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!-address �^/���T �c.� �,0 Title of File
Page of
Date File Open: Date filedosed: .
Doc Document/Action Tifile
action Date of Refer to other Purpose of Documernt/Action and notes
Document/ document/
Num. Action Department
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Board of Appeals — Board of Health — Plannun-g.Board _ Conseruaflon Commission — 13 ilding De ar —'—
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TOWN OF NORTH ANDOVER NOV 1 4 2M2
SYSTEM PUMPING RECORD
DATE:
4
SYSTEM OWNER &ADDRESS SYSTEM LOCATION
67t-oJ�ov�-- I(ok- (example: left front of house)
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DATE OF PUMPING: Lha-O�L— QUANTITY PUMPEDGALLONS
CESSPOOL: NO YES SEP C TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER (EXPLAIN)
SYSTEM PUMPED BY:
COMMENTS:
CONTENTS TRANSFERRED TO:
Board of Hsalth
North Andover,Mass. SEPTIC SISTIM
INSTAMATION CHECK LISr LOT
OPED DATE DI PROVED EMAVATIMI OK _L
ea�nsit
FJ4IL ox 0.OP
1. Distance Tot
/ a. Wetlands
b. Drains
c. Well
2. Water Line Location
3• No PVC Pipe
4. Septic Tank
a. Tees - Length & To Clean Out covers
b. Cement Pipe to Tank On Both Sides of Tank
5. Distribution Box
a. Covers & Box - No Cracks
b. All Lines Flowing Equal Amounts
c. No Back Flow
6. Leach Field or Trench
a. Dimensions
b. Stone Depth
c. Capped Eads
d. Clem Double Washed Stone '
7. Leach Pits
a. DizDoers ns
b. Ston Depth
c. Sp sh Pads
d. T s
e. ownt Pipe to Pit - Both Sides
f. Clean Double Washed Stone
8. No Garbage Disposal
9. Final Grading Inspection
10. Barricading Covered System
11. As Built Submitted
a. Lot Location
b. Dimensions of System
c. Location with Regard_to Pere Test
d. Elevations
e: Water Table
` TO: NORTH ANDOVER, MASS 19 19 e0
BOARD OF HEALTH
FROM: DESIGN ENGINEER Re: Soil Absorption Sewage
System Inspection
This is to certify that I have inspected the construction of the said disposal system at
9 C�7Nbze S 7-/c/< 'ea a. 0( North Andover, Mass.
SITE LOCATION
The grades and construction are as specified in my plans and specifications dated
19 �P`t�H O F �9gsS
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NoReg. P o We"��R Abitarian
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SOIL PROFILE & PERCOLATION TEST DATA
Town/City. No.&Street ��,� �,/��CZ Lot No.�_
Loc./Subdiv. ✓ ,' ,-� i',-, (��« plan Owner _4'� h
V Investigator 0'r, L,+.,r Observer
SOIL PROFILES-DATE --
1' E ev.\ 2' Elev. 3' Elev.
4.Elev.
0 �0 77>� 0 lO 0 0
IV1 S 1 1 1
�
2 2 2
' 3 3 3
---
5 - 5 5
6 6 a 6 6
T 7 . -- 7 7
\8 .. 8' 8 8
9 9 9 9
a
10 10 10 10
L Benchmark Location --
Elevation Datum
Percolation Tests-Date
22
Pit Number 1 2 3 4 5
Start Saturation � -
Soak-Mins. S
Start Test-Time
Drop of 3"-Time
Drop-of 6"-Time f Q
Mins.lst 3"Dro
Mins. 2nd 3"Dro
Notes & Sketches on Back Frank C. Gelinas & Associates, 'North And.
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SUBSURFACE DISPOSAL SYSTEM CHECK LIST
Fl
NORTH ANDOVER BOARD OF HEALTH
APPROVED DATE PROVIDED DISAPPROVED DATE TIME REASON
Ti le
Reg. 2. 5 Fail OK The submitted plan must show as a minumum:
(a) the lot to be served (area,dimensions,l,ot #,abutters)
(Planning Board files)
Lb) location and log of deep observation holes-distance
to ties
(c) location and results of percolation tests-distance
/ to ties
(d) - design calculations- & calculations showing required
leaching area
-(e) location and dimensions sf system (including reserve
area)
iIT? existing and proposed contours
g). location of any wet areas within 100' of the sewage
disposal system ot- disclaimer (check wetlands mapping)
(h) surface and subsurface drains within 1001 of sewage
disposal system o r disclaimer
(i) location of any drainage easements within 100' of
sewage disposal system or disclaimer (planning board
files)
(j,)-'known sources of water supply within 200' of sewage
disposal system or disclaimer
(k) . location of any proposed well to serve the lot (100'
from leaching facility)
. location of water lines on property (10' from. leaching
;facilities)
'"(m) location of benchmark
�(n�) driveways
o)--garbage disposers
,_,,,-(.p_)-"no PVC is to be used in construction
/(q) a profile of the system (elevations of basement , plumbez
pipe septic tank, distribution box inlets and outlews,
distribution field piping and ,any other elevations)
(r) maximum ground water elevation in area of sewage dispose
. system
(s) plan must be prepared by a Professional Engineer or
other professional authorized by law to prepare such
plans
Septic Tanks
Reg. 6 Capacities - 150% of flow, water table, tees , depth
of tees , access, pumping,
(b)' .Cleanout
(c.. 10' from cellar wall or inground swimming pool
�-(d� 25' from subsurface drains
North Andover Subsurface disposal system check list - Page 2
M
_ I
Fail OK Distribution Bones
Reg.10. 2 (a) Slope greater than 0.08
Reg.10.4 (b Sump
Leaching Pits
Leaching pits are p-r,,e'�erred where the installation is
possible
Reg.11 .2 (a) Calculations of leaching area (minimum 500 S.F. )
Reg.11 .4 (b) Spicing
Reg.11 .1 (c),,'Surface drainage 2%
Reg.11 .11 d') Cgver material
Leaching Fields
Reg.15.1 (a) N2Greater than 20 m' es/inch
Reg.15.1 (b) Area (minimum-990 )
Reg.15.4 (c) Const r eta on of field
Reg.15.8 (d).--Su fr ace drainage 2%
Reg. 3.7 --(e) 20' from- cellar wall or inground swimming pool
Leaching Trenches
f
Reg.14.1 (a) Calculations of leaching area (min. 500 S.F.) +
Reg.14. 3 b� Spacing (4 ft. min. 6 ft. with reserve between)
Reg.14.4 -'�(c� Dimensions I
14.5 ,
Reg.14.6d)r Construction
Reg.14.7 f_ --(e) Stone
Reg.14.10 f) Surface drainage 2%
Downhill Slope
NaSlope y/x = (to be shown)
y/x X 150 = (to be shown)
Pum-Ps
Reg. 9.1 (a) Approval
Reg. 9.6 (b) Stand-by power
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