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HomeMy WebLinkAboutMiscellaneous - 206 FOREST STREET 4/30/2018r t SEPTIC SYSTEM INSTALLATION CONDITIONS: Is the installer licensed? YES NO Type of Construction: NEWEPAIR ew-E-offistrtretion: / Certified of Plan Review YES NO 14 D b / ✓ /ON Floor Plan Review YES NO Conditions of Approval from Form U YES NO Issuance of DWC permit: YES NO DWC Permit Paid? NO DWC Permit # 10( Y4 Installer: f 'YES cc a/ /- Begin Inspection: YES NO Excavation Inspection: Needed: Passed: By: Construction Inspection: Needed: As Built Plan Satisfactory.- YES: atisfactory:YES: Approval of Backfill: Final Grading Approval Date: Date: Final Construction Approval: Date: By: Certificate of Compliance: Approval: Date: l' .b 0 05 �. ✓ Lot & Street Map/Parcel CONSTRUCTION APPROVAL Has plan review fee been paid:ES NO Permit# Plan Approval: Date:I'll Approved by: Designer: _ Jar'( t� Plan Date: 7/V �o7 Conditions: Watr Supply: ow Well Well Driller: Well Tests: Chemical Bacteria I Bacteria II Plumbing Sign -Off: Comments: Date Date Approved Date Approved Wiring Sign -off: Form "U" Approval: Approval to Issue: YES NO Date Issued By: Conditions: Final Approval: All Permits Paid? YES NO Well Construction Approval? YES NO Septic System Construction Approval? YES NO Certification? YES NO Other? YES NO Any Variance Needed? 4jo NO D) S �- 7L6 0e)_5 FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Heidi Griffin acting Public Health Director TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE February 9, 2004 This is to certify that the individual subsurface disposal system constructed ( ) repaired (X) by Mike Reilly at 206 Forest Street North Andover, MA 01845 Telephone (978) 688-9540 Fax(978)688-9542 as been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Z��t•__ti bus Y. Sawyer, R.S. ' Public Health Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, Massachusetts 01845 Heidi Griffin Acting Public Health Director TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE December 4, 2003 Telephone (978) 688-9540 Fax(978)688-9542 It This is' -to certify that the individual subsurface disposal system constructed ( ) repaired (X) by Mike Reilly at 206 Forest Street North Andover, MA 01845 as been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. JonathaAarkey Chairman, North Andover Board of Health BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System 04constructed; ( ) repaired; by located was installed in conformance with the North Andover Board of Health approved plan, System Design Permit .# , plan dated, with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title S and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. Bed inspection date: I — 2--073 Final inspection date: 1 d 3 Installer: Engineer: Engineer Representative Eng' eer Representative �. r Date: Z `� DEC - 3 Town of North Andover, Massachusetts F°•m N°. a ot M°RTI{ BOARD OF HEALTH -Aar �,5•,T•�•'t� DISPOSAL WORKS CONSTRUCTION PERMIT SACHusE Applicant ' A . _ NAME ADDRESS TELEPHONE Site Location Permission is hereby granted to Construct ( ) or Repair ( an Individual S it Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN, BOARD OF HEALTH Fee % D.W.C. No. .01 p APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: CURRENT INSTALLER'S LICENSE# LOCATION::�b(o Fm5;s� s.,fi . LICENSED INSTALLER: SIGNATURE: TELEPHONE# 97) CHECK ONE: REPAIR: (/ NEW CONSTRUCTION: IF NEW CONSTRUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. $175.00 Fee Attached? Foundation As -built? Floor plans on file? Approval Administrative Use Only Yes L___� No Yes No Yes No Date / J INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at �Do C' (7o cue, SA 'S'r relative to the application of \ _ dated_ -t-1-p a for plans by Sec-L,=X-L<g and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection - Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after- which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. C) Final Grade Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer Disposal Works Constructs n Permit # Date: 3 -2- Q') ° 10 h 1° :0 y � N O O O O N w O O p O � N �.w•r O ��.N� wC.w woo .�-K `1 '3 OW y• N O� U "� O O O O O r r N� O B O O OO ? A CG CD W CD W G H W W W O 7 vCD GJ ° cCD 7 w d 0. a °°° °° w cm,, o w o° a 'o,c° m s a" w S CD o N O G� K A o n K fc d 0 0� "R, 0 x O c'a ii0 ° ° ya c o d aCD+ o O 00 -w* UO (4 [J w fIQ CL 1. o CD ° o w ao•� � _�� w �� vw 0 ID a o o b y =CD rn w EL Z CD o w CD n Fl, y 5w w w° CD 'ri ... p I CD rn z w g��°cam o' CD 3 a n 0 `D C1 o CD x K h w o CD CD r! n d 4 N b b ti A low hS ti e d b � o � y � p 111 ° 10 h 1° :0 y � N O O O O N w O O p O � N �.w•r O ��.N� wC.w woo .�-K `1 '3 OW y• N O� U "� O O O O O r r N� O B O O OO ? A CG CD W CD W G H W W W O 7 vCD GJ ° cCD 7 w d 0. a °°° °° w cm,, o w o° a 'o,c° m s a" w S CD o N O G� K A o n K fc d 0 0� "R, 0 x O c'a ii0 ° ° ya c o d aCD+ o O 00 -w* UO (4 [J w fIQ CL 1. o CD ° o w ao•� � _�� w �� vw 0 ID a o o b y =CD rn w EL Z CD o w CD n Fl, y 5w w w° CD 'ri ... p I CD rn z w g��°cam o' CD 3 a n 0 `D C1 o CD x K h w o CD CD r! n d 4 N b b ti A low hS ti DEC -11-2003 12:16 PM JOSEPH J_ SERWATKA 1 978 683 6595 P.01 Joseph J. Serwatka, P.E. Post OfTiee Box 1016 North Andover, MA 01845 (978) 683-6595 December 10, 2003 Mr. Brian LaGrasse, Health Inspector North Andover Board of Health 27 Charles Street North Andover, MA 01845 Re: 206 Forest Street Dear Mr. LaGrasse: Pursuant to our telephone conversation, this letter is sent to state that, in my opinion, the grading over and around the septic system installed at 206 Forest Street meets the requirements of Title 5 relative to 15' to a 3:1 slope. As I mention6d, the slope will have to be stabilized, the additions need to be built, and then a certificate of compliance will be requested from the Conservation Commission. The Commission's agent, I am sure, will be conducting site inspections to ensure the proper stabilization of the slope. Until that time, I would recommend that all erosion controls remain in place. Should you have any questions concerning this letter, please contact me. atka, P.E. Page 1 of 1 DelleChiaie, Pamela From: Lagrasse, Brian Sent: Thursday, December 04, 2003 3:22 PM To: DelleChiaie, Pamela Subject: RE: 206 Forest Street need the installer to sign certification form and i need a letter from serwatka stating that the final grade was constructed as proposed. spoke to doug and he will call joe and mike to let them know what they need to do. -----Original Message ----- From: DelleChiaie, Pamela Sent: Wednesday, December 03, 2003 2:46 PM To: Lagrasse, Brian Subject: 206 Forest Street 12/3/03 - Doug Beach, h/o called re: status of paperwork received, and whether he needs a final grade inspection. Please call him at 978.686.8121. File and paperwork are on your desk. 12/4/2003 TOWN OF NORTH. ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES 0f �° p HEALTH DEPARTMENT 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 y9sS HU tt9 Heidi Griffin 978.688.9540 - Phone Acting Health Director 978.688.9542 - FAX September 26, 2003 Mr. Joe Serwatka P.O. Box 1016 North Andover, MA 01845 Dear Mr. Serwatka: Please note that 206 Forest Street received a Final Grade Inspection today. Upon inspection, it was noted that the following items need to be followed up on before a Certificate of Compliance can be issued: • Complete an Installation Certification form with all the required signatures • Submit a series of pump calculations, specifications of the pump installed, and a pump curve for review by the office • Fix Erosion • Letter from you regarding that all the grades are okay and meet all requirements As soon as all the necessary paperwork is submitted a Certificate of Compliance will be issued. Sincerely, Brian LaGrasse Health Inspector /pd TOWN OF NORTH ANDOVER � NORF6/ q Office of COMMUNITY DEVELOPMENT AND SERVICES o ' 4,4ee HEALTH DEPARTMENT 27 CHARLES STREET �s �s,r.o NORTH ANDOVER, MASSACHUSETTS 01845 ' ��CNus Heidi Griffin 978.688.9540 — Phone Acting Health Director 978.688.9542 — FAX September 16, 2003 Joseph Serwatka P.O. Box 1016 North Andover, MA 01845 RE: 206 Forest Street Dear Mr. Serwatka: Please be advised that during the construction inspection for the septic system you designed that it was noted that no pump had been specified as part of the system design. Apparently the contractor spoke with you and with a pump sales company and then selected a pump for the system. Prior to issuance of a Certificate of Compliance, please provide a series of pump calculations, specifications of the pump installed, and a pump curve for review by the office. Thank you very much for your anticipated cooperation. Sincerely, 2 Gam. asse Health Inspector Cc: H meowner e Chrono Sheraton WORLDWIDE HOTELS, INNS, RESORTS & ALL -SUITES ut ZDV ci- l '1-• � C C h�C) N je 1,J) ru Calc mso V -- FOR RESERVATIONS DIAL 800-325-3535 IN U.S.A. AND CANAD J Page 1 of 1 Pamela DelleChiaie From: "Dan Ottenheimer" <info@millriverconsulting.com> To:<blagrasse@townofnorthandover.com>;<pdellechiaie@townofnorthandover.com> Sent: Monday, September 08, 2003 9:40 AM Attach: Forest Street #206, Bottom of Bed Inspection.pdf Subject: 206 Forest Street Brian and Pam, Attached are results of bottom of bed inspection at 206 Forest Street. Everything looked good. They had the septic tank and pump chamber installed too so I checked on them. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 info@millriverconsulting.com 9/8/2003 andover consultants 1 East River Place Inc. Methuen, Massachusetts 01844 Tel. (978) 687-3828 Fax (978) 686-5100 August 26, 2003 Town of North Andover ' T C �'. �, _� ° - 57 E� -. ti, Board of Health 27 Charles Street North Andover, MA 01845 AUG 2 7 2003 Re: Town M_ p15.0 -D, To—w Lot 3__ 9 (Lot .A) own ap 150 D, Town Lot 71 (Lot Forest t., ortndover, Mass. Dear Members of the Board: This office conducted percolation tests and test pits on the above referenced lots on April 7, 1999. We prepared plans for sewage disposal systems in April of 1999 and after review by Port Engineering, your consultant, we revised the plans on May 12, 1999. Your office issued design approvals on May 20, 1999 for Lot `A' and May 27, 1999 for Lot `C'. On behalf of our client, Forest Glen Development, Inc., we request the Board of Health re- issue design approvals for these lots. I have inspected the sites and no work has occurred on site that would change the soil characteristics. It is my opinion that additional testing on the lots would only further disturb the parent soil in the area of the absorption trenches. I will attend your meeting on August 28, 2003 to answer any questions you might have. Sincerely, ANDOVER CONSULTANTS INC. Z04fvt�z_ William S. MacLeod, P.E., P.L.S. President WSM/bsn C/MyDoc/TowndNA Civil Engineers 9 Land Surveyors • Land Planners Q K Engineering Associates 235 Newbury Street Danvers, MA 01923 (978)777-3050 Fax (978)774-7816 Bolton, MA (978)779-6767 Boston, MA (617)350-7906 #6787 May 5, 2003 North Andover Board of Health Community Development 27 Charles Street North Andover, MA 01845 Attn: Ms. Sandra Starr Re: Lots 2 & 3 Forest Street Extension (formerly Lot A Forest Street Extension) North Andover, MA Dear Ms. Starr: On behalf of our client, Mr. Scott Roth, I respectfully request that the results of deep observation holes performed at his property (Assessors Map 1058, Lot 2) be extended for at least an additional two years. These soil tests were performed on May 1, 2000, July 26, 2000, and August 30, 2001. They were performed by myself and witnessed by Carlton Brown of Port Engineering on the first two days and by John Noonan of Noonan and McDowell on the latter day. I believe you will agree that the soil logs are sufficiently comprehensive as to not require additional testing. The site has not been altered in the area of the performed soil tests. Therefore, these soil tests still meet the purpose of section 7.02 of the Town of North Andover Minimum Requirements for the Subsurface Disposal of Sanitary Sewage being that the character of the soil, the seasonal high ground water elevation and the depth to bedrock would not have changed. After the soil testing process was completed Mr. Roth had the property divided into three lots (including the existing dwelling in Boxford), which required approvals from the North Andover and Boxford Planning Boards as well as the Boxford Board of Health. Now Mr. Roth is in the process of selling the two lots on which these tests were Division of Hancock Survey Associates, Inc. North Andover Board of Health May 5, 2003 Page two conducted and subsurface sewage disposal systems will need to be designed in the near future. Extending the results of these tests an additional two years will set the expiration date for May 1, 2004, which should give Mr. Roth and any potential buyers adequate time to have systems designed. I have enclosed a concept sketch of where soil absorption systems would fit within the confines of the performed soil tests. Should you have any questions regarding this matter, please do not hesitate to contact me. Sincerely, HANCOCK ENGINEERING ASSOCIATES k�� arles R. Ogden, Project Engineer CC: Project File #6787 NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nmgconversent.net October 16, 2002 Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/068B 206 Forest Street Assessors Map 106A, Lot 107 Dear Members of the Board, -4,,, au .'/ OCT 2 1 2002 Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated May 17, 2002 and revised: 7/31/02, by: Joseph J. Serwatica. It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health `By -Laws" if the following is addressed: 1. Revise bottom of stone in leaching field to highest ground grade offset to water table: 161.5. 2. For design given, provide flow rate a first orifice and last orifice in same lateral. This should be equal or less than 10% of flow. Respectfully, John L. Noonan, P.L.S.-P.E. G: office/forms/tonarev/boh/ 1770-068b Land Surveyors Civil Engineers Environmental Planners NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, 'Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm@netway.com Date GT ITown of of North Andover Office of the Health Department Community Development and Services Division �V 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System XD Plan Review, 1770/ d r Z Q 7 - Assessors Map/n4-4 ,Lot I % Dear Members of the Board, Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated /7, Zc? 'i It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health `By -Laws" if the following is addressed: L-`Gr�'�<v� F/t-PA j O lcr-<7 /0 . e--- <;, 3; E 7- Tv 7-4,V GGA. l d* Al ffff aPz i Fc cc G .f 5' 7- 7-// / Y -///S D !7 ��i''-�� c_ P•� c, mss Respectfully, John L. Noonan, P.L.S.-P.E. G: office/forms/ton arev Land Surveyors Civil Engineers Environmental Planners Joseph J. Serwatka, P.E. 31 Kendrick Street Lawrence, MA 01841 (978) 683-6595 July 31, 2002 Mr. John L. Noonan, P.L.S., P.E. Noonan & McDowell, Inc. 25 Bridge Street, Suite 6 Billerica, MA 01821-1023 Re: 206 Forest Street Revised Septic Plan Dear John: I am in receipt of your June 26, 2002 review letter. Unfortunately, the Town forgot to send me a copy until I called them today. Anyway, I have revised the plan and calculations per your comments. It appears from your comments that you did not receive the original set of pump calcs and specs. I have revised the plans as follows: 1. The variance request is now on the plan. 2. A note is on the plan regarding water supplies and wells. 3. All gravity piping is listed as SCH 40. 4. The field has been raised to be 4' above groundwater at the highest ground elevation. 5. The notation has been added regarding joints. 6. Pipe type and slope is shown to pump chamber. 7. Gas baffle is now specified. 8. Notation for 12" max. distance has. been added to tees. 9. Notation for risers has been added. 10. Notation for max. depth on tank has been added.. 11. Alarm float has been lowered. 12. Pump control catalog cut has been added to the pump specs. 13. Alarm spec has been added to the specs. 14. Pump curve has been added. 15. Manual switch for pump has been specified. 16. Max. depth on pump chamber has been added. 17. Note 13 has been revised. 18. The flow rate in all orifices is the same. This is evidenced by equal head at each lateral during testing and my own observations. 19. Orifices have been revised to 5 & 7 O'clock. 20. Note has been added regarding forcemain into manifold. 21. Note has been added to waterline. i0 Should you have any questions concerning this letter, please contact me. Sincerely, , Jo ph J. Serwatka, P.E. SEWAGE PUMP STATION DESIGN COMPUTATIONS OWNER & APPLICANT 206 Forest Street North Andover, MA Beach 206 Forest Streit North Andover, MA PUMP.XLS DESIGN DATA: PUMP: .S !` DESIGN FLOW 440 Gal/Day SOIL CLASS 1 PERC RATE 5 Min/Inch FORCE MAIN DIA. 2" SDR 21 PVC HAZEN-WILLIAMS COEFF. 150 MANUFACTURER: PEABODY-BARNES MODEL #: SE -411 HORSEPOWER: PUMP CHAMBER: STORAGE PRIMARY 110.0 gallons RESERVE 440.0 gallons VOL. IN PIPE RUN 0.0 gallons TOTAL 550.0 gallons DIMENSIONS LENGTH* 7.50 WIDTH* 4.50 DEPTH* 4.25 *INSIDE DIMENSIONS ELEVATIONS INLET INVERT 161.70 SUMP 157.45 OFF 158.20 ON 158.64 ALARM 159.96 STATIC HEAD: LATERAL ELEV. 165.60 FT PUMP OFF ELEV_ 158.20 FT TOTAL STATIC HEAD 7.40 FT PUMPALS M, A EQUIVALENT LENGTH: FRICTION LOSSES IN PUMP CHAMBER - 1 2"DIA 900 BEND 0 2"DIA 450 BEND 1 2"DIA CHECK VALVE 1 2"DIA GATE VALVE TOTALLOSS b 1 21.0 FT FRICTION LOSSES IN PIPE RUN: 3 2"DIA 900 BEND 0 2"DIA 450 BEND 0 2"DIA 22.50 BEND 1 2"DIA TEE 35 LENGTH OF RUN FT MISC. PIPE 1.8 TOTALLOSS 0.63 b 1 66.0 FT� TOTAL EQUIV. LENGTH: SYSTEM CURVE: 5.0 FT 0.0 FT 14.0 FT 1.2 FT 20.2 FT 15.0 FT 0.0 FT 0.0 FT 12.0 FT 35.0 FT 3.5 FT 65.5 FT 87 FT Q V HF/100 HF Hs TDH GPM FPS FT FT FT FT 20 1.8 0.72 0.63 7.4 8.03 25 2.3 1.09 0.95 7.4 1 8.35 30 2.7 1.52 1.33 7.4 8.73 35 3.2 2.03 1.76 7.4 9.16 40 3.6 2.59 2.26 7.4 9.66 50 4.5 3.92 3.41 7.4 10.81 60 5.4 5.50 4.78 7.4 12.18 70 6.3 7.32 6.36 7.4 13.76 80 7.2 1 9.37 8.15 7.4 15.55 90 8.1 1 11.65 10.14 7.4 17.54 FROM ATTACHED PUMP CURVE: 87 gpm @ 12 TDH TIME ON: 1.3 minutes PUMP.XLS H Q ��V4D 00000N�M(OO.N� r N N O u') 00 r 00 In r r U) - W O J m Z w H W W W coW U HJ w 0Qz W U- 2 g�JQ o0= n zw W :5 LU 0 w F- Jz00 p ~-0zQzW z=pQ> =gin J >wQ cn zaLL- i - Na-WJw J w0000Q<— Ix W— ��WOOwwwWW��O LL w- mzzm IL ILww LLJ ~W�Q¢500iEF-E-?n gJz2MzU-LL00gga.= U_ �Q=rn�m���arov°r°oo z W rNI�66oi46 U fn 0 0 0 0 0 0 0 0 0 0 0 F- U) w lo: v Vr V: V: lo: d v O= 0 0 0 0 0 0 0 0 0 0 0 U .�.LnM0 4t I'- In 000WLn0 fA 2In007to0� V:OU�r00U� O J'OOrrrNNM�itLo J Z Ow Fg.. r M� t0 00 .- M t0 O M c0 O LL = 0 0 0 0 r r r r N N Cl) = rNCM'It ulg00ofrCIV: O o, O o 0 0 0 O O O � r r J J Z O O�= F -z:. 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U� o �P- I'- LoNMNInLnLoN In M M cM V: q O LL = O r N N M VLf) <0 1-- 00 (3) (n �NMaM(OrMNONOM w Un 0— J zw O P: c. U D 0 n an N w N Ln In U) N ExU- r 0vOt`LnMMMv0O LL=O r N N M et c0 I� 00 M J O In O tn O Wn O In 0 4o 0 w0 a ONLnI-ONInI-ONwi F -J(' In c0ti0o0rNMLocoI'- � v r r r r r r r 0 J LL O m o 0 0 0 o o o 0 0 0 0 Z J O 6666Ouiol 666 O Q LL N N M M4 st In In 0 0 1-- W�� o 0 0 0 0 0 0 0 0 0 0 �Oa0000o00000a }LJL 0 NNMMstd'OLr) COor- 0) BARNESOSUBMERSI13LE NON -CLOG PUMPS Series: SE, Manual & Automatic 1-1/2" Spherical Solids Handling Series: SEA HP 1750 RPM (SE411 & SE421) THE BELOW LISTINGS ARE FOR SE411, SE411A & SE421 ONLY. CIP0 Canadian Standards Association File No. LR16567 U` Underwriters Laboratories Inc. File No. E142177 Description: SUBMERSIBLE NON -CLOG SEWAGE PUMP DESIGNED FOR TYPICAL RAW SEWAGE APPLICATIONS. Sample Specifications: Section 1 Pages 13-14. Specifications DISCHARGE: LIQUID TEMPERATURE: VOLUTE: MOTOR HOUSING: SEAL PLATE: IMPELLER: Design: Material: SHAFT: SQUARE RINGS: HARDWARE: PAINT: SEAL: Design: Material: CABLE ENTRY: SPEED: UPPER BEARING: Design: Lubrication: Load: LOWER BEARING: Design: Lubrication. Load: MOTOR: Design: Insulation: SINGLE PHASE: FLOAT: OPTIONAL EQUIPMENT: CRANE I PUMPS & SYSTEMS Barnes Pumps, Inc. Barnes Pumps, Inc. Distributor Sales & Service Dept. Bid -To -Spec & Project Sales 420 Third Street/P.O. Box 603 1485 Lexington Ave. Piqua, Ohio 45356-0603 Mansfield, Ohio 44907-2674 Ph: (513) 773-2442 Ph: (419) 774-1511 Fax: (513) 773-2238. Fax: (419) 774-1530 SECTION 1A PAGE 1 DATE 5/94 REPLACES 7/93 2" NPT, Vertical 104° F Continuous. Cast Iron, ASTM A-48 Class 30. Cast Iron ASTM A-48, Class 30. Cast Iron ASTM A-48 Class 30. 2 Vane, Open, With Pump Out Vanes On Back Side. Dynamically Balanced, ISO G6.3. Zytel 70G43 Nylon, Glass Filled. 416 Stainless Steel. Buna-N 300 Series Stainless Steel. Air Dry Enamel. Single Mechanical, Oil -Filled Reservoir, Secondary Exclusion Seal. Rotating Face - Carbon Stationary Face - Ceramic Elastomer - Buna-N Hardware - 300 Series Stainless 15 ft. Cord w/Plug On 115 and 230 Volt, Pressure Grommet For Sealing And Strain Relief. 1750 RPM (Nominal). Sleeve Oil Radial Single Row, Ball Oil Radial & Thrust NEMA L Torque Curve. Completely Oil -Filled, Squirrel Cage Induction. Class A. Permanent Split Capacitor (PSC). Includes Overload Protection In Motor. Automatic Models. Wide Angle, Polypropylene, 15ft. Cable. SE411A & SE421A, Float w/Plug Attached To Discharge Piping, SE411AU & SE421AU Float Attached To Pump. ON and OFF Points are Adjustable. Seal Material, Additional Cable and Cast Iron Impeller. SECTION 1A PAGE 2 DATE 5/94 REPLACES 7/93 SE411A & 421A SE411 & SE421 (Less Float) SE411AU & 421AU Q 120° Pumping 9.00 Differential 16.00 U "" I O 7.72 0 4.00. 120° 9.00 Pumping Differential 16.00 . 4.00 2 MODEL PART HP VOLT PH RPM NEMA FULL LOCKED CORD CORD CORD NO. NO. (Nom) CODE LOAD ROTOR SIZE TYPE OD AMPS AMPS SE411 068701 0.4 115 1 1750 A 10.0 19.0 14/3 SJTOW-A 0.390 SE411A 082215 0.4 115 1 1750 A 10.0 19.0 14/3 SJTOW-A 0.390 SE411AU 093193 0.4 115 1 1750 A 10.0 19.0 14/3 SJTOW-A 0.390 SE421 082089 0.4 230 1 1750 A 5.0 9.5 14/3 SJTOW-A 0.390 SE421A 093194 0.4 230 1 1750 A 5.0 9.5 14/3 SJTOW-A 0.390 SE421AU 093195 0.4 230 1 1750 A 5.0 9.5 14/3 SJTOW-A 0.390 Mercury Switch on SE411A & Mechanical on SE421A, Cable 16/2, SJOW-A, 0.320 O.D., Piggy -Back Plug. Mechanical Switch (SE411AU & SE421AU), Cable 14/2, SJOOW-A (UL), SJOW (CSA), 0.370 O.D. IMPORTANTI 1.) DO NOT USE THIS PUMP TO PUMP FLAMMABLE LIQUIDS. 2.) THIS PUMP IS APPROPRIATE FOR LOCATIONS CLASSIFIED AS DIVISION II. 3.) THIS PUMP IS hQI APPROVED FOR USE IN SWIMMING POOLS, RECREATIONAL WATER INSTALLATIONS,DECORATIVE FOUNTAINS OR ANY INSTALLATION WHERE HUMAN CONTACT WITH THE PUMPED FLUID IS COMMON WHILE THE PUMP IS RUNNING. 4.) PUMP CAN BE OPERATED DRY FOR EXTENDED PERIODS WITHOUT DAMAGE TO MOTOR AND/OR SEALS. CRANE PUMPS & SYSTEMS Barnes Pumps, Inc. Barnes Pumps, Inc. Distributor Sales & Service Dept. Bid -To -Spec & Project Sales 420 Third Street/P.O. Box 603 1485 Lexington Ave. Piqua, Ohio 45356-0603 Mansfield, Ohio 44907-2674 Ph: (513) 773-2442 Ph: (419) 774-1511 Fax: (513) 773-2238 Fax: (419) 774-1530 ■■■■■■■■■■■■■■■■■■■Ws■■■■■■■■■■■■■■ STANDARD - ■■■■■■■■■■■■■■■■■■■II■■■■■■■■■■■■■■■ SIZE ■■■■■■■■■■■■■■■■■■■'/■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■I■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■ll■■■■■■■■■■■■■■■■Pump HP Imp. 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Box 603 Piqua, Ohio 45356-0603 Ph: (513) 773-2442 Fax: (513) 773-2238 SECTION 6A PAGE 3 DATE 7/93 REPLACES 7/90 Specifications: ENCLOSURE: NEMA 3R Raintight, Outdoor Mounting G-90 Galvanized Steel, Gray Polyester Powder Finish, Door Gasket for RAINTIGHT Outdoor use, Padlockable Draw -Pull Latches, Panel Drilled and Tapped, Machine Screw Mounted Componets. CIRCUIT BREAKER: For Short Circuit Protection STARTER: Electromechanical OVERLOAD RELAY: Bimetal Type, Ambient Compensated HEATER ELEMENT: Class 10 Quick Trip, One Heater for Each Motor Phase. SWITCH: Hand -Off -Automatic, 1/2 Inch NEMA 1 LIGHT: Pump Motor Run, 1/2 Inch NEMA 1 SUB PLATE: Switch and Light Mounting TRANSFORMER: For 115 Volt Control on 3 Phase FUSE: Control Transformer Primary When Used. Meet Requirements of NEC. FUSE: Control Circuit, Meet Requirements of NEC. TERMINAL STRIP: Box Lugs for Customer Wring WIRING: Color Coded to NEC Requirements; Black Power Wiring Red Numbered Control Wring White Numbered Neutral Wiring Green Ground Wiring ALTERNATOR: For Duplex ONLY, Automatic. Available in Sizes for .5 HP to 15 HP, 115 and 230 Volt AC, 1- Phase. .5HP to 200HP, 200, 230, 460 and 575 Volt AC, 3- Phase. All 230 volt panels are stamped "200/230 volts" and may be used throughout this voltage range. All components are "UL" Listed. NOTES: 4.5 and 7.5 horsepower single phase panels are designed for use with Barnes Pumps special single phase models, 4SE4526L, 4SE4526HL, 4SE4524L, 4SE7524L & 4SE7524HL. Optional Equipment Available See Pages 15 thru 20. UL 508 Label.on Request. Barnes Pumps, Inc. Bid -To -Spec & Project Sales 1485 Lexington Ave. Mansfield, Ohio 44907-2674 Ph: (419) 774-1511 Fax: (419) 774-1530 SECTION 6A PAGE 4 DATE 7/93 REPLACES 8/87 CRANE PUMPS & SYSTEMS Barnes Pumps, Inc. Distributor Sales & Service Dept. 420 Third Street/P.O. Box 603 Piqua, Ohio 45356-0603 Ph: (513) 773-2442 Fax: (513) 773-2238 Barnes Pumps, Inc. Bid -To -Spec & Project Sales 1485 Lexington Ave. Mansfield, Ohio 44907-2674 Ph: (419) 774-1511 Fax: (419) 774-1530 -'1 D -------A ----------------------i POWs, INC I 1 I r ---------- � H M A ' B I 1 I L C Enclosure Size Mounting Dimensions Part No. HP PH Volts Wt AxBxC DxHxM 6 .5 1 115 15 14x12 x6 4 x 16.12 x 15.12 065401 .5,.75 1 230 15 14x12x6 4 x 16.12 x 15.12 065402 1.0, 1.5 1 230 20 14 x 12 x 6 4 x 16.12 x 15.12 065403 1.9, 2,2.8,3,3.7 1 230 30 14 x 12 x 6 4 x 16.12 x 15.12 065404 4.5 1 230 40 20 x 16 x 6 4 x 22.31 x 21.31 065405 7.5 1 230 50 20 x 16 x 6 4 x 22.31 x 21.31 065407 .5 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065408 .75 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065409 1.0 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065410 1.5 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065411 2.0 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065412 3.0 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065413 5.0 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065414 7.5 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 065415 10.0 3 200-230 28 16 x 12 x 6 4 x 18.12 x 17.12 068009 15.0 3 200-230 29, 20 x 16 x 8 13 x 22.25 x 21.25 068010 20.0 3 200-230 34 20 x 16 x 8 13 x 22.25 x 21.25 068011 25.0 3 200-230 34 20 x 16 x 8 13 x 22.25 x 21.25 068012 30.0 3 200-230 39 24 x 20 x 8 13 x 26.25 x 25.25 068013 40.0 3 200-230 46 24 x 20 x 8 13 x 26.25 x 25.25 065422 .5 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065423 .75 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065424 1.0 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065425 1.5 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065426 2.0 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065427 3.0 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065428 5.0 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 065429 7.5 3 460 28 16 x 12 x 6 4 x 18.12 x 17.12 CRANE PUMPS & SYSTEMS Barnes Pumps, Inc. Distributor Sales & Service Dept. 420 Third Street/P.O. Box 603 Piqua, Ohio 45356-0603 Ph: (513) 773-2442 Fax: (513) 773-2238 Barnes Pumps, Inc. Bid -To -Spec & Project Sales 1485 Lexington Ave. Mansfield, Ohio 44907-2674 Ph: (419) 774-1511 Fax: (419) 774-1530 BARNES®ALARMS Wall Mounted P/N: 061486 FOR INDOOR USE ONLY. P/N:061487 FOR IN ORUSE ONLY. SECTION 6A PAGE 43 DATE 7/93 REPLACES 10/85 Specifications: 061486 High Water Alarm includes stainless steel wall plate with red jewel light and one mercury level control with 10 ft. of 18/2 cord. 2.75 2 HOLES FOR 6-32 x 1/4 SCREWS 061487 High Water Alarm (Solid State) includes stainless steel wall plate, audible and visual alarm with silencer button and one mercury level control with 10 ft. of 18/2 cord. 4.56 I �— —49 3.28 4.50 ® ®- 1.81 CRANE PUMPS & SYSTEMS Barnes Pumps, Inc Barnes Pumps, Inc. Distributor Sales & Service Dept. Bid -To -Spec & Project Sales 420 Third Street/P.O. Box 603 1485 Lexington Ave. Piqua, Ohio 45356-0603 Mansfield, Ohio 44907-2674 Ph: (513) 773-2442 Ph: (419) 774-1511 Fax: (513) 773-2238 Fax: (419) 774-1530 w July 31, 2002. Joseph J. Serwatka, P.E. 31 Kendrick Street Lawrence, MA 01841 (978) 683-6595`'�'�p�� Mr. John L. Noonan, P.L.S., P.E. Noonan & McDowell, Inc. 25 Bridge Street, Suite 6 Billerica, MA 01821-1023 Re: 206 Forest Street Revised Septic Plan 1 % 7 06�6-'-B .7-- ev<7/et;-V/trk"", Dear John: I am in receipt of your June 26, 2002 review letter. Unfortunately, the Town forgot to send me a copy until I called them today. Anyway, I have revised the plan and calculations per your comments. It appears from your comments that you did not receive the original set of pump calcs and specs. I have revised the plans as follows: 1. The variance request is now on the plan. 2. A note is on the plan regarding water supplies and wells. 3. All gravity piping is listed as SCH 40. 4. The field has been raised to be 4' above groundwater at the highest ground elevation. 5. The notation has been added regarding joints. 6. Pipe type and slope is shown to pump chamber. 7. Gas baffle is now specified. 8. Notation for 12" max, distance has been added to tees. 9. Notation for risers has been added. 10. Notation for max. depth on tank has been added. 11. Alarm float has been lowered. 12. Pump control catalog cut has been added to the pump specs. 13. Alarm spec has been added to the specs. 14. Pump curve has been added. 15. Manual switch for pump has been specified. 16. Max. depth on pump chamber has been added. 17. Note 13 has been revised. 18. The flow rate in all orifices is the same. This is evidenced by equal head at each lateral during testing and my own observations. 19. Orifices have been revised to 5 & 7 O'clock. 20. Note has been added regarding forcemain into manifold. 21. Note has been added to waterline. Should you have any questions concerning this letter, please contact me. Sincerely, Jo ph J. Serwatka, P.E. a' NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm gconversent.net June 26, 2002 Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/068A 206 Forest Street Assessors Map 106A, Lot 107 Dear Members of the Board, Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated: May 17, 2002, by: Joseph J. Serwatka. It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health `By -Laws" if the following is addressed: v�List variance request for setback from wetlands. 220(4)P Identify the presence or lack -of surface water supplies within 400 -ft public wells within 250 - ft and private wells within 150 -ft. 220(4) &,3<ldentify all gravity piping as schedule 40. NA 10.01 —> 4) Revise bottom of stone in leaching field to highest ground grade offset to water table. 161.4 Provide a notation that all joints in septic tank and pump chamber are to be grouted. Provide pipe type and slope from septic tank to pump chamber. /,--7) Add gas baffle to septic tank detail. 227(4) k,8) Add notation for 12 -in max distance to tees in septic tank. �) Add notation for riser to within 6 -in of final grade for septic tank. 228(2) //r0) Add notation for maximum depth below grade is 36 in to top of septic tank. 221(7) 11) Lower alarm float to 0.5 + above pump on float. The existing elevation will rise within the inlet pipe. c -"'*l 2) Pump controls shall be specified. 220(4)(r) SO4 °.v L/" 13) Specify alarm type and location. 231(2) & (9) Land Surveyors Civil Engineers Environmental Planners VI Provide plot of head loss performance curve for various discharges on pumpperformance graph. C45) Specify manual switch for pump. NA 12.01 V-'(6) Add maximum depth below grade is 36 -in to top of pump chamber. 221(7) 7) Revise note 13 to indicate a 2% minimum grade. 18) For design given provide flow rate at first orifice and last orifice in same lateral. This should be equal or less than 10% of flow. Vf9) Pressure guidance policy suggested that orifices should not by oriented directly downward. Please provide a detail showing orifices at 5 & 7 o'clock. cA20) Show forcemain connecting to manifold in center. /21) Identify water line as either pressure or suction. Respectfully, John L. Noonan, P.L.S.-P.E. F:/Office/boh/ 1770068A. doc Land Surveyors Civil Engineers Environmental Planners 2 APR -16-2002 02:47 PM JOSEPH J. SERWATKA 1 978 683 6595 P.01 Joseph J. Serwatka, P.E. 31 Kendrick Street Lawrence, MA 01841 (978) 683-6399 April 15, 2002 Ms. Sandra Starr, Health Director Town of North Andover 27 Charies Street North Andover, MA 01845 Re: 206 Forest Street Septic Variance Dear Ms. Starr: I am sending you this letter to get some guidance on a septic design which will require a variance from the wetlands setback. Prior to spending the effort of preparing a plan and my client's money, I would like some reasonable assurance that the proposed design and variance request will be acceptable to the Board of Health. The Board's potential actions will affect the long term use of the property and my client's plans. The existing three bedroom dwelling located at 206 Forest Street has a well in the front yard and the septic system in the backyard. The existing (functioning, but would need to be upgraded to accommodate expansion) septic system is about 110' from the well, but one of the existing leach pits is only about 50' from the wetlands to the rear of the property. A wetlands replication area was created on land to the north of my client's property several years ago that moved the buffer zone 30-40 feet fiuther onto my client's property, My client would like to add onto the rear of the house by about 8 feet to make room for an senior parent. (I would be able to provide you with expansion plans if you request) The existing house has three bedrooms, and the expanded house would have four bedrooms. Whether my client does a straight septic repair with no addition, or a septic system with the addition, the setback to the wetlands would be about 80-85 feet to the wetlands on my client's property, and about 60-70 feet to the replication area on the adjacent property (note that this would have been over 100 feet prior to the replication area being constructed). The setback to the well would remain at about 110' in either case. In both cases, the existing leach pit about 50' from the wetlands would be removed. While conducting soil testing with your consultant, Mr. Noonan, I mentioned all of these facts, and the more suitable location was judged to be the back yard with a variance. We both felt that putting the system in the front yard would make it difficult or impossible to access the existing garage, because the system would have to be raised to accommodate the water table. It also appears that knobs of ledge exist on each side of the front yard. In summary, my client would like some reasonable assurance that if he submits a plan for a new septic system to accommodate the expanded dwelling with a variance to APR -16-2002 02:47 PM JOSEPH J. SERWATKA 1 978 683 6595 P.02 r , the wetlands setback, that the variance would be granted. Otherwise, he would like to know at this point that the expansion plans are not possible. Please get back to me at your convenience. Should you have any questions concerning this letter, please contact me. Sincerely, oseph I Serwatka, P.E. cc: Douglas Beach andover consultants 1 East River Place inc. Methuen, Massachusetts 01844 Tel. (978) 687-3828 Fax (978) 686-5100 April 20, 1999 Town of North Andover Health Department 30 School Street North Andover, MA 01845 Re: Subsurface Sewage Disposal Plans Lots A & C Forest Street To the Board of Health: Enclosed are four copies each of proposed subsurface sewage disposal plans for Lots A and C, Forest Street. These plans are being filed on behalf of the applicant, Gerard E. Welch Inc. Also enclosed are the soil evaluator forms, two application forms and two checks for $125.00. Please put these two lots on the agenda for the Board of Health meeting on April 28, 1999. If you have any questions, please contact me at 687-3828. Sincerely, ANDOVER CONSULTANTS INC. David R. Jordan, P.E., P.L.S. Vice President Civil Engineers 9 Land Surveyors 9 Land Planners andovar consultants inc. May 12, 1999 Ms. Sandra Starr, R.S. Town of North Andover Board of Health 27 Charles Street N. Andover, MA 01845 RE: Proposed Septic System Plans Lots A and C Forest Street Dear Ms. Starr: 1 East River Place Methuen, Massachusetts 01844 Tel. (978) 687-3828 Fax (978) 686-5100 Enclosed are revised plans for the proposed septic systems at Lot A and Lot C Forest Street (Map 105D, Lots 39&71). The following revisions have been made in response to your comments in your letter dated May 7, 1999: 1. For both lots, the distribution box detail has been revised to show a 6" crushed stone base. 2. The location of the trenches on Lot C has been changed so that the bottom of the trench is at least 4' above the groundwater. If you have any questions, please feel free to call me. Sincerely, ANDOVER CONSULTANTS INC. David R. Jordan, P.E., P.L.S. Vice President 7Q'•A/�1 OF Civil Engineers • Land Surveyors 9 Land Planners May -26-99 12:39P Paul D. Turbide, PE/PLS May 26, 1999 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 508-465-0313 P.02 RE: Title V second review (revised) for Lot C Forest Street (Map 105d Lot 71) Dear Sandra, Enclosed find the "Checklist for North Andover Septic System Plans" for the above- mentioned site. The following is a personal observation. • 310 CMR 247(2) states that a minimum of 2" of 118 to % inch stone is to be placed on the top of the leaching bed. The plan design calls for a layer of untreated building paper to be laid on top of this stone. There is no regulation that I could find that allows untreated building paper to be laid over the peastone, and therefore I would recommend that the untreated building paper be removed from the design. If you have any questions or comments please feel free to contact me. Sincerely Carlton A. Brown, PE/PLS Forest 105d-7 Ldoc PORT ENGINEERING Civil Engineers & Land Surveyors One Harris Street Newburyport, MA 01950 (978) 465-8594 03{19!1999 11:21 50SS899937 GERARD PAGE 02 '�4 m1,L f 7 /'?f I /-- 6e.)2 $' � D- 6( f 1 SEPTIC PLAN SUBMITTAL FORM LOCATION: f .. NEW PLANS: YES $160.00/Plan REVISED'ANS: YES $ 60.00/Plan SITE EVALUATION FORINTS INCLUDED: YES NO DATE: DESIGN ENGINEER: DATE TO CONSULTANT: g /g Ing, When the submission is all in place, route to the Health Secretary. SEPTIC PLAN SUBMITTAL FORM LOCATION: NEW PLANS: =S $160.00/Plan C/ REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: NO DATE: 6 -C�D —Za `2 DESIGN ENGINEER: DATE TO CONSULTANT: When the submission is all in place, route to the Health Secretary. H Town of North Andover, Massachusetts Form No. z NORT1yBOARD OF HEALTH ,ti ._ ' 3: - , o0 a o AL DESIGN APPROVAL FOR aSACHUSEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant. ,�}�CTJ Test No. ,/ 12, Site Location Reference Pla Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. Fee Fee CHAIRMAN, BOARD OF HEALTH ------ Site System Permit No. C INSPECTION CHECKLIST FOR SEPTIC SYSTEMS Yes NO Initials A. Bottom of Bed 1. Excavation to prW er depth 2. With trenches, sides of excavation at* beneath s horizon 3. (Edge ofcxcaavation .specified distance from foundation, etc. Commurts:,, 0 �f,,� g3(cf �J✓"� E. ,Rttaining Wall 1. Watt height and width as specified 2. WawWooled - 3. Wali mormaum I0' to leaching facility 4. wail meets specifications of plan Comments: C. Building Sewer i. Pipe diameter minimum 4- I. L cM 2. Scbeduk 40 pipe r/ 3. Watertight joints _ v' -- 4. Inlet to tank cemented V` 5. Slope minhu n 0.01 or 118" per foot minimum 7. Inlet tee minimum 12" ander invert b. pipe property set an compact firm base ✓ - _ 7. Ripe laid on contimious grade itr straight line 10. Air space 3" above tees S. Cleanouts precede all change in alignment and grade 9. Manholes at any 90' wage 13. Compact base with 6" of'/." crushed stone udder tank 10. 10' minimwn offset to water rare Comments: 0- Septic Tank I. L cM 2. 1,500 gal minimum r` 3. Gas battle present onoutlet i 4. Manhole to grade V-1_ 5. Iulanholes over center and each tee V` 6. 3-20" manholes L" 7. Inlet tee minimum 12" ander invert L/ 8. Outlet tee min ri Wunder invert ./ 9. Outlet tine rented sJ 10. Air space 3" above tees 11. 2" -- 3" drop f om inlet to outlet 12. pipe set c/ 13. Compact base with 6" of'/." crushed stone udder tank 14. Tank is watertight J roliltFtc IqN Comments; ;;;0?ifkWl� 6 tE#III PRO -1 M / f r - Yes NO E. Pump Chgmber 1. if sepame fam tank, compact base with 6" of/," stone underneath 2. Minimum 2" pipe to d -box if gravity system 3. 20" access manhole - 4. Tank level t )1�� R+4oltol 5. watertight _ 6. Tank size agrees with plan specification 7. Manhole to grade 8. Chetic valve and bleeder hole present k f 9. Alarm in budding on separate circuit 10. Alarm ferncdons It. Manual open ting switch r t I2 Pump delivers liquid to d -box _rJ� Comments: --- �� P a lN;r,�+� CION&j F. Distribuf m Box 1. D -lox level 2.. mhairnurn o. i r (27') +trap from inlet to outlet - 3. Minimum G'swap 4. outlet pipes show ecpwl distribution 5. Compact base with S' ofstone beneath box i r v 6. Box is watertight/jl 7. All lines cemented with hydmulic cement 8. Schedule 40 pipe Comments: 0. Soil Absorption systeaaa 1. All stone do able -washed - V -1 'l:" ✓�- - pea stone ✓ Bucket teat done? ✓ 2.. Minimum. 2" of pea stone above distrib Won lines e% I Minimum 6" store: beneath pipe 4. Distribution lines upped or connected together 5. Grading mew 3:1 slope 6. Minimum of 9" of fill graded over system 7. Tot: ofslope strops mittirnum 5' franc edge of p vperty; ifnot, then swale. Comments: l fee* (f6j-,3, iY Ott e-tvy r xv - K Leach Trenches I. Minimum 2 trenches 2. Length of trenches agree with plan. (ax. terga 1W) _ - 3. width of tri agree with plan - Minimum 2', mucimuaa - 4. 4. Vent present if <50 feet or specified 5. Distance between trenches minimum 4' and maximum of 6' 6. Minimum distance between trenches 10' 7. pipe: slope minhoum 0.045 or 0" per 100' 8. Depth oftreudres blow outlet invert minimum of 6". ?".6-F:I&�Ir c F Yes NO 9. Pipes set on stable hese. Comments: L Lesch Field 1. Maximum length of field 100' 2. Pipe slope minim= 0.005 or 6" per 100' 3. Separation between pipe 6' maximum 4- Pres connecters at end 5. Separation between adjacent fields 10' minimum 6. Pipes set an stable: base ✓ 7. Maximum 4' separation fruit edge of field to first shoe it & Minimum two dim -Moo lines 9. Maximum pert rate 20 nnpi COM MOM qhf ?� �/ evY 01 I Leaching Pits 1. Minimum mitt pipe 4" 2. nits ofco ncreto 3. Siderwall between 12" and 48" wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement K. Final Grade 1. Slope over soil absorption rystern minimum 0.02 2. All system components covered by at least 9" soil 3. Cover soil five of stones lww dm 6" 4. Grassing slopes away from dwelling _ .5. No arms rivet' system that may pond NOONAN & Mc DOWELL, INC. 25 Bridge Street, Suite 6, 'Billerica, MA 01821-1023 Voice (978) 667-9736 Fax (978) 671-9565 Email: nm@netway.com. Date Z� Town of North Andover Office of the Health Department Community Development and Services Division 27 Charles Street North Andover, MA- 01845 RE: Subsurface Sewage Disposal System Plan Review, 1770/ e,* /3eev�- c cfi S T Assessors Map , Lot l0 7 Dear Members of the Board, Please be advised that Noonan & McDowell, Inc. has reviewed the plan dated 7 -- by y o E" - It is our opinion that the proposed design will meet the requirements of Title 5 and the North Andover Board of Health "By -Laws" if the following is addressed: l � 4-15 T v im✓ C 67— �--� ✓*�_s r- z -Z !7 14. 01 l� S w i Tisa �--i 2zo l¢/� / ;C,:P- 17- �X--- - - - „ - ___�> /"P&­�T�A' 7-0 Respectfully, �� ak-ev> v- 1%,-5 f -e7. 7S y A 47, 471 � ,6= s TQC � ✓� E. �`� c>y/ry e i�>� S' = ! 7-q .� G> �,zv v �� � �-- ✓vim T.�- ,rf� �v r—i1=�`T L�- c- c_ fiT{-✓ i" T S i "v John L. Noonan, P.L.S.-P.E. F'l/i`>r�' G11�'�s2 G: offic e/forms/tonarev ;7) P- - 7� 7:;;�' /A,- 0 z Land Surveyors Civil Engineers Environmental Planners Y) " -12 /2 1Z / f / I -- 7 E � 7 -0 r % TO d12 7-1 / `C _� /SEI G� � TiY/•✓ %?/� A-V z -Z 72NP 04z s �`j� ,! �` 4i /�G i4 0 GK'S T c:— ez— ry Alter P��i �� L-Elof Lo � t4T4-9 Jr 7- G K c, s A,, j/J�iy 4-ov- .r- r.- T, -res c�1 S/yove--v .,iv T Orte— 7-5a5:;P D i, -c t:E;-- c7-cr`/ prt//=/c5- 7 cco c Hca � s 7-0 � S A/ / �'cti'f s'=�t✓.,rt I` r ,�'i ...A l �"�' �^�...+.i .v �� 'a-,n� L= T`'Ci . S �� C�'�%�X n d CHECKLIST FOR NORTH ANDOVER SEPTIC SYSTEM PLANS N & M Job 1770/ �% � C� �' The following is a checklist that incorporates all Title 5 and local regulations for septic plans. Name of 'Applicant: .e5 -, C/ i Name of Designer: Plan Date: % Revision Date: Date of Review: Property Address: 2 n /=Qk-- 65- s 7- s % Map:/64� Lot: BOH Reviewer: Type of Plan (new o pgrade) Number of Bedrooms in Assessor's Records: gpd) Garbage Disposal Allowed:/ General Information: N.A. = North Andover Septic Regulations Other numbers refer to Title 5 OK Pyr blem N/A _� Street number and map/lot - 220(4)(u) �- Maximum scale of 1 "=40' for plot plan - 220(4) Maximum scale of 1 "=20' for profile and component details - 220(4) !/ Legal boundaries of the facility being served - 220(4)(a) Names of abutters from recent tax map - NA 8.02j _ Number of bedrooms, design calcs., - NA 8.02i Name & address of record owner & applicant - NA 8.02k Name & address of designer - NA 8.021 Holder and location of all easements - 220(4)(b) �— Date plan drawn & any revision date - NA 8.02m All dwellings and buildings, existing and proposed - 220(4)(c) Location of all existing or proposed impervious areas - 220(4)(d) All distances on site plan - NA 8.03a -c Elevation of proposed driveway - NA 8.02t Location and elevation of foundation drain - NA 8.02y Location and dimensions of the system incl. reserve (new const.) - 220(4)(e) Limits of excavation of leach area on site plan - NA 8.02z 1�~ Locus plan - 220(4)(t) (Not to scale) North arrow - 220(4)(g) Existing and proposed contours - 220(4)(g) t / Locations and logs of deep holes - 220(4)(h) Locations and logs of percolation tests - 220(4)(i) Date(s) of soil testing - 220(4)(h) & (i) ��---- Existing grade elevation of each deep hole - 220(4)(h) Elevation of percolation tests - N.A. 8.02n ��- Name of approving authority representative - 220(4)(h) & (i) Name of soil evaluator - 220(4)0) Soil logs and perc test logs match BOH records -^ Locations of waterlines, drains, and subsurface utilities - 220(4)(m) Observed and adjusted g.w. elevation in the vicinity of the system - 220(4)(n) �- Complete profile of the system to scale - 220(4)(o), NA 8.02c `�- Cross section of leaching facility - NA 8.02w (Not to scale) ` Location of benchmark(s) within 50-75 feet of facility - 220(4)(q) Note listing all variance requests with proper citations - 220(4)(p) Local upgrade approval request form submitted = 403(l) Original R.S./P.E. stamp, signature & date - 220(1) & (2) If P.E., discipline specified within stamp. MGL C. 112 s. 81M sfc. supplies (w/in 400'), pub. wells (w/in 250'), pvt. wells (w/in 150') - 220(4)( Location of watercourses, wetlands, wells, etc. Win 150' of system - NA 8.02r Wetland disclaimer - NA 8.02s ( RLS plan reference & certification required (prop line setbacks) - 220(3) Use approvals / standards checked for UA system - DEP docs., 2 Perc rate >30 MPI - not allowed for new, LUA for upgrade - 245(1)&('3) Perc rate > 60 MPI - must use modified tight tank or UA technology - 245(4) Proposed system qualifies as "shared" system - 002 (definitions) Flow is over 2,000 gpd - No R.S. allowed - 220(1) 1 Design flow was set in accordance with code - 203 39} Existing system location and note on proper abandonment - 354 Leaching facility at least 1' above Base Flood elevation — NA 9.05 —�_ All piping Sch 40 minimum — NA 10.01 Basement floor minimum 1' above groundwater elevation — NA 5.04 Foundation drain present with elevation — NA 8.02y On-site Soil and Groundwater Review OK Problem N/A Proper deep observation hole logs on plan - 220(4)(h) All deep holes and peres shown, including aborted tests — NA 8.02n �� ( Soil evaluation forms submitted within 60 days of field work - 018(2) r Proper percolation test log - 220(4)(i) Ample deep observation holes in primary disposal area (minimum 2) - 102(2) ll \ QQ1 ��j Ample deep observation holes in secondary disposal area (minimum 2) - 102(2) �n1 / Ample perc testing (one in each disposal area, 3 in prim. > 2,000 gpd) - 104(4) V4 Deep hole testing conducted within two years.— NA 7.05 Hole Identification Numbers: ground elevation el. acceptable soil el. Leach facilitv invert el. ground water el. C�- refusal el. bottom of leach facility el. Cl thickness of acceptable soil before & after soil R&R ."'separation to groundwater / separation to refusal e— soil class w perc rate loading rate �• septic tank below g.w. table (yes or no) pump tank below g.w. table y (yes or no) l.f in fill `t/ -255(l) Setback Distances (Given in feet) 15.21 1 YES NO Is the lot in the Lake Cochiewick Watershed? NA 6.00 & 5.02 OK Problem N/A G� Septic Tank Leach Facility I Property line 10 10 t/ Cellar wall 10 20 7 n Downhill slope , 15' to 3:1 slope w/o barrier Building Sewer Inground pool 10 20 Slab foundation 10 10 _ Deck, on footings, etc. 5 10 f 325 325 2 Waterline 10 10 Reservoirs 400 400 Invert elevation at building: Tributaries to reservoirs Private drinking well 75 100 Drains (wat. supply/trib.) Irrigation well 75 100 ►F� Wetlands 75 100 Downhill slope , 15' to 3:1 slope w/o barrier Building Sewer Public well 400 400 Wetlands bordering surface 150 150 _ water Supply or Crib. (in Watershed) t� Pipe cast iron or Sch 40 PVC - NA 11.02 Watertight joints specified - 222(3) & (4) Trib. To Surface Water supply 325 325 2 Cleanouts precede all changes in alignment and grade - 222(8) Cleanout provided every 100 feet - 222(8) Reservoirs 400 400 Invert elevation at building: Tributaries to reservoirs 200 200 Length of run: Drains (wat. supply/trib.) 50 100 C-'- Drains (intercept g.w.) 25 50 Foundation drains 10 20 Drains (Other) 5 10 Drywells 20 25 Downhill slope , 15' to 3:1 slope w/o barrier Building Sewer OK Problem N/A Grease trap required for certain uses (check 230 for details) ,4' Pipe diameter listed (4" minimum) - 222(1) _ Pipe schedule listed - 222(3) t� Pipe cast iron or Sch 40 PVC - NA 11.02 Watertight joints specified - 222(3) & (4) Pipe laid on compact, fin base - 222(5) Pipe laid on continuous grade in straight line - 222(7)@ Cleanouts precede all changes in alignment and grade - 222(8) Cleanout provided every 100 feet - 222(8) Manhole at any 90 degree alignment change - 222(8) e Invert elevation at building: Invert elevation at septic tank: r/ Length of run: (minimum of 0.01 - 0.02 desired) - 222(6) C ---Slope: 10' offset to private well or suction line - 222(2) 3 3 Septic Tank OK Problem N/A Tank is accessible - 228(3) No structures above tank — (228(3) Tank can accommodate both primary & reserve — NA 9.04 200% of flow (required & provided given. 1500 min.) - 220(4)(f) & 223)(1)(a) 2-3" drop from inlet to outlet - 227(5) Minimum of 4' liquid depth - 223(2) 3" air space above tees/baffles (minimum) - 227(4) 9"air space above flow line (minimum) - 227(4) Tees are not to be replaced by baffles - 227(1) Tees extend 6" above flow line - 227(1) Inlet tee extends 10" below flow line (minimum) - 227(6) Outlet tee extends 14" below flow line (more for deeper tanks) - 227(6) Gas baffle installed on outlet - 227(4) Access manhole cover above center of tank & each tee (except 2 compart) 228(2) 3-20" manholes - 228(2) 1 childproof, 24" riser/manhole Win 6" of final grade if <1000gpd- 228(2) Inlet and outlet tees on center line - 227(1) Soil compaction below tank specified (if soil is non-native) - 221(2) 6" of <=3/4"stone beneath tank specified - 221(2) & 22 8(1) If > 1,000 gpd AND not a single fam. dwell. must be 2 tks or 2 comp. - 223(1)(b) If plan specifies disposal must be 2 tanks in series or 2 compart. tank - 223(1)(c) Buoyancy calcs. required if tank at or below water table - 221(8) Tank is watertight - 221 (1) 9" of cover over tank (minimum) - 228(1) H- 10 loading (min.) - H-20 if traffic - 226(3) Top of tank <=36" below grade - 221(7) All pumping to tank (if applies) in accordance with - 229 Tank is set to keep old system in service during install if possible Distribution Box (Check here if not present: 1 OK Problem N/A Inlet elevation: Outlet elevation: 0.17' drop fr inlet to outlet (minimum) - 232(3)(b) 6" sum drop - 232(3)(e) utlets at same elevation - 232(3)(b) utlet pipes laid level for first 2 ft. - 232(3)(c) Pipe Sch 40 - NA 10.01 Number of outlets: Numbe aterals: Size of outlets: Inlet baffle/tee min. 1" ove tlet invert for all d -boxes - 232(3)(a), Soil compaction belo stribution box specified (if soil is non-nat' ZZj 6" of stone bene istribution box specified - 221(2) Box is wat - t - 221 (1) To ox <=36" below grade - 221(7) Buoyancy calculations required if b s at or below water table - 221(8) Pump Chamber (Check here if not present: ) OK Problem N/A Volume specified: 220(4)(r) y Pump on elevation- 220(4)(r) Pump off elevation: 220(4)(r) Alarm on elevation: 220(4)(r) Number of cycles per day - 220(4)(r) (also 254(1)(d) if gravity from d -box) ter- Minimum 2" delivery line to d -box if gravity - 254(1)( c) 4 4 0 D N Pressure dosed l.f. if flow >= 2,000 gpd - 254(1)(a) & 254(2)(a) Cycles per day is consistent with chamber volume - 23 1 Volume calculations include flowback volume - 2') 1(2) ✓ 24 hour storage capacity above pump on elevation - 231(2) Number of pumps: 2 if system serves >2 dwelling units - 231(6) Capacity of pump(s) - gpm @ ' TDH - 220(4)(r) Pump can pass 1 1/4 "solids (minimum) - 231(7) Pump controls specified - 220(4)(r) Z'3f Alarm equipment specified - 231(2) Alarm is in building and powered on separate circuit from pump - 1(9) Pump sequence correct (off -lead on -lag on-alan-n on) - 231(8) Pump performance curves included - 220(4)(r) Manual operating switch - NA 12.01 "Check valve, bleeder hole - NA 12.01 l lam/ 1 childproof, 24" riser/manhole to final grade - 2'31(5), ✓ Soil compaction beneath pump chamber specified (if soil is non-native) - 221(2) 6"of <=3/4"stone beneath chmbr. specified - 221(2) & 228(1), /? Buoyancy calculations if chamber is at or below water table - 221(8)@ 9" of cover over chamber (minimum) - 228(1) H- 10 loading (min.) - H-20 if traffic - 226(')), Chamber is watertight - 221 (1) Top of chamber <=36" below grade - 221(7) Leaching Facility (general - complete for all designs) OK Problem N/A 50% larger if garbage disposal - 240(4) -=--� Trenches to be used whenever possible - 240(6) No vehicle or imperv. area above l.f. unless unavoidable - 240(7); NA 13.02 Vented if under impervious cover - 241 (1) -�— Vented through same pipes as distribution system - 241 (1)(a) -- Vent protected from precipitation/animal entry - 241 (1)(b) Vent is placed beyond traffic or impervious area - 24 1 (1)(c) "— All lines connected to vent if bed of trenches - 241(1)(d) 9" cover over peastone - 240(9) Reserve area provided (new construction) - 248(1) r-- Reserve 4' from primary leach area - NA 9.04 4' (5' if perc rate <=2 MPI) separation to g.w. - 212(a) & (b) 4' (down to T with variance or I/A - upgrades only) of natural soil under 11. GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005 - 251(9) Require 5' removal and replacement if in fill - 255(5) } <� - Top of leach facility <= 36" below grade - 221(7) J Final grade over l.f. minimum 0.02 ft/ft -240(10) Surface & subsurface drainage away from I.f. - 240(1 1) & 245(5) Minimum design flow 440 gpd without deed restriction - NA 13.01 3:1 slope where grading required - 255(2) f Toe of fill slope stops 5' from property line or swale installed - 255(2) Impermeable barrier if < 3:1 slope or < 15 feet to-3:1slope - 255(2) Impermeable barrier/retaining wall poured concrete - NA 9.02 Retaining wall stamped by P.E. - 255(2)(b) `—^ Top of retaining wall >= top of peastone elevation - 255(2)(f) 10' offset from edge of leach facility to edge of ret. wall - 255(2)(g) Perc test(s) done in most restrictive layer - 104(2) Perc test 4' below leaching elevation - NA 7.06 z�— Design flow listed and required/provided leach area given - 220(4)(f) Leach pipes SCH40 PVC - NA 10.01 Leach pipes minimum 4" diameter except for dosed system - NA 14.04 Leach lines capped, vented, or connected together - 251(9) Pressure dosing guidance followed if pressure distribution - 254(2)(c ), �' Pressure dosing required over 2,000 gpd or with I/A remedial use - 231(1) off, Leaching Trenches (Check here if not present: ) OK Problem N/A Number of trenches: Minimum of 2 trenche - NA 9.01(2) Depth of trenchesax eff. 2`): -247(l) Width of trench (2' min., 4' max.): - 251 (1)(b) Length of tre hes (100' max.): - 25 1 (1)(a) Trenches a vented (when > 50') - 251 (11) Trenc follow contour lines - 251(2) Tre spacing 3 times effective width or depth minim 251 (1)(d) I ill or reserve between trenches, 10' min. - NA 14 & 14.03 Available leach area given (Min. 500 s.f.) - NA�Q. 1(2) Bottom = L x W # — Sidewall = L x D C# x 2= Effective leach area given Loading factor: Effective area = total area s.f. x LTAR = Effective area is >= design`flow of facility being served 2"of 1/8"- 1/2" 2x washed peastone.- 247(2) Trench depth of 3/4" to 1 1/2" double washed stone - 247(1) 11-11 Leach Fields (Check here if not present: ) OK Problem N/A Final Grading OK Problem N/A 1� 5/24/01 s.f. ' s. f. g/day Number of fields: (need dosing chamber if > 1, 231 (1)) Length (100' max.): - 252 (2)(b) Width: Total area: L x W = s. f. Minimum 900 square feet - NA 9.01(1) Distribution lines connected with solid pipe — NA 15.01 Effective leach area given Loading factor: Effective area = total area s.f x LTAR = g/dav Effective area is >= design flow of facility being served Minimum of two distribution lines - 252(2)(a) 6line separation (max.) - 252(2)(d) 4' maximum separation from edge of field to line - 252(2)(e) 10' minimum separation between adjacent leach fields - 252(2)(f) Between 6" and 12" of 3/4 - 1 1/2" stone beneath field - 252(2)(g) & 247(2) 2"of 1/8"-1/2" 2x washed peastone.- 247(2) Slope over leach area minimum of 0.02 feet/foot — 240(10) Grading shall divert drainage away from leach area — 240(l 1) Grading slopes away from dwelling f./office/forms/tonackltr.doc I 6 0 Town of North Andover, Massachusetts Form No. 1 NORT{� BOARD OF HEALTH -; s -, - __ APPLICATION FOR SITE TESTING/INSPECTION Applic Site Location _ C t`y � Engineer Test/Inspection Date and Time -CHArRMAN, BOARD OF HEALTH Fee ZOQ Test No. /4—:3 --�21 S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. BOARD OF HEALTH - NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE:... J MAP & PARCEL:/o p LOCATION OF SOIL TESTS: E)AL' K-- V.Ag p �-' f��S OWNER: 0 f=r—C---Ef TEL. NO.: ADDRESS: ENGINEER: ZLS6 TEL. NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Single Family Home Is This: Repair Testing: In the Lake Cochichewick Watershed? Undeveloped lot testing: Yes Commercial No DEG 11 2001 THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of 1200.00 per lot for r___pairs or upgrades. (If time is not critical, fee for repairs is $75.00) GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, ,a scaled plan (no smaller than 1 "-100') shall be submitted to the Board of Health showing the location of all tests (including aborted tests). it, ,',a of NORTH AN -DQ* 7. Within 60 days of testing soil evaluation forms shall be submitted. BOARD of HEALTH Please Do Not Write Below This Line j MAR 6 2002 N.A. Conservation Commission Approval: 315-1d Z v v Date Received: G OZ Check Amount: A206 Check Date: J2 //f 161 0 FORM 11 - SOIL EVALUATOR FUR,%1 Palle 2 of -z e 17 7,5/ 0,0 8 �. U:,e— Location ,e—Location Address or Lot too- Zy 4 t . On-site Review _ j° 2 3 C0 Deep Hole Number ! Date: 3.- o °L- Time: / ' WeatherGGoyoyQ� Location (identify on site plan) Land UseT 'Z'� Slope M�' Surface Stones �yo,, Vegetation G ie- 5 r Landform Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way J�p`l feet Possible Wet Area deet Property Line _-_ feet Drinking Water Well /rte �- feet Other -- _'----..---_-- %r DEEP OBSERVATION •IliOLE LOGS Depth from Surface (inches) Soil Horizon Sol Texture (USDA) Sol Color !Munsell) Soil i Mottling Otfiet (Structure, Stones.16-iiders, Consistency, % (Graven a— 5 400o`// C" ,�1 �� �� ; -rr � ort �,�� 'f �S � � �'� �i f# / r�r 7! �; ',�,r G lila y Gf71S 4ilk f - Y Parent Material (geologic) f.a Oe�ORflBed<oc#'a r' d Depth to Groundwater: Standing Water in the Hole: Weeping from Pit face- Estimated Seasonal High Ground Water: 'l G DET APPROVED PORjM _ t2M7!!5 FORM 11 -SOIL EVALUATOR FOR11 I'age 2 of 3 %77vla, Location Address or Lot r4o. ZQ 6 1664_Zt�5T 77— A) 02 7i} - yv o.o VC--� On-site Review _ �—"!LG/"Z A i J C' Deep Hole Number Date: � Time: Weather d= t- 01-v / S0 Location (identify on site plan) Land Use '4 0 S)ope M Surface Stones eo 1/ Vegetation G +c A ✓ ,� Landform Position on landscape (sketch on the back) ..:_.. Distances from: )� Open Water Body �'-"' feet Drainage way'-;;,/ feet Possible Wet Area �' feet Property Line feet Drinking Water Well �2 ` ` feet Other f- o`"-A"v -7 - ry A 0 -- DEEP OBSERVATION HOLE LOGS Depth from Surface (Inches) Soil Horizon Sol Texture {USDA) Sol Color tMunsell) Sol Mottling Other (Structure, Stones, Soulders, Consistency, % Graved 4 -- �, r s-,�.�- � •��, . ; _ �- �� �-�..� fes_ 1 z Te 1 Parent Material (geologic) DaPd: Death to Groundwater Standing Water in the Hole: RoSed Weeping Iron Pit Face: -- Estimated Seasonal High Ground Water: Y F DEP APPROVED FORM - 0107195 I I _ FORM 12, - PERCOLATIO.N TEST. Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS ry o, -t riy 4 N O o vi. -7z , Massachusetts 'i - R13;1ate Min./Inch f.t Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed D'-�Site Failed ❑ Performed By: ------------------------------_........................ � r� Witnessed By: Comments:.. ,..:.:...._..._....:.. r....:.. DEP APMOYm *oar - umjps Percolation Test' Date: -..... ��' 4 /"-7— Time% Observation Hole # Depth of Perc �J o Start Pre-soak LIQ End Pre-soak Time at 12" v 79 -_i Time at 9 - w �l Time at 6"- S Time W-6") 'i - R13;1ate Min./Inch f.t Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed D'-�Site Failed ❑ Performed By: ------------------------------_........................ � r� Witnessed By: Comments:.. ,..:.:...._..._....:.. r....:.. DEP APMOYm *oar - umjps A FORM 11 - SOIL EVALUATOR FORM Page I of 3 F NORTH AND& " EOARD OF € EACI H JUN 19.2002 No. Date: Commonwealth �U- N0(2-rT--tq Massachusetts Soil Suitability. Assessment for On-site Sewage Disposal Performed By: . ',I!— ., . S 4�� ',,�J,- =;_=i- Date: -'3 2 2 - . Witnessed By: .......... I .. ................ . . L�tInn Add,"s Owmt*s Name' La Addrnz. &M Tekooml Jew construction M Repair X I Office Review Published Soil Survey Available: No ❑ Yes Year Published )q,5 I Publication Scale � 4 Soil Map Unit Drainage Class 6. - - Soil Limitations . ..... .......... ....... ........... . ....... .. .... ......... Surficial Geologic Report Available: No El Yes ❑ Year Published Publication Scale GeologicMaterial (Map Unit) ............................................................................................... ........................... ............................... Landform Flood Insurance Rate Map: Above 500 year flood boundary No E]Yes Within 500 year flood boundary No El Yes 0 Within 100 year flood boundary No OYes n Weiland Area: National Weiland Inventory Map (map unit)......_ . .................. ... Wetlands Conservancy Program Map (map unit) .................................. I ........................ ......... ......................... .. Current Water Resource Conditions (USGS): Month Range :Above Normal E]Normal OBelow Normal ❑ Other References Reviewed: kiDEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 location Address or Lot No. 4;,��.M.� f :tet`" —7— Opt-site Revie Deep Hole Number /-'`' l Date: - ; —Z92, Time: % P,611 , Location (identify on site plan) Land Use L fi `tit t4 Slope (%) Z� Surface Stones Vegetation�.,�� Landform Position on landscape (sketch on the back) Distances from: Open Water Body ' ; U 0 feet Drainage way >'•f�l � feet Possible Wet Area &0 feet Property Line Go feet Drinking Water Well ;i)c)0feet Other Weather • 0 a/ DEEP OBSERVATION HOLE LOG' k0eplh(f.,orn ce chesl Soil Horizon Soil Texture (USDA) Soil Color (Munselq Soil Mottling Other .Structure, Stones, Boulders, Consistency, % G(avel) pp Ii� i P .�2A Oz.s' 0 �^ ) *1 l �F •-•••••••••. ••• �• .w�.c.a ncu V,RCU NI tvtrli rnvrvatu u1JrvJAL~UZ./ Parent Material (geologic) 2- Z— DepVvD8eOrock: > Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Water: DU APPROVED FORM • 12/0755 FOR_%I 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.r�_a .. . Oji -site Review Deep Hole Number mow. Date: ;a Time: Location (identify on site plan) Land Use a '.I V s` 1"J Slope (%) Surface Stones Vegetation' Landform Position on landscape (sketch on the back) Distances from: Open Water Body —7 10O feet Drainage way -7 feet Possible Wet Area f feet Property Line feet Drinking Water Well -;�,. Meet Other Weather DEEP OBSERVATION HOLE LOG' Depth from Surface (Inchesl Soil Horizon Soil Texture (USDAI Soil Color (Munsell) Soil Mottling Other .Structure, Stones, Boulders, Consistency, % G(avel) • 1 • -C•:Ye'� mea.. � f.� i� (y} �F �,. � ,.,y�..1j e p • �� �' t� ".0 S/"i!pr raa C)v Parent Material (geologic) ,E , DePtvto6odrock- Death to Groundwater- Standing Water in the Hole: Weeping from Pit Face: Estimated Seasonal High Ground Wale(: , s f i DEP APPROVED FOPu%j - 12/0755 FORM 12 - PERCOLATION TEST Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test Date: Time: Observation Hole # Depth of Perc Start Pre-soak 141 End Pre-soak Time at 12" 2,7 Time at 9" Time at 6" Time (9"-6") Rate Min./Inchsf Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed F] ..................................................................................... ................................................... Performed By: Witnessed By: Q - � _1 tj Comments: wDEP APPROVED FORM - 12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole . inches ❑ Depth weeping from side of observation hole inches ,® Depth to soil mottles inches ❑ Ground water adjustment ................ feet Index Well Number ......... Reading Date ................ Index well level ... Adjustment factor Adjusted ground water level ..................................... Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification I certify that on �� / (date) I have Passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature -``` Date 2z4i DFP APPROVED FOPM - 12/07/95 P Zap. po . t4 L OTA � o S.T- To-ca.L OFA OR'.. AiMG. SOIA9D OF HEATH � DEC 1 1 200 � 1 Z Lo Ul e- V 1ul N 30. lA xls�- 71:,wrr 0:.1 32 . od �o' rn v � m �0 ao _GFT-"� �25.ZS'• - 92.�r,' S2(o'-21'-O5"E-52�.�-t• � _ 1Po.5a S'Lfa'3fo=0T"� - .cam G,q 4L. 15 PO lz E 6 T (WIt7T a`VA2lE15 T !� A