HomeMy WebLinkAboutMiscellaneous - 2060 TURNPIKE STREET 4/30/2018 (2)v A
vi
rt
ti
('f
QONSTRUCTIO.
HAS PLAN REVIEW FEE .BEEN PAID? YES NO
PLAN APPROVAL: DATE p_ P. BYC.
DESIGNER: ////(/CJ PLAN DAME. -�
CONDITIONS
d
WATER SUPPLY: TOWN WELL
WELL PERMIT DRILLER
WELL TESTS: CHEMICAL DA1 E APPROVED._IY
BACTERIA I DA f E f)PPRUVED
BACTERIA II DATE APPROVED
COMMENTS:
FORM U APPROVAL: APPROVAL TO ISSUE YES NO
DATE ISSUED r �oZ� �9"7 BY
CONDITIONS:
FINAL APPROVAL:.
ALL PERMITS PAID
YES
NO
WELL CONSTRUCTION
4.• It ^� r�'`'� t, �•
•
NU
.. � - l
^^�J`�'���3" [�
MAP #
OTHER
-h. # .
NU
q�s6��6 ANY VARIANCE NEEDED —
(,C�E� , rA�/Cw �•,r�
LOT
NO
-
PARCEL #
FINAL BOARD OF HEALTH
APPROVAL:
STAKE TT
.._ ....By:-.
QONSTRUCTIO.
HAS PLAN REVIEW FEE .BEEN PAID? YES NO
PLAN APPROVAL: DATE p_ P. BYC.
DESIGNER: ////(/CJ PLAN DAME. -�
CONDITIONS
d
WATER SUPPLY: TOWN WELL
WELL PERMIT DRILLER
WELL TESTS: CHEMICAL DA1 E APPROVED._IY
BACTERIA I DA f E f)PPRUVED
BACTERIA II DATE APPROVED
COMMENTS:
FORM U APPROVAL: APPROVAL TO ISSUE YES NO
DATE ISSUED r �oZ� �9"7 BY
CONDITIONS:
FINAL APPROVAL:.
ALL PERMITS PAID
YES
NO
WELL CONSTRUCTION
APPROVAL
YES
NU
SEPTIC SYSTEM CONSTRUCTION APPROVAL
YES
NO
OTHER
YES
NU
q�s6��6 ANY VARIANCE NEEDED —
(,C�E� , rA�/Cw �•,r�
YES
NO
,
FINAL BOARD OF HEALTH
APPROVAL:
DATE:. _,_......_
.._ ....By:-.
i r•>„i':�i L.l '. * A4 1 1
�X/ 1.' �
1. �<.
1 f' -. .'1 1 rT••', �.. � tY: J•
',,AS , THE INSTALLER LICENSED? `yet
NO .,
.• 1.•• f - .rM1� �n �. -. {n• / .1Ali � , ... f
.. _ '
TYPE. OF CONSTRUCTION: t' .--��
NEW REPAIR
,.
`REVIEW
CONSTRUCTION: , :.. CERTIFIED PLOT-PLAN
NO
'� ! j.i.; -i` "• " '' CONDITIONS OF:. APPROVAL
YES NO .
.. t !.
-- (FROM FORM U) ...
;'`F- ;i�� A 1 � , ;pal , y `�" ''::.. •}�:•'
f
... -
r ,r—ISSUANCE ~ OF DWC PERMIT _ • '.•
ES NO
DWC % •. INSTALLER:
PERMIT.NO.
� .,: :{.,..g' t .. .ate .• s:�.'!•,,":• ••• • '�; ,, - . '
BEGIN INSPECTION YE 0: - -'
EXCAVATION, INSPECTION: ;NEEDED:
PASSED HY
:-:CONSTRUCTION INSPECTION: NEEDEDt
-
;S ��"'?��9
A BUILT PLAN SATISFACTfli*.:•
1
•r :•:
APPROVAL TO BACKFILL: DATE: BY
FINAL.GRADING APPROVAL: DATE ' ! '1 BY
' FINAL CONSTRUCTION APPROVAL: DATE:
BY
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.
4:1
reaan
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner's Name
North Andover
City/Town
MA 01845 12-16-2010
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.
A. General Information
1. Inspector:
Michael J. Wood
Name of Inspector
Service Pumpin
Company Name
5 Hallberg Park
Company Address
North Reading
City/Town
978-276-0217
Telephone Number
& Drain Co.. Inc.
B. Certification
MA 01864
State Zip Code
5021
License Number
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
❑ Needs Further Evaluation by the Local Approving Authority
S
12-21-2010
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 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 - 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 1 of 17
0
MlMill
Owner
information is
required for every
page.
t5ins - 09/08
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner's Name
North Andover MA 01845 12-16-2010
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:
® 1 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):
Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 2 of 17
4 f
WI
Owner
information is
required for every
page.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner's Name
North Andover
Cityrrown
B. Certification (cont.)
B) System Conditionally Passes (cont.):
MA 01845
State Zip Code
12-16-2010
Date of Inspection
❑ 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
❑ obstruction is removed
❑ Y ❑ N ❑ ND (Explain below):
❑ 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 • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 3 of 17
Commonwealth of Massachusetts
w W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover MA 01845 12-16-2010
page. City/Town 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 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:
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 1/z day flow
t5ins • 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 4 of 17
Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
•''2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
nform
on
equine d fotifo is every
eNorth Andover MA 01845 12-16-2010
quire
age. City/Town 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:
El® Any portion of the SAS, cesspool or privy is below high ground water elevation.
E]® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
El® Any portion of a cesspool or privy is within a Zone 1 of a public well.
El® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
El® 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.]
i
p
❑ ® 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
❑
r
the system is within 200 feet of a tributary to a surface drinking water supply
❑
❑
the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area — IWPA) or a mapped Zone II of a public water supply well
❑ ® The 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 • 09108 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
•�''� 2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover
page. City/Town
C. Checklist
MA 01845
State Zip Code
12-16-2010
Date of Inspection
Check if the following have been done. You must indicate "yes" or "no" as to each of the following:
Yes No
®
❑
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
The size and location of the Soil Absorption System (SAS) on the site has
this inspection?
❑
®
Were as built plans of the system obtained and examined? (If they were not
® ❑
Determined in the field (if any of the failure criteria related to Part C is at issue
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.
® ❑
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): 440 gpd
t5ins - 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 6 of 17
3 '
Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,•�''t 2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover
page. City/Town
D. System Information
Description:
MA 01845
State Zip Code
12-16-2010
Date of Inspection
Number of current residents:
not occupied
Does residence have a garbage grinder?
❑ Yes
®
No
Is laundry on a separate sewage system? [if yes separate inspection required]
❑ Yes
®
No
Laundry system inspected?
❑ Yes
®
No
Seasonaluse?
❑ Yes
®
No
Water meter readings, if available last 2 ears usage d
9 ( Y 9 (gp ))�
N/A
Detail:
Sump pump?
❑ Yes
®
No
Last date of occupancy:
Approximately
June 2010
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203): Gallons per day (gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non -sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 7 of 17
Commonwealth of Massachusetts
u Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 2060 Turnpike Street
D. System Information (cont.)
Last date of occupancy/use:
Other (describe below):
Pumping Records:
Source of information:
MA
State
01845 12-16-2010
Zip Code Date of Inspection
General Information
Was system pumped as part of the inspection?
If yes, volume pumped:
How was quantity pumped determined?
Reason for pumping:
Date
1500
gallons
gauge on truck
maintenance/in
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 I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other (describe):
t5ins - 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 8 of 17
Property Address
Fannie Mae
Owner
Owner's Name
information is
required for every
North Andover
page.
Cityrrown
D. System Information (cont.)
Last date of occupancy/use:
Other (describe below):
Pumping Records:
Source of information:
MA
State
01845 12-16-2010
Zip Code Date of Inspection
General Information
Was system pumped as part of the inspection?
If yes, volume pumped:
How was quantity pumped determined?
Reason for pumping:
Date
1500
gallons
gauge on truck
maintenance/in
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 I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other (describe):
t5ins - 09108 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 Form - Not for Voluntary Assessments
M ,••�' 2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover
page. Cityrrown
D. System Information (cont.)
MA 01845 12-16-2010
State Zip Code Date of Inspection
Approximate age of all components, date installed (if known) and source of information:
System is original to the home which was built in 1998 according to contractor on site.
Were sewage odors detected when arriving at the site?
Building Sewer (locate on site plan):
Depth below grade:
Material of construction:
[I cast iron ® 40 PVC E] other (explain):
Distance from rivate water su I well ors tion lin
❑ Yes ® No
18"
feet
N/A
ppp y uc e. feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
no visible signs of failure
Septic Tank (locate on site plan):
Depth below grade:
Material of construction:
® concrete ❑ metal
13"
feet
❑ fiberglass ❑ polyethylene ❑ other (explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate)
Dimensions:
5'x5'x10'
Sludge depth:
❑ Yes ❑ No
t5ins • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 9 of 17
s
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover
page. City/Town
D. System Information (cont.)
Septic Tank (cont.)
MA 01845
State Zip Code
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
12-16-2010
Date of Inspection
> 2'
no scum
no scum
no scum
How were dimensions determined? 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.):
There were no visible signs of failure and both inlet and outlet tees are intact and working properly.
Grease Trap (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal
Dimensions:
Scum thickness
feet
❑ fiberglass ❑ polyethylene ❑ other (explain):
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:
t5ins • 09/06
Date
Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 10 of 17
Commonwealth of Massachusetts
u . Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover MA 01845 12-16-2010
page. Cityrrown 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:
gallons
❑ polyethylene ❑ other (explain):
gallons per day
❑ Yes ❑ No
Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
* Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins - 09108 Title 5 Official Inspection Form: 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 Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner's Name
North Andover MA 01845 12-16-2010
City/Town 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
0"
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.):
No visible signs of failure or 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.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System - Page 12 of 17
Commonwealth of Massachusetts
a W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover MA 01845 12-16-2010
page. Cityrrown 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
1, approx 40'x40'
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
No visible signs of failure.
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
t5ins • 09108
❑ Yes ❑ No
Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 13 of 17
• a
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
•�''
2060 Turnpike Street
Property Address
Fannie Mae
Owner
Owner's Name
information is
required for every
North Andover
page.
City/Town
D. System Information (cont.)
MA 01845 12-16-2010
State Zip Code Date of Inspection
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 • 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 14 of 17
• a
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover MA 01845 12-16-2010
page. 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:
t5ins • 09/08
® hand -sketch in the area below
❑ drawing attached separately
—t i aKi tv_s_ Siec;. —t
A. .
AD 303
$D 40B
E ) &g
Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 15 of 17
Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
2060 Turnpike Street
D. System Information (cont.)
Site Exam:
®
Property Address
®
Fannie Mae
Owner
Owner's Name
information is
required for every
North Andover
page.
City/Town
D. System Information (cont.)
Site Exam:
®
Check Slope
®
Surface water
®
Check cellar
®
Shallow wells
KAA A4QAC
12-16-2010
Date of Inspection
Estimated depth to high ground water: >8
feet
Please indicate all methods used to determine the high ground water elevation:
no
O
Obtained from system design plans on record
If checked, date of design plan reviewed:
Date
Observed site (abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health - explain:
❑ Checked with local excavators, installers - (attach documentation)
❑ Accessed USGS database - explain:
You must describe how you established the high ground water elevation:
There is a surface water supply at the back right side of the property and is approximately 8' above
the surface of the water.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins • 09108 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 16 of 17
i ' e�
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
•'� 2060 Turnpike Street
Property Address
Fannie Mae
Owner Owner's Name
information is
required for every North Andover
page. Cityrrown
MA 01845 12-16-2010
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 - 09/08 Title 5 Official Inspection Form: Subsurface Sewage Disposal System • Page 17 of 17
7.1
1-4078
DEP. ha i D!ovId )hl�Ylo/rn ,..,. ,
oa ('.bn'I(Iod to r
` lh9 IOC 11 evbr(: C'/ nOJlln p, CIhO/ IA�rOrin� �. nprl
A. Facts In(orrrl on
,•a
M Still
�� m�;•: Clq/iprn
ell
CL)i
B,:P,umping Rekord
�. calio o! PumDlnp : o�:,
., I
3. .rYPa of ryslem;.. � C699�001(9f
Emvonl Too Flllo(P(,9,.mr? r' t'o01
9 no
I
• SY Pylmpod 8y:
r;1 `/iirl!,kr,
oli
...,'7.. Loca on wh+jr�••oor�lonu'•were dl9posaa:
rl
Q1 ho y
ff,)"w.maw.goy/dad` aiei/eflP/ovaJa/Iblorms.r maln9�acc ^
c
�SoDI!c Tens
Ucon+,,,/
ER' MASSACHUSETTS
.�' (�Q Y 710.5 ((1 L
.t try lr' tlrJ sr •f "1'( .jet, (�i.41,^'f•'IV'�517�i:1
::.r V�; t{R� f I li{('I'1 r1'•; �: , • ,iY f; 11'
rst�;t �'r.11i:i"'1't•U''4r °j'"
DEP ha provided li...f',
,form for use by local BoaR EAE�'he S
b. $ubinl4ed to th0.local'Board of Health o oth
or r•: :I:�y ,;':,t ..,,;,..,..,, approving authorlt
A.,Facllity Inform-atlon ,)EC 77 ZU97
J,T�W►`. (a11n� out : , . System Location; ` ! TOWN OF NORTH ANDOVER
r' HEALTH_DEPARTMFNT
+''oomPulor, used. ,: • .,�,. a�D D
only the tab key r Address
to move your:; . %�� • L�%�2G��'%�cP/�
do Pot
us. th, rottirn :% '.:I' ; ; .Clty/Town
key, to Il '��:X11''r,;�v:.'i:'':: �5'?'';I ,.:,.Y :'•�..•,,.., '•:i:;;• ..
,�, • , • .Sys am1 :,� • ••
�.`,r. �..`l�';�,:';v('if'"`,,,�'yl.y:,''Ji'�%E: t; ;i{,;�I:;JApry:lr•L�'•''
tem Pumping Recora mss
(S%-
State
7JP Code
.l.'+, i'• ;� ��'�+;'.:'�;`;�•=. Name':''o;'.; `''!�•,,,•r••;;..
j.,
"• �' d4i, ;t i.Addrets (If dlfrerent from location)
,
Ci�iTOWM1.• '
ti,' . r it ;:'
r% r
State' ZIP Code
Telephone Number
t' � 1 ,i.Ji16i�1'{}9`.L,1• 4w'.'••
.. :'�,, .:.i:'
.'. 1, ,tr(••.J:
a, l
�•� • 1 Date of Pumping-'i",Dae
2, Quantity Pumped:
. . r•' '' ' ' .
Gallons
' .3 :TYP,e Gf system; ; ❑ . Cesspooi(s)
-eptic RA Tank
, ;,' �'��:'', :, : ,:�'1:•::,,,::r�:
�
•�,•,Y,•'„'•CI:. 'lin ': '.
❑Tight Tank
•, " ,���r �.
�;� l;'; .�'
jOther (dascrlbej;•'�
4,:' Effluent Tea Fllte{,present? .❑ Yes Lilo
",�°
If yes, was It
,.; , .
.. ;•;;;.,',�,• �, ': •: ";�;..:�(.,art�Wl�f"r. ay;'r, F i..rC''', `
cleaned? ❑ Yes. N 0 i
:,,.,
'"'• •!;•..41,; �„•�h'a,+•(i•ii�ifl'•4:r Lr•.tl.,,� Ir
�
�,;
.. •;:� Il:•,:Jr. !. ''a�fuyj{•�tyi<�(: r.v:�i�v'r,,.•flyi�r��r�j��s;�','.,,' ...
'�
.. ': •j'' y:�ifr( i,•1{4;�%�Y u.r<'1�",,,�.,i1 :�.is,,�hli�,ll'� �! �•i ,�
..., �; �', :r:ir::��fl'S:T.',:l YSrj''{'.bt:(!i{Sr�•4�'r' !lt Y�,•'i ,'t'f:..
:�;;��'�••'�?'. � �'.,+r.!+y PURI �•'�• ,
Cj
, ��'. ;: ... :; �;1;;, ped By,•..:•:.�.•; " .
is '�� '•�li `. t.. :•;:. :; :, .. .
.'i:'����. r.i",';•,�'.St
, ! : ;i°:Sa1t"•%•�'r''`'
ITr,� c)15r<rl�/gyf�i
::L:: �" � `' "'7. •.dh �: :��. 1 ,��lYr"V''rl: , 1�•,.� �� 1'4'51 �.; 7'i.;
. 'ir; •''.'t=Y'` J'r�i', r:;i tu•(istr I ,p+ v•ali; ��l•{y. 4/..;} r.lr,I �
• 'i.':1 ,. X77 ' 1'..1..,,.t I ) r.. � �.; . •''+,(.'!',
1. f�',F';;.,. ,.,:'7;' LocafJon.where contents were:dhposed:
Iv •,trr••I:...r� !•ti,:
:I,:r':%,.4•, '..�+.• ,rrf t.t Pr' r:' :I•
'' i•' "•�:,; 1'r,' .. ;t,'�:: f,l r'i.'.• �'''• ,�liti•;�?',i,,:. 'r ,r;I �:::r
{'_ .t ,+'•' .. :. : `.. r.'' :.til:^i .,•y.;'• P, ; ...
8•'.v:.±)qi•,l •.�'r° 14.1�5•o 91♦,ii'
kCI•S
:..;' ,; a;►'�'` �;'x;: 4; r:,;r?:Sbnalure of Haule(;i�i ;;r� e..',.::<•t:
htip /irvtivw;mass,gov/dei%water.approvaJs/t5(orms,htm#Inspect
LSi0rR;4.dop!08/QJ
............
iVehicJe Ucen+e Number
Date
Sy:lam PumPln9 Record ' Paye 1 a
Commonwealth of Massachusetts
�`- City/Town of NORTH ANDOVER MASS iUSET,
- System Pumping Record
Form 4 AUG 0 4 2006
DEP has provided this form for use by local Boards of Health. n ,n�N QF NCRTH ANDOVER
�System)P:ucr�pn:g�ftecord mu:
be submitted to the local Board of Health or other approving au q. -
A. Facility Information -
Important:
When filling out 1.
System Location:
forms the
computer, use ,,
620 /
�P
only the tab key
move your
Addressto
cursor - do not
use the return
D
City/Town
_-- -- �- State '— -------_.___-___..._..
key.
y.
Zip Code
2.
System Owner:
0`A
Name
----_—__
- same --
_
Address (if different
City/Town---___._
- ---- - --- State ----------- - ---- -
Zip Code
Telephone Number
umping Record
1. Date of PumpingDat -- 2. Quantity Pumped: 1 .�
Gam's-- -
Type of system: ❑ Cesspool(s) eseptic Tank
❑ Tight Tank
❑ Other (describe):---
4.Effluent Tee Filter present? E]Yes,�lo If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of Sys em,.
6. Sy em Pumped By:
Name---��---
Vehic a License Number -
s5�?.�
Company
7. Location where contents were disposed:
Si ature ofHau �" '..------- D
Date �`-------------- -- -
http://www.mass.gov/dep/water/ provals/t5forms.htm#inspect
t5form4.doc- 06/03
System Pumping Record • Page 1 of 1
see
7
. , J*OWN Ur ANLX,)4 _OCT 0 1 ",IV
- 05 Ql&,vi, NORTH ANDO
HEAL .LPARTMENT
T�s 7
C>26
QOA N71TY PLIMP",
l-'0SP'Q0L; y43,
rUK4 Oe
150
Qb4dx
Vco0ODmtqlDrrl(,)N
KOM
"CUMB SOLID& FLOODED
YOL rD CA KA YQ YUR , ONER EXPLAIN'
14M
l'UMMhNT�.
-, uti I tN )'i MANJItx&bo i, -,
SYSTEM OWNER & ADDRESS
' 0 W N OF N , /IT'IH4 A N D 0 f" R
SYSTEM PU PINQ RECO L)
lozot 0 EPP,
ve OVA
ao�o T��i� c.Sf
DATE OF PUMPING:
CESSPOOL: NO..._._. _._ _IyEs—
SYSTEM LOCA
Q(JANTITY PUMPED:
SOPUC 71'ank: NO
NArVREOFSERVICE; ROUTINE -....1// ...EMERGENCY
OBSERVATIONS -
GOOD CONDITION FULL TO COVER
HEAVY CIRF-ASE BAFFLES IN PLACE
ROOT$ LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLID CARRY0VER,._._,__ OTHER EXPLAIN
System Pumped by
ral c
COMMhNTS.
-- -__ ------ ---------
CUN 11N I'S rKANSFERRED'i-O 5 f,
TO: 1)11cvz&e FROM:
L
FAX #.
#:
FROM:
L
FAX #:
.66 . 27
DATE:
/ a)
PAGES INCLUDING
THIS PAGE:
PHONE 151
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE; A6 20M
SYSTEM OWNER & ADDRESS SYSTEM LOCATION
Oc�>&d (example: left front of house)
DATE OF PUMPING: '7- C1 QUANTITY PUMPED I.. GALLONS
CESSPOOL: NO YES ,� SEPTIC TANK: NO YES V
NATURE OF CE, SERVI :.. . V :......
ROUTINE � EMERGENCY
OBSERVATIONS:
GOOD CONDITIONFULL TO COVER
HEAVY GREASE BAFFLES IN PLACE �_
ROOTS LEACHFIELD RUNBACK _
EXCESSIVE SOLIDS FLOODED _
SOLIDS CARRYOVER OTHER (EXPLAIN)
SYSTEM PUMPED BY: CSL
COMMENTS:
CONTENTS TRANSFERRED TO: S . D
CURRIER
SEPTIC & DRAIN SERVICE
107 FOREST STREET; MIDDLETON, MA 01949
(978)774-2772
•
FORM 4 - SYSTEM PUMPING RECORD
COMMONWEALTH OF MASSACHUSETTS
�(S /J7 16 Vt'r , MASSACHUSETTS
t
SYSTEM PUMPING RECORD
SYSTEM OWNER: c3 ,e
6?/-,�7 7%
DATE OF PUMPING: �T i1 - 9 9
SYSTEM LOCATION: r—/U Y?
33� 0 uFro
4-o fL-r Filq��
�1U�• ►' Fromm
r1� Lr,rlSP
QUANTITY PUMPED: /S-0 U GALLQNS
CESSPOOL: NO 0 YES F7 SEPTIC TANK: NO YES
SYSTEM PUMPED BY: CURRIER SEPTIC & DRAIN SERVICE
CONTENTS TRANSFERRED TO: �' S
DATE: r y ` S g INSPECTOR: < Pp ��i-e
II ��
w
oi (3i
(z;
Qi 00 mow.
oi oi II II II �b 3 c 0
to O O
°o C II II Qm Qm a V� �,
C
Q
nAlF
............. i
i
U
c�
Q)
N
y
� O
� O
O
'3yo
o°
3
y � j
Jj0
�q)
0
0
X
Shy'
yO
> U
� C y
Sh.o
Q
tq
�w
rz�°�'""o
q)�a
U
a)
a�
c�q�o
o,
lmo
.cz�
c I
ow"�.
W
i
Cj-
�3C
�Q)�CC�
C
Q
nAlF
............. i
i
U
c�
Q)
N
o
�00
C
G
C
pN
O
q,
O a) op
�Jo�
Jj0
> U
� C y
Q
tq
�w
ao
c�q�o
o,
_
W
i
C
Q
nAlF
............. i
i
U
c�
Q)
N
O w
tz-
C r Q
Lo
DO
14 � •� 0 � `iU O p b II o0 0 °� � C�� Zx �"" ° off.
�0 �o o
q q o�•-
O
64A ~W
i t i
W,
•4 q
api ai
b,g)4a
,1110i;
e
,
Lo
jo
v �
J �
V
Rx,
Q)
41
t
2
O
co
O
� O
'1
'�-w
Oa
tq0
03',
*jJoM
O cn
Q
�t
tj Co
co
q)to
o
.o
`.1
c �
�p0
O'er
,oma
a
o Q
q)
O y 0
.�.o
q �
Q�lb
'b .�
w
o
c�g2'o
•o,HWd-�
yew
yfi.,
° O
p ai
03
Q-- —40
�0 �o o
q q o�•-
O
64A ~W
i t i
W,
•4 q
api ai
b,g)4a
,1110i;
e
,
Lo
jo
v �
J �
V
Rx,
Q)
41
t
2
O
co
o
V C
C
p
v, U O
03',
*jJoM
J(ji0
Lb O
U
O Cy
.c)oc�
m�
CC
"bb
c�g2'o
•o,HWd-�
O '-j
W
�
�0 �o o
q q o�•-
O
64A ~W
i t i
W,
•4 q
api ai
b,g)4a
,1110i;
e
,
Lo
jo
v �
J �
V
Rx,
Q)
41
t
2
�� ����5
�o � �����"��
��,O��a e�- e '�s
TOWN OF NORTH ANDOVER
SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System (V} constructed; ( ) repaired;
by 6,4 `--, 6
located at / L / u v' m. o r /:.
was installed in conformance with the North Andover Board of Health approved plan, System
Design Permit # dated with an approved 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 5 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: ��4 f 9� (\�e . m
Inch
Final inspection date: S/ry
trios i^ger r
Installer: -��.�,�. Lic. #: Date:
Design Engineer: ��le1Gw� 'h.� �►'l 04.w. Date:
C �
B d
10 O
Cl)CD
Z CO)
CD o -v
ar
� O
C. = CO)
aU2 -0
O
c v CD
EDCL
O
rF
c� =r
�dCD
CD 0
C O co)
cocc) I
� v
CA O
CD Z
CD
O �
• CD
O
C
CD
=950
Crr7
cin
n
O
VJ
C
n
�d0
n C/
ccl c �� c
CA
°'
2ECD
-� cr
dO m
y
-0
y
�mn
m
C'j
yO an
m
0
y
O
K O
T
Fn -
?
m d?d
CD y
O
O
Cm
O
m
�
>
> m yo :
n
—1
cc
O
0
y
0 CC2
a m
7d
W
C
?y a:
a
a :
o Cc
x
co
C= ,.., ..
O
m y
CDCD
n�
to
C
CL CD
'
m
.0-►
y
O
NJ
0 y
C=L d
Q
C
W
�
o
CL
y
�
•
a
�Q
.-►
C
m
y
l
y
y
m,
O
d
�C.)�
3.,IL
CD o
a
a
cl
.i y
O'
o CD
m
m
n'o
nom:
O
y
C O
O �
n C/
qo
o
oo
o
CC
oa
7 0
7d
x
r
Z
d
3.,IL
omi
0
0
c
North Andover Water Treatment Plant Lab
420 Great Pond Road * North Andover, MA 01845 (978) 688-9574
Mass Certification No. for Bacterial Analysis * M-21054
Sample Number: A3057 Sample Date: 6/30/98
Submitted By: Mark Ruggles
D & M Builders
Sample Source: Lot 2050 Turnpike St.
Analysis:
Total Coliform Bacteria 0 per 100 ml.
PH 7.96 m/1
Turbidity 1.9 ntu
Color 6 units
If you have any further questions please call us at the above number.
Kelly Long — Senior Water Analyst
Form No. 4
Town of North Andover, Massachusetts
BOARD OF HEALTH
July 1 19 _98
CERTIFICATE OF COMPLIANCE
This is to certify that
the Individual Soil Absorption Sewage Disposal System constructed (i or repaired ( )
by Robert Inns
INSTALLER
at Lot _6C 02050) Turnnika qt-rppt N A-4--- MA n QA r -
SITE LOCATION
has been installed in accordance with Board of Health Regulations as described in the Design
Approval Site System Permit No
dated May 29 19 98
The issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily. A
BOARD OF HEALTH ENGINEER
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
30 School Street
North Andover, Massachusetts 01845
WILLIAM J. SCOTT
Director
Mark Ruggles
D&M Builders
8 Victory Road
Billerica, MA 01821
RE: Lot 6C Turnpike Street (#2050)
North Andover, MA 01845
July 1, 1998
y9SSA�HUS�t h
This letter is in regards to the well water test results at the above property, which
showed slightly high counts in turbidity and color. Please be advised that the
following must be provided to the North Andover Health Department within 30
days of the date of this correspondence. One of the following,
1) additional well water results which show levels which do not exceed
recommended guidelines
2) proof of the installation of a filter system, and a passing water sample.
Thank you for your cooperation in this matter.
Sincerely
usan Ford
Health Inspector
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
_. -41
COMMONWEALTH.OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
cIA
TITLE S
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: t
N Algoma -a d 5
Owner's Name: ch
Owner's Address: c�
Date of laspectioa:.T, i n s 1O ., 9002
Name of•IInspector: (please pript).T_ h_T cn,tit-w
Company Name: ice Inc
Mailing Address:Street
76
Telephone Number:
CERTIFICATION STATEMENT
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 Amcdon 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). 'Che system:
Passes
onditionally Passes
cads Further Evaluation by the Local Approving Authority
Inspector's Signature: s�" / z too= Date: — �Lo -o �-
The system inspector shall submi(a copy of this ins}6on rpKott 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 10,040
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.
Notes and Comments
""This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection. does not address haw the system will perform in the future under the same or different
conditions of use..
Title 5 Inspection Form 6/13/2000 page 1
Page 2 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
PropertyAddrasP60 Turnpike Street
N. Andover,
Owner:Chris Stewart
Date of Inspection: June 19c 2002
Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D
A. System Passes:
1 have tat found any information which indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 13.304 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.
Answer yes, no or not dctamined (Y.N.ND) in the for the following statements. If "not determined" please
P
The septic tank is metal and over 20 yeah old' or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfUtration 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.
ND explain: . •
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipes) or due to a broken, settlt4 or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s) aro replaced
_.._ obstrw don is removed
distributiop,. box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
Pus inspection if (with approval of the Board of Health):
ND explain:
broken pipe(s) aro replaced
_ obstruction is removed
2
Pager 3 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACESEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:2060 Turnpike Street
N. Andover, MA 01845
Owner: Chr_ is S L -ewart
w�w.ww,w
Date of Inspection: ,Thi n P 39 20
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 win pass unless Board of Health determines in accordance with 310 CMR 1S.303(ixb) that the
System is not functioning is a manner which will protect public health, safety and the environment:
— C MPool or privy is within SO feet of a surface water
_, Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will flail unless the Board of Health (and Public Water Supplier, if any) determines that the
system is functioning 10.6 aarwer that protects the public helalth, 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.
Tire system has a septic tank and SAS and the SAS is within a Zone I of a public water supply.
_ The system has a septic tonic, ad SAS and the SAS is within SO 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 welt$$. Method used to determine distance
"This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than S ppm, provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
Page
4ofII
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 2060 Turnpike Street
N. An over, 845
Owner. Chris Stewart
Date of Inspection: z}e 19 ,� 200'2---
D.
002D. System Failure Criteria applicable to all systems:
You mug indicate "yes" or "ao" to each of the following for IIiL.inspecdons:
Yes No
._ _y,% Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
�( Discharge or ponding Of eiiluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool .
Static liquid level in the disWbutioq 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'h day now
--- JC Required pumping move than 4 times in the last year �,IQT due to
Of times pumped clogged or obstructed pipe(s). Number
;
JC 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 conform bacteria and volatile organic compounds
indicates that the wen b free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than S ppm, provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
./X) (Y"O) The system il1l& 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.
1. l Arge Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
tlpd.
You must indicate either "yes" or "ao" to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
,yes no /
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
..._ _. tit system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA) or a mapped
Zone lI of a public water supply well
If you have answered "yes" to say 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 syst4m owner should contact the appropriate regional office of the Department.
Page 5 of 1 I
OFFICIAL INSPECTION FORM.- NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE„SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PARTB.
CHECKLIST
PropertyAddress:2060 Turnpike Street
N. Andover, --MA--M4 5
Owner:,-; G Stewart
Date of Inspection: ju ne 19 2002
Check if the following have been
You must indicate,
or "no” as to each of the
Yes o
Pumping information was provided by the owner, occupant, or Board of Health
Zwere any of the systemcomponents pumped out in the previous two wee
/ ks .
✓ Has the system received normal flows in the previous two week period ?
ZHave large volumes of water been introduced to the system recently or as part of this inspection ?
lz 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 ?
-I/—_ Were the septic tank manholes uncovered, opened, and the interior of the
of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sl tankspected
depthoof the
condition
Was the facility owner (and occupants if different from owner) provided with informati
maintenance of subsurface sewage disposal systems ?.
on on the proper
The size and location of the Soil Absorption System (SAS) on the site has been determined based on:
Ye,� no
Existing information. For example, a plan at the Board of Health.
_ Determined in the field (if any of the failure criteria related to Part C. is at issue
is unacceptable) u
ptable) [310 CMR 15.302(3)(b)] . e approximation of distance
Page 6 of I 1
OFFICIAL INSPECTION FORM - NOT FOR'VOLUNTARY ASSESSMENTS
SUBSURFACKSEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C,
SYSTEM INFORMATION
Property Address: 2060 Turnpike Street
N. Andover, MA 0145
Owner: Chris Stewart
Date of Inspection: June ' 1 9 4 2002
RESIDENTIAL FLOW CONDITIONS
Number of bedrooms (design):., ; Number of bedrooms (actual): ,'�/
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): i c0
Number of current residents: Ij
Does residence have a garbage der (yes or no): t'L�
Is laundry on a separate sewage system (yes or no) A" [if yes separate inspection required]
Laundry system inspected (yes or no): gD
Seasonal use: (yes or no):
Water meter readings, if available (last 2 years usage (gpd)):_4A*0A=Q VC
Sump pump (yes or no): &O
Last date of occupancy:44,
COMMERCIALIINDUSTRIAL
Type of establishment:
Design flow (based on 310 WRA 5.203): agd
Basis of design flow (seats/persondsgli,etc.):
Grease trap present (yes or no): _
Industrial waste holding tank present (yes or no): _
Non -sanitary waste discharged to the Title 5 system (yes or no): —
Water meter readings, if available:
Last date of occupancy/use.
OTHER (describe):
GENERAL INFORMATION
Pumping Records
Source of information: apipa
Was system pumped as Part6f th pection (yes or
If yes, volume pumped: allons -How was quantity umped determined?
Reason for pumping !L^'��t+/ ,/Nk
TY E OF SYSTEM
Septic tank, distribution box, soil absorption system.
_ Single cesspool
Overflow cesspool
_ ivy
_ 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)
— Tight tank _ Attach a copy of the DEP approval
_ Other (describe):
Approximate age of all components, date installed (if known) and source of information:
Were sewage odors detected when arriving at the site (yes or no): IV
6
�1Page 7 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE:DISPOSAL,'SYSTEM INSPECTION FORM
PART C .
SYSTEM INFORMATION (continued)
Property Address: 2060 Turnpike Street
N. Andover, MA 01845
Owner: Chris Stewart
Date of Inspection: Jun -e-791 2002
BUILDING SEWER (locate on site plan)
Depth below grade:
Materials of construction: _cast iron A/40 PVC __other (explain): _
Distance from private water supply well or. suction line:
Comments (on condition of joints, venting, evidence of leakage, etc.):
SEPTIC TANK:V (locate on site plan)
Depth below grade:
Material of construction:concrete metal fiberglass ,_polyethylene
_other(explain)
If tank is metal list age: , Is age confirmed by a Certificate of Compliance (yes or no): _ (attach a copy of
certificate) ,t
Dimensions:
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle;,
Scum thickness: ,6r -
Distance :.. :... ��
from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle�ex How were dimensions determined: ' a- ��
Comments (on pumping recommendations, inlet and outleftee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
trom' O/tGP ,del 'selvl► --,-,._
GREASE TRAP locate on site plan).
Depth below grade: —
Material of construction: concrete _metal fiberglass _polyethylene _other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
7
Page 8 of I 1
OFFICIAL INSPECTION. FORM , NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL' SYSTEM INSPECTION FORM
PART C.
SYSTEM INFORMATION (continued)
Property Address: 2060 Turnpike Street
N. Andover. MA 01845
Owner: Chr7-i-
Date of Inspection: Ju,�1 9 2002
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 „_polyethylene other(explain):
Dimensions:
Capacity: gallons
Design Flow: allons/day .
Alarm present (yes or no):'
Alarm level: Alarm in working order (yes or no):
Date of last pumping:
Comments (condition of alarm and float switches, etc.):
DISTRIBUTION BOX: Vi
(f present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:
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.):
PUMP CHAMBE&�Llfvocate on site plan)
Pumps in working order (yes or no):
Alarms in working order (yes orno):
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
8
Page 9 of l l .
OFFICIAL INSPEGTION:FO RM - NOT: FOR VOLUNTARY ASSESSMENTS
SUBSURFACSWAGE DISFOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: _2060 Turnni ke Street
AndQyer� MM, 01845
Owner: Phri c Gf-a n�r�-
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required)
If SAS not located explain why: ;
Type
leaching pits, number: _
leaching chambers, number:
leaching galleries, number:
leaching trenches, trenches, number, length::.W'(AC�
leaching fields, number, dimensions:
overflow cesspool, number:
innovative/alternative system Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,
etc.):
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 or no):
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.):
Page 10 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSALSYSTEM INSPECTION FORM
PART,C
SYSTEM INFORMATION (continued)
Property Address: _2060 Turnpike Street
14, Andover, MA 01845
Owner: (-hri s Stewart
Date of Inspection: �T„ e 1� 0 0 2
SKETCH OF SEWAGE DISPOSAL SYSTEM f
Provide a sketch 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.
10
!fie iI ofll
OFFICIAL VOWTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFAC$ SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM FORMATION (fwd)
Prouty Addrwt 2 0 & 0 .T'u:u; ke S reet
N -And jig". M�845
sffI r6X"
Swo .Swtw*/
Chak �J
Sbdlow wds
EKimwd depth to pound wwr rou
P lodM a (dwk) d m4ab wod to doWmin the hiyb Vqwd WSW elevsdoa:
b9m oym dull Piw ON NOW • if obook4 dM of Omipi plan revitwod:
—► (+��t FQP`�/yy/0bwM0ft. hole within 130 9W of SAS)
AC��wkb � exor twti itNWIO W (tlti#A docwam ai )
You must dacribe
I
7- T-70
- v • ! �.G y T�PitA�Yi �I�f - � ���s I ,t. �.
-
. , - I�"�,,iC v � � 1 ;,• 4i i �t�� � a q + �i , of �;� _
7 4
Pi t 9R 1
I .Eiev,�-��--►'6'; ! '
El e 1 D0. 'V. 99
D o .5 ,
.... rS
Topsoil Topsoil5 ....
Y« ,q.
Subsoil "'• Subsoil
�� r
*+ St ro t.
3� Ln428
//
k
t^ h.
Ve.-y Bonet' ;
Brown Sondy C 2..
rj rt
Till �` ` Very
y:�` ,'. •• Fine Ton ;
•. , r 1 Sonjy Till Sond)
ti. 1
$# ,
�Wat or P 60,9
„r C 2
Bonet' Till Very
SVM v
! /U
4" 84 " S. w. T ® 84 ")
(91. P)
54
�' (Refusol4 4�'
/Inch' ' �� , ; (90.8') 104 „
f n'
Pero..
ec 9Q -4#A
De V. -_ • (No Oroundwvlen)
9?
Rote _• .3t'Inch
M..s'I• t Y M..wHwi.MY(Yb.M.s �... v a.M•' . K... n � . - ..v . ... ... .. ... - .. ..,r..., ... - � ......,.........,...r• . �.
Pr
0 .,r1e
xf�
Scales: Hoy. ; r Q Vert. /, _ ,
(sob
07
s�
D
y
.0
C �
d
CO)CD
n
n Z y
O O 'v
CZ u C.
d � H
� c
'00 �
v CD
CDo
CL _
Q C
CD O CD
C CD co
_.CD
O y
� I
ccs CD
H O
Z
CDn
O CD
O
CD
o y_m,.cc) 3 m
re.
z H =+
d y
�_• -+ n -;io'
sa-+ m *41%, Go
m
o � r CD a
to
o Zn
0 C2
CD:
C =rCL
N
cc C =rC :
CD y
CD
CD to o m
c a 9 :
M
CD � :. Y
O w y 4/ i •-�•�
H d d C
CA
0
a �m
�mTl o
CA �
m �
CA
,� o
CD a ' a �G
�3
o
oCD�
CD
y
CD
o �
gyCD : '
d :
=CM2
o:
rM
2o'
M
v
O `� O
rD
TJ'rl
w O
w
w � O
oc :
1
w G
rti
t'
1 n 0
w G G
dcl O
°'
(D O
b O
a
Z� w
d o
o
y 0
tl
v
....... .. _ o..rrr..........w...,.L1sr:wY..i...t�+•1c. •.e.#r<.6...e.R..N..... .:.eyr.,..w�...a.YYsS .I.a..e.-�......�� _ i' •.II V.�Flm .,..�.. ..
omi
0
9
North Andover Water Treatment Plant Lab
420 Great Pond Road * North Andover, MA 01845 (978) 688-9574
Mass Certification No. for Bacterial Analysis * M-21054
Sample Number: A3058 Sample Date: 6/30/98
Submitted By: Mark Ruggles
D & M Builders
Sample Source: Lot 2060 Turnpike St.
Analysis:
Total Coliform Bacteria 0 per 100 ml.
PH 7.88 m/1
Turbidity 0.84 ntu
Color 1 units
If you have any further questions please call us at the above number.
Kelly Long — Senior Water Analyst
..Z' t `" I
TOWN OF NORTH ANDOVER
SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System constructed; ( ) repaired;
by &Z—
located at 0 7L - E, Gy - �p�� 2—
was installed in conformance with the. North Andover Board of Health approved plan, System
Design Permit # ,dated with an approved 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 5 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.
Installer:
Lic. #: Date:
Design Engineer: Date:
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: .3 n9 F CURRENT INSTALLER'S LICENSE# O 7
LOCATION: Z a� TV rt a 1, k-9
LICENSED INSTALLER: 'S6 L T A, -, s
SIGNATURE: �- ��, �, TELEPHONE# 97?
CHECK ONE:
NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
$75.00 Fee Attached?
Foundation As -Built?
Administrative Use Only
Yes No—
yes �'/ No
Floor Plans? Yes No
Approval _�� �C Date: ��
r 11 ly VV J.��V 11 VV I I IVI 1ll.,J L• 11L'.=L �VVVtir. I . Vi
From:
John Morin
Thomas E. Neve Associates, Inc.
Questions?
Call 978-887-8586
447 Old Boston Road
Fax 978-887-3480
Topsfield, MA 01983
To:
Susan Ford
Company_
North Andover Board of Health
,
Address:
North Andover
Date:
April 6, 1998
Time:
11:00 AM
Pages: 2 (including this one)
Re:
Lot 6C - Salem Turnpike
Dear Susan:
As you requested, the following sketch shows the existing dwelling location drafted on
the plan view of the septic design. I spoke with Mr. Ruggles regarding a deck on the
rear of the dwelling, he is proposing to build a deck and it is shown on the sketch. I
relocated the septic tank based on the existing dwelling location and the proposed
deck.
I hope this additional information answers your concerns and you can issue the permit
to start the construction of the septic system.
If you have any further questions please do not hesitate to call.
Sincerely,
CC: Mark Ruggles
t
TOWN QF NORTH AN"IC' .fps/
BOARD or -
APR r - _
3 ioa y[�
7harite-wev 90C.
66 LMLETON ROAD WESTFORD. MA 01886
Report Number: C-wps-25514
Client:
Wilmington Pump supply Inc.
P.O. Box 517
Wilmington, MA 01887
Sample Taken By: WPS Staff
(508) 692.8395 FAX (508) 692-0023 1 -800.649 -TEST
Report Date: July 18, 1997
Sample Taken At:
k �
American Realty Trust
Lot 1 Rt 114
N. Andover MA
On: July 15, 1997
CERTIFICATE OF ANALYSIS
TEST PARAMETER:
EPA Max
RESULTS
UNITS
Total Coliform (P)
0
0
Per 100ml
Calcium
No
Limit
28.6
mg/L
Copper (S)
1.3
0.08
mg/L
Iron (S)
0.3
# 0.58
mg/L
Magnesium
No
Limit
2.6
mg/L
Manganese (S)
0.05
0.05
mg/L
Sodium
" 28
5.6
mg/L
Potassium (S)
No
Limit
0.5
mg/L
Alkalinity (S)
Not
Spec.
66.5
mg/L
Ammonia
Not
Spec.
<0.03
mg/L
Chloride (S)
250
22.5
mg/L
Chlorine (total)
Not
Spec.
0.81
mg/L
Color (S)
15
# 25
CPU
Conductivity
No
Limit
186
umhos/cm
Hardness
No
Limit
82
mg/L
Nitrates(as N)(P)
10
0.11
mg/L
Nitrites(as N)
1
<0.01
mg/L
pH (S)
6.5-8.5
7.9
SU
Odor (S)
3
3
TON
Sulphates (S)
250
18.8
mg/L
Turbidity
5
3.72
NTU
sediment
pos/neg
neg
NT=Not Tested, #=Value Exceeds EPA STD, TNTC=Too Numerous to Count
*=Background Bacteria Noted, "=EPA Advisory Limit
'=Exceeds EPA Advisory Limit
(P)=Primary EPA Standard, (S)=Secondary EPA Standard (may affect
aesthetics of drinking water i.e. taste, color, etc.)
MAR ?3
This water sample, as submitted, is considered SAFE to drink according
to EPA guidelines. However, one or more of the parameters exceeds
EPA secondary standards as indicated by the (#) sign.
Massachusetts State Certified
Testing Laboratory #MA048
l�� /10— 6-* 904r-
Michael P. Carlson, for
Thorstensen Laboratory Inc.
7houtemaem 4aBozator enc.
66 LITTLETON ROAD WESTFORD, MA 01886
Report Number: C-wps-25515
Client:
Wilmington Pump supply Inc.
P.O. Box 517
Wilmington, MA 01887
Sample Taken By: WPS staff
(508) 692.8395 FAX (508) 692-0023 1.800.649 -TEST
Report Date: July 18, 1997
Sample Taken At:
American Realty Trust
Lot 2 Rt 114
N. Andover MA
On: July 15, 1997
CERTIFICATE OF ANALYSIS
l_
TEST PARAMETER:
EPA Max
RESULTS
UNITS
Total Coliform (P)
0
***0
Per 100ml
Calcium
No
Limit
31.2
mg/L
Copper (S)
1.3
0.06
mg/L
Iron (S)
0.3
0.3
mg/L
Magnesium
No
Limit
3.4
mg/L
Manganese (S)
0.05
# 0.06
mg/L
sodium
It
28
7.6
mg/L
Potassium (S)
No
Limit
1.0
mg/L
Alkalinity (s)
Not
Spec.
88.6
mg/L
Ammonia
Not
Spec.
<0.03
mg/L
Chloride (s)
250
22.8
mg/L
Chlorine (total)
Not
Spec.
0.03
mg/L
Color (s)
15
5
Conductivity
No
Limit
209
CPU
umhos/cm
Hardness
No
Limit
92
mg/L
Nitrates(as N)(P)
10
<0.01
mg/L
Nitrites(as N)
1
<0.01
mg/L
pH (S)
6.5-8.5
7.8
SU
Odor (S)
3
1
TON
Sulphates (S)
250
11.3
mg/L
Turbidity
5
1.52
NTU
Sediment
pos/neg
neg
NT=Not Tested, #=Value Exceeds EPA STD, TNTC=Too Numerous to Count
*=Background Bacteria Noted, "=EPA Advisory Limit
'=Exceeds EPA Advisory Limit
(P)=Primary EPA Standard, (S)=Secondary EPA Standard (may affect
aesthetics of drinking water i.e. taste, color, etc.)
This water sample, as submitted, is considered SAFE to drink according
to EPA guidelines. However, one or more of the parameters exceeds
EPA secondary standards as indicated by the (#) sign.
Massachusetts State Certified Michael P. Carlson, for
Testing Laboratory #MA048 Thorstensen Laboratory Inc.
MAR 2
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
*****************Applicant fills out this section*****************
APPLICANT:
LOCATION: Assessor's Map Number
Phone C , -1-10 1
Parcel
Subdivision Lot s) c_—
Street "'1v i
St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Town Planner
Comments
Food Inspector -Health
_,S'ep,tZc Inspector -Health
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved oz
Date Rejected
Received by Building Inspector Date
fl1 11 VV 1JJV 11' VJ II IVI 11"IJ L. I+IL`.L I-IJJVS..
I . VG
G�''�..sw% 635. Zo
Lead► Tr-eAdh �9b' J �'�• r ~'�
5prcm W/ �``�' ••tom • °`=�G
i 100 % Future ; , �:�.�_ C28 ••
Reserve.........../ 0'
tot
♦ r Z � COBS ���•'•: �
t `103 \\ e
SIG ` �b.� -• ��.
\ 1 02"
%D7
t 6C
fb
OURCE AREA -
a Zi -T S -r
}�A`( BALES ---
Proposed 24"
(Class
S 1.0'/0 (Lay in existt. di i at.
Inv. In - 9 t. 94'...... , n
Inv. Out = 91. 6 4'
I tj3\_-
Keith
WC1;h jS••..
C'Z .l.
e9urr
Note
FOU N DA-r10IQ
CD�R^I>rl
Ie i./ = 93-S
1, 1, ( I
1
,!
lox
• , ,. --Pr-o posed Well
( 93' Froom Septic
lC3 From System
/�� / Existing 24' R.C.P.
(To Be Kula ce d )
B? ••Fxistino 4 Wide Pitch----,
--
1 Exisrin9 AIEdye Of Pc
Salem �' u .rpdn p
TOTAL P.02
_0.
THOMAS E. NEVE ASSOCIATES, INC.
Engineers * Land Surveyors • Land Use Planners
447 Boston Street US #1
TOPSFIELD, MASSACHUSETTS 01983
(508) 887-8586
FAX (508) 887-3480
TO Susan Ford,
B oat' c_ of ?-lea i +Vi ,
1Joc +1-, Anoko je " M A
WE ARE SENDING YOU Attached ❑ Under separate cover via
❑ Shop drawings
❑ Copy of letter
Prints
❑ Change order
❑ Plans
C
DATE
�t-1a19s
JOB NO.
C_
ATTENTION
ATTENTION
S.�s4r-, Ford
RE:
R.e.�.�iSc�.t loves L.o lcsC.
Salo+ To rn l 1Cq
4 J g
9(oZ-GG
5A.s ITATty DISPOSAL, 5 XS Te,,, 42EPAJl2
the following items:
❑ Samples ❑ Specifications
COPIES
• DATE
NO.
DESCRIPTION
-3
4 J g
9(oZ-GG
5A.s ITATty DISPOSAL, 5 XS Te,,, 42EPAJl2
THESE ARE TRANSMITTED as checked below:
❑ For approval
)(For your use
❑ As requested
❑ For review and comment
❑ FORBIDS DUE
REMARKS
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
19
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
❑ PRINTS RETURNED AFTER LOAN TO US
"i�eo,c' Sysar>
-rt.f e,r,clflseck o1On liow-e bec,- t^cy:sed S) `!1•e cxiS-1 r`.,u
L'.' V, 10c'ac &Se -d olld( %,cL re-- lcc v,+eA .9e.p+*C +4,k --
OL ko
4,k-.OLIso revised CD Cor r^.,.,n�wi
1.7)teJ bWW_ cLr\y a - es rS oLe..S a Ga
��..c p r�c
COPY TO Mtic' K �Gckw _jCS
RECYCLED PAPER: g� SIGNED: Contents: 40 % Pre -Consumer - 10% Post -Consumer
i
If enclosures are not as noted, kindly notify us "Ce.
7hoestewev ,C'a8oeatoepr, .9,#e.
66 LITTLETON ROAQ WESTFORO, MA 01885 (508) 692.8395 FAX (508) 692-0023 1.800'649•TEST
Report Number: c-wps-25515 Report Date: July 18, 1997
Client, sample 9!aken At:
Wilmington Pump supply Inc. American Realty Trust
P.O. Box 517 Lot 42 Rt: 114
Wilmington, MA 01887 N. Andover MA
Sample Taken By: WFS staff on: July 15, 1997
CEEt' IrICATE OF ANALYSIS
TEST PARAMETER:
EPA Max
RESULTS
UNITS
Total Coliform (P)
0
.**0
Per 100ml
Calcium
No
Limit
31.2
mg/L
Copper (S)
1.3
0.06
mg/L
Iron (s)
0.3
0.3
mg/L
Magnesium
No
Limit
3.4
mg/L
Manganese (S)
0.05
0._Q:6:�:)
mg/L
sodium
" 28
7.6
mg/L
Potassium (s)
No
Limit
1.0
mg/L
Alkalinity (S)
Not
Spec.
88.6
mg/L
Ammonia
Not
spec.
<0.03
mg/L
Chloride (a)
250
22.8
mg/L
Chlorine (total)
Not
spec.
0.03
mg/L
Color (S)
15
5
CPU
conductivity
No
Limit
209
umhos/cm
Hardness
No
Limit
92
mg/L
Nitrates(as N)(P)
10
<0.01
mg/L
Nitrites(as H)
1
<0.01
mg/L
PH (e)
6.5-8.5
7.8
$U
odor (s)
3
1.
TON
sulphates (s)
250
11.3
mg/L
Turbidity
5
1.52.
NTU
sediment
Poe/neg
nag
NT -Not Tested, #=Value Exceeds EPA STD, TNTC=Too Numerous to Count
*Background Bacteria Noted, "=EPA Advisory Limit
Exceeds EPA Advisory Limit
(P) -Primary EPA standard, (s)=secondary EPA Standard (may affect
aesthetics of drinking water i.e. taste, color, etc.)
This water sample, as submitted, is considered SAFE to drink according
to EPA guidelines. However, one or more of the parameters exceeds
EPA secondary standards as indicated by the (#) sign.
Massachusetts state certified Michael P. Carlson, for
Testing Laboratory #MA048 Thorstensen Laboratory Inc.
zaquzay� ` Q y� Q -4 S ugof
` J-L.YS1IMVSSVN.40 H17rg IOHNOD IKL
BOARD 017 HEALTH
L Town of North /cndover,Mass.
Date % 19
APPLICATION FOR WELL & PUMP PERMIT
:.'lppi`x cation .is hereby made for permit -to drilla well O • Application i,.S
'.'nade to install ( ). a pump system.
Lot #l_�
'•vocation: Address XL
::Owner C�
Address ib iiirn%���Au� �,,�%l /yl�i Tc1.Sf1Sz93T�%/Oi
AddressA9�d -/C11 Contractor Contractor. o/ -7°s --✓H
Tel.
?ump Contractor cS�
Address
`JELL CONTRACTOR (To be completed at tine of Pump test)
Type of Well Well used for
'Diameter of Well =Size of Casing
Depth of Bed Rock Depth casing into Bed hock
,Was Seal Tested? Yes (_) No (_) Date.of Testing r
Dep
th of tlell — Well 1:nded in What. Material
~D "_h to Water_ Delivrrs _Gals .Per Min. for 4 hours
hours- a t GPM
Drawdown feet after pumping _—
Date of' Completion—
Signature WeI-1 Contractor
`n �� iX iX �. :: :. is .. n .. n .::C i. .. TC i•: i•: ij•nii.iC iC•i. .• n •. n •. .. .. •. .. .. .. .. .. �
PUMP INSTALLER (To be-- filled in' before installation)
1'u1np Type Used
Size & Name Pump --- ------ ---
Water Pump Delivers GPM Size of Tank.-
Pipe Material Used in Well: C,ilst Iron (_) OnivniiiZed (_) PLasCic
14ell Pit (_) or Pitless.Adapter (^)
ed torotect pipe? Yes (_) 1J0(_) Type or Name Well Seal
us
Was sleeve P
Date
r `'e Water a•nalysi.s . repor--t 'submitted to hoard of 11ealtli
Dp_e .release given w owner of record & Bldg. InsP
Health inspector
NORTH ANDOVER BOARD OF HEALTH
DESIGN REVIEW REPORT
FEE: PERMIT # 834 DATE RECEIVED <3 1,218 /q6
APPLICANT -e1DIA/6 Y T,eu.sT MAP 08C PARCEL /8
ADDRESS LOT # Co d
ENG. /VEV & /?5,5e)0. STREET TU, AJPIA 4!�
ADDRESS 44% D/ -4 o/96,3
PLAN DATE A2 1,Qo /9U` REV. DATE
CONDITIONS OF APPROVAL
APPROVED
DISAPPROVED
REASONS FOR DISAPPROVAL:
55
e oo /-/o�� �E,et'o� Mcg —'t 2 io.e �o
o��'�o ��� G �,�7"i•�i c/�TiQ.c> /�- 5 �'i �-E E �//3-� c� A ro.�, /r�u s �-- '��
E
a. Nv y -o ,v c/i/.
�y
-1-5. /Vo ZJ��T�Ati�s
J EPT/ c TA A.�,e /1/0 % 7 6 ✓"�--o vtJD AT/C�� ,
a
A)07-
111-7,Ab D 7-0
U LVOT -E
oy
jUi� SQA c� 5065016 9(- O
MORTH
pt t��o ys1ti0
3? a `r. •.' .. ^ OL
O
F 9
L � ,'� •
,SSACHUS�t
Applicant_
Site Location
Form No. 3
Town of North Andover, Massachusetts
BOARD OF HEALTH �pp
19_1L._
DISPOSAL WORKS CONSTRUCTION PERMIT
A
G
Permission is hereby granted to Construct ( or an Individual Soil Absorption Repair ( ) �D
Sewage Disposal System as shown on the Design Approval S.S. No.
—CHAIRMAN, BOARD OF HEALTH
!_ZS__ D.W.C. No.
Fee
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
146 Main Street
North Andover, Massachusetts 01845
May 7, 1996
Neve Associates
447 Old Boston Rd.
Topsfield, MA 01983
Re: Riding Realty Trust
Map 108C, Lot # 6C
Turnpike St.
No. Andover, MA 01845
To Whom It May Concern:
This is to inform you that the proposed plans for the site referenced above have been
disapproved for the following reasons:
'to 'e
1. Deep holes performed prior to S. D'Urso's certification as site evaluator must be done
again. See 310 CMR 15.100(2).
2. No foundation drain (N.A. 6.02V
3. No wetlands disclaimer (N.A. 6.020)
4. Septic tank not 25' to foundation. Leach area not 35' to foundation. (N.A. 4.18)
5. Less than 1 00'to wetlands (N.A. 4.18).
6. Design flow not based on 165GPD - insufficient leach area (N.A.2.14(4)).
7. Please add to note 18 that "the excavation of topsoil, subsoil and other impervious
material shall extend at least 6 inches into the natural pervious material." (N.A.
2.18).
If you have any questions, please do not hesitate to call the office at the number below.
Sincerely,
Sandra Starr, R.S.,
Health Administrator
SS/rel
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
PLAN REVIEW CHECKLIST
ADDRESS Ad76 C ENGINEER /UGVG'
GENERAL
3 COPIES STAMP LOCUS NORTH ARROW SCALE
CONTOURS J PROFILE r/ SECTION BENCHMARK k� OIL &
PERCS ELEVATIONS WETS. DISCLAIMER. -V WELLS & WETS
WATERSHED? DRIVEWAY -1-III(Elev) WATER LINE L--' FDN DRAIN
SCH40 TESTS CURRENT? /v ' P01 (a6 SOIL EVAL
SEPTIC TANK
MIN 150OG V11- .17 INVERT DROP
25' TO CELLAR MANHOLE ELEV
GARB. GRINDER -&(+200% EDF) + C vMf'!5.
GW # COMPS.
D -BOX
SIZE # LINES FIRST 2' LEVEL STATEMENT
INLET 99, 9,5' - OUTLET 99,76_ = ZO ( 2" OR .17 FT) TEE REQ' D? (
LEACHING
MIN 660 GPD?Z RESERVE AREA ✓ 4' FROM PRIMARY? ✓ 20 SLOPE
100' TO WETLANDS 100' TO WELLS !/ 4' TO S.H.GW (5'>2M/IN)
35' TO FND & INTRCPTR DRAINS,Z 325' TO SURFACE H2O SUPP --/
4' PERM. SOIL BELOW FACILITY ., MIN 12" COVER FILL? ✓ (25'
if above natural elev; 10'if below) BREAKOUT MET?-,,-'
TRENCHES
MIN 660 gpd_e SLOPE (min .005 or 6"/100') '�SIDEWALL DIST. 3X EFF.
W OR D (MIN 61) L,,-' RESERVE BETWEEN TRENCHES? L,-' IN FILL? MUST
BE 10' MIN. t--. 4" PEA STONE? VENT? (>3' COVER; LINES >50' )
BOT 06 a + SIDE 3 X LDNG = TOT 4W-
(L
¢(L x W x #) (DxLx2x#) (G/ft2)
Copyright 0 1995 by S.L. Starr
Page 3
Minutes: June 27, 1996
Lot 29C Sugarcane Lane:
Mr. John Morin, Engineer, Neve Associates was present representing Mr. Bob Janusz and
requested to come before the Board for a variance to the design on 110
gallons/bedroom/day and to use new "Title V" criteria regarding distance from leaching
facility to foundation drain. Also to construct leaching facility reserve area 97 feet from
wetlands.
On a motion by Dr. Rizza, seconded by Dr. MacMillan, the Board voted
unanimously to grant to the design on 110 gallons/bedroom/day and to use new
"Title V" criteria regarding distance from leaching facility to foundation drain.
VARIANCE REQUEST - LOT 6C SALEM/TURNPIKE STREET - NEVE
ASSOCIATES:
Mr. John Morin, Engineer, Neve Associates was present representing Riding Realty Trust
and requested to come before the Board for a variance to design on 110
gallons/bedroom/day and 100 feet from a wetland.
The Board Members suggested to table this until the next meeting July 25, 1996 in order
to get Michael Howard, Conservation Administrator's recommendation.
Mr. Morin asked if the Board could vote contingent upon a favorable recommendation
from Mr. Howard, Conservation Commission.
On a motion by Dr. Rizza, seconded by Dr. MacMillan, the Board voted
unanimously to grant a variance to design on 110 gallons/bedroom/day and to grant
a variance of 100 feet from wetlands contingent upon a favorable recommendation
from Mr. Howard, Conservation Commission.
PHASE IV PRD OFF BOXFORD STREET:
Ms. Starr stated that a request came in from Tom Neve's office to waive the current
North Andover regulations and old Title V in reference to Phase IV PRD off Boxford
Street - 19 lots and to construct according to the proposed regulations and the new Title
V.
Ms. Starr stated she had several discussions with Mr. Neve about this PRD and the plans
to revise local septic regulations because she believed the regulations would be in place
prior to plans being filed. She recommended that designs be based on 110 GPD with
Title V setbacks from foundation to tank and from foundation to leach area. Because of
May 29, 1996
Sandra Starr, R.S.
Board of Health
146 Main Street
North Andover, MA 01845
RE: Lot 6C- Salem Turnpike
Dear Sandy:
I9 DO AER/
GOWN Or RL� N- 0 ;r4�i�LTr,
l3OA
-31996
1
We are in receipt of your disapproval letter dated May 7, 1996 for the above referenced lot.
Enclosed please find three prints of the revised sanitary disposal system for Lot 6C. The plan has
been revised to show a foundation drain and the additions to note 18 that you requested.
The following numbered comments coincide with your numbered reasons for disapproval for
ease of reference.
I. Since Mr. D'Urso performed these soil logs using the current soil evaluation criteria, we
feel that we will not see a significant change in the groundwater elevation used even if he
perforins new deep hole tests now. Therefore, we suggest that deep holes be conducted
when you inspect topsoil and subsoil removal in order to verify the design groundwater
elevation. If you disagree, would you please schedule us for testing on this lot and
inform us of the date and time.
2. A foundation drain has been added to the plans.
3. The wetlands disclaimer has not been added to the plans since we will be seeking a
waiver from the Board of Health to allow the construction of a septic system closer than
100 feet to a wetland.
4. We are seeking a waiver frorn the Board of Health to allow the construction of a sewage
absorption system less than 100 feet from a wetland.
5. See #3.
• ENGINEERS • • LAND SURVEYORS • • LAND USE PLANNERS •
447 Old Boston Road U.S. Route #1 Topsfield, MA 01983
(508) 887-8586 FAX (508) 887-3480
Sandra Starr, R.S.
May 29, 1996
Page 2
6. In order to minimize the distance from wetlands (see item #4) we are seeking a waiver
from the Board of Health to allow the construction of a septic system using "Title V"
design loading rate of 110 Gallons/Bedroom/Day. By designing on 110
gallons/bedroom/day we can keep the system as far away from the wetlands as possible
and design a system that is 736 sf in size, 236 sf larger than the minimum system size
required by the town for a trench, system.
7. The additions to note 18 that you requested have been added to the plans.
Please schedule us for your next available Board of Health meeting so that we may discuss issues
3-6 above with the Board, if you feel that this is required.
Thank you in advance for your time and effort. If you should have any further questions please
do not hesitate to call.
Very truly yours,
THOMAS E. NEVE ASSOCIATES, INC.
cPi„ 'Y(etiy,
John Morin, E.I.T.
Civil Engineering Consultant
JM/mp
Enclosure
WILLIAM J. SCOTT
Director
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
146 Main Street
North Andover, Massachusetts 01845
memorandum
Date: 9/20/96
To: Sandra Starr, BOH Agent
CC: NACC
From: Michael D. Howard, Conservation Administrato MD�
tE :. WAIVER REQUEST - LOT 6C SALEM TURNPIKE STREET
vegetated buffer zones are perhaps the most effective way to control non -point
: a vital link with water quality protection in the following ways:
TEMPERATURE - shade and cover provided by riparian vegetation can moderate water
temperature in small streams.
2. SEDIMENTS & OTHER CONTAMINANTS - buffer strips filter sediments and other
contaminants (i.e. pesticides, heavy metals) from surface flow. Buffer strips also prevent
erosion in riparian areas and preclude development which could lead to increased
contaminant loading.
3. NUTRIENTS (Nitrogen and PhoThorousand PhoThorous - buffer strips reduce nutrient inputs into
streams by filtering sediment bound nutrients from surface flow, removing nutrients
from groundwater via uptake in vegetation and by denitrification, and precluding
development which could increase nutrient loading (i.e. septic systems).
4. MAINTENANCE OF STREAMFLOW - buffer strips can store water and help maintain
stream base flow (and water quality) during low flow periods.
Pollution attenuation is one of the most important public values provided by wetlands. Upland
buffer zones can protect (and enhance) the natural capacity of the wetland system to attenuate
pollution. The upland has its own pollution attenuation capacity as well. This is an important
factor to consider when assessing the cumulative impacts of a waiver request with regards to surface
water quality.
When considering a waiver from the regulations governing setbacks we need to evaluate
sedimentation rates, topography, surface and subsurface drainage characteristics, soil types
9/20/96
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
9/20/96
Memorandum
(particularly oxidation-reduction potential), the successional status of vegetation, and nutrient
loading rates from uplands per unit area of buffer. To clarify, the larger the buffer zone the better
the attenuation. While I agree with a 100' setback for septic systems, it would be hypocritical of me
to provide an unfavorable recommendation for this particular lot. Until the NACC revises the
wetland bylaw to reflect a 100' setback (versus 50') I must support the present provision. Therefore,
please allow this memorandum to serve as a favorable recommendation specific to the waiver
request.
MDH
2
9/20/96 2
r / V
THO
February 22, 1995
Ms. Sandy Starr
Health Agent
120 Main Street
North Andover, MA 01845
Re: 1995 Soil Testing
Dear Sandy:
Following is a list of properties we would like to schedule this year for soil testing.
Location Number
Deep
Lots Holes
Peres
Applicant
Jerad Place Phase N
of
27
27
27
Bob Janusz
Forest Street
2
2
2
Bob Janusz
Rocky Brook II
7
7
7
Peter Breen
(770 Boxford Street - Rear)
770 Boxford Street - Front
1
1
1
Peter Breen
Lots 3, 9, 10, 11, 12 & 14
6
6
6
Peter Breen
Rocky Brook Road
Lost Pond Lane
12
12
2
Dave Kindred
(Lots 1-13)
Lost Pond Lane - Lot 14
1
1
1
Dave Kindred
(Farm lot)
Lot 6C Turnpike Street
1
--
1
Bob Webster
Summer Street
3
3
3
Rockwell
(Map 107A, Parcel 162, 164 & 167)
• ENGINEERS •
• LAND SURVEYORS •
• LAND USE PLANNERS •
447 Old Boston Road
U.S. Route #1
Topsfield, MA 01983
(508) 887.8586
FAX (508) 887-3480
r
s � �
Ms. Sandy Starr
February 22, 1995
Page 2
Please call Kathy at your earliest convenience so that we may schedule these testing dates. It is our
understanding that any lots previously tested are not subject to new fees. We have advised our clients
where new lots are concerned to pay the fee directly to your office.
Very truly yours,
THOMAS E. NEVE ASSOCIATES, INC.
Thomas E. Neve, PE, PLS
President, CEO
TEN/km
SOILTEST.WPS
FEB 25 '94 1b: J9 NEVE H55UUH 1 t5
i
I.
r -M
February 25;1994
Ms. Sandy Stan
Health Agent
120 Main Street
North Andover, MA 01845
Re: Lot 6c Turnpike Road, Route 114 - Soil Testing
Dear Sandy.
Please be advised that we would like to schedule pere and deep hole observation
test pits for the above -referenced lot. Enclosed is a COPY Of the plan showing Lot
6c.
Please contact Kathy at our
off to schedule a day when the testing can be done.
If you should have any questions regarding this matter please do not hesitate to
COUW our office.
Very truly Yours,
THOMAS E. NEVE ASSOCIATES, INC.
c,
Thomas E. Neve, PE, PLS
President
Am
F.nclosum
#M RIDRL1Y.W"
• LAND SURVEYORS • • LAND USE PLANNERS
Topsfield. MA 01983
• ENGINEERS • U.S. Route #1 FAX (�) 887-3480
447 Old Boston Road
15091 88 .8586
F . L
F Eii t�5 "J4 10 -JJ HLVL H55V1..1H I t5
•7
'srArt
joCjj.5 MAP
wi
,
V -^t V-'44 , ZONE
LINE
SITE
/. 1
I
j
T
z
cc
n
Lu
o
m
i m
Z>
a)
Z:)
z I
n
a
6
J W
• • • •
•
2
�1
n o
m In
) 1
Uo
oo
%0
m
00
T
3m
cpm
f
fin
w
J oo
C7
m-w
mm
r~
m
�
a
lX�
ff
a¢
CS
Ul ta- U
w
p G
0
F wm
qF,�
H a w
ffp
4/7F�
m
m U< o
z
o y
W �Q
4C
a O ti
t
Z
mD
fM
J ��WF-
QCW
�tLl.l�i
cw. ra- v O d
p
¢
r
ttoj
dE
V
(yJ W -j
- ¢¢
UZC?
N ¢ ¢ ¢ ¢
m a¢ a Z r
U
O p
t
�`
D
W
Of O�
rn
Zf it
x
H R.
r
w
r w
W U
r• cC y
w C
� >` Q
r-M0
aiUW
J J
f- W W W W p
¢¢
¢¢
Z
¢ N
w �'E
iii ��v
L1M •
aaaw¢
Uvm
z, �m
-
C-)
-a
W�a
tl a n.
0
f a o
as M
r) m
4n 4d1
41)
Cry
V m
-� Q'
• pC f •
m
411 In
1).1
LT
LL Orn
N w U- P
to
Nl v
MZ
i•
to
j+111
Z
u Q
co
w J. a
[ c ro
LL10 6,x 1^t
¢ Q
mLU
r
0
Mor
CU
CL )- >
<
r
o u 3
°
O -°c
2Q4UJ
W I.- C.)Q
In
w
x
r
z z
2 i
w
J
y co
Y KIG iC G
U
w
a
a a
iZ Z
C) is
Nrn
'Qt7QO
a
w
r
a
CD
�zxx
U)
w ¢
w
to (�
a
a z
¢ ¢
>cx
66i
^�.
w
¢
NQ •
r
O
r w
O ¢
p r
¢
i
UZ
t{
V' -
Q
V+
�.
r-1
[14
W
rs
U.1
{>
IL (q
a
U!
It
• (
w
O
}
4%) C9
N
F 0X
• <��1
w
O
U
L7c
G ~
4..1 Nm
SJ
LL
U ^� O
ui
P G
O
q mac[
I
w
Cl
N r- O
Nc <2
z
00
u
t,•, •ll n
U
W
O>
U
F-
cy
F-
J
C7 �� •
• a
m
LLJ
i C)
V
Z W u
p
taE,. �
]C./
Z
M
cIdo
ex
0
I
10
q ~
M
U uCD Njco x
!L
?�'�
Z
2
U
O
w
a��
f-10 �'
c¢
a'i
U-
C7 Q
O
O
oiyl
T•
^-
\
C
i
U
W. wl�Q••.t1CL/.1
o
a
s
2
¢ N a
U.1 0- (-j --
r It
�a a-
cj/X.)0.Lj1- it
O
I
U
m
THOMAS E. NEVE ASSOCIATES, INC.,-,,.,-
ENGINEERS • LAND SURVEYORS • LAND USE PLAN
447 BOSTON ST. - ROUTE 1 Nok �p 0
TOPSFIELD, MA 019113
,?
(508) 88748586
TO \ \ /` DATE
March 6, 1996
V
_ —Sandy Starr SUBJECT Lot 6C Turnpike Street
North Andover Board of Health
Sandy, —
Enclosed are three(3_)—prints of^the septic design for
the _above -referenced lot. � We have revised it according to the
_ Conservation-Commiss_ion's_request._._
Please call p�us if you have any
_questions. _—
_ Kathy, Neve -Assoc._—
ITEM # ML72L The Drawing Board, Dallas, Texas 75266-0429 Fold At (—) To Fit Drawing Board Envelope #EW9DW
0 Wheeler Group, Inc., 1982
'il"Ol l,
! Ma'.
* *Vv
iyA{Zxt, �vNl�lt'Nll -
I A
u
7--/ -, K,
Joe -so
ILI
7
f A
lo
42-
ILI
f A
lo
42-
f A
Applicant
Site Location
Engineer=
Town of North Andover, Massachusetts
Form No. 1
BOARD OF HEALTH `" - as 19—L
APPLICATION FOR SITE TESTING/INSPECTION
Test/Inspection Date and Time
Fee (-5b
CHAIRMAN, BOARD OF HEALTH
Test No. (o 1
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
Town of North Andover, Massachusetts Form No. 1
NORTtjA BOARD OF HEALTH
�O6 '11 ib �•Y� _ _
19
>", A
° APPLICATION FOR SITE TESTING INSPECTION
Applicant
NAME ADDRESS TELEPHONE
Site Location--.-, �-
Engineer`
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
Fee
CHAIRMAN, BOARD OF HEALTH
Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
CHANNEL
Memorandum
To: Sandy Starr
Town of North Andover
Board of Health
From:. Greg Wiech
Date: March 21, 1996
RE: Lot 6C, Turnpike Street, North Andover
lei
Attached please find the $60.00 review fee for the above project which has been filed
by Neve Associates. Let us know if there are any problems.
Thanks.
Channel Building Company, Inc. • Real Estate & Construction
242 Neck Road • Haverhill, Massachusetts • 01835
508-373-3000 FAX 508-373-4900