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Miscellaneous - 1761 SALEM STREET 4/30/2018 (2)
vn V� k�aC���) tOD 9cn o L m (tel 0 N } LL W W U) m W J a U) ti -0 U) �w U � L 0 Q Q O J (Y- w TU N QCL 2a_ a- x 0 - x0 N N w �N CO 0r 00' U r L6 (n co N N N �� V7 { J J �4t. N \ O O O N N 3COU) U� �� a•' a U N V N, fn M O (0 N N 0 '� 0 0 s ,� U),@' aM; CL c N W OO N y'N c,0 y. _�wUrs. Q 0 z a LL �N ,. t� ,,dw rl Z N N 7' i Z� w`ZZZ 0 s0 � 0. F=- w:CU z a 'Lo CU c, ogL0N a Z y'0 0 �N W C �,OE J J LL u' k xa s ' J ,.�Q� UQ oo Z 0 Qa > m O QOM f d: OO COML' c O V L' L: LL Z U .a Z C\F C6 cUc ID!O Q SCO O NN r M. 01 (6 MN; d iZ'�H�I��. O c Q LL O LCCD :z U) M m ih l a aW'P U)EtO J J s W O J 0) 0) _O -0 w fir, „�• W � O a w V uj 0 X =" _ 10 a �, ip c N a (4.CD r N (n Q m N W L O 00 00 C7R ya w �� F K to f` w, (. ` a•'C w. rN Z ' U)'0 m '�'o Ln m a-- ` W iw m d co v J a` !W, t0U=o�.'�. N O'N 0) Qi O W 00 l Z. 0 I ? M U) C.0 F- C O 0 p Z IN)';r N V) U) ci i g Uw Qom} i� c € pi LO N. �1 € O (D (D;r E N N, (n U) U) in N :.. " N a • • �— L�+. f € s7 r NO L. ��Q (07000Qi— 0 0 .+,IL �>.Oi 011 0) oa F' as iM � iTl "Ln FA C Z M Il 151 0 W is I' ui _Ctip rnMZ a c•. n Aii e 71 Z IA �r d. �w iil S .. MD > I� " � to I .A s0� �xOki ygz�o o� or D f. C V C C Z yy O O C3 E-' ru O RJ ru Er .ice E3 Ln -_ k 'r o C) iA -' N C) o - 'u y -,lb. O W N -010 W to W LA tD W �'I i/ � Ln 4 m x ru ru 0 ru 0 0 0 0 0 Ln m C3 4/18/2017 +C1c� NORM, 'OVER Massachu tts RE: Contacting Joe Zee 1 message Town of North Andover Mail - RE: Contacting Joe Zee mike@beaversolutions.com <mike@beaversolutions.com> To: Jennifer Hughes <jhughes@northandoverma.gov> Cc: Michele Grant <mgrant@northandoverma.gov> Thank you Jennifer. Michele Grant <mgrant@northandoverma.gov> Sun, Apr 16, 2017 at 7:22 AM Michele, I look forward to hearing from you how you were able to contact Joe Zee regarding the 1761 Salem Street beaver - related flooding. Thank you. Happy Easter to you both, Mike Callahan Michael Callahan, Owner Beaver Solutions LLC "Working With Nature" 14 Mountain Road Southampton, MA o1o73 Cell: (493) 695-0484 Office: (493) 527-6472 Web: www.beaversolutions.com From: Jennifer Hughes [mailto:jhughes@northandoverma.gov] Sent: Saturday, April 15, 2017 9:40 AM To: Mike Callahan <mike@beaversolutions.com> Cc: Michele Grant <mgrant@northandoverma.gov> Subject: Re: Contacting Joe Zee I do not have any information. I believe Michele used the police department to get in touch with him. I have copied her on this email. Jennifer A. Hughes Conservation Administrator Town of North Andover 120 Main Street hftps:Hm ai l.google.com/mail/calu/0/?ui=2&ik=d4458df3d9&view=pt&search=i nbox&th= l5b76800b9O6ba3a&si m l=15b76800b9O6ba3a 1/3 4/18/2017 Town of North Andover Mail - RE: Contacting Joe Zee North Andover, MA 01845 Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web www.northandoverma.gov On Thu, Apr 13, 2017 at 4:40 PM, <mike@beaversolutions.com> wrote: Hi Jennifer, I hope you are doing well. Do you have any records of correspondence from Joe Zee on Salem Road from last year when his driveway was flooding? I have been unable to reach him for payment for the work I did last year or for flow device maintenance for 2107. 1 am hoping you have information that is different from mine about how to reach him. Does he live at 1761 Salem Street? I am hoping his nonpayment is the result of a communication problem rather than him trying to avoid paying for the work he requested. Thank you for your assistance. Sincerely, Mike Callahan Michael Callahan, Owner Beaver Solutions LLC "Working With Nature" 14 Mountain Road Southampton, MA 01073 Cell. (413) 695-0484 Office: (413) 527-6472 Web: www.beaversolutions.com https://m ai I .googl e.com /m ai I/calul0/?ui=2&i k=d4458df3dg&view= pt&search= i nbox&th=15b76800b9O6ba3a&si m l=15b76800b9O6ba3a 2/3 4/18/2017 NORM -AR DOVER Massachus tts_ Fwd: 1773 salem street email 1 message Town of North Andover Mail - Fwd: 1773 salem street email Jennifer Hughes <jhughes@northandoverma.gov> To: Michele Grant <mgrant@northandoverma.gov> Michele Grant <mgrant@northandoverma.gov> Who from NA Police did we work with on this? Could we ask them about contact info? Jennifer A. Hughes Conservation Administrator Town of North Andover 120 Main Street North Andover, MA 01845 Phone 978.688.9530 Fax 978.688.9542 Email jhughes@northandoverma.gov Web ' www.northandoverma.gov Thu, Apr 6, 2017 at 10:53 AM ------- Forwarded message ----- From: <mike@beaversolutions.com> Date: Thu, Apr 6, 2017 at 9:41 AM Subject: RE: 1773 salem street email To: Cat Bartlett <catbartlett@comcast.net>, jrz1@icloud.com Cc: James Henry <james.henry@andoversoft.com>, "LaMarca, Stephanie" <slamarca@comcast.net>, Jennifer Hughes <jhughes@northandoverma.gov>, Heidi Gaffney <hgaffney@northandoverma.gov>, Lisa Hadge <Ihadge@northandoverma.gov>, Michele Grant <mgrant@northandoverma.gov>, markstoolrepair@gmail.com, "Henry, Marinete" <madnetehenry@msn.com>, info@beaversolutions.com Hello All, I have bad news which unfortunately may affect you. https://maiI.google.com/mail/ca/u/0/?ui=2&ik=d4458df3dg&view=pt&q=salem%20st&qs=true&search=query&th=15b43c1ecd2eab6b&simI=15b43cIecd2eab6b 1/4 4/18/2017 Town of North Andover Mail - Fwd: 1773 salem street email Despite repeated attempts by phone, e-mail and snail mail I have not been able to reach nor receive a reply from Joe Zee regarding the 2017 Maintenance Plan of the flow devices at 1761 Salem St. What is worse, he still has not paid me for any of the flow device work I did last year to resolve the flooding problem at his request. I have repeatedly emailed him at jrzl @icloud.com and phoned 781-520-0000. Does anyone know if his contact information has changed? Obviously it is important that I be able to reach him. Thank you for any information you may have. All the best, Mike Callahan Michael Callahan, Owner Beaver Solutions LLC "Working With Nature" 14 Mountain Road Southampton, MA o1o73 Office: (413) 527-6472 Web: www.beaversolutions.corn From: mike@beaversolutions.com [mai Ito: mike@beaversolutions.corn] Sent: Monday, November 28, 2016 8:07 AM To: 'Cat Bartlett' <catbartlett@comcast.net> Cc: 'James Henry' <james. hen ry@andoversoft. corn >; 'LaMarca, Stephanie' <slamarca@comcast.net>; 'Jennifer Hughes' <jhughes@northandoverma.gov>; 'Heidi Gaffney' <hgaffney@northandoverma.gov>; 'Lisa Hadge' <Ihadge@northandoverma.gov>; 'Michele Grant' <mgrant@northandoverma.gov>; 'rickmwws@gmail.com' <rickmwws@gmail.com>; 'markstoolrepair@gmail.com' <markstoolrepair@gmaii.com>; 'Henry, Marinete' <marinetehenry@msn.com> Subject: RE: 1773 salem street email Hello Cat, I am not surprised at all that the water level has risen significantly. Due to the drought the level had been well below the height of the pipes and now that we are getting rain the water flow has returned. I can look at it the next time I am in the area but in the meantime any of you can do the same by seeing if the pipes are flowing. If so then it should be fine. When I last saw the pipes this summer they appeared high because the water level was "low", but the pipes were in good condition. Reminder, the pipes are not designed to bring the level back to pre -beaver levels. They need a ponded area so the beavers do not block them. However, they should keep the water from rising to the levels you saw prior to their installation despite the presence of beavers. https://mail.google.com/mail/calul0/?ui=2&ik=d4458df3d9&view=pt&q=salem°/a20st&qs=true&search=query&th=15b43clecd2eab6b&siml=15b43clecd2eab6b 2/4 4/18/2017 All the best, Mike Callahan Michael Callahan, Owner Beaver Solutions LLC "Working With Nature" 14 Mountain Road Southampton, MA o1o73 Office: (413) 527-6472 Web: www.beaversolutions.com Town of North Andover Mail - Fwd: 1773 salem street email From: Cat Bartlett [mai Ito: catbartlett@comcast.net] Sent: Monday, November 28, 2016 7:52 AM To: mike@beaversolutions.com Cc: James Henry <james.henry@andoversoft.com>; LaMarca, Stephanie <slamarca@comcast. net>; Jennifer Hughes <jhughes@northandoverma.gov>; Heidi Gaffney <hgaffney@northandoverma.gov>; Lisa Hadge <Ihadge@northandoverma.gov>; Michele Grant <mgrant@northandoverma.gov>; rickmwws@gmail.com; markstoolrepair@gmail.com; Henry, Marinete <marinetehenry@msn.com> Subject: Re: 1773 salem street email Hi Mr. Callahan, I live on Beaver Brook Rd. in North Andover. The water level in the "pond" has risen significantly in the past few weeks. I am not sure if anyone has been in touch with you yet about this, but I am concerned that it is heading back to the levels we saw last Spring. Is there any way to check to see that the pond levelers are working? Thank you, Cat Bartlett From: "Mike Callahan" <mike@beaversolutions.com> To: "James Henry" <james.henry@andoversoft.com>, "Stephanie LaMarca" <slamarca@comcast.net>, "Jennifer Hughes" <jhughes@northandoverma.gov> Cc: "Cat Bartlett" <catbartlett@comcast.net>, "Heidi Gaffney" <hgaffney@northandoverma.gov>, "Lisa Hadge" <Ihadge@northandoverma.gov>, "Michele Grant" <mgrant@northandoverma.gov>, dckmwws@gmail.com, markstoolrepair@gmail.com, "Marinete Henry" <madnetehenry@msn.com> Sent: Friday, April 29, 2016 7:38:05 AM Subject: RE: 1773 salem street email Good Morning, Yes, we were very successful yesterday installing the two large Pond Leveler pipes which will allow for continuous water flow under the bridge that the beavers will not be able to block. Each pipe is https:Hmail.google.com/mail/ca/u/O/?ui=2&ik=d4458df3d9&view=pt&q=salem%20st&qs=true&search=query&th=15b43clecd2eab6b&siml=15b43clecd2eab6b 314 4/18/2017 Town of North Andover Mail - Fwd: 1773 salem street email 40 feet long and extends deep out into the pond. See attached info sheet for more details. All the best, Mike Callahan Michael Callahan, Owner Beaver Solutions LLC "Working With Nature" 14 Mountain Road Southampton, MA o1o73 Office: (413) 527-6472 Web: www.beaversolutions.com From: James Henry [mailto:james.henry@andoversoft.com] Sent: Friday, April 29, 2016 6:43 AM To: Stephanie LaMarca <slamarca@comcast.net>; 'Jennifer Hughes' <jhughes@northandoverma.gov> Cc: 'Cat Bartlett' <catbartlett@comcast.net>; 'Mike Callahan' <mike@beaversolutions.com>; 'Heidi Gaffney' <hgaffney@northandoverma.gov>; 'Lisa Hadge' <Ihadge@northandoverma.gov>; 'Michele Grant' <mgrant@northandoverma.gov>; rickmwws@gmail.com; markstoolrepair@gmail.com; Marinete Henry <madnetehenry@msn.com> Subject: RE: 1773 salem street email Good morning Mike, My understanding is that you were able to lower the water level and install something yesterday. What were you able to install and where do we stand with the water flow issue? https://mail.google.com/mail/ca/u/0/?ui=2&ik=d4458df3d9&view=pt&q=salem°/a20st&qs=true&search=query&th=15b43clecd2eab6b&siml=15b43clecd2eab6b 4/4 N V N bOA a U C C C O .j 0 0 CL U N N N J to N O O N 0 O N 0 00 0 0 N cy 00 � O i a,X y R3 .L O •� ca y .o A •L C C) Q ti N A O b ob y a O � � � .o •v o �o/ R% 5 c L N fC K. a v o w�� V1 O N 'O ,� v y� N •� ❑ ,� � � .o �C x. cc y d D 0 N. w` o 0 0 0 v� "o o z W 7E 7E bo O u a x x F ¢ c O O O O t7. N �Q a w°Ll z ri0 d 4.) 0, F -r oo ox a L � U z° . "o CA �O A °�°z� �3 ti > by Eo � y (� L 00 110 00 L 4 o o L W v 0 i W N w C, C,N ke) � (V E . O bb W o 0 oOD U .. m b �� V � N � � y. 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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, I� use only the tab 01 %il 3/7 key to move your Address cursor- do not N. Andover Ma use the return City/Town State key. a7 h �n 2. System Owner: --os Can �) Name Address (if different from location) City/Town State Telephone Number Zip Code Zip Code B. Pumping Record 1. Date of Pumping Na u I 8 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 ❑ No 5. Condition of System: 6. System Pumped If yes, was it cleaned? ❑ Yes ❑ No Cr S�i Name Vehicle License Number Stewart's Septic S ice Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant,..20 So. Mill Bradford, Ma 01835F `+ Signature of Hauler Signature of Receiving Facility Date q TpWN C-: NCR7kt ANDOVER T1,J nEPARYtitENT Date .- - t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 TRANSMISSIiON '-JERIFICATIOH REPORT TIME : 07/24/2007 13:14 NAME HEALTH FAX : 9736888476 TEL 9786888476 SER.# : 0004J120960 DATE DIME 07124 13:14 FAX NO. /N44E 816179644617 DURATION 00:00:36 PAGE(S) 02 RESULT GK tvIODE STANDARD ECM North Andover Health De artmAnt 1600 Osgood Street Building 20, Suite 2.36 North Andover, MA 01845 978.688.9540 - Phone 978.608.8476 — Fax beaithdept&ownofnortbandover corn - E-mail .townanC+ andover.Co - Wellsite Letter of Transmittal Page —..L of _Kj TO: �,7 DATE %r�I s•� � COMPANY; FROM: Pamela DelleChit Fox: We are sending you. O Copy ofLofter Doane O fter(fi//do hOlOw) These are transmitted as checked below: > L74vm*a►asXW* rnv L7&4Pvw L 7fvrRey# uaWwmu" Drcrrow& Q`{K4Eo 16fe�� � r Health Department Assistant > L7AkM" qpi7sfnr qPvMW > LA& w*fbrc%t Health Department Assistant > L7AkM" qpi7sfnr qPvMW > LA& w*fbrc%t In North Andover Health Denartment 1600 Osgood Street Building 20, Suite 2-36 North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 — Fax healthdept(CD-townofnorthandover.com - E-mail www.townofnorthandover.com - Website Letter of Transmittal Page _ / of 9-, l t%ORTy q O �tuto 16. 4.0 6 OL O �► T0: COPY TO: COMPANY: FROM: Pammela DrelleChiaie, Health Department Assistant Phone: ' D 7 D 7U RE: J Fox: <= CP 1/ / L� / "/ �� v�-'�✓^=�� We are sending you. O Copy of Letter O Plans O Other (fill in helow) These are transmitted as checked below: ➢ L74pa WkwNatad ➢ OaslPgmsted ➢ OkrgptcVAi ➢ OrorRh*wandmwv# ➢ EArro um ➢ MsAny afaisfor WVW ➢ O&" apiesfarAt. REMARKS: COPY TO: COPY TO: SIGNED: COPY TO: t r Kms* �4Yb •il �� CJ�C�t Fri, "„�/ SEIOVSR du r r r 3 a Gil 1W ✓ ZO6Nva , 6� ` � b PUBLIC HEALTH DEPARTMENT Community Development Division To: All North Andover Residents with Septic Systems and Garbage Grinders Please note that due to recent reviews of Title 5 Reports, your property has been identified as maintaining a working garbage grinder that is being used in conjunction with a septic system. The Health Department is concerned for the longevity of your septic system. Garbage grinders are never recommended where septic systems are used, but if they are installed, the system must be specifically designed to handle the waste from them; your system can not handle the waste as designed. Please note that continued use of this grinder could quickly cause a pre -mature failure of your septic system, resulting in a large expenditure to replace it. The North Andover Health Department recommends that you remove it from your home as soon as possible. Some information regarding regular maintenance of your septic system is attached. Please call the Health Department at 978.688.9540 if you have any questions, or e-mail your questions to: healthdept(a,townofnorthandover.com. Thank you for taking the time to consider the impact that your current setup has on your septic system and the environment. Sincerely, Sus=Ya , RENS/ Public Health Director /pfd Enc: Septic System Information: http://www.mass.gov/del)/water/wastewater/dodont.htm 1600 Osgood Street, North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web http://www.townofnorthandover.com for hom... Page 1 of 1 How Do I as a System Owner Properly Care for my Septic System? Conventional on-site septic systems can function very well with minimal care. In fact, most septic tanks will only require an inspection and pumping out by a professional every three to five years if they are used properly. This does not pertain to 1/A_sy-stems, which need more frequent oversight. DO... I IDON'T... have the system inspected and pumped every 3 to 5 rs. If the tank fills up with an excess of solids, the tewater will not have enough time to settle in the c. These excess solids will then pass on to the leach 3, where they will clog the drain lines and soil. know the location of the septic system and drain 3, and keep a record of all inspections, pumpings, firs, contract or engineering work for future :rences. Keep a sketch of it handy for service visits. Do grow grass or small plants (not trees or shrubs) above the septic system to hold the drain field in place. Water conservation through creative landscaping is a great way to control excess runoff. Do not use your toilet or sink as a trash can by dumping non-biodegradables (cigarette butts, diapers, feminine products, etc.) or grease down your sink or toilet. Non- biodegradables can clog the pipes, while grease can thicken and clog the pipes. Store cooking oils, fats, and grease in a can for disposal in the garbage. not put paint thinner, polyurethane, anti -freeze, ticides, some dyes, disinfectants, water softeners, and -r strong chemicals into the system. These can cause or upsets in the septic tank by killing the biological t of your septic system and polluting the groundwater. all amounts of standard household cleaners, drain msers, detergents, etc. will be diluted in the tank and uld cause no damage to the system. Do not use a garbage grinder or disposal, which feeds into the septic tank. If you do have one in the house, severely limit its use. Adding food wastes or other solids reduces your system's capacity and increases the need to pump the on-site tank. If you use a grinder, the system must be pumped more often. Do install water -conserving devices in faucets, Do not plant trees within 30 feet of your system or showerheads and toilets to reduce the volume of water park/drive over any part of the system. Tree roots will running into the on-site system. Repair dripping faucets clog your pipes, and heavy vehicles may cause your and leaking toilets, run washing machines and drainfield to collapse. dishwashers only when full, and avoid long showers. Do divert roof drains and surface water from driveways Do not allow anyone to repair or pump your system and hillsides away from the septic system. Keep sump without first checking that they are licensed system pumps and house footing drains away from the system as professionals. well. take leftover hazardous chemicals to your approved ardous waste collection center for disposal. Use ich, disinfectants, and drain and toilet bowl cleaners Tingly and in accordance with product labels. o not perform excessive laundry loads with your ashing machine. Doing load after load does not allow )ur septic tank time to adequately treat wastes and ✓erwhelms the entire system with excess wastewater. ou could therefore be flooding your drain field without lowing sufficient recovery time. You should consult )ur tank_ professional to determine the gallon capacity id number of loads per day that can safely go into the Do use only septic system additives that have been Do not use chemical solvents to clean the plumbing or allowed for usage in Massachusetts by DEP. Additives septic system. "Miracle" chemicals will kill that are allowed for use in Massachusetts have been microorganisms that consume harmful wastes. These determined not to produce a harmful effect to the products can also cause groundwater contamination. individual system or its components or to the environment at large. http://209.85.165 .104P,earch?q=cache:OSxSWhzZovAJ:www.mass.gov/dep/water/wastew... 1/22/2007 R f m O v v e °w' m y 3 3 O Z J J Q Cc,- w L w w d tQp a C e0 aQi a m O In ;I LL V1 to W B F- U) U) an Vl V o E CN E O w H O U d o _ v e °w' m 3 O y = Q Cc,- w a y w Z Z Z J In ;I LL V1 to W B F- U) U) an Vl V o E CN E O w H O U d o _ r ?•, a Of NORTOI 1h h 9 r • Town of North Andover `+,'••,,,,,.�'` HEALTH DEPARTMENT cNustt CHECK #: 3—X76*" DATE: LOCATION: H/O NAME: CONTRACTOR NAME: Type of Permit or License: (Check box) ❑ Septic - Design Approval ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type: $ '. ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector ` $ itReport le 5 00 $ ❑ Other. (Indicate) $ �. '7 5 5 9 t-A� Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer Owner information is required for every page. Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. II Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Asses: 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Ma. 01845 Cityrrown State Zip Code ECEIVED , �C nts AUG - 6 2007 I , b:EALTH DEPARTMENT 7-28-07 Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information 1. Inspector: F. Paul Cardone Name of Inspector Septic Compliance, Inc. Company Name 447 Boston Street Company Address ToprSta. � Cityl1'ownown State 978-887-8586 or 978-681-0726 Telephone Number License Number B. Certification 01983 Zip Code 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 ® Fails ❑ Needs Further Evaluation by the Local Approving Authority In is Signature Date 07 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. ****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. Estate of Toscano 1761 SaiemSTNoAndmer7-28-07.08106 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 1 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M ,.•''r 1761 Salem Street Property Address EState of Carmen F. Toscano Owner Owner's Name information is required for No. Andover Ma. 01845 7-28-07 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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 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 Estate of Tosceno 1761 SalemSTNoAndnver7-28-07.08M Title 5 Official k%spection Form: Subsurface Sewage Disposal System • Page 2 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Ma. 01845 Cityrrown State Zip Code B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: 7-28-07 Date of Inspection ❑ 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: 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. Estate of roscano 1761 SalemSTNoAndmrer7-28&07.08/06 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 3 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Ma. 01845 Cityrrown State Zip Code B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): 7-28-07 Date of Inspection ❑ 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 indicates absent 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. D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No ® ❑ 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 ® ❑ 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 '/ 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. Estate of 7oscano 1761 .4atemSTNoAndnver7-28.07.08106 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 4 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Cityrrown B. Certification (cont.) Ma. 01845 State Zip Code D) System Failure Criteria Applicable to All Systems (cont.): 7-28-07 Date of Inspection Yes No No ❑ ® 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 the system is within 200 feet of a tributary to a surface drinking water supply 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 fecal coliform bacteria indicates absent and the presence Area — IWPA) or a mapped Zone II of a public water supply well 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ 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. For large systems, you must indicate either "yes" or "no" to each of the following, in addition to the questions in Section D. 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. Estate of Toscano 1761 SalemSTNakxlrw r7-28-07.08/06 Title 5 Official hupection Forth: Subsurface Sewage Disposal System - Page 5 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Ma. City/Town State C. Checklist 01845 7-28-07 Zip Code Date of Inspection Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No ❑ ® 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? ® ❑ 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: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] Estate of Toscano 1761 SalemMoAndnver7-28-07.08M Title 5 Official Inspection Forth: Subsurface Sewage Disposal System - Page 6 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Cityrrown D. System Information Ma. 01845 State Zip Code 7-28-07 Date of Inspection Residential Flow Conditions: Number of bedrooms (design): 3 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 have a garbage grinder? Is laundry on a separate sewage system? [if yes separate inspection required] Laundry system inspected? Seasonaluse? Water meter readings, if available (last 2 years usage (gpd)): Sump pump? Last date of occupancy: Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? Industrial waste holding tank present? Non -sanitary waste discharged to the Title 5 system? Water meter readings, if available: Last date of occupancy/use: Other(describe): Gallons per day (gpd) Date 330 ® Yes ❑ No ❑ Yes ® No ❑ Yes ❑ No ❑ Yes ® No ❑ Yes ® No Occupied Date ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No Estate of Toscano 1761 SalemSTNoAndnver7-28-07.08106 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System - Page 7 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Cityrrown D. System Information (cont.) Pumping Records: Source of information: Ma. 01845 State Zip Code General Information Was system pumped as part of the inspection? If yes, volume pumped: How was quantity pumped determined? Reason for pumping: Type of System: 7-28-07 Date of Inspection Person handeling estate didn't know gallons System is due for routine pump ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Yes ® No ❑ 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: According to plan on file design was donn on 9-27-82 and according to estate person house was built in 1985 Were sewage odors detected when arriving at the site? ❑ Yes ® No Estate of Toscano 1761 SalemSTNoAndnver7-28-07.08/06 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 8 of 1 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M s•'' 1761 Salem Street Owner information is required for every page. Property Address EState of Carmen F. Toscano Owner's Name No. Andover Cityrrown D. System Information (cont.) State 01845 Zip Code Building Sewer (locate on site plan): Depth below grade: slab feet Material of construction: ❑ cast iron ❑ 40 PVC ❑ other (explain): — Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 7"feet Material of construction: 7-28-07 Date of Inspection ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 10'6" x 5'8" x 5'5" invert 56" Sludge depth: 7-9,1 Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 4" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Estate of Tosceno 1761 SalemSTNoAndnver7-28-07.08106 Septic Dip -Stick and tape Trlle 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 9 of 1 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 1761 Salem Street Property Address EState of Carmen F. Toscano Owner Owner's Name information is required for No. Andover Ma. 01845 7-28-07 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): We recommend tank be pumped on a yearly basis depending on usage, baffles were on , structural integrity appeared to be o. k., liquid level was a little high, no apparent leaks. Grease Trap (locate on site plan): Depth below grade: N/A feet 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: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Estate of Toscano 1761 SalemSTNoAndnver7-28-07.08106 Title 5 Offiicial Inspection Form: Subsurface Sewage Disposal System • Page 10 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M .�y 1761 Salem Street D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: Design Flow: Alarm present: Alarm level: 01845 7-28-07 Zip Code Date of Inspection N/A gallons gallons per day ❑ Yes ❑ No Alarm in working order: Date of last pumping: Date Comments (condition of alarm and float switches, etc.): ❑ Yes ❑ No * Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 4 lines leaving box 3 had solids in pipe 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:): Box was level, one line doing most of the work, solids carryover in three lines, no apparent leaks in or out of box. Pump Chamber (locate on site plan): Pumps in working order: Alarms in working order: ❑ Property Address ❑ EState of Carmen F. Toscano Owner owner's Name information is No required for No. Andover Ma. every page. Cityrrown State D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: Design Flow: Alarm present: Alarm level: 01845 7-28-07 Zip Code Date of Inspection N/A gallons gallons per day ❑ Yes ❑ No Alarm in working order: Date of last pumping: Date Comments (condition of alarm and float switches, etc.): ❑ Yes ❑ No * Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 4 lines leaving box 3 had solids in pipe 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:): Box was level, one line doing most of the work, solids carryover in three lines, no apparent leaks in or out of box. Pump Chamber (locate on site plan): Pumps in working order: Alarms in working order: ❑ Yes ❑ No ❑ Yes ❑ No Estate of Toscano 1761 SalemSTNoAndnver7-28-07.08/06 Tittle 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 11 of 1 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner's Name No. Andover Cityrrown D. System Information (cont.) State 01845 Zip Code 7-28-07 Date of Inspection Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): N/A 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: ® leaching fields number, dimensions: 1 - 20'x50' 1000 Sq. Ft leaching ❑ 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.): Moist No None Yes Overgrown back yard area Field is relatively shallow there are big truck rut s in the area. Estate of Toscano 1761 SalemSTNoAndnver7-28-07.08/06 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 12 of 1 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , 1761 Salem Street Owner information is required for every page. Property Address EState of Carmen F. Toscano Owner's Name No. Andover Ma. 01845 7-28-07 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A 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 ❑ 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 N/A Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Estate of Toscano 1761 SalernSTNoAndnver7-28-07.08106 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 13 of 1 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Property Address EState of Carmen F. Toscano Owner Owner's Name information is required for No. Andover Ma. 01845 7-28-07 every page. cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including des to at least two permanent reference landmarks or benchmarks. Lute all wells within 100 feel. Locate where public water supply enters the building. WN ,% of • ... ' w,,, � T" .�� � X44 (• 9 7,n !' •, . Estate orToscaw 1761 X7,28.07.08/08 r Y • ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1761 Salem Street Owner information is required for every page. Property Address EState of Carmen F. Toscano Owner's Name No. Andover Ma. 01845 Cityrrown State Zip Code D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ❑ Check cellar ® Shallow wells Estimated depth to ground water: 4'+ 7-28-07 Date of Inspection feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record 0M If checked, date of design plan reviewed: Date 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: I dug a hole outside of the perimeter of the leach field 4' deep no water observed, deep holes and peres are going to have to be performed for repair Estate of Toscano 1761 SalemSTNoAndrner7-28.07.08/06 Tdle 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 15 of 1 P t r 1 . •77 f �( F Ale I a7j,r,z ,s - r.'../ � o i �'r1 i �\t �LS !AI oi.!-r/I'� 7-,9Nk ..fes ,s - r.'../ � o i �'r1 i �\t r t r • , _I rte. �� - "• :, ., + f li, ,3.' _. 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" .. !� ° �• � ���a[[[���77YVV11111 C � - I1 I • - ,' • •• � war -a .'.- _ r* � �L•�1i' a ��� ,r Yr 5 it ��. * f i q i t 4 a j r9 K r�A • .< ��} ..,ti 1. i.l Yw a ,� fit'. s„ a } 7w y r 1 - • 4:. - � 1 '• • .. , _ ` �'�' Y :d" 1 k 4 a/•'4r„ �. +� ! + y c A x , } � e/•.. . •� �-, TI s+f �t 3 ;t}�77� � \+J � `I i , Y ��• .a h a f ,4r .. , . _ r f c. V - . t - ': f 1 a r x4 ' ' � S < �tl' +: • ^ t4 �r a . � 3�"� . i' � r F ��y.�(�y'M ' C,�`'r`1� • � � � >' `• 1 y, � b �' ' � ' c 11'.1 `� U � "� • ��'4�tV� 'A � �� ,.'`'-,-q.j~ R •�� � , ® � ,. � gip` (.� p 0- Pi fit IS 14 , 1. le r � N •' V ' ir�•��J'r T ��/.�{) �" TIG hF r •iI' �iIJ•R A � +; .t ti „ a ,�p Y` ! �i +`71``1 M�kI F .. s. 1 a y.v �Jmc • r - ' Board ql ticaL-Ln North Andnv5.,jY aa. AFFhUV hV VAT J5 O$ Y BEMC SISTai INSTALLATICK CHBCK LIST LOT [EXCAVATICH OK FAIL -1. Distance To: a. _ Wetlands b. Drains c. Well 2. Water Line Location �. Septic Tank a. -Tees -_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 Equal Amounts c. No Back Flow 6.. Leach Field or Trench a. Ditensions b. Stone Depth c. Capped Inds d. Clean Double Washed Stone ?, 'Leach Pits a Dimansi"no b. Stone epth c. Sp sh Pads d. T s e. �nt Pipe to Pit - Both Sides. f. Clean Double Washed Stone G 8. No Garbage Disposal,"'�� � V $� 9. -Final Grad;; Inspection 10. Barricading Covered System I 11 As Built Submitted ol _. Lot Location b. Dimensions of System v -- / c. Location -Ath Regard -to Perc Test d. Elevations e.' Water Table TO: NORTH ANDOVER, MASS SEP 17 19 �92— BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at 5i`i114 5 7 —, North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated ©C 7` 1 19—e_Q MoTc 45 �" —T" 101-IIIV Bo rd of He�,! t1, NerW An.dor(-. rsy.'Iss APPROVED DATE Provided: SUBSURFACE DISPOSAL DESIGN CHECK LIST DISAPPROVED DATE Reasons: / -7d Title V FAIL (X Reg 2.5 / The submitted plan must show as a minimums I the lot to be served-areasdimensions lot #,abutters location and log deep observation hoes -distance to ties location and results percolation tests -distance to ties d design calculations & calculations showing rewired leaching area (f location and dimensions of system -including reserve area f� existing and proposed contours ✓ (g) location any wet areas within 1001 of sewage disposal system or / disclaimer -check wetlands mapping (h),surface and subsurface drains within 1001 of sewage disposal system or disclaimer (i) location any drainage easements within 1001 of sciage disposal i - system or disclaimerPlmudng Board files i (J) knowa sources of neater supply within 200, of sewage disposal system or disclaimer (Ir)location of any, proposed well to serve lot -100, from leaching facility location of water lines on property -101 from leaching facility L,--74 location of benchmark driveways �o)�garbage disposals e(q), noPVC to be used in construction e, profile of system -elevations of basements plumbs pipe, septic tank, distribution box inlets and outletss distribution field piping and '1Other elevations 0"'maxinum 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 7(a) capacities -15D% of flow, water table, tees: depth of tees,, accesss pining b) cleanout (c) 101 from cellar wall or inground swimming pool :77(d) 25+ from subsurface drains Reg 10.2 10.4 Distribution Boxes (e eater 0.08 b) stup FAIL eg 15.1 15.4 15.8 3.7 14.1 14.3 14.6 14 14.7 14.10 9.1 9.6 Check List I � I Page 2 Leaching Pits Leaching pits are preferred where the installation is possible a calculations of leaching area -minimum f / � 500 eq t b) spacing c surface drainage 2% dj cover �terial e) R'x2 T splash pad f) tee a elbow g) no bends in pipe from d -box to pipe Leaching Fields a) no greaterthan 20 minutes/inch area -minimum 900 sq ft construction of field d, surface drainage 2 % e) 201 from cellar wall or inground swan d.ng pool LeachinR Mvenches/' a)—calculations or/leaching area -min 500 sq ft b) spacing -4 ft min 6 ft with reserve between C) dimensions` d) construction e) stone / f) sur g6e drainage 2% Dow3hill Slo e a) sip y x' _ (o be shown) b) y/x X 150 = (to be shown) 2PEOS a)vhl b) stand-by power SOIL PROFILE & PERCOLATION TEST DATA Town/City', C,aa'g" No.&Street _t J06 /n-17-7 Lot No. 1 � Loc./Subdiv. Plan Owner .�-- 1 Investigator_ d� ',���. Cid/!f1 Observer i� SOIL PROFILES -DATE Elev. 3' Elev. 3' Elev. 4'Elev. ` o ,5 a3 7? � o 0 0 1 1 1 2 2 2 2 .� 3 3 3 _ 3- 10 t Benchmark Elevation 4 5 6 7 r1 9 10 4 5 6 7 8 9 4 5 6 7 8 9 10 1 I 10 1� Location- Datum ocationDatum Percolation Tests -Date W/ 7 ti e Pit Number 1 2 3 4 5 Start Saturation Soak=Mins .,., Start Test -Time p Drop of 3" -Time Droo of 6" -Time Mins.lst 3"Dro Mins.2nd 3"Dro Notes & Sketches on Back Fra)ik C. Gelinas & Associates, North And. le /cf-n 711-7177 1,.,2" J.- 6,; 1666 4117 i 1 I y