Loading...
HomeMy WebLinkAboutMiscellaneous - 19 OLYMPIC LANE 4/30/2018 19 OLYMPIC LANE 210/106.&0143-0000.0 i I I „f,1 �CEIVED-. ACN'US T-7 OCT 4t,,1l�,,�.�, J,�Il ;,ll`I �,I „ ;y,l)'.1,)�h1.0rl,ryt:r.l;oI l8rncrIOrcr: c•! v'o l l n o r o l n o c' 0 6 2009im ,QePp/OYdrd+on)llBoa TOWN OF NORTH ANDOVER8LAM”DEPAFISfAT, A' Faclllty InlorIMl lon, Sys;sm l(;�Avon: •� '\.l,�jl•",'�'UI G1�''I•$YJIlfI1 oWn•9P�'"J�� ,� II ------__ T 1Ar'I'',,I' L9drµr d fr)nl ra'n buUon) (ljQp • . �'`I,I 'll1'dl;' 4,111,,1,I!�rl�lll�l' ' ' !� L . y.' dale of Pum9lnp�,�'� •� '� '� r.. 01;1 ? n','dr"/ r .gr ( J' TYPI ,,' �t;',,,'.; •1,f";.:+,'• � $ODIC r9n. r .'Q:I'ur�m�/1��1 Ill Ftlll/( I(,9„Jonl? [' yo it 1e,; .%, f10 I y9), n'91 I; C 007 PP.yI1"5'rI:��U'l�''�'rrJ;,'' �. . ' f i IUI '1'�I1't lr;Intl Ilrbl/”I�' Vi ' 'J�h„''�'i'''i'1' '1�' •11{Ir�'.� ilii JI 'I� , I'! • ' ,. N .i��)'�•r N,I I ICY' 1 '14V � 11,11,y'; :, r I 1 1 l;'ll,� a4!+� I�'1,•►,���1�,� ��'Jr�i�f;/I' t�l�'il" / .`1" 9Fd 9n,W�10( C I,I,I,;t I'• I:•t ooplbnupio dl�posov, Ill' 'yr I If r, �1,'',,:Y'';,;rr;•','•' S�n14Y1 0� '1 ': 1,1: 1 __ // „ nl.mai,porldepYelei/ipp(gyi a1141orma,r,:mal ill, TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: ° SYSTEM OWNER & ADDRESS SYSTEM LOCATION / (example: left front of house) X/1 i DATE OF PUMPING: QUANTITY PUMPED_Z41ZGALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES v NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: - p4VeiefJT�C� COMMENTS: CONTENTS TRANSFERRED TO: 6?6 1 IS- ?L- ' rr lxa� TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE�� p r SYSTEM OWNER 8t ADDRESS SYSTEM LOCATION F DATE OF PUMPING_ QuANTTTY PUMPED le OIC CESSPOOL NO_kl YES SEPTIC TANK NO YES r NATURE OF SERVICE: R()UTINEL�z EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN LACE — ROOTS LEACHFIELD RUNBACK _ EXCESSIVE SOLIDS FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY COMMENTS: CONTENTS TRANSFERRED TO �''`J�yx��y. S, � ,Q 1,p 5•J 3. 11A4.+�� +a t�' ���H�� j ?,, .. , III lir � i � ; cfusetts l i yw 1 t /rtA1'Q�t�7Qf�'NORTHANDOVER MASSACHUSETTS ; A.$Yem'Pumping Record Forn1 �l l I, ✓V t et 7 r J, f x\VJ,y t.G^l}�iYJ I.✓J•i,` `;. .: „1,,.�y c - f!EC , DEP has provided this form for use by local Boards of Health. The ystem Pumping Record ust be submitted to the local Board of Health or other approving author ty. SSP 7 2007 & Faclllty Inforrnatlon TOWN OF NORTHANDOVER ��•-amRortant. HEALTH DEPARTMENT ,,,Wfien flung out 1.:: System Location forms on the; •�� � only the tab key Address to move your :.cursor•do not uss the return' Clty/Town State •. Zip Code key . a4 tilt : 2 System Owner r .Name , ��l/�/�S�• Address(if different from location City/Town.,.. State zi Telephone Number ,!B. Pumping Record w+ Ja 1' Date of Pumping Date 2. Quantity Pumped; Gallons 3, TYpe of system ❑ Cesspool(s) eptic Tank El Tight Tank ❑ Other(describe); 4 Effluent Tee Filter present?.❑ Yes to If yes, was It cleaned? Yes No ;a ❑ 6 CoAdltlon of System," 6 y em Pumped By �tC Vehicle Ucen#e Number j ° � y k n 1�'}yy 5h t 1Y�1V1! •JI: � /j o •}I //�'�,�,� ,,,///yyy77i///��� t •9 i^ °�*' >•t'J'i5•r Srf415 s•(�•�� ;/ti jltty K�-�/ �/ •�(/] ,//// try t• y . 1r I •C'1V 71 I S v1 I '. W` r Company', y t y !T t a'•II✓.r•tJ hlq.��wl 7 Location where contents Were disposed; , Date http/Iwww.mass.gov/depJwafeNapprovals/t5forms,htm#Inspect t5forrn4 doC 08/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts W City/Town of L'0'WVN0FN0R7-HAN S �U 4 1System Pumping Record ETI Ve , °0,�� 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 1. System Location: /ane on the computer, use only the tab key to move your Address ^ cursor-do notl,K Rj ` 1 Ma use the return key. City/Town State Zip Code 2. System Owner.. rab I Name lento Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping l(lAto Z-t �2. Quantity Pumped: Gauor;s ,� 3. Type of system: ❑ Cesspool(s) [/Septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes EzNo If yes, was it cleaned? ❑ Yes ❑ No 5. Conditio f Syste 6. Syst ed By: i Name' Vehicle License Number Stewart's SO/tic Service Company - 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signa re of Hauler Date nature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: r 01 I!Sa a SYSTEM OWNER& ADDRESS SYSTEM LOCATION U ku vn e� (example: left front of house) DATE OF PUMPING: i o L�310o QUANTITY PUMPED logo GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE -BAFFLES IN PLAOE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: 3 bu S et�De ,T�,� COMMENTS: CONTENTS TRANSFERRED TO: Gr. La r. Sctr►, i,5� 11 A .y Commonwealth of Massachusetts 1 Executive Office of Environmental Affairs L JUL 9 `,97 Department of �-- ---� Environmental Protection William F.Weld Trudy Coxe Governor secretary Argeo Paul Celluccl David B.Struhs U.Governor C*MMwiorwr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: !V Vln� �!L �.. vA �C^ (�Q� �� Address of Owner. Date of Inspection (If different) Name of Inspector. Company Name,Address and a ep one Number. BATESON ENTERPRISES, INC. TEL:(508)475-1.174 Excavating-Water&Sewer Lines-Septic Systems&Pumping Service FAX:(508)475-5451 CERTIFICATION STATEMENT 111 Argilla Road a Andover,Mass.01810 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: L/Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority F ' Inspector's Signature: I "X�� Date: �� q7 The System Inspector a bmit a y 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 flow of 10,000 gpd or greater,the inspector and the system owner*hall 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 applicable and the approving authority. r INSPECTION SUMMARY: Check A, B, C, D: A] SYS 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 ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street • Boston,Massachusetts 02108 6 FAX(617)556.1049 i Telephone(617)292-5500 Q?Printed on Recycled Paper `- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A y CERTIFICATION (conti^nued4UAaV---v ) Property Address: Vlh�j C �,O t Q Iv©i-V � Owner. , \A Date of Inspection: B)SYSTEM CONDITIONALLY PASSES (continued) 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(a)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping mor than four 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 CI 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 1S 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 ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more Emm 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 leas than 5 ppm. 3) OTHER (revised 11/03/95) 2 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (conttinnure'd,), Property Address: t q o1 �� G e 1 '�'�/\ Owner. Date of Inspection: ("— 60-1 til DI SYSTEM FAILS: v 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. 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. r El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 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 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) 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 11/03/95) 3 L ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Addresm (9 G IVO( I`�� jlQl? i Owner. ( �, — t '1 IJV laO Date of Inspection:/U?"` C� Check if th=Pumping have been done: information was requested of the owner, occupant, and Board of Health. ;IN..,of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates d that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. tl As built plans have been obtained and examined. Note if they are not available with N/A. ZThefacility or dwelling was inspected for signs of sewage back-up. �e m does not receive non-sanitary or industrial waste flow 7The was inspected for signs of breakout. m 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 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 /The ted by non-intrusive methods. _ facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: ®I L c. L-o v-vA Owner- Date wnerDate of Inspection. FLOW CONDITIONS RESIDENTIAL Design flow:-Y-0 ons Number of bedrooms: q Number of current residents:�o�� Garbage grinder(yes or no):-Eo V Laundry connected to ayste (yes or no):-Y-0-5 Seasonal use(yes or no):TO Water meter readings, if available: Last date of occupancy: C%j e vzk- COMMERCIALANDUSTRL4L Type of establishment: Design flow:_„_gallons/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 RECORDS and source of information: A K- System pumped as part of inspection: (yes or no). Ye:s R yes,volume ping: Reason for pumping: VAS TYPE OFSTEM t/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) "PRO TE AGE of all components, date installed(if known)and source of information: " 'ter 1p'�S 6 -V Sewage odors detected when arriving at the site: (yes or no) (revised 11/03/95) b SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1 1 Q Owner. Date of Inspectio ` C..�v\a d n: SEPTIC TANK._ (locate on site plan) N4 Depth below grade: ' 1 Material of construction: vconcrete_metal_FRP—other(explain) Dimensic1.12: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: ss Scum thickne :__L 8 I Distance from top of scum to top of outlet tee or baffle: (a 1 Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pump' nditionof role and outlet tees or baffles,depth of liquid level in relation to tlet invert, stra integrity, evidence o leakage fte.) UU Ll~ \ v c.. rT� G TRAPV )Vke (locate on site plan) Depth below grade: Material of construction: _concrete_metal_FRP_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: 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 11/03/95) 6 , n SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 4 PART C SYSTEM y � INFORMATION((oontinued) f rl Property Address: t q, 0` V�. L /� � — kb4t& Owner. Date of Inspection: `1 v TIGHT OR HOLDING TANK:h � (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: C7 Comments: ( to u level and ribution is equal,evic ence solids carryover,evid ce of ealca to or out of ,etc.) D- C�1V �( .-�c� � 1 I'J GYM VCL. S• �G L. PUMP CHAMBER:�QY��- (��UU''� ti (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C fir,t SYSTEM INFORMATION(cont i �nued) Property Address L3 C/l "JXA,� ` Nv`A t u4olam"Date of Inspection: t-AA 0 �- I —q, 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: t�S leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note con 'tion of soil, signs of hydraulic fail level of ponding, condition of vegetation,etc.) '�' U �� No CESSPOOLS: r\oy\p (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: Indication of groundwater: inflow(cesspool must be pumped as part of inspection) 4' Comments: (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: Vie (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 11/03/95) 8 k- e 4 t` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: C� V` C Owner. Date of Impaction � ' a SIWrCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' -A6 jAL4 y 3 3 P n TEI t � GROUNDWATER u _( adwater: 1 feet //�� p � � O� arm,nation or approximation: as 1 `�J� dg5 � 1/� Q� �^ z f95) 9 I i [3ATESON E=NTERPRISES INC. Septic Systems-- Excnvnting ---Waler A Sewer 1-hies r _ — 111 Argllio Flood Andover,Massachuselle 0 18 10 15081415.1414 Title 5 Inspection Report Property Address : 1 PSC- �CX/\A �D Owner : Date Of Inspection : V My report contained hereiit does not constitute e gita.rantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my obsetrvation* $ and I hereby disclaim any further operation of your current septic system. 9J � on Bateson Enterprises Incl 10 Of 10 / FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT e r6 A.) PHONE Vl' ASSESSORS MAP NUMBER LOT NUMBER / 3 SUBDIVISION ,1� /n cy LOT NUMBER /— STREET /��� L LIV STREET NUMBER ` OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS ��P�/�c�e I L yFI(� b E-C.K w j Ia0 DATE APPROVED Lt Z(Joe's CONSERVATION ADMINISTRATOR DATE REJECTED COMIVIENZS k)0 i ti����^�� yL DATE APPROVED TOWN PLANNER DATE REJECTED CON viENI'S DATE APPROVED FOOD INS CTOR-HEALTH DATE REJECTED DATE APPROVED a z:> SEPTIC INSPECTOR-HEALTH �f DATE REJECTED CON VIENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CON BENTS RECEIVED BY BUILDING INSPECTOR DATE rLmlpll, enU RIKArUA MORTGAGE INSPECTION PLAN NORTHERN ASSOCIATES, INC. 912 N.MAIN 5TRE6T AA OVER AM O!B!D ra; (SOB)474-44io PAX, (3091171-5067 AIOM M#M Of UWJV If,I AUMM f. 411�YI ONaAlm. il+"/ LOIOA T W to aLrl p=AD~ PLAN - / Cl Ti;SrAM MMIN AAComp AU !! �C !- p, d17ia �'I//7 j9W R Y7/qs 6� p0 M 1 1� r 1— 43,989 M M 01 \ A G 0 IM 1 ; i 39 72sty.vow C 7IMTE +� 019 019 158+!- Lm 37 1 150.001 OLTMPIC A V E N U E Brad Powers Construction carr:rna 70V04" MAW „lair:awes co.rn,+c. 22 Wymans Landing Danville, NH 0�j3�811j9�+y� .erf, toff sIorrt••p .w.f.ft .. frw•an vel•awrtfc�f 'mpetljen.. • /�t03� ¢a— ((/ ! r/`" rnot to lr_1 wrtfq.fw:prre Tlr•fo •pr p•rw3 Iw n-•r.en•r lV/ nc!to M MSd to, lG aM frcMle•1 N•Nuww I•r-fff aow ww 1fM ar er•ardee Di ::T* w ll•we N "pt" toff LOM Ilwe rtr One rrff frr Y••wrem. Nea.rin,ati tN W the rrf.wfJn�ettr amN •r .oreaetlfar. K aln.tNKIM. f0 C.Rlflt efT• rrlM of RwrrNlplfl .nd Land .�. WIStMf Ifcr ilfn aae err fwt•Mf aar•M" 1.0 Ctla a0t, *rare el.f lelp leaftN M tM f►rwd W / CAJiMtfl ` ftr h•r$e.N test la.p ilrol.efJ.NaJ OOIn{n.cMl fe.wn fapell.Lf Jiy rwr te•!ff f•twralwftlon -�'•• F•wtrYCLYrN ifOtrf OeFT•rw YiMI tN.11Ca1 toel of f•elfewlfl -wlf f•f Ir.nO[to to ufff to NZInu K4ortf .l Mwf1M-1 fwta•ot ra�•JrfeMntf ft the tir Of..efttY01JM o; :3Mf• Tae watlKw fea.l on on aea"rt rr.on."'-afpr pr-eloiNe N N.O.L. CM. rw•f foo. t. 10 IYrtNiT iatM-.•i9at tia(wN.W eta�ddri.M. 4 t3.Propaf Cr/IloaN 3f not in a ►land M.taed. e!wI' fn1 otnrr News or re.fed m erwelplw Ff 2{57 R Q7.D1[Oplrt]1NO.N !f in • flopd Nea.rd do.. or otMr rlf•a. wnrwrw aerwuer, t•e.ew•Yrw ne 1 7l.iwlNew•elew 1. f»-!pliant t0 aot.talpe rwef.Mililitr am in b too IM wlw•r•r w--wpfwt, lA hood Mf[K0. •eanu wo rwr+••lulur Iw.fawawr roeWtLlf ittn fwH flacd laf[.rd O.terflnod !rm ',btest f.d.ral flood f^l`ooN M•wrww rWe tnww ttc.w1f ccrstgeN rM Ir.•Nl�J�1- I/ /7I SMuram-1-to ap pp."I 4. wwt\r.l lw IN Kre•fN w•reffe•stem,""Nt.••tt�wfff. �.[l�Li. [Ona ��•., -- . . �.• •� ctJnl n Vnl_unuyuon v.AnH Z9:0T 00-OZ--Ady Bow` SEPTIC SYSTEM North- .�ov�, .�aaa. INSTALLATION CHECK LIST LOT (�'•Gt -APPRUVO DAT$ DI PROVED EXCHATICH OS FAIL Reaffimst FAIL OB 1. Distance Tot a. Wetlands b. Drains c. Well 2. Water Line Location 3• No PVC Pipe 4. Septic Tank a. Tees - Length & 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."'-iseach Field or Trench a. ions b. Stone 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 S�rstem 11. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard-to Pere Test d. Elevations e. Water Table ;. � : .',;;E DISPOSAL SYSTEM CHECK LISTTQ �, 3p OL '1OR`I'H ANDOVER BOARD OF HEALTH ,AV ED ')! TE PROVIDED DISAPPROVED DATE TIME REASON v//i - ZP Ti e - 5 Reg. 2. 5 Fail OK he submitted plan must show as a minumum: a) the lot to be served (area,dimensions ,l.ot //,abutters) (Planning Board files) (b,) location and log of deep observation holes-distance to ties location and results of percolation tests-distance to ties design calculations & calculations showing required leaching area e) location and dimensions sf system (including reserve area)- existing rea)-existing and proposed contours g location of any wet areas within 100' of the sewage disposal system o t- disclaimer (check wetlands mapping) (}�) surface and subsurface drains within 100' of sewage disposal system or disclaimer (i) location of any drainage easements within 100' of sewage disposal system or disclaimer (planning board files) (j ) known sources of water supply within 200' of sewage disposal system or disclaimer (k) _location of any proposed well to serve the lot (100' from leaching facility) (1) location of water lines on property (10' from, leaching facilities) m) location of benchmark h) driveways moo) garbage disposers (�) no PVC is to be used in construction (q) a profile of the system (elevations of basement , plumbE pipe septic tank, distribution box inlets and outle:-s, distribution field piping and any other elevations) (r) maximum ground water elevation in area of sewage di.spo: . System ( s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Septic Tanks Reg. 6 (a) Capacities - 150% of flow, water table , tees , depth of tees , access , pumping, Cleanout 10' from cellar wall or inground swimming pool AV (d) 25' from subsurface drains r Subsurface aisposal system cnecK ±lsz rage e it OK Distribution Boxes 1 r a) Slope greater than 0.08 (b Sump Leaching Pits Leaching pits are preferred where the installation �,s possible Reg.11 .2 Ia Calculations of leaching area (minimum 500 S.F. ) Reg.11 .4 Spacing Reg.11,10 Surface drainage 2% Reg.11 .11 Cover Smaterial / L F� e e"'V a pta s{� `{ Ate( I o�-�G Leaching Fields Reg.15.1 (a) RoGreater th 20 minutes/inch Reg.15.1 (b) Area (m' mum 900 S.F. ) Reg.15.4 (c) Corist cti_on of field Reg.15.8 (d Sur ce drainage 2% Reg. 3.7 (e 2 from cellar wall or inground swimming pool Leaching Trenches Reg.14.1 (a) Calculations of .leaching area (min. 500 S.F. ) Reg.14. 3 (b2 Spac'i.ng t. min. 6 ft. with reserve between) Reg.14.4 (c) Dimen ' ns 14.5 X Reg.14.6 (d nstruction Reg.14.7 (e� Stone Reg.14.10 (f) Surface drainage 2% Downhill Slope (a Slope /x be shown(b y/x 150 = �to to be shown Pumpa Reg. 9.1 (a) A/pp Reg. 9.6 (b) St nd-by power Solt, PROFILE & PERCOLATION TEST DATA oard of Re 1th-North Andover, Uass . reef; Lot No. 4,oc rd o. 14 Ivi S i on, Owner Invc,stigator Observer SOIL PRO1'IL1t',S Date Daae e Date 4. Da t e Elev. Elev. Elev. Feet inches .0 .7yPils� Ties to Test 2 2. 211 36 48 72 96 108 X;L0 OL—_11 20 Dote : Top & subsoil depth; depths of othe' r Soil types; depth of water table ; depth of refusal. PERCOLATION TESTS Date Date ---Date - Date____Date­ Pit Number 1 2 3 4 Start Saturation-- .- i— -- q `��^ --- --- --_`-- —_ ---_- --- —__ __-_ r- T e—s t-Da"t ri I_01- Drop of 'Urop of 6"-Time 4- Flins. I-9t-3" 13,0VT Ra-Ce _N1Tn_. /T_n".