRUCTION INSPECTION: :• NEEDED: AS BUILT PLAN SATISFACTORY: YES: - .= / BY APPROVAL TO BACKFILL: DAT D ( Q� BY ( m < FINAL . GRADING APPROVAL: DATE 'W D6 �5 '' FINAL CONSTRUCTION APPROVAL: DATE: ` BY North Andover Health Department (ommunity and Economic Development Division 12/29/16 Address: 10 Jerad Place All North Andover Residents with Septic Systems and Garbage Disposals Please note that due to a recent review of a Title 5 Report, your property has been identified as maintaining a working garbage disposal that is being used in conjunction with a septic system. The Health Department is concerned for the longevity of your septic system. Garbage disposals are never recommended where septic systems are used, but if they are installed, the system must be specifically designed to handle the waste from them; your system can not handle the waste as designed. Please note that continued use of this disposal could quickly cause a pre -mature failure of your septic system, resulting in a large expenditure to replace it. The North Andover Health Department recommends that you remove it from your home as soon as possible. Some information regarding regular maintenance of your septic system is attached. Please call the Health Department at 978.688.9540 if you have any questions, or e-mail your questions to: healthdeptgnorthandoverma.gov. Thank you for taking the time to consider the impact that your current setup has on your septic system and the environment. Sincerely, rian LaGrasse, CEHT Director of Public Health 120 Main Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web http://www.northandoverma.gov A Owner information is required for every page. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Owners Na CY City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Telephone Number B. Certification Q Par�a'A &--C- IQ Q61% HEALTH Lf d f l U State Zip Code S 1 >-Ct V License Number 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: r Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evalytion by the Local Approving Authority Date The system inspect hall 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. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System . Page 1 of 17 7 Commonwealth of Massachusetts Title 5 Official Inspection Form r s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V– )3 d— ad 0 Property Address �vS I cs� Owner Ow er�s Nan))") information is every f j 2 - page.required for eve ^/ `� �''�'`''` r_� d' `C �i Jy- page. City/Town, _ State Zip Code Date of Inspection . B.: Certification (cont.) 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: tom^ lid,16 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,k3oard of Health, will pass. Check the 6 -for "yes% "no" or "not determined" (Y, N, ND) for the following statements. If "not determined," ple explain. The septic tank is metal a over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial Itration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is re ced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if itlsstrucl Compliance indicating that the tank is less than IQIIYII ❑ 'Y ❑ N ❑ ND (Explain below): rally sound, not leaking and if a Certificate of ars old is available. t5ins - 3113 Title 5 Official Inspection Foran: Subsurface Sewage Disposal System • Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection For a _ p m Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's Nam information is 4"V�- required for every 4t ULA_— 1 Z •—� 3 l page. City/Town State lin cnriP M.f. „f Ine. a ii B. Certification (cont.) ❑ Pump Cham umps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are r d. B) System Conditionally Passes (co ❑ Observation sewage backup or break out or high static water level in the distribution box due to broken or obs ted pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with roval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ ND (Explain below): ❑ The syste quired pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pas ection if (with approval of the Board of Health): ❑ broken pipe(s) are ced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed Y ❑ N ❑ ND (Explain below): C) Further Eval 'on is Required by the Board of Health: ❑ Conditions exist which ire further evaluation by the Board of Health in order to determine if the system is failing to protec lic health, safety or the environment. I. System will pass unless Board of th determines in accordance with 310 CMR 15.303(1)(b) that the system is not functions 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 t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System . Page 3 of 17 Commonwealth of Massachusetts e -- - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form/ - Not for Voluntary Assessments Property Address Owner Owners Nq�1 y l information is �` j`"'� required for every � � T—, �/C-�ti �_ �>t-��„S f Z-� /6 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety�d environment: ❑ The system a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surfaceValer supply or tributary to a surface water supply. ❑ The system has a Sep i nk and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank an S and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the 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 certifiedPpratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitra a nitrogen is equal too ' ss than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attac to this form. 3. Other: D) System Failure Criteria Applicable to All -Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No ❑ 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 in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than % day flow t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System . Page 4 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments W Property Address �T V� � N Own isNa� City/ Town B. Certification (cont.) Yes No /U 6 f r Z ---a -� -71�� State Zip Code Date of Inspection ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Any portion of cesspo^I or prir`y is vv hin 1^vii feet Gf a surface water supply or tributary to a surface water supply. pp y ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) 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 gpd. For larg stems, you must indicate either "yes" or "no" to each of the following, in addition � to the questions in ction D. Yes No ❑ ❑ the system ' ithin 400 feet of a surface drinking water supply ❑ ❑ the system is within 20 t of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitroge nsitive area (Interim Wellhead Protection Area — IWPA) or a mapped Zone II of a blic water supply well If you have answered "yes" to any question in Section E the system is nsidered a significant threat, or answered "yes" in Section D above the large system has failed. The ow or operator of any large system considered a significant threat under Section E orfailed under Section shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact th ppropriate regional office of the Department. t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 5 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for/Voluntary Assessments Property Address Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): tains • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 6 of 17 ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Were. any of the system components pumped out in the previous two weeks? K•❑] 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) ❑ Was the facility or dwelling inspected for signs of sewage back up? 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 y� information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): tains • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments <1e,A.*4 Property Address OwnerO�O wnet's N information is required for every M4 e1 g�, S 3 lA page. City/Town State Zip Code Date of Inspection D. System Information Description: t5ins - 3/13 Number of current residents: a Does residence have a garbage grinder? K Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) ❑ Yes No Laundry system inspected? ❑ Yes No Seasonal use? ❑ Yes No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? Last date of occupancy: Commercial/industrial Flow Conditions: TypeXEstablishment: Design flow ed on 310 CMR 15.203): Basis of design flow (se ersons/sq.ft., etc.): Grease trap present? Industrial waste holding tank present? Non -sanitary waste discharged to the Title 5 system? \A'ater meter readings, if ava lade: per day (gpd) ❑ Yes V No Date ❑ No ❑ Yes ❑ Yes ❑ No Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 7 of 17 Owner information is required for every page. Commonwealth of Massachusetts x Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments J C -s P/4IC-C.- Property Address ti d %A Owner's Na ity/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Other (describe below): General Information Date Pumping Records: Source of information: Was system pumped as part of the inspection? Ej Yes �j, No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: 10, Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy Shared system (yes olaif 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): t5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 8 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address �► S� a� State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? Building Sewer (locate on site pian): Depth below grade: Material of construction: ❑ cast iron 940 PVC ❑ other (explain): Distance from private water supply well or suction line: ❑ Yes k No feet feet Coles meni (on condition of joints, venting, evidence of leakage, etc.): c� � 4d Septic Tank (locate on site plan): Depth below grade: Material of construction: Kconcrete ❑ metal ❑ fibergiass If tank is metal, list age: feet ❑ polyethylene ❑ other (explain) years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5� Xz o Sludge depth: d iI t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address 1 7% A Owner Owners Na information is required for every page. City/Town State D. System Information (cont.) Zip Code Date of Inspection Septic Tank (cont.) It Distance from top of sludge to bottom of outlet tee or baffle da 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 !� How were dimensions determined? Comments (on (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 on site plan): Depth below grade: feet Material f 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: Date t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17 . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 16 Property Address Owner Owner's Na information is Pam—�- w��Z3 required for every �" ��"" page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid is as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspe n) (locate on site plan): Depth below grade: Material of construction: concrete I❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Dimensions: Capacity: Design Flow: Alarm present: Alarm level: gallons gallons per day ❑ Yes ❑ No Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 11 of 17 Commonwealth of Massachusetts -- . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owners NjCvila information is � required for every �" wB IPJ 1 Z a 3 �- page. City/Townn State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): /� CCPV Pump Chamber (locate on site plan): Pumps in ing order: Alarms in working or ❑ Yes ❑ No" ❑ Yes ❑ No - Comments (note condition o mp chamber, condition of pumps and appurtenances, etc.): If ps or alarms are not in working order, system is a conditional pass Soil Absorpti System (SAS) (locate on site plan, excavation not required): If SAS not located, expla hy: t5ins • 3/13 Title 5 Official In ection Form: Subsurface Sewage Disposal System - Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Ow is N; information is required for every � V v w page. City/Town D. System Information (cont.) State Zip Code Date of Inspection Type: ❑ leaching pits number: ❑ leaching chambers number: U leaching galleries number: leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ 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.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): and configuration Depth – top of liq-i d�inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes \ ❑ No t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's information is sk- required for every page. City/Tovt State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Privy (locate on site plan): Materials of construction: Dimensions ne.,+t, ..F--I;A.. t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 14 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments C -L"- 4- CL ?/?C --P__ Property Address Owner Owner's Na information is �i�u required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: R_hand-sketch in the area below ❑ drawing attached separately t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form .- Subsurface Sewage Disposal System Form - Not for Voluntary Assessments P/'4 " Gd �c � g-- P�•a - rrDperry hadress �-�--+ Owner Ownffz-l� N WV information is required for every �.� page. City/Town D. System Information (cont.) Site Exam: ❑ Check Slope Surface water A) ��► Check cellar ❑ Shallow wells State Zip Code Date of inspection Estimated depth to high ground water: tT� feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) (� Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 16 of 17 .r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner information is required for every �d page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist [� Inspection Summary: A, B, C, D, or E checked Inspection Summary D (System Failure Criteria Applicable to All Systems) completed System Information — Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins - 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF EN MMMAL AFFAW DEPARTMF.N'P OF &%TMONMENTAL PROTECTION ONE WINTER S'T'REET, BOSTON MA 02108 (617) 2924500 TRUDY CORE Sew"ry ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor � . SUBSIIMACE SEWAGE DISPOSAL SYSTEM 111111MECT110111111 FORM PART A CE iTFICATION Property Address: 10 Jerad Place Road, North Andover Name of Owner. James Santoianni Address of Owner: 10 Jerad Place Road, North Andover, MA. 01845 Date of inspection: 5/20/2000 Name of Inspector: Neil J. Bateson I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Bateson Enterprises Inc. Mailing Address: 111 Argilla Road Andover, MA 01810 Telephone Number. ( 878 ) 475-4786 CERTIFICATION STATEMENT 1 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _X Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Abmita Inspector's SignatuIsall Date: 5/20/2000 The System Inspectof this inspection report to the Approving Authority (Board of Heafth or DEP)within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS i ,26 revised 9/2/98 Page I of 11 Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 10 Jerad Place Road, North Andover Owner: Santoianni Data of Inspection: 512012000 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: _ X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: One or move 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. Indicate yes, no, or not determined (Y, N, or NO). Describe basis of determination in all instances. If "not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four 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 revised 912198 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 10 Jared Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 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 the public health, safety and the environment 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 THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (appropmation not valid). 3) OTHER revised 9/2/98 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 10 Jerad Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less -than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E.'LARGE SYSTEM FAILS - 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: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 11 of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 912198 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 10 Jerad Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No _X Pumping information was provided by the owner, occupant, or Board of Health. _X None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined. Note if they are not available with NIA. _X_ The facility or dwelling was inspected for signs of sewage back-up. _X The system does not receive non -sanitary or industrial waste flow. The site was inspected for signs of breakout. X All system components, excluding the Soil Absorption System, have been located on the site. X The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: X Existing information. For example, Plan at B.O.H. X Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (I 5.302(3)(b)] _X_ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 912198 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 10 Jared Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 FLOW CONDITIONS RESIDENTIAL: Design flow_ 165_ .g.p.d./bedroom. Number of bedrooms (design):_4 _ Number of bedrooms (actual)- -4 -Total DESIGN flow _660 _ Number of current residents: _3 Garbage grinder (yes or no): Yes _ Laundry (separate system) (yes or no):_ No If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use (yes or no):_ No_ Water meter readings. March 99 to March 00 = 17,200 ft 3x 7.5 = 129,000 Gallons / 730 Days = 177 gals. / Day Sump Pump (yes or no): _No _ Last date of occupancy: _Current COMM ERCIALIINDUSTRIAL: Type of establishment: Design flow: gp( Based on 15.203) Basis of design flow 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: OTHER: (Describe) _ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Pumped 4/7/99, owner System pumped as part of inspection: (yes or no)—Yes _ If yes, volume pumped: _1500 gallons Reason for pumping: Inspect tank & tees. 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed (if known) and source of information: 3 years old, 4/18/1997, as built plan. Sewage odors detected when arriving at the site: (yes or no) - No - revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Jared Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 BUILDING SEWER: X (Locate on site plan) Depth below grade: 18" Material of construction: cast iron _X_ 40 PVC _ other (explain) Distance from private water supply well or suction line: Diameter: 4" Comments: 4" PVC thru wall to septic tank. 3" PVC in house. SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction:_X concrete _metal _Fiberglass _Polyethylene _other (explain) If tank is metal, list age _Is age confirmed by Certificate of Compliance _ (Yes/No) Dimensions: 10' x 5' x 4' x 7.5 = 1500 gallons. Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle. 24" Scum thickness: 1" 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: 20" How dimensions were determined: Subtract scum & sludge depths to tee length. Comments: Pumped septic tank, inlet & outlet tees ok. Depth of liquid at outlet invert. No evidence of leakage. GREASE TRAP: None (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: revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Jerad Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 TIGHT OR HOLDING TANK: _None (Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade: Material of construction: concrete — metal _Fiberglass Polyethylene _other(explain) Dimensions: Capacity:_allons Design flow:_gallons/day Alarm present Alarm level: Alarm in working order: Yes _ No Date of previous pumping: Comments: DISTRIBUTION BOX.:_X_ (locate on site plan) Depth of liquid level above outlet invert: 0 Comments: D -Box level & distribution equal. Evidence of solid carryover, pumped d -box to clean. No evidence of leakage. PUMP CHAMBER: —None, gravity system_ (locate on site plan) Pumps in working order. (Yes or No) Alamos in working order (Yes or No) Comments: Revised 912198 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued)) Property Address: 10 Jared Place Road, North Andover Owner: Santoanni Date of Inspection: 5/20/2000 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, if possible; excavation not required, location may be approximated by non -intrusive methods) If not located, explain: Type: leaching pits, number leaching chambers, number: leaching galleries, number: leaching trenches, number, length: 3 Trenches 90' long leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: Soil ok. Vegetation ok. No sign of ponding to surface. CESSPOOLS: None (locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: revised 912198 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Jerad Place Road, North Andover Owner. Santoianni Data of Inspection: 5/20/2000 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) Septic Tank revised 9/2/98 Page 10 of 11 A to 1 = 33'11" Ato2=41'1" A to D -box = 82'6" B to 1 = 28' Bto2=35'8" B to D -Box =64'5" SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 Jerad Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 NRCS Report name Sal Type Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 4 Feet Please indicate all the methods used to determine High Groundwater Elevation: X Obtained from Design Plans on record _X Observed Site (Abutting property, observation hole, basement sump etc.) —X—Determined from local conditions X Checked wdh local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) As per design plan. revised 912198 Page 11 of 11 BATESON ENTERPRISES, INC. Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 10 Jerad Place Road, North Andover Owner: Santoianni Date of Inspection: 5/20/2000 Tel: (978) 475-4786 Fax: (978) 475-5451 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. Neil J. Bateson Bateson Enterprises, Inc. • C o0 Oo GC C 44 Co zi Zj �I �L O •6 0 Co -,t ;- ;�3 (6 od �ql � � , .-•,,� 0 � o of � � v o tv�� cry � � QCgU ALU ' FDG OF LAND Z 0 h oo, Lq O moo ioW IV) W Ci C ornrn r4 Lo v 'b L4^ zo U Z -------- --- - - cNN ��-N I ,O , Q) Clq C,4 --------------------- a�o o------------ J-- o � C a II IL 4 C' O rt 11 O Sight Distance ;n, ' II 0i ^ 11)h i Easement (25' Wide) 4.8 q) ,009 --- ,9s'P,9 e t o o II ; 'I Forest Str • •C Variable Width Iq a�ia�i�l�i C P u b l i C — G) ' (n J) C) zo O -iql p - F t„? co ve c L6 E� lb o Z 2 w O � O -tiOQ�iC 0 o.a'Oi a N j�q) r., C w O V C� Q C a) 0 O Q) -Z �ppo0 'b ' � ,l °a •o •ti a 4z-� 0�0 vqi 0 3 0 o C) (o q) vip30.0 4 p q fi0 `�•� 3 'Q Q� O 'Q .�1•p O lb U Q U �ago"EZi aQv�3.� ,£'O 9 Op , � I F / •/ O � pG•� ,t- aF W � I_ /V l7'� O � J� O 7 W� O H ►til k-� W Q IV) I ;, zo Q1 (ZN- � un co N � N 4.4 q O O II O(o LC) r� J 01 LC, II S o0 Aorn II II Q� II II Q� J V � r zo O -iql p - F t„? co ve c L6 E� lb o Z 2 w O � O -tiOQ�iC 0 o.a'Oi a N j�q) r., C w O V C� Q C a) 0 O Q) -Z �ppo0 'b ' � ,l °a •o •ti a 4z-� 0�0 vqi 0 3 0 o C) (o q) vip30.0 4 p q fi0 `�•� 3 'Q Q� O 'Q .�1•p O lb U Q U �ago"EZi aQv�3.� ,£'O 9 Op , � I F / •/ O � pG•� ,t- aF W � I_ /V l7'� O � J� O 7 W� O H ►til k-� W Q IV) j, I Sight Distance Easement (25' Wide) 98'P9 o r e s P u b l i c �J- rri0Q)o N� N Cd �IJ t s t r V d r i° b l e Q) e e t width I° G cj c Go �p-4o � J ; q) � c j C � Wi oIZ3 w� I ;, zo ch(3i (ZN- h un nuu uu N 4.4 q O O II O(o LC) r� � LC, II S o0 Aorn II II Q� II II Q� j, I Sight Distance Easement (25' Wide) 98'P9 o r e s P u b l i c �J- rri0Q)o N� N Cd �IJ t s t r V d r i° b l e Q) e e t width I° G cj c Go �p-4o � J ; q) � c j C � Wi oIZ3 w� I ch(3i h "� nuu uu N 4.4 O O II O(o LC) r� � LC, II S zL II II Q� II II Q� Y ch(3i h h N 4.4 O O II O(o LC) �o tn � LC, II S zL cc �mQp Town of North Andover, Massachusetts BOARD OF HEALTH Form No. 4 19-2Z CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( X) or repaired ( ) by Bob Innis INSTALLER at Lot 15A Forest Street (Jared Place Road) has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 788 dated Novemb _r The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. May 16, 1996 Sandra Starr North Andover Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 158 Forest Street Lot 15A Jerad Place Road Lot 29C Sugarcane Lane Dear Sandy: 01 2 0 190 Please find enclosed 3 prints each of the revised sanitary disposal system designs for the above-mentioned lots. The following revisions have been made per your telephone conversation with Tom on Tuesday, May 14: Lot 158 Forest Street: The trench design is based on 110 Gal/Bedrm/Day maintaining "Title W setbacks. The note regarding the existing dwelling to be razed has been emphasized. Lot 15A Jerad Place Road: The address of the site has been revised to Jerad Place Road. The trench design is based on 165 Gal/Bedrm/Day maintaining "Title W setbacks and North Andover setback where possible. Lot 29C Sugarcane Lane: The trench design is based on 110 GalBedrm/Day, maintaining "Title W setbacks and North Andover setback where possible. The reserve area is 97' to the wetlands. • ENGINEERS • 447 Old Boston Road (508) 887-8586 • LAND SURVEYORS • U.S. Route #1 • LAND USE PLANNERS • Topsfield, MA 01983 FAX (508) 887-3480 Sandy Starr May 16, 1996 Page 2 We realize that you have a very busy schedule, but hope that you may find the time to approve these designs as Mr. Janusz is very eager to begin construction. He has informed us that his priorities are as follows: lot 29C, Lot 15A and 158 Forest St. Please review lot 29C as soon as possible, as it is holding up the sale of the lot. Thank you for all your time and effort in resolving these issues. If you should have any further questions, please do not hesitate to call. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. John Morin, EIT Civil Engineering Consultant cc: Bob Janusz JM/ec John\305.doc THO ASS( April 11, 1996 Sandra Starr, R.S. North Andover Board of Health 146 Main Street North Andover, MA 01845 Re: Lot 15A Jerad Place Road Dear Sandy: INC. We are in receipt of your letter dated April 3, 1996 regarding the above - referenced lot. The original system designed by us was dated October 31, 1995 and consisted of 276 linear feet of leach trench, 2 feet wide and 2 feet deep based on a 25 minute per inch perc rate. The soils found on the lot were variable till with a high SHWT, therefore requiring 3-4 feet of sand to be placed beneath the system and 5 feet beyond the system. Steve aborted P-4 since this site would have required an overnight soak. But since he moved to another area and was further limited to a design rate of 25 minuytes per inch with a large sand fill, we felt comfortable with the design. When we met on January 30,1996 we felt you would allow the design to be based on 110 gallon/bedroom/day; therefore we redesigned and hence your disapproval. Under the circumstances I am recommending that we return to the trench design, therefore affording 1,656 square feet of total leaching compared to a 1,120 square foot bed. The sand fill under the trenches is considerably more, and the design is more intrusive to the land. Under these circumstances, however, we would revert back to the trench design. Find attached a revised trench system showing the perc test elevations of the perc tests. However, we must ask for a waiver since the system is only 22 feet from the foundation. • ENGINEERS - 447 Old Boston Road (508) 887-8586 • LAND SURVEYORS • U.S. Route #1 • LAND USE PLANNERS • Topsfield, MA 01983 FAX (508) 887-3480 Sandra Starr April 15, 1996 Page 2 I hope you accept this situation. Find attached a history of the plan and correspondence for your files. I will ask Bob Janusz to drop off a check for $60.00. Very truly yours, THOMAS E. NEVE ASSOCIATES, INC. F U, Thomas Neve, PE, PLS President, CEO Attachments cc: Bob Janusz TEN/ebc Tom\305-15.doc 310 CiIMR: DEPARTi�vENI' OF ENVIRONMENTAL PROTECTION 15.255: continued 100 90 80 70 Z g360 W 6q W 40 U a: � 30 20 10 0 (a) The retaining wall shall be constructed of reinforced concrete, shall have no weep holes. and shall be waterproof. (b) The retaining wall shall be designed by a Registered Professional Engineer, who shall certify that the above condition is met by the submitted design. (c) The upgradient side of the retaining wall shall be waterproofed. (d) Construction of the retaining wall shall be supervised by the design engineer. (e) An as -built plan shall be prepared and certified by the design engineer that the wall has been constructed in accordance with his approved design plan. (f) The elevation of the top of the retaining wall shall be no lower than the "breakout" elevation, which is the elevation of the top of the two inch laver of 'A inch to '/z inch washed stone aggregate cover. (g) The distance from the wall to the edge of the leaching area should be at least ten feet. (3) Fill material for systems constructed in fill shall consist of select on-site or imported soil material. The fill shall be comprised of clean granular sand, free from organic matter and deleterious substances. Mixtures and layers of different classes of soil shall not be used. The fill shall not contain any material larger than two inches. A sieve analysis, using a #4 sieve, shall be performed on a representative sample of the fill. Up to 45% by weight of the fill sample may be retained on the 94 sieve. Sieve analyses also shall be performed on the fraction.of the fill sample passing the 44 sieve, such analyses must demonstrate that the material meets each of the following specifications: SIEVE SIZE EFFECTIVE % THAT MUST PARTICLE SIZE PASS SIEVE # 4 4.75 mm 100% 450 0.30 mm 10%_100% #100 0.15 mm 0%- 20% #200 0.075 mm 0%_ 5% A plot of the sieve analyses of the portion of the sample passing the 94 sieve shall fall on or between the lines on the following graph: PARTICLE SIZE DISTRIBUTION #200 1100 #50 CP ql,-�' R °. t4 Sieve Sze Mcror. 60 200 600 1 2 6 10 mm 12/1/95 (Effective 11/3/95) - corrected 310 Civa - 531 Mai a■n■u ■aon■ i Mcror. 60 200 600 1 2 6 10 mm 12/1/95 (Effective 11/3/95) - corrected 310 Civa - 531 NEW ENGLAND CHROMACHEM 6 NICHOLS STREET SALEM, MA 01970 1-508-744-6600 NEWO UM SNVIBONIIENTAL TES MG AND ANALYSIS 6 NICHOLS STSSET SAXAM, !IA 01970 508-744-6600 CLIENT: EAST COAST SAND & GRAVEL NEC ID: 703017 CLIENT ID: BARRINGTON STOCKPILE DATE RECEIVED: 03/06/97 DATE ANALYZED: 03/07/97 DATE SAMPLED: 03/05/97 PARAMETER: GRAIN SIZE ANALYSIS PAN # 4 50 100 200 TRAY 03/07/97 DATE UNITS: PERCENT 5.7 74.6 14.2 4.6 0.8 BRU"C"E A. BORNSTEIN LABORATORY DIRECTOR Ai .DRAFTSMAN 154'' /��_ �s2�`. _- -- __ ��� �\\\ ��\ `�\ •t m oo 56 �° r 1 It O Isat3 OL 1 1s7 0 / �� � INVt OT /:P7 `' �' -- /3OF/5'`R PP ' f' x-0.005,' t X A6 (� /� \ 1 " 1 t \ I \` 1 rlra� l t' �p'Z-► `o �0.Od'3'�4' . Ll cj:t DET fit 1 ` t. / ' ./'i/` [ ••�h'4,� 1 ' I , •� I ,' S 1 t } 1 it . , �. ' l �� ' I 1 � _ 61 P(L SEKD /* ETzJ I /* -37 01 Wr9TER ,qR Nt 1 1 4 " I 'Ic- 1 w. uj �;�� t � \ .ESM `T _ ,.. �• • ..,�., , S/EE T ZJ �� �:vi T'tX .Fl vi'tR :+iy4\ \.� \ 4! y. _ •�/ r.•,+, ::iii RIy, ,gF�i i FLA RE ` 1.`rw, VlfJj�'FVIiJi't t , / C�1 / k ,71 ''.,� � ( � • . AI ±�z vlo 91 i :l IvAXIIF�t� -�. 1 't 1., tF 1 \ ``EE 4(j .1t i, k `'�1• 'j AT•� 41�_ '1; I J I SI DE SLo .. "� 'a �. ,.,.ev�\ '(� R !�' 'I.�1�'.I, ,`; 1 �,, ;�•. ,��' ,;,�'� I.I�:'I} ;� +�. "fir I 1 ,��'� r'. ti•�` ; i � ^�j Q fr r��';G ";,' („ti'� • j}• ° �i� �a , ir� , • �� 4 �:��,�!'' ! _ / �.r�l►1 p'L i V FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *****************Applicant fills out this section***************** APPLICANT: �(��,� f,93A /6 /J Phone LOCATION: Assessor's Map Number Parcel 1"6* R 13 Subdivision ✓�1j) Lots) Street 0_4ft 101�k_ IfM--d St. Number ************************0 icial RECOMMEN TION O OWNS' GENTS: Conservation A Comments pYni;ltrator Q�1 wow V-A Cwt )_R � o Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments .r Use Only************************ Public Works - sewer/water connections - driveway permit Fire Department Date Approved Ix! Date_Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date PLAN REVIEW CHECKLIST v, A 2 , � ADDRESS Z �� �Q�ES 3 ENGINEER GENERAL 3 COPIES N1 STAMP LOCUS Irk NORTH ARROW kO� SCALE CONTOURS IIf PROFILE LI--� SECTION �i� BENCHMARK OIL & PERCS ELEVATIONS�i WETS. DISCLAIMER WELLS-,& WETS WATERSHED?A/0 DRIVEWAY Elev) WATER LINE FDN DRAIN SCH401� TESTS CURRENT? SOIL EVAL SEPTIC TANK, MIN 150OG V/ .17 VERT DROP t// GARB. GRINDER(+200% EDF) 25' TO CELLAR MANHOLE �Z-- ELEV e--- GW — - COMPS. D -BOX SIZE 7 LINES / FIRST 2' LEVEL STATEMENT < -- I f G 4 INLET 4 - OUTLET ,L�� = r (2" OR .17 FT) TEE REQ' D?J/L LEACHING MIN 660 GPD? RESERVE AREA FROM PRIMARY?k�% SLOPE 100' TO WETLANDS �/ 100' TO WELLS 4' TO S.H.GW c/ (5'>2M/IN) 35' TO FND. & INTRCPTR DRAINS 325' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY &, MIN 12" COVER if above natural elev; 101if below) BREAKOUT MET?=� TRENCHES MIN 660 gpd V SLOPE (min .005 or 6"/100') �SIDEWALL DIST. 3X EFF. W OR D (MIN 6') C, RESERVE BETWEEN TRENCHES? &,'�IN FILL? MUST BE 10' MIN. L, 4" PEA STONE?Z VENT? C---�(>3' COVER; LINES >50') BOT + SIDE_ �Q X L D N G = TOT (L x W x ) (DxLx2x4) (G/ft2): 16 13�5 copyright u 1995 by SA.. Surr THOMAS E. NEVE ASSOCIATES, INC. Engineers • Land Surveyors • Land Use Planners 447 Boston Street US #1 TOPSFIELD, MASSACHUSETTS 01983 (508) 887-8586 FAX (508) 887-3480 TO At_jCV -faas✓� �t7 Pr(UD 01;: }-k�,� t✓�� 11©12'`t-� WE ARE SENDING YOU ❑ Shop drawings ❑ Copy of letter ❑■ AirMlisdote coverkvia nts Plan. [LCE44CEn @P M%KNEU4ad DATE i t \ DATE JOB NO. -^ %S^, - 13b5; -3T-1'5'5 Nd►4-_') ZSC ATTENTION ep� srfp��Z-e' cp RE: 1 � 158 FAST s' � PLP.-� Of . �JI;kQw�t►->•CQ'Tt,}� P �-tt�� 'D15t�#}L�-CS'c�n � ltsC Von GGs r � e�vtsco z-1 W- l� � - t58 �, stew« _ PPS PCsc-,�,-t,2-( a� Poss�c sKs-�E� F�cst ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION vls� z(�410,16 PLP.-� Of . �JI;kQw�t►->•CQ'Tt,}� P �-tt�� 'D15t�#}L�-CS'c�n � ltsC Von GGs r � e�vtsco z-1 W- l� � - t58 �, stew« _ PPS PCsc-,�,-t,2-( a� Poss�c sKs-�E� F�cst Possess K_;C7a �• A _A_ {PL_N+ 5- tPPvy___ VkS6P_'*1 A -a E P%=� Q -6D B_m4orvtaS 4_Q, t— J p-ssoc THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted Resubmit cD copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS 'TI-�S� �`�' �-��nS �-►-Avg 'g�� '� p� S ► C� -f' � >�E ��'T �C��.. -- , s�'S-r n s t-�+�.r� -� s� c��. c�eJ t c) jtW=C>czeo,M ad--ArP $iG'�'-9 G N-rte►-� GfaD �-YLc�rn � -T�-�-�c.�-1 � `-�S�-r�5 • � o `P�.�DS . '(�-SSE �S-t�S W t Lrt_ 04: t.,c�'S t rv\ < L-Tt tis W l - H rZES tie --T 'Ccl cam► QL_I, s-tt �s VuEprjr- LPK..L_ . COPY TO RECYCLED PAPER: SIGNED: SCO t.- o C� ` Contents: 40% Pre -Consumer• 10% Post -Consumer if enclosures are not as noted, kindly notify us at once. PLAN REVIEW CHECKLIST ADDRESS4,T k -5-91P ST ENGINEER GENERAL 3 COPIES v STAMP C--' LOCUS L--' NORTH ARROW L�-- SCALE CONTOURS (--� PROFILEC,� SECTION4-� BENCHMARK L--� SOIL & PERCS � ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED?I/a DRIVEWAY '--."(Elev) WATER LINE FDN DRAIN SCH40 C ----TESTS CURRENT? l�i9s SOIL EVAL 7 SEPTIC TANK MIN 1500G .17 INVERT DROP � GARB. GRINDER(+200% EDF) 25' TO CELLAR &,-' MANHOLE ELEVGW # COMPS. D -BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET %,53. 9-1- - OUTLET , 6 Z0 (2 " OR .17 FT) TEE REQ' D?/t/O LEACHING ` / MIN 660 GPD? C",/ "RESERVE AREA V 4' FROM PRIMARY? 1-"�2o SLOPE 5 100' TO WETLANDS? � 100' TO WELLS 4' TO S.H.GW �-�� (5'>2M/IN) 35' TO FND & INTRCPTR DRAINS �C 325' TO SURFACE H2O SUPP �- 4' PERM. SOIL BELOW FACILITY i,� MIN 12" COVER C, FILL:V-� (25' if above natural elev; 10'if below) BREAKOUT MET? TRENCHES MIN 660 gpd V SLOPE (min .005 or 6"/100') �SIDEWALL DIST. 3X EFF. W OR D (MIN 6') ��_ RESERVE BETWEEN TRENCHES? t-�iN FILL?MUST BE 10' MIN. "--4 11 PEA STONE? '(--' VENT? (>3' COVER; LINES >501) BOT cSaZ + SIDE //40¢ X LDNG TOT (L x W x #) (DxLx2x#) (G/ft2) Copyright 0 1995 by S.L. Starr April 3, 1996 Mr. Thomas Neve 447 Old Boston Road Topsfield, MA01983 Re: Lot #15A Forest Street Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. No deep holes in system. No peres in reserve area. Aborted perc (P4) in primary area. 2. No elevations for perc tests. 3. Leach area is not 35 feet from foundation and the tank is not 25 feet. 4. Reserve area not 4 feet from primary area. 5. Minimum 660 GPD leaching not met. / If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S., Health Administrator System Owner Commonwealth of Massachusetts Massachusetts System Pumping Record System Location Date of Pumping: S . 10, 2000 Quantity Pumped: / S -o -D gallons Cesspool: No 1') Yes Septic Tank: No System Pumped by: Fctredort 5iI&M,61ma License # Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector - Yes �, a e 1 Town of North Andover of ",ORT ",ti OFFICE OF ` COMMUNITY DEVELOPMENT AND SERVICES p p f 146 Main Street p41Tfp �P '�y North Andover, Massachusetts 01845 9sSACHUSE� (508) 688-9533 December 7, 1995 Mr. Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot #1'e Forest Street 15A Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1') Who is soil evaluator? 2-r ., Leaching area less than 35 feet from foundation drain."," 3)'' Please check distance to wetlands across the street. 4a--. What are map and parcel numbers: 5- Please update fill requirements. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sin erel , .111 Sandra Starr, R.S. Health Administrator SS/cjp BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Parrino D. Robert Nicetta - " Michael Howard Sandra Starr Kathleen Bradley Colwell > THOMAS E. NEVE ASSOCIATES, INC. Engineers • Land Surveyors • Land Use Planners 447 Boston Street US #1 TOPSFIELD, MASSACHUSETTS 01983 (508) 887-8586 FAX (508) 887-3480 TO 16,0PW__fl � V�'C A L_,T4. ND . "Ar Ck8 A-5 WE ARE SENDING YOU Attached ❑ Under separate cover via ❑ Shop drawings X Prints ❑ Copy of letter ❑ Change order ❑ Plans IMUCTIM @17 DATE 1 t _ JOB NO. _ al:- 1 ATTENTIO DESCRIPTION 2 copies for approval lZ t 1 A UCST kVb -E=�f -C ❑ Submit the following items: ❑ Samples ❑ Specifications COPIES DATE NO. DESCRIPTION 2 copies for approval lZ t 1 A UCST kVb -E=�f -C ❑ Submit copies for distribution ❑ As requested "J ry . �4SSor_ Returned for corrections ❑ Return corrected prints r THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted )4 Resubmit 2 copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS ''Ar�ri�4 ' �EP15E� NO-cE. TtwyV E A Bco%j f JE3C) wT t- � w %--T4 -<60e- 2+E C) V ea rr S tt--, 46'.ht- t_ Tme- V* CI� Z � `1 X95 • A•b DrA 'CO 'Ib�� R-P'a-� W rc.it� Sb t t.. c�E�rL.Tt Ft L�"R al-� � � t 1�1� ?� � T h+--Y� rnPrP � C-�Pt�«� Ir3cst'�-S • P�.S�t �-�A-SE. 1S�rC� -Ci-}�-T 'iH� wE�Cu�-.sem c . t N S. A�t,VCc�SS 'Trci� `sem N",C> res" b15'CA�-�� -t'o j7hi 6ECT-1 ptiZRt� pts�T c -� ut>JV1159- Pat_�CTf.-� VC01 'tHel f3p.o.01 mn1£TttJ� -t '8f Nt" . 25, V c?) 9(p. Fol -,CtME W t?k.1��wt►-�� ^R�rIS vn4�'Ct�e t'E W E- c> 6L otG ¢uK�'C�1�s� &,55-k 5-r -Ic-��--- rr)PY Tri RECYCLED PAPER: Contents: 40% Pre -Consumer • 10% Post -Consumer SIGN '� �.1:i•. If enclosures are not as noted, kindly notify us at once. Engineers + Land Sc:rreyors � lanti Use Planners J-47 Ssoston Str.;et US ;;i OPSr ELD, MASSACHUSE! ;S 011983 1508) 387.8586 87 ,. .1 TO WE ARE SENDING YOU Attached ❑ Under separate cover via > ❑ Shop drawings Prints ❑ Plans i ❑ Copy of letter ❑ Change order ❑ —ACT I In 017 7T ° ° Q1 )WO s i��L CATE JOB NO. ATTENTION RE.R Lcrr5 ""'_-.. -- _ 5 , - _ _ a- 156 ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION ?% .�.vISGp Z�1410`b F'i.,'k, 7!-`t�+-a��-•- :r,� G!CO �� �h�+-..�_^. -( Etc. � I c� ,�1J� ' '4� (�7� Z-P��• j�•*o.,.. ; � `. -T�+� p�:t� . ._ � � Sr-�–.1 : �.i � 1 '-� � :� ���L y-r� t ,-- eulw� I � THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted Resubmit ':D copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ 0 FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS 5ti' s-�rns X02_ -f�-1� ,413ou E. `�Errr.�.i�eo Lcrt-S. � t_�AS� � t �� -�•-kn�-r T f r �� Lt s l c.-�S nn r� of PEAL ov rL_ r✓� ���' i �--, � o t-= � �Ll r�� 30, 1 �� . T►-�f�- S�S'f�rn S N Av � 5�,�,� i� S� �.t-,Elm o� 0.10 �A�. / C�A-� lgE�2oowt F4 AJC-' u 5G o. A t_5o, Pu- Ns �f.E� G N-f�.►-� GEb �fL,<3rvt .� -��� S' -{s -`C -+MS -fo ��5. '�-�S� �s-Ta�vL OU E-kA.v E Ate` r QC.1 es -n CSS COPY TO-�C_�El_� RECYCLED PAPER: Contents: 401/, Pro -Consumer • 10% Post -Consumer SIGNED-7— If IGNED' —If enclosures are not as noted, kindly notify us at once. Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 April'), 1996 Mr. Thomas Neve 447 Old ;;oston Road Topsfield, MA01983 Re: Lot -915A Forest Street Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. No deep holes in system. No peres in reserve area. Aborted perc (P4) in primary area. 2. No elevations for perc tests. 3. Leach area is not 35 feet from foundation and the tank is not 25 feet. 4. Reserve area not 4 feet from primary area. 5. Minimum 660 GPD leaching not met. In addition, since this is an entirely new design, the review fee of sixty (60) dollars is required. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S., h� Health Administrator l� SS/cjp BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 April 3, 1996 Mr. Thomas Neve 447 Old Boston Road Topsfield, MAO 1983 Re: Lot #15A Forest Street Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. No deep holes in system. No peres in reserve area. Aborted perc (P4) in primary area. 2. No elevations for perc tests. 3. Leach area is not 35 feet from foundation and the tank is not 25 feet. 4. Reserve area not 4 feet from primary area. 5. Minimum 660 GPD leaching not met. In addition, since this is an entirely new design, the review fee of sixty (60) dollars is required. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S., Health Administrator SS/cjp to '6 BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: PERMIT APPLICANT -BO B J AA) L) 5 Z. ADDRESS ENG. /yc-V6- DATE RECEIVED 9- / Ag MAP /dw PARCEL o5? 13 LOT ## STREET x/2.,5 7- Si ADDRESS PLAN DATE o`j/%�/J� REV . DATE CONDITIONS OF APPROV APPROVED REASONS FOR DISAPPROVAL: DISAPPROVED (r -P4) Ilk)6 ADT /US T GENERAL 3 COPIES i--' STAMP L--' LOCUS &,-' NORTH ARROW SCALE CONTOURS I/� PROFILEt� SECTION Cid BENCHMARK 4-� SOIL & PERCS ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED?1t/O DRIVEWAY ±:�'(Elev) WATER LINE t,-� FDN DRAIN t/ SCH401,,::�-' TESTS CURRENT? SOIL EVAL 'G)pSd SEPTIC TANK. MIN 150OG .17 PLAN `` REVIEW CHECKLISTje � v. ADDRESS �3%� �Q,-j 25' I ENGINEER GENERAL 3 COPIES i--' STAMP L--' LOCUS &,-' NORTH ARROW SCALE CONTOURS I/� PROFILEt� SECTION Cid BENCHMARK 4-� SOIL & PERCS ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED?1t/O DRIVEWAY ±:�'(Elev) WATER LINE t,-� FDN DRAIN t/ SCH401,,::�-' TESTS CURRENT? SOIL EVAL 'G)pSd SEPTIC TANK. MIN 150OG .17 INVERT DROP y' GARB. GRINDER (+200% EDF) 25' TO CELLAR MANHOLE ELEV GW S::-- # COMPS. SIZE , LINES 17 FIRST 2' LEVEL STATEMENT INLET /cJ-9 63-- OUTLET ZO (2 " OR . 17 FT) TEE REQ' D?zy-02- LEACHING MIN 660 GPD?� RESERVE AREA 4'�4' FROM PRIMARY?/_z 2% SLOPE 100' TO WETLANDS 4100' TO WELLS 4' TO S.H.GW c/— (5'>2M/IN) 35' TO FND & INTRCPTR DRAINSI( 325' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY t-� MIN 12" COVER el FILL? -x(25' if above natural elev; 101if below) BREAKOUT MET? TRENCHES MIN 660 gpd SLOPE (min .005 or 6"/100') �SIDEWALL DIST. 3X EFF. W OR D (MIN 61) RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. 4" PEA STONE? VENT? (>3' COVER; LINES >50') BOT + SIDE X LDNG = TOT (L x W x #) (DxLx2x4) (G/ft2) Copyright V 1995 by S.L. Swrr PITS MIN 660 LEACHING MIN 1 (13'xl6') PIT MANHOLE/PIT GW MIN 4' BELOW BOTTOM EXC 2x EFF W OR D 12"-48" STONE BOT + SIDE x LOAD = TOTAL (L x W x ##) (2x(L+W)xD x #) (G/ft2) CHAMBERS MIN 660 LEACHING GW MIN 4" BELOW COVER >3 FT - VENT MANHOLES 12"-48" STONE SPLASH PADS SLOPE .005 BED/TRENCH (Bed max. 60' X 601) MIN 13' X 16' PIT BOT + SIDE X LOAD = TOTAL (L x W x ##) (2 x (L+W)xD x ##) (G/ft2) FIELDS MIN 660 GPDZ 900 ft2 BED C� GW MIN 4' BELOW BOTTOM OF FIELD PIPE ENDS JOINED? 4" PEA STONE? L-� DIST LINE SLOPE .005? >31COVER-VENT SCH 40 MIN 12" COVER 4--�- RATEa5MP/ LDG ¢ X 660 = //ZD X ¢ = TOTAL G/ft2 REQ'D (ft2) LXW DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY 9Pm L W D Vol. DISCHARGE SIZE DISCHARGE RATE 9Pm MANHOLES TO GRADE ALARM SEP. CIRC. inlet) HWL LWL CHECK VALVE OP. SWITCH Copyright 0 1995 by S.L. Starr DISCHARGE TIME GW (Min. 1' below BLEEDER HOLE MANUAL NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: � ' PERMIT ##�7?e DATE RECEIVED APPLICANT' MAP PARCEL ADDRESS ENG. /V C -U& /):5 5-1:5y-' , ADDRESS LOT ## 16-61 STREET 7D,2EE57" PLAN DATE (' J Cir V� %, /���� REV. DATE CONDITIONS OF APPROVAL APPROVED REASONS FOR DISAPPROVAL: 14 DISAPPROVED �ou�v D r� 7'/(0 A-) 77/5 7 U667 Td G[J��L /�tiP�S THOMAS E. NEVE ASSOCIATES, INC. Engineers • Land Surveyors • Land Use Planners 447 Boston Street US #1 TOPSHELD, MASSACHUSETTS 01983 (508) 887-8586 FAX (508) 887-3480 TO mc) . At_ADovce,1 "4%r a8 v5 112"Tu n OCP 4 D s HQ3W044La1L DATE 1 15 JOB NO. i�305 _ =' ATTENTIO'A ,, 1`T9,4ZZ 1'L t NpR�N A�© N 3 ' ir WE ARE SENDING YOUAttached El Under separate cover via ief Ingitems. ❑ Shop drawings X Prints ❑ Plans ❑ amples (cations ❑ Copy of letter ❑ Change order ❑ COPIES DATE DESCRIPTION 1'L t +�,,NNO. t �tT L ba Ear i3gV t .psSSOC.. t1JC_ , THESE ARE TRANSMITTED as checked below: may, El For approval ❑ Approved as submitted y� Resubmit •5 copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS p�A���`� : �t..EPrS� t�o-r�'CtT'-,rt}1E i�►L-3�E62E►Jt_EafJ t-�T 11� $E66 -a eQ%j 15f� ATO C-mnn P�-'-� W l't1� %tires ?.�cOV EATS ►N PPnr_o 12 l-1 `9c' , R'D�f�U -'1.O 'c�i�. R� W rca(t�c Sett.. C£YLTtFtC.t�'Ttaa• �u�--. 'T iA�rJ rnArP � �Cfc�.• V.ScSC�S • A.��/ R�E.aS£. 1StsCE_ T�}�+T' �E_ vsE-Ct.r�-gyp t--t►J'�- A�t�itoSS 'its :stp-�'r A,�s� ICS• C7t5'CR�—��E —Co �_ 6i`�SrC+�aM i�Ay£. S'E�� AX7flEA. W �. W tt�t..•. '!3�. � 4t_t�5'ttr�t� R V Vit P�f�. G� 'i1i� 5"{Sr['��M —CD FNO DtS'tP�cjes t.1r-aVf-2 P� SEQE¢-A%T� u*'K-rV-+e_ fee, 'LVAE, $. o, N., 1\&MT1t,(_4 'Co e "-LAP Com" SSR+" . zy" 139-0. -WPA-4'WK "toc-A VO2 -dwe, '1ro-kS V-4 �ky�Et�t�c� "C�riS vn�'Ct+E� t� W'E- c 8L otc Fut. asst 5-c�c - sf_ c�A-�s--• COPY TO G`�+�1G�Q.�I."t• RECYCLED PAPER: g� SIGN `�-R•1 Contents: 40 % Pre -Consumer • 10 % Post -Consumer if enclosures are not as noted, kindly notify us at once. Town of North Andover f HORT" , OFFICE OF �? °s °'° 0 COMMUNITY DEVELOPMENT AND SERVICES p 146 Main Street o�A�TtD •TP`y'�T7 North Andover, Massachusetts 01845 9sSACHUSEt (508) 688-9533 December 7, 1995 Mr. Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot #158A Forest Street Dear Tom: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1) Who is soil evaluator? 2) Leaching area less than 35 feet from foundation drain. 3) Please check distance to wetlands across the street. 4) What are map and parcel numbers: 5) Please update fill requirements. If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sing�erel Sandra Starr, R.S. Health Administrator SS/cj p BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Julie Parrino D. Robert Nicetta Michael Howard Sandra Starr Kathleen Bradley Colwell Date I-� Complaint Complaint# 20 Complaintant I Jim Santioanni Addresss 10 Jared Place Road North Andover, MA 01845 Action Owner of Property I Owner's Address Phone# Smell in the area. Question of septic. OL Sent ❑ iC / G. l �-t._ � c"3:✓� � dr'�� � e r�" �'�O��f,,� f� S Cs�i'�. � Date F -JI/121981Complaint Complaint# 17 Complaintant I Janet Eisenberg Addresss 1557 Sharpness Pond Road North Andover, MA 01845 Janet stated that she has noticed a septic smell in the area and she thought it was her septic system so she had it pumped and "no problem" She called her neighbors and took a walk and notice the smell in the area of 34 Liberty St. - 1/2 mile away. Action continued: she is not sure if its a septic smell or the it is Owner of Property unknown I coming from the wetlands - the smell comes in goes. She also questioned dumping. I told her to notify Conservation Dept. too. Owner's Address Phone# OL Sent Date 1 11/17/981Complaint Complaint# 18 Complaintant Martha McQuade Addresss 12 Femwood Street North Andover, MA 01845 Work#978-092-5511 x227 Home#989-0706 Action Owner of Property Owner's Address Phone# Date - Complaint Complaint# 20 Complaintant I Jim Santioanni Addresss 10 Jane Place Road North Andover, MA 01845 Action Owner of Property I Appro)amately 12 stray cats in her neighborhood. Getting into garbage and diging holes under her house. She has children and it is getting to be a health problem. OL Sent ❑ Smell in the area. Question of septic. Owner's Address I Phone# OL Sent ❑ TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE:_ SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) /,(2 Al Sin DATE OF PUMPING: QUANTITY PUMPED )3C0 GALLONS c� CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE ✓ EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) - Yr v:,!-6 r N_�U COMMENTS: - -72601 ; CONTENTS TRANSFERRED TO: �-L—\ Commonwealth of Massachusetts _rs City/Town of NORTH ANDOVER, M System Pumping Record Form 4 DEP has provided this form for use by local Boards of be submitted to the local Board of Health or other app Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. f�'!ab irrun. , A. Facility Information System Location: Address N • pm . IN er Cityrrown 2. SvsteAn Owner: Name Address (if different from location) Cityrrown B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): C, NOV 14 2007 The Record must MIA 0 I Ry State Zip Code State 1 r, Zip Com q 1� �b 1 3(q Telephone Number Date 2. Quantity Pumped: Gallons Cesspool(s) (Septic Tank ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes '�No 5. Condition of System: r 6. System Pumped By: If yes, was it cleaned? ❑ Yes ❑ No ,M/,u ---- —7 cP " aI,�-/ t—1 N e IVehicle License Number AM 31 uj'ez 2�kk U— Company - 0 7. 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Date of Pumping ', � = l l Quantity Pumped: l�8allons Cesspool: No `T Yes L) Septic Tank: No n System Pumped by: Fel reQort gm.&Vmi4ed License # Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector: Yes .F;fvvm OF NORTH gOARC �R 2 699' �J ti S. CO) C •C �± Q 10 o C � Z y C� CD o -a d �+ o CC/) O � C CZ to n CCD 0.� Q CD � f'Y rf =r —1 O CD O CD 00 c CD CD C!) v CA CD $ O Cn CD oZ d CD o CCP COcc '--1 m c CS H C O CL ca O O� O. z� cn �-o c d c� N OCS H CL aa. CD =-,�mn . n C1 n O . c 3 =r= H H .-► = ' O =r a "'„ CL -L, 9 CD 03 O = O H O O 3E =rW CD d C) -00 (� CD O O .n -r 25.E O N n ; O O N n =� g CL .., �. ® H CD O CD CD 3 CA Co CO = CL n, c 00 - � a. �C 'm� � c G O CA H O O msp � "= y Cs7 CD CO g CA C-) m T m CO 2 C) n 1 w /� t" t7lr CD o CL aa. a. ce G1 C121CA . . CD CD ' 0 o x ... CD -L, 9 _CD: CD d d C) (� _=: 1 w /� t" t7lr CL=: CL aa. a. ce G1 C121CA . . Z ' 0 o x -L, 9 o ~;10=�x 1 w /� t" t7lr w "d CL aa. a. ce G1 ' 0 o x -L, 9 'i\ d APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: Nar c4 3, /4 y7 CURRENT INSTALLER'S LICENSE# LOCATION: / , Id -A t T a y z �� 70' cc c P Pd - LOCATION: INSTALLER: `�®A -e r _V, a �t h /c s' SIGNATURE:eL r' '° � TELEPHONE# �a f _ _ 3--,(oc� (, CHECK ONE: rjz. VIS NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As -Built? Yes No Approval Date: y/,y 0 Town of North Andover, Massachusetts Form No. 3 BOARD OF HEALTH f NORTH 19 L R DISPOSAL WORKS CONSTRUCTION PERMIT �,SSACMUS t ApplicantNN1 AME ADDRESS � TELEPHONE Site Location 5 A 61 ) Permission is hereby granted to Construct (kor Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. 'CHAIRMAN, BOARD OF HEALTH N Fee D.W.C. No. Town of North Andover, Massachusetts Form No. 2 ,40RT#j BOARD OF HEALTH DESIGN APPROVAL FOR Aw. HUS SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant aecr Test No Site Location UT7 I SF5� Reference Plans and Spec ENGINEER 4� Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. zdj CHAIRMAN, BOARD OF HEALTH F Site System Permit No.