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HomeMy WebLinkAboutMiscellaneous - 1650 TURNPIKE STREET 4/30/2018 (2)26,3,7/ Ol cs cc � LD i Z Tu)?/va �j vC/,J—v j?j y 42 orno'�� -i A -1 L4 �cecnrnp�� r,7 r► -�' tv al y ct, t*t A _ C`4 a. 13 \D �J 6`WWOpt�1 A -11 13 rQ 6 r 0 A 0 i Ol cs cc � LD i Z Tu)?/va �j vC/,J—v j?j y 42 orno'�� -i A -1 L4 �cecnrnp�� r,7 r► -�' tv al y ct, t*t A _ C`4 a. 13 \D �J 6`WWOpt�1 A Commonwealth of Massachusetts City/Town of RECEIVED System Pumping- Record Form JUL 16 2015 DEP has provided this form for use by local Boards of F[MW.F0#Fi�r"f6"'W8Vi ay be used, but the Chi �.,� �r,np�Ii:%r information must be substantially the same as that provided h�re�. B'ef6ie 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. A: Facility. Information 1. Syst—em L eft / Right front of house, Left / Right rear of house, L / of house, Left/ g t sih de of buildin , Left / Right front of building, Left / Right rear of building, — er of Cityrrown 2. System Owner. �� O Name' Address (if different from location) Citylrown ' B. Pumping 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): Date Cesspool(s) A 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Conditioof stem: 6. System Pumped By - 7 s Zip Code r� State � � i Code ; Telephone Number r — 2. Quantity Pumped eptic Tank r'. Gallons , ❑ Tight Tank If yes, was it cleaned? ❑ Yes ❑ No Neil. Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc- Company ncCompany where contents- were disposed: t5form4.doc- 06/03 System Pumping Record • Page 1 of 1 age 10 of 11 Official Inspection Form - Not For Voluntary Assessments SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _1650 Turnpike Street- - North Andover— Owner: _Scinto_ Date of Inspection: _10/4/2005_ 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. Parking Area Note: d -boa located under back loading dock driveway Warehouse Building with Office Water Meter /A B\ Sept�Tank D - Bog A to Tank = 22'8" A to D -Bog = 33'4" B to Tank = 55'3" B to D -Bog = 56'5" COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFF. DEPARTMENT OF ENVIRONMENTA_ R _TE( OCT 1 2 2005 TOWN OF NU,i ri ANLjOVER HEALTH DEPARI NIENT TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: _1650 Turnpike Street _ _ North Andover Owner's Name: Steve Sciuto, Mutual Sales Owner's Address: _1650 Turnpike Street _ North Andover, MA 01845_ Date of Inspection: 10/4/2005_ Name of Inspector: Neil J Bateson_ Company Name: Bateson Enterprises Inc._ Mailing Address: _111 Argilla Road_ _Andover, Ma. 01810 Telephone Number: _( 978 ) 475-1786_ 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: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority 'ls Inspector's Signature: I Date: _10/4/2005_ The system inspector shall 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 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. Page 2 of I 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _1650 Turnpike Street North Andover — Owner: _Sciuto_ Date of Inspection: _10/4/2005 Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not 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: 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 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: Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _1650 Turnpike Street- - North Andover— Owner: _Sciuto_ Date of Inspection: _10/4/2005_ 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 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: Page 4 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _1650 Turnpike Street _ North Andover— Owner: _Sciuto_ Date of Inspection: _10/4/2005 D. System Failure Criteria applicable to all systems: You must indicate "yes" or "no" to each of the following for all inspections: _No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _No Liquid depth in cesspool is less than 6" below invert or available volume is 1/2 day flow. —No Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _No Any portion of the SAS, cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _No Any portion of a cesspool or privy is within a Zone 1 of a public well. _No Any portion of a cesspool or privy is within 50 feet of a private water supply well. No 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.] _No (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 15,000 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. Page 5 of l l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1650 Turnpike Street _ North Andover _ Owner: _Sciuto_ Date of Inspection: _10/4/2005_ Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No Yes _ Pumping information was provided by the owner, occupant, or Board of Health No Were any of the system components pumped out in the previous two weeks ? Yes — Has the system received normal flows in the previous two week period ? No Have large volumes of water been introduced to the system recently or as part of this inspection ? N/A _ Were as built plans of the system obtained and examined? Yes — Was the facility or dwelling inspected for signs of sewage back up ? Yes i Was the site inspected for signs of break out ? Yes_ _ Were all system components, excluding the SAS, located on site ? _Yes_ _ 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 ? _Yes_ _ 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 N/A_ — Existing information. Yes _ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distan_ce is unacceptable) [3 10 CMR 15.302(3)(6)] Page 6 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: _1650 Turnpike Street- - North Andover– Owner: _Sciuto_ Date of Inspection: _10/4/2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): _ Number of bedrooms (actual): _ DESIGN flow based on 310 CMR 15.203 Number of current residents: _ Does residence have a garbage grinder (yes or no): _ Is laundry on a separate sewage system (yes or no): _ Laundry system inspected (yes or no): _ Seasonal use: (yes or no): — Water meter reading: _ Sump pump (yes or no): Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Warehouse with office _ Design flow (based on 310 CMR 15.203): 200_gpd Basis of design flow (seats/persons/sgft,etc.): 2000 square feet office _ Grease trap present (yes or no): _No Industrial waste holding tank present (yes or no): –No— Non-sanitary waste discharged to the Title 5 system (yes or no): No Water meter readings, if available: _Yes_ Last date of occupancy/use: –Current— OTHER (describe): GENERAL INFORMATION Pumping Records Source of information: Pumped 10 years ago, owner _ Was system pumped as part of the inspection (yes or no): Yes_ If yes, volume pumped: _1500_ gallons -- How was quantity pumped determined? _Measured tank Reason for pumping: Inspect tank & tees_ TYPE OF SYSTEM X 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/Altemative 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 installed (if known) and source of information: _Building built in 1984, owner Were sewage odors detected when arriving at the site (yes or no): _No Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _1650 Turnpike Street _ North Andover _ Owner: _Sciuto_ Date of Inspection: _10/4/2005_ BUILDING SEWER _ X _ (locate on site plan) Depth below grade: _31 _ Materials of construction: _X_ cast iron _40 PVC _other Distance from private water supply well or suction line: Comments (on condition of joints, venting, evidence of leakage, etc.) SEPTIC TANKS: X Depth below grade: _2' _ Material of construction: X concrete ` metal _fiberglass _polyethylene _other(explain) If tank is metal list age: _ Is age confirmed by a Certificate of Compliance (yes or no): — (attach a copy of certificate) Dimensions: 10' x 5' x 4' Sludge depth 8"_ Distance from top of sludge to bottom of outlet tee or baffle: _l9"_ Scum thickness: _8" Distance from top of scum to top of outlet tee or baffle: _8" Distance from bottom of scum to bottom of outlet tee or bale: 13"_ How were dimensions determined: _Tape Measure _ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc. _ Inlet tee ok. Outlet tee ok. Depth of liquid above outlet invert, found outlet pipe clogged to d -bog. Snaked pipe, level return to outlet invert. No evidence of leakage. Pumped septic tank. _ 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 to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Page 8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _1650 Turnpike Street- - North Andover– Owner: _Sciuto Date of Inspecti_on: _10/4/2005 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass _polyethylene other(explain): 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 BOXES: X Depth of liquid level above outlet invert: 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.):_D-box level & distribution equal. No evidence of leakage. Evidence of .carryover, pumped d -box to clean._ PUMP CHAMBER: _ (locate on site plan) Pump in working order (yes or no): — Alarm in working order (yes or no): Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _1650 Turnpike Street _ North Andover _ Owner: _Sciuto_ Date of Inspection: _10/4/2005_ SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan, excavation not required) If SAS not located explain why: Type leaching pits, number: _ leaching chambers, number: — leaching galleries, number: leaching trenches, number, length: X leaching field, number, dimensions: _1 field 15' x 351 _ 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.): _ Soil ok. Vegetation ok. No ponding to surface._ 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 sludge layer: Depth of scum layer: _ Dimensions of cesspool: Materials of construction: _ 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 condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Page 10 of I 1 Official Inspection Form - Not For Voluntary Assessments SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _1650 Turnpike Street- - North Andover— Owner: _Sciuto_ Date of Inspection: 10/4/2005_ 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. Parking Area Note: d -box located under back loading dock driveway Warehouse Building with Office Water Meter A Septiicc�T,ank D - Box A to Tank = 22'8" A to D -Boz = 33'4" B to Tank = 55'3" B to D -Boz = 56'5" Page 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _1650 Turnpike Street _ _ North Andover - Owner: _Sciuto_ Date of Inspection: _10/4/2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water _ >6' _ 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) _X Accessed USGS database -explain: Essex County Soil Map_ You must describe how you established the high ground water elevation: Essex County Soil Map, Sheet # 40, Canton Soil, Water >6' Deep _ Mart Scarce Cis - Water De.,, GOyERrd :10.1,71,4 R.,, .I tam Sun:4n&re TOD,.. I Tekret 10.1.71.55 ~ ' «'�'' 9;15 phi Thursday, Sep 22, 2005 09:15 AM Thursday, Sep 22, 2005 09:15 AM i � �o ���-�-- Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 1650 Turnpike Street, North Andover Owner: Steve Sciuto, Mutual Sales Date of Inspection: 10/4/2005 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. F Zaate e t1son Bateson Enterprises, Inc. LT 2C)/ ; \� �)c n : 9 � ` E rL ® k }}� � x � 6 a Ln tQ \ Go E -_j 2 � E z p QVC N 0 0 cn m —4 co F -m I 'a —All -.7; rte n Fs MESSAGE PC A; Exr O M4 0 LJ C3 91 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** ✓APPLICANT- S�is-r M btSTiZ���T�dLS Phone &�J- ✓ LOCATION: Assessor's Map Number Parcel Subdivision -/Street I (P2© rtvF-N rt t S T. Lots) St. Number ************************Official Use Only************************ RECO14ME 1DATIONS OF TOWN AGENTS: NlA- Conservation Administrator Comments N Town Planner k Comments 7 Health Agent 5Ao %0 y 5T?�Rt- Comments Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections YL& - driveway permit NLA - /Fire Department�,,� �,r ,r tee. % � �y Received by Building Inspector Date JUN 29 192 20:09 PFEUFER/RICHNRDSON P.01 P F E U F I; R/ R I C I1 A R D S 0 N P. C. A R C 11 I T E C T S 700 MASSACIIUS ETTS Av£ N Ut FO URT11 FLOOR CAM fiRl DG£ M ASSACIIUSf TTS 02139 29 June, 1992 rA X TO: Ms. Sandy Starr, Health Officer Town o= North Andover FROM: PLEASE FORWARD TO HEALTH OPPICH Preston Richardson REGARDING-: 1620 Turnpike Street Follow -Up on Our Discussions Today Dear Ms. Star, Erie R. Pfau fer Alk PresionT ftiehardson AIA Ric liard( 1 v6rd Al Carroll W Williamson ASLA After our discussion today regarding the Tpk. Street property, I have made several observations from visiting the site with the plan you provided and speaking with the property owners. .In reviewing the site area shown on the as -buil., I did locate a vent for the system in the general location of the system as shown on the plan, located just outside of the edge of pavement in this area. •Regarding occupancy count, I have confirmed that they employ 18 persons, of which 3 are full time traveling system, support personnel. •The previous tenants at the building employed 20-30 persons varying with seasonal fluctuation in their operations. I hope that these observations will be helpful in your review. we would be pleased to discuss your review at the earliest possible time, as the owner of the property has a very tight schedule to begin operations in the building. We appreciate your consideration and would be pleased to discuss any questions or Comments you may have. cc! TSD file Tel i,101onc 617 354 3561 She V� vq 617 354 6218 Fax 617 354 1487 -J F-lul3b ofOF HE41-� NoTrh MAI SS r� f'Pi{ov ED D,4rt' COAJPITIO"5 = DI54PPxnvep pgTE R�(15aNS L-oi" Z Tc l�vf A�PU (f 4ti I_ \46Nry -So pFV sE�r� sy s ,—E,', -vest wE.- /PR�OUIN6 AUPhoI,�lTy Dwc- SrPT'c c SYSTEM 1 O S TA I L ATIO- IJ C-X4V4Ttol,J P/a0455 CJ FAIL - Q4 T C- A►(._. Q4TC L-�,0vwG +���IT��IJA(., 1�5�i (ops ���= A►-�y) DISAPMO\j6D D,arC J�CA's0 NS , RUM APPROVAL ,. APP►�0� 6 � i �-►oR I � C TO: FROM: RE: DATE: BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 M E M O R A N D U M Building Department Michael Rosati, Health Agent 1650 Turnpike Street December 19, 1991 According to our files, the Subsurface Disposal System TEL. 682-6483 Ext. 32 or 52 was installed in an acceptable manner and received final Board of Health approval on April 2, 1987. MJR/cjp ; !� 4p T1 7 8 5 6 7 8 9 9 10'---- 10 Benchmark Elevation 5 6 7 8 9 A Location Datum PERC01,ATION TFSTS 5 6 7 8 9 10 )it N-Lunber 3+ -p -rt Saturation SOIL N 2Z -:'-C �L:A -t Andover, North I A No Mass. Street c, a);,-! Y`inu �ce s Lot No Pland-- 6K -jro p -A Owner V, Loc/ Subdiv. drop Observer— Drop percolation Investigator- SOIL PROFILE DATES ev—. 2.Elev- 3.Elev 4.Elev— 0 /47 0 0 0 4 C, Ti -es to Te -t Pits 2 2 rn� 2 2 3 3 i 3 3 4 4 4 4p T1 7 8 5 6 7 8 9 9 10'---- 10 Benchmark Elevation 5 6 7 8 9 A Location Datum PERC01,ATION TFSTS 5 6 7 8 9 10 )it N-Lunber 3+ -p -rt Saturation 2 c, a);,-! Y`inu �ce s )rop of )rolD of 6" -Tine drop Drop percolation I Board of Health NvrtY, :Andover,Mass i L� APPROVED DATE ovided: Title V FAIL I OK Reg 2.5 SUBStiRFACE ' biMSAL DESIGN CHECK LIST DISAPPROVED DATEr Reasons: VF -A) rU RA LOT # 7;Z eUtD,)P1 rE ST The submitted plan must show as a minimum: a) the lot to be served-area,dimensins lot #,abntters b localocal n and reon and sults percollati nn testssdistanceeto s to ties c d design calculations & calculations showing required leaching area e) location and dimensions of system -including reserve area f) existing and proposed contours g) location any wet areas within 100' of sewage disposal system or disclaimer -check wetlands mapping h) surface and subsurface drains within 1.00' of sewage disposal system or disclaimer ;i) location any drainage easements within 1001 of sewage disposal system or disclaimer -Planning Board files j) known sources of nater supply within 2001 of sewage disposal o system or disclaimer ;k) location of any proposed well to serve lot -1001 from leaching facilit; ;1) location of water lines on property -10' from leaching facility ;m) location of benchmark ;n) ' driv+eways 'o) garbage disposals ;p) no PVC to be used in construction ;q) profile of system -elevations of basement, plumb, pipe, septic tank, distribution box inlets, and outlets, distribution field piping and other elevations ;r) maximum ground water elevation in area sewage disposal system ;s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks (a) capacities -150% of flow, water table, tees, depth of tees, access, pumping (b) cleanout (c) 10+ from cellar wall `or inground swimming pool (d) 251 from subsurface drains Reg 10.2 7 Distribution Boxes i(a) slope greater UMM 0008 Reg 10.4 b) sump.