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Miscellaneous - 208 CARLTON LANE 4/30/2018 (2)
[Ni y N Q W a QNB � T Z O O z o m 0 r 4. Commonwealth of Massachusetts RECEIVE F City/Town of No Andover System Pumping Record L�ay Form 4 �� r4URIH ANDOVERL.TTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other fbe used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority within 14 days from the pumping date in accordance with 310 CMR 15.351. B. Pumping Record Date 2. Quantity Pumped: Gallonst_�C) ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap 1. Date of Pumping 3. Type of system: ❑ Other (describe) 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Condition of System: � Cji, cYJ� 6. System Pumped By: J Name Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant. 20 So. Mill Bradfo► Signature of Hauler Signature of Receiving Facility If yes, was it cleaned? ❑ Yes ❑ No Vehicle License Number Ma 01835 Date Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 A. Facility Information Important: When filling out forms 1. System Location: on the computer, use only the tab 208 Carlton LAne key to move your Address cursor - do not No Andover MA use the return key. City/Town State Zip Code 2. System Owner: L Fitzgibbons rewn Name Address (if different from location) City/Town State Zip Code Telephone Number B. Pumping Record Date 2. Quantity Pumped: Gallonst_�C) ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Grease Trap 1. Date of Pumping 3. Type of system: ❑ Other (describe) 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Condition of System: � Cji, cYJ� 6. System Pumped By: J Name Stewart's Septic Service Company 7. Location where contents were disposed: Stewart's Pre-treatment Plant. 20 So. Mill Bradfo► Signature of Hauler Signature of Receiving Facility If yes, was it cleaned? ❑ Yes ❑ No Vehicle License Number Ma 01835 Date Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used.to verify that allnecessary approval /permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and` or landowner from compliance with any applicable requirements. 0aEwa . wow a.....aar..asaamaa...wee ..aawe aaaaONass ss.s■*amen .am a a. as a a as a...... APPLICANT g 1 C H Ar i.� A �T}-}8Z PHONE !'' i 1 Z16 , 01 L ASSESSORS MAP NUMBER LOT NUMBER SUB �"N LOT, NUMBER STREET 0-0 S 0,4 R LP J L A! l�J , A STREET NUMBER ...a..:■aa:.aa.rsa■.......■....a..........■...ssas...............a....aa.s... a a. as OFFICIAL USE ONLY aamen ■s..sa,•sass.■s.as.asa■aria..ss.aa..s.aa■e■a-..saaas..aasas...sa.aaaa.ss.■ REC CATIONS OF TOWN AGENTS g... i...a...aa..a..m ■ ■... MEN ..■.■as.■aaa■aaDown a.aasaasa.aaaa.aaa.aaa..s..■ DATE APPROVED I 0 / CONSERVATION ADM]NIS OR DATE REJECTED DATE APPROVED TOWN PLANNER DATE REJECTED CONRV1ENTS DATE APPROVED FOOD IN�PECT;QR -HEALTH DATE REJECTED — DATE APPROVED , S C S CTOR - Ti3 f DATE REJECTED COMMENTS _r�cyt�.,.. r� _-►. r�.��Gl�z� -- �! c.s� 5 �/���to; v� �; ly .%." e PUBLIC WORKS — SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENTDATE APPROVED DATE REJECTED CONZdENTS ........ -.. RECEIVED BY BUILDING INSPECTOR DATE JE Wiss, Janney, Elstner Associates, Inc. W333 North Avenue, Wakefield, Massachusetts 01880 MADE BY fzW SHEET NUMBER 2 U p �.� � L,� 0 L jJ I U CHECKED BY PROJ. NUMBER DAT _ ? () rOLLo w "-IG A RE";u e57' f -?-Y THE E W O"H Aw DovO rz 13u i z. o j w� P>=PAt�T"Mt�1T r AP- pLarr mT OF E 1G ATID :5EPPG �YST£tij w� LOCATE A X-40 ��E pW't'7� 331�.Ut.J . MOCIG GiiLUM)'jSE�(,TLaV— GoQf2 15Uo CSAt , 77)A)11- 7)A)IG4'-a 41- 6" -5 "wjr->E x 9'- "Gvuc, G N v OLIM A 11rOF uF-c1c (�l-AtjL/ 1Q6, 3'-lfl" 1 m r)' 5cl'fiiL Jyjr.1le- caV'E2 +\� N f �- f Z; 1,-2n l /% / rCU O VA? 100 p"id WJ Wiss, Janney, Elstner Associa 333 North Avenue, Wakefield, Massachu 9,0 ?-1 CA 12 L,1V AJ L �,1- tes, Inc. setts 01880 MADE BY SHEET NUMBER I— CHECKED BY pROJ. NUMBER DATE n _ n .. 11 1 - - i Tt? r r3 NPE,& Su PPo 2TET--- r�Y Goy , G LOS cr 7�� 7 S' = 014.S .2 X 3; s x Jz-= ,q q, Z X S. S - 14,E 4to, t. si= x oo psr- = 233016 Al2EA GF 10 J' Tu rhe 13fSTRESS = 4123 C, 16 %S p � Pt.P&jv-S OTU t3 E m Fl ra M S -n FF GLA--� C- q 000 p5p (j �G fi�R 1 �� co �.t�. OF Dov w3 tJ AT t U *� { fJU r ti! SE TAN !L C'V-) COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTA ,`] - :,6TECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 2v r,> _ C i+ a L71 o t j L. A !v E Owner's Name: N r g 6 R D W P -q?Qz Owner's Address: Z,> t3 C r} t; y=N t -AN c -��a7IV A N D O., M /K,4 Date of Inspection: I I IUI oil Name of inspector: (please print) Beniamin C. Osgood, Jr. CompanyName:New England Engineering Services Inc. Mailing Address:60 Beechwood Drive. North Andov ,MA 01845 Telephone Number: 978-686-1768 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 .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 Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 9 v 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. 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 how the system will perform in the future under the same or different conditions of use, Page 2 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Property Address: _ Owner: Date of Inspection: PART A CERTIFICATION (continued) 208 CARLTON LANE NORTH ANDOVER, MA RICHARD WALTHER 1/19/04 Inspection Summary: Check A B C,D or E / ALWAYS complete all of Section D A.. System Passes: LEL I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: Ald 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 determined (Y,N,ND) in the 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. ND explain: 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 distribution 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 pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Property Address: _ Owner: Date of Inspection: _ PART A CERTIFICATION (continued) 208 CARLTON LANE NORTH ANDOVER, MA RICHARD WALTHER 1/19/04 C. Further Evaluation is Required by the Board of Health: Conditions exist which require fiuther 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(l)(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 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 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 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address. _ 208 CARLTON LANE _ NORTH ANDOVER, MA Owner: RICHARD WALTHER Date of Inspection: _ 1/19/04 D. System Failure l _,,, .... app..%-Apie to all systems: You must indicate "yes" or ` nd' to each of the following for aIl 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 1/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped / Any portion of the SAS, cesspool or privy is below high ground water elevation. —Z 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 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 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] 41 (Yes/No) 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. You must indicate either "yes" or ` noP to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: _ Owner: Date of Inspection: _ 208 CARLTON LANE NORTH ANDOVER, MA RICHARD WALTHER 1/19/04 Check if the following have been done. You must indicate `fires" 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 this inspection ? Were as built plans of the system obtained and examined? (If they were not available note as N/A) -Z _ 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 baffies 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: Yes no _ Existing information. For example, a plan at the Board of Health. _ v/ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: _ 208 CARLTON LANE _ NORTH ANDOVER, MA Owner: RICHARD WALTHER Date of Inspection: 1/19/04 FLOW CONDPTIONS RESIDENTIAL Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): 6,6,06 -PO Number of current residents: ! — Does residence have a garbage grinder (yes or no). Is laundry on a separate sewage system (yes or no):.., [if yes separate inspection required] Laundry system inspected (yes or no): — Seasonal use: (yes or no): ,Arlt Water meter readings, if available (last 2 years usage (gpd)): Sump pump (yes or no): _4f;S Last date of occancy: /�U►_ r� f'-- -- ---- - — - ---------------------— COMIVIERCIAL/INDUSTRIAL Type of establishment: Design flow (based on 310 CMR 15.203): gpd Basis of design flow (seats/persons/sgf ,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): GENERAT. INFORMATION Pumping Records Source of information: too M Pr p Was system pumped as part of the inspection (yes or no): _/a If yes, volume pumped: gallons -- How was quantity pumped determined? Reason for pumping: 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) _ InnovativelAlternative technology. Attach a copy of the cement 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 - 19 -1 , L;-%— nformation:g-1,L;i ig94 Ply (Z ,,Z)�4 Were sewage odors detected when arriving at the site (yes or no): _A),D Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _ 208 CARLTON LANE NORTH ANDOVER, MA Owner. RICHARD WALTHER Date of Inspection: 1/19/04 BUILDING SEWER (locate on site plan) Depth below grade: 10 Materials of construction: cast iron Z0 PVC other (explain): Distance from private water supply well or suction line: _AIIA_ Comments (on condition of joints, venting, evidence of leakage, etc.): !'IPC IN Gt-)ora,J.D 110in JN gflsE-"Aee/V-T-' SEPTIC TANK; — (locate on site plan) Depth below grade: 12," 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) Dimensions: /5-,> £D i -L -O Al Sludge depth: 47 - Distance from top of sludge to bottom of outlet tee or baffle: Z Scum thickness: L f Distance from top of scum to top of outlet tee or baffle: 6 Distance from bottom of scum to bottom of outlet tee or baffle: Z© How were dimensions determined: m A5 e 4,f-, s n c , Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): %A;uK i N (rDca p/u N -P i?l 0 GREASIE TRAP locate on site plan) Depth below grade: _ Material of construction: concrete metal fiberglass (explain): _polyethylene other 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.): Page 8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 208 CARLTON LANE NORTH ANDOVER, MA Owner: RICHARD WALTHER Date of Inspection. 1/19/04 TIGHT or HOLDING TANK: ,,N# (tank must be pumped at time of inspectionXiocate on site plan) Depth below grade: Material of construction: concrete metal fiberglass _polyethylene other(explain): Dimensions: capacity. gallons Design Flow: gallonstday 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: (if 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.): --3��,� i.N raK cv•�a•�o.� ��sT�'�b�-,��.. � `+4i ,�,0 ✓�Oc=�yGc PUMP CHAMBER:/14-(locate on site plan) Pumps in working order (yes or no): Alarms in working order (yes or no): Comments (note condition of pump Chamber, condition of pumps and appurtenances, etc.): Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _ 208 CARLTON LANE Owner. — NORTH ANDOVER, MA RICHARD WALTHER Date of Inspection; /1 9/04 SOIL ABSORI`TION SYSTEM (SAS): (locate on site plan, excavation not required) If SAS not located explain why: Type ✓leaching pits, number: � S leaching chambers, number: leaching galleries, number: leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number: innovativelalte native system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): A R C4�= n, s s n Q .,., e2P t�s CESSPOOLS: kL (cesspool must be pumped as part of inspectionkocate 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: M (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 DISPOSAL SYSTEM INSPECTION FORM Property Address: _ Owner: Date of Inspection• . PART C SYSTEM INFORMATION (continued) 208 CARLTON LANE NORTH ANDOVER, MA RICHARD WALTHER 1/19/04 SKETCH OF SEWAGE DISPOSAL SYSTEM 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. Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSALL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 208 CARLTON LANE NORTH ANDOVER, MA Owner: RICHARD WALTHER Date of Inspection: 1/19/04 SM EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water to feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record - If checked, date of design plan reviewed: 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: NEW ENGLAND ENGINEERING SERVICES lk INC i Tf • �1i4 OF NORTH ANUC � ARp OF.HEMLTH JAN 2 12004 � January 19, 2004 North Andover Board of Health Town Hall Annex 27 Charles Street North Andover, MA 01845 RE: TITLE V REPORT: 208 Carlton Lane, North Andover, MA Dear Sirs: Enclosed is a copy of the Title V report for the above referenced property. The system PASSED our inspection. If there are any questions please call me at my office, 686-1768. Sincerely Benjamin C. Oood, Jr. 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 TOWN OF NORTH ANDOVER SYSTEM PUMPING R.ECOR_D ,,I Ofd I'E'vt OWNER & ADDRESS 0• c� .iVN. ( :- ')Ri ANL ER/ ' 'OF iEACT ' SYSTEM LOCATION (n,,ifnple: left frons of hou,t) L) 0 E OF PUMPING; 1611,O�XQUANTITY PUMPED t� �SPUOL NO YES SEPTICTANK `�O Y ES Al URE OF SERVICE: ROUTINE s>('RV.\TIONS: COOD CONDITION HFAVY CREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER >1 > I LM PUMPED BY: CC/�,/ U^� I l'S TRANSFERRED TO: EMERCENCY FULL TO COVCIZ BAFFLE'S IN PL.AC1,: LEACHFIELD RI,N13ACK., FLOODED Oj�HFR (EXPLAIN) NOV -- 4 2002 .A'f TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: I SYSTEM OWNER & ADDRESS Uvcjoer 3LO $ Ccs r I bn L -n/, N. owcku�� SYSTEM LOCATION (example: left front of house) DATE OF PUMPING:j�d (o _U ( QUANTITY PUMPED_12 GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: COMMENTS: y FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) CONTENTS TRANSFERRED TO: o`6 se; /P 11YA- Ci r n r a o 0 °o n ►r 4 rn c� 0 cn cn CL a ml 0 STEWARTIS SEPTIC TANK SERVICE 47 RAILROAD STREET BRADFORD, MA 01835 978-372-7471 KM OFOC47�Y (>r (�Rjt-) DATE ins 16 ZR ADDRESS &I or) J41 clh �3 i 7LL� H fteas(.? 3-)o 6rre-dendv.- '15F"R Ism 77 7 cr/ �1s 1066. 1 bc) �� iod'o 1w i 5�)J- 1115641) ,Yo -'s A ClflR6-0- _C2:n_LO /Was f-Wa� E i / S �'�" i //VL/E/e l 1CLFVd 7,-/c, NS -_- . 3 J 7 O O TO: NORTH ANDOVER, MASS oC t l9 19 BOARD OF HEALTH Re: Soil Absorption Sewage FROM: D'SIGN EN•'INEER' System Inspection This is to certify that I have inspected' .the construction of the said disposal system at L o 7` S 7 CfJ RL f o!y LAME North /Indover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated 1q Board of Health North AndoverZN.a.ae. 8EP'i'IC S25TEH� INSTAuLATICK CHECK LIST - OVED DATE DISAPPRUM eat Roast Mq���EI x AVATICN OK FAIL 1. Distance Tot a. Wetlands b. Drains c Well 2. Water Line Location 3. No PPC Pipe 4. Septic Tank a. Tees -_Length do To Clean Out Covers b. Cement Pipe to Tank - Cn Both Sides of Tank 5. Distribution Box a. Covers do Box - No Cracks b. All Lines FlorAng Equal Amounts C. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth a. Capped Ends d. Clean Double Washed Stone 7. Leach Pits -- a. Dimensions b. Stone Depth c. . Splash Pads d. Teas e. .'Cenent Pipe, to Pit ,- .Both Sides f. Clean Double Washed Stone $. Ila.. Garbage Disposal. 9Iriai Grading Inspection' 10. Barricading Covered System 11. As Built Snbmitted a. Lot Location b. Dimensions of Systam c. Location with Regard_to Pore Test d. Elevations e. Water Table ,., Boatd ,of Health :» E Ncrth..1i ndcver,Wa w .r ------------ APPROM Provided= � J Title 9 ! Reg 2.5 Reg 6 Reg 10.2 Reg 10.5 SUBMRFACE DISPOSAL DE.SIGm CHECK LIST -LOT # �� GVIMAJ ------------- DISAPPROVED . _ Reasons s FAIL CK :. The submitted plan must show as a Minimums a) the lot to be served-area,dimensions lot,abnttera b location and log deep observation hoes -distance to ties V location and results percolation tests -distance leac�g area �} design calculations & calculations showing .i rO �) location and dimensions of 5y5tem-including ceservs area existing and proposed contours 1 of sewage disposal system or g) location any vet areas thin disclaimer -check wetlands mapping 1 (h) surface and subsurface drains within 1001 of sewage disposal stem or disclaimsr (i) r cation any drainage easements within 100' of sege disposal system or disclairer-PLiuling Board files (3) kao= sources of meter simply vithin 2001 of Bu=gs disposal e stem or disclainer an-propOfied v 1 t° serve lot -100i leaching fac (1) location of -water lines on property -10' from leashing faflit^ m) location of benchmark n) driveways o) garbage disposals (p) no PVC to .be. used in construction i e septic tan (q) profile of -system-al evations of basemdnt, pluab j P P s gP distribution box inlets and outlets, distribution field piping an Other elevations (r) maxim= groimd meter elevation in area senagedisposaler o erste (s) Plan mast be prepared by a professional��e h plans professional authorized by law to P P _ Septic Tanks (a) capacities -150%' of flow, w3tex' table, tees, depth of tees, access, pu=9ing J (b) cleanout V(c) 10' from cellar --all or ingroimd sig Pool V (d) 251 from subsurface drains Distribution Saxes ►! (a) slope greater' taan 0.08 Li b) x ,1 4 1.1 I;, 3 0 uj I w 1L ILI WILLIAM F. WELD Governor ARGEO PAUL CELLUCCI Lt. Governor COMMONWEALTH OF MASSACHUSETTS ` a EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON. MA 02108 517.292-5S00 TRUDY CO> Secret: DAVID D. STRUT SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commrssior PART A _ CERTIFICATION �.0 8 ,i..� otr 1 ,1 Ka t 194� Property Address: _ rest o Ow r. Date of Inspection: �� ' Of different) Name of Inspector: Fi 4 $, I am a DEP proved system inspector pursuant to Section 15.340 of Title S (310 CMR 15.000) Company Name: Mailing Address:AR C -L 10G-L� GGq Telephone Number: aRTI f(CATf N 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Conditionally Passes _ Needs Further Evaluation B the Local Approving Authority _ Fa' inspector's Signature: Date' The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner %hail submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owne! and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, 8, C, or D: Aj 'SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: 51 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 teplaeement W repair, As approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N. or NO). Describe basis of determination in all instances. if 'not determined', explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank Iatlure is imminent. The system will pass Inspection if the existing septic rank is replaced with a conforming septic tank as approved by the Board of Health. (:.vLaad 04/25/01) page t of i0 DEP on the VYortd Wide Web: ntlD:rAww.mpnet.etacs.mi.uvdOP 10 Printed on RecyC*sd Papa? 10/15/1998 14:25 6174444699 HOMEPRO:NORTHEAST:IN PAGE 03 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 2 O t!� C.Y7► S►-TC%�%Qo'/��.p��ty W— Owners 5'CC l 415" V-r�'e—a Date of Inspection; Ct , Zq , 416 $J SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static: water level observed in the distribution box is due to broken or obstructed pipets) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipets) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipets). The system will pass inspection if (with approval of the Board of Health). broken pipets) are replaced obstruction is removed 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 the ~^ public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. LTH (AND PUBLIC WATER 2) THE SYSTEM IS FUNCTIONING E N A MANNER BOARD OF THAT SUPPLIER, APPROPRIATE) SYSTEM WILL FAIL UNLESS HAT PROTECTS THE PUBLIC HELY EALTH AND SAANDTRMINES THAT HE ENVIRONMENT: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. well The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply The system has a septic tank and soil absorption system and the SAS is within SO feet of a private water supply well. The system has a septic tants and soil absorption system and the SAS is less than 100 feet but 50 feet OF more from A, private -water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (appreattirttation not valid. 3) OTHER (rivia" 04/25/91) Page I of 20 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: L AtAV ( %OR^ C�k iii-ll7Od1 e , MA Ole�gq Owner: op—A We— Date of Inspection: q • 2-R - q�b D) SYSTEM FAILS: You must indicate ei;•,er "Yes" or "No" as to each of the following: ,I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to conecr the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/2S/97) Pago 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: duo CAe_►ZaNt , "Og_T" ► Dov( 2-� MA CnSA5 Owner: sc.o--C�c sa4e*^µC�0- Date of Inspection: R - Zq _ y I& Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No _ Pumping information was provided by the owner, occupant, or Board of Health. t/ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. V _ The facility or dwelling was inspected for signs of sewage back-up. f _ The system does not receive non -sanitary or industrial waste flow. V11- The site was inspected for signs of breakout. ✓, _ All system components, excluding the Soil Absorption System, have been located on the site. _✓` _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _ _ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub -Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) 115.302(3)(b)) (revised 04/25/97) Pago 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 20p CARR -%0N LAr(V- MA 0 t S A Owner: 5c 0T1 S edg vz-k v*Cte- Date of Inspection: Ct•2�1•q0 FLOW CONDITIONS RESIDENTIAL: Design flow: (SO st.p.d./bedroom for S.A.S. Number of bedrooms: 4 Number of current residents: Garbage grinder (yes or no):t0 Laundry connected to system (yes or no):Yas Seasonal use (yes or no): KO Water meter readings, if available (last two (1) year usage (gpd): Sump Pump (yes or no):1�0 Last date of occupancy: t ggCo - f. 5 /Dft� - 6,0,c300 6- k ct 91 — t 13 C ALLO WY6fiy _ 63,000 G COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non -sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no) NO If yes, volume pumped: Rallons Reason for pumping: TYPE 0� 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) I/A Technology etc. Copy of up to date contract? Other Sit'_:-Di1W F'AG lK �:t..vrJ2VJ APPROXIMATE AGE of all components, date installed (if known) and source of information: 1 `+ YAR Pas - - 0, l I Sewage odors detected when arriving at the site: (yes or no) 0 (saviaad 04/25/97) Papa 5 of 10 Property Address: Owner: Date of Inspection: BUILDING SEWER: (locate an site plan) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM WFORMATION (continued) So j3 t;FYt�To14 I.RT %lot^_ -ca ft*ufov(J? SMA X1.29. •�� �t Depth below grade: I e Material of construction,_ cast iron + 4t) PVC _ other (explain) Distance (ram private water supply well or suction line M 1.)14L— Diameter 1% Comments: (condition of joints, venting, evidence of leakage, etc.) nKtJt-ftny4 gK $td-gwx SEPTIC TANK -,Z (locate on site plan) Depth below grade:lZ material of construction: Zconcrete ,metal Fiberglass _Polyethylene _other(explaln) if Link is metal, list age r.... Is age confirmed by Certificate of Compliance _ (Yes/No) Dimensions: lot K 5 t' g�) x `- Sr Sludge depth: I Distance from top of sludge to bottom of outlet tee or baffle: 31 Scum thickness: - Distance from top of scum to top of outlet tee or baffle: �- Distance from bottom of scum to bottom of outlet tee or baffle:_ How dimensions were determined: MfIAStrt4,tt:Mi�tT Comments: (recomrttendalion for pumping, condition of inlet and outlet tees or baffles, integrity, evidence of leakage, etc.) _ 0_ CA?ja;;tS _ Vtt.VC w0 CREASE TRAP: (locate on site plan) 0%eA" CPsQf- 9( m �o *� � liquid level in relation to outlet invert, structural c(E`vMF�uNG- Depth below grade: Material of construction: _concrete _metal ,_Fiberglass "Polyethylene _other(explain) Dimensions: Scum thickness Oisunce from top a( Kum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: — oat of lax pumping: Comments: (recommendation for pumping, condition of Inlet and outlet tees or baffles, depth of liquid level In relation to outlet invert, structural integrity, evidence of leakage, etc.) (ssvlrad 04/25/87) page 9 oat 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 208 cpp-_-com L�N� T`l°+�rt4 tq"0ov�'. t MA 0 te4� Owner: SCcJi1 �' Date of Inspection: cl • ZG ' ra TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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: gallons/day Alarm level: Alarm in working order _ Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: v (locate on site plan) Depth of liquid level above outlet invert: - 0 Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.)_ A _C,nV c LPOP - . 1DtS-%/aRij-1(m4 -QQfNL A"d Kit % ldej a OP t_VAY- PUMP CHAMBER:_ (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/75/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 2 09 CAP—L Lf�etF No y( A� IJcv�►Z,, MA MOA �� Owner: CF- S' Civ P ry Date of Inspection: q , 7-9 , q e SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non -intrusive methods) If not determined to be present, explain: Type: leaching pits, number:? leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) 'Oee ict? lS t�14(`N1Gkt� — CESSPOOLS: _ (locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) 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.) (revised 0{/75/97) Page 8 of 10 Property Address: Owner: Date of Inspection: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) 2 (D Qj CA (�—LTo N , N0,e--ab NtA00"-, , MI\ sco-rt G, "O,�C A tam q.2a,q�? SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) C�rLT(OVA [-A V�l A.-- iN GfZoV14x� PLAN l - IN PSGGQf-' 1'�-f V- 1� -I., TO off t�G O .(6Q,4 Lo cA-t t oN (revised 04/25/97) Page 9 of 10 13 Property Address: Owner: Date of Inspection: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) zo 2, CRK'LC ;C0't4 LAI-te , 'NOe ctA -5c of 1 I-Sev "LAt4C31L &I -2q-99 OWL \ Depth to Groundwater g Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) 7. Cwf;�tc�2 A� ��5fl�� �-c ► �`E� (revised 0{/25/97) Page 20 of 10 r i ' • W (���1'�• V S;R Cs� V, CA-(�.a0 V-A L.Avw- N - PSIA%)OV WP n pvJp vv I 1 z-rlw: m a �o N W or .o I I CD •% LO t W I I x O O r 0 1 rt a ••f v 'r1 -4 •V •V 00 w "n I . • • • t N. W I o u1 1 v v rt rt1v� m 1 �• ' J I p -► r=* N N I p' rp i t '1 Z -IJ W N -►NCC) 1 0c O Nip JN� i pAD � nrt, aaaaaal-•� I � W I C7 -40 3 00.40L 1 In O c rp N o. rt •. � �. •. 3 I n .. rp •O b •O v O I Z -t V, a a o. o I A r? v o� Nca -" a C N I O V9 -J N• rp � I O 1 -► -h Z c I Ui %0 V1 1C 1 c O J W .1 J J 1 a V1 I rt a A a aaa WW3�-o v u 0 rt C Z m O C Z O N-- -- N c rD vp-►vvp '-� W •• ••, rt a�ONw3-S I W O V1 V9 v1 I "% a a v = rt ar, w W � � too N rn x N rt -I W N-�NjN I O �Opvp W I c't7N rr W I N Z O w aaaaaaY• I M M O. F+ N 1 1% c .. N I •• N �pvv-+vw 1 •• -� Nwa�oNw� 1 ro '•.tt�t"�Ia I c 42-0 C I N W W W W 3 1 O 1 I rt I = I N In I y I � W 1 1 u l I I j W N N N;r 1 I 00 pNl`t7. W+•1 I 1 aaaaaall I I I N c1.Qgj �,e, �AkADJY�,- It�sP. roaomn rx�>> rtn O Pt 1 C7 fD Z •� .. a rt Z c n •• oo S 111 a p .. N J � p 6 �u 6-J 6-J C G 3r••,cv3v rt > > W. rt rr In W.Im Z c c� rr rr W. •. rr O so In rt # = CL •• to •• S m v 7 Z R p u p v v r. v p (,0 v 1"• c u p W C O- c� o - O, :t- 3 ro a rt 6-1 rc»3� o�N•cp nn�1� .s rt ro r•t •v .. H. a W= In pPJ- I -"M © N N.ro .. r N C z N v v fA © QC m v Z p r• v..r p r a, H. p N In r v c n ro v C rt p v r0 .p as \ ©1C • • ao o = v ac MIT rt 06 n ; u u u u u STEWART'S a s SEPTIC TANK SERVICE 47 RAILROAD STREET, BRADFORD, MASS. 01835 Telephone: 372-7471 Date Street al City SERVICE CHARGE DIGGING PUMP TAN''' SNAKE LINE SERVICE CHARGE' ` Od Not responsible for grass & driveways. INVOICE DUE AND PAYABLE UPON RECEIPT Driver Signature Work done in satisfactory manner. aq? , ANDOVER SEPTIC 47-RaUroAM ad Street ROTO -R" Nature of Service Reg O WC (978) 475-2593 Bradford, MA 01835 (978) 452-9022 O Reg. O Emergency Emergency ❑ Day ❑ Night Date SorvicK PAY FROM THIS BILL Custo erN'am'e—: Septic Tank Pumping and Cleaning "Done the Right Way" Emergency 24 Hour Service - 7 Days a Week Service Location: Phone: Contact: Billing Address: City: � _ / V� Zip: Special Instructions ❑ Completed ❑ Incomplete Reason: Per: AM/PM Services Rented Vacuum Pumping Observations Drain Cleaning ❑ Septic Tank ❑ Good Condition ❑ Main Line ❑ Dwell ❑ Leechf'ield Runback ❑ Toilet Bowl ❑ Leech Pit / Overflow / �� ❑ D -Box C) 0 ❑ Pump Chamber ❑ Grease Trap E3 Catch Basin ❑ Portable Toilet O Other Ory. Size: ❑ Under 1000 gallons ❑ 1000 gallons ❑ 1500 gallons ❑ 2000 gallons ❑ 3000 gallons ❑ 4000 gallons ❑ 5000 gallons ❑ other ❑ Riding High (liquid level) ❑ Full to Cover ❑ Excessive Solids Top / Bottom ❑ Use No Powdered Soap ❑ Heavy Grease ❑ Roots ❑ Suggest Electric Rootering ❑ Van Called ❑ Other ❑ Kitchen Sink ❑ Bathtub / Shower ❑ Vanity ❑ Floor Drain ElYard Drain ElVent ❑ Sewer Jet ❑ Other Footage: �G Misc. ❑ Digging Charge ❑ Backhoe ❑ Inspection ElLocation n. ❑ Consultation ❑ Certification: P/F ❑ Service Call ❑ Labor ❑ Estimate Reason: ❑ Portable Toilet Rental _._ ❑ Pump Repair ❑ Waiting Time ❑ e_- --- it Digging Charge Is Per Driver QChemical ent Discretion ❑ Other - Description of Work Recommendations Terms of Payment Parts Vacuum Pumping Yr, Drain Cleaning Month Yr. Month NIETI��A"11YS Tax Discount Terms & Conditions ❑ Cash ❑ Check ❑ Credit 1. Not responsible for damage beyond curb line. 3. 1.S% per month will be charged to accounts past due. 2. All complaints shall be reported within 48 hours. a. The purchaser agrees to pay all cost of collection. Total l Customer Signature HE WILLIAM F. WELD Governor COMMONWEALTH OF MASSACHUSETTS - scc�Sv-�_, (,� 0�_". EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON. MA 02108 617-292.5500 ARGEO PAUL CELLUCCI Lt. Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A r CERTIFICATION Property Address: l0� 2Q' CLO VA re s 'OMf __1Wn©1$4� �' Date of Inspection: (If different) Name of Inspector: `q&O ; MAD -D V X I am a DEP approved system inspector pursuant to Section 15.340 of Title S (310 CMR 15.000) Company Name: 10M,6-4161 uoeiRaots-C me Mailing Address: $4-Qt�-t PLEM AVS I hill] 021.c(. -z Telephone Number: E300 - C0ro2- - GCoQQ� TRUDY CO!. SccrcU. DAVID B. STRUI Commission 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Yasses _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: � Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owne and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR Any failure criteria not evaluated are indicated below. COMMENTS: 15.303. B] SYSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upor completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; oi the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:/twww.mgnet.state.ma.us/dep 0 Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 2 p Q� Cf�Rt"�t pal LA S ( QQ"C� PAW4kVQA,-t MA 0 k 04 5 Owner: �@,q"- Date of Inspection: cis B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed `C1A PL S?- Ytc- -(AN41 - IkAs At4 C3APPt_ - -r"T %4ev-4�S Ra'eLA C0— l.W'T - Au- a ct{reaR Cot, t Vtl>t,-cs AfR- 6uru--ctov4 (,-+Ct As tte-c"o4p 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM 15 FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/95/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 2 d Q CA41,LT() f`@ L Iktiv- ( t�(0`"n`- R4 -Lb ovilik t M A 01.ib45 Owner: scotiZ Date of Inspection: q • D) SYSTEM FAILS: You must indicate ei:,:er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: hop CAP ---Cat`` I, Mt411 , "OeCIT,W lk"Ovf R_. MA o vaAl5 Owner: sco--C-� Ga'Nl "VgCL Date of Inspection: 9 - Zq ^ 91& Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No V _ Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. f _ The system does not receive non -sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub -Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)) (revised 04/75/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Z o 9 CAR,LZO" LAtt.V H.O1,6y (Rt Ov , FAR 00845 Owner: SCoT-f SV&k1°�`4 Date of Inspection: C� , Zai • °i s FLOW CONDITIONS RESIDENTIAL: Design flow: (50 a.p.d./bedroom for S.A.S. Number of bedrooms: Number of current residents: Garbage grinder (yes or no):jJ0 Laundry connected to system (yes or no):Yf'S Seasonal use (yes or no): KO C _ �� � /D Cap,000 G Water meter readings, if available (last two (2) year usage (gpd): f Sump Pump (yes or no):1�6 1 q 91 V1 GALLOV Y0 4Y _ 63,000 G Last date of occupancy: COMMERCIAUI N DUSTRIAL: Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non -sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no) NO If yes, volume pumped: gallons Reason for pumping: TYPE Off, 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 04/25/97) Page 5 of 10 .1;,PW PA C-9 LIR CW VJ W 14 `eA2S - -�'-0,H- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 2-00 3 cpr(>'L'covQ LAW a �'(aP`Cb1 R�-W®Ulk NA Owner: �Co"C-i C1"0&"4'Lr— Date of Inspection: • Zo{ QQ) BUILDING SEWER: (locate on site plan) cti Depth below grade: C b Material of construction: _ cast iron /40 PVC _ other (explain) Distance from private water supply well or suction line M fat46. Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_✓ (locate on site plan) Depth below grade: IZ Material of construction: Vconcrete _metal _Fiberglass _Polyethylene _other(explain) if tank is metal, list age _ Is age confirmed by Certificate of Compliance _ (Yes/No) Dimensions: 10 1 K S I - ell _ x S V- 81 Sludge depth: I Distance from top of sludge to bottom of outlet tee or baffle: '3 1 Scum thickness: 2 Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: t 1b How dimensions were determined: fVtRASUtE'.rW�Ni o 1 eY4'! Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) CONCR'V2 tC dLq(,VZ �� �� GP_VMQ'Ll9& 22k:nc�,M"T 5PactVia> tH P,R2tc3 - C0ito\-t•k0q 4t- Ass; -cu3,z t1,\VdAg-T E iN L5 -?1 I to R KaaA V.W COQ VC10U A 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: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 04/35/97) Pape 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: '2O8 Cp*t--coM L-P� t t - Oe -T(4- AWoVf-4P, t NSA 0 Owner: Sc� t SVJJVCf� Date of Inspection: q lzq , Ta TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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: gallons/day Alarm level: Alarm in working order _ Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) f) &J( (S LeQyA- t 0%S—%aR jtot4 fz-Qk9P4L- &,Kt1 TLA Uhdbhtl- OF LtAIC661 PUMP CHAMBER:_ (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (seviped 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 2 08 WL-[0ll LAH , 'l4o"1 ( PrNtoovbi ,I MA o 1 @- 41� Owner: �E -( e=�ev P=. E'er Date of Inspection: q • 29 • Q 18 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non -intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) CESSPOOLS: _ (locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: _ (locate on site plan) Materials of construction: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (=wised 0//25/97) page a of 10 Dimensions: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 10 91 CPr (b,-70 N , t4()fgx k WOO",", �&Pt Owner: SCoT-C Date of Inspection: q. 7-q SKETCH .7 - SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) -p V'0K VO\JJIA 20�� Sem, (- It Att►: 'Dowty C��L,-T©�A [-AVAE <2o01�tt PLA14 10- la 84 z).(6qv, Lo cPrct o" (revised 04/25/97) Raga 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ,��p ( A Property Address: 'Z© �'s GAKI-CzOt4 �a�� , t� O RM'taK, +Yt Owner:-5C,(3j-(' V4kkcsL Date of Inspection: Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation.Must be completed) PO,A ftrt C,©A b,� `AUL• J.-9AK?t 6-A0-0 ' `µit',�-�o+gr1��`�(1CA'V- z 5'Cd 1 Lt' A !, C �.J. 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W1 I I Chi 1C 1 I CO O 10 p aaaaaa 1 I ChC C7m I I rt O.. . u 1 u p I u u u u u aC1, STEWART'S a s' SEPTIC TANK SERVICE 47 RAILROAD STREET, BRADFORD, MASS. 01835 Telephone: 372-/7471 Date M� Seve ,v Streetat city SERVICE CHARGE DIGGING PUMP TAN"" ` SNAKE LINE SERVICE CHARGE' t OC) Not responsible for grass & driveways. INVOICE DUE AND PAYABLE UPON RECEIPT IOTA +� Driver AZ 3 Signature Work done in satisfactory manner. e i, i(>;;�,'jily'`�ry��i�'�'�!i �1',�M1���lA1��fr� Vt('p;b.k,,��}}t rt 1•'^i:•' ;•a.Z...!'P•. ,1• .. I .:,llJJ,r�ti.,•,yli: tVGYI ;Ytl lf�l .t.^C1'ld,,r6' 1 `. .� . .(` 'SII ,/ `I Y^•� I l,t, l l..'. .1: L., l,'Y'. •� .- .��i11� 1 111'.� ,.1 1�lli, yf� "f?{i•,rY1 '..'. �T�`;,q'�,I..•. �..�.....�..�.��... o.... . I`1',�.•4i,(rdi'1'':.;'�i>`',�.:,%%'1(Jr'IJ1.� 'T.,.1. l r' 'IW_(1 W:�.' 7i t•„ h 1.,`'a ��;•''\,.V LII i.i Tll\ll!lu ll. �\!i '1�1>'.Y �: l,�:fi: Ihi41 :S �•:ITI,+iTO ia'.•�;Py'. . . 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I 'I,:'•1;,J:.}�.j;?,u:"fnl,,;., ka„1,;'7,%,'ri'.e';u ,;:;� '� ... .',.... .,1;1';1 J•�IIrY ?�, {qrI d� 1 J 1j.:Y1; , ,'S, bi.;:q l,� SII n,I.'..,;y',ra•� ,. ': 1.:.. T---�--�---•—•- 4 E 6 1 e o'd "r 7. Ph of PrOldo form for use by locdl Boar( be's ubm,l4,id to:thq.10CAI'Soard of Health or other Facilit f 177. I 1 y. nfdrftation a� 0,* the W key" Address to move yQw :•.. . . "—/& vst M owner'" t' -'P% saw 9 'MAY. 0-9 408"... of Health. The System povy lag vo�fffu , , M DOVER P H-cAL1HDEPARTCNT- ping Recorc -r,_: e,� -------------- ''`^dr(rr- - - - - - - - - - mala ,/7 - IT $Late ZJP 9V4 Telephone Number 9, UM Plh I,Z No; of x".. 6< Dot . 2QuanUty Pumped: L5 ,, Gallons 3 'T' YP.Q 9 'sy4terh::,. COS tic Tank ❑ Tight Tank 4 i' ee FlIte C] Yes If 1Effluent yes. was it �Iean'ed? C] yes C] N)o lb. `',:'•7r44 Q j 0c V 1 .4., I "Ay J U Wf VY h It IMF *7. Date SWOM PU/41n9 Record - Pige 1 �! !