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HomeMy WebLinkAboutMiscellaneous - 111 WOODCREST DRIVE 4/30/2018tv C'a Please forward us as much of the following information that is possible; 1. Type of system L FI t! 2. Age 3. , Location" 36AC4�� YACLP 1 t WO cep Cl,<,�g 4— Maintenance records and date of last pumping out 5. Documentation of repairs and reconstruction b. Site conditions 7 i 7. Builder of system 8. Engineer who approved% — Site - System D (Z- a 2 Ip 9. Installation Procedure 10. Problems WATERSHED RE/SI_DENTS QUESTIONNAIRE 1. Name �✓� t �� , O2. Street Address 3. How many members are in your household? I 4. What type of sewage disposal system do you have? ❑ cesspool Aseptic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑. do not know 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? \ yes ❑ no ❑ do not know 6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years 11-20 years ❑ over 20 years ❑ do not know 7. Has your sewX age disposal system been rebuilt or repaired? El yes, no ❑ do not know If yes, approximately how long ago? — years. What was done? 8. How frequently is your sewage disposal system pumped out? ❑ annually Q ❑ every 2-4 years >1 < 1 1 every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes no If yes, what problems? ❑ repeated pump -outs needed ❑ system clogs, backs up, or drains slowly ❑ odors ❑ sewage surfaces through ground 10. How many of each appliance are connected to your se ge disposal system? washing machine jam- dishwasher A garbage disposal dehumidifier drain sump pump toilet' roof/pavement drains shower/bathtub 11. Please state the brand a d type (liquid or powder) of detergent you use for: dishwasher _Sc11V L / G -/-f 7— clotheswasher zyL�- 12. Does your property have a lawn? yes ❑ no If yes, approximately what size? ❑ less than '/a acre '/a acre ❑ '/z acre ❑ 3/a acre ❑ 1 acre ❑ . more than 1 acre (Sp cify . acres 13. How often do you fertilize your lawn? O No. of applications per year Season(s) of the year 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: Check here if your lawn is maintained by a professional landscape contractor. Robert C. Stemke Woodcrest Drive 9:00 - 10/28/67 APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I hereby make application for a permit for a sewage disposal installation at Lot #49 - Woodcrest Drive . I will install this system in ac- cordance with all the laws of the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre- ceding the septic tank, where the grade shall not exceed 2%. I will install a con- crete septic tank of 1000 gal, in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of 240 lineal (square) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/4" (dia.) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I further agree not to cover any portion of this installation until approved by the inspection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application. DATE /� ,30 / Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachusetts. DATE October 30, 1967 Si ature of Health Agent I have inspected the uncovered system indicated above and find everything done as Aeacribed. DATE LSI` /L�0/ rip Signature of n pecting Officer Percolation Test 8 Minutes - Soil: Clay Garbage Grinder 1& Yes — '30 BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. I ,► S • Jo" a,#)-�'�e1 M � $0 -� led- � I'DI Psi PLL I - "I jr "m 1. NAME a , C ' DATE r' ; _ 2. ADDRESS 1446 ¢ � �,� ; �itT� � LOT NO. TEL . e - ,34i 3. N0. OF BEDROOMS '` DEN YES NO 4. GARBAGE GRINDER YES NO 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE,OF SEPTIC TANK -OR CESSPOOL 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM (Alo W F4 G) 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. 'v 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. (sass, , V > (I V' %A) vl Z ko `3-L `Llb t 7j\ 4r_.5 -b. BOARD OF HEALTH OF NORTH ANDOVER, MASSACHUSETTS SEWAGE DISPOSAL DATE November 4. 1967 NAME OF APPLICANT Robert Stemke LOCATION Lot 49, Woodcrest Drive Address of lot no. BUILDING: Dwelling X Other SYSTEM: New X Repair GENERAL DESCRIPTION OF LAND Nigh SUBSOIL: Clay X GravelSand PERCOLATION TEST 8 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 1,000 gallon capacity. LEACH FIELD 240 lineal feet of drain pipe. William J. scoll, Engineer Board of Hea h \ COMMON'ArEALTH OF MASSACkSET &, EXECUTIVE OFFICE OP tWkONME1'TAL AFFAIRS DEPARTMEINT OP EN*V19() 'MENTAL- PROTECTION �,- y; ONE WINTER STREET. BOSTON. MA 02ios .6 i 293=5 01) r ; WILLIAM F. WELD TI�UfiY twit Govemo: Set retrEr± ARGEO PAUL CELLUCCI DAVID STIt HS Lt. Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM iNSPECfiON'TORfiA— ` PART A CERTIFICATION Property Address: /-{'�e�Cl�16os of Owner Date .of Inspection.,—Cr t Of different)'J. Name of Inspector -i . I am a bEP proved system in ect' r pursuant.to Settioh .3d0 bf Title S (jib CMit 15.000) . r. C Company Namei Mailing Address: 1it4 V� Telephone Number:4257-t 470-ki—, CERTIFICATION STATEMENT I certify that i have personally inspected the sewage disposal system at Thit ad'd'ress and that the trifomiabon repotted below is thio; accurate and complete'as of the time of inspection: The inspection wg 'perforfhed based on my training and &Oir-' once in the pfoper fuhtti6hn and . hiaintenance of on-site sewage disposal Systems. The system: a Passes 3 _ Conditionally Passes Ne urthef Evaluation By the Local Approvthg Authority Inspector's Signature: r i Date The System inspector 'shall su iia copy 611 this irispectioh Iepoft to the 1pprbviii %utkbrity Witliih ihtrty (30) Bays bf eoi' olhtth5 this inspection. If the 'system is a shared system tir has a desigh flow of 16,000 Bpd of greater; the inspector acid ti,e system :iywirier`skall submit the report to the appropriate regional offite of the Departhtent. of I nviroiitnehtai prbtectioh. The tsngtnal.3hould tsC refit tts thn system owier and copies sent to the buyer, if applicable; and `the appfovin$ autlonty INSPECTION SUMMARY: Check A; B, Cj b!: b.' A) SYSTEM PASSES: y 3 9 I have not found any information which indicates that thi systems ►folates any of the failure criteria as defined in 310 CMii 15 303. Any failure criteria not evaluated are indicated below. COMMENTS: S f Bj SYSTEM CONDITIONALLY PASSES: One or more system components as described Irl the °Coriditlofial lass *dloh need to be repi5oed bt repaired ' The system, upon completion of the replacement or repair; as appfcived by the Boafd bf Health, will pais , } Indicate yes, no; or not determined (Y, N, or ND): bescribe basis of deteitriihattori lr; iii~ihstances. i1 "not deteinsriedi eitplitn hot The septic lank is motil; unless the bwtter or opeiatof,lias`pto Titled the I; e– inspector with A dopy t�� a Ceftifildii bf, Compliance (attached) indicating that the tank Was ifi3talled �ulthirt bNMty (26)'years prior its the dile til & IPt ctibn; or. the septic tank; whether of not frietal) is.cracked;.ltrticiiirally fir sound shoals substarttii) il�ihitimi6h oY' exiiltratlon, 5r tank failure is imminent. The system will pass thspectr6M if the 64tin f iieptid tank is "Idt*d with 3 confb miliR , It tank. A f' as approved by the Board of Health . . . . . . . . . . (r*viaad 64/25/071 s"d¢ 69 X10 n� DEFT oti the Worm %hWA Weti httPJh rw+N magri$f 3tate.insi U3ldep 4 i� piiirted ttt� I28Cycl� Pii�r � SUBSURFACE SEWAGE 61506SAL SYSTEM iNSpECTION FORtii PART A CERTIFIt AT10N (t oittinued) J. f Property Address: Owner: (Y,- Date $Date of Inspection: B) SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed in the distribution box it due to broken or obstiated pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval 6fthe Board of Health): bescribe obsetvatioris: r �h IT- brokeh pipets) are replaced ; obstruction Is removed i distribution box is levelled or replaced t _ The system required pumping more than four timet a year due to brok or obstNded pipe(s) 'The # Miffs svifl Out inspection if (with approval of the Board of health).'"' broken pipe(s)'are replaced obstruction it removed � 4 C1 FURTHER EVALUATION IS REQUIRED RY THE BOARD OF HEALTH: _ Condition's exist which require further evaluation by the Board of Health..in' arder,to deterM lid ►f the systerfi is failirsgto priifect the, public health; safety and the environment.�x.4 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT T1E SYSTEM i3 NW FtlNt:riONING r.IN4A MANNER ,,'f, ... " .. .0 i i -. 1 WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THS ENVIRONMENT. r � Cesspool or privy within 50 feet of a 'surface 4vater Cesspool or privy is within So feet of a bordering vegetated wetland or S.salt fnarsh 2) SYSTEM WILL FAIL UNLESS THE BOARD -OF HEALTH (AND PUKk WATER SUPPLIER;' -4 A0060R10 D81 iNES{THAT , .. THE SYSTEM IS FUNCTIONING IN A MANNER .THAT PROTECTS THE i'UBLiC,HEALTH AND SAF& ANt3 THS x ENVIRONMENT: t K r aha :'�� ,+ .. � �yd,�-..' �r. fir:, � # ...44', �v r rGr.'.r ._ The system has a septic tank and soil absorption„system 1�iSti artd the SAS is W�tWA 100 t” to a surfaces at sii{ip(y ar ` tributary it) a surface water sUpp Y ( w" _ The system has a septic tank and soil aWsorptior+ "system and the SA5 is vii*h a Zone I of a public water sup[�ly welt _ The system has a septic tank and soil absorptioh §ysiem and the SAS is within 5b. eel of a privalei ater sirp l well The system has aseptic lank and soil absorption system and the §AS is less than`tb0 feet but 5b. feet or moil from a private water supply well, unless a well water analysis fol toliforrrl bat�ri3 send vitsiatile tlganic'fr�itripbdnds°lfidi that :. the well is free from pollution frcrn #kia£ facilely aitd th presence of amimonia Fi(tro$eii and nitfate hitrbgeii isJaf trs bf less than 5 ppm. Method used to datermine, distance �' (aPpFoictrtlitt(Oii **�4 , JV 3) OTHER vµ� t (reviiid 04!25%§7) l..:F.+.t. a;'•titi n��..-... -:r. .<. xr: '. ^Pw-: -. rr!u c.n... b:. ;1 a �.A+ .:a �'.5 f a�:y yv�\k :ls. 14' i •1 W.�' i ft l * i �� k � •�.i.. � . ('i..':. .x:: Utz id �. P }.. t, - , y q is s J40 1 46 0 r EM SUB5URFACE SEWAGE bISPOSAL SYSTEM INSPECTIbN. 101tfN PART A CERTIFICATION (6 itinued) 6 - -Property Address: WOC)C� C -S 1 • �%©1C`�y`�/\ Owner: �( . C._C-�e"t� irQA l, pp Date of Inspection: P-0 ♦ f ', t 77 a 4� a D) SYSTEM FAILS: ; You must indicate. either "Yes or "No as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15 3b3 T1ie 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 k B ckup of sewage into facility or 'system component.due to an overloaded• of clogged 5AS of ttisspool _ ��xk w: Discharge or ponding of effluent to the surface of the ground or surface ii waters due to ati over 6bc ed br, clogged SAS br _= cesspool.¢: S 'c liquid level in the distribution box above outlet i6virit due to an overloaded or clogged SAS or tesfpoo� tet+ — Li d depth in cesspool is less than 64.6elow.,irivert or available volume is less than V2 day flow , � u� Required pumping snore than 4 times ifi the last year OT due to clogged of obstftidecl pipe(s). Nu ber of timespumped An ion of the Soil Absorption System, cesspool or privy is below the high gtoiindwateF elevation '''" f $ g �j • „ ds•� F — An onion of a cesspool or privy is within 160 feet of a "surface water supply of ffibutary to a surface water Supply `' t/ An ion of a cesspool or privy is Within a Zone I of a public we ^ A onion of a cesspool or privy is within SO feet of a privato. water supply -Well z° Any portion of a ce's'spool or privy is less than t00 feetrlsut greater thMi-, g0 feet 1ro"rti a or! Water suppfyritv2ll with no p� acceptable water quality analysis. If the well has been aiialyted to be acteptable, attach copy of well Watfii anal sit for coliform bacteria, volatile organic compounds; ainrhonfa nitrogen r E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the foliowirlg: The following criteria apply to large `sy"stems ih addition to the ctiteria above The system serves a facility with a design flow of 10 000 gpd or gttk& (Large §ysiom) and the system is a Significant thr�t to public health and safety and the environment because one or.ina of the #61164if g conditions exist y6t Yes No the system is within 400 feet of a surface drinking water supply" the system is within loo feet of a tributary to a surface drinking -Water supply the system is located in a.f itr`ogen sensitive area itnteHM Wellhe5d Pn eCtion Ati!a fWFA) or a one it o a public water supply Weill'`` ,41 The owner or operator of any such system shall bring the system and fadlity into full 66mp3lance with the grounJi W4 treatlrtertt ogPam requirements of 314 CMR 5.00 and 6.00. Please consult the focal fegibnai office of the pa men frtapped•t fol furthef ififorrrtatro�i r+ ' =R ° y; lh- t jy (revin6Q G4i2s/�7) SUBSURFACE SEWAGE 61$063Al m INSPECTION FCSftM c PAiRt B A a CHECKLIST x, Property Address: /' ,. –l\ �J`' x Owner:\<r t Date of Inspection:`– Check if the following have been done: You must indicate.eithel:."Yes 60 "Noas to each of the foliow�ng: ,, ` Yes o x Pumping information Was provided by the owner, occupant, or Hoard of Health ' E None of the system components have been pumped for�at least two weeks and the system has been`reebiving oriv — flow. rates during that period. Laige 4blutnits of Watet have fiot been introduced into tke system tetp+tly bt as part of this inspection. As built plans have been obtained and.,Nbtr3 if they ate hot available nrkh iV/A * z m The faciliy or dwelling was inspected: for iw t of Sewage back-up wY r The system doe's not receive non-sanitary or industrial iWaste flow. y v , + _ he site was inspected foe signs of breakout.. y All system component's, excluding the toll Absorption System, have been Incited on the site r" The se tic 'tank manholes were uncovered o ned, and the interior of the septic tank was inspected for tohdi#ion of p`. . P n 0-06n ed, or tees, material of construction; dimengiMC depth of liquid, depth of sludge depth The. size and location of the Soil Absorption System on the ijig hal been detefrniLied used ori` The facility owner (and occupants, if different from5owned Were provided wtth info(mation bn the propel ma�nteriahce of Sub-Surface Disposal System. Yr F Existing information. Ez. Flan at g,O.l-I.' Determined in the field (if any of the failure ckitena felated to Part C if at issue; apptoxiinaUbn fii distance unacceptable) (15J020)(b)J - ' . .. 'a to ? e.. p r �> `� r � . ! • �y1 `'fY °�,�' r x> �r � w v i r}• 3�: ;''` e�Y J+. r irk i s «+ '{"•`. i, . t . pV,.. �.. '� R•' Y T` vii � Y.'� , 01 `fisT=i`°i. 4 ya e M'4 A % 14 SUBSURFACE SEWAGE DISPOSALty0CM, INSPECTI��o 0 im PUT SYMM, INFORMATION ,., . . . . . . . Addresst VJOOA tf—ve&-V 10 ;A -LA, j4 Property Owner: 4C Single cesspool Date of Inspection. FLOW CONDITIONS 'A RESIDENTIAL: as zk ,k Design flow: g.p.d./bedroom for S.A.S. Number of bedrooms: 4 Number of current residents: Garbage grinder (yes or no):Iets con6act? Laundry connected to system (yes or ho):—ITS Seasonal use tyes or no); MOS Wator meter roWings, If available (last two (2) year usage (gpd)' q0o %A14 Nbelt Sump Pump (yes or no):_ Last date of occupancv: APPROXIMATE AGE of all compoh6hig, date installed (if k6bwn) and of l4deritaticin: 5,K, COMMERCIALANDUSTRIAL! Type of establishment Design flow: gallons/day Grease trap present: or no)_ Industrial Waste Holding Tank present: (yes or no) Non -sanitary waste discharged to the Title 5 system: (yids ' 0 r hb Water meter readings, If available: Last date of occupancy: OTHER: (Describe) Last date of occupancy:_ PUMPING RECORDS and source of Information: 'ehe" % 14 If yes, volume pumped: eailons k Reason for pumping: . . . . . . . j4 fir:v Single cesspool GENERAL MORMAtION Privy 'ehe" System pUmped as part of ihitp6dioh: (-yes or hb)(Vo 14 If yes, volume pumped: eailons k Reason for pumping: TYPE-Ymm �O Septic tank/distributionbox/soii absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach OtOV1609 ifigpodi6firecords, tf any) I/A Technology etc. Copy of up to date 4 con6act? Other A APPROXIMATE AGE of all compoh6hig, date installed (if k6bwn) and of l4deritaticin: t Sewage odors detected when arriving it the 'site: (yes or no) 04/25/97) bi is 'ehe" StJgSURfACE SEWAGE bISIsOSAl5Y3tEM IIVSPECt1ON FOitM PA -Rt C�, SYSTW 6NP— R' kMATibN (tbntinued) Property Address: + � lf! • ^ d i 1 � 4' f --+�<, t ` p �� Ccs- Owner: Date of Inspection:' - BUILDING SEINER: (Ldcate on site plan)' Depth below grade: Material of construction: _cast iron _ 40 PVC _other (explain) w r Distance from private water supply well or suction hnn _ k Diameter. S ut Comments: (condition of Joints, venting, evidence of leakage, etc.) s r` qw SEPTIC TANK:._ 4. (locate on site plan) ` (� Depth below grade ' < k Material of construction: _ oncrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age Is age confirmed by Certificate of Compliance.,_ (Yes/No) Dimensions: Sludge depth: a1 Disfance from top of sludge to bottom of outlet tee or baffle:-�6 Scum thickness: O t. r. Distance from top of scum to top of outlet tee or baffle:. 1 t ; Distance from bottom of "scum to bottom of outlet tpe or baffle: a How dimensions were determined: Comments: pumping (recommendation for umpin , conditio of inlet Arid outlet tees or baffles) depth of liquid level )n do i outlet nvisrt, sim�; int eg ity, eviderlcg of leakage; etG} - fie-'' 1 e 1J 'e,F t e GREASE tRAP: (locate on site plan) Depth below grade: h Material of construction: _concrete _meta) ,Fiberglass. Pol yet yleve 0her(e lain kP ) Dimensions:,K.w g Scum thickness: k i Distance from top of scum to 'top of outlet tee of baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: ' Comments: structural r z'' (recommendation for pumping; condition of filet and outlet tees or. baffies;'depth of HOW level in relation to outlet invert, integrity; evidence of leakage; etc. (revised 04/2S/97) sy. t DISTRIBUTION 1110X:rMy 9y' (locate on site plan) 1t i; Depth of liquid level above outlet IhVert: Comments: ( to if le el. and distrit�y[ion ' equal; evidence of solids cariyo�(er, evi en , . . lea a e into of out of bb" ie 1 N11 n, n 1 1 .1 _1 r V`Z.0 PUMP CHAMRER:C�`'t� SUBSURFACE SEWAGE DiSP05Al SYSTEM IN5ffECfION FORM `- PART t (locate on site plan) SYSTEM INFORMATION (continued) �iCSfP/t(� Property Address: Owner:Cill�� cf1 Date of Inspection s tt ar Pumps in working order: (Yes or No) TIGHT OR HOLDING TANK: (Tank must be pumped prior to, of at Time, bf inspection) Alarms in working order (Yes or No) (locate on site plan) Depth below grade: Material of construction:_concrete ,_metal _Fiberglass Polyethylene 4_. other(explaih) (note condition. of pump chamber; condition of pumps and appuit#hances; etc ) Ar � {' f Dimensions: Capacity: gallons P ih" . Ilons/da Design flow: ga 1' Alarm level: Alarm in working order Yes. _ No r t _ Date of previous pumping:#r Comments: (condition of inlet 'tee, condition of alarm and float switcheg,o eic.) sy. t DISTRIBUTION 1110X:rMy 9y' (locate on site plan) 1t i; Depth of liquid level above outlet IhVert: Comments: ( to if le el. and distrit�y[ion ' equal; evidence of solids cariyo�(er, evi en , . . lea a e into of out of bb" ie 1 N11 n, n 1 1 .1 _1 r V`Z.0 PUMP CHAMRER:C�`'t� NR (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No) Comments: (note condition. of pump chamber; condition of pumps and appuit#hances; etc ) ' t NR b 's 41 ' t r t y of is v�lk ------------- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C r $ SYSTEM INFORMATION (continued)': Property Address: Owner. Date of Inspection: ' SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible- excavation 1 of required, but may be approximated by non=intrusive methods) If not determined to be present, explain: f - t q Type: leaching Its, number. leaching chambers, number: x leaching galleries, numbery t a P� leaching trenches, number,lengthi leaching fields, number, dimensions: r - a overflow cesspool, number. Alternative system: R r � Name of Technology:o .. ; Comments:- (note c nditto (�\oftoil, signs of hydr uiic f ilure; n etc . level of p(ondmg; cofidttion of vegetatio , ) f CESSPOOLS:�� _ r (locate on site plan) Number and configuration: ter: • ti Depth-top of liquid to inlet invert:: , xr Depth of solids layef, Depth of wim layer Dimensions of cesspool: Material's of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) �• - - x* �' "" Commerris: ., .. .. _. 1 fi-. '412 `. .< "soil, hydraulic failure, level of ponding; condition of vegefiatiort, etc l A w (note condition of signs of � f � � w PRIVY: ' r 41 (locate on site plan) Di Bions � r nom^ Materials of construction: Depth of solids: Comments: 4° 3 (note condition of soil, signs of hydraulic failure, level of ponding; condition of °vegetation; j (revised 64/29/97) a y a' } f (zevirad 04/2.5/97) My report contained hereiin does not `constitute a :guar".anteej of future usage and the functio' nality of the YOXisting."sept, system: Such report issued herewitH is'mereiy,basod upon my observationsi and t hereby ai6ciAim an" -y further oP+araton of your current septic systems .. hr...y