HomeMy WebLinkAboutMiscellaneous - 175 SALEM STREET 4/30/2018 (2)4
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EASE BAFFLES IN PLACE
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EXCESSIVE SOLIDS LEACHFIELD RUNBACK
FLOODED
SOLIDS CARRYOVER'.' OTHER (EXPLAIN) -----
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Lawrence 688 11812 7
Haverhill 373-7151
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Salem, NH 603-898-1554 Plaistow, NH 603-382-3322 I
Methuen 686-2214 Andover 475-4711 Newburport 462-4661
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STAR iezATg-
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I n �
O DAY WORK
O CONTRACT
0 EXTRA
TOTAL AMOUNT 6 P�
No one home
Signature Total amount due �` Total billing to F.
+
for above work: or be mailed after
I hereby acknowbdge the satisfactory comWetion conlplefion l
TERMS; C.O.D. of th* above oescnbed wodL of work
Because of the nature of the work herin described and of Its emergency, we prefer
that all payments be made to mechanic on the Job after completion.
A FINANCE CHARGE computed at a periodic rate of 1 1/2 % PER MONTH which is
an ANNUAL PERCENTAGE RATE of 18% will be charged on all accounts remaining
unpaid by the 10th -of the month following the purchase.
THANK YOU.
A service charge of $15.00 will apply on all returned checks.
ESTABLISHED 1945
l//36�s3
125 SUMMER STREET, SUITE 1150, BOSTON, MASSACHUSETTS 02110 (617) 737-7799
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GILBERT REA
• 44 Rea St.
NO. ANDOVER, MA 01845
Phone 682-9864
.............
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7
PRUDW 204-1/A �Lw Inc., Glotm Mm. 01471.
JOB
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SHEET NO.
OF
CALCULATED BY
DATE
CHECKED BY
DATE
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PRUDW 204-1/A �Lw Inc., Glotm Mm. 01471.
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DEPARTMENT OF LABOR AND INDUS'T'RIES
DIVISION OF INDUSTRIAL SAFETY
NOTIFICATION OF ASBESTOS WORK
(In accordance with the provisions of M.G.L. c. 149, §6-6F and 453 CMR 6.12)
All sections of this form must be completed in order to comply with
the notification requirements of 453 CMR 6.12
TEN DAY PRIOR NOTIFICATION IS REQUIRED OF ANY ABATEMENT PROJECT
GREATER THAN THREE (3) LINEAR OR SQUARE FEET
DLI FILE NUMBER
Contractor performing project PROFESSIONAL ASBESTOS
License fiAC00.U104
CON'T'RAC'T'ING INC.
Do prevailing rates of wages apply to this project as required
under M.G.L c. 149, §26, 27 or 27F?. (circle one) YES NO
Address of Project
Building Name (_i.f. any)
Street Address
City rl (/yc r Zip �� 0 vl _ Phone
Project type (circle one): DEMOLITION RENOVATION REPAIR OTHER
If Other" select-ed,.ple_ase explain
Asbestos Activity: (circle one): ENCAPSULATION ASSOCIATED PROJECT
ENCLOSURE, REMOVAL
------------
Indicate amount of: asbestos surface on pipes or ducts 2 LINEAR FEET
OR
asbestos surlvice on structures other than
pipes or ducts to be removed, enclosed or encapsulated SQUARE .FEET
Start date—[ -
a /' V
am
pm '1� weekends?
Completion bate
- 3 0 -
17
Project Supervisor Name 13RE,rT J. LAWRENCE Certificate y SF 01.936
U.V. CORPORATION PM 00063
Asbestos Analytical Lah Name DENNISON LABS Certificate N
Name & Address of disposal site(s)
SAWYER ENV. REC . FACILI'T'IE INC.
0049a/1
358 EMERSON MILL RU.
IIAMPDEN, MAINE.
Is asbestos contract written or.verbal?
Contractor's Idorkers' Compensation lhsurer FIDELI`T'Y CASUALTY CO. 2008718737
Policy Number
Facility Owner (11 ('- 0 ah'
Address 1 e
City State Zip
Description• of work practices to be followed; G SIV I
Description of decontamination system(s) to be used \
Description of handling/disposal methods to comply. with 453 CMR 6.14(2) (g)
2 6 mill poly bags labeled asbstos
Name and address of transporter(s) if other than the asbestos contractor:
CHEMICAL RECOVERY, PORTLAND S'T'. BOS'T'ON, MUSS.
The undersigned hereby states, under the penalties of perjury, tJ)at he/she has
read and understood the Commonwealth of Massachusetts Regulations for the
Removal, Containment or Encapsulation of Asbestos, 453 CUR 6.00, and that the
information contained in this notification is true and correct to the best of
his/her knowledge and belief.
Date Ll—d- G Signed:.__ /? �Z
711t1e: uWNRR
Company: PROFESS IONAL ASBESTOS CONTRACTING INC
Please return this form to:
Asbestos Control Technical Services
Department of Labor and Industries.
Division of Industrial Safety
100 Cambridge Street, Room 1101
Boston, MA 01202
0049x/2
7
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SEPTIC SYSTEM INSPECTION FORM
ADDRESS
DATE INSPECTED
PROPERLY FUNCTIONING? N
WEATHER CONDITIONS
COMMENTS: -
WA I E:R QuALI T Y TIES t Eb ? 'ReSULTSS
DYE TEST PERFORMED? Y .N
DATE?
SKETCH:
'•---��..�i+Auy V C.0 . MA
Watershed Se tic 8 stem
Servicing Report
Date: i l -W I✓
Homeowner: —f Vic
Street1-� C
^ --
Ph, -ane
Nat:uri� of Servic,a:
Ob,ervations:
Desc:-ipl:ion of Work:
Commeits
Ro .Mine
Emergency
Pumper : 00
Address:
Phone
U& - 61995
Good Condition
T—
Fu. --1 to Cover
..
IVO 'A
Baj'fles in Place
AS
LeE chfield Runback
Excessive Solids
N
Heavy Grease
NO
Roc is
PUO
Oth ar, (Explain)
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name Gavle 4 -Dcavicd Kle.mel-
O2. Street Address l 7s Sal e n SF. N . A,,Jcyei-
3. How many members are in your household? 2-
4.
4. What type of sewage disposal system do you have?
❑ cesspool
Q� septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for our 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 C' do not know cJ.UP-d -f4 e- hose.
we . ��st �)ur
7. Has your sewage disposal system been rebuilt or repaired? (N 70 yrs. old) a 14te aver
❑ yes ❑ no Z do not know f ta- a
y qo.
If yes, approximately how long ago? years. What was done?
t 8. How frequently is your sewage disposal system pumped out? ❑
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years
owe w;,11 kdVe -,t de.,e{�►�s spm' (ar,d every - Z Years). &44 re owvnV j
9. Have you had any problems with your sewage disposal system?
If yes, what problems?
❑ repeated pump -outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
EO
annually
❑ never
ICA Yew-, we. C6,"t "c -
El yes R no ham
-�,e
a k da
10. How many of each appliance are connected to your sewage disposal system?
washing machine 1 dishwasher 0_ garbage disposal o
dehumidifier drain O sump pump 0 toilet —Z
roof/pavement drains 0 shower/bathtub I
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher '—
clotheswasher Usually Gq%A',J T,k - cn care oecarilb L7,;d 4o1d or• UY d Fab.
12. Does your property have a lawn?
If yes, approximately what size?
❑ less than 1/4 acre ❑ 1/4 acre
❑ more than 1 acre (Specify)
13.
2" yes ❑ .. no
V1/2 acre ❑ 3/4 acre ❑ 1 acre
acres
How often do you fertilize your lawn?
No. of applications per year never, spec��ca,ll�
Season(s) of the year
because. we. 114e ti, tl,e wo-kr-sked _
14. Please state the brand and Aype (liquid or granular) of lawn fertilizer you use: ZT ,,,,,e oppii
a��'
n'1 io 44 lawn k wdl be, liVne iv deac;d.f a,J died nwnure -(.r- 41-0;x;
❑ Check here if your lawn is maintained by a professional landscape contractor.
CUSTARD INSURANCE ADJUSTERS, INC.
145 Rosemary Street . Needham MA 02494
Telephone: (781) 449-2300 • Facsimile: (781) 444-9498
tj of
Board of Health/Board of Selectmen
AR 2 4 iDo
Town of North Andover
North Andover MA 01845
RE: Insured: Peter P. Devlin, DMD
Property: 175 Salem Street, North Andover MA 01845
Loss: 01/17/04 — Water Damage/Freeze-up
Insurer: Merrimack Mutual (Policy #SPB214-11-65)
Our File: 129-5315
Claim has been made involving a loss, damage or destruction of the above -
captioned policy that may either exceed $1,000 or cause
MASSACHUSETTS GENERAL LAWS Ch.139,46, to be applicable. If any
notice under MASSACHUSETTS GENERAL LAWS Ch.139,43B, is
appropriate, please direct it to the attention of the writer and include a
reference to the captioned insured, location, date of loss and our file
number.
Jason Martin
Adjuster
On this date, I caused copies of this notice to be sent to the person(s)
named above at the indicated addresses by first-class mail.
(Signed)
(Date) March 23, 2004
i
William F. Weld.
Governor .
Trudy Coxe
Secretary, EOEA
David B. Struhs
Commissioner
Commonwealth "bf. Massachusetts
Executive Office of . Environmental Affairs
Depart nment of., 1
Environmental Protection
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
tiUHnv yr —
>i\19V 2 41995
Property Address: r I� �� Address of Owner:
Date of Inspection: (If. different)
Name of Inspector:f�1r18
Company Name, Address and Telephone Number: Re�[a.cwtirnx-60" 4'4 {� W-11 ewc-
kb. Pi4wer, Ma. 0(84,T rVts ' 68&- 7016'
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 inspection. The inspection was performed based .on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
Passes.
— Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: r 1 Date:
1
The System Inspector, shall submit a copy of this inspection report to,the Approving Authority within thirty (30) days of completing this
inspection. If the system, is a shared system or has a design flowof '10,600 gpd,or greater, the inspector and the system owner shall submit
the report to the appropriate regional office of the Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if appiicabie and the appro�irs aUtilvi it;.
INSPECTION SUMMARY:...
Check A, B, C, or Df ,
A) SYSTEM PASSES:.
I have not found any information which indicates. that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
B] . SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced'or repaired. The system; upon completion of the replacement or repair,
'passes inspection.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not)
The septic tank is metal, cracked,. structurally unsound, shows substantial infiltration or exfiltration, or tank failure is
imminent. The system will pass inspection.if the existing septic tank is replaced with a conforming septic tank as
approved by the Board of Health. .
(revised, 8/15/95)
1
One Winter Street • Boston, Massachusetts 02108 • FAX (617) 556-1049 • Telephone (617) 292-5500
i~, Printed on Recycled Paper
Sqsul
I �
Property AddrL.—i-:7
Owner:
�U�h, �grnN IKS
Date of
B] SYSTEM CONDITIONALLY PASSES (continued)
SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
,//�� .
1�l- kuor, ma,
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the
Board of Health):
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled .or,replaced,
_ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass
inspection if (with approval of the BoardofHealth):
� P
broken pipes) are repbaced 'i i
obstruction is removed ,
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 the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
F'�VIRONMFNT
Thesys w►, has asepris• Tank and soil absorption system and is within I nn fcc! a unnl� � Cr t•;t ..tl to
surface water supply.
_ The wsten- has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
The sy,,ten, has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
The �y�ter;; kap a septic tank and so;! absorption system and is less than 100 feet but 50 feet or more from a private water
supply well, unless a well water analysis 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.
D] SYSTEM FAILS:
I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis
for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Backup of sewage into facility or system component due to an 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.
(revised 8/15/95) 2
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: �J� L51-
Owner: a1Ci�h i�o.�nKiv�
Date of Inspection: 1916-
D)
91sD) SYSTEM FAILS (continued):
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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
E] LARGE, SYSTEM FAILS:
The following criteria apply to large systems in addition. to the criteria above:
The design flow of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety
and the environment because. one or more of the following conditions exist:
the system is within 400 feet of a surface drinking.watersupply
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)
The owner„ or operator of any such system shall bring the system and facility" into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 8/is/9s) 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
'PART B
CHECKLIST
Property, Address:
Owner: 5'0�4h.V11ihS
Date of Inspection: �12*1CW
Check if the following have been done:
Pumping information was requested of the owner, occupant, and Board of Health.
None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
19 As built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
Y The system does not receive non -sanitary or industrial waste flow .
Z( The site was inspected for signs of breakout.
All system components, excluding the Soil Absorption System, have been located on the site.
The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees, material of construction, dimensions, depth -of liquid, depth of sludge, depth of scum.
The size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non -intrusive methods.
The faciht• c, 'd occupants, if differen! from own.e•) were provided \vith information on the proper maintenance of Sub -
Surface. Disposal System.
}
(revised 8/1'5/95) 4
0
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
�> PART. C
SYSTEM INFORMATION.
Property Address: I -7 j` for,."
ti
Owner: ��
Date of Inspectio
FLOW CONDITIONS i
RESIDENTIAL:
Design flow: gallons
Number of bedrooms.-2—
Number
edrooms: Number of current residents:
Garbage grinder (yes or no):-
Laundry connected to system (yes or no):�
Seasonal: use (yes or no):
Water meter readings, if available:�o_/__� �n� �✓
Last date of occupancy: Com-
,(.7
i
COMMERCIAUINDUSTRIAL:
Type of establishment:
Design flow:allons/day
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:
OTHER: (Describe) _
Last date of occupancy:
GENERAL INFORMATION
PUMPING CORDS and source of informati
��...�.14-18-g� .a.2
Syste p ped as part of inspection: (yes or no)h)
If yes, volume pumped: gallons
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)
Other (explain)
A XI TE GE of all components, date installed (if known) and source of information:S7aA/0- /9,?2
Sewage odors detected when arriving at the site: (yes or no)
(revised 8/15/95) 5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
'
SYSTEM INFORMATION (continued)
Property Address:
Owner: LN WtapKfKt
Date of Inspection: '
SEPTIC TANK:_
(locate on site plan)
rl
Depth .below grade:
Material of construction: $concrete _metal _FRP —other(explain)
Dimensions:
Sludge depth:,_
Distance from top of �udge to bottom of outlettee or baffle:y�
Scum thickness: $_ it
Distance from top of scum to top of outlet tee or baffle: 11
Distance from bottom of scum to bottom of outlet tee or baffle:
Comments:
(recommendation for pumping, conditi;n of inlet, and outlet tees or baffles,
integrity, evidence of leakage, etc.) t" 1 h ` ceA j j�9 ear
GREASE TRAP:_
(locate on site plan)
Depth belov+, grade:
Material of construction: _concrete _metal _FRP —other(explain)
of liquid level in rela
I Ieu 4%na,e o
.�r
outlet invert structural
Dimensions:
Scum tilickneDs.
Distance from top of scum to ton of outlet tee or baffle:
Dioanrn from hottnm ro <ru^, t'l ry�n (gym M nUr'P( IPP fir tl?t}iP .t • 1 ,77 �' r 1 .. -
__ I
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integrity, evidence of leakage, etc.)
(revised 8;15/95) 6
C
2
SUBSURFACE' SEWAGE DISPOSAL SYSTEM INSPECTION.FORM
PART 'C
SYSTEM INFORMATION (continued)
Property Address: 155alew�S� �p, w1dO"-
�
Owner: JCikh IrWIAt'LINI� r',r• , '
Date of Inspection:
TIGHT OR HOLDING TANK:_
(locate on site plan)
Depth below grade:
Material, of construction: _concrete _metal _FRP—other(explain)
Dimensions:
Capacity; gallons
Design flow: gallons/day
Alarm level:
Comments:
(condition -of inlet tee, condition of alarm and float switches; etc.)
DISTRIBUTION BOX:_
(locate on site plan)
Depth of Liquid level above outlet invert:
Comments
..
1n0�1y+ I1 le''E i andUI�111, e\ hui�r Or SC l > Cc _ j' i'."ef, e' IdC7CC OC i leZnZ int -,Of OU; of b0>;, eta.)
PUMP CHAMBER:_
(locate on site plan)
Pumps in working order:(yes or no)
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
trevised 8/15/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 7J� S�o(�C'�u�Tt 1 Vim• AN6►��d� i 4 - -
Owner: 0.hrL(tl�
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS):_
(locate on site.plan, if possible; excavation not required, but may be approximated by non -intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:_
leaching fields, number, dimensions:
overflow cesspool, number:
Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) u ce 6L
��• or �tat,Q��T.
CESSPOOLS: _
(locate 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:
ind cauun of gruund,vate!.
inflow (cesspoolrmust be pumped avpari of, inspection) cr . • :: 1 ;
Comments: (note condition of Wil, 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.)
(revised 8/15/95)
SUBSURFACE SEWAGE DISPOSAL -SYSTEM INSPECTION FORM
PART C
t {SYSTEM INFORMATION (continued)
soProperty Address: �A�J ��C�w��m �%a• Hv►(�oV�Q`
Owner:. -
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
DEPTH TO GROUNDWATER
Depth to groundwater: feet
method of determinatiom or approximation: 1 . emA& e-- �t'v (,,, {Q,, a �(�CjkV Sr -114 0 4RI
(revised 8/15/95) 9
M
SMUUB04A/CS/VO4/L017 TOWN OF NORTH ANDOVER
TERMINAL NO: -_ CONSUMER METER F/N
DATE: 11.
--'-
"Oct: 01-4306000-0 MANNING, JOHN /�n�: 09
r
Meter No: 1 Rev Mtr/#: '�: N 175 SALEM
Connector: � ] Digits: Book�: 16 Page: 43060 00000
Mal -If C6: ' ] gts� 3l Dim Cd: A] Multipliers ^ ] Meter Fig: 0
Un
Req: Inst:
s: Pipe Size: J Lan;
#:
=tt: Cnct: n: ] Type
Wrk Cd:
] Mt Code: Disc:
Notes: 5/8 TRI ] Met Loc: [
8gn:3 In/Oo
Fr C«r: 772aA pre ] Serial #: 0001892600
Next.
07/28/�5 To: 10/11/95 «: 736 A 2nd Prev; 684 C
`^ Cns Cr: Cur2i Prev2:
--------------------------Co Mth Bill: 03 User:
~--- First 12 Billing Months Consumption Information ___________ ]
12/95 36 A 06/g4 ./ ------[3] 1------ Last 12 Billing -------------
09/95�"�"��� l� A (12/g2 Months ---___
2 A g4 45 A �
7 E ~��/g3 35 E /09/92 6g A
~03/95 -W C ^�'g3 36 C I06/92 2W A
12/94�An 6 C --g3 E /03/92 38 A '
09/g4�7* -~' ' '30 A T-
' /43 C 03/93
First 12 Total73 / Last
44 A |
(ESC) to E t Enter N ~ 3 t 12
(ESC) Exit New Meter Number s Total: 172
cc (F1) Header (F2) Service (F3} Sery History (F4} Dialog Histc