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HomeMy WebLinkAboutMiscellaneous - 103 LOST POND LANE 4/30/2018 (2). �, i � �'• - yt c � F?r� )T a .r � 4 � H�~..i`�ry i ,A ix � r .� M � .3' n, .Stir �A?s� �;; r , . f i r�k� int ,�� �; �*i�'S`Ya�., ��ry+'f'r1 �"4 °r tYNr t1f�J, •r:... MAP # r. , LOT..,# F t PARCEL # {STREET -n... .._._..� QQNSTRUCTION_APPRO HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE /7 157a APP. BY/,X,--e- DESIGNER: DESIGNER : %V6 -I/& PLAN DATE: 12-12- 7 ALF7 CONDITIONS s WATER SUPPLY: `\`y TOWN WELL WELL PERMIT ' DRILLER._.,._.____.._.__._..__ WELL TESTS: CHEMICAL DA l E APPROVED. BACTERIA I AIE (IPPliUVEU _ BACTERIA II DATE ROVED _ I. COMMENTS: FORM U APPROVAL: APPROVAL TO ISSUE" YES 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 NO YES NO DATE:. /gwr....BY:... \AOn A w..f] rn..b w—X C H—Z C H-2: ivy .4 —400'.4 vryx0 00 H o '.d co r co M 00 �to —H `'L=J II `'O II `-'HH' En-4 Ln Ul 7y CO H N ,b co N OD N N N 01 F-A co � to pyx H. P tll �P �P b NQ to d cl : H ci z o r z z�� P. 001< o o z o o N O H O N HHO w N co W J 00 Fj W H ti Fl N U] N N Fl H N N I-' F` H O W v co 00 w N O N H N W �J \ \ \ F H \ F O N O N O N O H O N 0%0 0%0 O %0 O %D O %0 .. 00 .. W N .. (n 01 N 00 O ?�� OD W W~ W W W F-' O O O O H0 m iA0 I;N.O coO FJro H oz oro �ro O co �P J �D O O w O to O O 0o O ::4z woz �z �z C) t7 o x o C7 N d o C7 w tj HC to C \C H LTJ O 7 O LTJ H h7 Fl LTJ O ;U co d J ;U Ut \ W \ O H H \ H N rn l0 o O LTJ o H O �D cn J co o N O J `U ox R O F E DC :2 TJ z G] W o o W hJ W o nJ W o 0 to O t' ,.� vw vao cc) Crv � � ttLI Z eco o t) Ad oAUo F✓C) Ul Fj N O Ul J Ul y H Ll ,a o m y y tv vJ o U) �,-91- x1 1 rn y y ---------- -M, fPZW ELEVAT10N FLIMTI"-4,: IW,. SCALE: 1/, : = 1'-0" JOE- NO: 111q-2 (AIC) F] CONTRACTOR TO VM" ALL PIM&OM5 At* STMV,"AL MOM TO 5TAitrrm6 C4N6TRJXTICK ALL BIAL0946 is TO h=T OR CX=D ALL STATC AND LOICAL MnLOM6 dlOVft. r rn ZZ D I o°r m➢ �`o° rn c rn z0 rn< D r r U� UN ?a = D� °z \ dN rn �z y d a ELEVATIOMS SCALE: 1/8" V 0 3 k CONTRACTOR TO VERIFY ALL olme 510H6 AIb LTM CRRAL reBE" PRIOR TO STA"H& . JOB NO: I l lq_2 CONSTRUCTIOPL ALL WLVWA 1! TO MEET OR CXCCW ALL OTATC AND LOCAL EULDM& COM. UPFM M47OQ PLAN Fl-IRn-OCK, IWI. SCALE: 1/4" = 1'-0" J05 NO: Illq_2R (1119_4) . CONTRACTOR TO VEMPY ALL DIt- N45k 6 MIO OTRWTURK h8 -100R.9 MOR TO STA"NO CON!.TRULTIOK ALL DAWt * ro TO MELT OR MJNCCGCO ALL CTATL' AW LOCAL ONLODK COPM 7 B I rp f. b • a 1'-0" .I 5'-0" .1 I6'-0" I I N t ---------i----°--------------- IX o i fox X zr-XX--0 I I rz4N ^��'_ �'nD�� p A ,p � U Q! i y�o °y I ���� foo I rnp-+ �r --� 3>� �r �nz I DDD ZD `-Or -i --i per I + I X �rnrn ynr I 0 Ire ° g zz -9 n<� N n D� Qy dzp >z I ru ., < �u < d � -0-JU r- i porn D Nrn(ti -� n 14'-0" / I I I I 0 rn a> < rnrn nD N A Qy �N� >z I ()z � 5u t� � d � -0-JU r- i O O rn z orn < i rn� I I A= Np— full' I Oz I I o I o m 0 rn a> < rnrn nD N -4------- 2b'-O" FOUNVATION PLAN Fi.INT1 ocA ar'. 5GALE: 1/4" = 1'-0" JOB NO: 1119-2 C NMACTOR TO VMPY ALL DIFro+sla6 AV STMXY AL T@MOE/t� PRIOR TO WA lt"o COteTiLr,TWK ALL WLOM6 IS TO FOET OR M-Ew ALL STATC Atm LOCAL VALOMO CODGO. i �� x rn0 � I I�\ ()z � 5u t� ro o Om I i I N> z3� O rn z orn < i I 1 I A= Np— zA I Oz I I o I L - -J i 2x10 FLOOR J015 5 ® Ib" O.G. hU RII INSUL. 2<10 FLOOR J015T5 ® Ib" O.G. NU RII INSUL. I/ I I I I � L - - - - - - ----------T,---------------J I -4------- 2b'-O" FOUNVATION PLAN Fi.INT1 ocA ar'. 5GALE: 1/4" = 1'-0" JOB NO: 1119-2 C NMACTOR TO VMPY ALL DIFro+sla6 AV STMXY AL T@MOE/t� PRIOR TO WA lt"o COteTiLr,TWK ALL WLOM6 IS TO FOET OR M-Ew ALL STATC Atm LOCAL VALOMO CODGO. II bf 4 a /-F 0 R 'Ma U r LV nEbLAV1r E v..t�. /,410NS: This form is used to verify that all necessary approvals/permits from and Departments having jurisdiction have been obtained. This does not relieve Meant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT S �_t? " vCOCATION: Assessor's Map Number. SUBDIVISION Q ✓STREET r7y QST rO/I D /�_ PHONE9_ZZ- (S YO -q3421 L44RCEL 4/ LOT ESj L4T. NUMBER ** * ** *** *************** k**" OFFICIAL USE OtSLY *,►********,►,t***,� ********* **** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED / D DATE REJECTED TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS Fc INSPECTOR -HEALTH DATE APPROVED �` DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED 'L r( DATE REJECTED PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT zc e, (• �C?-/' i�l .3iC�1.t`r� f fI �blti :f �y h a ✓F1RE DEPARTMENT• i r RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm I FORM - U - LOT RELEASE FORM W- INS C ONS: This form is used to verify that all -necessary approval / permits from �oards ' d D artrnents having jurisdiction have been obtained. This does not relieve the app an or landowner from compliance with any applicable requirements. r ADPL, �-� n OWN 2 S TC'. ✓A PHONE ASSESSORS MAP NUMBER�� < B LOT NUMBER SUBDIVISION LOT NUMBER I STREET ��U � �U A4 � .� � �" STREET NUMBER .........•.•■......■r....•..■.■•r■■•■.■•..■r■...r.r..r....................■ OFFICIAL USE ONLY RECOMA4ENDATIONS OF TOWN AGENTS J 06 00 040000, 68,80,08989808028 0000 wow 858 "on 0. DATE APPROVED CONSERVATION ADMI1,0TRATOR _ DATE REJECTED ( � U 0 AA ('MAXATT�� � I P J TOWN PLANNER COMivIENI'S DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPEGTOR - TH DATE REJECTED / DATE APPROVED SEPTIC IN CTOR - HEALTH / DATE REJECTED —�M-0 )4 !ktl c. 4 - z ry 7'7-k -, �j PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS RECEIVED BY BUILDING INSPECTOR DATE APPROVED DATE REJECTED 4--> LA W R. ,n 0 0 10 247 10'11 2'1 117 - 57 5'4 6'2 5'5 (i tD 3'2 1 2'4 167 247 w CD 24'7 13'5 11'2 N OD 15`10 24'7 5 .A W i L i I 3'2 — �-- 3'2 —— 2'5 a N �— 391 lh ---- 11 ,5 8.9 _ 18 68----fi--- 5'9 6'4 2'5 F ED T— N DINING 1011 x 10'8 proposed family room —UP— LO PiA l � � LIVING i 12'11 x 12'11 j I 1— �' I i --_4'S---"'% 1 /INGAREAI 8'5 6'4 5' —� 3'3 5 9 11 1248 sq ft 13'5 25'8 39'1 l C0'1 {i AG}O/i O?OSe � Q�finj -S A,%_ _e y U,jr-it2 Qe\:eK" O� L..$ �ON� LANA N0 ry,A m r N R=60.00' Plan of L and �4 ,­ j �l ✓ ` rs North Andover, Mass. • -� 19g� Showing '=As' Built Sani tory Disposal Sys tem " Lot 7 - Lost Pond Lane Prepared For Flintlock, Incorporated Scale: May 6, 1997 J. l� Zoning District: R-1 (Residence 1) Planned Residential De veloprmen t) Note: Property line data token from a Planned Residential Development plan by Thomas E. Neve Assoc., Inc., dated Sept. 23, 1994, revised to May 5, 1995, and on 81X plan dated Feb.2, 1996. Schedule Of Tie Distances AD BD Schedule of In verts ' Invert ® Foundation = 129.86' I o Sep tic Tank In = 128.93' I I Septic Tank Out = 128.71' AL = BL = D -Box In = 128.60' ' D -Box Out - 128.42 I Chamber /n = 128.25' (l � 128.26 (J� W i 128.24 (K) Schedule Of Tie Distances AD BD = 16.6' AG = = 2J. 7' BG = 63. 1 39.4' AJ = BJ = 72.0' 46.4' AE BE = 27.0' AH = = 21.0' CH = 81.8' 71.4' AK = BK = 69.2' 48.3' AF BF = 54.2' Al = = JJ. 0' Cl = 75.5' 69.7' AL = BL = 69.8' 53.6' l hereby certify that l have inspected the construction of this disposal system and that the construction and final grading has been in accordance with the designer's intent and that the materials used conform to the plan specifications and 310 CMR 15.0. This plan has been prepared for the purpose of showing the "As—Built" conditions of the sanitary disposal system installed on the premises. All work was done in substantial conformance with the design plans as prepared. All work was done withinth onstruction /imitations expected for a job Of, - O- h S tVD- SSC �7 Date No.3o13lI 0 �d81n�►� E`16/ Thomas E. Neve Associates, Inc. Engineers — Surveyors — Land Use Planners 447 Old Boston Road — U.S. Route 1 Tops field, Massachusetts 01983 887-8586 R I k M I� O 265 pp, 1 1 I I I I 239.24 , , , , 4- 4 , , , , , Lot 7 66,514 S.F. 1. 5,3 A Cres 1-1 Upland = 42, 483 S.F. Top Of Foundation Elevation = 133.82' ®� N Septic Tank I t � 93► -SSA OD—Box' v P93 -l5 K J t vi L H t � 0 t Z 2DI� t P - J4, ZO i IO Leach Mamber System '1 t 1 I � 1 - Utlll t.Y E'aSem en t _ h'lde 1 � 1 1 0 �t nal Easem el?t a I k M I� O 265 pp, 1 1 I I I I 239.24 , , , , 4- 4 , , , , , Lot 7 66,514 S.F. 1. 5,3 A Cres 1-1 Upland = 42, 483 S.F. Top Of Foundation Elevation = 133.82' ®� N Septic Tank I t � 93► -SSA OD—Box' v P93 -l5 K J t vi L H t � 0 t Z 2DI� t P - J4, ZO i IO Leach Mamber System '1 t 1 I � 1 - Utlll t.Y E'aSem en t _ h'lde 1 � 1 1 0 �t nal Easem el?t APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: f� C CURRENT INSTALLER'S LICENSE# n LOCATION: 6 -1 LICENSED INSTALLER: rf- 6 �e/L SIGNATURE: t-exn TELEPHONE# 6 ---2-22 CHECK ONE: REPAIR: NEW CONSTRUCTION: V IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. $75.00 Fee Attached? Foundation As -Built? Administrative Use Only Yes No Yes `' No Approval Date: .. . ._. .. ,. . . . . . . . . . . . . . .. . . ... To- •. CSD CO CD N 'i . ��•:1 '. CD N � z � � 6 3 rn N aav a VI M -� O o • N CD a. Y v o n o LA CD v� p 0 n O Q co �- O T p`D i � D Z 070 rn r 3 LA w n L —I = Di cn Z o m _ 0 3 C� v o a: c Z T � m N D O x D m c v" rrri 3 mw THOMAS E. NEVE ASSOCIATES, INC. Engineers * land Surveyors • Land Use Planners 447 Boston Street US #1 TOPSFIELD, MASSACHUSETTS 01983 (508) 887-8586 FAX (508)8) 887.3480 dIEVVIEQ @7 4 ° e MMUMIL DATE m zJ 1 s* —11 11 JOB NO. izq6 .r ATTENTI}O�N�{�i�1"'�YL� RE: t V L 4 • r ?6"P L-A."f_r111. TOWN OE NOF NEA►-iH iz-u�-'..j WE ARE SENDING YOU 'Attached El Under separate cover via ti mIY�s: ❑ Shop drawings '� Prints ❑ Plans ❑ Samples ❑ S ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION .�l��E� Z iz-u�-'..j PLA+—i �1ovJt►J Ea '�%k�nPbS1�p SPr+jtTA2`'�C >�'S�At.. "•� i-�vl t lA'T n — L-05-17 THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted Resubmit 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 ❑ A ❑ FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS G.Jb�- JIt�f�E FIS--L,� 6"t`N y[ cwt SC- St Cg V-� L �,trf '� , 9 E tsrsT� `rte Gil ►-� C , s rn� � "I'o c.ar•t �t-s-t Iw t-t�l �frA►� Ve-QQles-lS. Vv.� -,em-Le, Lje� Ex- -p'A L -S S4AC— Grtl SG—w u4 rn,GqLAL_ —tom t• --e `1 S' C�'s'r S—trnNL. . Pe-stC�" S�S�f�--+� o� C�-6�►-�� �uEyfl�t�c o� L2Z�` Vicke- `foo e. --fl MIS. 1.ZAGE jt CAIN) t� C� `(L-1-tS Vx A__Vtr419__ OPY TO i RECYCLED PAPER: , l ontents:40%Pre-Consumer -10%Post-Consumer SIGNEe - ��•G Ci �.� �. if enclosures are not as noted, kindly notify us at once. Town of North Andover, Massachusetts BOARD OF HEALTH June 2 3, 19 97 CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed (K) or repaired ( ) by Peter Breen INSTALLER at Lot #7 Lost Pond (#103) SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. 792 dated Nov. 3, 19 95 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. ARD OF HEALTH r: Town of North Andover, Massachusetts Form Mo. 2 of•14 0 1?01 BOARD OF HEALTH 19 0� F A t DESIGN APPROVAL FOR SACMUS S� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant Test No. Site Location Reference Plans and Specs. �Q Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. I, f Fee b CHAIRMA , BOARD OF HEALTH Site System Permit No.9q_c)-- ca C � S. d CO) Cl) Z cop) C.O �• O CL =• y ia= 0 v CD CL � O cr CD CCD O C CD y CL v CO) -• O to CD F v CO2 O 1 Z CD � O CD O CD C W10= p = _ —.y O Q y GAO C m y O. :*m m n y n CL O - rn Z �-c y Er® d?d O y m O m y p N O =r m m = O OCD C n n O y' n CSry CIL Q r"� > CA 0 = /^ 40 0 0-0^`: VJ m m y : m 1 O m ^ C d n •+ SI O y O1 •=cn C o: "C ��..►► �CD A y rte•+. cn C O O 00 z mai �, O y z CD CS CD CD "`• ocn CD Ecr CD �0 o CY o = ' gyD: �q cn cn b7 =° �l 0 p O ny p O ;�y /O "d o O x CL CJ n91 r, °� d o n r = � r� O G x C omi 0 0 c 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*****/***n********o* APPLICANT: i Al f-)_rLod T AJ L Phone 6 b b SS o LOCATION: Assessor's Map Number Parcel �,q7,c) c F Z� IS 23 -1 J Subdivis ion L o 5 / Po VP Lot (s) 17 Street Z o 57' 1 6iv0 L4JVG St. Number ************************Official Use Only************************ RECOIrIlKENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Date Date Approved Rejected Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector -Health Date Rejected OJ;k ) Date Approved a /� Septic Inspector -Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date Town of North Andover o f NORTH 1 OFFICE OF 3? °'t �o0 COMMUNITY DEVELOPMENT AND SERVICES p i { Y 09 � • 146 Main Street �, 40. r10 North Andover, Massachusetts 01845 is CHUSEt (508) 688-9533 December 12, 1995 Thomas Neve Neve Associates 447 Old Boston Road Topsfield, MA 01983 Re: Lot #7 Lost Pond Road 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 benchmark shown within 75 feet of system. 2) Groundwater should be at least 122.3 feet. 3) Map & parcel missing. 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 BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Jute Parrino D. Robert Nicetta Michael Howard Sandra Starr Kathleen Bradley Colwell NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT FEE: 0 PERMIT ## ' oq- , DATE RECEIVED <3 APPLICANTMAP PARCEL ADDRESS LOT ## ENG. �iEVC STREET ADDRESS PLAN DATE 5&PT. REV. DATE CONDITIONS OF APPROVAL APPROVED DISAPPROVED 1-Y REASONS FOR DISAPPROVAL: . No �CIV/i'l�X r � /`facv� W 7 V 4005 �SJ`E/� 0- � vu � � �' 7" LEf3s i /� z c c, L PLAN REVIEW CHECKLIST ADDRESS ENGINEER GENERAL / 3 COPIES`l.i STAMP L--' LOCUSy/ NORTH ARROWy SCALE CONTOURS &/ PROFILE 1---'' SECTION L� BENCHMARKS SOIL & PERCS ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED?4& DRIVEWAY (Eley) WATER LINE 11 FDN DRAINc--'� SCH401Z TESTS CURRENT? SOIL EVAL SEPTIC TANK MIN 150OGyS .17 INVERT DROP GARB. GRINDER_2/2 (+200o EDF) 25' TO CELLARL- MANHOLE ELEV GW # COMPS. `r D -BOX SIZE # LINES FIRST 2' LEVEL STATEMENT INLET OUTLET 1Z ,.3 = Z-0 ( 2" OR .17 FT) TEE REQ' D? -&/0— LEACHING MIN 660 GPD? RESERVE AREA 4' FROM PRIMARY? v 20 SLOPE 100' TO 'WETLANDSIZ100' TO WELLS "� 4' TO S.H.GW—)( (5'>2M/IN) 35' TO FND & INTRCPTR DRAINS [/ 325' TO SURFACE H2O SUPP 4' PERM. SOIL BELOW FACILITY v MIN 12" COVER'S FILL? (25' if above natural elev; 10'if below) BREAKOUT MET? TRENCHES MIN 660 gpd SLOPE (min .005 or 6"/100') SIDEWALL DIST. 3X EFF. W OR D (MIN 6') RESERVE BETWEEN TRENCHES? IN FILL? MUST BE 10' MIN. BOT (L x W x #) 4" PEA STONE? VENT? (>3' COVER; LINES >501) + SIDE X LDNG = TOT (DxLx2x#) (G/ft2) Copyright © 1995 by S.L. Starr PITS MIN 660 LEACHING" MIN �1— (13`' x16' ) PIT v MANHOLE PIT GW MIN 4 BE LOW BOTTOM EXC 2xE�'F�fni` 0 D '� 12"-48" STONE r. BOT 41cl. z + SIDE i / x LOAD (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 V SPLASH PADS 1,� 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 GPD 900 ft2 BED GW MIN 4' BELOW BOTTOM OF FIELD PIPE ENDS JOINED? 4" PEA STONE? DIST LINE SLOPE .005? >3'COVER-VENT SCH 40 MIN 12" COVER RATE LDG X 660 = X = TOTAL G/ft2 REQ'D (ft2) LXW DOSING TANKS AND PUMPS DIMENSIONS X X = PUMP CAPACITY Spm L W D Vol. DISCHARGE SIZE DISCHARGE RATE DISCHARGE TIME Spm MANHOLES TO GRADE ALARM SEP. CIRC. GW (Min. 1' below inlet) HWL LWL CHECK VALVE BLEEDER HOLE MANUAL OP. SWITCH Copyright m 1995 by S.L. Starr 1` TOWN OF N SYSTEM P1 EQ,a 4, - �f DATE:� SYSTEM OWNER & ADDRESS ING RECORD RECEIVED NOV - 2 2004 TOWN OF NORTH ANDOVER HEALTH DEPAPTMENT SYSTEM LOCATION (example: left front of house) Cx-- DATE OF PUMPING: `F QUANTITY PUMPED: (� GALLONS l/ CESSPOOL: NO YES �SE'TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED To: G.L.S.Dr____ Lowell Waste DelleChiaie, Pamela From: Sent: To: Cc: Subject: 103 Lost Pond Lane Susan Bielichi 978 557-0372 susanmail@comcast.net Sawyer, Susan Monday, March 09, 2009 1:34 PM DelleChiaie, Pamela; Grant, Michele Hughes, Jennifer beavers Jennifer and I both had a long talk with the resident. They live on the "pond" which they used to be able to walk around and it is creeping up their yard. This is not an emergency.... Anyway, 1) 1 am sending her information on the beaver law and told her to let us know if any of the public health criteria apply. 2) Jen and I told her one of us would drive by as a courtesy 3) 1 will pull the assessor's information to see if the town owns the property for our info. 4) If she thinks the problem fits the criteria she will call back. 5) 1 think she wants our opinion if we do go by as well so we could call her or email her the results 6) If it is on Town property and not a major health hazard Jen told her that the neighborhood could consider pooling resources and hiring a beaver person. The town would not pay for it however. Or apply for any permits needed. That is it for now. Susan Pam can you log this. Thanks ERECE:IVED � Commonwealth of Massachusetts City/Town of System Pumping RecordForm 4 M V , t5form4.doc• 06/03 DEP has provided this form'for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left / Right front of house, Left Igh rear of hous Left / right side of house, Left / Right side of building, Left / Right front of building, a Rightrear o building, Under deck Address r City/Town 2. System Owner. State Zip Code Name Address (if different from location) City/Town StatesZip.CQde Telephone Number _ B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company contents were disposed: I nwcll Wnefc Wofcr <36 U C�� vc'�- �� System Pumping Record • Page 1 of 1