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HomeMy WebLinkAboutMiscellaneous - 17 WILDWOOD CIRCLE 4/30/2018 (2)0 NEW ENGLAND ENGINEERING SERVICES INC August 29, 2003 North Andover Board of Health Town Hall Annex 27 Charles Street iGirv,d OFpR�;�: North Andover, MA 01845 �On`r� OF HE A,! RE: TITLE V REPORT: 17 Wildwood Circle, North Andover, MA _ 3 2U Dear Sirs: Enclosed is a copy of the Title V report for the above referenced property. The system PASSED our inspection. If there are any questions please call me at my office, 686-1768. Sincerely Benjamin C. Osgood, Jr. 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 03-72, COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: ) 7 W ti o ws eop L 1 R, �g-i7-f �► r.� � c� J f�i ern � Owner's Name: 00 LA K L 1 F FEL A/ Owner's Address: 1:1 Date of Inspection: � 3 i Name of Inspector: (please print) Beniamin C. Osgood, Jr. CompanyName:New England Engineering Services Inc. , Mailing Address: 60 Beechwood Drive, North Andover, NLA 01845 - Telephone Number: 978-686-1768 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: ►Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: —9 , C 0, j Date: zj/03 17 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 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: / 7 W i L D f ..` (� ,-> 1 , j2C LF K). And D c>J F Q Owner: P U ft 1j, 1.-1 P FFL- Date of Inspection:�gc�y�, Inspection Summary: Check A,B,C,D or E /ALWAYS complete all of Section D A. System Passes: 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 3. The system, upon completion of the replacement or repair, as approved by the Board of Healyi, will pass. Answer ye no or not determined (Y,N,ND) in the for the following .statements. If :�n etermined" please explain. The septic is metal and over 20 years old* or the septic t/(w�heAtherl or not) is structurally unsound, exhibits su tial infiltration or exfiltration or tank failurem will pass inspection if the existing tank is replaced a complying septic tank as approved blth. *A metal septic tank will p spection if it is structurally sound, nCertificate of Compliance indicating that the tank is less 20 years old is available. ND explain Observation of sewage backup or bi or static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled uae distribution box. System will pass inspection if (with approval of Board of Health): broken s) a replaced o ion is r ved bution box is 1 elect or replaced ND explain: The system r ed pumping more than 4 times a year due o broken or obstructed pipe(s). The system will pass inspection if ( ' approval of the Board of Health): broken pipe(s) are replaced obstruction is removed ND explain: °Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: t 7 w l- D wc) 0, C p -iV o R?l7 A,,J 9 o ,, m Owner: _ P(�j t~A- JkLI SFEL- Date ELDate of Inspection: —_Q !ZA! V S C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine is failing to Votect public health, safety or the environment. I. System NAMI, pass unless Board of Health determines in accordance with 310 CMR 115.*(l)(b) that the system is no ctioniug in a manner which will protect public health, safety and a environment: — Cesspool or p 'vy is within 50 feet of a surface water _ Cesspool or pri . within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of H th (and PublicZZI f any) determines that the system is functioning in a manner that protec the publie-7environment: _ The system has a septic tank and soil absorp system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface watd sawly. The system has a septic tank and SAS And the SAS isXthin a Zone 1 of a public water supply. The system has a septic tank an AS and the SAS is within 0 feet of a private water supply well. The system has a septic and SAS and the SAS is less than 10 feet but 50 feet or more from a private water supply well". ethod used to determine distance **This system passes i e well water analysis, performed at a DEP certified ratory, for coliform bacteria and volatile ganic compounds indicates that the well is free from poll 'on from that facility and. the presence of onia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, rovided that no other failure criteria a 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: _ J"7 w t I-- p w o o i> C%4 �3- ltNpo0e (2 - Owner: Owner: _ 91qy LR 1'-L1 (2 Fc- Date CDate of Inspection: 81 2q/ t?,�:, D. System Failure Criteria applicable to all systems: You must indicate "yes' or "no" to each of the following for all inspections: Yes No _It- Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool -A-11 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _v 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. ,i 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 pollation 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.] _LO_ (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 gpd. You must indica 'ther "yes" or `�no" to each of the following: ('The following criteria 1 to large systems in addition to the criteria above) yes no the system is within 400 feet o urface drinking water supply _ _ the system is within 200 feet of a tribe a surf . g water supply _ the system is located in a nitrogen s 'five area (Int Wellhead Protection Area — IWPA) or a mapped Zone II of a public water su well If you have answered " es' to any question in Section E the system is consi a significant threat, or answered "yes" in Sectio ve the large system has failed. The owner or operator of anarge system considered a signifi eat under Section E or failed under Section D shall upgrade the system ccordance with 310 CMR 15.304The system owner should contact the appropriate regional office of the Departmen . Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 17 ASN DOS elL Owner: Kt -1P r -FL Date of Inspection: a LQ p3_ Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No -Z ^ Pumping information was provided by the owner, 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) _ 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 ? jhe— Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems ? The sine and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes no Existing information. For example, a plan at the Board of Health. _ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] 'Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: / 7 wn_p weog> C,,2 t?, s4N ,� oue 2 Owner: Fay L r- Date of Inspection: - Zq I a 3, 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): (G00 Number of current residents: _ 6 Does residence have a garbage gender (yes or no): NO Is laundry on a separate sewage system (yes or no): &0 [if yes separate inspection required] Laundry system inspected (yes or no): — Seasonal use: (yes or no): No Water meta readings, if available (last 2 years usage (gpd)): w G L- L Sump pump (yes or no): NO Last date of occupancy CQLe .tt COMMERCIALINDUSTRIAL Type of establishment: Design flow (based on 310 CMR 15.203): end Basis of design flow (seats/persons/sgketc.): 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 meta 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): Ad> If yes, volume pumped: gallons — How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank, distribution box, soil absorption system _ Single cesspool _ Overflow cesspool — Privy — Shared system (yes or no) (if yes, attach previous inspection records, if any) _ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) _ Tight tank _ Attach a copy of the DEP approval _ Other (describe): Approximate age of all components, date installed (if known) and source of information: ;fN9iAL.L(9 1,v IIck a3 Were sewage odors detected when arriving at the site (yes or no): Al,> `Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _17- „2 A2 - AAJP 0cJV P Owner:c- Date of Inspection: BUILDING SEWER (locate on site plan) Deptk below grade: iR Materials of construction: ✓cast iron _40 PVC other (explain): Distance from private water supply well or suction line: ,30' Comments (on condition of joints, venting, evidence of leakage, etc.): P/PG ao/Xs oK /,-)9,S F-44 A/-/— SEPTIC vim SEPTIC TANK: _ (locate on site plan) Depth below grade: Material of construction: ✓concrete _metal fiberglass polyethylene _other(explain) If tank is metal list age: — Is age confirmed by a Certificate of Compliance (yes or no): — (attach a copy of certificate) Dimensions: A5 Sludge depth: j z ° Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness; Z)" Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Z Y " How were dimensions determined: A1F,4,s ulte -5 77c.,4 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.); -- Ti9n/K c�✓ G-v:.,� co..1n 1770". C0AJC n-82:7 7? J Civ,' rJNV i77v.✓- GREASE TRAP:�%#locate on site plan) Depth below grade: — Material of construction: — — --fiberglass __polyethylene concrete metal fiberglass 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: 17 C ,,Z RV_ Ayv�e�t Owner: p/�uLff IcL�P�EL Date of Inspection: im TIGHT or HOLDING TANK -.A0 (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 BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: O E 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.): gON t N 0/1- C.7, D i.%✓. /-0 Eco, a4f ncec�F� L �f4 196-ef- f ti 017— 6..T Oa sot- ns e4atly oye2 rn..57-9/,8u173ri Z - PUMP CHAMBERW - (locate on site plan) Pumps in working order (yes or no): Alarms 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: / 7 C, /Lc t e A1_ &2P000A, Owner: P/�U c- lq Aw(-11zW .- Date of Inspection: O f z 6-4103 SOIL ABSORPTION SYSTEM (SAS): (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: 3 n c He-- l!2 ` ICA, (- leaching fields, number, dimensions: overflow cesspool, number: innovative/alternative system Typelname of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): �s� aIL �,v✓sv.4t_ ✓ =-c-f779—i_7.)A/. CESSPOOLS: AIA- (cesspool must be pumped as part of inspectionxlocate on site plan) Number and configuration: Depth — top of liquid to inlet invert: Depth of solids 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: 4�6- (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 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: j,2 �3 u C, ,i N-iJJ Owner: PA,,L,,4 Date of Inspection•�2r��_ 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. vttxjc "Page 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 17 w r j,0 w W o r1Z _IUs A^JP0uCL Owner: pg ji- 4 A L 11-7 FCL - Date of Inspection: 43//v,— SITE EXAM Slope Surface water Check cellar ,V- Shallow wells ,,;,,�,� Estimated depth to ground water __!q feet Please indicate (check) all methods used to determine the high ground water elevation: -A 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 established the high ground water elevation: 6,04 - C51C A3 N/A L)n/j !y , ,BL's — .6 1-0 &1z4D Aniv ,��:j5 01:s1.Al( y` /,Fab,/E WA7Y-9 77i'aLE ru FORM U - LOT RELEASE FARM } INSTRUCTIONS: This form is used to verify that all necessary ts approvals/per from Boards and Departments having jurisdiction have been obtained. This doeno (relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICANT eV2ov �i'4%Ckjr�I LOCATION: Assessor's Map, Number SUBDIVISION 4REET / % 'W , ld iv:wd Ck,� PHONE_ I- 3RI 3 PARCEL GAG 4 � LOT (S) ST. NUMBER. **`'`**►*�`*****"OFFICIAL USE QNL **** ntUUMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR ED DATE REJECTED COMMENTS (VeAlgj_s :� %,'„ ice` Ar o On ose A — s� jC 5� +v 5© no - 6,mi t TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS mare r un -t kALTH INSPECTOR -HEALTH COMMENTS_ VyeS /�, A DATE APPROVED DATE REJECTED UAJ t APPROVED: DATE- REJECTED Z S PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT 0 RECEIVED BY BUILDING INSPECTOR _____PATE -- ---_ Revised 9197 jm Lagrasse, Brian To: pklipfel@mail.com Subject: 17 Wildwood Circle, North Andover building permit application '8MRW1— 4 �-e 6 W_Vr I reviewed the bldg permit app and have to deny it at this time. I need a few things before i can approve it. Please get me the following: 1. Current Title 5 inspection report should be your first step. If it passes then I'll need the following. 2. Accurate, scaled plot plan depicting the house addition and its distance to all septic system components. The addition must meet all Title 5 setbacks ( 20' to leach for found. wall or 10' to slab found; 10' septic tank, 5' for sonotubes and sewer pipes etc.) 3. Floor plans of existing house and plans of proposed house with all rooms 'labeled' (ie. kitchen, dining, bedroom, office, etc.) Please note that the system was sized for 4 bedrooms when it was constructed and can not service a house with more than 9 rooms, so you may also want to consider taking a look at the total # of rooms existing now before the homeowner spends additional money on an unapprovable project. If you have any questions or comments you can reply to this email or call me at 978.688.9540 Thanks, Brian and of Health BEPTIC SISTM orth An ver Msaa. Z tJ/LDI.Jdt7D INSTAIS,ATIGb1 CHECK LIST LOT Reamst— FAIL7 OB 1. Distance Tot a. 'Wet lands b. Drains w�Vo o Well Water Line Location 3. No PPC Pipe �. Septic Tank a. :Tess -_Length do To Clean Out Covers b. Cement Pipe to Tank On Both Sides of Tank 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing E aal Amounts c. No Back Flow 6.- Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Ends . d. Clean Double Washed Stone 7. Leach Pits a. Dimensions b. Stone Depth c. Splash Pads d. Tees e. Cement Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No Garbage Disposal 9. Final Grading Inspection 10. Barricading Covered System As Built Submitted a. Lot Location _ b. Dimmisions of System c. Location with Regard_to Perc Test d. Elevations e; Water Table fe Board of Health .gort? :,ndover,Ma.B5 APPRMn DATR_ Provideds ee f SUBSURFACE DISPOSAL DESIGN CHECK LISE No 4A40, ,O dNve9e_ &A&eE 05 o� rV4 6,'oE o,-- Title fTitle V I FAIL I CK Reg 2.5 CA%e-- V 4— jb. A%b sr2etir CSV_ P-ce.oys -OrOOET DISAPPRUM DATE Reasanss w t to vJv V" The submitted plan must show as a mini m=l a) the lot to be served-area,dimensions lot #,abutters blocation and log deep observation hoes -distance to ties c location and results percolation tests -distance to ties d design calculations & calculations shoring required leaching area e) location and dimensions of system -including Eeserve area �f) existing and proposed contours ,g) location any vet areas thin 100' of sewage disposal system or within • disclaimer -check wetlands mapping h) surface and subsurface drains within 100' of sewage disposal system or disclaimer `i) location any drainage easements within 100' of sevsge disposal system or disclaiir-er-Planning Board files j) know sources of vater supply within 2001 of sewage disposal a system or disel.ainer ;k) location of any proposed well to serve lot -1001 from leaching facili Fl) location of water lines on propexty-10' from leaching facility ,m) location of benchmark ;n) driveways A) garbage disposals =p) no PVC to be used in construction ;q) profile of system -elevations of basement, plumb, pipe, septic tan:, distribution box inlets and outlets, distribution field piping and Other elevations rr) maximum ground later elevation in area sewage disposal system ;s) plan mast be prepared by a Professional Engineer or other professional authorized by lax to prepare such plans Reg 6 ( Septic Tanks (a) of flow, Nater table, tees. depth of tees, access, pining b) cleanout (c) 10' from cellar wall or inground sig pool (d) 25I from subsurface drains Reg 10.2 Reg 10.4 Distribution Foxes a) slope greater than 0.08 b) suap 15.1 15.4 15.6 3.7 eg 111.1 14.3 14.4 lh.6 14.7 14.10 9.1 9.6 Che^ List 2 FAIL CK Leashing Pits Leaching pits are preferred where the installation is possible a) calculations of 1 area-minimwm 500 sq ft b) spacing c surface a 2% d) cover mat al e) 21x2 f splash pad f) tee elbow g) beads in pipe from d -box to pipe Leaching a) no grea2tes/inch b) area-misq ftc) construfield d) surf drainage 2 % e) 2 Pram cellar ull or inground swimming pool Leaching Teenches ✓_ a) c ons o leaching area -min 500 sq ft b) spacing -4 ft An 6 ft with reserve between dimensions _ d) construction e stone f) surface drainage 2% Downhill Slone ✓ a) slope to be shown) N0 `-j- yx a ) y/x 1 150 = (to be shown) Purms a) val �-- b) stand-by polder • � ptp R.o V Arles �, w �,oM -SOIL PROFILE & PERCOLATION TEST DATA 6P/6'/8Z North Andover, Mass. Street No �L2,'16160 »W Lot No 2 Loc/Subdiv. Pland Owner Investigator m G eC. Observer i ` SOIL PROFILE DATES 1.El.ev 2.Elev 3.Elev 4.Elev X1,30))192 0 v� 0 0 0 . ©R 12L 31 - no 1_ ©o No 01 ©o :N up 110!- I Elevation ' 1 2 3 u 5 6 7 8 9 7010 IF 10 10 no WCr �5C) 10 l Location Datum PERCOLATION TESTS DATES Ties Pit i sTest Pit Number 1 2 3 Start Saturation Soak -Minutes Start e Drop of 3" -Time Drop of 6" -Time YAW-lst 3" drop Mins.2nd 311 Drop Percolation SS117d wc��G-mac/✓ 32 Z ��e - SOIL PROFILE & PERCOLATION TEST DATA North Andover, Mass. Street No �A 1 1 (.ScSZC� G4✓ e\ P- Lot No Loc/Subdiv. Pland Owner 6 IAe 0 yk Investigator Awr BVI > %< e Observer✓`C�,�p SOIL PROFILE DATES l.'Flev 2.Elev 3.Elev 4.Elev n Benchmark Elevation 0 1 2 3 4 5 6 7 8 9 10 DATES 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 f.9 5 6 7 8 9 10 Tiesto Test Pits Location Datum PERCO TION TESTS Pit Number-- - Start Saturation ROAM I •'S_J �M INN o -p of 61' -Time 51FA Percolation :. ct,a v (OAS ck LOT L IAJV. OUTS How E 137.gy 1tJV Ifi QK�,, 37.74 rr'FA !-A K4 Pa )3-7.(,4 �► �°� 0°-f3OX -17 43 � Q V DU*ra- D- BC -Y, 137.51 L 1 137.©4 #�lmF X37.33 1500 C t)i_ c o, Q '-' Sr: P nc— TA,*,J K REALTY TRU S T '. RIGI�ST, 1983 L 4 • .- ��� lam.: { � $,, PROFtSSiONAI ENGINEERS + LAND SU#tVf,(ORS PLA�Wtkg- f 66 PARC SWEET + ANDOVER, M45SACMUSETTS 01k,1 355. 373.37.2.1 - _-.,..z. __-mob .. . 4., ,.. ..x r. _...,.«..<..,......... V \ SOIL PROFILE & PERCOLATION TEST DATA North Andover, Mass. Street No 4✓ O c� 4� . Lot No Lqe/Subdiv. Pland Owner Gt: InvestigatorObserver/ SOIL PROFILE DATES 1„'Elev In Benchmark Elevation 0 1 2 3 4 5 6 7 8 9 10 DATES 2.Elev 3.Elev f 4.Elev 0 n 1 2 3 4 5 6 7 8 9 10 Location Datum_ PERCOj,ATION TESTS 'V, / Z 3/b'Z Cd - Pit Number Z-..... 1 2 3 4 Start Saturation ' ; 30 Soak -Minutes 7.'% 5. l5 Starte q•, So Drop of 3" -Time Drop of 6" -Time /Z: 22 / .' M ns.lst 3" drop f Mins.2nd " Drop Percolation IQ U.!'iy v L } r G i.iJ s 47- L540--/�E7 ;.. , . • r)L• , �I INyr lx.0 lSinl } ,:•;p :i';b •r.+;'� ,. `I 51 )1Lj �J I'1+iYf iLr, irrYi�1J1 I.f WL I+`� I+l li,' 77-77-77-7 — ,;. .. � 1:''•��i•�;� `sir j1'4�4/+�y��i' �f1. r45/✓ i� �ri��l. ! 7�Ir')1 ). 5,( l F` Rd77+�, ''IV'y f• r..l 1 J L' I p I '1 r♦ r��, ���+.�^'' yl ''.•��yl',5��.(L•g•J,).:If , 4{ +'• ,j'�`ph. I .Jl�,I, I, .. i('i.: off >1 Y! r it MY SYSTIDryl 11UMp I ADDRC SS SYSTCM L (As To N ' I ,�`1�-�' � �� . � (� �z � m � l e ; I clx.�f�r'c�•i o f n"'......... QI 77 ,------_ QUANTITY f'UMPQ, D r UUNO:.YDS _____,SEPTIC TANK: NO yF UfZE OF.SERVICE,:'ROUTINE, EMERCt~NCY • .... ,1.1.1 �; �:. �(� +�;V,1,.; L: .,. - C.�,U co Y c k. t:rl LA:; Y l�jPFLUS N — T.S:'„>;:`I,.;y, FA CH FICLD RI' U) l.r,l I:'' 1✓�:5.�0:1✓1.OS: -(�O O.D FD' s4 a;;RY:o.:Y' lirXf'L,A.IN1 ' :.1:.:(i iI/f•iit:ll.. .S,C.•/<I\ �-N:V 1'i'll'r 'i ls: J.'I.r/I�:I,it I.S•�1:��'''''".�:::�I .'V'�'\ii.• :(Ir ��'•: .j� .� / 'r11��'�''I• .III• I.��I':,:. ':lf: .l i: 1. ..iZ :a!d.•�Y �l'��•.JI 11�: ,5':1/�>iU �1, /,f IC•4 N�, .C(I\+:?/i. `,'t3'.1' "ao;;:(; ;' � '%�G�;;"..,..., •, J ' d Y'... •'!i,!��, a,�� ':i'I:�!r11.5�`r �:: ,'l'•1ri; ;I'.1-;'.��8`��I;r:ii�;,,il,�j;,'.t�' •i r.),�� { {'• i l�sy�l,, r a.7'J,);�l{IIS J 1i i.( +. i c- ' P =5Z i: i a.v:iYff,:,`rr� '•� •1 r )� r lsetts �7 • 1`%Clef„; a a A en n :.sump ng 0r �r\'„'1•��' I�sf'�r,�' f�.0r�h '•;�''...;,:. �1�.,'la��k::;�l y�rrrj; ril�vl, 1�Y?i:��oi'k'•:.7.}t.b . Cr.:: •:v'',r�' �����i�1llrnty r ,.1 yil ., DEP..has provided this form for use by local Boards of Health. be submitted to the.local'Board of Health or other approving a f L r ►CHUSETTS The ust A. Facility Information JUN — 4 2007 tmRortant. jr7+wuv1+ f�un� out 1 System l.Ocatlon, �,,�,` on'tt10'', •VPN Ur NORTH ANDOVER COi1lpUter, use T DEPARTMENT , only the tab key Address move your:; c cursor - do not use the tetum' Uq/io” State ZJp Code 2 System Ow ' r r r i Address (If different from location) .. `(•• 1.,, cltylT,own•; ' Sia % �• e ` Telephone Number _;J.. ,,: �'utnping:.�e�ord ''� , .,.,. 1 M .� ,l, +1• (i �/ lir a� jty^'� Y r(7. , }. • f Pumping ' 2. Quantity /Sby Da Pumped: Gallons ,: `.Type of system; . ❑ cesspools) Septic Tank 11 Tight Tank Other (describe); ' 1 Effluent Tea Filter present? . ❑ Yes, o If yes, was It cleaned? C1 Yes ❑ No on'of y, 4 �`,;;` .7:;..i;,..,,, f 1 1111111 •�;..,'p' .. . . , ,.,.},,,, Lr.� r+(I,li:,�`4� i� � +1 ! h, * (r f i•r . 1 ,� iC _ /.1 1 jl', r {Nl .} ,'t.✓. !1'.;"r,'i.t1 1117 i , 6 SyPumped By � I S Vehicle Ucen#e Number t TP �.' 7`afYlrt � }��r',���'.'" N �Y I lr4' �✓{ ..: i f/1 • s,.3 1.1, �f4 �^��"tai;^;+;,;y'i�,otir�ti�yi;c�';7,�;It,��Yr,;cs„ 1 r+'�•dF•yf/t%�}y�,�1Wy ' `ri��Ylr4"�'"', t,� r .. '•, 5 ��. ., -, $' , 7 '. Locatlgn where contents Were 0posed: Aa4ld ai'{rf. vrhY i4,r.�� ••Hy }.i `� 1 , Gr + .!,.. .. ' Slpnaturs OI Date http;//rvww. mass, goV/dep/wate�/approVgIs/t5forms, htm#Inspect t5fOrm4.doa 080$ System Pumping Record Page 1 of t Commonwealth of Massachusetts W I City/Town of North Andover ► IOWN D7 N0111 H ANDOVER System Pumping Record V ACTH -PARTYENT 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 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 on the computer, use only the tab key to move your cursor - do not use the return key. VQ renin 1. System Location: Address North Andover Ma City/Town State 2. System Owner: Name Address (if different from location) City/Town State Telephone Number 01845 Zip Code Zip Code B. Pumping Record /GA /I Date 1. Date of Pumping-� 2. Quantity Pumped: U ped. Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Condition of System: 6. S Pumped By. T(f\jc 7 aW Name Stewart's Septic Service Company 7. Location where contents were disposed: _Stewart's Pre-treatment Plant, 20 So. Mill B If yes, was it cleaned? ❑ Yes ❑ No Vehicle License Number Ma 01835 nature of ul Date of Receiving Facility Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1