HomeMy WebLinkAboutMiscellaneous - 188 VEST WAY 4/30/2018 (2)L 1 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. 011—� t5form4.doc- 03100 Commonwealth of Massachusetts City/Town of North Andover System Pumping Record Form 4 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 1. System Location: 188 Vest Way Address Noah andQver City/Town 2. System Owner: Ferrro Address (if different from, location) City/Town 13 TOWN C" 40RTH i-oNDOVER . — .. T.. --A n-rhArK-'r Me State 4ip Code Telephone Number 'b -z 1 50p qL 1. Date of Pumping — /9 i 15 Date 2. Quantity Pumped: G ons 3. Type of system: Cesspool(s) M Septic Tank Tight Tank Grease Trap El Other (describe): 4. Effluent Tee Filter present? F1 Yes El No If yes, was it cleaned? 0 Yes [] No 5. Condition of System: ex / 6. System Pumped By: Name Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 10 So. Mill BrLdtorq, Ma 01835 Signature of —Hauler -- -bwt6 -§71grlature�OR;ceiving Facility' Date System Pumping Record ¢ Page 9 of �yll/►��f(�; inti i,� ;`,YY S- T OCT 0 6 2009 �D�P,h11 P/9Yld►0 illi lolls 19f �� I..'vmlllod to lh► Ioc 11 8c+lc A, aCIII'L o`rI'no`p0r 18oal� V FTH'AgUOVEP) ENT,ThHENA 7PARTM (y Ifoorrrtlon Ll 1.1 v 1 ' 1 j ,11'!�`�',�'; Y. rl 4i'1;S i1�rY. ���'/`IIP nI'.'`(r li n.v uf'•.. ' .'1 �. ,/.' S' '•; I'�,I � j. 1..1 ''S, �ri','/r'i7 1' �t�yl''f i; � i ' . '.I�r',�d►µl I p IIInI ren buUon) R Cq^o,n ., fIf',nOnl nlmol7 �s�. •,',;,;6��PumPlllg,,�I�a��ord I, Oale of PvmDlnp,�' � 1 •' ` 1 '' �y�lem,:,' Ce>>Pool(;) QthOl (deJC,�1be�, on r? r Yoe 0 n'o .. •�'t /'•'�i .'n •,V,pn'a�0111'QG' +'�'�`;�r�1!'�'� . pvmped ,8y'' ' ,',;'.' :'�,I,��, �',i,Y, •�►•,,; l,00dl�nU,�ora dhposov: .. •'I .111' J'y It' It'll 1 11,% ` C ,',,,,,� , 99YlOep aleila9DroYi�s�lblorm11) 1.. $epoc len, A07A Oo O Vsa > -- ti W QD V O Q f Q \5 W �..�� Qa�� .. •,a aq IR Q • • • • p W �t `'e• V � o oc Ot ? ` I• W o ? W '' W Q Q �� o W vi J`�J O Alf O � o BE Q Q a h Pi � W h h v o i q a � � el QQV. Q Q a Q W� OV�i �QQ\J4 e�hhv°�a�a� a s W r.N `O Ul d- M '- O Q" dN 3 c rN Ll W a h t � W h h v o v q Q W� OV�i �QQ\J4 e�hhv°�a�a� a s W r.N `O Ul d- M '- O Q" dN 3 c rN Ll W a h � J t V a � � W QQV. 41 n V a q s� . Q o� N � �i Board- of Health : North Andover,Krss. J APM— J OVED LATE f2: At_w SEPTIC SnTEH INSTAM ATICK CHECK LIST i . DI SAPPROUD DAT 6 eaf� -sons — LOT"i_w10') „ XAVA'ITICN OE IAIL 1. Distance Tot a. Wetlands b. Drains c.. Well 2. Water Line Location 3. No PVC Pipe 4. Septic Tank a. _Tees -_Length k To Clean Out Cowers b. Cement Pipe to Tank Cu Both Sides of Tank 5. Distribution Box a. Covers be Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Inds 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. -yinal Grading Inspection 10. Barricading Covered System 11. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard -to Peak Test d. Elevations e; Water Table TOWN OF NORTH ANDOVER. MASSACHUSETTS OFFICE OF CONSERVATION COMMISSION NOfTH TELEPHONE 683-7105 do -ie authority of to, tl the Wetlands Protection Act, I --3- .,,.1 s e t t s General- Laitis Chapter. 131, Secrioi, 40, as amended, I-Ai,I., Town of Nortl-i Andover's �\'etland Protect' -on By Law, the :".-idovor. Conservation Commission will hold a 'Public Hearing 20 1985 at 8:00 P.M. at the Town Building 0!,j 1.20 Main Street North Andover, 1,11 on the Notice Cooli.(1j-(-.-- Construction Cwripf-inv to alter land at 71, (,root Pond 'J'o'-d for purposes of '11w -is are available at the Conservation Cimmission Office, 11,,iilding, 120 1,11ain Street North Andover, 1A, on Tuesday 12:00 noon to 2:00 p.m. and by appointment. By: A G,.Ivagna Chair, an Ic 1-1 'L11) i, N.A. Citizen on March 14, 1,985 • -ilt to: 1;.:::iin n Board .S()il-L—Q, Of Health ul ) i j c 'b,*, orks Hi 1111'.";ciy Dept. cal -001- A- hJ April 2, 1986 Mr. Make Graf �f -'a 4& Board .of Health �j TD oop-4r_L North Andover, Ma 01845 Dear M r. Graf OF A '44ji) P941" '1 The following residents of North Andover have expressed their lit concern over the water drainage problem that has resulted ,in a newly formed pond created by.the builder filling in an area to build two houses that restricted the natural flow of water, in the rear areas of lots 55 and 56 on Vest Way..,This pond also abuts several other property owners. The current abutting property owners were all here before the existence of the pond, so the pond is not only a surprise but has created a potential health and safety factor that is a concern to us. Due to the interference with the natural flow of water, combined with rains on March 13 and 14 1986, there was a pond created which was of sizeable depth and circumference. This pond is a safety concern to us because there are several small children that live in the immediate area. Our major concern is one of health, which is potentially created by the placement of nearby septage leaching beds and in particular two beds that directly abut the pond. Their natural flow is in the downward direction toward the problem area. This problem is man-made, due to the reckless placement of fill. We ask that before we are inundated with bugs, mosquitoes, and eventually a potential health hazard created by septage leachate potentially flowing into the pond, that the builder -be required to provide for sufficient drainage away from the area, drainage which did exist prior to excavation and construction. We ask for your' prudent and serious consideration and determination of this matter. Sinc6re1y, NAME ADDRESS _YosL AIAX- CvMtf 41 Mol r .BOARD OF HEALTH+ No.Andover, Mass. R SUBSURFACE DISPOSAL DESIGN CHk K j IST go -- LOT # 5SV S I WA APPROVED DATE �%SC DISAPPROVED DATE Provided: Reasons: or 2_ N©T S��M S� Title V FAIL OK Reg 2.5 The submitted plan must show as a minimums a) the lot to be served -area dimensions lot #abutters b location and log deep observation hoies-distance to ties c location and results percolation test. -distance to ties d design calculations & calculations shoring required leaching area (e) location and dimensions of system-in.c_iding veserve 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 1101 of sewage disposal system or disclaimer (i) location any drainage easements wil Ar 100' of sewage disposal system or disclaimer -P a n{ng Hoard fL ,$ (j) known sources of Water supply within 200- of sewage disposal e system or disclaimer (k) location of any. proposed well to serve lot -1001 from leaching facility (1) location of water lines on property -101 from leaching facility (m) location of benchmark (n) driveways (o) garbage disposals (p) no PVC to be used in construction (q) profile of system -elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Other elevations (r) maximum ground water elevation in area sewage disposal system (s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks (a) capacities -150% of flog, water table, ' -.ees, depth of tees, access, pumping f (b) cleanout (c) 101 from cellar wail or inground swim. pool (d) 251 from subsurface drains Reg 10.2 7 Distribution Boxes I(a) s ,pe greater 0.08 Reg 10.4 b) sump t ittlgvaa111t u[ hf aaacltuelis IIY�IPm tl�vt�s?t ��-- �'Gr{pc►►►i: N►! I eg I I syS1e111 l.ucUun (R� cx-)� w� 01181►Uty I'unp�t J:-�g�lldiu Septic - OO& W F I i,ea I4 --'i SYPICttt 1'►ut►1►0d by: Victim N _ C11101114 1114 Itnttslc 1011 fit: =« ter i�r r�tn�� #n11�►v Dish id IMP: I!lspeClur: _ _ q • q . `�'ZWN OF NORTH -ANDOVER. SYSTEM PUkPING RECORJD 51 -STEM MER & ADDRESS d. SYSTEM LOCATION (example: left front of house) . /'rata,' //," ,�. jj . v VATF OF PUMPING: & h QUANTITY PUMPCo. 156D YES SEPTIC TANK: NO YES a NATURE OF SERVICE; ROUTINE „ EMERGENCY (Mir- RVATION s: GOOD COnDITION. FULL TO COVE• !t HEAVY GREASE -BAFFLES IN PLACE ROOTS :; LEACHFIELD RUNBACK,. EXCESSWE SOLIDS .__ FLOODED SOLIDS CARRYOVER ,OWHRR (EXPLAM) i1•a'I'lN! PUMPCb BY: • ' - ' C•V .%'l tvI F. NTS: c u�7'Is!YTS' I'RANS'hLRRE0 TO.