HomeMy WebLinkAboutMiscellaneous - 1809 SALEM STREET 4/30/2018 (2)Commonwealth of Massachusetts
City/Town of North Andover RECEVED
System Pumping Record
Form 4 AUG C 4 2014
DEP has provided this form for use by local Boards of Health. Other forms��y� be—JrdQ`Kbut, lieVER
information must be substantially the same as that provided here. Before u' �ragit�s�orlrpf'cktUour
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 q� e�
use only the tab
key to move your Address
cursor - do not North Andover Ma 01886
use the return City/Town State Zip Code
key.
2. System Owner:
5eluerio
Name
�emnn
Address (if different from location)
City/Town
B. Pumping Record
1. Date of Pumping
State
' Telephone Number
7
Date 2. Quantity Pumped:
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes ❑ No
5. Condition of System:
6. System Pumped By: �/ l
t5form4.doc• 03/06
Zip Code
/6eo
Gallons
❑ Grease Trap
If.yes, was it clearied? ❑ Yes ❑ No
Name Vehicle License Number
Stewart's Septic Service
Company
7. Location where contents were disposed:
Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835
Signature of Hauler
Signature of Receiving Facility
Date
Date
System Pumping Record • Page 1 of 1
TOWN OF NORTH AN'DfJVS�,
UA 11 SYSTEM PUMPING R.ECC)R.D
SYSTEM _o_W_-NSp,& AD
VA I r., VY FVMflNO:
SYSTEM LOCATION
ZT, n 1_-ro V) -(- 0;-7
� coo ), ) i rl I,4 -) T I
__QUANTITY PUMPED-
k:t3SPWL: NO
YES
sop'ic Tank: Nu
A-V Yes
14A rvmi oi,
ObSbAVA'nom:
GOOD CONVITI("'X, PULL. TU (,OvER
HEAVY OUA38BAFFLES IN PLACE.ROOTS LEACHFIELD RUNBACK
excullivo SOLIDS
SOLID CAKAY0 FLOODED
YZR�_._. 07KER EXPLAIN
VUMMENTS.
cl-
w
RECEIVED
JUN 0 3 2005 ,
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
ma�
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE: l/h �
SYSTEM OWNER & ADDRESS
S
9
SYSTEM LOCATION
(example: left front of house)
DATE OF PUMPING: QUANTITY PUMPED/600 GALLONS
CESSPOOL: NO d YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
CONTENTS TRANSFERRED TO:
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
R
TO: NORTH ANDOVER, MASS -56c 7— 19 79
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
Z 511V ST , North Andover, Mass.
SITE LOCATION
The grades and construction are as specified in my plans and specifications dated
19
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AI,
t"Al
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/Y 1� 'Ir 14;
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COi1; �, ERV Tit) \ CM 1.I I55ION
NONT! A N 1)0VEI., l)[AS S.,('Ir[-i0184;-
t� �; ORT1/ YT
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r'S•.••. 'C�<
YtT'TTPPP,
February 4, 1979
'Alilmar Properties, Inc.
P.O. Box 182
West Boxford, I!A 01885
RE: File 242-38: Lot 41, Salem Street
Dear Sir:
On the basis of observations made by members of the
Conservation Commission on Thursday, January 25, 1979, at
the above referenced site, it is the opinion of the North
Andover Conservation Commission that the mouse constructed
cn Lot 41 lies within the flood plain of Boston Brook.
Thus, the Commission plans to initiate proceedings
to consider the revocation of their permit issued for Lot
41 under the 1,1etlands Protection Act (1^1,G.L. Chap. 131,
s.40). Your attendance at the next n;eeting of the Conser-
vation Commission, on February 14, 1979, is required.
Very truly yours,
Vincent S. Turano,_ Ph.D.
Chairman
VST/dlp
cc: Building Inspector
Board of Health �—
Town Counsel
Planning Board
Schruender Real Estate
Copy to, Public Works�
SUBSURFACE DISPOSAL SYSTEM CHECK LIST
NORTH ANDOVER BOARD OF HEALTH
APPROVED DATE PROVIDED DISAPPROVED DATE TIME REASON
Title 5
Reg. 2.5
Reg. 6
Fail
The submitted plan must show as a minumum:
;,_(na)--'the lot to be served (area, dimensions, lot //,abutters)
(Planning Board files)
--(b) location and log of deep observation holes -distance
to ties
(-c-) location and results of percolation tests -distance
to ties
std) design calculations & calculations showing required
leaching area
(e) location and dimensions of system (including reserve
area)
�(f existing and proposed contours
( location of any wet areas within 100' of the sewage
disposal system of disclaimer (check wetlands mapping)
4, -h) surface and subsurface drains within 100' of sewage
disposal system of disclaimer
(i) location of any drainage easements within 100' of
sewage disposal system or disclaimer (planning board
files)
known sources of water supply within 200' of sewage
disposal system or disclaimer
location of any proposed well to serve the lot (100'
from leaching facility)
,=<'17 location of water lines on property (10' from leaching
facilities)
location of benchmark
"(n driveways
=-(o)-- garbage disposers
no PVC is to be used in construction
_�,q�---a profile of the system (elevations of basement, plumber:
pipe septic tank, distribution box inlets and outlets,
distribution field piping and any other elevations)
.,(r)— maximum ground water elevation in area of sewage disposal
.system
--CW plan must be prepared by a Professional Engineer or
other professional authorized by law to prepare such
plans
Septi.ceTanks
(a) --Capacities - 150% of flow, water table, tees, depth
of tees, access, pumping.,
(b) Cleanout
(c) 10' from cellar wall or inground swimming pool
(d) 25' from subsurface drains
Nortyr-Andover Subsurface disposal system check list - Page 2
it
Reg.10.2
Reg -.10.4
Reg. 11 .2
Reg. 11 .4
Reg.11.1C
Reg.11.11
Reg. 15.1
Reg.15.1
Reg. 15.4
Reg. 15.8
Reg. 3.7
Reg.14.1
Reg.14.3
Reg.14.4
14.5
Reg.14.6
Reg.14.7
Reg. 14.1C
Reg. 9.1
Reg. 9.6
iii
Distribution Boxes
(`a) Slope greater than 0.08
(b Sump
Leaching Pits
Leaching pits are preferred where the installation is
possible
(a) Calculations of leaching area (minimum 500 S.F.)
(b) Spacing
(c Surface drainage 2%
(d) Cover material
Leaching Fields
(a)'NoGreater than 20 minutes/inch
(,b) Area (minimum 900 S.F.)
,(c) Construction of field
(d) Surface drainage 2%
(e) 20' from -cellar wall or inground swimming pool
Leaching Trenches
(a) Calculations of leaching area (min. 500 S.F.)
(b) Spacing (4 ft. min. 6 ft. with reserve between)
(c Dimensions
(d) Construction
(e) Stone
(f) Surface drainage 2%
Downhill Slope
(a) Slope y/x = (to be shown)
(b) y/x X 150 = (to be shown)
Pump
(a) Approval
(b) Stand-by power
H
SOIL PROFILE & PERCOLATION TEST DATA
North Andover,Mass. No.&Stredt 5;LL 41 - Lot No.
Loc./Subdiv. Plan Owner..
Investigator �,� .�� Observer
SOIL PROFILES -DATE 4 21-ZT
1. Elev. 2. Elev. 3. Elev. 4'Elev.
0 0 0 0
1 1 I 1
Ties to Test Pits
2 2 2 2
3 3 3 3
4 4 4 4
5 5 5 5
6 6 6 6
7 7 7 7 331 i 2f
8 8 8 8
9 9 9 9
10 10 10 10
Benchmark Location
Elevation Datum
Percolation Tests -Date
Pit Number 1 2 3 4 S
Start Saturation
Soak -Mins.
Start Test -Time
Drop of 311 -Time -
Drop
"-Time-Dro of 6" -Time
Mi.ns.lst 3"Dro
Mins.2nd 3"Dro
Notes & Sketches on Back
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