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Miscellaneous - 1430 GREAT POND ROAD 4/30/2018
1430 GREAT POND ROAD oad \ 210/062.0-0026-0000.0 i I I i i I SRMMONS Environmental Services,Inc. William A.Simmons Licensed Site Professional 213 Elm Street Salisbury,MA 01952 Telephone 508-463-6669 Fax 508-463-6679 r.. SENDER: I also wish to receive the h Complete items 1 and/or 2 for additional services. y • Complete items 3,and 4a&b. following services (for an extra d ` • Print your name and address on the reverse of this form so that we can fee): > return this card to you. L d • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address to L doss not permit. t • Write"Return Receipt Requested"on the mailpiece below the article number. 2 ❑ Restricted Delivery a • The Return Receipt will show to whom the article was delivered and the date U c delivered. Consult postmaster for fee. cc 3. Article Addressed to: 4a. Article Number Z 115 794 826 E Mr. & Mrs. Mel Marchese 4b. Service Type C 1430 Great Pond Road ❑ Registered ❑ Insured V WNorth Andover, MA 01845 Certified 1:1 COD 5 W ElExpress Mail E] Return Receipt for p� Merchandise c D 7. Date of Deliver w o M5. Signature (Addressee) 8. Addressee's Address (Only if requested Y and fee is paid) r- H r L, 6. at r� (Agen � L 0 PS Form 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVI oe E S SFf Pik 3 Official Business 0 c9 QEF t75E�TO AV�FO�PPCY�fE NT v /9 36 Print your name, address and ZIP Code here if HEALTH 1��srrssr���rr�rr�rr�r�rrrlr�rr�r�rr�r�rr�s�sss{r�sr�rlrs�irr7 i Commonwealth ®f Massachusetts City/Town of North Andover Sysern pumping Record Form 4 'wY DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided steme. Pufm ping 1Reco Rng this ecord must be check ubmitted o local Board of Health to determine the form they use. The System p date in the local Board of Health or other approving authority within 14 days from the pumping accordance with 310 CMR 15.351. A. Facility informati®n Important When filling out forms 1. System Location: on the computer, use only the tab key to move your Address Ma 01886 cursor-do not North Andover State Zip Code use the return City/Town key. IJQ 2. System Owner: a Name ramp Address(if different from location) State Zip Code City/Town Telephone Number B. Pumping Record 2. Quantity uantit Pumped: Gallons 1. Date of Pumping Date 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): . ❑ No 4. Effluent Tee Filter present? ElIf Yes ❑ No . Yes, was it clearied? E] Yes 5. Condition of System: O�1 6. ` emr�Pumped By: c�1 nC Vehicle License:AluV rnber Name o1� Stewart's Septic Service 1� Company v�R 7. Location where contents were disposed: �v� PR0MSte sPre-treatment Plant, 20 So. Mill Bradford, Ma 01835NOE o1� nature of r Date rQ nature o ceiving Facility to NORM�R�MN� N v Opp .�p � System Pumping Record-Page 1 t5for oc•03/06 R-0 i0 �R�1'��AYI�JDOVER �M 7 :•. J ' �8i / h1 'Record A2 ACHUSET7 ..Yr��lr.,l,���,r•��yi�.,,�'{• '..I„'•.4.�� has provWoo jhli lolrn ror , eo ;oco( RECEIVED 00 + .Irr.11lod to the loci' BOW: rl noa,{n 8oa/c1 0( . .. ,4 .,. � .. Clnvr Ip,7rQ:ln� 1 ,.{npri A. Facility In(ortaUon _ TOWN OF NORTH ANDOVER "�'�4'r^�� c• 5,)'S;".m Lw-auon, HEALTHDEPART MENT as lM n i m ►i+ I"9040nl f1QM buVon) Cq^o n Ttio2non, n,m0i PRumpin Reyord l8 0! Pumpinn TYPa of +yslem C999p001(9) Sep(!C r ,��� '.`.•." 11';..;x.' ensr7 . IS.^.( ra^.� Q-Oher (describe�: Emt enJ Teo FIIIe(p(p.onr? [' ro9,�j n'o II ye9 �e ✓_ r ed '.,4 � -;`:. ,��';C.oiidl�lori'Qr;9yt,�m,'.�.,,•. — P�'mpow. d 8y: .i IIJ',.1,�`^J�'��•!,�I((r�r �`.+� d!' /1;���I �,�I!�/r,lr4 f��,' •� I V��Id� 'Jconlr n'.:^wr/ —. .r j .,.•,ll.{�.r t Sr .•r�' .�.�„�' ✓�'b�'n'I' '''��1 AVM 'I I` li• lVr? I,I ri' T(/I�/ �� on.�rhera'Coi nla',ry dlyposeo: •:,)''rr� ••r. :,,i a Ill;,. 1;:'�,:/�•',,:r.�.,, 1, S�ntkur olh'��:,ly�,;.a,�<'1. ,,, Z ^: ,{.mesa.goY/d0F,tiielei/epproY,Ja worm 5.n:maln9pecr �r l .r � �d�/'j,•` „����ItT'7V"�1�(�f��'f 5ir 4'yH '�. ; `I.� ,I ' ' 141. 'i4 '11 `:�',fr�r„ ,, 'Iv• vl r' ,�,If/ 1��;� � o�rd E 1-' NOV 10 2009 �+ piorl00Wo lolrn 19l Iry Ap�(�1 I,:OmI((odllo OF IOCII 8clrc rr nP0 In (HWN©T ap�� k%[DVTER HGA,L, , A' Faclll 1'" ty In(orm�Ilo.n .`., �,•.! '�: gar ;.,,III ' I u/ ���'lY'!�V%I,f,tl �• I�h�''liCr�+��'"',� , �1• ' 51111 '1� rj 11�• �------. Owngr,'.,,,1 , 'I. 'M �';�'�.Odrµ/ 14 Irinl rtm buVvn� � 917 C> 11,17npn� n mp�V�/��V ; umping• ord ` •� �I , 'I�i�� 4,!'I 411 11'Ir/ I. Oslo of Pvm�1n9-, •• ;' i '� r. 07.1 ? n'.'d�'..', r "br / OGS ',�, �� " ��.,,'rYPr•�rpl iy�}I�em,,�;' � Ca l��ool(,� �1: • . ly'•r,x,1';' DI!c Ten, r7 ' ' I�';"/„ m�°'��rrrll4F�lllt(+pf•0.,>3cnR r'' Yo) n'o Ir :"y, '"�';��u'/1'�J'�''�', 'up�l%1'Jr�;"yJL``;11 ',,',t,•.• r9). 91 it croane97 _� r r .. I •;�'r'' '•jr�' /'r ,i+'i,1'� waw ,I1,t r � ,..,'',71'V;;!�''y'',,JyJI7�'I,ti'r�:��ll'+I�:�'�rf;,''� yi, .f,i%!,�',rY+•H'. "I;i,; Irl. , I�� ' PIG , ,,,, 1 :j• "',,,,�r;'i�� �' 1/fl�11�t'y� ill '�I �rL),; I'I . • ,' j Gr Q I ,.�', ',,; r,•I,i,`/«Y11N 111��5��f�,�,! I ��ji\(�`�11�1���1'•' � ;�,,,,' 11,, W erf 99�Iirila Qro Ppgm. , Ir •., „�•r', '1 �i'r;r t'• ' '', r'I /,I •-',:.'; ,�:i:•;�.;�;'.',.'r S�nl„�l• me4,p0Yl4qp'1�algilapp(9Yallo('mr,',�,al �II! i Commonwealth of Massachusetts W City/Town of No. Andover System Pumping Record Form 4 �M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Reeer-d-past be-ubrait#ed to the local Board of Health or other approving authority within 14 days from th purrRIWE MD accordance with 310 CMR 15.351. A. Facility Information TOWN OF NORTH ANDOVER Important: HEALTH DEPARTMENT When filling out 1. System Location: forms on the computer, use 1430 Great pond Rd only the tab key Address to move your No. Andover Ma 01845 cursor-do not use the return City/Town State Zip Code key. 2. System Owner: Muldoon Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping 5/31/11 2. Quantity Pumped: 1500 Date Gallons 3. Type of system: ❑ Cesspool(s) ® Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: Good Condition 6. System Pumped By: Chad Tannian Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: *ewart's Pr -treatment Plant, 20 So. Mill Bradford, Ma 01835 I" M ure of Haul Date Signature of Re eivi g acility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 1430 Great Pond Rd Page 1 of 1 Sawyer, Susan From: Tymon, Judy Sent: Tuesday, October 14, 2008 11:30 AM To: Sawyer, Susan; Hughes, Jennifer Cc: Brown, Gerald; Bellavance, Curt Subject: FW: 1430 Great Pond Rd 1430 Great Pond Road—Mr. Muldoon—is done. No sunroom. From: Gary Muldoon [mailto:gary.muldoon@hitachisoftware.com] Sent: Tuesday, October 14, 2008 10:20 AM To: Tymon, Judy Subject: 1430 Great Pond Rd Hello Judith, Thanks for your call this morning. Before you spend too much more time on this however, I wanted to let you know that,given some information I just received as to the cost of the sewer tie-in, I have just decided not to proceed with the project. I had had an estimate for the tie yesterday that was about$7,000 which,while expensive,was OK. That contractor had not yet looked at the plans for the location of the town sewer and was assuming it was directly across the street from my house. Two other contractors who had reviewed the town plans, now tell me the connection is actually down the street a distance,which means much more digging and both are telling me the job could cost in the neighborhood of$20,000. Given the money I have already spent on the engineer for the Conservation Commission and various fees and related expenses, I have almost$10,000 spent to-date. Putting another$20,000 on that would mean my sunroom,originally expected to cost 40,000 would end up being a $70,000 room. Thank you for your efforts and willingness to go the extra mile to research this for me. I really appreciate your assistance. Gary Muldoon 10/29/2008 Page 1 of 1 Sawyer, Susan From: Sawyer, Susan Sent: Tuesday, October 14, 2008 1:33 PM To: gary.muldoon@hitachisoftware.com' Cc: Tymon, Judy; Hughes, Jennifer Subject: FW: Message from KMBT_600 Attachments: SKMBT_60008100916100.pdf Mr. Muldoon, As you can see this regulation says"becomes available" in section 4.1 So, if you show me that it is not"available" by way of the estimate details, the Health office will not require you to tie in. Of course there is a ..however... You would need to do the following as all people on septic that apply for a permit. Systems on septic all do the following. Submit a floor plan showing the 8 rooms. Submit proof of function of the existing system, otherwise know as a Title V insp. or a legal binding agreement to tie into sewer in lieu there of. For Planning you must contact Judy for the details. It is clear that you would have to do more work if you want to go ahead and build this room. Judy will help you with that one. Also, remember your ConCom approval is good for 3 years. This office appreciates that you wish to move forward on the sewer line either way. It would definitely add to the resale value of your home. Let us know if you have any other questions. Susan From: Sawyer, Susan Sent:Thursday, October 09, 2008 4:34 PM To: 'gary.muldoon@hitachisoftware.com' Subject: FW: Message from KMBT 600 Mr. Muldoon, Thank you for taking the time to check out the options before quitting on this project. That is not our goal or intention here at the Community and Development offices. Here is the basic regulation. Let's talk more tomorrow. Thank you Susan Sawyer Health Director 978 688-9540 From: noreply@yourcopier.com [mailto:noreply@yourcopier.com] Sent:Thursday, October 09, 2008 5:11 PM To: Sawyer, Susan Subject: Message from KMBT 600 10/29/2008 BOARD OF HEALTH TOWN OF NORTH ANDOVER REGULATIONS FOR SEWER TIE-IN 1.0 Authority Under the authority of Chapter 111, Section 31 and Chapter 83, Section 11 of the Massachusetts General Laws, the Board of Health of the Town of North Andover . adopted the following regulations at a pfablic meeting held on March 17, 1994. 2.0 Purpose The purpose of these regulations is to safeguard North Andover's drinking water, surface waters, groundwaters and surrounding environment by requiring all residents to hook up to municipal sewer whenever possible. Sanitary sewer is believed to be the most effective form of wastewater treatment. 3.0 Definitions Establishment: Includes but not limited to all schools, nursing homes, camps, single and multiple dwelling units, country clubs, churches, mobile homes, office buildings, t' restaurants, service stations, retail stores Individual septic system: Any subsurface sewage disposal system, including cesspools, consisting of household wastewater, including graywater, owned and operated by a person as defined below. Owner: Every person who alone, or jointly, or severally with others has legal title to any dwelling or dwelling unit or has care, charge, or control of any dwelling or dwelling unit as agent, executor, . executrix, administrator, administratrix, trustee, lessee, or guardian of the estate of the holder of legal title. Person: Every individual, partnership, corporation,firm, association, or group owning property. sewer: A pipe which carries sewage without storm, surface or ground waters. Watershed: The land area in North Andover which delineates all surface and groundwater which drains to Lake Cochichewick. r 4.0 Terms of Connection 4 . 1 All establishments that currently do not have municipal sewer available to them must connect to the sewer as soon as it becomes available, with a maximum time limit of six months. 4.2 All establishments outside the North Andover watershed that are currently able to connect with the municipal sewer have a maximum of two (2) years from March 17, 1994 to tie-in. 4.3 All residences inside the Lake Cochichewick watershed that are currently able to to connect with the municipal sewer have a maximum of one year from March 17, 1994 to tie-in. 5.0 Variances 5.1 The Board of Health may vary the application of the time frame during which any individual connection must be made to the municipal sewer. 5.2 Variances will be based on significant financial hardship only. A properly functioning septic system will not be considered a factor for a variance. 5.3 Every request for a variance shall be made in writing and submitted with documentary proof of the specific financial { hardship. 6.0 Penalties 6. 1 Any person or owner who shall fail to comply with this regulation shall be punished by a fine not more than two hundred ($200.00) dollars and legal action. 7.0 Severability If any provision, sentence, clause or phrase of. this regulation is held to be unconstitutional, or in violation of state law, the remainder of the regulation shall continue in full force. i i i i 72 I � 1.10ac - r�ia'� 3c 1.10 ac m/ 73 1.n9c / 25 / 26 2 23 /' a3�'s' 5.56 ac ' 59 :/ Iq 1.334 ac /9 sf ll / 40 24 2 60 43 s 366 ec 1.333 ac 71 /A 27 ' I `/ P 1.333 ac 1.07 ac 99 >A a 20 / `o' C�n'IA A1.o ec 1.0 ac9 P 81 5 (M0 1.326 ac 80 1e> 1.0 1-0 ac 82 Q 21 28 174• 147 1.0 ac Z A 8 6 1.0277ac 11Zl 43,576 sf '0. 83 .Q A 'O x �• 1.0 ac JJa 74 10-1 4 29 sf 1.14 ac ;c 92 ¢ 1 uj 6 1.0ac '� t.o a� 84,Q 93 LlJ Lu9 �$ 30 � Is oa 09 1.0, 75 8 76 .' 45.530sf 1a s O 1.0 ac 91 :� 85 1.0 ac II 14P 6.26 ac 1.o ac c 31 15 / 46.206 sf 9AA 1.02 ac At/ 9 96 176 i3 D ' 86 1.0 ac a asr 1.31 ac E � 94 103 ac 1.00ac a/ 89 SCI( 2.636 ac /- 44s• / 87 'aa 6A 1.0 ac 0 a 2.26 ac � 33 Isc 1.0 ac 11A 6g,g006( IfiAAP 16 /51,062 sf 32 1 41 84,283 6f 10 48 s 1.01 ac / ' 59 595 sf 2A 1.476 ac M s,. g5 49 43,664 st eQN/����• 42 1.679 ac 10 53.172 sr •►/ B & 7A ,3a 34 we i• 41A " 0 50 43,5 6 sf !>4, 3A e 47 t 63,260 sf / 4 - 12A BA SA / 35 43 01 45 46 4 / 45,649 sf 58 44 13 1.1 ac 51 1 36 +su 1s& ,� ,� 2 51,644 sr ; / 45,356 sf 'Ac '.r LANE ,s 52: ,4C ,sr w.`I a 58,692 sf 37 158 17C 14 45,217 sf 57 15 15 54 53 ac 2.1 ac 56 cmc / 1.4 ac 65,212 sf 67,360 sf 65,212 sf POND y" La�k�e.�•� 41,745 d CochfchevA& 12 2s.s6s sr f 4 i7 K 18 s,aea e FISCAL 2001 MA C DRAWN E62 MEASUREMENTS ARE S ONLY NOT FOR SURVEY PURPOSE. 35 -- -- SEE PLAT NO ' —_—_STREET 4 y, �e / 138 — • /' 9.7 ac �--- / 2 / 139 \ 6.9 ac \ / / / 8 104.451 ac / \ 27.33 ac \ \ l i i i i i i V o , z 33 31 122 9 \ 10 127 o of \ n- 126ror / f 88g 131\ UlY Y Y Y 0.52 x tar 0c\ � 6 25 4 S 0 125 m °" obox 110 109 108' 23' 106 5 o.a0 ac 1a 0. 136 0.5o x 15\ 0.53. 0.51x 107 1 13` w Y5 ze 137 135 -132 75 7a 10]' 1 104 100 41 19 39 a qF 102 HICKORY °a na 0.62 19 v 011, � 103101 — a• ar 111 112 11 118 0 707 o.5tto a` "21t r ,.We 134 9132 0.5o x °v GG wea 016 117 . t 17 /FAS% 22 114 0 4115 119 17 43' °' / ROAD x 3 w w N T �e 13 7 13r 1 q / s x X °�; 120 121 14e 1244 x74 6 7 9 y R 10 0.ft, OJ,3� 122 123 0.563x i ,6 0.5,34 � 67 1. °SOJae 43,564 of n{ 2 6 68 U 49.6014 � t7 43 707 of 11 65 69 13 r 1o17oosr. 46,80111 8 ".722 6.931 ac1 ,OA 61 4 7.1 {5,1141 ..Q 44.111 19 5.03 x 12 63 i u SEE PLAT NO. 78 Ott) !s5' 1.33 FAaa. _ r.... Commonwealth of Massachusetts - - City/Town of NORTH ANDOVER ,FAi •z fv i194 M,6 System Pumping Record Farm 4 _ DEP has provided this form for use by local Boards of Health. Other forms relay be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351, A. Facility Information Important:When filling out forms 1• System Location: on the computer, use only the tab 1430 GREAT POND RD key to move your Address cursor-do not NO ANDOVERMA use the return key. City/Town —m _ _ tate dip Code � 2. System Owner: MULDOON Name.-,- Addre4s(if different from location) state dip Code ._..-.�.,,..__,... Te,ephone Number ---. YT� B. Pumping Record 1. Date of PumpingY9 ---- 2,. Quantity Pumped: -J' � --- J.'. taalions 3. Type of system: Cesspool(s) Septic Tank Tight Tank Lj Grease Trap L� Other(describe): 4. Effluent Tee Filter present? YesgNo If yes, was it-leaned? Yeas No 5. Condition of System: 6. System Pumped By: Name Vehicle License Number Stewart's Septic Service Company m 7. Location where contents were disposed: Stew 's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 GateAV-1 _ _.. I. fatur ocility ,._,._ Date t5forn*doc-03{06 lystern Ptimoing Pgcord-Page 1 of 1 s s COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION m OF NORTH AI"DO"/`. .i POARC3 OF HEA Tti j 1U d 13 2001 TITLE 5 t OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY AfiSESSMENTS-; SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A � CERTIFICATION Property Address: 7/,50 r eG T Otid p(/ 14"Cle Owner's Name: /7l 4't L"ACS 'L Owner's Address: Date of Inspection: --T 301 1 Name of Inspector: (please print) J Q �,l L.. I VI" N e e AO-�O Company Name: s GWGI rt G Mailing Address: 412LC L Gcc .57, Telephone Number: 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 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: asses Conditionally Passes Needs F er Eva ation by the Local Approving Authority Fail Inspector's Signature: ate: The system inspector shal ubmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of c mpleting this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the 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 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(ccontinuedj Property Address: Z o e—'t^ec T Pja O Owner: ,`9?G f-E!,rSe- Date of Inspection: I-- V -0 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A�zl Passes: e not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 ar in 310 CMR•15.304 e)dsf.Anyrfail#9recriterianot evaluated are-indicated below. Comments: B. System 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 explain: ' Observatidn of sewage`b9ckup'or break out of high static waterlevel 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 of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: d t 2� Owner: Date of Inspection: 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 pass unless Board of Health determines in 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 within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance **This system passes ifthe-well-rater 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: / y&) 1LID AiV O Owner: /'G S-e— Date of Inspection: - 'D D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes . C Baeltup of'sewage into t'aeility Ar system cdmporfent 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 overloadedor clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times 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 from 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. r E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 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) yes no the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area–IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D 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. 4 jPage5ofII OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B �CHE,fCKLIST Property Address: ��o t:rtq 7- f d',�p'� �q' O Owner:/'!1 L!/'G Date of Inspection: 3 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Pum ; information was provi ed bI'lly the c3wrier occupant,or Board of Health ` 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? Were as built plans of the system obtained and examined?(If they were not available note as N/A) V _ 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 onxthe proper maintenance of subsurface sewage disposal systems? The size and l&Aion of the S it'}Abs'drpti n System(SAS°+j on the site lias^b�en deterAined bdsed 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)[3 10 CMR 15.302(3)(b)] 5 *Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: O �rey-,f t/1�'0� Owner• Date of Inspection: 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 bedrooms): Number of current residents:'— Does residence-pave a.garbage ptinder�ye orno)-4) Is laundry on a separate sewage system(yes or no):�d [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):/N� Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no):rS Last date of occupancy: CCU P I COMM ERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):�� If yes,volume m ed: allons- How_ was. uani um ed determined?,, .>_ (ti?Ce- P! P g . . . 9 tY P P , Reason for pumping: %jV �p E G11" �N lL TYP F SYSTEM 7eptic 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 i _Other(describe): Approximate age of all components,date installed(if known)and source of information: /tel yea res Were sewage odors detected when arriving at the site(yes or no):" 6 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C v� SYSTEM INFO/RMATION(continued) Property Address:49 0 ee; 7- d N c•�t✓' Owner: MCt r S Date of Inspection: —G TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Materiaj of cons tuctio#►: c 6fr t-efer,null bergkass ; Dolyethylene ;othei(explain); # r Dimensions: Capacity: gallons Design Flow: gallons/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: Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: D Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leaks a into r out/of boxcc. : _ /v a a t f f PUMP CHAMBER: (locate on site plan) Pumps in workin order(yfs or o): Alarms in workingorder or no): " Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 i Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: /Vo J.a�acuer Owner• G✓' . -C Date of Inspection: �' G SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: L ! Y, � y � 1 Type leaching pits,number:_ leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: ;;,5— overflow cesspool,number: 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.): ,1 _ // /VO �i'cc vL L �G ✓ D o"W/ti or 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: t Depth of scum layer: Dimensions of cesspool: Materials of construction: !,� h Indication of grogndwater;infloh.(yes or poi: _ r�; ? 1 A i A, Comments(note condition of soil,signs o hydraulic failure,level of pb�nding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 1 9 Paje 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: aqf POAJW O e:►u.tr Owner:1?74 CC e—s-e— Date of Inspection: 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,w't Q9,,feel. Locate where public water supply enters t�e building. r 1 1 10 Pale 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C T 1 , • SYSTEM INFORMATION(continued) 'Property Address: ' t Owner:M 4q t-iC Jr Date ofInspection: SITE EXAM Slope Surface water Check cellar&//" Shallop wells` u. �— �V 1� + �4�� ,v rr'. Estimated depth to ground water %Id feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained 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 must describe how you es blished the high ground water elev?tion: Gt/Q' tCO- bL e ra r6 u 3 ��tc.i S S e le 29 Z2X I ; s 11 Commonwealth of Massachusetts W City/Town of NORTH ANDOVER MASSACH STTSIVED IR System Pumping Record IJ Form 4 APR 0 5 2006 ' M DEP has provided this form for use by local Boards of Health. The S ust stey be submitted to the local Board of Health or other approving authoriy. A. Facility Information Important: When filling out 1. System Location: forms the ,%2 a computer, use 7y only the tab key Address to move your �D,• �Z X cursor-do not use the return City/Town State Zip Code key. 2. System Owner: Name n, Address(if different from location) City/Town St to Zip Code Telephone Number B. Dumping Record 1. Date of Pumping Date 2 Quantity Pumped: /S Gallons 3. Type of system: ❑ Cesspool(s) e$eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes.ao If yes, was it cleaned? ❑ Yes4iE�Lwo 5. Condition of System: 6. System Pumped By: Name- 6Y am 6i �. Vehicle License Number 6 Company ��/ 7. Location where contents were disposed: Si ature of Haul — 2— 7 -06 Date hftp://www.mass.gov/dep/water/approvals/t5forms.htm#inspect t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachus RECEIVEDCi#y/Town of NORTH ANDOVER SAGH SETTS System Pumping Record UN'= 5 2006 Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. The System Pumping Record mu: be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: forms on the computer,use A130 only the tab key Address to move your cursor-do not =C St-- use the return City/Town — — Zip Code_ key. 2. System Owner: Name ��� -- — --- L-A- - �'Ql'ne --- - ----- Address(if different from location) City/Town - _ State--- Zip Code Telephone Number ""-- . Pumping Record 1. Date of Pumping Date~ 2. Quantity Pumped: '-0 /6 Gallons Type of system: El Septic Tank El Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: tib J 6. Sy ern Pumped By: Name 'C Vehicle License Number — Company r clt Q 7. Location where contents were disposed: Qol Si ature of Haul — f h / Date ttp:/www.mass,govi/dep/water/ provals/t5forms.htm#inspect e t5form4.doc•06/03 System Pumping Record•Page 1 of 1 TOWN OF NORTH ANDOVEP, SYSTEM PUMPINU RECORD SYSTEM OWNER dt ADDRESS SYSTEM L710N DATE OF PVMMNQ; a2/ O�_.. _QU^NTfTY PUMPED; ...�_. -- V63SPOOL: NO_... YES Snpcic Ank: NU YES _ NA rUKU ON SERVICE: KovrINEtMkRUENC'1'. RE ED ... oeSF,RVA'nQN3: MAY p 6 2005 GOOD C'ONVITION PUL. 'f'U COvER TOWN yr vC TH VT+L)JVER 1VY OSB _ BAPPLSS IN PLACE, HEALI H DEPARTMENT ROOTS .._ LBACI IUD RUNBACK . BXC688IVE SOLIDS FLOODED . 10LiD CARRYOYER, OTHER EXPLAIN Yyotam PumpcJ by .. VUMMENTS. t:uN I'BN'I'S fINNSF'ERRfiU I'() t� ���•�,���� c Sl . SS f Town of North Andover NORTH OFFICE OF 3a o,``,•c '',�°oma COMMUNITY DEVELOPMENT AND SERVICES p 30 School Street North Andover,Massachusetts 01845 <t WILLIAM I SCOTT SSACHUS� Director January 15, 1998 JAN 1 5 1998 a Mr. William Simmons, LSP 1 Simmons Environmental Services, Inc. 213 Elm Street Salisbury, MA 01952 RE: ENFORCEMENT ORDER—Hazardous Materials Release @ #1430 Great Pond Road. Dear Mr. Simmons: Per your request, enclosed please find an Enforcement Order authorizing remediation activities at the above referenced locus in accordance with the attached report dated January 12, 1998. In addition, and as a means of satisfying the concerns of this Department and the Conservation Commission, I am mandating that a qualified Wetland Biologist be on-site while the excavation activities are proceeding. Thereafter, the Biologist will be required to inspect the site weekly verifying that the erosion control is in tact and functioning as intended. As referenced on page #2 of your report, it is proposed to divert the sump "discharge into a stream" when "approved by the Conservation Commission". I would suggest that Simmons Environmental Services, Inc. and Wetlands Preservation, Inc. look at other alternatives. If feasible, this Department would prefer to eliminate or otherwise mitigate the existing point source discharge. It is my understanding that the floor of the basement is going to be excavated and subsequently replaced in order to remove the contaminated soil currently beneath the floor. At that time, please re-locate the sump to a more suitable location which would provide for some buffer zone mitigation prior to reaching the wetland. Chemicals and other cleaning products utilized by the property owner may enter the sump from time to time and it becomes increasingly important that these situations be avoided all together. The "Site Restoration" section (page 4 & 5) is not authorized under this Enforcement Order. Please file a Notice of Intent no later than noon on April 24, 1998 complete with the CONSERVATION-(978)688 9530 • HEALTH-(978)688-9540 • PLANNING-(978)688-9535 *BUILDINGOFFICE-(978)688-9545 • *ZONING BOARD OF APPEALS-(978)688-9541 • *146 MAIN STREET minimum submittal requirements as outlined in the North Andover Wetland Bylaw/Regulations (C.178 of the Code of North Andover) and the Massachusetts Wetland Protection Act (310 CMR 10.00). Please schedule a pre-construction meeting with this Department and a representative from Wetlands Preservation, Inc. prior to implementing this plan. Thanking you in advance. Sincerely, Michael D. Howard Conservation Administrator Encl. CC: Curt Young,WPI Sandy Starr,BOH Administrator Kathleen Colwell,Town Planner Richelle Martin,Conservation Associate Bill Martineau,NAFD NACC file 310 CMR 10.99 DEP `P3c No. 242- N/A Form 9 - (ro be provided by DEP) - C3tyjrwn NORTH ANDOVER Appi;cani Simmons Environmental Commonwealth of Xassachusetts Enforcement Order Massachusetts Wetlands Protection Act, G.L. c. 131, 540 AND UNDER THE TOWN OF NORTH ANDOVER BYLAW, CHAPTER 3, SECTION 3.5 rrpm NORTH ANDOVER CONSERVATION COMMISSION (NACC) Issuing Authority To Simmons Environmental Services, Inc Date of Issuance 1/15/98 Property lot/parcel number, address 41430 & #1420 Great Pond Road Extent and type of activity: Remediation work as described in the approved report dated 1/12/98 (reference 4971210) prepared by Simmons Environmental Services, Inc. The NACC has determined that the activity described 'above is in violation of the Wetlands Protection Act, G.L. C. 131, 540, and the Regulations promulgated pursuant thereto, 310 CXR 10.00, because: ❑ Said activity has been/is being conducted without a valid order of Conditions. ❑ Said activity has been/is being conducted in violation of an order of Conditions issued to , dated , File number 242-N/A ' , Condition number(s) AEK other (specify) Mitigation Approval The NORTH ANDOVER CONSERVATION COMM. hereby orders the following: ❑ The property owner, his agents, permittees and all others shall immediately cease and desist from further activity affecting the wetland portion of this property. XEr wetland alterations resulting from said activity shall be corrected and the site returned to its original condition. Effective 11/10/89 9-1 Issued by, NORTH ANDOVER CONSERVATION Cosmmission Completed application forms and plans as required by the Act and Regulations shall be filed with the NORTH ANDOVER CONSERVATION COMMISSION on or before April 24, 1998 @ 12:00 PM (date) , and no further work shall be performed until a public hearing has been held and an order of Conditions has been issued to regulate said work. Application forms are available ats NACC Office, Town Hall Annex �The property owner shall take every reasonable step to prevent further violations of the act. other (specify) Refer to the correspondence attached hereto and made a part hereof. Failure to comply with this order may constitute grounds for legal action, I Massachusetts General Laws Chapter 131, section 40 provides: Whoever violates any provision of this section shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not more than two years or both. Each day or portion thereof of continuing violation shall constitute a separate offense. Questions regarding this Enforcement order should be directed to c Michael D. Howard Issued by NORTH ANDOVER CO SERVA ON 0 SSION i signature(s) (Administrator) (Signature of delivery person or certified mail number) 9-2b Town of North Andover 40RTIy OFFICE OF 3�°,'" 1�o�c COMMUNITY DEVELOPMENT AND SERVICES ° . A 30 School Street X * North Andover,Massachusetts 01845 WILLIAM J. SCOTT 1 OWN OF NORTH ANDO Director BOARD OF HEALTH 4_lAN 12 19QR January 12, 1998 Mr. William A. Simmons Simmons Environmental Services, Inc. 213 Elm Street Salisbury, MA 01952 Re: 1430 Great Pond Road - home heating oil release Dear Mr. Simmons, Thank you for appearing before the Planning Board last week to discuss the home heating oil release that occurred at 1430 Great Pond Road and the steps that will be taken to remediate the situation. The Planning Board has authorized you to take whatever actions are required to in the short term to protect the Town's drinking water supply from this release. You are therefore directed to submit a written plan of action to the Town Planner for review prior to any activity on the site. You must then file an application with the Planning Board for a Watershed Special Permit for any long term work planned for this location. If you have any questions please do not hesitate to call me at 688-9535. I look forward to hearing from you soon. Very truly yours, Kathleen Bradley Colwell Town Planner cc. R. Rowen,Chairman,Planning Board S. Starr,Health Agent M. Howard,Conservation Administrator L. Martineau,NAFD C. Young, Wetlands Preservation Inc. M.Marchese BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 SIMMONS December 18, 2000 Environmental Services,Inc. Reference #971210 Sandra Starr, Health Inspector Town of North Andover, Municipal Building 120 Main Street North Andover, Massachusetts 01845 RE: Release Tracking Number 3-15859 1430 & 1420 Great Pond Road North Andover, Massachusetts Dear Ms. Starr: Simmons Environmental Services, Inc. (SIMMONS) has submitted a Class A-2 Response Action Outcome (RAO) Statement to the Massachusetts Department of Environmental Protection (MDEP), pursuant to Release Tracking Numbers #3-15859, for property at 1430 & 1420 Great Pond Road, North Andover, Massachusetts. This submittal package has been filed with the Northeast Regional Office of the MDEP, 205A Lowell Street, Wilmington, Massachusetts 01887. Arrangements may be made to review or copy the above referenced submittal and disposal site file by calling the MDEP Northeast Regional Office at (978) 661-7600. Very truly yours, William A. Simmons Licensed Site Professional WAS:rac 7'320 213 Elm Street Salisbury,MA 01952 New Area Code(978)Telephone 508-463-6669 Fax 508-463-6679 `. f""TOWN OF NORTH ANDOVER/ BOARD OF HEALTH ig 09 SIMMONS April 13, 1999 Environmental Services,Inc. Reference #971210 Sandra Starr, Health Inspector Town of North Andover, Municipal Building 120 Main Street North Andover, Massachusetts 01845 RE: RTN 3-15859 Tier IB Classification 1430 Great Pond Road, North Andover, Massachusetts Dear Ms. Starr: Simmons Environmental Services, Inc. (SIMMONS) has recently submitted correspondence that will confirm that an Initial. Site Investigation in support of a Tier IB Classification pursuant to 310 CNIR 40.0500, Massachusetts Department of Environmental Protection (MDEP) Release Tracking Number #3-15859 for property at 1430 Great Pond Road, North Andover, Massachusetts has been undertaken. This submittal package has been filed with the Northeast Regional Office of the MDEP, 205A Lowell Street, Wilmington, Massachusetts 01887. Arrangements may be made to review or copy the above referenced submittal and disposal site file. The files are available at the MDEP Regional Office, 205A Lowell Street, Wilmington, Massachusetts. Call.for an appointment at (978) 661-7600. Very truly yours, 4 "L�� Wiliam A. Simmons Licensed Site Professional WAS:rac 213 Elm Street Salisbury,MA 01952 New Area Code(978) Telephone 508-463-6669 Fax 508-463-6679 INS Invironmenmi Scr•iccs.Inc NOTICE OF INITIAL SITE INVESTIGATION AND WASTE SITE CLEANUP PERMIT APPLICATION RESIDENCE 1430 AND 1420 GREAT POND ROAD NORTH ANDOVER, MASSACHUSETTS RTN#3-15859 Pursuant to the Massachusetts Contingency Plan (MCP) codified as 310 CMR 40.0480, an Initial Site Investigation has been performed at the above referenced location. A release of oil and/or hazardous materials has occurred at this location which is a disposal site (as defined by MGL c21E §2). This site has been classified as an Initial Tier IB (310 CMR 40.0500) and a Tier IB Permit application is being submitted on April 13, 1999 to the Massachusetts Department of Environmental Protection (MDEP) pursuant to 310 40.0703. A permit is required to proceed with Comprehensive Remedial Responses at all Tier I sites. Anyone interested in reviewing the permit application should notify MDEP by writing to MDEP, Bureau of Waste Site Cleanup, Permit Section, at 205A Lowell Street, Wilmington, 01887 by May 18, 1999. If anyone notifies MDEP of his or her interest in reviewing or submitting commenting on the Tier I permit application, MDEP will conduct a public comment review period of twenty (20) days which shall run concurrently with MDEP's Initial Technical Review of the application. Anyone who fails to notify MDEP in writing of his/her interest in commenting on the application by the above date may be deemed to have waived his/her rights, if any, to appeal MDEP's permit decision or to intervene in• an adjudicatory proceeding with respect to this application, pursuant to 310 CMR 40.0770(2). MGL c21E and the MCP provide additional opportunities for public notice of and involvement in decisions regarding response actions at disposal sites: (1) The Chief Municipal Official and Board of Health of the community in which the site is located will be notified of major milestones and events, pursuant to 310 CMR 40.1403; and (2) Upon receipt of a petition from ten or more residents of the municipality in which the disposal site is located, or of a municipality potentially affected by a disposal site, a plan for involving the public in decisions regarding response actions at the site will be prepared and implemented, pursuant to 310 CMR 40.1405. To obtain more information on this disposal site and the opportunities for public involvement during its remediation, please contact William A. Simmons, LSP, of Simmons Environmental Services, Inc. at 213 Elm Street, Salisbury, Massachusetts 01952 at (978) 463-6669. \\Kmn\simmons\971210\Lega1 Notice.doc ' w COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION Metropolitan Boston—Northeast Regional Office r �a Y• ARGEO PAUL CELLUCCI Governor _ BOB DURAND Secretary JANE SWIFT LAUREN A.LISS Lieutenant Governor Commissioner SLS' 17 CERTIFIED MAIL RETURN RECEIPT REQUESTED Property 1430 Great Pond Road North Andover,MA 01845 ATTN: Mel Marchese,Owner RE: NORTH ANDOVER- Property 1430& 1420 Great Pond Road RTN 3-15859 Permit# 137395 PERMIT EFFECTIVE DATE Dear Mr.Marchese: Attached please find the first page of the Permit for the above referenced site,indicating the Permit's Effective and Expiration dates. Please attach this page to the Permit Statement already in your possession. The Department is urging you to review and familiarize yourself with the Permit's terms and conditions and the Massachusetts Contingency Plan(MCP),310 CMR 40.0000,in order to complete the required response actions within the timelines set forth therein. In addition,please notify the Department seven days in advance of any field activity and/or sampling event at the above referenced site,in accordance with 310 CMR 40.0550(6)(a). Please note that the Department may perform an audit of this site in the future,in order to ensure compliance with the terms and conditions of the Permit and the requirements of the MCP. Should this site become a candidate for an audit,you will be notified promptly. U 7670 2 71999 This information is available in alternate format by calling our ADA Coordinator at(617)5746872. 205A Lowell St. Wilmington,MA 01887 Phone(978)661-7600 • Fax(978)661-7615 • TM#(978)661-7679 c� Printed on Recycled Paper (North Andover,RTN 3-15859,Property) Page 2 If you have any questions,please contact Ida Babroudi~at the letterhead address or by telephoning(978) 661-7600. Very truly yours, Iris W.Davis,Section Chief Permits/Risk Reduction Bureau of Waste Site Cleanup Attachment-first page of Permit cc: North Andover Board of Health,Municipal Building, 120 Main Street,North Andover,MA 01845 Attn:Sandra Starr,Health Inspector North Andover Chief Municipal Official,Municipal Building, 120 Main Street,North Andover,MA 01845 Attn:Robert J.Halpin,Town Manager Simmons Environmental Services,Inc., 213 Elm Street,Salisbury,MA 01952 Attn:William A.Simmons,LSP# 1847 DEP NERO File Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup(BWSC) TIER I PERMIT This Permit is Issued to:. For DEP Use Only [X] One Permittee Effective Date: 9/8/1999 [ ] More than One Permittee* Expiration Date:9/8/2004 *A list of all Permittees is attached. One Permittee: Name of Organization: Property Permittee Name: Mel Marchese Title or c/o: Owner Street: 1430 Great Pond Road City/Town: NORTH ANDOVER State: MA Zip code: 01845 Telephone: (978) 685-8628 DEP Finding Concerning Tier Classification [ ] Tier IA(BWSC01) [ ]Tier IB(BWSCO2) [X] Tier IC(BWSC03) Permit No:137395 This permit authorizes the performance of comprehensive remedial response actions at: Disposal Site Number: 3-15859 Disposal Site Name: Property Street: 1430& 1420 Great Pond Road City/Town: North Andover State: MA Zip code: 01845 Unless a request for an adjudicatory hearing is made pursuant to 310 CMR 40.0770,this permit shall be effective 21 days after the date of issuance by the Department and the receipt of the signed Permit Acceptance Statement, whichever is later. The Permittee has 30 days from the date of issuance of this Tier I Permit to sign and submit . the completed Permit Acceptance Statement to the Department. This permit shall expire 5 years from its effective date. Town of North AndoverNORT#j OFFICE OF ?cy�t��� 1c COMMUNITY DEVELOPMENT AND SERVICES 30 School Street op � VVII LIAM J. SCOTT North Andover,Massachusetts 01845 �9SSgcHus�t�� Director MEMORANDUM DATE: January 5, 1998 TO: Michael Howard, Conservation Administrator Kathleen Colwell,Town Planner FROM: FROM: Sandra Starr,Health A n M for RE: 1430 Great Pond Road-Hazardous Materials Release As I expressed in our meeting earlier today with Curt Young of Wetlands Preservation,Inc. and Bill Simmons of Simmons Environmental Services, Inc.,the accidental release of heating oil which has occurred in the watershed at 1430 Great Pond Road is of critical concern to the Health Department. Because of the topography on the site,the high level of the groundwater present, and the proximity to Lake Cochiewick,this release has resulted in an imminent health hazard. The Board of Health would appreciate anything that you and your Boards can do to speed the process of remediation at this site. Please keep me apprised of the situation and your permitting process. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION t Metropolitan Boston—Northeast Regional Office ARGEO PAUL CELLUCCI BOB DURAND Governor Secretary JANE SWIFT EDWARD P.KUNCE Lieutenant Governor Acting Commissioner May 20, 1999 Property 1430 Great Pond Road North Andover,MA 01845 ATTN: Mel Marchese,Owner RE: DETERMINATION OF ADMINISTRATIVE COMPLETENESS Application for: PERMIT TO PROCEED WITH RESPONSE ACTIONS AT: North Andover-Property 1430& 1420 Great Pond Road, RTN 3-15859 Transmittal Number: 137395 Dear Mr.Marchese: The Department of Environmental Protection (the Department) has completed its Administrative Review of the permit application listed above and has determined that the application is administratively complete. This letter serves to notify you that the Department will proceed with the Technical Review. According to 310 CMR 4.04,the Department has 75 days from the date of this letter to complete its Technical Review. Pursuant to 310 CMR 40.0722(2), a Public Comment Period(PC-1)of 20 days shall run concurrently with this T-1 review period for those individuals who have notified the Department of their interest to review the application and submit written comments. The Technical Review(T-1),may result in a decision to grant or deny the permit,a Proposed Permit Decision to grant or deny a permit,the issuance of a Statement of Technical Deficiencies, or a determination that the above site does not need a permit. The issuance of a Statement of Technical Deficiencies would end the T-1 review period. Pursuant to 310 CMR 40.0722(2)and 310 CMR 4.04(2)(b),the applicant must respond to the Department within 30 days of issuance of such Statement of Deficiencies. This information is available in alternate format by calling our ADA Coordinator at(617)5746872. 205A Lowell St. Wilmington,MA 01887•Phone (978)661-7600•Fax (978)661-7615•TDD#(978)661-7679 0 Printed on Recycled Paper i • forth Andover,RTN 3-15859, 1430& 1420 Great Pond Road r Page 2 The submission of a copy of this Determination of Administrative Completeness to the North Andover Chief Municipal Officer and the Board of Health,constitutes the Department's compliance with the requirements of 310 CMR 40.0721 (5). Pursuant to 310 CMR 4.04 (2) and 310 CMR 40.0721 (6), a Determination of Administrative Completeness shall not constitute any finding with respect to the technical suitability,adequacy or accuracy of the materials submitted, and shall be no bar to a request to amend, revise,replace, or supplement such materials based on technical suitability, adequacy or accuracy. The Department may request additional information during the course of the Technical Review. In accordance with 310 CMR 4.04(2)and 310 CMR 40.0720(3),the applicant and the Department may,by -written agreement,extend any schedule for timely action or any portion,thereof. Withdrawal of the permit application shall be subject to the provisions of 310 CMR 4.04(3)(d). If you have any questions regarding this matter,please contact John S.Buckley at the letterhead address or by calling(978)661-7600. Sincerely, , -GL 9 John S.Buckley Iris W.Davis Environmental Analyst Section Chief, Permits/Risk Reduction Bureau of Waste Site Cleanup cc: North Andover Board of Health,Municipal Building, 120 Main Street,North Andover,MA 01845 Attn: Sandra Stan-,Health Inspector North Andover Chief Municipal Official,Municipal Building, 120 Main Street,North Andover,MA 01845 Attn:Robert J.Halpin,Town Manager Simmons Environmental Services,Inc., 213 Elm Street,Salisbury,MA 01952 Attn:William A.Simmons,LSP# 1847 TOFNid OF i�"CRS F;i� „J���1�/ 110ARI1 OF COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS -- DEPARTMENT OF ENVIRONMENTAL PROTECTION METROPOLITAN BOSTON -NORTHEAST REGIONAL OFFICE ~ ARGEO PAUL CELLUCCI TRUDY COXE Governor Secretary DAVID B. STRUHS Commissioner URGENT LEGAL MATTER: PROMPT ACTION NECESSARY CERTIFIED MAIL: RETURN RECEIPT REOL�STED ON 311991 Mi . Mel Marchese RE : N. Andover 1430 Great Pond Road 1430 Great Pond Road N. Andover, MA 01845 RTN #3-15859 NOTICE OF RESPONSIBILITY; M.G. L. c . 21E & 310 CMR 40 . 0000 Dear Mr. Marchese : On December 19, 1997 at 4 : 20 PM, the Department of Environmental Protection (the Department or DEP) received oral notification that there is or has been a release of oil and/or hazardous material . at the above-referenced property which requires one or more response actions . Based on this information, the Department has reason to believe that the subject property or portion (s) thereof is a disposal site as defined in the Massachusetts . Oil and Hazardous Material Release Prevention and Response Act, M. G. L. c . 21E, and the Massachusetts Contingency Plan, 310 CMR 40 . 0000 (the MCP) . The assessme-t and cleanup of disposal sites is governed by M.G.L. c . 21E and she MCP. The purpose of this notice is to inform you of your legal responsibilities under state law for assessing and/or remediating the subject release . For purposes of this notice, the terms and phrases used herein shall have the meaning ascrihed to them by the MCP unless the text clearly indicates otherwise . STATUTORY LIABILITIES The Department has reason to believe that you (as used in this letter, "you" refers to Mr. Mel Marchese) are a Potentially Responsible Party (a PRP) with liability under M. G.L. c . 21E, 5 5, for response action costs . Section 5 makes the =ollowing parties liable to the Commonwealth of Massachusetts : current owners or 10 Commerce Way 0 Woburn,Massachusetts 01801 9 FAX (781) 932-7615 0 Telephone (781) 932-7600 0 TDD#(617)932-7679 Page 2 NOR 3-15859 operators of a site from or at which there is or has been a release/threat of release of oil or hazardous material; any person who owned or operated a site at the time hazardous material was stored or disposed of; any person who arranged for the transport, disposal , storage or treatment of hazardous material to or at a site; any person_ who transported hazardous material to a transport, disposal, storage or treatment site from which there is or has been a release/threa- of release of such material ; and any person who otherwise caused or is legally responsible for a release/-hreat of release of oil or hazardous material at a site . This liability is "strict" , meaning i,- is not based c=, fault , but solely on your status as an owner, operator, generator, transporter or disposer. It is also joint and several , meaning that you may be liable for all response action costs incurred at the site, regardless of the existence of any other liable parties . The MCP requires responsible parties to take necessary response actions at properties where there is or has been a release or threat of release of oil and/or hazardous material . Iff you do not take the necessary response actions, or fail to perform them in an appropriate and timely manner, the Department is authorized by M.G.L. c . 21E to have the work performed by its contractors . By taking such actions, you can avoid liability for response action costs incurred by the Department and its contractors in performing these actions, and any sanctions which may be imposed for failure to perform response actions under the MCP. You may be liable for up to three (3) times all response action costs incurred by the Department . Response action costs include, without . limitation, the cost of direct hours spent by Department employees arranging for response actions or overseeing work performed by persons other than the Department cr their contractors, expenses incurred by the Department in support of those direct hours, and payments to the Department ' s contractors . (For more detail on cost liability, see 310 CMR 40 . 1200 . ) The Department may also assess interest on costs inc,.:rred at the rate of twelve percent (12%) , compounded annually. To secure payment of this debt, the Commonwealth may place liens on all of your property in the Commonwealth. To recover the debt, the Commonwealth. may foreclose on these liens or the Attorney General may bring legal action against you. In addition to your liability for up to three (3) t_mes all response action costs incurred by the Department, you may also be liable to the Commonwealth for damages to natural resources caused by the release . Civil and criminal liability may also be imposed under M.G.L. c . 21E, § 11, and civil administrative penalties may be imposed under M.G.L. c . 21A, § 16 for each violation o- M.G.L. C . 21E, the MCP, or any order, permit or approval issued thereunder. i • Page 3 NOR 3-15859 NECESSARY RESPONSE ACTIONS The subject site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the site have been eliminated and a level of No Significant Risk exists or has been achieved in compliance with M.G. L. c . 21E and the MCP. In addition, the MCP requires persons undertaking response actions at disposal sites to perform Immediate Response Actions ; IRAs) in response to "sudden releases" , Imminent Hazards and Substantial Release Migration. Such persons must continue to evaluate the need for IRAs and notify the Department immediately if such a need exists . The Department has determined that an IRA is necessary at the subject site to respond to the sudden release of fuel oil to the soils beneath your basement floor and the wetlands adjacent to your property. The Department has approved of the temporary shutdown of your sump, if necessary, the pump can be reactivated to prevent flooding. However, if the sump must be reactivated all product must be removed from the sump prior to reactivation. You are authorized to conduct only tie specific response actions for which you received oral approval from the Department at the time you provided oral notification to t--e DEP of the subject release . All additional Immediate Response Actions require DEP approval in accordance with 310 CMR 40 . 0420 . You must employ or engage a Licensed Site Professional (LSP) to manage, supervise or actually perform the necessary response actions at the subject site . In addition, the MCP requires persons undertaking response actions at a disposal site to submit to the Department a Response Action Outcome Statement (RAO) prepared by an LSP in accordance with 310 CMR 40 . 1000 upon determining that a level of No Significant Risk already exists or has been achieved at a disposal site or portion thereof . You may obtain a list of the names and addresses of these licensed professionals from the Board of Registration of Hazardous Waste Site Cleanup Professionals at (617) 556-1091 . There are several other submittals required by the MCP which are related to release notification and/or response actions that may be conducted at the subject site in addition to an RAO, that, unless otherwise specified by the Department, must be provided to DEP within specific regulatory timeframes . The submittals are as follows : (1) If information is obtained after making a oral or written notification to indicate that the release or threat of release didn' t occur, failed to meet the reporting criteria at 310 CMR 40 . 0311 through 40 . 0315, or is exempt from notification pursuant to 310 CMR 40 . 0317, a Nctification Retraction must be submitted within 60 days of ini:�ial notification pursuant to 310 CMR 40 . 0335; otherwise, Page 5 NOR 3-15859 If you have any questions relative to this notice, you should contact Timothy J. Boyle at the letterhead address or (617) 932- 7600 . All future communications regarding this release must reference the Release Tracking Number (RTN #3-15859) contained in the subject block of this letter. Very truly yours, Timothy J. oyle Environme al Engineer Roger Chu Branch Chief Emergency Response Section cc : Board of Health Fire Department DEP data entry/fi-le Attachment : Release Notification & Release Retraction Form,BWSC-103 • i T SR I K YLI(all 4S December 31, 1997 Environmental Services,Inc. Reference 4971208 Sandra Starr, Health Inspector Municipal Building . 120 Main. Street North And.ovcr, Xlassac'�usetts 01.845 Dear 'vis. Stars.: Simmons Environmental Services, Inc. (SIMMONS) has recently submitted correspondence that will confirm that a Immediate Response Action (IRA) Plan pursuant to 310 CMR 40.0424 (Massachusetts Department of Environmental Protection (MDEP) Release Tracking #3-15685 for property at 230 Andover Street, North Andover, Massachusetts. This submittal package has been filed with the v ith the Metro Boston/Northeast. Regional Office of the Massachusetts Department of Environmental Protection (MDEP), 10 Commerce Way, Woburn, Massachusetts 01801, On ThurscaY, November 5, 1997, personnel from the MDEP responded to a reported release of oil from the subject location. Upon investigation, it was found. that the copper service line between an aboveground domestic oil storage tank and the residence's oil. burner had leaked resulting in a release of an unknown quantity of oil to the subsurface beneath the cellar slab. The homeowner, Mrs. Helen S. Robertson, was orally notified of her responsibilities under Massachusetts General Law c.21F and the Massachusetts Contingency Plan (310 CMR 40.0000 et.. seq.). A sump pump siruated in. the basement and designed to discharge to a dry well on the weste�rly side of the residence was disconnected upon discovery of free phase product in the sump. Sorbent materials were left with the homeowner to be changed. on an as needed basis. On December 30, 1997, ENPRO Services, Inc. removed 255 gallons of oil and water mixture that had been manually bailed from the sump by the homeowner. The remedial waste was transported under a Uniform Hazardous Waste. Manifest to EN-VIRONME�NTAL COMPLIANCE CORPORATION Stoughton, Massachusetts for recycling. 213 Elm Street Salisbury,MA 01952 Telephone 508-463-6666- Fax 508-463-6679 230 Andover Street North Andover,Massachusetts Page 2 SIMMONS Environmental Services,Inc. Because of the presence of free phase product and a relative high static water table, SIMMONS proposes to install a larger sump and skim free phase product. Groundwater from the sump will be pumped through two granular activated charcoal drums and discharged either to a nearby storm drain or to the sanitary sewer. If discharged to a storm drain, a NPDES permit will be obtained and if discharged to the sanitary sewer, a permit will be obtained from the Greater Lawrence Sanitary District (GLSD). Once free phase product and groundwater control are in place, test borings and microwells will be installed throughout the basement and exterior of the property to determine the horizontal and vertical extent of contamination. Indoor air quality will also be measured in order to determine if an imminent hazard exists with regard to air quality. This will involve collection and analyses of indoor air samples and measurement of soil gas concentrations beneath the slab. Because of the relatively fresh nature of the release, soil and groundwater samples will be analyzed for both Volatile Petroleum Hydrocarbons (VPH) and Extractable Petroleum Hydrocarbons (EPH) fractions. It is anticipated that groundwater pump and treat measures will be initiated in mid-January 1998 and that site assessment measures will begin in late January or early February 1998. Arrangements may be made to review or copy the above referenced submittal and disposal site file. The files are available at the MDEP Regional Office, 10 Commerce Way, Woburn, Massachusetts at (617) 932-7600. Very truly yours, William A. Simmons Licensed Site Prof6ss enmi } WAS:rac i I i \\Karen\simmons\971208\I.etters to Officials-IRAP.doe ( IN OF N— ORTH DOVER/ { i60ARD OF HEALTH FAM 2 7 1999 SIMMONS April 13, 1999 Environmental Services,Inc. Reference #971210 Robert J. Halpin, Town Manager Town of North Andover, Municipal Building 120 Main Street North Andover, Massachusetts 01845 RE: RTN 3-15859 Tier IB Classification 1430 Great Pond Road, North Andover, Massachusetts Dear Mr. Halpin: Simmons Environmental Services, Inc. (SIMMONS) has recently submitted correspondence that will confirm that an Initial Site Investigation in support of a Tier IB Classification pursuant to 310 CMR 40.0500, Massachusetts Department of Environmental Protection (MDEP) Release Tracking Number #3-15859 for property at 1430 Great Pond Road, North Andover, Massachusetts has been undertaken. This submittal package has been filed with the Northeast Regional Office of the MDEP, 205A Lowell Street, Wilmington, Massachusetts 01887. Arrangements may be made to review or copy the above referenced submittal and disposal site file. The files are available at the MDEP Regional Office, 205A Lowell Street, Wilmington, Massachusetts. Call for an appointment at (978) 661-7600. Very truly yours, William A. Simmons Licensed Site Professional WAS:rac 213 Elm Street Salisbury,MA 01952 New Area Code(978) Telephone 508-463-6669 Fax 508-463-6679 Tad A i VL Environmentai Serviccs.Inc. NOTICE OF INITIAL SITE INVESTIGATION AND WASTE SITE CLEANUP PERMIT APPLICATION RESIDENCE 1430 AND 1420 GREAT POND ROAD NORTH ANDOVER, MASSACHUSETTS RTN#3-15859 Pursuant to the Massachusetts Contingency Plan (MCP) codified as 310 CMR 40.0480, an Initial Site Investigation has been performed at the above referenced location. A release of oil and/or hazardous materials has occurred at this location which is a disposal site (as defined by MGL c.21E §2). This site has been classified as an Initial Tier IB (310 CMR 40.0500) and a Tier 113 Permit application is being submitted on April 13, 1999 to the Massachusetts Department of Environmental Protection (MDEP) pursuant to 310 40.0703. A permit is required to proceed with Comprehensive Remedial Responses at all Tier I sites. Anyone interested in reviewing the permit application should notify MDEP by writing to MDEP, Bureau of Waste Site Cleanup, Permit Section, at 205A Lowell Street, Wilmington, 01887 by May 18, 1999. If anyone notifies MDEP of his or her interest in reviewing or submitting commenting on the Tier I permit application, MDEP will conduct a public comment review period of twenty (20) days which shall run concurrently with MDEP's Initial Technical Review of the application. Anyone who fails to notify MDEP in writing of his/her interest in commenting on the application by the above date may be deemed to have waived his/her rights, if any, to appeal MDEP's permit decision or to intervene in, an adjudicatory proceeding with respect to this application, pursuant to 310 CMR 40.0770(2). MGL c.21E and the MCP provide additional opportunities for public notice of and involvement in decisions regarding response actions at disposal sites: (1) The Chief Municipal Official and Board of Health of the community in which the site is located will be notified of major milestones and events, pursuant to 310 CMR 40.1403; and (2) Upon receipt of a petition from ten or more residents of the municipality in which the disposal site is located, or of a municipality potentially affected by a disposal site, a plan for involving the public in decisions regarding response actions at the site will be prepared and implemented, pursuant to 310 CMR 40.1405. To obtain more information on this disposal site and the opportunities for public involvement during its remediation, please contact William A. Simmons, LSP, of Simmons Environmental Services, Inc. at 213 Elm Street, Salisbury, Massachusetts 01952 at (978) 463-6669. \\Karen\sirnrmns\971210\Lega1 Notice.doe i'IYty Oh ,AN. JER/ TOWN OF NORTH 'ANDOVE SYSTEM PUMPING RECORD NGJ _ 4202 �1 STEM OWNER & ADDRESS SYSTEM LOCATION 1,21 (example: left front of house) U:\"I'E OF PUMPING: /lJ-P-o'L— QUANTITY PUMPED jj-oJ GALLU 6 C. 1:�.51,00L: NO YES SEPTIC TANK: NO YES ' ATURE OF SERVICE: ROUTINE L EMERGENCY c�(3.SFRV.:\TIONS; GOOD CONDITION_ FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSI-VE SOLIDS FLOODED SOLIDS CARRYOVER OCHER (EXPLAIN) l i PUMPED 8Y: i c Um Avl ENTS: UNTI:'N'1'S TIZANSFEIZRLD 'T0: Arnica Mutual Insurance Company GREATER BOSTON OFFICE Arnica Life Insurance Company 45 William Street,Suite 200 Arnica General Agency,Inc. Wellesley Hills,Massachusetts 02481-4050 Toll Free:888-7o-AMICA(888-702-6422) Claims Fax: (781)431-7899 AUTO HOME L I F E Production Fax: (781)431-1665 April 2, 2004 Town of North Andover Building Inspector Town Hall North Andover MA 01845 File Number: F01200404885D Date of Loss: April 1, 2004 Owner/Insured: Gary E. Muldoon Street: 1430 Great Pond Rd. Town: North Andover Type of Loss: Water Gentlemen: Please be advised that we insure the above named individual(s) . A claim has been made for Damage to Real Property and as the insurer, we are presently in the process of adjusting the loss . We are mandated to comply with Massachusetts General Laws, Chapter 139 and as such, if there are any present liens on the above property, please notify us within 10 days of receipt of this letter. If we do not hear from you, we will be under no obligation to pay you any portion of this claim. Very truly yours, Joseph W. Higgins) l Claims Department Amica Mutual Insurance Company jhiggins@amica.com *CTN Web Site:www.amica.com Offices Countrywide:800-24-AMICA(800-242-6422) 1 e `11 • .. ��'!�,.{JYI}t`� (rJy'r)''�o )' .7 �L 4 S�C,•�tljS/.1 3'1°1 t'�r713!1'�'lyi1�'S+•/I'r1�J�i t r r 11 '•^"��...�.`�.-..,,.-----,�.��._�_._. ;K r• �y1 !. � ,Y r! 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"t ,rl.AM f,1�J1j1%rrf�; I.Yt;r `'•' �4. tl” :il •,�,'J:S... .:,r ;t;.;. J all,�, Sr•ir �.,•1,,.,': V lir , , I'� •' ..k.'•i•':fit 1! fit. .,'';'1,' .. .y .�i°1':'f.yif�?,i,i:�Y:,w)\trlii;'..;�:!i}:r;�:!,,�.;1::�'fl r,}11 ,.�•.., � ., ?`.. ,'�`1 : � '::� t 'S1,;i:Z�a�•N�Srr,,�.I:�.I,�'!,D. r.U'�� ,,�'' , .. '.:"tali ;;Yt�9arif•yF,•.1;:•v:,1�1,.;Stl:,,yrj:rdi:1; 6,.. Town of North Andover - - - - t NORTH , OFFICE OF 3�°�`"• ••ti°oL. COMMUNITY DEVELOPMENT AND-SERVICES- - - 30 School Street :�o •" North Andover,Massachusetts 01845 sS�cNuSEttg WILLIAM J.SCOTT �`� C Director t December 30, 1997 Mr. Bill Simmons Simmons Environmental Services,Inc. _ 375 Elm Street Salisbury, MA 01952 RE: Hazardous Materials Release-#1430 Great Pond.Road,North Andover, MA. -- Dear Bill: -- -r Thank you for meeting with-this Department on site to review and discuss the above:referenced hazardous - _ materials release and anticipated mitigating measures. As l understand the current situation,-,an unknown -_-_ quantity of#2 home heating oil was released to the environment via a.faulty,subsurface copper flow line extending from "twin"above ground storage tanks in the basement. Furthermore,elevated groundwater elevations surround the parcel in question,and as such,the property owner had instalted'asump some -= - time ago to prevent flooding in the basement. The product which was.released from the copper line.settled. into this sump until such time as the pump switch kicked on and discharged the groundwater and-product _ into a wetland resource area on the abutting property (#1420 Great Pond Road). MASSACHUSETTS WETLAND PROTECTION ACT(310 CMR 10.00) NORTH ANDOVER WETLAND BYLAW®ULATIONS (C. 178 of the Code of North Andover) _.. Per your request, I have reviewed the Massachusetts Wetlands Protection Act and the North Andover - Wetland ByLaw which govern work within wetland resource areas. Assessment,monitoring,containment, _ mitigation,and/or remediation of a release of oil or other products within the Buffer Zone or within the limits of a jurisdictional wetland resource area are not exempt from the Act or the local bylaw. -However, _ remediation efforts do fall under the limited project provision (310 CMR 1053(q)) and,,-_as such,your client is responsible for filing a Notice of Intent in accordance with the parameters set forth under this citation. I have enclosed a copy of this section of the Act for your review. NORTH ANDOVER ZONING BYLAW-Watershed Protection District(Section 4.136) A quick review of the North Andover Zoning Map indicates that the-subject`property is located within the limits of the watershed encompassing Lake Cochichewick;the Town's sole source of drinking water. As a result,it is my opinion that regulatory review specific to remediation activities also falls under the jurisdiction of the Planning Board. CONSERVATION-(978)688 9530 • HEALTH-(978)688-9540 • PLANNING-(978)688-9535 *BUILDINGOFFICE-(978)688-9545 • *ZONING BOARD OF APPEALS-(978)688-9541 * *146 MAIN STREET RECOMMENDATIONS) - It is my understanding that you have tentatively scheduled remediation work within the limits of the identified wetland resource area during the early part of next week. At this.time I am prohibiting work within this wetland until all applicable permits have been applied for and/or issued by each agency asserting jurisdiction. Please consult with a qualifiedwetland biologist and perform the following tasks: 1. -Delineate the wetland-in.accordancewith 310 CMR 10.55 and/or C.178 of the Town of North Andover; __ 2. Please submit an"altemat_ives�anal sig"in accordance with 310 CMR 10.53(q)(1) or a "Comprehensive Remedial Action-Alternative"that is selected in accordance with the - provisions of 310 CMR 40.085a=thrtiogh 40.0869; 3. Please submit adetailed'"wetland restoration plan&report"which addresses the following issues: - --- - - -- _" _ :.a. Hydrologic changes;; - -' b: Best Management Practices(e: appropriate sedimentation/erosion control ---- __ measures), --- --c-- Construction equijepfstockpile Locations,sequencing, :de=watering etc...; d. Impacted floras iridud'uig=apost-cconstruction planting plan which will assure that at least 7596 of the=distuFbed:wetland surface area will be-r_"stablished with -- indigenous wetland plantspecies.after two (2) growing seasons; e. Work in resourceareas shaltocc6r-on,X when the ground is sufficiently frozen or_ .. _ -�_otheiwisestable,:� _ f. Please_identify.a_Wetlar�dBiologist who will act as an"Environmental Monitor". This _ designee must beton-site d'uringremediation activities. _ 4. Please file a,Notice of Intent with the Korth Andover Conservation Commission (NACC) no later than noon on January 9, t998: Ttiisfiling deadline will result in a public hearing before the NACC on January 2.1, 1998;,-I-have-decided on this_course of action (in lieu of allowing work _. to occur underan -7 to the parcel is located within the watershed, work is occurring on-an abutting property under separate ownership,and preliminary - mitigating measures by Simmons Environmental,Inc.have reduced any imminent threat to the Lake. Inaddition,groundwater.sampling and monitoring of the restored wetland will likely be on-going.- Typically,compliance of this=son`is best handled through an Order of Conditions. 5. Please contact the Town Planner-;-Kathleen Colwell(688-9535),discuss the situation with her and find out if an appearance beforFthe North Andover Planning Board is warranted. If you have any questions or concerns regarding this matter please do not hesitate to contact me. Sincerely, - = Michael D./H`oward Conservation Administrator Encl.- CC: ncl.CC: Kathleen Colwell,Town Planner Richelle Martin,Conservation Associate Lieutenant Martineau,NAFD NACC +._ file atY 1i I.. . i'Al . I�� .t al .to ,i i 1>i �!It �zr �'� #' L% '°� �' �I'I' ��I `���•fa�� `>1d t�Ha3, s'{,�'�%' : � r t t � i 1, •F . ;:�+ a .� �F`' !i- 3 °1,:'' k�1^'�'y.� � �'4e.j{)•t s '+' '� r� tp�kl >.t•i�'.`� ':ts+ _ t• h ��� �r � t it.�1. -{I 's s._yt�jj B2�lS:e 1� ;.. I s jI t,r� tt t i":t t 1� 9' _ 1 qs 5 ,1!• t '�4s h;� 1 s,� �y �!t 4'. ' t t 1 # �� !I •* '��, : ! _ z �'�^� r �° ;. !} 1 { •�k. 9 :r,: .41 t r S i..i :t aJ, t11 4 ix r. I i.i'I! 3 3 r�( .: t {. � '-' 4,. _ t td{,. ��:r �?���•d�;la �. .;r , j: s�.� •. �? I i �.' �'k ;!* S -r ; ( .�_.` �.. 5 ..t`•!{ y�-v.3y .4:y„tt�, I a: ).; •.�t: +:{.,T.. ,.r I, r - s t`z- �.t •1 :-� vf .4 iI 5 8'yy �t•� k, rr•rr.:...1}s,�s: 'L"A.�-. 1.t. I 1 I• •.1 t +;•;7i� i' � ! 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I.��i e 8. �✓: 4�...i�k3 t l S Y, i ,''S'yy :: fK 4a��#_'y'(. r rj 5 i:.ri t{13 r � {; �rl i,t� 4�k7 �I f , 310 CIv>3t: DEPARTMENT OF PRCLTEL r 10.53. continued T.errporary strucatres,work ares,and aherauons ta•resourct areasaiathcsr that no _ 104m are necessary tO LU the rsgPkUnaLts of 31A:CIk 4x:0000:and work of resource areas shall occur only when:tbG jrOund a sufl;aentt fro x " dr3or otherwise:stableto wpport tti --- y = Zt�e oonstruMam of a nerv'aocess:"for�for� . 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Box 4173 tation Service Location: � Andover, A 01810 Phone: (508) 475-2593 ' (508) 664-0640 .Contact: Professional Septic & Drain Billing Address: '. `/„�,q, � Locally Owned and Operated City: fY� ip':Ci Emergency 24 Hr. Svc. —7 Days Special Instructions �... Completed ' ❑ Incomplete Reason: Per: AM/PM Services Rendered Va uum Pumping Observations Drain Cleaning eptic Tank ❑ Goodnditiori ❑ Main Line _ ❑ Drywell / C) .� field Runback ❑ Toilet Bowl 4 ❑ Leech Pit/Overflow —[ 1 Riding High ~�V y❑ Kitchen Sink ❑ D-Boxli level)f ElBathtub/Shower 11Pump Chamber Full to Co rrVanity ❑ Grease Trap t/`� ElE flids ❑ Floor Drain JTo ttom ❑ Catch Basin '/ ❑ Yard Drain ❑ se No Powdered Soap Portable Toilet El Vent ❑ Other )0. 7 Heavy Grease ❑ Sewer Jet Qty: </ Roots ❑ Other Size: ' ;35 i ❑ Suggest Electric ❑ Under 1000 gallons ❑ 1000 gallo 1ogallons Rootering Footage: , ❑ 2000 gallons ❑ 3000 gallo ❑ 40 gallons ❑ Van Called t, ❑ 5000 gallons ❑ other Other Misc. _ ❑Digging Charge ❑Backhoe hrs. .0 Inspection nn. ❑ Location ❑ Consultation ❑ Certification: P/F ❑ Service Call ❑ Estimate Reason: ❑ Labor ❑ Portable Toilet Rental ❑ Pump Re it , ❑ Waiting Time ❑ Baffle ❑ P Digging Charge Is Per Driver ical Trea nt Discretion Q e /t Description of Work^ d7lP Recommendations Terms of Payment Parts Vacuum Pumping_ � � in Cleani . 3o T AN�S Tax / l/1 -scount Termn '' Cash El Check redit . Not responsibler1da;age beyond curb line. 3. 1.5%per month will be charged to accounts ast due. T2. All complaints e reporte 8 h 4. The purchaser agrees to pay all cost of collection. c Customer Signature Serviceman �'�” SEPTIC SYSTEM INSPECTION FORM ADDRESS )4 (o �r �4✓1d DATE INSPECTED PROPERLY FUNCTIONING? N WEATHER CONDITIONS COMMENTS : WA'D'ER OVALI-TY 'T'ES 1 E'b n R SOLTS� DYE TEST PERFORMED? Y N DATE? SKETCH: WATERSHED RESIDENTS QUESTIONNAIRE 1. Name e \ M G '(`CA10-S 2. Street Address c) G- VQ-47 �7 3. How many members are in your household? 4t- 4. What type of sewage disposal system do you have? ❑ cesspool X septic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑ do not know 5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health? ❑ yes ❑ no do not know. 6. How old is your sewage disposal system? 0-5 years ❑ 6-10 years ❑ 11-20 years ❑ over 20 years ❑ do not know 7. Has your sewage disposal system been rebuilt or repaired? ❑ yes ( no ❑ do not know If yes, approximately how long ago? years. What was done? S. How frequently is your sewage disposal system pumped out? annually ^ ❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes �0 no If yes, what problems? ❑ repeated pump-outs needed ❑ system clogs, backs up, or drains slowly ❑ odors ❑ sewage surfaces through ground 10. How many of each appliance are connected to your sewage disposal system? washing machine dishwasher garbage disposal dehumidifier drain sump pump 2 toilet 3 roof/pavement drains shower/bathtub L 11. Please state the brand and type (liquid or powder) of detergent you use for: dishwasher 5 clotheswasher e " A r 12. Does your property have a lawn? 0 yes ❑ no If yes, approximately whatssi�? - ❑ less than 1/4 acre 7" 1/4 acre ❑ 1/z acre ❑ 3/4 acre ❑ 1 acre ❑ more than 1 acre (Specify) acres 13. How often do you fertilize your lawn? - No. of applications per year Z- Season(s) of the year 14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: ❑ Check here if your lawn is maintained by a professional landscape contractor. r y 7 , TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD r„ DATE• 111T{ 'f ri SYSTEM OWNER&ADDRESS SYSTEM LOCATION - �►�C h es (example: left front of house) r a"L2� 1iII`4K�.R57r1L11�A '{k j, HATE OF PUMPING: v QUANTITY PUMPEDy GALLONS " { . CESSPOOL: NO YES_ SEPTIC TANK: NO YES . 1L ` a NATURE OF SERVICE: ROUTINE MERGENCY OBSERVATIONS: , GOOD CONDITION FULL TO COVER ' HEAVY GREASE �— BAFFLES IN PLACE f ' ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED ' SOLIDS CARRYOVER_ OTHER(EXPLAIN) z417 0/fb`lJ n t ., ��g £,�5't�lyi�S'Y9h ai ii,y1j{��?I,+•Art�jlir"tx�t�rhi taDl+at�h1fi�iJf+i��•r iri r•1 II'�{II'�rtr NT TYl '011,1 $: , "41 . loft ENT S..TRANSFERRED T0: oJ u{ Ft A'• t y{, 5 i ��4E`�` ,i �AS� tw�i���•�k �� t.+�Jk �Alj FyFetr�h I �':, , { I:� a Commonwealth of Massachusetts w City/Town of North Andover m System Pumping Record '�'��� �=�=` ° iG^M Form 4 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, A-30 (ea use only the tab key to move your Address cursor-do not North Andover Ma 01845 use the return key. Citylrown State Zip Code 2. System Owner: "u\ mn . Name renin Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record Ah 150c) 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) �] Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes I/No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: QCYA 6 stem Pumped By: Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Si reof Hauler _ Date at of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts City/Town of North Andover System Pumping Record Form 4 N DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information Important:When filling out forms 1. System Location: on the computer, 1 o =±Tw I use only the tab ' q �� key to move your Address cursor-do not North Andover use the return key. City/Town State Zip Code 2. System Ow er: rae Name rsuen Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping , 2. Quantity Pumped: �`VJ Date Gallons 3. Component: ❑ Cesspool(s) 2 Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Observed co dition of component pumped: 6. em Pumped ,4� 7L,--- Na 11 Vehicle License Number ewarts Septic 58 So Kimball St Bradford Ma Company 7. Location where contents were disposed: 20 so mill st bradford m 1�-IQ-IIS i ature of Hauler Date Signature of Receiving Facility(or attach facility receipt) Date t5form4.doc•11/12 System Pumping Record•Page 1 of 1