Loading...
HomeMy WebLinkAboutMiscellaneous - 100 CAMPBELL ROAD 4/30/2018rt.e fey+::-_+wn 114 North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 100 Campbell Rd. MAP: LOT: INSTALLER: James Boraczek DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: INSPECTIONS I TANK INSPECTION: DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS Vontractor reports any changes to design plan xisting sepned; tic tank properly abando ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: SEPTIC TANK ❑ Building sewer in continuous grade, on compacted firm base ❑ Cleanouts per plan ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading ❑ Monolithic tank construction ❑ Water tightness of tank has been achieved by visual testing ❑ Inlet tee installed, centered under access port .I Comments: PUMP CHAMBER Comments: CONTROLPANEL Comments: DISTRIBUTION -BOX Comments: ❑ Outlet tee installed, centered under access port (gas baffle/effluent filter) ❑ inch cover to within 6" of finish grade installed over one access port ❑ Hydraulic cement around inlet & outlet ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon Pump Chamber installed ❑ H-10 loading ❑ Monolithic tank construction ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ cover at final grade installed over pump access port ❑ Water tightness of tank has been achieved by testing ❑ Hydraulic cement around inlet & outlet ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: basement ❑ Alarm signal located inside: basement ❑ Installed on stable stone base ❑ H-20 D -Box ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) ❑ Schedule 40 PVC Pipe BOARD OF HEALTH 1600 Osgood Street, Suite 2034 North Andover, MA 01845 978-688-9540 APPLICATION FOR ABANDONME OF SUBSURFACE DISPOSAL SYS7 (SEPTIC SYSTEM) Pursuant to Section 310 CMR 15.35 Of the State Environmental Code, Titl U..l CY' S�1�tiUt J Name ��� �U�r� S�IOt �P( Phone Address /0 Contractor hired for work: Name do/01C5 /70i C -L e4 Phone Address /_/ 1A2C1 ()/ //9Mpsf(,/� All 01�% Date for scheduled abandonment The septic system at the above address has been abandoned according to Title V specifications. ignature of Contractor Method of septic tank abandonment (check one). ()removal () dfill crush ()other Name of Offal Hauler J ��. This form must be returned to the North Andover Board of Health. PLEASE DON �T WRITE IN THE SPACE BELOW WEALTH REPRESENTATIVES ONLY Fonn4 DEP has provided this form for use by local 09ards of Health1.0ther forim may be Used, but the information must be substBnMy the some as OW provided ". 66116M. using this form, check with yuu local Board of Health to determine the form they u4e. The $A4P PumPhV Record must be submitted the local Board of ftAh or other approving auftft within 14 -days from the pumping date in accordance with M CMR 15.351. A. Facility Information Important= when Lift out Mom I. System Location: on ftC"ApW", use 0* 0 to Z-0-0 C� l f r�►, key to move your Addrm cumi - do no use the Mum key - 2. Syste Owner Elk, 17�r Name Address (d ddlimont fiam Imbon) city/To" stem ?jpcode - S. Pumping Record I Date of Pumping Date 2. Quantity Pumped: uszn 3. Type of systern: Cesspool(s)-"�Seoc T8111( " C1 Tight Tank CJ Grease Trap 0 Other (describe); 4. Effluent Tee Filter present? [I Yes.AfrNo 5. Condition of If Yes. Was it Cleaned? C) Yes C) No %' Z) Name vehicle Lice ......... Se Ase Noftf Company 7. Location Whom' contents were disposed: SCSb S' sf muter Signature of ft*ft Faft Date 1510MA.dw 03406 Systema Pumping Record - Paqp i rj FORM U - LOT RELEASE 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 or requirements. ***********************%*****APPLICANT FILLS OUT THIS SECTION* APPLICANT '� `' S I'1 22 PHONE 6 O %� LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) STREET/00 C �t ri 12 // �Z �/ Ile fl � ST. NUMBER **************OFFICIAL USE ONLY*************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR COMMENTS TOWN PLANNER COMMENTS DATE APPROVED DATE, REJECTED_ DATE APPROVED DATE REJECTED - FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPVC'IN�ECTOR-HEALTH DATE APPROVED G / < /9 �' DATE REJECTED COMME PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE APPROVED DATE FAIL [ OK 1. qTH G R KART) OF HEn_LTH I14STALLA'?'ION C BECK LIST DISAPPROVED DATE EXCAVA'T'ION �%J Y Distance To. Wetlands Drains Well 2. Water Line Location 3. PVC PJ pe 4. Septic Tank Tees - Length & To Clean Out Covers Cement Pipe to Tank - On Both Sides of Tank 5. Distribution Box' Cover & Box - No Cracks All Lines Flowing Equal Amounts Ido Back Flow 6. Leach Field or Trench Dimensions Stone Depth Capped Ends Clean Double trashed Stone 7. Leach Pits Dimensions Stone Depth Splash Pads Tees - Cement Pipe to Pit - Both Sides Clean Double Mashed Stone 8. No Gar!',age Disposal 0 'inal G^ading Inspection 0. Barracading Covered System As - Built Submitted Lot Location Dimensions of System Location with Regard to Pere Test Elevations Water Table / -�I-fl ,�,76 NORTH ANDOVER .BOARD OF HEALTH SUBSURFACE DISPOSAL SYSTEM CHBCK LIST t47-36 6 c st.c RD. ROVED - PROVIDED /, u jt rw" DISAPPROVID $•�8 s , c/�w,G,r�t a �' � !� S'7+Pt . wat�l.�; I ad' Reg. 2.5 16*reft Reg. 6.1- R eg. .1- Reg. 6.7 Reg. 6.$ Reg. 6.9 Reg. 6.1 Reg. 6,1 Reg 3.7 Reg: 9:i Reg. 9.6 5-1.78 ; f ».a Information The submitted plan must show as a minimum: ()`the lot to be served (area, dimensions, lot #, abutters) (b) location and dimensions of system (including reserve area) (c) design calculations (d) calculations showing required leaching area (-e)- existing and proposed contours (f) location and log of deep observation holes -distance to ties (g) location and results of percolation tests -distance to ties (h) location of any wet areas within 100' of the sewage disposal system or disclaimer Vii) -•surface and subsurface drains within 1001 of sewage disposal system o sld cola m L • (j) location of ii, —dr ,ments within 1001 of sewage disposal system o __d ,(k) TlmoT.ai sources of ,�5r supplr trithin 2001 of sewage disposal system or disclaimer jl) location of any proposed well to serve the lot (1001 from leaching (m) location of water lines on property (101 from leaching facilities) any ma_—durum ground Crater elevation -in area of sewage disposal system bo) -_--location of benchmark Ep) plan must be prepared by a. Professional Engineer or other professional authorized by law to prepare such plans (p) drive nays (r) garbage disposers ('�j a profile of the system (elevations of basement, plumbers pipe septic tank, distribution box inlets and outlets, distribution field piping and any other elevations) (.-t,)."no PVC is to be used in construction s Capacities - 150% of. flood Water table Tees Depth of tees if (e) Access (f) P -orpi ng (g) Cleanout (h) 101 from cellar i -all or inground si;rl ming pool (i) 251 from subsurface drains I Pin s a (b) Approval Stand-by power 4 facility iv.,th Andover Subsurface disposal system check list -Page 2 • Fail; G strI oution Boxes f. Reg. 10..2 (a) Tope greater than 0.08 Reg. 10. 4 � r,. Tope(b) Sum Le"ring pits are preferred where the installation is possible Reg.11.2 ia} Calculationsof -leaching area (minimum 500 S.F. ) Reg. 11.4 (b) Spacing Reg.11.10 ( e) Surface drainage 2% Reg.11.l' (d) Cover material eachina Fields Reg.15.1 (a),,greater than 20 ndnutes/inch Reg.7.5, l Area (minimum 900 S.F. ) Reg.15.4 (c) Construction of field Reg 15 8 ( ) Surface drainage 2% Reg.3.1 �e) 20' .from cellar wall or inground swimming pool tanhill Slope (a) _ Slope y/x = (to be shovm) M y/x X 150 = (to be shot -n) 0 SOIL PROFILE & PERCOLATION TEST DATA R a North Andover,Mass. No.&Street -1"-. Lot No. Loc . / Subdiv . Plan- ___,,.Owner Investigator Observer SOIL PROFILES -DATE 1' Elev. �'.Elev. 3' 4'Elev. E 1 ev . n i 0 S—fb 0 0- 1 2 3 4 S G 7 9 Ties to Test Pits 25� 10 �� 10 10 I 10 Benchmark Location Elevation Datum Percolation Tests-Date`��y% f6`2 Pit Number 1 2 3 4 S Start Saturation ;' `' A `?'o Soak -Mins. Start Test -Time _ Drop of 311 -Time -- Drop "-Time-Dro of 6" -Time Mins.lst 3"Dro )� Mins . 2nd 3"Dro . Notes &. Sketches on Back % 1� SUE) SusLr_Ar_E UISPOSAL of P2E.PAFLILD F OR - 47 12_oY&L_,5-ro fJ rzo -rte M VESIGN FgZANK- C GE-L.INASo ASSo�IATE.S ENGfN��RS Ar+O Acz�NfTL- C'TS N O FZ"T F-1 /�,fv D o v � fZ O t= � f « P�, fz ►� No2`Tf t L�.svoovEcz 1�1n 0845 SZ N.G.QD* &S7-2 '41- G.3? 2 I r&ela ucT Cxl ✓,..ei:%T SI �. in' �:'R_Q M ; - I 1 TC1F"St�t L E L K,LI&L.L. F&S r,�.E>'� Tr✓5T P�,- tL.Er�iD./�+7 LST �AGNINC=• hR�A A►.lC� j P tZGvt aTtO>~ ! T S'i` r-CKZ A P EE -'1 IC TIEt'L' 0r' � S ' IW &LL. ' AQr- iZEir i7 I w,TU vZ.AveL- 2 qo C362666C- C�21�,Jr>EtI 'S-lAt.t ? P�,�u OI✓ �v�SUr�i=ALS C���Pd��� �aYS-��.M �� '. ��tc.�D � , C..a1APeC L L- e12. , OF DESIGN DATA CAI.CULAT IORS SOIL 0sszvtVATIONS bY: -� 3a��l�.C�L[�- - W�Trl�tc LtAil.L,i . �F.'l�OLAT IOK -TF-ST NO. t 3 4 s• PA -TE 12 I & 7 1 1 Z 11(o 1?? A50 GPD FLOW x Z.2. %1:/G -AL.= -ELI-ELI,VATION 99.2. TaP- ELE VATIgN g8.50 BOTTOM-ELa\/A-T lot4 `�Co • 2 SATURATION - MINS,. ( SIDEWALL ARIrA. i SF X 1 .. --•- g" Dft ftP - MIN5 . 3 SUBSOIL PARE NT SOIL .. w 01top -MINS. 7- GPD /PIT WATER-TA$i-E a v t avt . PATE -MIN./Ix. 14 SOIL PPl.4FILW. -DV tP PIT No. .3 4 ,s DAT F- 1 Z 11(o 1?? A50 GPD FLOW x Z.2. %1:/G -AL.= - i©OO SF TaP- ELE VATIgN g8.50 TypI mvit. ►.) -ToF:50IL SIDEWALL ARIrA. i SF X GrA.U. $F = GPS SUBSOIL PARE NT SOIL QrP ? -TOTAL PIT LE-AwCH INS CAPACITY _ _ GPD /PIT WATER-TA$i-E GPD/'PIT, pns Rf4o. USE.- Pates �jONE�( SF'LFx GALS ISP = - GAL./LiN.FY. 1BOTTOM Aft EA SF/LF A G�-AYE. f CwAL.1 Lim. Pr. TOTAL-IRENCH I_V-ACI-IIW., CAp^,ClTy _ GAL/ LiN.Pit'. ^ro4.� �,a/L�TE.tZ t35.,L. No -r ES: 4,Dr WATER?Am E E LEVA'T`toN q 4 , cep Sa"OM PELEVATioN BUILDINQ,r-T`fPlL0.40 3 B.'R.,oR X150_.Gat. JUNIT = 450 GPD FLOW 450 Gpb Flow x (o 5 6D USE t o oO GAL.S'ElPTUC TANK LFAr.WINrar fto A50 GPD FLOW x Z.2. %1:/G -AL.= '990 SF 13" USE i©OO SF PITS TypI mvit. ►.) SIDEWALL ARIrA. i SF X GrA.U. $F = GPS BOTTOM ARTA . SF Y.--- QrP ? -TOTAL PIT LE-AwCH INS CAPACITY _ _ GPD /PIT GP D Row GPD/'PIT, pns Rf4o. USE.- Pates SIDEWALL AREA SF'LFx GALS ISP = - GAL./LiN.FY. 1BOTTOM Aft EA SF/LF A GALS/SP _ CwAL.1 Lim. Pr. TOTAL-IRENCH I_V-ACI-IIW., CAp^,ClTy _ GAL/ LiN.Pit'. GPD 1PLoW1 LF.7IENGNE5 R�Q'b. t35.,L. No -r ES: ,Os SoN3 owddvc�- 3did -4ALV tOjfVU . Jr w A N ti I IL a a o Q a Z 7 Q 0 aLoa ►, c0 gw � N I v I r il N� P*J" 3 0ir 5 w LLW v I � D � Q J Q W O w i C Q LL 0 n w LLW v I � D � Q J Q W O p i V) Q y 0 W W J z Q Z N Z W J ) UJ I w �o �w � � jZ � '0 r 0 � a Z J o F" 2 1U W lU t� w V ZI N� u ! O z 9 to W w r w I�- w Yf 7't7 LL' �L' Ci- I� �iV, o 1 LU uj ml 09 I I A313 9'075 � D � Q J W O p V) Q 0 W z Q Z N Z wI UJ u4 0 �w � � I � '0 r 0 � a Z J Z! 2 1U W lU t� w V ZI N� u ! O z V' w r 0 I I A313 9'075 4 O wI uj u4 0 V/ _ �- a- '0 v� J Z! 1U W lU t� w V ZI N� u ! O z V' w r 0 ,r-A.C.E DISPOI of i� o'r Sv 64-M Y PiZ�PA�E_O F OR_ Gi"� �rT"vlaov CZE �L� `( 47 lZoY&L-,5-r'o �-i r'L.o4,-T--:) WE7L-LC- V M UESIGN �iZANK C.G�L�NAS A+V� ASSOCIA-i'1=S ENGIN��RS Ar+o AcZLNIT�C--TS NOa_rN ANI�ov�FzO��Ic-,E-- Paszw- NOR�'t-1 Atv00�/ER,MA OI$45 4 / z a f �g i N Lo Q rW 0 8 b' Lo Q DESIGN DATA j CALCULATIONS gD1l OBS[RVATrONS DY' �t+jZUAC � ptftOLxrIom -TZST IJD. ,�, .3- --- A-- .F DATE A50 crP FLOW x 1.5 SF f GAL.= 4075 SF $sm USE 900 SF 'To t.-ELtVATIaN Ag. 5 ,Tyr IL mvW,- oyp.) !' OTTo1A - MtKVA-V ►OFA 95.5 s1'DEWAL Rl:�, 'SF 7t GrALS4 $F = GPD SA`flURATION - MOAS Is G*Ls4 sF ; GPD -TU AL Prr LULArtmimer CApAGITY _ _ _ _ PARE NT SOIL -Rtm,C"as ---�. ` t3�pt . MI u. i q SIDE WALL EA SfiJL.F'+s 1�►L.S �SF �Ovac.. Rams-hlt4lii. r _ -r 7iEm 44 �V i 11� r3OI1: P1431�N.t-DE1E1► PIX No. .' 2 ,ar- Be .. DATE A50 crP FLOW x 1.5 SF f GAL.= 4075 SF $sm USE 900 SF 'rO P- ELE VWT ION 98.5 ,Tyr IL mvW,- oyp.) " Torselt 0-l"804 s1'DEWAL Rl:�, 'SF 7t GrALS4 $F = GPD acs AVt A SF- x G*Ls4 sF ; GPD -TU AL Prr LULArtmimer CApAGITY _ _ _ _ PARE NT SOIL -Rtm,C"as WATER'TAlbL.ta SIDE WALL EA SfiJL.F'+s 1�►L.S �SF CAL -IMM -FT. ps pN�Y 7iEm 44 �V i 11� CAp^ t ITY �esAL� L11y.PI. 'GPD I NOT es Wa`rsrt - - - P,aae �► 0c; WATER `TAsL,E E LevAT1oo °13.5_ IS01-TOM ELEVATION q 3 5 t' UILDINQ 1YM (, I CRO - GAL. JUP41T = 45o GPD Flow 450 GpD fl,Ow x Iso' _ (o 5 GSD USE 1000 /� GAL.S lE•PTI[ `Tr4'NK Lzer-w mer APmA Be A50 crP FLOW x 1.5 SF f GAL.= 4075 SF $sm USE 900 SF P ,Tyr IL mvW,- oyp.) s1'DEWAL Rl:�, 'SF 7t GrALS4 $F = GPD acs AVt A SF- x G*Ls4 sF ; GPD -TU AL Prr LULArtmimer CApAGITY _ _ _ _ GPD /PIT -Rtm,C"as SIDE WALL EA SfiJL.F'+s 1�►L.S �SF CAL -IMM -FT. 16 OTi AREI# 7iEm 44 �V i 11� CAp^ t ITY �esAL� L11y.PI. 'GPD I NOT es - - - P,aae �► 0c; i rwvz�— PG. 3 OF 5 IL f ILIL IL 14 .0 41 ©r5��ow Aqvi- ui i 11 Ul Cl II I IL it 0 C J T I 3 PG. 3 OF 5 14 .0 41 ©r5��ow Aqvi- Ul Cl lb 0 C J Lu 3 � � j A � Ji z Zl to 0 LL PG. 3 OF 5 14 Aqvi- LU C J PG. 3 OF 5 ' r W 0 W 7 pC Z O Q W? W J J W 0 4 n c W{ W�y3` W z �; Z; �G i 0.. p LlZ H, ►Z w Zµ (A lv ;0,01 yw °cc°LLJ r�IQ J� �►-��,W LUii� z+0 W Qi =�QCtl`vA�W LL ".0; UJ tim N U d I D 05 "Lb'i T 'A313 OV -15 ps a � LJ Z J o 11Q Y/ �- � :N 7 r rr a U,1 Z N 3. N N S �; Vi J w wa --+i F- W a LL K L J�°,ui��►-- W� (.h O nnr � I N U d I D 05 "Lb'i T 'A313 OV -15 ps Ni c le. " p e5 L- E 1..E,s/AT i 1.>t AIS- a Au�L-r Pa" E-=, Wc7"-�/, 30� 1 A 1 ez) P- Q4-rJ V- G E� +N nS A s�vG�o.T�S {_wL�p� V. FPI P E i NTO_ D. aO.X— � I�L..P12.E.._i2.I1T_Q.�X�_ a Au�L-r Pa" E-=, Wc7"-�/, 30� 1 A 1 ez) P- Q4-rJ V- G E� +N nS A s�vG�o.T�S