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HomeMy WebLinkAboutMiscellaneous - 116 BRIDGES LANE 4/30/2018 i 'I I - � 0'0000.8L00"Q'hOl/OlZ 3NVl S39018a g l !I� Board of Health 5EPTIC SISTER P8L( /�© North Ano ver -MaBse INSTALLATICK CHECK LIST LOT'` (NID DATg.... B1 SAYPROM ) AVATTCIN Ob FAIL Rea snnst • �D v�", �c.C.. 4tJ� T�� L �vR to'. q?OuA'D Vex" ------------- .i FAIL OK 1. Distance Tot a. Wetlands b. Drains c.. Well 2. Water Line Location t _ . 3. No PVC Pipe l�. Septic Tank - a. _Tees -_Length & To Clean Out Cowers. b. Cement Pipe .to Tank On Both Sides of Tank 5• Distribution Box a. Covers & Box - No Cracks b. All Lines Flo-Amg Equal Amounts c. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth a ' Capped lads Doublean Washed Stone' d: Cle ?. Leach Pits ' a. Dinansions b. Stone Depth c. Splash Pads } d. Tees e. Cement Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No Garbage Disposal P'"�✓' ' � � 9. Inspection � Sv - � . Grading I� (� 1©gyp 1A. Barricading Covered System D 11. As Built Submitted r" a. Lot Location b. Dimensions of System c. Location 14th Regard-to Pere Test j d. Elevations Water Table .o . { , Is `rs ird of Health !1aT`�..h :.nd�vsr,Ha.sE SUBSURFACE DISPOSAL DE,S'IMi CCK LIST r' LOT1OyE� - APPROVED DAT DISAPPROVED DATE Provided: `.�' Reasons: 6 .,i Title V FAIL CK . Reg 2.5 eThe submitted plan must show as a mi ni an'm: lithe lot to be served-area,di-mensions lot #,abutters location and log deep observation hoes-distance to ties location and results percolation tests-distance to ties design calculations & calculations showing required leaching area e location and dimensions of system-including reserve area existing and proposed contours location any vat areas Athin 100 of sewage disposal system or disclaimer-check wetlands napping surface and subsurface drains within 100' of se-w-age disposal system or disciaimer location any drain-age easements Within 10+01 of seimge disposal system or disclairer-Pl.azzning Board files 3) knoon sources of water simply within 2001 of se�jage disposal e stem or discl.ainer location of any proposed -sell to serve lot-1001 Brom leaching facili (1) location of water lines on property-101 from leaching facility ocation of benchmark drive,,ays o _ garbage dispo sats nno PVC to be used in construction q profile -of system-elevations of basem°nt, plumb, pipe, septic tangy:, distribution box inlets and outlets, distribution field piping and Other elevations- _ marSmam-ground later elevation in.-area se�,age._disposal system s)- plan mast be- prepared by-a Pro-fessional Ragineer-or other professional authorized by lax to prepare such plans Peg 6 Septic Tanks (a) capacities-150 of flow, meter table, tees, depth of tees, access, purping b) cleanout 101 from- cellar wall or inground s -_ng pool d) 251 from subsurface drains Reg 10.2 Distribution Foxes a) slope g:eater than 0.08 Reg 10.4 I b) uuuzwp tit } SOIL PROFILE & PERCOLATION TEST DATA �/�3/c North Andover, Jrl, Mass. Street No C� f Lot No�__ Loc/Subdiv. Pland Owner Investigator / Observer /") SOIL PROFILE DATES l.tiev 1, 2.Elev 3.Elev 4.Elev wl 0 �� 0 0 0 pit 1 TilesP Test 2 2 2 2 3 3 3 3 d 4 4 4 5 5 5 6 6 6 6 7 7z 7 7 8 8 8 8 9 9 9 9 10- 10 10 10 Benchmark Location Elevation Datum P CO;,ATION TESTS DATES q o v Pit Number 1 2 3 4 Start Saturation 0 Soak-Minutes Start e fl l L Drop of 3"-Time -Drop of 611-Time 10 Mmms.Ist 3" drop Mins.2nd 311 Drop ✓�V Percolation 4 Q '5 / / /l�O to /l>CJ ,� wa-//. � .� ' -;�r�� dt N5 • } t,f h. Yea - 7- [• 'x �•[ _. U4 A 4i - TM mss... - -.,. NOTE THFS PLAN YYAS ORAWN'FOA MORT. E'PURPOSES DILLY AND IS tJOt7O BE ". <RECORDED,Ofi'CQNSTRUED AS.AN INSTIWMEN`f SURVEYy 1'ti' Q 'GG LGA !'i�tSPETtQt� NG`T.T{7_BE.l$ED-FOR ERECTING FENCES OR ISSUING suk-boc,PERMITS t ic­ g: pL DEED REFERENCE: SK '1.4 3 P� 3`'�l PCANSREFEHENCE D R T � r I�IIASS. 1 C£R_ T1FY-THAT THE STRUCTURE O THIS PLAN-'IS LOCATED APPftlDX1MRTELY AS-6,OVEiN _ F . ANO THE';LOCATION OONF4RMED TO THE°ZONING i:AM1S-OF THE CITY OR Tdl+1 K OF ,: :S t- v COUNTY IV o'rt T-4 14/Va7a�E A2t'lId EFFECT W14EN QONSTRl1CTED(iN1TH.RESPECi-T6 .s � r 'E L�It�AEIVSIO(JAL�IEC?li1REMENV1OC,A710�t£NFORGEfiAENT TS,ONLY)OR IS EXEMPT FROM AC-ION UNZ)EEi MASS.G.L:T3rLE`:.VII,CHAP.40A,SEC.7.UNLESS OTHERWISE NOTED OR - r 2 SCALE: 1" �a ' tfC1Nt Z8 oov M 1 -SHOWN°HEREON_ k: ... H,cP,Ez3Y CERTIFY 7FiAT,THE STRUCTURE SHOWN bN THIS FLAN 66E NOT CEE 1NITNfN. E SPECIAL FLOOD HAZARD AREAAS SF{OYYfV Ots THE F f S,MAPS FORTHE CITY OR �G LANQ-S URVEYO R JA(UfES C'hYAlADES A N OF r /,i o'Jt-T,iq A•.N o o vE rZ 256 WORCESTER L' f, 1NALTl�Af4>�, MASS. �•NF .iS. r i 83 CpMMONITY PANEL Na.Z''$�' 0 9$ 4 U f�' � .....;.,. . , . . f. tl _ y, - e N :� r1 \:.» ,r�. . f• Fi :''t'.},.. ,c ''' ' --V. , y. a•.' } n>' �. -!'. .. •. 'L 'rt _ � .r, 'Er,.�. r. -.t `'aa+ 4"5 a 1 :- 4. .:. _ - • a . F ,•h '.,or, d. .14.ri M,.. t ,a 1 �' r_:4 I•i" r r. , _ .. j '.y. 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I Lo 00 i i i LOT 9 44,414 P.7k �a•I�/1Ap,� Lo? Io Lo-r a 56l'f16 TA.JK i s � 5 LN• G� ELEVATIONS description design as built INV. PIPE OUT Of Ii SE. --T42 0 ,t �S • BUILT " INV. PIPE INTO TANK 141,a INV. PIPE OUT OF TANK 141 ro INV. PIPE INTO DIST. BOX 141.4 SUB • SURFACE DISPOSAL INV. PIPE OUT OF DIST.BOX 1412 INV. END OF PIPE A 1".& SYSTEM e I s&-eo IN d WTII NO. AN DOVE 12 MA. FOR: PILL PAULAOWO. Scale: 1°=�1 Date: s5GP -4.,I-Dea-. RICHARD F. KAMINSKI AND ASSOCIATES, INC. ENGINEERS - ARCHITECT • SURVEYORS • LAND PLANNERS NORTH ANDOVER ,MASS. 3�a f�� , � s i r y it i � /I /�� � ��� C� � ��� I, .✓� � �,�� S � G�r-Q i��'' � �- a� �_ (/1 � � i ��� � t - � � w � . a� � ���p�� ��� ..-�.� . PATRICK J. DONOVAN ASSOCIATES, INC. elaim and Jass Muslments P. O. BOX 110 WAKEFIELD, MA 01880 TEL. (781) 245.5540 - FAX (781) 245.7016 March 2, 2001 h Building Commissioner City or Town Hall North Andover, MA 01810 Insured : Michael J & Maria D Magliochetti Property Address : 116 Bridges Lane, North Andover Insurer : Preferred Mutual Insurance Company Policy Number : PHOO100634566 Type of Loss : Water Damage Date of L'oss' ' :'2/21/01 Our File # : WAP31918 Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000 or cause Mass. Gen. Laws, Chapter 143, Section 6, to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned Insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. kz,�e Bill Thurs otn, Adjuster oi+D OF HES Nc H BT/so W 15 2001 -J 4JILASSOCIATIOXOF INDEPENDENT INSUU.AW ADJUSTDIIS of &1cwathusetts DOUINMa AddressTi it .�S le of File Page of Date File Open: Date file closed: , Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes _ action Document/ document/ Num. Action Department Board of Appeals - Board of Health Planning Board - Cvnservatiivn Commission - Building Departrnent - COMMONWEALTH OF MASSACHUSETTS EncUTivE-OFFICE OF ENVMoNMENTAL-AFFAIl�S-.— _____.__._-_-.----.._ _ ----- -.- -- ------- ---------- ROTE ��---DEPAItTMEN'P OF F.NVFRONMEI�iTAL.pTLON - _.. _ ONE WIlyTER STREET,BOSTON MA 02108 (617) 292-5500 _ - _ _... ASGEO PAUI.CELLUCCI Governor -•- DAVID.8.STRUHS SUBSURFACE SEWAGECommissioner DISPOSAL.SYSTEIIA NSPECTmm FORM PART A - -- CERTIRCATION Psopeaty Amt: -1 1 6 Bridges Lane Name of Owner Paul & Nancy Calvo North ,Andover MA Address of Owner:- 1 1 6 Br;tiQPS T antes r North Andover, MA Daft of kupecdoe: 7�7 //1-6 99 Mania of tisp.emrc pPMefal>iames 3. ht 1 am a W approsysum eetor to Seedon 15.340 of Tide 5(;310 CMR 15.000) comparMNames md R.J. Inspections, TNc- gym ' _978- 81-8759 r MA 81844 Ct�TIHCATIKin 5TATF1N61IT I certify that I_have personally irspeeted 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: _✓Passes _ Conditionally Passes ds P rther Evaluaton Ly the Local Approving authority aasrectors Signature- Date: The System lnsp ubmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty ( 0) days cf completing this' pection. 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 T4tltilV tar N,C)F i i 4,7 _ .. OAC1i2 C1Ftjl- p A .73 UG .. .... - revi s ed _9/_Z-_ 9.8:> - t i or u. Prtoted on Recycled:Paper. _ - SUBSURFACE SEWAGE DEPOSAL SYSTEIU nSPECMN FORM --------PART A----- __-----•--------- CIM 1t1RCATiON(coiginuedl - - - �P> tv Ada�iis� _1.1 6 .Bridges Lane, -North Andover, MA ^� Paul & Nancy Calvo 7. 11tSPEC1t101�1 SUlI�ARY :=t3+eel: 4. B.:_C, �._� __ !'have nottamd any information which_indieaus that any of the failure co eiiteris not evaluated are indicated below. ndrtions described in 310 CMR 15.303 exist. Any failure- B. SYSTBI CONDITIONALLY PASSES: C . One Of more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or rep* as mvroved 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 exfiitration, or tank failure is imminent. The system veli 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 walar lave! Observed in?he dis—ibuticr. box is due to b,oke't cr cbs ruCZad Di e3 or due to a broken, settled or uneven distribution•,box. The Vistarn --viii pass inspection, if(with 3per0/al of,he Hca, Health). broken pipe(s).are replaced obstruction is removed distribution box Gs levelled or replaced The system required pumping-mom than fcur times a year due to broker:or obstructed pipets). The system will-pass inspection if(with approval of then Board of Health):., broken pipe(s)are replaced obstruction is removed ---revised_9f2/9.g _ Page 2ocu SUBSURFACE SMAQt ftPOSAL SYSTBN NSPECi1pN FORM -- _ ti . .116 :Bridges Lane; North Andover, MA` Owns- -:,Paul_° & .Nancy .Calvo - ioaR�oto 7�16 f g 9 tw EVALUIkTl�I!IS 1f UMED:1mr BOARD oF.HEu nf: : . . . Caffons ei#st which nqurce further evaltistion by the Board of Healthm order to detemtine if the system is fading tothel Protect Die sataty ate3 the envltonment. ::- _... . . _4� YYB E PASS UNLESS BOARD OF HEALTH DETERMNES N ACCORDANCE WITH 310 CMR 15.303(10),THAT THE SYSTEM a..NOT FUNCTI IM N A MANNER WHICH WIR L PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVERONAMMz Cesspool or privyis within 50 feet of surface water _ Cesspool or privy is within 5O feet of a bordering vegetated wetland or salt marsh. 2ISYSTEM WILL FAR UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUppUER. IF ANY)DETERMINES THAT THE SYSTEM is FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: ,a .The system has a septic tank and sail absorpticn system(SAS)andAhe SAS is within 100 feet of a surface water supply cr. tributary 20 a surace water suppiy. _ The system has aseptic}.ansa and sail absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and sail absorption system and the SAS is within 50 feet of a private water supply well. T he system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or mare from a Private water supply well, unless a well water analysis for coliform bacteria and-volatile organic compounds indicates thatthe 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 iapprouimation not valid). 3) OTHER i l r _ 1r2Vi Sed-.9/2 Page 3 of11 SUBSURFACE SEWAGE DISPOSAL SYS' BMPECTM FdM _.. - FIMA t:19ti'F".11 N(eondrarem !aa«trAdb.. _11,6. Bridges Lane, North Andover,. MA owes- _ _ -maul & Nancy�alvo oat.of tnsp.c6oir_ 3 - 99 - You nrust`.rr 7ieasa iithar'Yea or"Ida to each of the following have daterrrrrred-that one or more of lite follow&rg failure conditions exist as described in 310 CMR 15,303. The basis for this del anon w iderre W;below. The Board of Health should be contacted to determine what will;be necessary to correct the failure. -Yes No --- Backup of•sewags into-facilityor sTstsm componentdoe-to an overloaded.orebgged-SAS or-ceaspool. -. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or dogged SAS or — — cesspool. Static liquid level in the dstnution box above audet invert due to an overloaded or dogged SAS or cesspool. _ Liquid depth in cesspool is less than 6' below invert or available volume is less than 112 day flow. Required pumping more than 4 times in the last year NOT,due to dogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System,cesspool or privy isJbelow 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 pri`rate water sup,iy yv211 nriits 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. LARGfi S`JSTM 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:servea a facility with:s design flow of 10,000 gpd or greateritarge.System)and the system is a'significant threati'to public health;and safety and the environment because one or more of the following conditions.exist: I Yes No _ the system is within 400 feet of a surface drinking water supply' _=_ the system l&-wi hin,200 feet of-a-Wkitwy to a surface ddrAh g-wMw supply OW system is located in a nib.ogee Sensitive Wear(Interim Wellhead Protection Area_IWPA)or a mapped Zone 11 of a.public 'Ai water supply ; [JIM owner air ape�ator of any Suci>V system shall upgrade'die system in accordance with 310 CMR 15.304(2). Please consult the local regional office of thi .. OeparhrtaiKfor madon.-' revised 9/2/98 Pageoof2l SUBSURFACE SEWAGE DISPOSAL SYSTF3A MMpECTM FORM -77 Ploputy -----11.6 Bridges Lane, -North- Andover MA owner -' -Vaul & Nancy Calvo Chedr if the f�iowiq;him bean done:You must indicate aither Yes"or No'-as to each of the following F.Yes ---11110 - �' Pwnping`udormation was provided by the owner,occupant,or Board of Health. 7. None of the system components Marabeen puw"MMorat least two weeks and•the systun b"AnW arrivingflow tabs during that penod• Larga volumes of water have not been introduced into the syaben m recently oras put oaf this fnspectlon. . As built plans have been obtuned•and examined. Note if they are not available with N/A. _ The facibty or dwelling was"wected for signs of sewage back-up. The system-,does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. a All system components,excluding the Soil Absorption System,hAve been located on the site. _ She 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. �+za an c loca ion of the Soil Absorption System on-the site has been.determined based on: Exislan inrcimation. For g g example, plan at B.O.H. uetermined in the field(if any of the failure criteria relatedto part C is at issue,approximation of distance is unacceptable) ;'S:302(3i(bil T% e `ac:aty owner(and occupants.if different from..ownerl..were:pro%dded.with informatiomon main the�rnper te.,a.,. , f . SuaSuraca Disposal Systems.. P .A. revised -9.x'2.-98: ftsesofit StRb1RlFACE SEWAGE DISPOSAL SYSTBI NSPEcnoflf FORM _. .. PART C _—_ SYSTEM NPORMATION �PMINMtI► 1T6 -Bridges Lane, -North Andover, -MA - -- Fau-1 & Nancy -Calvo - - Daft of Inspeetiorr: 7/16/99 . -- - Desrgn Nurntia of bedrooms tdesrgn) Numbac of barlroorrrs[sctuap: ToarF Dt316K`fWw Number or- Garbage f image!i Yes or no►'„ � - Laundry(separate"system) •(yea or no).-_/: R yes.:sopwale_bspectiovrequimd _ Lautdry syatamkisPected (yea'or no) 1. Seasonal use`(yse or no):ti 4' lfltaur meter readings,if available(last two years usage(gpd): SL '711�l/�L�) SUMP Pump lyes or no):162 Last date of.occupancy: L: Type of establishment: Design flow: aid (Based on 15.203) Basis of design low Grease trap present:(Yes or no)_ 1 Industrial Waste Holding Tank se .(yes or no)_ Non-sanity waste dacha ed the itie 5 Non-sanitary PQ/ system:(Yes or no)_ Water meter readings.if available: Last date of occupancy: OTHER:(Describe) - Last date of.octupancyi GENERAL INFORMATION PUMPING RECORmS and source of information: System-pumped as part of inspection:-(yes or notIf yes,volume pumped:��0 gallons Reasonfor pumping T7PE Septic tank/distribut(on box/sail absorption,system. Single cesapoc( Overflow:cesspool Privy Shared .system(yes or no) Cif yes,attach previous Inspection records,if any) UA.TwAnalogy atc.Attach.copy of up to date:operation and maintenance contract Tight Tank Copy of DEP'Approval. Other _. . APPR0X1111i AGE of.an components,date instaff"O known)-and scum of inforrnatiorr: Swrags,adara q0tectocl when arriving st:the site:(yes or no)/-141.- revraed, 9.-.//'-2/:9.a. - ..._ _. Pa¢e 6 of u -:..-SUBSURFACE SEWAGE DISPOSAL SYSTEM WS1PEC ION FORM _PART C_— -__-___- _- _-__..._ SYSTBA WFORMAT110N_( -- pt"MrAms• 1.1.6 ,Brldg:es. Lane, -North Andover, MA off' Paul ..& Nancy Calvo Ono it 7%16/99_.. -- _ on= - _ Mebnal of cortsttuetion. caat iron_4O PVC adw(explain) _ Dbunce Ruin; aup or suction line Deemabr _ Conanents:(c- p arin n.of ,evidence of leakage,etc.1 _ ' SI�'iIC TANK-.: on site pian) . T Depth below grade:ial Materof construction: -rete_metal 'fiberglass fiberglass _Polyethylene—other(explain) E O tm*fs metal;Wage_ 7s_age-confirmed by Certificate of Compliance_(Yes/No) - 1 Dimensions: Sludge depth:_ Distance from too of siudJgetc bottom of outlet lee orb Scum thickness: Distance from top of scum to toy of cutlet tee or ba �e:�� ,a ' flisance frDm � �xi ottoof scum c bo–,,-chi o?outlet a or baffle:: . How dimenseon,�<were dere-mired: Comments. (recommendation`for pumping, condition ai inielt nd outiet tees or bales,depth of liquid level in relation to outlet invert struc}uaiintegr j, evidence of leakage,etc.) /! 'r_ % G_L– i GS cl.ASE TRAP -:: (locate on site plan) ! Depth below grade: - ry I' Material of coflatructionc concrete _Fiberglass Pciyethylene othedexpisin) Dimensions: Sven thickness=. Distance from top of scum to toor baffle: Distance from bottom of sof outlet t"or baffle: Done of`fast pumping: Comnm ts: becomnendation for pumping,condition of.inlet and outlet tees or baffles.depth of Squid level in relation to outlet invert,strucmra(attegrky. evidence of leakage.etc.) - revised 9/2/98 Page 7of11 is --- --- SYSTEM NSpEC11pN FOIN --_ — PART C_ -- -- - -.. iji pnO 116 Bridges •Lane, North Andover, MA - -Paul & Nancy Calvo Dab 6./9.9 1�. _. ._ ii6Ni OltHOU) ltG FAN1(_- IgOk must be pumped pe-ror to or et Time of inspeetionl {lodib"an air Ptani _� - LVlatetial of uctian:_con+crots_metal _ ... .. _ _Rbeeglass_Polyatl►ylene_other€explain) Dinner: ---- CaYadh: Odom Desygrt 11ovr. goonsifty Alarm pe:errt Alaemiavel: Alarm in w ng er:Yes Date of previous pumping: - Commerits: (eondAion of inlet tee.condition f o alarm an . oat switches etc. CISTAi8ti'MN BOX:— (locate on site plan; Dem of liquid level above outlet ' + invert: Comments: (note if level and distribution is equal, evidence of solids carry ver, deuce of leakage into or out of'aox, tc.) _ (locate on site pian). Pumps in work- order:(Yes or N Alarms in worts"order(Yes Cammurts: (note>mrrdrA'on of pump chamber, of pumps and appurtenances,etc.) C revised .9/2/,98- _ _ _ -page s oG 21 _.._.SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART..0---- --- _ —. _ __._. SYSTEMWNFI IAATIOM tea dnuao "Piapieft-Adbeik" 116 Bridges :Lane;_- North Andover, `MA Paul & Nancy calvo fJMe of soa' sYsi>;M csAsx `-- - - _ _ (Matson sits plen,i#;possy6le•suesvation no;ragydred location may be approximated by non-umusyye'inethods} H not:foeated`ixptam - _ _ _ - l �. LT t w*w Pits.number- MsdWng dwobers,m ober: leacfwyg Gies,mimimr. 1 haching.trw ches.muni.length: Nad*q fi Ids.,umber,dimensions: overflow cesspool,mwe r. Aitemative system: Mame of Teduyology: Comments: mote condition of sol,signs of hytpffic fay re,level of ponding,damp sol,condition of vegetation,etc.) 1444 iN rT lo-.v CESSPOOLS: pocate on site plan) Number and consiauravcn: -Depth-tap of licusd c inlet imvert: Depth of solids layer: Depth of scum lap--e:_ 5,t Dimensions of.casarocl: 'Materials of construction: Indication of grouridwat,eninftaw trsspooP must.be pumped asf inspection} Comments: (note condylion of Soil._Signs of hydraulic falure,leve(of ponding,condition of.vegetation' etc.) PFWYs (locate;Tk6 plan! Materials of construction. Dimensions: Depth of solids: Carunerrts • signs of hydraulic ip0ure. eI ng,condition of vegetation. etc.} (note earultlon of sol. revised 9/2/98 r9ofu _ _ SUIISMAM SEWAGE DISPOSAL SYSTEM MPEXT M FORM PART C --- ------------ -___.._..�_A._-- :Prop.rcYwd�is. __B"r . ges Zane ,-Nor ' Paul & -Nancy -Calvo Door of! 7/1 6/9 9. :SKETCH o SEWAGE DISPOSAL bidudi tits to at INst twa PQM r0wen ca bndmwks or benchmarks aocets all wads wWn IW Mca is whereblic water pu supply comes.mto house) 3 71. S e' d revised` 9/2[g8 pap iooru _ SUBSURFACE SEWAGE DISPOSAL SYSTEM MPECTM FORM --SYSTEM NFORMATUM( Ads -1 t6 :Bridges =Laney North Andover, MA >`, Paul &: Nancy -Calvo ' Oats of hsPooflon- 7/16/99 aRcs swT-> ►Pe tXpkeaf 771Z.k USGS Data website viskted -- Ohi*vadon wells:�h Groundwater depth: Shallow Moderate Deep SITE EXAM. Slops `G `v Surface water LP�If� L Check Cepa Shaffo—w- wells Estimated Depth to Groundwater Feet i Please indicate all the methods used to determine tSgh Groundwater Elevation: Obtained from Design.Plans on record �Obervecl.-Site(Abutting property.,observation hole,basement sump etc.) . Determined from local conditions. i I Checked`,rfith vocal Board of health ecked : NLA neaps ChxcaC pumping records J ,' Checked local excavators,installers sed USGS Data 3 Describe plow you established the high Groundwater Elevation.(Must:be completed) r L revised 9-/'2./'987 �teuofu , SUMMARY OF GROUND-WATER LEVELS. FEBRUARY 1999 PROVISIONAL ----L----START___. _--- NET -CHANGE--.. - - DEPARTURE ---WATER LEVEE T I- . YEAR IN MONTH " -IN ONE FROM BELOW LAND- 0 T OF YEAR MONTHLY SURFACE P H RECORD MEDIAN DATUM . 0 0 (.FEET) (.FEET.) (FEET) (.FEET) DAY ;.MASSACHUSETTS ACTON 158 TS 1965 + 0.14 - 0.83 - 0.97- - 19.57 3/1 -ANDOVER 462: VS 1968 _._ + 0.08 - - 0._63' - 0.87 15..3-9, 23 ATTT;EBORO -83- -- - :VS"=1964_ + -0:18 - _ 0.09 + -- -0.57 2.91- ._.3./1 BARNSTABLE 230 FS 1957 + 0..19 - 2.41 - 0.71 24.27 23 BARNSTABLE 247. FS 1962 - 0.16 - 1.94 + 0.06 . 24.38 23 BECKET 12 TS 1.986 - 0.36 - 0.50 + 0.01 3.62 24 BILLERICA 363 HS 1962 + 0.38 - 3.27 - 3.40 9.11 23 BLANDFORD 9 VS 1986 + 0.11 0.38 + 0.05 2.36 24 . BOURNE 198 FS 1962 + 0.45 - 1.85 + 0.09 32.88 23 BOYLSTON 87 VT 1995 + 0.23 2.70 ----- 4.92 26 BREWSTER 21 FS 1962 0.26 - 1.44 - 0.25 10.22 23 BREWSTER 22 FS 196 - - 0.08 - 2.16 0.70 31.68 23 CHATHAM 138 FS 1962 + 0.02 2.68 - 1.04 24.94 23 CHELMSFORD 384 TS ,1987 0.14 - 1.28 - 0.42 15.78 23 CHESHIRE 2 HT 1951 + 1.94 - 2.35 + 0.76 5.41 23 CHICOPEE 95 TS 1984 + 1.00 - 0.31 - 0.44 21.85 23 COLRAIN 8 VS 1965 + 0.45 - 3.90" - 1.74 21.19 23 j CONCORD 165 TS 1965 + 0.16 + 1.11 + 2.11 40.03 3/1 CONCORD 167 . TS 1965 + 0.39 - 1.64 + 0.21 6.67 3/1 CUMMINGTON 13 VS 1986 - 0.68 - 0:56 - 0.25, 4.85 23 DEDHAM.'"231 ST 1965 - 0.65 - 1.87 - 0.01 5.15 24 DEER5IELD 44 VS 1965 - 0.16 - 0..39 0.16 2.48 23 DOVER 110 TS 1965 + 1.03 + 1.21 + 0*75 3:2.28 24 DU`XBURY 79 VS 1965 + 0.01 - 1.49 - 0.04 7.62 24 DUXBURY 80 VR 1965 + 0.43 - 1.72 + 0.38 20.70 24 EAST BRIDGEWATER 30 HT 1958 + 3.56 .3.11 + 1.19 5.29 24 . EDGARTOWN 52 VS 1976 ----- ___ _---- ---- FOXBOFtQUGH 3 TS 1965 + 0.74 - ' 0.26 +1 ,.1.7 17..34 3/1 FREETOWN 23 - TS 1964 + 0.56 - 0.69 - 0.36 13'.59 24 GEORGETOWN" 168, VS 1965 - - 0.34 4 1.78 + 0.00 4.1_ 23 GRANBY:68 VS 1954 + 2.23 + `0.45 + 1.08 6* 4 3 23 GRANVI.LLE 5 " TS 1965 + 0.65 - 1.39. - 0.75 34.19 24 { GRANVLLE 6 SS1965 + 0.37.' 1.14 + 0.35 4.33 24 GREAT BARRINGTON 2 VT 1951 + 0.50 - , . 0'.06 + 1.49 8.86 24 HANSON'76 VS 1964 - '0.24 - 1..40 - 0.40 4.58 24 HARDWICK 1 TS 1965 + 1.74 - 0.21 + 1.77 12.93 25 HARDWICK 31 TS 1984 + 0.21 . + 0.19 + 0.20 10.82 23 HAVERHILL. 23 TS 1960 + 0.23 - 2.12 + 0.10 11.73 23 HAWLEY`'8 ST 1986 + 0.53 - 0.52 + 0.14 3.76 23 ! HOLDEN 169 FT 1995 + 1..83 - 1.01 ---- .1.62 25 LAKEVILLE 14 TS 1964 + 1.40 - 0.98 + 2:34 12.57 24 LEXINGTON 104 VS11965 + 0.10 + 0.20 + 1.21 1..03 > 3/1 - MASHPEE.. 29 FS 1976. + 0.17 - 2.12 - 0.85 9.02 23 MIDDLEBOROUGH 82 VT 1965 + 1.82 7 2.82 + 0.60 4.77 24 MONTGOMERY 19 SS 1986- + 0.78 1.52 + 0.01 1.19 24 NANTUCKET 228 FS 1976- - -0-.29 - 2.01 , - 0.93 26.47 3/2 NEW BEDFORD 116._ VS 1964" - 0.38 - 1.08 - : 0.33 4.0.5 24 - NEWBURY: 2:7 _.VT .1965 - 0.06 - 2.11 + 0,15 5.04 23 _SUMMARY OF GROUND-WATER LEVELS FEBRUARY 1999- PROVISIONAL WELL L START NET CHANGE DEPARTURE WATER LEVEL 1 04 8/11/99 248 PM. __�__ .V.•Ws • VWIVY WLN/IJ VL.LAL u r __.-------_-_----_-------T ------------_T_I_OF.-----....-----IN_MONTH.___IN-ONE.__.-FROM_--------.BELOW_LAND!.-r- 0 T AND.-_0T_RECORD --._-MONTHLY--.__..__SURFACE. ----- P -H -- -- -- - - - --------- ------MEDIAN -- - DATUM - - 0- 0 - - (FEET) .(FEET);: .(FEET.). . (FEET) DAY _ MASSACHUSETTS (CONTINUED) NORFOLK-27 - 'VS 1965 0.20 - -+ 0.52 _.. + 1.48 _ 4;.44 > 3/1 NORTHBRIDGE 54 VS 198-4.,...: + 0`.05 0.17 + 0:15_ 3'._85 25 _NORTON _37 FS 1964 - 0.01 1.45 + 1.17 5.13 3/1 . .ORANGE 63 TS 1985- . - + 0.76 0.20 + 0.29 7.37 23 OTIS=7 VS_1965 + _O._00 - :. _.0.51 -+ 0.43 7,76 24 _. PELHAM 23 SR 1984 + 0.53 - 0.39 - 1.97 13.38 23 PELHAM 24 SS 1984 + 0.46 - 0.29 0.03 3.26 23 PETERSHAM 16 ST 1984 + 2.48 1.07 . + 1.32 12.18 23 PITTSFIELD 51 VS 1963 + 2.59 - 0.16 + 0.17 15.33 23 PLYMOUTH 22 TS 1956 + 0.78 - 1.00 + 0.70 23.65 24 PLYMOUTH 494 SS 1985 + 0.04 + 0.21 + 3.99 26.79 > 24 PRINCETON 64 HS 1995 + 0.45 - 4.20 ----- 16.23 26 SANDWICH 252 FS 1962 + 0.15 - 0.88 - 0.29 47.60 23 SANDWICH 253 FS 1962 - 0.26 - 0.30 + 1.15 49.02 23 SEEKONK 275 VS 1964- - 0.33 - 0.52 . + 0.36 5.62 24 SHEFFIELD 58. FS 1987 + 0.93 - 0.85 - 0..85 14.27 24 SOUTHBOROUGH 12 HT 1990 - 0.92 - 1.22 + 0.45 2.95 24 SOUTHWICK 95 TS 1986 + 0.85 1.81 - 1.38 4.46 < 24 STERLING 1 ST 1947 ----- + 0.07 . + 0.44 2.65 25 STERLING 177 ST 1995 + 0.40 - 0.83 ----- 13.96 26 SUNDERLAND 7 SS 1957 + 4.07 + 0.43 + 1.63 14.10 :23 SUNDERLAND 68 VS 1983 + 0..83 - 0`.36 =': 0.08' 2.93 ' 23 TAUNTON 337 TS 1964 + 0.07 ° - 0.75 + 0.35 7.80_ 3/1 TEMPLETON: 3 VS 1957 - 0.86 - 0..41 +. 0.07 3.46 . 2-5 TOPSFIELD 1 HT 1936 + 2.57 2.98 + 1.23 8..66 - 23 TOWNSE-ND 13 TS 1965 + 0`.62 .','= 0.97 + 0.00 13.60 23 TRURO :1 TS 1950 + 0.48 - 0.72 + 0.01 10.80 23 TRURO 89 TS 1962 + 0.19 - 1.13 - 0.33 12.23 23 WAKEFIELD 38 FS .1965 - 0.50 - 1.44: .. 4- 0.03 6.14 23 WARE 43. VS 1965 + 2.37 - 1.10 + 0.00 9.14 3 WAREHAM-51 TS 1559 + 0.55 2.43 1.32. 8.26 24 WAYLAN ` 2 TS 1965 + 0.15 0.29: + 0.59 . 1.5.37 24 WEBSTER 1. HS 1958 + 0.59 + .:0.04 . +:. 0.26 13.55 25 WELLFLEET 17 VS 1962 - 0.25 - 1.68 1.20 11.66 23 WENHAM;.76 VS 1965 - 0.53 , - 1.83 - 0.32 2.56. . 23 WEST ,BflYLSTON_26 SS.•1,995 + 1.02 - 2.33 ----- 4.39 2'5 WEST BOYLSTON 27 HT 1995 + 1.66 -. 3.89 ----- 17'.44 25 SII WEST BOYLSTON 28 VS 1995 - 0.08 - 2..08 ----- 11.58 25 WEST BROOKFIELD 2 TS 1959 + 0.21 - 0.40 - 0.44 19.55 25 WEST BROOKFIELD 10 ST 1970 + 1.99 + 0.03 + 1.12 2.79 25 WESTHAMPTON 20 SS 1986 + 3.08 - 3.70 - 2.75 . 1.4.15 < 24 WESTFIELD 62 SS 1957 +; 1.53 - 0.62 - 0.05 7.33 24 WESTFIELD 152 TS 1986 + 0.08 - 0.07 + 0.37 3.05 24 WEYMOUTH 2 FT 1965 + 0.59 1.37 + I.'42 7.32 24 r WEYMOUTH 3 VS 1965 - 0.56 - 1.42 - 0.23 4.81 24 WEYMOUTH 4. TS 1965 0.65 - 1.37 + 0..2.6 6.11 24 WILBRAHAM 55 TS 1965 + 4..01 + 0:07 + 0.04 39.79 23 WILMINGTON 78 FS 1951 + 0.-36 1.51 = . 0..06 7.39 23 WINCHE.NDON 13 . ST. 1,939 + 3.90 - 1.,60 + 0.54 4.60 . 25 WINCHESTER 14 ST 1.940 - 0..41 3..98 + 0..67 8.60 23 WORCESTER 274 TS 1965- 0.22 - 0.50 0..17 23.60 25 SUMMARY OF-GROUND-WATER LEVELS FEBRUARY 1999. PROVISIONAL 2 of4 8/11/99 2:48 PM TO: NORTH ANDOVER, MASS September 12 19 84 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage Disposal System This is to certify that I have reviewed the construction materials of 'said disposal system at Lot 9, Bridges Lane North Andover, Mass. The grades are as shown on the as-built plan 4� ?.$. % ptember 4 19 84 4 ILLIW ^ Reg. P f. Eitga n n eg. Sanitarian A No.31012 ,�