HomeMy WebLinkAboutMiscellaneous - 120 LACONIA CIRCLE 4/30/2018 (16) Commonwealth of Massachusetts
H W Title 5 Official Inspection Form
113 1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
cM 120 Laconia Circle
Property Address
Karen Crawford
Owner Owner's Name
information is North Andover MA 01845 August 2 2013
required for every g ,
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope—4-10% over SAS
® Surface water- None
® Check cellar- Dry
® Shallow wells- None
Estimated depth to high ground water: 2'feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: CFP-5/8/86
Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health - explain:
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database -explain:
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You must describe how you established the high ground water elevation:
Excavated test hole adjacent to system, no groundwater observed to elevation 124+/-. Sump pump
in basement dry 13" below cellar slab. Assume bottom stone in trench 30" below pipe invert
(conservative, code allows max. 24" of stone). Invert of pipe per CFP is 126.52, less 30" = bottom of
stone 123.75. Measured bottom of sump in basement, dry at elevation = 121.9. Groundwater at
least 2' below the bottom of stone in trenches.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
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