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Miscellaneous - 201 RALEIGH TAVERN LANE 4/30/2018
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. Commonwealth of Massachusetts RECEIVED Title 5 Official Inspection Form DEC 18201 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments b TOWN OF NOK I'H ANDOVER Pro Raleigh Tavern Lane H€ALTH DEPARTMENT Property Address Thomas O'Donohue Owner's Name North Andover City/Town MA 01845 State Zip Code 11/4/2016 Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information Inspector: Neil Bateson Name of Inspector Bateson Enterprises Inc. Company Name 111 Argilla Road Company Address Andover MA City/Town State 978-475-4786 SI -15 Telephone Number B. Certification License Number 01810 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 ❑ Needsi Further Evaluation by the Local Approving Authority f t i `r 11/4/2016 Inspectors Signature( Date 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 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. t5ins.doc • rev. 6/16 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 1 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 11/4/2016 City/Town 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: After permit from B.O.H.,replace outlet tee. outlet pipe to d -box, d -box & hydraulic cement in cellar around soil pipe, inspection from B.O.H., septic system now passes Title 5 Inspection. 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. Check the box for "yes", "no" or "not determined" (Y, N, ND) 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. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc - rev. 6116 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 2 of 17 PUBLIC HEALTH DEPARTMENT Town of North Andover Community and Economic Development Division CERTIFICATE OF COMPLIANCE As of: 11/7/16 This is to certify that the individual subsurface disposal system received a SATISFACTORY INSPECTION of the: Repair of Outlet tee and D -box By: Todd Bateson At: 201 Raleigh Tavern Lane Map 106.0 Lot 0117 N , rth Andover, MA 01845 The �ssuance of this c if1 t s 11 not be construed as a guarantee that the system will function satisfactorily. Michele Grant Public Health Agent 120 Main St., North Andover, Massachusetts 01845 Phone 978.688.9540 Fax 978.688.9542 Web www.northandoverma.gov North Andover Health Department (ommunity and Economic Development Division ONSITE WASTEWATER SYSTEM CONSTRUCTION NOTES LOCATION INFORMATION ADDRESS: 201 Raleigh Tavern Lane INSTALLER: Todd Bateson DESIGNER: PLAN DATE: BOH APPROVAL DATE ON PLAN: MAP: 106.0 LOT: 0117 INSPECTIONS Outlet tee and D -box INSPECTION: Il J4l 1 (0 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SITE CONDITIONS Comments: SEPTIC TANK ❑ Contractor reports any changes to design plan ❑ Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered ❑ Building sewer in continuous grade, on compacted firm base ❑ Cleanouts per plan ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon tank has been installed H-10 loading ❑ Monolithic tank construction ❑ Watertightness of tank has been achieved by visual testing ❑ Inlet tee installed, centered under access port ❑ Outlet tee installed, centered under access port (gas baffle/effluent filter) ❑ inch cover to within 6" of finish grade installed over one access port ❑ Hydraulic cement around inlet & outlet Comments: PUMP CHAMBER ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ 1500 gallon Pump Chamber installed ❑ H-10 loading ❑ Monolithic tank construction ❑ Inlet tee installed, centered under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off floats working ❑ Separate on/off floats ❑ Drain hole in pressure line ❑ cover at final grade installed over pump access port ❑ Watertightness of tank has been achieved by testing ❑ Hydraulic cement around inlet & outlet Comments: CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: basement ❑ Alarm signal located inside: basement Comments: DISTRIBUTION -BOX Installed on stable stone base H-20 D -Box ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑� Observed even distribution ❑/ Speed levelers provided (not required) Schedule 40 PVC Pipe Comments: ak,Ll�`(ij SPA WimOak`-- 4 dc,"+ 61t ate( 0�i bVr �n "('Q m,Xk y� R mx' 2:', Yet B Commonwealth of Massachusetts Map -Block -Lot 106.00117 BOARD OF HEALTH ----------------------- BP -26-057 Permit No North Andover H014 BH 01 457 FEE $175.00 ----------------------- DISPOSAL WORKS CONSTRUCTION PERMIT Permission is hereby granted Todd B-ateson - - - - -------- -------------------------------------------------------------------------------- to (Repair) an Individual Sewage Disposal System. at No 201 RALEIGH TAVERN LANE w-VA4ju-�&-W as shown on the application for Disposal Works Construction Permit No: 1311'-2016-045 Dated October 28, 2016 -- --------- M.# -%D__ � u Issued On: Oct -28-2016 BOARD Ol' Y ti 4- Application for Septic Disposal S stem Construction Permit - TOWN OF TODAY'S DATE NORTH ANDOVER, MA 01845 – Full Repair $ 25.001- Component Application is hereby made for a permit to: O Construct a new on-site sewage disposal system' ❑ Repair or replace an existing onsite sewage disposalsystem" tepair or. replace an existing system component- What? D k'Ilt-7'� -0- D—CSO - A. Facility Information. �l> ! oaf= l � ✓' !-,o✓` Address or Lot # Cityfrown 6 2: *TYPE OF SEPTIC SYSTEM*: ➢ ❑ Pump ravity (choose one) TM OF NORTH ANDOVER —If pump system, attach copy of electrical permit to application— HATH DEPARTMENT ➢ ❑ Conventional System (pipe and stone system) ➢ ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system_) ➢ ❑ Pressure Distribution S.A-S. (No D -Box) ➢ ❑ Pressure;Dosed (D -Box Present) S.A.S. ➢ Or Does',tiie system require an effluent filter? Yes No .1. K yes, does plan specify make and model of filter? YES = (no further info. needed) 'NO = (installer must specify brand of filter before DWC issuance) What is the Make? 2. Owner Information Name ' Address (if different from above) Cityfrown 3. Installer Information What is the Modc f' )- l 1,- State Telephone Number Zip Code Name Name of Compan _, PRISES, INC. 1 llr _ I l a it I X111 ARGILLA ROAD Address Cityfrown, 4. DeSigi Name Address Cityfrown State p, Zip Code Telephone Number (Cell Phone # if possible please) Name of Company State Zip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 .0 .7 TODAY S :DATE 1-845 $.250.06 t Pull Repair A2KJL,'II ANDOVER. AIA 0 Cqmpo hent ...PAGE 2 OF 2 A. Fac'111ty-Information continued.... s. Type,of Building: 09e-sidential, Dwelling or ElCommercial B -Agreement The underilgned agrees to ensure: the construction and maintenance of the afore-des'tribed on-site sewage. disposalsystemIn accordance with the.provIsIons of T16615 of the . EnvIronmental Code, as well as the Loca - I Subasuifice DlspOsal RegulatIons for the Town of North Andover, and not to place. the system th operation un Of a Cerfiflcate of Compliahce has been Issued b"Is Board of Health. Name A Date Application Dfitapproved. for the following reasons . 41�Date 2" ProleCtAfg-dsgctObffgadonFon7iA=ac'd? 51: PumaLSZ�? Lfsoj AmIch copy atff&=*4 4. . Fbundzd6&As-Bur7t? (new cons'tM'ctjon-r0nIy).- $Cdc as approved plan) -5. FI00rPLws?(heWcojjstrUCff0n- only).. yis M Yes NO -Y . CS NO 11 "Coon P8MIR P90a 2 of 9 SEP�`IC 5'S�'3'Y`$,1VLI'�I.T.�•�Rpjgl�Jr i��14�►��1At�•�}BI.iGA�I�hfS As f1ie.Nqi*AadoverJ=meditmda fbg di*tMmwidM fog septle g8ton-jetthe p=Veayat tj1Q4LCa of sq* jnwssr -QIi Road" to *"pAmdan of (iai eds 40m Aad dated Dated VA ievido: I rsadetatand the following obUgatioos fat to gemcut Of Ob project: i. As thefa tallar, I am.obligetcd iv abWssffpeapita andBosrd ofHealth qqmyvwphmpft to �etbonW any' voA c a a site.1imm thloamd" and &ev=&w aft to =Rut fa2. : At tiie .I }aus t Ilot sm►y aad SL I£looemnat t*4 ptqeammmge4 or lap Qthapc mri riotm4oc with my maymcbe;fi4"tim kgkm# ri and *cy. is notnady, dija . itxd ham• a—d"My ' af#isFa t 1:0t4ea•rioth�b4 ptftbaf-. b. r rto' it iap Oa fat pkm*w, be ttibiriitted•mm l*a.8�d Oflioo sbct: r m from the ea Geer must . � •, � t>�ne. I�asmlter it�ust pteseat< .#o�o�asic pump ?: d 'a� tic dyondable to C.-tnikr m�st�m�pectiaa �ahe�tll ga rnplC; IWia docs snot • have to bete. • - - . , 4. As•*e is Wkr•I uo d that only I'i�aq pts 1t (o t r ae (e gad I Am•foggired 1 - - - -- - - -- �'� -- - • --- � '�tme�iitath;a ice. ' 5.. 1SU �ciaat�Ites, I uta . x � � prce•�f � � oanrs . 'tea;- _ - • • - 4; De ad d'utt.Briep c�(ev�e� arftbe aaaet�ta� Qrs� ,bap s+escLee� A � taftbe'a�mrd �adat�aexa lie aascaL ' Pmal�aarrby8a�t�Ta A.1p rslrrffor�aaaa� d la�delfa�fa ofmn&, l.�-. oxt�, atrouQe, s�aat,F F , 4`04 ' wgtland other . b. 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. ream Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. RECEIVED A. General Information 1. Inspector: SEP I L 2016 iOWtI OF NORTH ANDOVER RTMENT Neil J. Bateson HFA pEPA _ Name of Inspector Bateson Enterprises Inc. Company Name 111 Argilla Road Company Address Andover City/Town 978-475-4786 Telephone Number B. Certification MA State S115 License Number 01810 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 ❑ s Furth Evaluation by the Local Approving Authority 9/1/2016 Ingpi[AaelsignaturV Date 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 originaI sF ould be sent to the system owner h and copies sent to the buyer, if applicable, and the approving a6`tfiority.' ****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. t5ins • 3/13 Title 5 official Inspection Form: Subsurface Sewage Disposal System •Page 1 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 Citylrown 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. Check the box for "yes", "no" or "not determined" (Y, N, ND) 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. ❑ Y ® N ❑ ND (Explain below): t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 2 or 17 F tCommonwealth of Massachusetts Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner Owner's Name information is required for North Andover MA every page. Cityrrown State B. Certification (cont.) 01845 9/1/2016 Zip Code Date of Inspection ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND (Explain below): ❑ 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 ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): 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 t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 3 of 17 =vA= Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection D=orm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owners Name North Andover MA 01845 9/1/2016 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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. ❑ 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 fecal 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: Outlet tee in septic tank & d -box needs to be replaced. Riser on d -box needs to be installed. Repair cement around outlet pipe leaving foundation. 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 t5ins • 3/13 Title 5 official Inspection Form: Subsurface Sewage Disposal System •Page 4 of 17 ❑ ® 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. t5ins • 3/13 Title 5 Official inspection Form: Subsurface Sewage Disposal System •Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner Owner's Name information is required for North Andover MA 01845 9/1/2016 every page. Cityrrown State Zip. Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ ® 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 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 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. t5ins • 3/13 Title 5 Official inspection Form: Subsurface Sewage Disposal System •Page 5 of 17 Commonwealth of Massachusetts IN Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner Owner's Name information is required for North Andover MA 01845 9/1/2016 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No Z ❑ 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. ® r-1 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): 600 t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System •Page 6 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 Citylrown State Zip Code D. System Information Description: Number of current residents: Date of Inspection Does residence have a garbage grinder? Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) Laundry system inspected? Seasonal use? Water meter readings, if available (last 2 years usage (gpd)): Detail: 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: 1) ® Yes ❑ No ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No Yes ❑ Yes ® No Current Date Gallons per day (gpd) ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No t5ins - 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Foran - Not for Voluntary Assessments rt 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner Owner's Name information is required for North Andover MA 01845 9/1/2016 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Other (describe below): General Information Date Pumping Records: Source of information: Pumped three years ago owner Was system pumped as part of the inspection? If yes, volume pumped: 1500 gallons How was quantity pumped determined? Measured tank. Reason for pumping: Inspect tank & tees Type of System: ® 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) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the 1/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): ►1 d • t5ins • 3/13 Title 5 official Inspection Form: Subsurface Sewage Disposal System •Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forme Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner Owner's Name information is required for North Andover every page. City/Town D. System Information (cont.) MA 01845 State Zip Code 9/1/2016 Date of Inspection Approximate age of all components, date installed (if known) and source of information: 35 years old, 4/14/1981, as built plan. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer (locate on site plan): Depth below grade: 2 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.): 4" Cast iron through wall, 3" PVC in house. Cement around pipe pulled away from founadtion, needs to be repaired. Septic Tank (locate on site plan): Depth below grade: Material of construction: ® concrete ❑ metal If tank is metal, list age: 1 feet ❑ fiberglass ❑ polyethylene ❑ other (explain) years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) Dimensions: 10'x 5'x 4' Sludge depth: 3" ❑ Yes ❑ No t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System •Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r( 201 Raleigh Tavem Lane Property Address Thomas O'Donohue Owner information is required for every page. Owner's Name North Andover MA 01845 9/1/2016 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? N/A 2" N/A = Outlet tee corroded off. N/A Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet tee ok. Outlet tee corroded off, needs to be replaced. Depth of liquid at outlet invert. No evidence of leakage. Pumped septic tank. Grease Trap (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass 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: feet ❑ polyethylene ❑ other (explain): Date t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 City/Town 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.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass Dimensions: Capacity: Design Flow: Alarm present: Alarm level: Date of last pumping• ❑ polyethylene ❑ other (explain): gallons gallons per day ❑ Yes ❑ No Alarm in working order: ❑ Yes ❑ No Date Comments (condition of alarm and float switches, etc.): " Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins - 3/13 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 11 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Foran - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert I 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.): D -box cover broke, replaced it. D -box has corrosion, needs to be replaced. D -box has carryover, pumped d -box to clean. No evidence of leakage. Pump Chamber (locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins - 3/13 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System - Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r� Owner information is required for every page. t5ins • 3/13 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system 2 Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil ok. Vegetaion ok. No sign of ponding to surface. Camera inside of pits though outlets in d - no liquid to inverts. Cesspools (cesspool must be pumped as part of inspection) (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 ❑ Yes ❑ No Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Foran - Not for Voluntary Assessments "t 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner owner's Name information is required for North Andover MA 01845 9/1/2016 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins • 3/13 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 14 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand -sketch in the area below ❑ drawing attached separately P( S�Qk-v_-t 3o g 9or a Qn0 V2. WCc�� 1 GV%,7 t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17 Owner information is required for every page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner's Name North Andover MA 01845 9/1/2016 Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 4 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 5/23/1980 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: Design plan ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: As per test pit data on design plan show no water 8' deep. Before Filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins • 3/13 Title 5 Official Inspection Forth: Subsurface Sewage Disposal System • Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments "( 201 Raleigh Tavern Lane Property Address Thomas O'Donohue Owner owner's Name information is required for North Andover MA 01845 9/1/2016 every page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins • 3113 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17 Commonwealth of Massachusetts City/Town of . System Pumping. Record Folnn 4 DEP has provided this form for use=by local Boards of Health. Other forms maybe *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. A. Facility. InforMation 1. System Location: Left / Right front of house, Left / Right rear of house, Left / right i e of house Left/ Right side of building, Left / Right front of building, Left / Right rear of building, Unde Address C 0 r C Z' y e -z n City/Town State 2. System Owner. ► Name' Address (if different from location) Cityrrown B. Pumping 1. Date of Pumping 3. Type -of system: A Zip Code state g &0 �� TC Telephone Number; Date 2. Quantity Pumped: Gallons ❑ Cesspool(s) ®-teptic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ©-Ko- If yes, was it cleaned? ❑ Yes ❑ No, 5. Condition of System: 6: System Pumped By.- Nell y: Neil. Bateson ' F5821 Name Vehicle License Number Bateson Enterprises Inc- Company ncCompany 7. Location where contents- were disposed: GLS Lowell Waste Water —1 Date t5form4.doo- 06/03 System Pumping Record • Page 1 of 1 Summary Record Card generated on 8/29/2016 12:13:32 PM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-106.0-0117-0000.0 Parcel Id 17750 201 RALEIGH TAVERN LANE O'DONOHUE, THOMAS 201 RALEIGH TAVERN LANE N. ANDOVER, MA 01845 Class j101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 1.07 Acres FY 2017 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until O'DONOHUE, THOMAS Payor 201, RALEIGH TAVERN LANE N. ANDOVER, MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 14143.0 - 201 RALEIGH TAVERN LANE Last Billing Date 6/14/2016 2100127 02 Cycle 02 Active UB Services Maint. Account No. 2100127 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 64.60 /1 UB Meter Maintenance Account No. 2100.127 Serial No Status Location Brand Type Size YTD Cons 36207138 a Active ERT HH b Badger w Water 0.63 0.63 634 Date Reading Code Consumption Posted Date Variance 8/2/2016 641 a Actual 26 53% 5/3/2016 615 aActual 17 6/21/2016 -5% 2/2/2016 598 a Actual 18 3/28/2016 -12% 11/2/2015 580 a Actual 20 12/30/2015 -21% 8/4/2015 560 a Actual 26 9/14/2015 6% 5/4/2015 534 a Actual 24 6/22/2015 29% 2/3/2015 510 a Actual 19 3/20/2015 -3% 11/3/2014 491 a Actual 20 12/15/2014 -31% 8/1/2014 471 aActual 27 9/11/2014 0% 5/5/2014 444 a Actual 28 6/12/2014 -6% 2/3/2014 416 a Actual 31 3/17/2014 2% 10/31/2013 385 aActual 29 12/20/2013 13% 8/1/2013 356 aActual 26 9/18/2013 7% 5/1/2013 330 a Actual 22 6/18/2013 2% 2/7/2013 308 a Actual 26 3/13/2013 10% 10/30/2012 282 a Actual 21 12/13/2012 -17% 8/2/2012 261 a Actual 26 9/26/2012 21% 5/2/2012 235 a Actual 21 6/20/2012 -20% 2/2/2012 214 aActual 27 3/14/2012 41% 11/1/2011 187 aActual 1'9 12/15/2011 -15% 8/1/2011 168 aActual 22 9/14/2011 5% 5/2/2011 146 a Actual 20 6/13/2011 -25% 2/4/2011 126 a Actual 29 3/15/2011 -5% 11/1/2010 97 a Actual 29 12/13/2010 24% 8/3/2010 68 a Actual 24 9/13/2010 13% 5/3/2010 44 a Actual 21 6/9/2010 -14% 2/1/2010 23 aActual 23 3/11/2010 -100% 11/7/2009 0 n New Meter 0 12/11/2009 -100% 11/7/2009 3277 r Replacement 19 12/11/2009 -24% 0 ��w E LF -VAT i O P4,5.— INV 4?5.INV PIPE OUT OF N5E 1tiV PIPE INTDTAh1V- KXV PIPEOUTOFrANIL I - (.I _ ^ 1NV.PliPE INTO D.&OX 13io• 1r3 I NV. DI P ni lT D P�nX I �% .(;�4 'A" I.3Go, _Zs T A V TAV 1500 - TtaNY. /� s & u i L -r 5v5-&uq-1=-AG.E DIspo5AL. 5Y�'T' EM ,N AiJDONf2 Mai L -L -E T t-4eIr,,lEE-=>2S ,Al -T- 0 i APPLICATION FOR SEWAGE DISPOSAL INSTALLATION HEALTH DEPARTMENT - NORTH ANDOVER, MASS. I reby make application for a permit for a sewage disposal installation at '"� % - . I will install this system in ac- cordance with all the laws 'f the Commonwealth of Massachusetts and regulations of the Board of Health of the Town of North Andover. Further, I will construct the house sewer of bell and spigot pipe, the minimum diameter being 4 inches, and will maintain a minimum grade of 1/ until 10 feet pre- ceding the septic tank, where the grade shall not exceed 290. I will install a con- crete septic tank of j— -c, in size. A manhole (s) permitting easy cleaning will be provided with removable cover (s) of iron or concrete within 12 inches of the ground surface. I will provide subsurface disposal field with 4 inch perforated or open jointed pipe and laid in a series of trenches, the bottom of which will pro- vide a minimum of yob lineal (square) feet of effective absorption area. The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar material to a height of 2 inches above the crown of the pipe. The joints of these pipes will be protected from clogging and before filling the trench, 2 inches of gravel or stone 1/8" to 1/41' (dia.) will be placed over the course gravel or stone. The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single tile line will exceed 100 feet in length and in any case, two lines of tile will be installed. A minimum of 6 feet will be maintained between the center lines of the disposal field trenches and the average depth of trench shall not exceed 36 inches. No part of the installation will be less than 100 feet from any private water supply, 25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line. I_further agree not to cover anyop rtion of this installation until approved by the inspection officer, as provided below, and to incorporate any additional requirements that may be attached to the permit. Plot Plans must be submitted with application. DATE Signature of Applicant I hereby issue the above permit for the Board of Health of the Town of North Andover, Massachu etts. DATE Sign, re o Health Agent I have inspected the uncovered system indicated above and find everything done as described. DATE //_ TZ_ 17g A Percolation Signature of I pecting Officer T ��/�-�-` est Garbage Grinder ID y BOARD OF HEALTH TOWN OF NORTH ANDOVER, MASS. l 1. NAMfi*,fe %"' �/ifl/�' t lj`� DATE s.Z -zze 2. ADDRESS ,/P f , 7-1- IP LOT NO. -�-- TEL. 3. NO. OF BEDROOMS_ DEN YES - NO 4. GARBAGE GRINDER YES NO r- 5. SHOW DIMENSIONS OF HOUSE 6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES 7. SHOW DIMENSIONS OF LOT 8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL 9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM 10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC. 11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY. BOARD OF HEALTH OF NORTH ANDOVER$ MASSACHUSETTS SEWAGE DISPOSAL DATE8�/20./t72 NAME OF APPLICANT Robert W. Saygge LOCATION Lot ##22 Raleigh Tavern Address of lot no. BUILDING: Dwelling X Other SYSTEM: New X Repair GENERAL DESCRIPTION OF LAND high SUBSOIL: Clay__j_ Gravel Sand PERCOLATION TEST 5 minutes per inch. MINIMUM INSTALLATION RECOMMENDATIONS CONCRETE SEPTIC TANK 1„000 gallon capacity. LEACH FIELD 200 lineal feet of drain pipe, w illiam J. Drifc1oll, Engineer Board of Health . Board` of Health North AncjoyerzMaas. S � 24 8$P'I'IC SYSTEM INSTALLATICK CHECK LIST LOT 6 - EXCAVATION OK FAIL I. Distance Tot a. Wetlands b. Drains c. Well 2. Water Line Location 3. No PPC Pipe 4. Septic Tank - a. -Tess --Length & To Clean Oat Covers. b. Cement Pipe to Tank-- Oa Both Sides of Tank 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing Equal Amounts c. No Back Float 6*. Leach Field or Trench a. Dimensions 'b. Stone Depth c. Capped 'Ends d. Clean Double Washed Stone' 7. Leach to a. sions b. no Depth c. lash Pads d. ees e. ement Pipe to Pit - Both Sides. f. Clean, Double Washed Stone 8. No Garbage Disposal 9. -- -Final Grading Inspection- 10. Barricading Covered System 11. As Built Sabmitted._- a. Lot Location b. - b. Dimensions of System c. Location with Regard -to Pere Test d. Elevations e. Water Table SOIL PROFILE k P kOLATION TEST DATA. 1�TortS Andover, No No -&Street Lot No. IR32�- v Loc. /Subdiv. Plan Owner Investigator 'Observer.-_ SOIL PROFILES -DATE 2. Elev. 3. 4.Elev. Elev. Elev. 0 0 0 0-- Ties to Test Pits 2 2 2 2 3 3 4 4 5 M 5 1 6 7 g- 9 7 8 - 9 4 7 8 9 - - 10I 10 , 1 10 1 1 10 Benchmark Location Elevation Datum /8 #pPercolation Tess -Date R • 1 , I Pit Number 1 3 4 S Start Saturation Soak -Mins. Start - Test-Time- Dr_p of 311 -Time - "-Time.Dro Drop of G" -Time bins. 1st. 3"Drop D Mins . 2nd 3"Dro - Pea-colation Rate Reg 1.0. 2 R(.g 71,o.4 LOT ns: 'it bo !at 7-j ":.7!d 2-o 7 t'O Ues Z-ticm Jt,- 1 -ion t C c z4 S tk! ti(-�,as 1C.-- tng area of r-rm 2!'X)I of Umstem or --r-O diLq -a -�h 5-a 10-D, of P-r%t�� posal T,rd es f A, r 17 61--wor-al 00� Or to fz-,-.:rv---- jot11C.D1 leacbing facility Of ma ftcility cf ri) 6r intyu is Pr) rao Pvc to 1XI q) jprofile of Df pl- q$ dZptic tank,, 6 ri llzo:r, 5XI-`6 tnd c 4AIcts.,E.,,.I�ributuL,n V , Id piping and -Lr'C-L '.Me 6. . s --t-vor. -a System Cw ot� r �Izrl 1--ist- Ix. aut. ed, '��O PI": -:1 L- u ;=h P! M-5 A C,-- Tw;!��. -c"E-I"ZOP of flo-e. va-t,�r accear, ., a1ewaout 1W f�om eel"= -,-Al or :1=,-ownd sm- 25f 0.08 tc tu & - c 11 L � , _phof tc.,es., rzign Check List Pae 2 FAIL OK Leaching Pits Leaching pits are preferred where the installation is possible calculations of leaching area -minimum 500 sq ft spacing p ' -surface drainage .2% cover material e 'x2'x4P splash pad tee at elbow g) no bends in pipe from d -box to pipe Leaching Fields' no greater- than 20 minutes/inch b area-minimram/900 sq ft c constructicn of field d) surface drainage 2 % e) 20'fl�on cellar wall or inground swindng pool Leaching/ Tuenches A) calculalons of leaching area -min 500 sq ft b) spacing -4' ft md.n 6 ft -with reserve between C) dimensions d) constru"ction e) stone f) surface drainage 2% Do Slope A) slope ► x = be shown) b) y/x 150 = (to be shown) a) �s' � al 1b) staid -by power ✓" ✓ laj