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HomeMy WebLinkAboutMiscellaneous - 19 PADDOCK LANE 4/30/2018 19 PADDOCK LANE / 210/107.D-M8-0000.0 ` 1 I i I 19 PADDOCK LANE 210/107.D-0008-0000.0 \ 1 i Commonwealth of Massachusetts City/Town of North Andover System Pumping Record �,wv`` ✓`� ! °w Form 4 • .l � M 0 7 2014 DEP has provided this form for use b local Boards of Health. Oth�r'forrfis,ma be.used b t the Y Y. ,.,, , ,., information must be substantially the same as that provided here-Before:usilagfthis 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 q /�n use only the tab U l"Al key to move your Address cursor-do not North Andover Ma 01886 use the return Cit !Town key. Y State Zip Code 2. System Owner: c� ll�rna�� Name Address(if different from location) City/Town State � � Zig Code Telephone Number B. Pumping Record 1. Date of Pumpinge /'r pate I f 12. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) ` (septic Tank ❑ Tight Tank ❑ Grease Trap ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: Cd 6. System Pumped By: NaiMe Vehicle License Number Stewart's Septic Service Company 7. Location where contents were disposed: Stewart' re-treatment Plant, 20 So. Mill Bradford, Ma 01835 Si to auler Date Si ature of Receiving Facility Date t5form4.doc•03/06 System Pumping Record•Page 1 of 1 TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: a C � SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) lam DATE OF PUMPING: QUANTITY PUMPED/--,�W GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES 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: �� �'yl p27/ COMMENTS: CONTENTS TRANSFERRED TO: .ioard of Health SE'PT'IC SZSTEK North Anc3Pvar2,Haa3. .INSTA!.I:AT'ICK, CHICK LIST LOT'i - _ _) � DATL DI Ft�Q�TE_D DAT X AVATIC� OK PAIL IO-Lt� eft ascins! FILL OK � No le!5� C?A) Q4 V. YK� 1. Distance Tot a. Wetlands I,-26 b. Drains c.. well 2. Water Line Location 3. No PVC Pipe 4. Septic Tank a. Tess -_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 Flo-Ong Equal Amounts c. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth . c. Capped ids d. Clean Double Washed Stone 7. Leach Pits a. Dimensions b. Stone Depth c. Splash Pads d. Tees e. Cmmt Pipe to Pit - Both Side's f. Clean Double Washed Stone - - -- --- $, u., rArb oe Disposal. ----- 9. -Final Grading Inspection 10.' Barr;.cading Covered System 11. As' 1lt SiibAtted' a. Lot Location b. Dimensions 'of System c. ' Location with Regard-toPere Test ' ti. Elevations e., 'Water Table SOIL PROFILE &/PERCOLATION TEST DATA North Andover, Mass. Street No /G Lot No Loc/Subdiv. Pland Owner Investigator Observer SOIL PROFILE DATES 1.tlev 2.Elev 3.Elev 4.Elev / 'IV y � o � o 0 0 Ties Pits est 2 2 2 2 31 3 3 3 4 I 4 4 4 5 N 5 5 5 6 � 6 6 6 �i 7 ^7 7 7 6 8 8 8 9 9 9 9 10 10 10 10 Benchmark Location Elevation Datum PERCO;,ATION TESTS DATES Pit Number 1 2 3 4 Start Saturation Soak-Minutes Start e Drop of 3"-Time Drop of 6"-Time Mms.lst 3" drop Mins.2nd " Drop Percolation i ra'`of E_ 1th sUBSURFACE DISPOSAL DESIGI CHKK LIST / ✓ 1 APPROM DATE /47 1 DISAPPROM DATE Provided: Reasons: Title V FAIL CK Reg 2.5 The submitted plan must show as a minimum: a) the lot to be served-area.,dimensions lot #,abutters location and log deep observation hoes-distance to ties- location and results percolation tests-distance to ties design calculations do calculations showing required leaching area e) location and dimensions of system-including reserve area f) existing and proposed contours g) location any wet areas within 100' of sewage disposal system or disclaimer-check wetlands mapping h) surface and subsurface drains within 100' of sewage disposal system or disclaimer i) location any drainage easements within 100' of sewage disposal system or disclaimer-Planning Board Piles 11-11 3) known sources of water supply within 2001 of sewage disposal system or disclaimer location of any proposed well to serve lot-1001 from leaching facility PPY location of water lines on property-101 from leaching facility ) location of benchmark driveways garbage disposals no PVC to be used �n 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) capacit es- 5Q7* of flow, water table, tees, depth of tees, access, pumping (b) cleanout c) 10t from cellar wall or inground s fi=ning pool d) 251 from subsurface drains Reg 10.2 Distribution Boxes a) slope greater than 0.08 Reg 10.4 b) �� Healer _ Ban- . � . lip Otover SU! C7' 117 rE59G?T CHECK LIST . t e -LOT Irl^`aL�`+ :�C :. ✓r: ^ liz r:D D-»TE DATE '1 i ti E V - - FAIL rc'I n t anon r' The subms ;,l i �w as a s 1 l (}tLa'vnJlanB lot fi abutter ) the e lo' ' =i es-distance to ti � on ho - locat. reolation tests-distance to tic d�sigr. tions shoring reauirE,''. lc_- 11 e) locati c: { .; of bTatem-including eeserr :. a" ex3stir p c��' ' contours ? g) to ca't�_j, „ , thin 1001 of- selage disco=fl, di scle; cry,. z ,cis raFping �.rfac, e.} . ^ (Ira -n- j,+Ithin'100�-of ae;- 1 syrtc: 'i �l ,' �l J) locat' set- crr.':.s vi thin 100' of s� Zc W.,a.rd files 1 a . r 5-L•op1 - �{.tii�a 200' -of sek?�� d'. tst�~ 3 1�. to serve lot-100_fzor: 1 Iocat' r t -¢ , , (1) laca=r • ) on pr-;perty-10' from loci j:C � iy �Ve Barba �) t , •nst�-Luc izo PVG ,. tions of basemt, plu>�, Tptil (4) d , b. .-,5`' `` stzand outlets, distribution f;c•, _ Other ovation in area sezage disc.-,:, _ ;. S) Plan r he p cl;. �)y a Prrocessional mineer or o profe:. {� �z a by lrsr to prepare such_pl- (a) capac. c C I r c, y -va tr-r table, tees, depth c•,, , acre- cl o n ci. sZrmm3ng pool (d) �51 f 'ns -1( Dista Siopc 40, Subs,dace Design Check'Liat Page 2 FAIL CK , Leaching Pits Leaching pits are preferred where the installation ,is possible Reg 11.2 a) calculations of leaching area-ninimsm 500 sq ft 11.4 b) spacing s,,•. 11.10 C1 surface age 2% 11.11 Id) cover materal e) ��� splash pad f) tee,.at elbow g) no- ends in pipe from d-box to pipe Leaching Fields Zeg 15.1 a no greater t 20 minutes/inch b area- 900 sq ft 15.4 lei cons on of field 15.8 d)_ ace drainage 2 % - 3.7 e) 1 from cellar -,,:all or inground swindng-pool L eachin Trenches -- teg 14.1 ) calculatIons of eaching area-min 500 aq ft 14.3 spacing-4 ft mina 6 ft with reserve between 14.4 ) dimensions _ 14.6 ; d) construction 14.7 e) stone 114.10 f) surface drainage 2% Dowabill-SlOR e a)_ slope .S/x -- (to be s*-otim). 1-150:= (tof bs-shown) by - - - SOIL PROFILEI& PERCOLATION TEST DATA North Andover, Mass. Street No �&Xkb S.K &AA L-C,kAJif S Lot No Lae/Subdiv. Pland Owner Investigator (� Observer SOIL PROFILE D ATES 1_'Elev 2.Elev 3.Elev 4.Elev 0 0 0 0 1 1 1 1 Tiles ' o Test Pits 2 2 2 2 3 3 3 3 4 4 4 4 5 5 5 5 l ? 6 6 6 6 7 7 7 7 8 8 8 8 `j" 4k 9 9 9 9 � s 10i 10 10 0 Benchmark Location /-1,-1 Elevation Datum IZ 1-3 PERCOµATION TESTS c DATES b 614 - dv� c`�.-P/.L Pit Number1�'�j ti 2 3 4 Start Saturation q 0' Soak-Minutes Start ie Drop of 3"-Time o4 Z Drop of 6"-Time ' Mcnms-1st 3" drop �. 14ins.2nd 311 Drop Percolation r. LOT I ZA k' ll i f" 2 1500 G&t-. SEPTtc T,&"ic. 0 ' � 1 � 1 � OT 13 A a 4 Coo 303 S.F.± C � !y �/F GOL_DEiJ I a 0 to f O 1f o O u/F MUtzP, -4Y 4r t S .w a I aj ; O �� ��•`39.2"1�� � ��; PM SIr-t4 As Cmuti-T 11.1V_ PIPE aVT OF HSE. 183.E 5 184.18 �+ E) U ( I NTO 183.25 183.4 v� 4 E 742ET 163.00 183. 15 cJU�� SUI . � V P INTO p, 182.32 16Z A7 ��+� © � DIPF 92LJ T 182.IS 1 182.34 �y5 T C--M 1 p 4 tJ I' Q0 OF rptPE -w- z1 P,2.o5 LJ O 12T N A m poyala.MA. i fill Fo ►2 i; IZOAF IZT GOL."MOM.E SG,o,L.E I " = 40� DATE;1,.10�,•19,1984 � 1?tc"Ac7 F1LAMIQ5KI s 4 til D dSSOGIOTES =►.1G . n� Eh1GItJEE�S � d�CI--IITEGTS , � I� � LdN� PL_d►.Ir.1E2S�dND Suc�..vEYOI�S �� ►Jb2-T I--i dNvovt=2 U�F1 GE PA.►ZIG- s:-�.��. :;,�,, - t TO: NORTH ANDOVER, MASS. November 19',`19 84 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage Disposal System This is to certify that I have reviewed the construction materials of said disposal system at Lot 13A Paddock Lane Site Location North Andover Mass . The grades and construction materials ;;�` ' , 1 conformance to plans and I WI LIMA specifications dated March 27, 11 a4d„EAs-Built November 19 19 84 . O rn lam• clvl� Reg. Prof .Elinee_ f=Reg E;YSanitarian rv, �i -- --- --.-... �. LOT 12A ��y t Le c"iQci Teewc-H ' 2 1500 GdL.SEPTIG TpA11C. W a __ T 13 a d Co 41) SOS S.F± 1 c N �/F GOLDE:-Q ' Q j o - E 7 � 1 1 fI O O 1..1 O � /F MURPHY Cl c ��S �I ` I k� q F F-LE -� ► ' { PE vT OF HSE. 183.45 184.1E) UIL-T 8 1 I NTo183.25 183.47 i � E TOFT 183.00 183. t5 .r ` P ►NTo P. 182 182.32 .4? u 5L ���� C> V fi INV VIPE OUT P.BOX . 182.15 18Z.34 �SY�5 1 EM IMV F=mt> OP:- I 181.`j0 182.17 Q or- plp e. z „ Iaz.lo Lloiz-rN ,�.��ovF.M.MA, OF p l 82.05 ri SC.o.LC ► " = 4O' D,n.TE;l,.l0�.19,198q. ' ti; iK.! rjp &SSOGIdTES =.IJG �JITEGTS � } �I.,;,>avErz-, Ma . LOT 1 ZA -S°5 0.2 f f Lr&c.HIMG Tv—ekIC.H i c' 1500 GAL. SEPTIG.Totvlc. O ! 3 (7 !I i oT I-SA 4 &4*> 303 S.F ti C i c u �/F GOL r,>aK.l 0 a r. I, Q O u/FU PN O � M rL Y (1 0 �i fl •� i 1 •a c. O V1> E L E NAf%-r ofj PES%c,►-► As 0o+t i.T I� I NY, Pl PE OVT OF HSE. 183.4 5 184.18 E) U ( 1••�1r � rJ I NTo 183.ZS 163.4-7 i `I It.ty PIPED TOFT 183.00 183. 15 CJ L-)6_ U P, D ' f I N v 01 VE I NTo p. ►82.32 16Z A7 INV MPF OUT D.E!>pX. 182.15 182.34 5Y5 EF-t_ t p I ISl. 90 t &2.17 11J ►-�D OF p1P>= ft Z " 182.10 �,Q ofp ta2.os 012.TN &WPoVF.Q'MA. Foy E� 906F.2T COL.L.AMOtZE f SGA LE 1 ' = 40` D .o.TE;1.1ov.19,1984 I1 �IGHd2 P. l(L i �.J '5 1 dNCvdSSOG14-7& = I.1G i 1 Et.►GItJ EELS � dr�CNITEC,'rS � �i l_�ta[7 PL.dNiN1=2S�QND SU�.✓ EYOk�S N cn Ef-T I-1 d N-J O F G I C E- P,6'0- - WELL DATABASE ADDRESS: AGE OF ,N L� ELL DRLT-LER." 1 'WELL l. PL"tlY G 1 .T. WELL.t . LCCA I7ON. / / c:.-a"—� �"✓ r -WELL PERLti7 DATE:- ,5 7 -� DEP-7H OF WELL _..TYPE OF WELL. b. `N-GTr-TYPEOFWAT�EE��RI NG ROCK- WA= OCK: WASAYAZYSIS DADS= .2 4 HIGHMANCANESE- Y ==- IRON: Y O=EZCCN7-A MTAiYiS: Y Fv'EL.L DAT?.�A�E ADDRESS: AGE OF V F=r: WELL DRILL.E- WELL PER��'I ,, WELL LOCATION: WELL:PERiVE T DATE: Z DEPTH OF WELL ` TYPE OF WELL: a.. DRILLED �, b. DUG c. UNK�IO Wti TYPE OF WATER BEARR iG ROCK: WATER.,k Ai YSIS DATE: HIGH ily1ANGANESE: Y N HIGH IRON: Y N 1' OT= CONTAv i A-NTS: Y N '. .,, ,'<i;{ ,.'Yry;:',rJ;'::::.- t.<: '•,,:dui/.,�....C,, . . '.'.. ..,. .... .' ti'. ....'.... : ...i , ..•.. !,.',': ::::.: ... :1 �I`:V:L iii- :•j.. • :TOWN�F`NO$THANDOVER sxsT�M piNa REcoRD DATE 5- SYSTEM SYSTEM OWNER&ADDRESS SYSTEM LOCATION \ 40, /7,K La rte ro.,7- A/0 - 0/V.8 A/0 . 0/V.8 e� DATE OF PUMPIN4 � QUANTITY'PUMPED CESSPOOL NO _YES, SEPTIC TANK NO YES NATURE OF SERVICE,,.RQyI' E' EMERGENCY OBSERVATIONS:- GOOD BSERVATIONS: 'GOOD CONDITION• '/FULL TO COVER _HEAVY GREASE : BAFFLES IN LACE ROOT'S :__ LEACHFIELD RUNBACK EXCESSIVE SOLIDS T-FLOODED SOLID CARRYOVER OTHER EXPLAIN SYSTEM PUMPED BY COMMENTS; � , CONTENTS TRANSFERRED TQ`