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Miscellaneous - 1175 TURNPIKE STREET 4/30/2018 (2)
COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICEC OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION METROPOLITAN BOSTON - NORTHEAST REGIONAL OFFICE ARGEO PAUL CELLUCCI TRUDY COXE Governor Secretary DAVID B. STRUHS Commissioner October 14, 1998 Charles Carrell B.C. Realty Trust 1175 Salem Turnpike North Andover, MA 01845, I, 119 8 RE: APPROVAL OF TIGHT TANK (BRPWP64a) 1175 Salem Turnpike, North Andover (IRV) DEP Transmittal No. 200198 Dear Mr. Carrell: The Metropolitan Boston -Northeast Regional Office of the Department of Environmental Protection has received and reviewed your application for approval of a tight tank pursuant to 310 CMR 15.000, Title 5 of the State Environmental Code, with the above transmittal number. This application contained written notification, dated August 27, 1998, stating that the North Andover Board of Health had approved the installation of a tight tank. Accompanying the application were plans and materials titled as follows: Title: Sewage Disposal System Upgrade Location: A.B.C. Bus Company, 1175 Salem Turnpike Municipality: North Andover Applicant: B.C. Realty Trust Designer: Vaclav Talacko, P.E. 34026 Date (Last Revision): August 24, 1998 (September 16, 1998) An engineer of the Department reviewed the plans and the accompanying data, and it is the opinion of the Department that the plans are in compliance with 310 CMR 15.000. It is the opinion of the Department that the requirements for the granting of an approval as specified at 310 CMR 15.260 have been satisfied. The tight tank is to be used to service a commercial bus line. Because of site restrictions, including drainage swales, there are no other feasible alternatives that would allow a conventional or an approved alternative sewage disposal system for new construction. There is also the proposed construction of a municipal sewer system which is scheduled to be available to service the facility sometime in the near future. As part of its approval of the tight tank, the Department will require that the following conditions be complied with by the applicant and all subsequent owners or this approval be rendered null and void: 205a Lowell St 0 Wilmrogton, Massachusetts 01887 0 FAX (978) 661-7615 0 Telephone (978) 661-7600 0 TDD # (978) 661-7679 • Prior to construction, the applicant must obtain a Disposal System Construction Permit (DSCP) from the North Andover Board of Health. • Where any portion of the proposed tight tank is placed at or below the groundwater table, the tank shall be designed with counter weights, anchors or ballast and a buoyancy calculation for the entire volume of the tank, when empty, shall be performed. • An operation and maintenance (O&M) plan, acceptable to the North Andover Board of Health, shall be implemented which requires monitoring of the system at a minimum frequency of once every three months. • The tank shall be pumped as often as needed and the applicant shall maintain an updated record of the pumping history of the tight tank, including the date pumped, the quantity of effluent pumped, all analytical results performed to characterize the contains of the tank and the disposal site. • Failure of the applicant or person having control of the tight tank to properly maintain it and keep it from overflowing shall constitute grounds for revocation of the approval for the use of such tank. • It is the applicant's responsibility to assure that the approved plans are available at the site during construction. • Approval of the proposed tight tank also is conditioned upon the recording in the appropriate registry of deeds of a notice that discloses the existence of this tank and the involvement of the Department in the approval of the sewage disposal system. • When a sewer system becomes available, the applicant or person having control of the tight tank shall connect to the sewer within thirty (30) days and the tank system shall be abandoned in accordance 310 CMR 15.354, Abandonment of Systems. The special conditions, outlined above, in no way should be viewed as superseding any conditions imposed by the North Andover Board of Health. The above conditions are meant to supplement any other conditions imposed upon the facility. If you have any questions or additional information is required, please contact George Kretas at (978) 661-7744. Sincerely, Madelyn Morris Deputy Regional Director Bureau Resource Protection mm\gak CC: - Sandra Starr, Board of Health, 20 School Street, North Andover, MA 01845 - Vaclav Talacko, P.E., Hancock Engineering Associates, 235 Newbury Street, Danvers, MA 01923 - Marcia Sherman, BRP/Wastewater Management/Boston h^ Massachusetts Department of Environmental ProtectioniA. Application Information 3. Three (3) copies of Transmittal Form for Permit Application and Payment Transmittal # 200198 Permit, approval or other category : a ®©� ®®❑4- ❑A (7 or 8 character code from first page of'How to Apply" instructions, e.g. BWPAQOI, BRPWP596, etc.) - ...................................................................................................................... . Name of Permit Category _ 1. Please type or print........Ot.iJ ........�.N s l A`LS,.'...... �..I N` r.-%........ A� A separate Transmittal Brief Project Description Form must be completed for each B Applicant • Legally '-•.•- Official permit application. 2. Your check shouldT� TQv S �11� �.�►^ iZ�ES CAe'Pa•'tL be made payable to the Last Name First Name Middle Initial Commonwealth of—J„� "�uQtii Q�% Massachusetts. Please .............. ............... ......................................................................................................................................... mail your check along Address with a copy of thisform 1b'1rOCJiP.,%................ 41$�l.,S,'................ ...................... .... 03.3...)5..3 to: DEP, P.O. Box 4062, n--_******--*- Stafe Zip Code Telephone Number Boston, MA 02211. 41' ....... this form will be needed. _ • • ' - • • • • • • , Copy 1 (the original) must accompany your ��L �JS Gp • ............ C/t� i�tA��-a.:S ................... .r............................................... C� �LC> ¢�IF............................................................ permit application. Name of Facility, Site or Individual Copy 2 must.►� \�.7Ar........ _1..4;;x. t.....T.4)5�.. ..`..... ....................................................................................................................... Q, accompanyyour fee payment. Address 1 iN111 �I�e. A !i1$q \1�, �'! Copy3 should be retained for your records .�............................................................. Cky/Town .................................................................................................................................................... State Zip Code Telephone Number G.4tLr,-4.............................................................................................................................................:. Contact this form will be needed. _ • • ' - • • • • • • , Copy 1 (the original) must accompany your ��L �JS Gp • ............ C/t� i�tA��-a.:S ................... .r............................................... C� �LC> ¢�IF............................................................ permit application. Name of Facility, Site or Individual Copy 2 must.►� \�.7Ar........ _1..4;;x. t.....T.4)5�.. ..`..... ....................................................................................................................... Q, accompanyyour fee payment. Address 1 iN111 �I�e. A !i1$q \1�, �'! Copy3 should be retained for your records .�............................................................. Cky/Town .................................................................................................................................................... State Zip Code Telephone Number 4. Both fee -paying and D. ApplicationPrepared • exempt applicants must mail a copy of this transmittalform to DEP, ..... tJ...........L................�................................................................................................... L�................................................ P.O. Box 4062, Boston, Last Name First Name Middle Initial MA-, 02211 . ....... I.. ....S... 17•............................................................................................................................................. Address For 'DEP Use Only %Ct l\(S. iZS...............................MSS..................r W.. z.zj................ �I��!....7. n.S.O.-S-7b ................. Permit No. City/Town State Zip Code Telephone Number Recd Date Reviewer.............. A.G.L.AV.......%A.�..pt.G.�G7r..l...Q..G................................. ...............)............................................................................ ❑ Approved ❑Denied Contact CSP Number for 21 E only Decision Date DEP offers coordinated reviews of multiple permit projects. Check here U if this application is part of a larger project for which two or more DEP permits are being or will be sought. Please indicate the project's EOEA file number (assigned when an Environmental Notification Form [ENF] is submitted to the Massachusetts Environmental Policy Act [MEPA] unit.) EOEA#F—][--]1-17F—1 Project is not subject toMEPA Is this the first DEP permit application submitted for the project? yes E]no If no, indicate previously assigned DEP Project Code: 01-1 F-1 1-11-1 F-1 F. Amount Due I Special Provisions: ❑ Fee Exempt' (city, town or municipal housing authorrty)(state agency if fee is $100 or less) ❑ Hardship Request (payment extensions according to 310 CMR 4.04(3)(c)] ❑ Alternative Schedule Project (according to 310 CMR 4.05 and 4.10) 'There are no fee exemptions for 21E, regardless of applicant status s Check# Z 1 Z , Dollar Amount $ 3dp Date: _ �a Make check payable to the Commonwealth of Massachusetts. Please mail check and one copy of this form to DEP, P.O. Box 4062, Boston, MA 02211 rev: 07,9748 Massachusetts Department of Environmental Protection Transmittal # Z0019% Bureau of Resource Protection - Water Pollution Control Facility ID (if known) Title 5 Permit Application -- BRP WP 59a Approval of Septic Tank in Parallel or Connected to a Sewer BRP WP 64a Approval of Tight Tank This application is to be filed by persons required to obtain approval for the categories specified above in accordance with 310 CMR 15.000: The State Environmental Code Title 5: Standard Requirements for the Siting, Construction, Inspection, Upgrade and Expansion of On-site Sewage Treatment and Disposal Systems and for the Transport and Disposal of Septagge. DEP approval is subject to fees established under Massachusetts General Laws, Chapter 21A, Section 18 and regulated under 310 CMR 4.00 Timely Action Schedule and Fee Provisions. Note: Applications for modified tight tanks pursuant to the provisions of 310 CMR 15.261 must apply using the category for review of Department variances: BRP WP 59c. A. Applicant Information 1. Which permit category are you applying for? ❑ BRP WP 59a (per 310 CMR 15.225, 15.354(2) S BRP WP 64a (per 310 CMR 15.260) 2. Applicant. ----- qP — Name — — Address City/Town State Telephone 3. Facility Address/Location: --�� '"--$Ac=—_'y_-_t-T- k----- -- Q --Aar+ -%J- Aar -1'lA--0-1945 4. Design Engineer or Sanitarian: Name Address City/Town State -- q'7 $--_'�"�"� 3 c S- ------------ . Telephone - BRP WP 59a, 64a.App -----.Rev. 3/31/95 Massachusetts Department of Environmental Protection Transmittal # Z00 MS Bureau of Resource Protection - Water Pollution Control Facility ID (if known) _ 5. Registration: --- yacy_.Av-=----V.c,�Go------ P.E. ----------------------------------- -------------------- Sanitarian ------------ __ 3`-i z ------1--gip`------ Registration Number 6. Does this project require a filing under 301 CMR 11.00 and MGL C.30 ss 61-62H, the Massachusetts Environmental PolicyAct? `/ ❑ Yes (MEPA #� L( No If yes, has final action been taken? ❑ Yes (Date ) ❑ No 7. The legal entity which will own this facility is: ❑ -Individual ❑ Municipality 0 - Private Partnership ❑ Federal ❑ State/County ❑ orporation Other (Specify) ----- - -- �}--- � t-------------------- ---------------------------------------------------------- 8. Two (2) complete sets of plans and specifications, including a locus map, properly stamped and signed by a Massachusetts Registered Professional Engineer or Massachusetts Registered Sanitarian must accompany the application.- The plans must be prepared in accordance with 310 CMR 15.220. Are plans and specifications enclosed?-- - - MreYes ❑ No J Have the plans been revised? B Y -es ❑ No d I (, 19% 9. If applying for a tight tank (BRP WP 64a) and the system had failed, documentation must be submitted supporting the determination that no other feasible alternative exists to upgrade the system in accordance with 310 CMR 15.201 through 15.293. Is the documentation attached?- 0111y, ttached? Yes ❑ No Sri A ::.:.____BRP WP -59a, 64a.App Rev. 3/31/95 -- Massachusetts Department of Environmental Protection Transmittal # Bureau of Resource Protection - Water Pollution Control Facility ID (if known) 10. If applying for a tight tank (BRP WP 64a) for new construction or for increased flow to existing— systems, and the system is for boat waste pump -out facilities, documentation must be submitted supporting the determination that no other feasible alternative exists. Is the documentation attached? ❑ Yes ❑ No Nb 11. If applying for a tight tank (BRP WP 64a) for new construction or for increased flow to existing systems and the system serves buildings necessary for the operation of a public water supply, documentation must be submitted supporting the determination that it is not feasible to connect to a sewer or to construct a system in compliance with 310 CMR 15.000. Is the documentation attached? ❑ Yes ❑ No 12. If applying for a tight tank (BRP WP 64a), a plan for the disposal of the contents, including the method and frequency of disposal and a written statement from a licensed septage transporter specifying a disposal site and method of disposal, must accompany this application. Isthe plan and statement attached? M/Yes 04,40 13. If applying for a tighttank (BRP WP 64a), an operation and maintenance plan -acceptable to the local approving authority must accompany this application. Is the plan attached? RYes ❑ No 14. Is the complete application submitted to the local authority attached? VYes ❑ No B. Certification "I certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there are significant penalties for submitting fall atiorinthe possibility of fine and imprisonment for knowing violations." -- ----- ---------------- Aant's sign — --------------- Print Name Name of Preparer --------------------------------------------- Date =$RFI -WP 59a, 64a.App_ Rev_ 3/31/95 Town of North Andover a NORTH OFFICE OF �� o •``� �� COMMUNITY DEVELOPMENT AND SERVICES 30 School Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT SSACNuSE Director September 4, 1998 Jeremy Matosky Hancock Engineering Associates 235 Newbury Street Danvers, MA 01923 RE: 1175 Turnpike Street Dear Mr. Matosky: This is to confirm that on August 27, 1998 at their regularly scheduled meeting, the North Andover Board of Health approved your application for a tight tank for the property referenced above, conditional upon approval of DEP. Please copy the Board of Health when you send your application to the State Department of Environmental Protection, which, as you are aware, is necessary before the plans are approved and a permit issued. Please call the office at the number below if you have any questions. Sincerely, D4 �fflaa-wor Sandra Starr, RS. Health Administrator Cc: File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 MANAGEMENT, OPERATION & MAINTENANCE for HOLDING TANK located at ABC BUS COMPANY 1175 TUNPIKE STREET NORTH ANDOVER, MA OWNER B.C. Realty Trust c/o Charles Carrell 1175 Turnpike Street North Andover, MA MANAGEMENT 1. A disposal agreement for the HOLDING TANK shall be established with a licensed septage transporter. Said agreement shall include location and method of disposal. 2. Said agreement shall be for a minimum of one year. 3. In the event municipal sanitary sewer becomes available, the HOLDING TANK shall be pumped and abandoned, and the building connected to the sewer within 30 days. OPERATION 1. As -built plans showing the location of all installed components shall be kept on site. 2. Any odor problems shall be immediately reported to the North Andover Board of Health. 3. The HOLDING TANK shall be used for storing waste effluent only. 4. A copy of all pumping records shall be submitted to the Board of Health. MAINTENANCE 1. The HOLDING TANK shall be pumped as required. The visual and audible alarms shall be set to signal when the tank is 3/5 full. 2. The septage transporter shall be notified when the HOLDING TANK is 3/5 full or whenever the alarm is triggered. 3. The visual and audible alarm shall be tested at least once every three months to ensure that it is functioning properly. MANAGEMENT, OPERATION & MAINTENANCE for HOLDING TANK located at ABC BUS COMPANY 1175 TUNPIKE STREET NORTH ANDOVER, MA OWNER B.C. Realty Trust c/o Charles Carrell 1175 Turnpike Street North Andover, MA MANAGEMENT 1. A disposal agreement for the HOLDING TANK shall be established with a licensed septage transporter. Said agreement shall include location and method of disposal. 2. Said agreement shall be for a minimum of one year. 3. In the event municipal sanitary sewer becomes available, the HOLDING TANK shall be pumped and abandoned, and the building connected to the sewer within 30 days. OPERATION 1. As -built plans showing the location of all installed components shall be kept on site. 2. Any odor problems shall be immediately reported to the North Andover Board of Health. 3. The HOLDING TANK shall be used for storing waste effluent only. 4. A copy of all pumping records shall be submitted to the Board of Health. MAINTENANCE 1. The HOLDING TANK shall be pumped as required. The visual and audible alarms shall be set to signal when the tank is 3/5 full. 2. The septage transporter shall be notified when the HOLDING TANK is 3/5 full or whenever the alarm is triggered. 3. The visual and audible alarm shall be tested at least once every three months to ensure that it is functioning properly. 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION 15.300: continued (3) The Department shall produce educational materials suitable for distribution to the general ; public describing the importance of proper maintenance and operation of on-site systems and the impact of such systems on public health and the environment. In addition to its own distribution, the Department shall make such materials available to local approving authorities and other interested persons. (4) Any person owning or operating a facility on which an on-site subsurface sewage treatment and disposal system is installed shall be responsible for the inspection and maintenance of, and any necessary upgrades to, the system. (5) Facilities with an increase in the nitrogen loading rate in accordance with 310 CMR 15.262(6) and (7) shall be inspected annually. The inspection shall document at a minimum the continued operation of the system as approved, if the system consists of a Greywater filter that it is operating properly, and compost and blackwater is disposed of off-site in accordance with all applicable laws and regulations. The results of each annual inspection shall be submitted to the Department and the local Approving Authority by January 31" of the following year. 15.301: System -ins ,pection (1) Inspection at Time of Transfer. Except as provided in 310 CMR 15.301(2), 15.301(3), and 15.301(4), a system shall be inspected at or within two years prior to the time of transfer of title to the facility served by the system. An inspection conducted up to three years before the time of transfer may be used if the inspection report is accompanied by system pumping records demonstrating that the system has been pumped at least once a year during that time. If weather conditions preclude inspection at the time of transfer, the inspection may be completed as soon as weather permits, but in no event later than six months after the transfer, provided that the seller.notifies the buyer in writing of the requirements of 310 CMR 15.300 through 15.305. A copy of the complete inspection report shall be submitted to the buyer or other person acquiring title to the facility served by the system. (2) The following transactions shall not be considered transfers of title for the purposes of 310 CMR 15.301(1): (a) taking a security interest in a property, including -but not limited to issuance of a mortgage; (b) refinancing a mortgage or similar instrument, whether or not the identity of the lender remains the same; (c) a change in the form of ownership among the same owners, such as placing the facility within a family trust of which the owners are the beneficiaries, or changing the proportionate interests among a group of owners or beneficiaries; (d) adding or deleting a spouse as an owner or beneficiary; or a transfer between spouses during life, out right or in trust; or the death of a spouse; (e) the appointment of or a change in a guardian, conservator, or trustee. (3) Applicability to Specific Transfers of Title. (a) Units in a Condominium or CoUerative Co oration. The cooperative corporation or condominium association shall be,responsible for the inspection, maintenance, and upgrade of any system or systems serving the units, unless otherwise provided in the governing documents of the condominium association or the cooperative corporation. For a facility comprised of five or more condominium or cooperative units, each system located on the facility shall be inspected at least once every three years instead of at time of transfer of title and all existing systems shall be inspected by December 1, 1996. For a facility comprised of fewer than five condominium or cooperative units: 1. each system located on the facility shall be inspected at least once every three years and all existing systems shall be inspected by December 1, 1996, or 2. at the time of transfer of title of any unit, the system serving that unit shall be inspected in accordance with the time of transfer provisions of 310 CMR 15.301. 4/21/06 310 CMR - 548 AUG -26-98 WED 12:26 PM CURRIER SEPTIC 508 750 0206 107 Foroat St. p\� Middleton, MA 01949 O� (508) 774-2772 5tiQ �rPv�C� B.C. REALTY TRUST ATTN: CHARLES CARREL RE: ABC BUS COMPANY 1175 TURNPIKE STREET NORTH ANDOVER, MA 01845 AUGUST 26, 1998 TO WHOM IT MAY CONCERN: CURRIER SEPTIC & DRAIN SERVICE, HAS AGREED TO PUMP, HAUL, AND DISPOSE OF WASTE FROM THE HOLDING TANK AT A.B.C. BUS COMPANY. WHICH IS LOCATED AT 1175 TURNPIKE STREET, NORTH ANDOVER CURRIER SEPTIC & DRAIN SERVICE WILL DISPOSE OF THIS WASTE AT GREATER LAWRENCE SANITARY DISTRICT WATER TREATMENT PLANT. WE WILL BE PUMPING 6,500 GALLONS UPON REQUEST PER A.B.C. BUS COMPANY. SINCERELY, - DAVID CURRIER PRESIDENT -- -%IHE PROFESSIONAL EXPERTS IN THE SEPTIC ANTWWN INDUSTRY -e= --- P.02 N N z Q a O U N w z m w N a w w z w rm 0 N ril a ti s C- ru 0 rm a a 0 Ln RJ Er ru 0 0 HANCO K COO p� Engineering Associates #6676 Re: 1175 Turnpike Street (Route 114) — Septic Design Dear Sandy; Enclosed please find the design plans for the tight tank at the ABC Bus Co. Property located at 1175 Turnpike Street (Map 107c Lot 12). We are proposing to utilize a tight tank to store effluent for the site for the following reasons: 1. The existing, system is currently in failure. 2. Lack of suitable soils on-site, official and unofficial soil testing (see attached) did not yield an area suitable for construction of a soil absorption area: 7 3. Percolation rates were greater than 90 min/in, therefore an Innovative/Alternative system was not considered a feasible option. 4. Currently, there is a proposed sewer force main along Route 114 being reviewed by the State. If sewer were to become available the owner would discontinue use of the tight tank and connect to the sewer within 30 days in accordance with 310 CMR 15.260(5) The minimum required storage volume is 6,500 gallons based on the design flow which was determined to be 1298 gal/day. The design flow was calculated using 150 gal/day for each service bay and 75 gal/day per 1,000 square feet of office space in accordance with Title 5. We expect the actual flow to be significantly lower than the design flow which will allow for less frequent pumping than the required 5 day minimum storage. The proposed tank will be installed in front of the existing building, will be accessible 24 hours per day and will have a visual and audible alarm to prevent overfilling. We have also enclosed a draft copy of the Operation & Maintenance Plan and a letter from Currier Septic & Drain regarding a contract to dispose of waste from the site. In accordance with 310 CMR 15.260 we are seeking local approval of the design. Once we have the local approval we will be submitting to MDEP for the required approval (BRP WP 64a) to install a tight tank. If you require any additional information or have any questions please contact our office. Sincerely; HANCOC ,ENGINEERING ASSOCIATES Jeremy M. Matos Project Engineer Enclosures cc: Charles Carrell, B.0 Realty Trust, HSA File Division of Hancock Survey Associates, Inc. Iz 235 Newbury Street August 24, 1998 Danvers, MA 01923 (978)777-3050 Fax (978)774-7816 Sandy Starr Bolton, MA Board of Health (978) 779-6767 Town Hall Boston, MA North Andover, MA 01845 (617) 350-7906 Re: 1175 Turnpike Street (Route 114) — Septic Design Dear Sandy; Enclosed please find the design plans for the tight tank at the ABC Bus Co. Property located at 1175 Turnpike Street (Map 107c Lot 12). We are proposing to utilize a tight tank to store effluent for the site for the following reasons: 1. The existing, system is currently in failure. 2. Lack of suitable soils on-site, official and unofficial soil testing (see attached) did not yield an area suitable for construction of a soil absorption area: 7 3. Percolation rates were greater than 90 min/in, therefore an Innovative/Alternative system was not considered a feasible option. 4. Currently, there is a proposed sewer force main along Route 114 being reviewed by the State. If sewer were to become available the owner would discontinue use of the tight tank and connect to the sewer within 30 days in accordance with 310 CMR 15.260(5) The minimum required storage volume is 6,500 gallons based on the design flow which was determined to be 1298 gal/day. The design flow was calculated using 150 gal/day for each service bay and 75 gal/day per 1,000 square feet of office space in accordance with Title 5. We expect the actual flow to be significantly lower than the design flow which will allow for less frequent pumping than the required 5 day minimum storage. The proposed tank will be installed in front of the existing building, will be accessible 24 hours per day and will have a visual and audible alarm to prevent overfilling. We have also enclosed a draft copy of the Operation & Maintenance Plan and a letter from Currier Septic & Drain regarding a contract to dispose of waste from the site. In accordance with 310 CMR 15.260 we are seeking local approval of the design. Once we have the local approval we will be submitting to MDEP for the required approval (BRP WP 64a) to install a tight tank. If you require any additional information or have any questions please contact our office. Sincerely; HANCOC ,ENGINEERING ASSOCIATES Jeremy M. Matos Project Engineer Enclosures cc: Charles Carrell, B.0 Realty Trust, HSA File Division of Hancock Survey Associates, Inc. Iz MANAGEMENT, OPERATION & MAINTENANCE for HOLDING TANK located at ABC BUS COMPANY 1175 TUNPIKE STREET NORTH ANDOVER, MA OWNER B.C. Realty Trust c/o Charles Carrell 1175 Turnpike Street North Andover, MA MANAGEMENT 1. A disposal agreement for the HOLDING TANK shall be established with a licensed septage transporter. Said agreement shall include location and method of disposal. 2. Said agreement shall be for a minimum of one year. .. 3. In the event municipal sanitary sewer becomes available, the HOLDING TANK shall be pumped and abandoned, and the building connected to the sewer within 30 days. OPERATION 1. As -built plans showing the location of all installed components shall be kept on site. 2. Any odor problems shall be immediately reported to the North Andover Board of Health. 3. The HOLDING TANK shall be used for storing waste effluent only. MAINTENANCE 1. The HOLDING TANK shall be pumped as required. The visual and audible alarms _ shall be set to signal when the tank is 3/5 full. 2. The septage transporter shall be notified when the HOLDING TANK is 3/5 full or whenever the alarm is triggered. - — 3. The visual and audible alarm shall be tested at least once every three months to ensure that it is functioning properly. - AUG -26-98 WED 12:26 PM CURRIER SEPTIC 508 750 0206 P.02 Mlddll ton Forest 01949 (508) 774-2772.fidLQh Qv� ev 5� B.C. REALTY TRUST ATTN: CHARLES CARREL RE: ABC BUS COMPANY 1175 TURNPIKE STREET NORTH ANDOVER, MA 01845 AUGUST 26, 1998 TO WHOM IT MAY CONCERN: CURRIER SEP'T'IC & DRAIN SERVICE, HAS AGREED TO PUMP, HAUL, AND DISPOSE OF WASTE FROM THE HOLDING TANK AT A-B.C. BUS COMPANY. WHICH IS LOCATED AT 1175 TURNPIKE STREI+'I', NORTH ANDOVER. CURRIER SEPTIC & DRAIN SERVICE WILL DISPOSE OF THIS WASTE AT GREATER LAWRENCE SANITARY DISTRICT WA'T'ER TREATMENT PLANT. WE WILL BE PUMPING 6,500 GALLONS UPON REQUEST PER A.B.C. BUS COMPANY. SINCERELY, - DAVID CURRIER PRESIDENT - 4i 111E PROFESSIONAL EXPERTS IN THE SEP11C AN6_01AIN INDUSTRY-�— — Off' P1 C- % Net, FORM 11 - SOIL EVALUATOR FORM Page I of 3 No. (P G-7 Le Date: Commonwealth of Massachusetts N. Atsoo\xz—,e- , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal Performed By: ............. Date: r-> $ Witnessed By: SOZE T:b2-9 .. .. ..... ........ Ltcawn Addras a 11-15, I -PV—. (;q114) 1z="Crj Ad&us. and Tckphwv I %%4 Few Construction 0 Repair(g Not "A Office Review Published Soil Survey Available: No ❑ Yes Year Published Publication Scale Soil Map Unit Drainage Class Soil Limitations ......................................... Surficial Geologic Report Available: No 0 Yes El Year Published Publication Scale GeologicMaterial (Map Unit) ........................................................................................................................ Landform .............. Flood Insurance Rate Map: Above 500 year flood boundary No E]Yes El Within 500 year flood boundary No E]Yes 0 Within 100 year flood boundary No Oyes n Wetland Area: National Wetland Inventory Map (map unit) ....... .......................................................................... ... . ................... Wetlands Conservancy Program Map (map unit) ........ 4 ......................... . ........................................................... Current Water Resource Conditions (TJSGS): Month Range :Above Normal El Normal El Below Normal El Other References Reviewed: DEP APPROVED FORM - 12107/95 rrvG- FORM 11 -SOIL EVALUATOR FORNI Page 2 of 3 Location Address or Lot No. _l 1 "7S S4�MI HAr Ia-7c ?TCc¢ry Atwov.� 1 MA On-site Review Deep Hole Number T- l Date:. (-P"" Time:.:" - IZ:60 Weather SyN 5" Location (identify on site plan) Land Use +4lr Slope (°k) "Z�o. Surface Stones Nva Vegetation f6i"-- Landform . Position on landscape (sketch on the back) Distances from: �� Open Water Body._ r'J�� feet Drainage way 7 I1*0 feet Possible Wet Area le� feet Property Line .t_15p feet Drinking Water Well feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) M(—L- 1�Iv lsGoD ( a Parent Material (geologic) "(" (ILj_ DepthtoBedrock:_ Depth to Groundwater: Standing Water in the Hole: rJ a Weeping from Pit Face: _ Estimated Seasonal High Ground Water: 5'711 L=VAt�UQ Wt,-rN��3S'. SVS (�DI✓� �3.0.1�> DEP APPROVED FORlt - 12/07/95 FORM 11 - _SOIL EVALUATOR F iv�%% OIt111 Page 2 of 3 Location Address or Lot iJo. _1 l TS S4L..--M M,4P IC'7C- MA On-site Review Deep Hole Number T I Date-.-5-Z(.v-q% Timer �� IL:Do Location (identify on site plan) Weather Land Use p•4'>Z.tiG----- Slope M). —2'o Surface Stones ?Vot u3 Vegetation �4�?T�— {� 1►..1�_ (�AQ� � � .�A Landform Position on landscape (sketch on the back) Distances from: Open Water Body.—W--IA— feet wa Drainage ao 9 y•feet Possible Wet Area 21��L feet Property Line"+'�.� .. ' - feet Drinking Water Well �i A feet Other DEEP OBSERVATION HOLE LOG' Parent Material (geologic) `T�� - - - Depthth ,/ toBedrock: ,/ Wa Depth to Groundwater Standing Water in the Hole: 0L ' u Weeping from Pit Face: _ Estimated Seasonal High Ground Water: L=VA"04 -to?- : �.'�¢2T�� Z`�lo�To sIG-{ W �T?uc�3�'. Svc DEP APPROVED FORM - 12/07/95 Depth from Surface (Inches) Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil MottlingOther (Structure, Stones, Boulders, Consistency, % Gravel) 0 — 5S' FILL _ --- C1.o�►ty 1 G P_.,vt>�. , A r. ` ::....� ``b v zq " 130 4(Co > so/. FIeM , .,cz -Z, >bo" &TIAN ►� F"rt--�ff Z -Cay 7.SYit MASS,%Ar-- FXLAekQ,- F -72M St$ (,00/,o 1-tMi e Q.4 5—fd�o Cvt3s -5 v p -tom Parent Material (geologic) `T�� - - - Depthth ,/ toBedrock: ,/ Wa Depth to Groundwater Standing Water in the Hole: 0L ' u Weeping from Pit Face: _ Estimated Seasonal High Ground Water: L=VA"04 -to?- : �.'�¢2T�� Z`�lo�To sIG-{ W �T?uc�3�'. Svc DEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR POIt111 Page 2 of 3 Location Address or Lot No. 11 -7 S S� k N1 (� l ,lA p 10_7c 07c �`Co eTtr A>tio o V, M A On-site Review Deep Hole Number T 3_ Date: S- �o''aa ;oo,-IZ •-----� Time:.. Weather Location (identify on site plan) S1c�rla , Land Use 'PArR.krN(r Slope (°�) '-Z•e. Surface Stones �rvo Vegetation �QpLt, -- (-L (FAQ 1Gpg A=.4' Landform , Position on landscape (sketch on the back) Distances from: Open Water Body.—I-4-LA— feet Drainage wa 9 y-� feet Possible Wet Area -� feet Property Line"+'�_ .. � �feet Drinking Water Well -143A feet Other DEEP OBSORVATION HOLE LOG' Depth from Surface (Inches] Soil Horizon Soil Texture (USDA) Soil Color (Munsell) Soil Mottlingother (Structure, Stones, Boulders, Consistency, % Gravel) �=7c.�, — — Com, G�►v� t,t,.,_ :.....1 , /� 1 D g g ZIP- asst VC—, , V—%arm (o16 -So ��..� FSc.. ►v �R .- 1't�ss 'R� Ait V" F1QM , So°1re GC2Av.z� .I Z� C' ��� Z•6Y irJ% YiASSit�kr-r-YL�At'SL•:rz V� y 13 1 .SYit z%' Parent Material (geologic) DepthtoBedrock: o Depth to Groundwater: Standing Water in the Hole: NDfVL: Np�Ls Estimated Seasonal High Ground Water.Weeping from Pit Face:_ �tr W . Sum I�DeO 3.O.ta uer �ettot+t;n Font - 12r0719s FORM 11 - SOIL EVALUATOR kOni Page 3 of 3 Location Address or Lot No. 1175' Sptiw•'T-� -1-Pk, �1AP 10-7c. lob IT) 'Non" ANOov.-`Q � MA Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole inches N Depth to soil mottles �" . inches ❑ Ground water adjustment feet Index Well Number Reading Date Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system?,`—�_ If not, what is the depth of naturally occurring pervious material? Certification I certify that on OCT. 15, t 96(date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DEP APPROVED FORM - 12/07/95 FOP.Al 12 - PERCOLATION TEST # COMMONWEALTH OF MASSACHUSETTS Massachusetts Site Passed ❑ Site -Failed X .......... a .......................................................................................................... .. ................ Performed By: Witnessed By: T --*-4 72—..0% t Comments: .... 1:)Zo.(zO . ...... zvo. IV ,a lb Zi CO CL b8 0 12,E o a co Q Co Jho \ V 4: LL 061 ' Y _ J N ` 1U3i1 L 0:- ` - Q �\o i, 01 N cj� � Ssb v�C-3� Q i i" ♦ 'awe` \ L ��;' •I rlv // `,o � , p: _ - North A dover - o t ) Center % - _ 220+ J�—� :.3 �, °._ �3 \,` OpLE �Oo / I�c'•,Rli)gewoo y'� \94 \\\ �7a"Hill K\ ° r 1 Iv if u��- / I.W. Franklin'�+•�� °'1, 3 oy� o'',h c \� ''o 0 .,,,�j .\\ !,p ti °• i90 0Ftesery irs11 0 am • I °�a�• \ o w- '� , _ - it if .239i.Hl '•��.•.•� \�8�� ��`:`.•• q Lc9tiF ;� �• p ` Ila. aN �_ t 1 S.� ler aek ;1 Z. ` 6T \ <5 ege - REp \ vel , �� \ `�7,1•n Pito ' �,°° - ��` o [ f, oodc uc _ o/. • \°l';i 1 ` X/,jc �/ .�,. • /7 moo_ 1 ` 3J H Itt \ •� ; \, -�� ' moo °� �238 ;� Clay _ ° , -,Hill 11A JMMER •S t' 1z' . .I iIARO1.D\�PAREf - Y�Z•o p - - ... y \ ` o• ., - )/ \. g}TATE FOREST 0� �,,° • _ BM 286 \ 'r (1 \\ if 1 _.. - _ ti. � O �� - - r;,o '�� .. ' , � •...0 �\` u ori - 215 74 A Oyj\ 1 - - - _ LiftB on WO n,111 291 �� \. .. %A III � o0 R \ \'w �n f poo- �1 To Ge s _ 14) If °27If i 5 V250_ - _. - m o U ��p�f,CVkf E % • O %�� ..�✓ • '-r s �\ �`ro ate a �. %f ii ti - - - ., \\ • �� �,. .�..,, . ^7. O Tan < f n �� J \asp �' s (• 0 ° . am / ii 5t1�%^ j� % • it �\\3 \ �a'., Zg, %213 - I \ �� ;1; STA 148 q ts O' 11y it o 1 5 °O� RP•l - ( �j� " '- 1_ lcc,.. `' •, S'i s \� _ Fc l s..-- .r �^ ?37 PF-L7. • r'Rq' '��, - :� ` - . O n .rN All Ii 4ROLD PA`RKERI \ J. • .. • ••`iii... . COUNTY ?,';S:�ICNUSE.1"TS )--?THERN PAR' SHEET NU?.'E3.: F' 36 o Sa w, se ,PB .CbB' RIB SrA Sh6 CbC ,Pe�`r ' .',CbC � y. Se Se }fWE'• Pg MA :. Gug S�6' rHfC ,CcD �t0r UD CaB rA .,CbC Min�'i G CbC r� HfA $rB Q p SubLWsC.. HfC tl , MmA r _ �L : • aq Se :.. G r19- ,� 5 �• sin' � / _ � ; • ' • F. r V s i S. Seg M HfD e s Sr6Gym G CcC 'Sr8 ,.� �/9 Wh } Pf s CrD HfB ; • m WOODCHUCK. Sa Wa6 CaB s Coc r xz I+a / �O HILL dq HfB jSr 'W iu S� . QbC V / L SUC' _ q�`Y' �/� � { PbB 9 :-RIB ,�`> �" ,� SrB � � � .. ;Za. UD • . 1C 1. r` yj� ��a . T ,,. zyr c<a .j ?Ju 3°t4 n •'A '�\ :� �•{.`Y , W • Ys �_ {7er . •f�� cMC - CbD j,,�" 1y�5}c '`s" i , �..i .ti 6C� ' � ` :f CD' ` iNC - AC° ,�r;o � t SV .,Y. 't rX', '� a1• Uii r�,c • ,I'S.r.�� '. �' h: N-G10f�"s4� - � � .. � - 'I ^T i D �(tF ijtl^ C>. .�,. ♦• t.� .. J' ;'S� �� .� S WSC kr ' Q d�D i i� Ff RIB CbD' ", .0 G rK S I Pt 8 F +�.' W4. v CvB` CoC Tti6 PcE,, ar .I U mc: lNhr P ID r - Cb6 y r r r &Ch a WsC 1 ,r �``o P`tlrc t ;.,'� CbC G »� ` ' s f J My°B 1 Sh6 Se C4C �r :• R_d_ A r• FI (C p Cb tl` ^+ \- H(B � s: ��. RdA <ri �. °s' r nz'"'i 'iti. .RoD• "` :. _..Cc' Pb8 �•� krf. •t, .ti 'SS r Y. ,Y RIA`:. T�. Y �`.Cc,. ,-•CrC \•.Wh _ .` A 4 `_ r ..Cb6 />4_' h -" is MC \ •� xv .< s ". `• YJsBsi- z Ur x _. .fit ! - l�<I Fvi '�c<si'',:S !. �' �:. hi 'i' •4.Yrz �. t ki3 y :5 a'ff a;�LVh LS z w'� r�! a roti r1 Paps rLC . R° 1. t F'w ; NLtAr .k �r,4 •�r _n ��. \'��• 4C t. a * r --I.r YD "CrCMC ` - ° •'M/nAl' 4�.� �y,yL�i•' a °,r e •�,'� ��"r> ,Rg Crp t'> !•K 1 -x}•4 ..t rr : I �f '�` s� } �• � t ;� _ �'- 1l `�,.5• �' f,.'. y O x,,� •4S' � �'S" �`rr. ^ PaC MC Ili _- >4 . 4 r� F. �fT Sf=,�`_ i�r' a s . . P e ' • H f 6 .?t�r'�• �- � . �L:i. a":, , a4-..:��%-";�� r 't' F .. t 4.;�W` OS'TON•+;i`.i MC Pe Pb6 •-.�r u-� CC}} '_,, ��•�''�•�: �• p# ` < - I: -,%- Sr6 G 1 �J- t jj tt�� , c f' iPCY`tq vgytf{� F{�ILL` r �• r;wLTty,'f;. rc r v f s r. !f rrti r. ` hQCwy , T r oU .4�,h :y.• f rl h`t t• .�,.• p 61 �yAti Cb8 z: �.�<'.C:•fa ii•r' ;Ei ' t.l-...j `�• ri r. . yT C�y6�8 s r 1' �' ' �s �� �L•C'�� ��'� � -� • � - a � �, i,� G. r •?l4�`.;!ir•• Y 'a•�, W .'4 ;'' bF)T Als _'Y s;�r'� .G• • f � ��� li' < K J d ti M I _ �/ _` •1 Jwj 1 - t1:1 •!n y is �`' Cbl -� ` .(I, h ', \•. r r.Mc } � >• ..C6� > '-� -�i � r ] akl .r c � � >;�. r t 1' �d �r4 rY S` r _,� il• �;. -Y ->.-'G Vim\ rte• ��• y. ,. z: I, ! � WSB , y :!N ° t . � ' � �j,r�KF � � �� •.+. �,. �8 J� •° X ,"�C x• F ,Oet' ,r ' '>- c % c `.' t ';',yi >' ter �t�: " e• �.i.:i -,{�o�gF 9 14r °y -'a� . '{;: •` � .r, �'" \-f�yrf�F�"t�:�Q �A K1.,••,4ar C�y�-'.•=�•'� Y� t� Hf6 ry'�, � � tt�Y2 A*Ir ' • ,rwC. MD t -\rte SrA r�. CbC Vie. f. Y, f .CiC: , r CrC = •yiA�t,..As.>. -� �yt . •1•`�, Pe til/ SrA jy ,�2y �i. .�^�. G .Wh �* �r �f26C'+t t,,RoD•.,a` ;MC �'�bp�. �'�� �;�',• 114 CrB,\ ,,Seti. x,'. ,.H - FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 No. 76 . Date: 4Z Commonwealth of Massachusetts 'm . A-njovLr , Massachusetts Soil Suitability Assessment ,for On-site Sewage Disposal Performed By: �,Irr� ..-A.t>�t� Date: �1Z3-`�8 Witnessed By: — l'Nici [-F 1 u f) L— J LA=tan Address or >�US Cp owKr: Name. PC Z=-AC.TIyp Tt2V5T I1 lar 1175 TL, n P, l� ST Address. &Mjyl,r Cl�gy iC S CA Y f L'.(I N occ-r�-+.4� couez MA rekplbne , 1175 7-bemPi IKE -vT ew Construction ❑ Repair N. /-�NDOVE72 tr1')i'i Ultice Keview Published Soil Survey Available: No ❑ Yes Year Published jg8j Publication Scale I�0 Soil Map Unit L05B k Drainage Class Soil Limitations ............................. ............ ........._ . . Surf icial Geologic Report Available: No El Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) ................................ Landform Flood Insurance Rate Map: Above 500 year flood boundary No ❑ Yes 9 Within 500 year flood boundary No Eyes ❑ _ Within 100 year flood boundary No KYes ❑ Wetland Area: National Wetland Inventory Map (map unit) -......................................................................................._.............. Wetlands Conservancy. Program Map (map unit) .................................. I...................................................... - Current Water Resource Conditions (USGS): Month - Range :Above Normal (Normal ❑ Below Normal ❑ Other References Reviewed: DFP APPROVED FORM • 12/07/95 fnn_....1,�ag FORA 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. Oft -site Review Deep Hole Number T-- y Date: �p f �0 Time: Weather Location (identify on site plan) Land Use F�I121U Q (o LO -r Slope (%) d-3 Surface Stones BONE Vegetation n! C)KI S Landform Position on landscape (sketch on the back) Distances from: Open Water Body I C�o + feet Possible Wet Area 100 4- feet Drinking Water Well NIA feet Drainage way feet Property Line 1,D4 feet Other DEEP OBSERVATION HOLE LOG' _ Depth from Surface (Inches) Soil Horizon Soil Texture (USDA] Soil Color (Munsell) Soil Mottling Other Structure, Stones, Boulders, Consistency, % Gravel) -0 :Ne � S 7,sy2�� E�. Iln - IS(o C I SAND/ z,�Sy�iZ l5/ ��J�. L01W L4Iloy ro A 5 1011- v1-IPi5uE: MINIMUM OFTY3=11-1m,"Mil I P" .5 uE:— F7i ?—�l Parent Material (geologic) T1 L_(-., Depftoaedrock:15y� fr t Depth to Groundwater: Standing Water in the Hole: D fA" Weeping from Pit Face: vv��p rr Estimated Seasonal High Ground Water: i DEP APPROVED Font • 12/07/9S FOR -%I 11 - SOIL EXALUATOR FORA Page 2 of 3 Location Address or Lot No. I1�5 TSPi LE �T On-site Review Deep Hole Number Date: (Z3I� 0 Time: Weather Location (identify on site plan) Land Use Lo -r Slope (%) 0- 5 Surface Stones Nt)�de 7S° - Vegetation `, 10K1C Landform Position on landscape (sketch on the back) Distances from: Open Water Body 100+' feet Possible Wet Area 10 feet Drinking Water Well t;�1;� feet Drainage way NIA feet Property Line 1,04 feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) _Soil Horizon Soil Texture (USDA) Soil Color (Munsetq Soil Mottling _ Other .Structure, Stones, Boulders, Consistency, % Gravel) ib 7 � �SL0 1�1{�d � ,gC ' Z-5 3/z Ab -a 136 afe- m iKec! 0 MINIMUM OF 2 Parent Material (geologic) Tit 1 _ OePtMoBedrock l li Depth to Groundwater: Standing Water in the Hole: E I i�lr pig ap rf STEEA j1IF 13z - Estimated r`�V� Weeping from Pit Face: Estimated Seasonal High Ground Water: i DFP APPROVF-D FORM - MOMS FORM 12 -_PERCOLATION TEST Location Address or Lot No. 1175 T_U1Z0FI LC 5-r COMMONWEALTH OF MASSACHUSETTS N. �I . AJUPC>,,lC_fZ_ , Massachusetts Percolation Test` Date: (p 73 1'7S Time: Observation Hole # Depth of Perc �O Start Pre-soak End Pre-soak Time at 12" Time at 9" EN 00362 2.-30 11 .5 Z �O Time at 6" Time (9"-6") Rate Min./Inch .> 20 VY11 U /1)J Minimum of 1 percolation test must be performed in both the primary area AND reserve area. SitePassed ❑ Site--F-ailed ...................................- _._.... - -- --- --............................... ......... _............... -- Performed By:� ITYI Witnessed By: Comments: _.. M....m opo DEP APPROVED FORM - E2/07/9S FOR -m 11 - SOIL EVALUATOR FORM--- Page2of3 Location Address or Lot No. 1.1.75 : R091 On-site Review / Deep Hole Number CQ Date: Time: Weather � W� �rr il�kf Location (identity on site plan) / Land Use En�iG of Pl,}gKIQ6 Slope (96) 5--Z5 Surface Stones Vegetation, - I f 6:5 LCAT Landform �JP�S 4 Position on landscape (sketch on the back) Distances from: Open Water Body l.Go f feet Drainage way S POND /—f- l feetqt—E J Possible Wet Area ICO+ feet Property Line (p _}.. feet Drinking Water Well �VA feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Horizon Soil Texture -- (USDAI – Soil Color (Munsell) Soil Mottling Other —_ -Structure. Stones. Boulders. Consistency, % Gravel) O - q- -1 y gw F::sL Ioyrs16 -;, ►��L C— z�, s /4 I )� _ 1 M 6 LE 6OP-1 V - Sy -7/t -54 7 �y�S� L ern `D 166) r rr Parent Material (geotogicl- _ � Depdxo8edrock: h Groundwater: Deptto Standing Water in the Hole:Face- Estimated ) r — Weeping from Pit Face: Estimated Seasonal High Ground Water:_ -- i OFF APPROVED FORM - t210719S FORM ti - SOIL EVALUATOR FOPh1 Page 2of3 Location Address or Lot No. 1I75 TueN.Q( — fT Ori -site Review Deep Hole Number T_— I Date: �p(Z��'(b Time: Weather Location (identify on site plan) ��� Land Use ESE CWk)6 LOISlope (%) 15 ZS Surface Stones f Vegetation > Landform Position on landscape (sketch on the back) Distances from: \\ Open Water Body V00 -� feet Drainage way G s feet Possible Wet Area feet Property Line )0+ 0+ feet Drinking Water WellN/4- feet Other DEEP OBSERVATION HOLE LOG' Depth from Surface (Inches) Soil Hori2on Soil Texture (USDA) Soil Color (Munself) —Soil Mottling Other .Structure. Stones. Boulders. Consistency. % Gravell 12 - 690' �d7TC1�1 _ _ L L Parent Material (geologic S ( g DePfco8a&ock: !� Depth to Groundwater: Standing Water in the Hole: n1 Weeping from Pit Face: ! t l ly 11 Estimated Seasonal High Ground Water: ' DEP APPROVED FORM - 12107195 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Addressor Lot No.ST) Determination ,for Seasonal Hiph Water Table Method Used: ❑ Depth observed standing in observation hole.. inches Repthepth weeping from side of observation hole inches to soil mottles 1//Wta inches ❑ Ground water adjustment .................. feet Index Well Number .. Reading Date ............... Index well level ...... Adjustment factor ........... Adjusted ground water -level .................................... Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in II a 1. reas observed throughout the area proposed for the soil absorption system? D If not, what is the depth of naturally occurring pervious material? 1�1 o 602V 6906 Abom--D Certification IF certifythat on i -- - (date) -I have passed the soil evaluator examination approved by the Department of -Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017: Signature Te - Date y DEP APPROVED FOPM - 12/07/95 No. THE COMMONWEALTH OF MASSACHUSETTS FEE 1i_' BOARD -OF HEALTH --\ !� w N OF N D 2 '_A APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade (A Abandon ( ) - (]Complete System ❑ Individual Components LOcal' in Map/Parcel # \Z Lot # Installer's Name Address Telephone # Type of Building: C.�> Ej-=�e Dwelling — No. of Bedrooms Other — Type of Building O�1w o. of persons Other fixtures C u S Owner's Name / v Address Telephone # Designer's Name Address Telephone # Lot Size 1 b ,15 fi q. feet Ne, Garbage Grinder ( ) Showers ( ), Cafeteria Design Flow (min. required) 1 Zoj 21. gpd Calculated design flow i Z'1 % gpd Design flow provided i 21 gpd Plan: Date 7 -Lt Irl -6 Number of sheets = - Revision Date Title `;mwr G` -D,nQ. Ort 'S f -S �l 0Jl,uA'Zz�= — It'►<9- t-, iLea- Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation et `.- DESCRIPTION OF REPAIRS OR ALTERATIONS /N ?-,kty'9aK i--� t 5; t tiC, ?� tkeJ1 6 IJ . The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections - - FORM 1 - APPLICATION FOR-DSCP DEP APPROVED FORM 5/96 No. THE COMMONWEALTH_OF_MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description oMork: ❑ Individual Component(s) ❑ Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ), Repaired ( ), Upgraded ( ), Abandoned ( ) --------- by: ---- -- at _ has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificati =s -aWnot be.construed�A3 a guarantee that the system will function-as� fined. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96