HomeMy WebLinkAboutMiscellaneous - 108 LIBERTY STREET 4/30/2018 (2) 108 LIBERTY STREET .-
f/ 210/090.6-0055-0000.0
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Commonwealth of Massachusetts
W City/Town of NORTH ANDOVER EREIVa .
a System Pumping Record Ar ,
QV 14
Form 4
ORTH ANDOVER
DEP has provided this form for use by local Boards of Health. Other form d,�ktW1�r
information must be substantially the same as that provided here. Before using this formic 7 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 within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
Important:When
filling out forms 1. System Location:
on the computer,
use only the tab 108 LIBERTY STREET
key to move your Address
cursor-do not NORTH ANDOVER MA 01845
use the return
key. City/Town State Zip Code
2. System Owner:
PHIL QUINN
Name
ream
Address(if different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping 4/25/14 2. Quantity Pumped: 1500
Date Gallons
3. Component: ❑ Cesspool(s) ® Septic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No
5. Observed condition of component pumped:
-GOOD CONDITION -- —
6. System Pumped By:
JAMES H CURRIER II H79406
Name Vehicle License Number
X SEPTIC & DRAIN
Company
7. Location where contents were disposed:
GLSD
" .' %'�`"t 4!25/14
Signature of Hauler Date
Signature of Receiving Facility(or attach facility receipt) Date
t5form4.doc•11/12 System Pumping Record•Page 1 of 1
BOARD OF HEALTH
J Town of. North Andover,Mass .
Permit #� ••
Date ;�� /r ' 19�'�
APPLICATION FOR WELL & PUMP PERMIT _
Application. is hereby made for permit to drill a well K) • Application is
made to install (_) a pump system'.
Location: Address 77 .
. . Lot # •
Owner SCIS /� CJ/ Address �/f��t�,e S Tel .
Well Contractor �'' Address ? � Tel .
Pump Contractor Address Tel .
WELL CONTRACTOR (To be completed at time .of pump test )
Type of Well LC L t• Well used for Airs
Diameter of Well n Size of. Casing_6
Depth of Bed Rock Depth casing into Bed Rock /
Was Seal Tested? Yes .(/) No (_) Date. of Testing
Well Ended in W.ha-t. Material t7 rC
.Depth �o-f—«eTl— _ '3�S _ -
Depth to Water Delivers Gals . Per Min. for 4 hours
Drawdown 36 after pumping hour at /f ' GPM
Date of Completion S t'',� _
Sig
ture Wel Contractor
'. PUMP INSTALLER (To be-- filled it'
.n before i.nsall.at,ion) r
Size & Name Pump ____ _ ' __'_Pump Type Used
Water Pump Delivers GPM Size of Tank
Pipe Material Used in Well : Cast Iron (_) GaIIvani.zed (_) Plastic (_3
Well Pit ( ) or Pitless •Adapter
Was sleeve used to protect pipe? Yes (_) NO(_) Type or Name Well Seal–
Date
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Date Water analysis repor-t submitted to Board of Iieal'th
Date release given tD owner of record & Bldg. Insp
Health Inspector
w i Grine
16 E.MAIN ST.,P.O. BOX 1153,GLOUCESTER, MASS.01930•TELEPHONE: (617)281-0222
L
To: Quinn Realty Builders Report No_: 18170
179 Newbury Street Date: May 18, 1988
Danvers, MA 01923
Attn: Mr. Scott Quinn
Re: Well Water Analysis
Sample Description: Sample of water taken from a new well 340 feet
deep, located on lot 2, Liberty Street, North Andover.
Sampling: Delivered by customer on May 13, 1988
i
Findings:
pH Value 7.8
Hardness(asCaCO3. mg/L) 96
Iron Content (mg/L) 0.04
Manganese Content (mg/L) 0.06
Sodium Content (mg/L) 7.2
Nitrate Nitrogen Content (mg/L) < 0.01 i
Specific Conductance (µmhos/cm) 240 f.
Total Coliform Bacterial Count per 100m1 (MF) 0
Remarks: This sample was found to be free of pollution indicator
bacteria. The water represented by it is considered safe for consumption
on this basis. All chemical parameters listed above meet EPA guideline
values.
By: 49�r
Jo Lovatt
Biomarine, Inc.
JL/stl
Mass. Certified Lab No. MA026
HANCOCK SURVEY ASSOCIATES, INC.
235 NEWBURY STREET•ROUTE 1 NORTH DANVERS, MA 01923 (508)777-30501283-2200/(61 7)662-9659
FAX:(508)774-7816
139 BEACH ROAD SALISBURY, MA 01950 (508)462-3036/352-7590
FAX:(508)462-5547
#2778
December 14, 1988
North Andover Board of Health
Town Hall
120 Main Street
No. Andover, MA 01845
Attn: Mr. Michael Graf, Health Agent
Re: Subsurface Sewage Disposal System for Tot 2 on
North Liberty Street
Dear Mr. Graf:
I hereby certify that the subject system was installed as shown on the
enclosed as-built sketch.
Please call Chuck Johnson, Project Engineer, if you have any questions.
Very truly yours,
HANCOCK SURVEY ASSOCIATES, INC.
l
Gus
�;, P:E.
Chief Engineer C
AFS/bc
Enclosure
cc: Republic Development Corporation
175 Andover Street
Danvers, MA 01923
Attn: Mr. Scott Quinn
HSA File
P
t HANCOCK SURVEY ASSOCIATES, INC. JOB 277 2 ,�cio�BGic 7t/ Goes
235 Newbury Street (Route 1 North) SHEET NO. OF
DANVERS, MASSACHUSETTS 01923 / q
(617) 777-3050 (617) 662-9659 CALCULATED BY ✓ `�/ DATE
(617) 352-7590 (617) 283-2200Q Q
CHECKED BY f DATE_/✓�G.
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PRONET 2141 iv' Ir.[.,tom Vx 91471.
HANCOCK SURVEY ASSOCIATES, INC.
235 Newbury Street (Route 1 North) SHEET ND. of 2
DANVERS, MASSACHUSETTS 01923 / Q J�� Qp
(617) 777-3050 (617) 662-9659 CALCULATED BY V DATE_/ DEC-1 I PO
(617) 352-7590 (617) 283-2200
CHECKED BY DATE_ ff
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BOARD OF HEALTH
No-Andover, Maas . - 1
4 SUBSURFACE DISPOSAL DESIGN CHECK LIST
LOT # Ll� S�
.APPROM DATE 3-3'$b DISAPPROPED DATE_
Provided: f.USC J.3. P14N rqA Erpc 57,6, Reasons:
I: G49Z-1 Advfo)� Wk_4ocgl:::�
Title V FAIL
Reg 2.5 The submitted plan must show as a minimum:
a) the lot to be served-area,dimensions lot #,abutters
b location and log deep observation holes-distance to ties
c location and results percolation tests-distance to ties
d design calculations & calculations showing required leaching area
(e) location and dimensions of system-including reserve area
f) existing and proposed contours '
(g) location any. wet areas within 100' of, sewage disposal system or
disclaimer-check wetlands mapping __-
(h) surface and subsurface drains within 100' of sewage disposal
system or disclaimer
(i) location any drainage easements within 100' of semge disposal
system. or disclaimer-Planning Board files
(3) known sources of water supply within 2001 of sewage disposal e
system or disclaimer
(k) location of any proposed well to serve lot-1001 from leaching facility
(1) location of water lines on property-101 from leaching facility
(m) location of benchmark
(n) driveways
(o) garbage disposals
(p) no PVC to be used in construction
(q) profile of system-elevations of basement, plumb, pipe, septic tank,
distribution box inlets and outlets, distribution field piping and
Other elevations
(r) maximum ground water elevation in area sewage disposal system
(s) plan must be prepared by a Professional Engineer or other
professional authorized by law to prepare such plans
Reg 6 Septic Tanks
(a) capac t es• 50�6 of. flow, grater table, tees, depth of tees,
access, pumping
(b) cleanout
(c) 101 from cellar wall or inground sudmmi.ng pool
(d) 25, from subsurface drains
Reg 10.2 Distribution Boxes -
- (a) slope greater UM 0.08
Reg 10.4 b) sump
r
. - d
Subsurfjace Design Check List Page 2
FAIL OK
Leaching Pits
Leaching pits are preferred where the int tallation is possible
Reg 11.2 a) calculations of leaching area-ndnimum 500 L- ft
11.11 b) spacing
n ao c) surface drainage 2%
?x.11 d) cover material
e) 'x2'x4" splash pad
f) tee at elbow
g) no bends in pipe from d-box to pipe '
Leaching Fields
Reg 15.1 a) no grea�t`hsn 20 minutes/inch
b)
area-minimum, 900 eq ft
15.4 c) construction of field
15.8 d) surface drainage 2 %
3.7 e) 201 from cellar van or inground swimming pool
Leaching Wenches
m
Rell-.l a) ciculaon8'o `-leaching area-min 500 sq ft
14.3 b) spacing-4 ft min 6 ft with reserve betweoa
14.4 c) dimensions
14.6 d) construction
14.7 e) stone
14.10 f) surface drainage 2% .
.-- .... Doudhill Slope
a) slope yjx --Tfo be shown)
b) y/x X 150 = (to be shown)
PWVB
Reg 9.1 a) approval
9.6 b) stand-by power
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41PBi® arine
16 E.MAIN ST.,P.O.BOX 1153,GLOUCESTER,MASS. 01930•TELEPHONE: (617)281-0222
ttrtiraate of sualpfig
To: Quinn Realty Builders Report No.: 18170
179 Newbury Street Date: May 18, 1988
Danvers, MA 01923
Attn: Mr. Scott Quinn
Re: Well Water Analysis
Sample Description: Sample of water taken from a new well 340 feet
deep, located on ic. 2, Liberty Street, North Andover.
Sampling: Delivered by customer on May 13, 1988
Findings:
pH Value 7.8
Hardness(as CHCO3, mg/L) 96
Iron Content (mg/L) 0,44
Manganese Content (mg/L) 0,06
Sodium Content (mg/L) 7.2
Nitrate Nitrogen Content (mg/L) < 0.01
Specific Conductance (µmhos/cm) _ 240
Total Coliform Bacterial Count per 100m.1 (MF) 0
Remarks: This sample was found to be free of pollution indicator
bacteria. The water represented by it is considered safe for consumption
on this basis. All chemical parameters listed above meet EFA guideline
values.
By:
,jo Lovatt
Biomarine, Inc.
JL/stl
cc North Andover Board of Health
Mass. Certified Lab No. MA026
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