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HomeMy WebLinkAboutMiscellaneous - 140 BRIDGES LANE 4/30/2018 10 BRIDGES LANE 210/104Q0000.0 f / w COMMONWEALTH OF MASSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS y DEPARTMENT OF ENVIRONMENTAL PROTECTION ,K See TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: tLio I An does lAne Pr Owner's Name: Owner'sAddress: 14b RY-tidl)iol� 'Urx-" I Date of Inspection: 01 D RECEIVED Name of Inspector: ( ease print lX!r �� �E — s 2005 Company Name: ,f_ 0 TOWN OF NORTH ANDOVER Mailing Address: j `r HEALTH DEPARTMENT INT Telephone Number: 5 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time jof the inspection.The inspection was performed based on my training and experience in the proper function maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Se ion 15.340 of Title 5(310 CMR 15:000). The system: `Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: U+ The system inspector shall su i cop this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of co is inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspecto d the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 — COM MONWEALTH OF MASSACHUSETTS z = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 140 Bridges Lane 1�1- Andover MA RECEIVED Owner's Name: Rnh Pa-Lardy ardy Owner's Address: 1 d) Rr i r1gps T ane SEP — 6 2005 1\T AridoyL MA Date of Inspection: 71/51/05 ANDOVER TOWN OF NORTH A HEALTH DEPARTMENT Name of laspector: (please print) James Wright Company Name: R.J. Inspec ions nc. Mailing Address: One Osgoo S Methuen MA 0 44 Telephone Number: 978-681 —8759 CFRTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported be.lov,,is true, accurate and complete as of the time of the inspection. The inspection was performed based on niy training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DI P approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails DInspector's Signature: Date: ? The system inspector sh submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 Pd or gxeater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Note, and Conunents . Sys �:I_�e. �... N•,ey.-l+¢s �O'ti•r J� �:-���0>,� f" ��� ,,L - I� „A!'�%'�tr'�i --This report only describes conditions at the time of inspection and and time P under the condition This inspection does not address hog sof use at that v the system will perform in the future under the same or different conditions oi'use, Tide 5 Inspection Form 6/15/2000 page I U1jr ntr-/eb5 b f:4y y rtiy111111 SENSITECH BEVERLY PAGE 01 A Town of North Andover Office of'the Health Department �°`°°- •`-• Community Development and Services Division 400 OSGOOD STRUT `� North Andover,Massachusetts 01845 Susan Y. Sawyer,'REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax RVEICA qtp OT COMPU OYCE As of .,august 26s 200.5 9his is to cert fy that the individuarsukurface d?sposaCsystem Re pair " o.f a Distn&tion Owq and ankBafffes 6y Arthur utton �t 140 Bridges Lane Nvrth.,gndover, q1A 01845 Yfas been instatTed in accordance with the prOv4yions of Vitre v of the State Sanitary Code and with the Yorth-Andover 0oardof9feaftht rqufations. qie Tssuance of this cert f cate shalt"not 6e construed a$ auaran g tee that the system wilt function sett actor � ir y. S an rY.sawyer Tublzc Meafth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688.9535 i 0 . O — \ COMMONWEALTH OF MASSACHUSETTSV/ W EXECUTIVE OFFICE OF ENVIRONMENT.0 AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION 11M Sye� TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:—1 40 Bridges ani N Andover MA RECEIVED Owner's Name: _ Bob Palardy Owner's Address: 140 Bridges—Lan—e— JUL 12 2005 1\7 Andayer MA Date of Inspection: 7 � �0� TOWN OF i- 0U TH ANDOVER Name of Inspector: (please print) James Wright HEALTH DEPARTMENT - Company Name: R.J. Inspec ions Inc. Mailing Address: One Osgoo St Methuen MA 0--1T44 Telephone Number: 978-681 —8759 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is rrue, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP Approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: /Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails t Inspector's Signature: _---_.-.--�;=----_______Date• (,, A(--5 The system inspector sh I submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 ,pd or i-eater,the inspector and the system owner shall submit the report to the appropriate regional office of Cite DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Continents �"�,_,f�j L".� ✓2��"L��� /`� /�._ .�,�' Cid .� _� -��%.l-/ � f..' �%G,%-/ "This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. I-isle 5 Inspection Form 6/15/2000 Page 1 Page 2 of 11 OFFICIAL, INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 140 Bridges Lane N. Andover M Owner: Bob Palardy Date of inspection: 7/5/0 5 Inspection Summary: Check A,B,C,D or E I ALWAYS complete all of Section D A. System Passes: 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 1x.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. Systewrr Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance. indicating that the tank is less than 20 years old is available. ND exp jti: '� Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board ofHealth): broken pipe(s)are replaced ybst5uction is removed 2-/distribution button box is leveledr replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will Pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page; of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1 dRri rI T ono N Andover MA Owner: Rnh Pa 1 ^rd Date of inspection: 7 15 10 S C. Further Evaluation is Required by the Board of Health: ___ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will y pass unless Board of Health determines.i.n-accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which Will protect public health,safety and the environment: — Cesspool or privy is withip 501eet of a surface water — Cesspool or privy is.witfiin 50 feet of a bordering vegetated wetland or a salt marsh l 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank-and SAS and the SAS is tVitin a Zone 1 of a public water supply. The system has a septic tank and..S-AS'and the SAS is within 50 feet of a private water supply well. The system has a septfc"tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply,-*eel**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the 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, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: I Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 140 Bridges Lane N. n over Owner: BobPa ar y Date of Inspection: 7/5/05 D. System Failure Criteria applicable to all systems: You must indicate"yes" or"no"to each of the following for all inspections: Yes No 4'/ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ ✓' Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool /� quid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number oftiines pumped ---'Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of 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 1 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 Irom a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the 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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (/'(Yes,/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 1-5,000 gpd. 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) i yes 110 _ the system is within 400 feet of a e inking water supply the system is wi 00 feet of a tributary to a surface drinking water supply the , tem is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped one Il of a public water supply well If you have answered"yes"to any question in Section E the system is consider q ed a significant ant threat or S answere � , d "ves" in Section D ab o above the large system has failed.The owner or operator of any large system considered a. significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR .15.304.The system owner should contact the appropriate regional office of the Department. O O Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 140 Bridges Lane N. Andover Owner: BobPa ar y Date of inspection: 7/5/05 Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes o f Pumping information was provided by the owner, occupant, or Board of Health _ p/Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? _ Have large volumes of water been introduced to the system recently or as part of this inspection ? t/ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ✓ter' Was the facility or dwelling inspected for signs of sewage back up? / Was the site inspected for signs of break out? Were all system components, excluding the SAS,located on site? Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid,depth of sludge and depth of scum ? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no _ Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] I i i 0 0 Pay-e 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 140 Bridges Lane N. Andover MA Owner: BobPa ar y Date of Inspection: 7/5/05 FLOW CONDITIONS RESIDENTIAL ` Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on.310 CMR 15.203 (for example: 110 gpd x# of b drooms): Number of current residents: {�— Does residence have a garbage grinder(yes or no): Is.laundry on a separate sewage system(yes or no):k yes separate inspection required] Laundry system inspected(yese no):— Seasonal use: (yes or Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no):A Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 C .203): gpd Basis of design flow(se ersons/sgft,etc.): Grease.trap presen es or no):— Industrial wa olding tank present(yes or no):_ Non-sani y waste discharged to the Title 5 system(yes or no):— Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION 1"umping Records Source of information: Was system pumped as part of the inspection(yes or no): "V1—/ If yes, volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: `1 YP'—OF SYSTEM s_Septic tank,distribution box, soil absorption system _Single cesspool _Overflow cesspool _ Privy _Shared system (yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _ Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components, date ins lled�if known)and source of informa 'on: �. Were sewage odors detected,when arriving at the site(yes or no): �lC Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 140 Bridges Lane N. Andover—MA Owner: Bob Palarcly— Date of Inspection: 77 57-G5 BUILDING SEWER(locate on site plan) Depth below grade:�_� Materials of construction:!'cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage, etc.): SEPTIC TANK: _(locate on site plan) Depth below grade: Material of construction: concrete_metal_fiberglass polyethylene __other(explain) If tank is metal list age:_ Is age con fume by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 0S Sludge depth: F/ Distance from top of sludge to bottom of outlet tee or baffle: �(b Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: e./r /Pe- C:oniments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leaka e,etc.): _ GREASE TRAP:_(locate on site plan) Depth below grade:— Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum t p of outlet tee.or baffle: Distance from b�uwmn�ping m o cum to bottom of outlet tee or baffle: Date of last puComments(on reconunendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): . Page S of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 140 Bridges Lane N. Andover MA Owner: _ Roh Palardy - Date of Inspection:_ 7 r,./o r, TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metfiberglass_polyethylene other(explain): Dimensions: Capacity:_ ��<(Yallons Design Flow:_ ns/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage Ain�o or out.of bo etc.): _ /� Al % / - / fi G ✓ — PUMP CHAMBER: (locate on site plan Pumps in working order(yes or Alarms in working order or no): Comments (note conditi n of pump chamber, condition of pumps and appurtenances,etc.): R 0 Q Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 140 Bridges Lane N. Andover MA Owner: _ Bob Palardy Date of Inspection: 715/05 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Typy— . _ � leaching pits,number:_ _ leaching chambers,number: leaching galleries,number: Leaching trenches,number, length: Leaching fields,number,dimensions: _ overflow cesspool,number: v P innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil, condition of vegetation, etc): _ CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cz o Materials of c-nstruction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): PRIVY: (locate on site plan) Materials of construction: .Dimensions: Depth of solids: Comments(note co , tion of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 9 l'agk. 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 140 Bridges Lane N. Andover MA Owner: Bob Palardy Date of Inspection: 7/5/0.5 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building. 1 ----------------- N\V17,�( in Paoe Il of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 140 Bridges Lane N. Andover MA Owner: Bobalardy Date of Inspection: 7/510_5 SITE EXAM Slope Surface,watel` Gliecic cell Shallow wells Estimated depth to d ound watert Please indicate (check) all methods used to determine the high ground water elevation: brained from system design plans on record-If checked,date of design plan reviewed: _ 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: You n ust describe how you established the high ground water elevation: 11 0 ' SUMMARY OF GROUND-WATER LEVELS JUNE 2005 PROVISIONAL (NOTE: Wells with * also available in real-time at top of Ground-Water Data page; OWc, monthly measured value used in high ground-water level estimation report, USGS Open-File Report 80-1205. ) WELL L START NET CHANGE DEPARTURE WATER LEVEL T I YEAR IN MONTH IN ONE FROM BELOW LAND- 0 T OF YEAR MONTHLY SURFACE P H RECORD MEDIAN DATUM 0 0 (OWC) (FEET) (FEET) (FEET) (FEET) DAY MASSACHUSETTS ACTON 158 * TS 1965 - 0. 67 + 1.24 + 1.46 16.59 30 ANDOVER 462 VS 1968 - 0.01 + 0.77 + 0.74 14.00 22 ATTLEBORO 83 VS 1964 - 0. 96 + 0.06 - 0.23 4 .28 30 BARNSTABLE 230 FS 1957 - 0.51 + 1.28 + 1.27 22.10 28 BARNSTABLE 247 FS 1962 0.08 + 1.94 + 1.94 22.00 28 BECKET 12 TS 1986 + 0.46 + 1.06 + 1.43 2.48 27 BLANDFORD 9 VS 1986 - 0.47 + 0.08 + 0.49 2.13 27 BOURNE 198 FS 1962 ----- ----- ----- ----- BREWSTER 21 FS 1962 + 0.05 + 1.75 + 1.55 8.23 28 BREWSTER 22 * FS 1962 - 0.27 + 2.05 + 1.58 28.75 30 CHATHAM 138 FS 1962 - 0.06 + 1.67 + 2.28 21.21 28 CHESHIRE 2 HT 1951 - 2.20 - 3.00 - 2.91 8. 48 28 CHICOPEE 95 TS 1984 - 0.58 - 0.20 - 0.26 21.40 27 COLRAIN 8 VS 1965 - 1.48 + 0.71 + 0.52 18.06 28 CONCORD 165 TS 1965 + 0.35 + 1.75 + 0.80 39.87 21 CONCORD 167 TS 1965 - 0.87 + 1. 47 + 0.45 6.80 21 CUMMINGTON 13 VS 1986 - 1.15 + 0.00 - 0.39 5. 63 28 DEDHAM 231 ST 1965 - 1.18 + 2.16 + 1.13 6.69 21 DEERFIELD 44 VS 1965 - 0.88 - 0.18 - 0.28 3.19 28 DOVER 10 TS 1965 - 0.08 + 0.66 + 0. 67 31.81 21 DUXBURY 79 * VS 1965 - 1.16 + 0.24 + 0.31 8.34 30 DUXBURY 80 VR 1965 - 0. 66 + 0.27 + 0.55 21.56 29 EAST BRIDGEWATER 30 HT 1958 - 2. 64 + 0.15 + 0.17 8.75 29 EDGARTOWN 52 VS 1976 + 0.56 + 2.28 + 2.49 14 .71 7/1 FOXBOROUGH 3 TS 1965 - 0.19 + 0.08 + 0.13 18.82 27 FREETOWN 23 TS 1964 - 0.57 + 1.15 + 0.73 12.36 30 GEORGETOWN 168 VS 1965 - 1.90 + 0.67 + 0. 67 4.15 22 GRANBY 68 VS 1954 - 1.25 - 0.07 + 0. 12 7.56 27 GRANVILLE 5 TS 1965 - 0. 60 + 0.21 + 0.14 31.85 27 GRANVILLE 6 SS 1965 - 2.42 - 0.24 - 0.82 6.54 27 GREAT BARRINGTON 2 VT 1951 - 1.82 - 1. 15 - 0.57 12. 10 27 HANSON 76 VS 1964 - 0.77 + 0.01 + 0.07 4.82 29 HARDWICK 1 TS 1965 - 1.29 - 0.45 - 0.48 15.19 30 HAVERHILL 23 TS 1960 - 0.92 + 1.67 + 2.01 9.44 22 HAWLEY 8 ST 1986 - 0.84 + 0.17 + 0.29 3.75 28 LAKEVILLE 14 * TS 1964 - 2.52 + 2.07 + 2.05 12.19 30 LEXINGTON 104 VS 1965 - 1.20 + 0. 64 + 0.76 2.23 21 MASHPEE 29 FS 1976 - 0.48 + 1.45 + 1.14 6.86 22 MIDDLEBOROUGH 82 VT 1965 - 2.36 + 2.45 + 2.15 8.12 29 MONTGOMERY 19 SS 1986 - 0. 96 + 0.03 - 0. 11 1.71 28 NANTUCKET 228 FS 1976 + 0. 46 + 2.20 + 2.46 21.19 29 NEW BEDFORD 116 VS 1964 - 0.63 + 0.15 - 0.08 4.35 30 NEWBURY 27 VT 1965 - 2.08 + 2.34 + 3.20 4.20 22 NORFOLK 27 * VS 1965 - 0. 98 + 0.48 - 0.01 6.38 30 NORTHBRIDGE 54 VS 1984 - 0.32 + 0.09 + 0.30 3.95 21 NORTON 3`7 FS 1964 - 2.09 + 0.37 + 0.44 7.86 27 ORANGE 63 TS 1985 - 0.65 + 0.36 + 0.30 6. 68 29 OTIS 7 VS 1965 - 1.20 - 0.25 - 0.57 9.23 27 PELHAM 23 * SR 1984 - 0.36 + 1.03 - 1.42 15.35 30 PELHAM 24 SS 1984 - 0.25 + 1.11 + 0.58 4.02 30 PETERSHAM 16 ST 1984 - 1.29 - 0.10 - 0.50 14.34 29 1 of 3 7/8/2005 1:50 PM PITTSFIELD 51 * VS 1963 - 1. 66 - 1.40 - 2.08 17.47 30 PLYMOUTH 22 TS 1956 + 0.29 + 2.31 + 1.73 21.51 29 PLYMOUTH 494 SS 1985 + 0.51 + 1.78 + 1.64 28.06 29 SANDWICH 252 FS 1962 - 0.37 + 1.05 + 0.88 46.20 22 SANDWICH 253 FS 1962 - 0.04 + 1.75 + 0.81 48.84 22 SEEKONK 275 VS 1964 - 0. 95 - 0.04 + 0.50 6.27 29 SHEFFIELD 58 FS 1987 - 0. 64 - 0.13 + 0.37 12.58 27 SOUTHBOROUGH 12 HT 1990 - 1.07 + 1.17 + 0. 66 6.89 21. SOUTHWICK 95 TS 1986 - 1.20 + 0.17 - 0.81 3. 60 28 STERLING 1 ST 1947 - 2.37 + 2.36 + 1.46 3. 41 21 STERLING 177 SS 1995 - 0.10 + 0.48 + 0.25 14.23 21 SUNDERLAND 7 SS 1957 - 1.23 ----- - 1.43 12.52 28 SUNDERLAND 68 VS 1983 - 0. 91 - 0.18 - 0.18 3.42 28 TAUNTON 337 TS 1964 - 0. 98 + 0.40 + 0.44 8.76 30 TEMPLETON 3 VS 1957 - 1.10 - 0.68 - 0.81 4 .69 < 29 TOPSFIELD 1 HT 1936 - 4.86 + 1.53 + 1.00 10. 92 22 TOWNSEND 13 TS 1965 - 0.27 + 0.59 + 1.30 11.13 21 TRURO 1 TS 1950 - 0.46 + 0.54 + 0.76 10.04 28 TRURO 89 TS 1962 - 0.39 + 0.85 + 0. 66 11.29 28 WAKEFIELD 38 * FS 1965 - 1.14 + 0.43 + 0.82 6.35 30 WARE 43 VS 1965 - 1.03 + 0.87 + 1.43 7. 60 30 WAREHAM 51 TS 1959 - 0.37 + 1.86 + 0.45 6.55 23 WAYLAND 2 TS 1965 - 0.27 + 0.39 + 0.19 15. 63 21 WEBSTER 1 HS 1958 - 0.70 + 0.17 - 0. 95 14 . 60 21 WELLFLEET 17 VS 1962 - 0.30 + 1.53 + 0.55 9.24 28 WENHAM 76 VS 1965 - 1.49 + 0.55 + 0. 69 2.28 22 WEST BOYLSTON 26 SS 1995 - 1.10 + 1.04 + 0.48 6. 09 21 WEST BROOKFIELD 2 TS 1959 - 0. 64 + 0.55 + 0. 68 17.73 30 WESTHAMPTON 20 SS 1986 - 3. 65 - 0.17 - 0. 94 10.33 28 WESTFIELD 62 SS 1957 - 1.31 - 0.22 - 0.55 7. 65 28 WESTFIELD 152 TS 1986 - 0.46 + 0.08 + 0.74 3.03 28 WESTFORD 160 VS 2001 - 0.73 + 0.33 ----- 11. 11 30 WEYMOUTH 2 FT 1965 - 0. 67 + 2.31 + 2. 10 9.24 20 WEYMOUTH 3 VS 1965 - 0.16 + 0. 66 + 0. 62 4 .80 20 WEYMOUTH 4 TS 1965 - 0.33 + 0.57 + 0.43 6.85 20 WILBRAHAM 55 TS 1965 - 3.11 - 1.24 - 0.46 38.86 27 WILMINGTON 78 * FS 1951 - 1.36 + 0. 64 + 0.13 7. 94 30 WINCHENDON 13 ST 1939 - 0.84 + 2.34 + 1. 15 5.08 29 WINCHESTER 14 ST 1940 - 3.37 + 0.48 + 0.02 11.44 22 RHODE ISLAND BURRILLVILLE 187 TS 1968 - 0.73 - 0.15 - 0.45 15.37 27 BURRILLVILLE 395 UT 1992 - 1.39 + 1.11 + 1.01 7.79 30 BURRILLVILLE 396 VT 1992 + 0.52 + 0.52 + 1.23 4.49 > 30 BURRILLVILLE 397 HT 1992 - 2. 93 + 0.85 + 0.82 17.20 28 BURRILLVILLE 398 HT 1992 - 1.71 - 0.46 + 0. 11 9.31 28 CHARLESTOWN 18 FS 1946 - 1.76 + 0.41 + 0.41 16. 98 27 CHARLESTOWN 586 VT 1992 - 0.53 - 0.11 - 0.08 4 .07 27 CHARLESTOWN 587 ST 1992 - 1.86 + 0.12 - 0. 93 10.22 27 COVENTRY 342 VS 1991 - 1.72 - 0.23 - 0.25 10.04 27 COVENTRY 411 SS 1961 - 1.00 + 0.19 + 0.03 21.41 27 COVENTRY 466 VT 1992 - 1.40 - 0.58 - 0.79 4.15 < 28 CRANSTON CITY 439 ST 1992 - 4.13 + 0. 96 - 0.08 15.51 28 CUMBERLAND 265 SS 1946 - 1.08 + 0.78 + 0.48 13.04 27 EXETER 6 VS 1948 - 1.23 - 0.15 - 0.02 6.05 27 EXETER 158 ST 1991 - 4.88 - 0.49 - 0.48 12.00 27 EXETER 238 FT 1991 - 0. 65 - 0.10 - 0.11 12.54 27 EXETER 278 HT 1991 - 3.17 + 0.34 - 1.03 13.30 27 EXETER 475 VS 1981 - 1.18 , - 0.05 + 0.01 14.10 27 EXETER 554 SS 1988 - 0.59 + 0.11 - 0.01 10.13 27 FOSTER 40 HT 1991 - 3. 46 - 0.84 - 0.87 7.77 27 FOSTER 290 HT 1992 - 3.35 + 0.37 - 0.21 8.71 28 HOPKINTON 67 ST 1991 - 3.23 + 0.04 + 0.04 16.58 27 LINCOLN 84 VS 1946 - 1.48 + 0.42 + 0.42 4. 91 27 LITTLE COMPTON 142 ST 1992 - 2.09 + 0.48 - 0.20 15. 94 29 2 of 3 7/8/2005 1:50 PN Jul 08 05 01 : 53p O 0 P• Y Summary Record Card generated on 7/8/2005 2:46:43 PM by Lisa Warren Page 1 Town of North Andover Tax Map # 210-104.D-0080-0000.0 140 BRIDGES LANE PALARDY, ROBERT B. 140 BRIDGES LANE N. ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 1 Acres FY 2005 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until PALARDY, ROBERT B. Payor 140 BRIDGES LANE N.ANDOVER, MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/inactive Bldg Id. 3063.0- 140 BRIDGES LANE Last Billing Date 718/2005 3170455 03 Cycle 03 Active UB Services Maint. Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0,63518 7.82 1/ WTR WATER 01 ALL METER SIZE 135.74 11 UB Meter Maintenance Serial No status Location Brand Type Size YTD Cons 0029220683 a Active ENC F.L. ? w Water 0.63 0.63 0 Date Reading Code Consumption Posted Date Variance ` 6/28/2005 3969 a Actual 38 7/15/2005 -10% 3131/2005 3931 a Actual 51 4/5/2005 24% 12/14/2004 3880 a Actual 30 1/14/2005 -20% 9/27/2004 3850 a Actual 46 10/8/2004 -7% 6/23/2004 3804 a Actual 35 7/30/2004 180/0 4/16/2004 3769 a Actual 53 5/17/2004 00% 12/16/2003 3716 n New Meter 0 12116/2003 0% Io net 1(1.1.71.55 0/1', ACCUUNr HISTORY METER 111: 31^f14S BX: 17 P(;: 5{ 1110 BRI DGS LAHF !'ACCT 4: 31.;'1,1455 104.1? 000 WOO.11 MflP: 104.D BLOM 00861 1,01: E90N.J.0 PRIOR ID: 01, 48.11Eioo-0 OUNER111: PALAHDY, ROBERT B. ADDRESS: 143 BH DGFS LANE CITY: N. ANDOUB STALE: MA ZIP CODE: 491.$45 PHONE 11: TAX CIXS l� HOUSE It: 140 ALT fl: STREET: BRIDLES LANE 11A5 SERUICE ADDRESS <LOCATIUN>: 1.10 BRIDGES LANE �r RA1'1" TAR1,F CR>: RF, 1'f;E TABU: SNA%: NA r USE DISC. RATE: tN>: N SPEC. HANDLINi, <N>: N REASON_: Mn,94.1a[t j y �i7P l�'rr•'R t!1 ID: :51. d}AILH IISI> :1.EN7: 11,10, SEWER USE C1FI1:: fl , METER 112 ID: UATf.R USI? V' 0 SEIIFR USE 1410>: —lflfl- _ ? �k> ......! 3 r P}Ir;SS CFNTERi TO SEF BILLING-DETAILS: :"�; — � i s Fx r % X31 f1 IcS. s - .. Nf) Hriu l:: Avil1].able W r-fl"k'r y�x 81ZUK r .1�< 1 su.u-•,Jd1°,�.�are1,lSgi c (1 6Jk yei"11 s Al sul:, 5 'i 41j �� Y ry af"is�'y` t9 �t IJ a "'�• i -c ea., y s.19 -.+xy� 1° '''�{°' Y!>tvAy��, 'fl" �i,_l i YV f0= •� L d r� i 'Y s � tY ;.' A } 1 I�yAw r :;IT � r�Ns'� �'{ { � � � ��A s�� � `', •`'„ � wt�S,P•d a e �A+ 4? E S It iclnrt k11,1.71.55 ���� f, Fa s �41/S NCGJBfidT HISTORY 31'751455-PA!.Rt3114', ROBERT B. t1I:TE1? In 300455 BK:140 DIDGES UNI: 8 CYCLE SERVICE PIIIOR CI11tRFN1' USE t1t1TEP, SEWER FEB 701,6E _ 1 24300-13 07/J.3rl,9 2H? 3039 92 251.16 ti.00 0.00 251.16 2 2000-23 01/13/2000 35139 3t1r13 5.1 14142 63.013 61,00 117.42 3 2000-33 IN/04/2000 3619`s 427 34 92.02 0.00 0.00 97,.82 4 ?51M 43 11641/251410 312"x' 3161 3.1 92.82 0.00 0.00 92.82 5 200,13 539/27/2516111 31h1 .1212 51 119.23 100 11,00 LS©,23 6 2001 -'l:; 01/08/2001 3212 3259 •17 128.31 13,00 11.011 139.31 r]� I n00 20 .4.61 OAW 11.03 ' 6.051 32 9 3 21t bk 8 2001-43 06,22/20M 32" 3336 57 155.61 41,00 11.00 166:61 sm " k J 2N203 0/25- ?001 3336 :3385 49 153,51 OAR 5.55 159.06 10 2N243 0irr',5!2435l2 3355 3430 45 125.71 0.419 5.55 131.26 11 :00033 414/11:'".4163! 300 3456 26 751.94 0.00 SAS 76.49 12 200143 06/20/2002 34SG 3486 :341 8534 100 S.SS ?4.3.85 13 20412-CP.D 139/26/213511 3185 33RS 0 1.i6 0.00 0.00 -3.36 x 1k� 5019 1.4 200013 09r1.8� N2 x386 3540 S4 1'?6 O 0.00 S.97 .,3!.77 Ell 15 24103-2; ?/18''011' :ir'i5 575 414.6c1 koo 5.97 1151,57 �1 I. 1 � � , 3 35 1 16 200133 OWN= :;51'5 .3f09 34 -16351,1;13 OAA 5.97 106.77 17 201% 0647/2001 3609 3647 3F 113.16 P.430 S.97 119.1. 18 200.1-13 09/14M 36.17 3685 31; 1.98,88 0.00 A42 liG.30 � �' `ry„ X14 RI'!1I1:11 CNG1".1 Il or ':CNTEPsi MORE N UOBY S' r s f{I 0 QQR ;I Int, �� •� � �� 1�A:�.p{ ��� t, �t�x�� `M acc Y..,uti ,y i,_ � S v' d'-:: •� .<:.n -y .: 8 t„t:t:. ,< sh fW'�,��G"�c t���"�.t-jj 'W 4F-t ti O r'3 auk?3. f3 f.l FFA i i 1 v�Ctt. :W3 l r rtz; �. f i'1/P ��iv iL.. it �1tp. yy: } &tom vq s, :• Y )m ffil F. t :1 aits it .. 2t a Y Mr L� ' �^ a���t4,y.' T v `� l:' �")•v to .YT's > s sm i' t..1�w iF�,s $}. r V it aM s :ten a h fly .v,,.. r. .. 1• 11 Telnet Io.I:JLS5 ti { ACCOUNT H 1 STORY 3171345., ALARDY, (01 F,;....,,M � S • ' if/S ACC r_p 'I('I' R 1!E•CLR 111: 31174,,5 D ---------------- R:M) IRIDt,'I LANE �� a # CYCLE SERVICE PR I OR CURRENT US1: WATER S )Eli FEES TOTAL 1 204-213 12/16/200-1 30's 3716 31. 85.97 0.00 7.112 93.39 ;g n IT �1 i t N 9 REV)Ell CHOI(M-11 ur :ENTER; MORE HISTORY: o ! 3.= 'rt...f.y tl p Mt it- r � � �It)��r ! s 4 •4 �4 1''�.r J �;tl { e.{J � a= {�,K ie P_ • y µ� r -T �7f xg t 'S 'fi :dots � { i4 f I.l t'.i l' .�� •t!'y j y .p 'n� rc .• �J�1 JIfN' 1 Da f ta' � :•Y. ,.kt','.'�V''P k"r... .t ,IR�r 3 � A a. F"��jr�,�.C' . . . �a � :.(� c � .. 1• 11 1 Town of North Andover „ORT„ °ftt,°O 161V Office of the Health Department ti: • .° Communityp Development opment and Services Division 400 OSGOOD STREET • 4+ • North Andover,Massachusetts 01845 ��s°+,..•mst, s�cNust Susan Y. Sawyer, REHS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax CWR' q7jCA`nE Off' COJI�I-A.Aa 5VCE As of: August 26, 2005 This is to cert that the individual su6surface disposal system Repair (X� of a Distribution Oo.)• and lank0affles by ArthurYfutton At 140 O idges Gane Yorth Andover, 5lA 01845 Was been installed in accordance with the provisions of Title v of the State Sanitary Code and with the 'North,4ndover Board of 1feafth regulations. 'The Issuance of this certfcate shall not 6e construed as a guarantee that the system will function satisfactorily. S an LTSau�yer AMC Ylealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 i Town of North Andover40 Office of the Health Department �a��A Community Development and Services Division ` 400 OSG " " + 00 DST BEET � o r * toe.ww�a4 North Andover,Massachusetts 01845 C, ,s Susan Y. Sawyer, RENS/RS 978.688.9540-Phone Public Health Director 978.688.8476-Fax OF C0911'GI 05VCE As of: August 26 2005 7fiis is to cert that the individual su6surface disposal system Repair (X' of a Distribution Bo.)• andTankBa les by ArthurYfutton At 140 Bridges .Gane YorthAndover, 5WA 01845 Yfas 6een installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of 9feafth regulations. The Issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. i I an �2'Sawyer S fu6CC 9feafth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 V. 'Town of North Andover 4 Health De-parknent Date: l b S _ Location: (Indicate Address',,if Residential,or Anie of Business) Check#• Type of Permit or License: (Circle) ➢ Animal $ Dumpster $ T- a ,- ➢ Food Service-Type: $ ➢ Funeral Directors $ Massage Establishment $ ➢. Massage Practice $ ➢ Offal(Septic)Mauler $ Recreational Camp $ SEPTIC PERMITS: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC)$ ❑ Septic Disposal Works Installers(DWI) $ Sun tanning $ Swimming Pool $ Tobacco $ 9 Trash/Solid Waste Hauler $ Well Construction $ 73 ➢ OTHER(Indicate) .,PV 48 tfi Xgent Initials White-Applicant Fellow-Health Pink-Treasurer Town -f North Andover, Massachusetts Form NO.3 NORTH - BOARD OF HEALTH 04:.:'7 O � f A '�•,.,o •• DISPOSAL WORKS CONSTRUCTION PERMIT 1SgACMUSE'� Applicant 4r c� 1'Z�ccr N ME ADDRESSTELEPHONE Site Location L Permission is hereby granted to Construct ( ) or Repair an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S. No. CHATRMAN,4VOWD OF HEAL Fee Z D.W.C. No. aORT TOWN OF NORTH ANDOVER 4 ,� H q Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 27 CHARLES STREET m. NORTH ANDOVER,MASSACHUSETTS 01.845 4Ss+cHosE` Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX healthdept@townofnorthandover.com www.townofnorthandover.com APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: LOCATION: 0 6A- e15-e.S k, vaw -e- LICENSED eLICENSED INSTALLER NAME: h`�rt (; J T-l a `J PLEASE PRINT SIGNATU TELEPHONE# ���- G� CHECK ONE: FULL SYSTEM REPAIR: COMPONENT REPAIR (indicate what parts): D �x �S NEW CONSTRUCTION: * If NEW CONSTRUCTION,P lease.attach the Foundation As-Built Plan. $2"5,0.0,0 Fee Attached? -�j 7,S R a;r Yes No Project Manager Obligati Atiched-? Yes No Foundation As-Built? Yes No i Floor Plans? Yes No Approval of Health Agent Date: �� �� ILIV TOWN OF NORTH ANDOVERN°RTN Office of COMMUNITY DEVELOPMENT AND SERVICES a �'``��� `6 N m l p HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 CU Susan Y.Sawyer,REHS/RS 978.688.9540—Phone Public Health Director 978.688.9542—FAX D-BOX ❑ Installed on stable stone base ❑r Inlet tee (if pumped or >0.08'/foot) L�1 Hydraulic cement around inlet & outlets (,,50-C-.�W\ ` GY Observed even distribution U-" Mtn- 4(�- wd-A ❑ Speed levelers provided (not required) CA0� e Comments: A- ) �` S SOIL ABSORPTION SYSTEM ❑ Bottom of SAS excavated down to soil layer, as provided on plan ❑ Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 Y2" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/ concrete /timber/ block) ❑ Final cover as per plan Comments: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Comments: Page 3 of 4 Board of Health North Anc�ver,�?Saaa. BF,PTIC S15TII�i IN STALLATICK CHECK LIST LOT r C�TID D PROVED EXCAVATICH OK FAIL OK 1. Distance Tot a. Wetlands b. Drains 00� c.. Well 2. Water Line Location //c,/o 3. No PVC Pipe !t. Septic Tank a. .-Tess -_Length k To Clean Out Corers. b. Cement Pipe to Tank -- On Both Sides of Tank 1l�Il 5. Distribution Box a. Covers k Box - No Cracks b. All Lines Flowing F vial Amounts c. No Back Flow ago 6. - Leach Field or ch a. Dimensi0 _ b. Stone th --Capte _�hds— d._ C baa Double'Washed-Stone' 7. Leach Pits a. Dimensions b. Stone Depth C.-: Splash Pads-- d. Tees e. Cement Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. --No Garbage Disposal 9. -Final Grading Inspection 10. Barricading Covered System ll-._ As Built Subnitted a. Lot Location b. Dimensions of System 00 c. Location -with Regard-to Pere. Test d. Elevations ' e: Water Table Y i Board"`b"T Health , Ncrth',.ndover,YaBa STBSURFACE DISPOSAL DESIGN CHECK LIST ` -LOT APPROM DATE DISAPPROVED DATE Provined: Reasons: Title V FAIL CK :. Reg 2.5 e submitted plan roust show as a nSrni nUMI the lot to be servers-area,dimensions lot #,abutters location and log deep observation holes-distance to ties ! location and results percolation tests-distance to ties i design calculations & calculations shmring required leaching area location and dimensions of system-including reserve area existing and proposed contours g) Iocation any vet areas -ithin 1001 of sewage disposal system or disclaimer-check wetlands napping (h surface and subsurface drzins i4thin 1001 of sewage disposal system or di gclainsz' (i) •ocation any drainage easements $thin 1001 of sci.age disposal system or disclair eer-P omni ng Board files j) = sources of -ester surply vithin 2001 of sel,age disposal e _ system or disclainer --- $tion of proposed serve lot-1001 f�i-cm leaching facifli_ location of water lines on property-101 from leachi g facials p� Location of benchmark )� drive�6­ays garbage disposals _ 'no PDC to be used in construction q) profile of system-eleva- ions of basement, plumb, pipe, septic tarda, distribution box inlets and outlets, distribution field piping and 0'Mer elevations Vf r) mz,-itmm ground meter elevation in area se-►.age disposal system V (s) plan must be prepared by a Professional Ragineer or other professional authorized by 1su to prepare such plans Reg 6S tic Tanks th of tees J (a) capacities-150%' of flow, water table, tees, dep , access, pumping (b) cleanout- ' J ) 101 from cellar v-3 1 or ingr`o=d ^g Pool (d) 251 from subsurface drains Reg 10.2 Distribution Foxes Via) slope greater than 0.08 Reg 10.41 b) sum 'j6 -rc,- SOIL PROFILE & PERCOLATION TEST DATA North Andover, Mass. Street No Lot No Loc/Subdiv. Pland Owner Investigator � Observer ��2 SOIL PROFILE DATES 12Elev 2.Elev 3.Elev 4.Elev 1 1 1 1 T 5 T t 5 Tres P Test est 2 2 2 2 3 3 3 3 4 4 4 4 -g"Cy -e.044E y G2�ar 4ea�G- 5 5 5 6 6 6 6 7 7 7 7 E 8 �vS�L $ 8 9 9 9 9 10 10 . 10 10 Benchmark Location Elevation Datum 1 PERCO: ,ATION TESTS DATES �> (. Z"� 8 3 Pit Number i 2 3 4 Start Saturation O Soak-Minutes Start e Drop of 3"-Time Dro of 6"-Time 1— Mons.lst 3" drop Ydns.2nd 3" DropZO Percolation $ CT 1 �G.t"\v 1 � �'Z ,. ...+ 'fir-` .. �._.k s�+r,.••.•.' =••..iw�.-..e.-?.`..."^"'f---$'r.l..•.,..—....�...�c....�--w..^.-...1 ..-...,.'�a.ti,pw.-d.r�.. F.,.w....a•..r+.m':+•;.�+..w-. :;,r.•-.•.•+�.,•A.•-+r+ti r _ 'yC.' i.. ♦ `� ,3 ' '. •� .Y Ri DO rw Ws LANE 4 • i Rt 7V1 '4. '� t •iF� x• � .'�' .� ' •. `' � t •• V 4 '� �b4AF .. - , .. ly v -•� ,, •'! F yam` ` �r1'd "h '�-- {{{��� •.,7 �'�. •. i = . , • * �. .�.M•'• .� _ ' r��a +.�. ` • . r S �' • , { f A„-St EXISTING � .. FWNIXJ ION zu ? . . A-, SNOWN�'Nl� vib INNID1+ ARI ,NY OF INE syn,B4 , I -� ',357 MP FND 1�Ot E OV"L 154. 0 F/ • '~ t {' �! f..•�����f�O( a ti^!'?T � t T INLET 154tw'f S r ST f�QTLEt�:�T7 • 154- 0, o� , D4aX OUTLET 11E 1� 1 3x .7 • IA ,.." ['QW'N H,, . r . F i,.-++.,q"�>.'.r••'r�.- - .�.w...w..r•+'Y..«....r..-. .:.«.+•:..:...••.d.w:...mr .`a.'a.+•,.•'•..a�..i+.+-..r�.......�+r.+e,y.+.Y....,t.n.,_..rr.,,.�...— -_.�,w t - � ;. -