HomeMy WebLinkAboutMiscellaneous - 2201 TURNPIKE STREET 4/30/2018 (2)QN
Na
C
c
:2
O
Ln
m
o cn
o �
o m
o m
o m
rr
fi
O
m
MAP LOT # .... .......
___
PARCEL # STREET//
'
CONSTRUCT.-ION_HP2RWVAL.
HAS PLAN REVIEW FEE BEEN PAID?=X!�-S—NO
_
PLAN APPROVAL: DATE APP. BY_____________
DESIGNER: PLAN DATE
CONDITION
WATER SUPPLY:
WELL PERMIT__
WELL TESTS:
COMMENTS:
FORM U APPROVAL:
DATE ISSUED
CONDITIONS:
FINAL APPROVAL:
TOWN
DRILLER_____________' _-'-
CHEMICAL DA|E APPHUVED_______
BACTERIA l DA(E (U`P|lUVED
BACTERIA II DA7E APPHUVEU______
APPROVAL TU ISUUE YES NO
BY
ALL PERMITS PAID NO
WELL CONSTRUCTION APPROVAL YES MU
SEPTIC SYSTEM CONSTRUCTION APPROVAL 4�-� NO
OTHER YES NO
ANY VAr�IANCE NEEDED YES NO
FINAL BOARD OF HEALTH APPROVAL: DAE: DY:
k�4��/Y
�-�� c� Le 5 �/
�-=,..^ /,1 ���������'
'
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 or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT_i t cLa rd 4S PHONEl70 62(�.-8'q93
LOCATION: Assessor's Map Number PARCEL
SUBDIVISION LOT (S)
STREET ke S ST. NUMBER
OFFICIAL USE ONLY
RECOMMENDATIONS OF TOWN AGENTS: I
/ CONMERVATION
DATE APPROVED U/O& V
DATE REJECTED
COMMENTS �✓P��:5 ? S `ro. Orocr� ��. % . ��
TOWN PLANNER
COMMENTS
DATE APPROVED
DATE REJECTED
FOOD IN CTOR-H TH DATE APPROVED
DATE REJECTED
P 1 INSPEC -H TH DATE APPROVED i a
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
/ PLOT PLAN OF LAND
IN
NORTH ANDOVER, MA. _
�V RICHARD F. KAMINSKI AND ASSOCIATES , INC. • NORTH /ANDOVER, MA
0
TURNPIKE (RTE.114) STREET
ftf, rl,�J G7r W v Pepe A izele_L • - r,LX� cli:,&a r-,.0- R.r.,,
PREPARE FR, Property Line and Street Line Offsets Shown On This
� �tQVr!VL+ 7 Peon Are Specific�oIvfly For The Oeterminotion Of Zoning
Fienuire PI O.
LOCAA�TIIO�N::: , IQ�E iiA The 6-,J Locoted On Lot_T
"IN�NF' —`7� '� G� �``N of �a Is &9 _Located Within Zone A'.;rrec
SC 11L�E : 1 X DATE : k O � $��/^�i� 0f fOO yr. flood ) As Shown On 11.U.0. F,rrr
y Comm. Pon 1 ° 2�7G7G��i� Odl�f
PLAN REFERENCE:l �AAlO N _
��l- r „ Doted: q -
BEING
BEING ON A PL N BY A No. 3075 Q I hereb Certify Thot Thr t'
�$' Y ! u1�Dla7_,Gti
j�� {�jijG'7 �s�'11tR ' Shown On This Plon'I5 Loin,,;] On The
h tANd
DATE DAND RECORDED IN A5 Shown Ano Thou Its Location Dries
:�� {q
r,
EiX COUNTY c� Conform To The Zoning Lows Cf Tne 'Iowa
17 ��JLJIf%. �I`7 .
7-7 1 City Of When Constructs:
-- - 2 f- 7
9
'Y+s;
'wtx`
f'
'` ,.
L.c�C ATGI= 1 U � D• A�!�'�i.' 1, i '�/ �% . r �
_
ki Etl1Z-rl-1 . A 1 => ov Ems: tv'(q cam,. S
17
•�T �< �
t LCAT �
� •
EY -1,5T, SOLO
r
.. •• �
� 21z
l\k,
'
�� �✓`
1'.45.'28
�
..
,,..- r`
11=y- T14A
o f=, FS T +tow ►.1 ` AQ.� Co Q: T 1-1E
ie- 8 tj
S K o 4.r &.-I
VJ r- -ri 'iFl E. z,61�1 �l� �y
�E`z-fc.t2 t it t cx-T- t c61...1 i:=,
'
Pty l...Ak„(S co �
�CouF-o2M rr�'y "d2 I.lo�;l Coni F-o2✓M fT5/
'01
9
'Y+s;
� V
•
GE�r• l �► E.D •�ou u AaT+ n wi �. A t•J
AS O' -
...
a S,u: lwS.t3"
c
{
V-14.7,37
^
^ .
'
`
• .
�. 'l4-Ss4 ��
145 i
.,
`
� •
...
• - ,"
145 �r
..... _
tU(1. s�
,
F
-r Wrvi
° `T'H� d F'_rr' SATS
l.)'y�•, ro F" "T-4-bpm � U t�...`C71►,1 � ..
O�� ��
S 1-L o
`i A --A o V S
�,c1 rrH 'THE.ZoUIUG
W.-AAmr kCo),.f oF' �c&-A ItiG�
H
Pay L..jjp►.���►�s o -
Cd&AIora,M rry 02. ►10►., coti F-o2,e✓, 1-ry
!7 .
NNNV«1C_: aM
\A.J N Q— I.S Co 1J ST i�+l )GTEifl.
$
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE: S-jLQ(qL—
Co01A5
c).2o l TZA rte;
SYSTEM LOCATION
(example: left front of house)
� -CT�- ��Ov�- 0-� kous�-
DATE OF PUMPING: S-1 `i_b -QUANTITY PUMPED O � GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
-Z
NATURE OF SERVICE: ROUTINE —Z EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
Saul io -
CONTENTS TRANSFERRED TO: e5--, L ° J - > .
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE: -G-6
SYSTEM OWNER & ADDRESS
6ctt"O'5
SYSTEM LOCATION
(example: left front of house)
DATE OF PUMPING: (a -6-61 QUANTITY PUMPED [SO 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:
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
CONTENTS TRANSFERRED TO:
co,�..�.�
TOWN OF -er'
SYSTEM PUMPING RECORD
DATE:
SYSTEM OWNER & ADDRESS
APR 1 8 2003
DATE OF PUMPING: q- � S -63, QUANTITY PUMPED : ` S CZ GALLONS
CESSPOOL: NO X/ YES SEPTIC TANK: NO YES ✓
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COlVIlVIENTS:
CONTENTS TRANSFERRED TO:
C onIlMonwettith of Massachusetts
4��CMassqcliusetts
System Pumping Record
System Owner
��O 0V's
System Location
S�-
Date of Pumping: Quantity Pumped: /��gallons
Cesspool: No Yes L._) Septic Tank: No Yes
System Pumped by: Felred4l6 it aided License #
Contents transferrred to : Greater Lawrence Sanitary District
Date:
Inspector-
A
•r�
vo
Cesspool
No Yes L) Septic Tank: No Yes
System Pumped by:
'"` _ _•__ �Ca.,.__�_t�� !Sc��1�r.. ilir�riw� ..: '..: .,, c,.+v,r..._ .. :. "' ,n"'3»�.r!f`, .., _. "...,.
Contents transl'errred to :
Date:
ttt 44,��
'"` _ _•__ �Ca.,.__�_t�� !Sc��1�r.. ilir�riw� ..: '..: .,, c,.+v,r..._ .. :. "' ,n"'3»�.r!f`, .., _. "...,.
Contents transl'errred to :
Date:
Applicant Applicant
Site Location
Town of North Andover, Massachusetts
BOARD OF HEALTH
Form No. 3
DISPOSAL WORKS CONSTRUCTION PERMIT
A
LI
ESS
M
Permission is hereby granted to Construct ( ) or Repair xan Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No.
Fee
CHAIRMAN, BOARD OF HEALTH
D.W.C. No.
Mr. David Burns
12S
DebG0 P P
0 Governors Ave 155
Medford, Ma_
Northeas�Environl`ne�ntal �,E
Labor6ory�,
Inc.
17
271 Western Aven�i.123 ttix. ('171 X771•
Lyn^ MA 01904 L019
Report No.' NE
August 20 , 1992
IlAntlliYsis of well water ' on August 18, 1992. from outslde nozzle 01 new
was Taken by Steve Murray
gaM tin : Sample 1 Turnpike.
house in North Andover #2Z0
An is: Date Guideline*
Result Analyzed
Lab Id pindinjS 08119!92 6.5-8
per 100 m1 0 08118/92 6.5-8.55
4926 Total C011iam ga�erial count P 7.96 08118/92 30-100
PH 166 08118192 15 max
Alkalinity <5 08118/92
Color 45218132 50-200
Specific Conductan'.e (Pmos/cm) -26974 08/18192 0$!19192 50-150
Hardness 65.8 0.3 max
Calcium Q.12 08119192 p.05 max
Iran X0.08, 08!19/92 -
Manganese 10A 08/19192
Magnesium 11.4 08/19192 11. max
Sodium 08/18/92 .0 max
Turbidity0.8 NTU 10,0 max
0.26 08120/92
Nitrate X0.02 08118192 1.0 max
Nitrite 08118/92 250 max
Sulfate
Methods-. Standard Methods for the Examination of Water & Wastewater, 17th L..
Methods for Chemical Analysis of Water and Wastes EPA -600/4-79-020, 1983.
* Guidelines are based on Private Well Guidelines recommended maximum levels of the
Commonwealth of Massachusettes, Department of Environmental Protection and Bureau of Resource
Protection . ( Division of Water Supply . October , 1989.)
A
By. — dt�
John Lovatt / Lab Director
a
to
BOARD OF HEALTH
120 MAIN STREET TEL: 682-6483
NORTH ANDOVER, MASS. 01845 Ext. 32 or 33
October 15, 1990
Mr. Robert Nicetta
Building Inspector
Town of North Andover
Re: Lot 4 Turnpike St.
Assessor's Map 108C, Lot 59
No. Andover, MA 01845
Dear Bob:
Tye ar
On October 10, 1990, I conducted a site inspection of toe Y-rO CM
'-above referenced lot. Large amounts of construction debris had J1
been dumped behind the existing dwelling. I am not quite sure if
this dumping violates any Public Health laws and I am in the
process of getting a determination through the Department. of
Environmentsl Protection.. Upon my inspection, I discovered that
the trucks dumping the material had been driving over the
leaching facility and would appear to have crushed the system.
This is evidenced by the collapse of the distribution box.
It is my understanding that a certificate of occupancy has
not yet been issued by your office. This letter is to inform you
that the Board of Health final approval has been revoked since it
is evident that an acceptable means of disposal of sewage does
not presently exist for this lot. Therefore, the certificate of
occupancy should not be issued for this lot until this matter can
be resolved.
Thank you for your cooperation in this matter.
Sincerely,
Michael J. osati
health Agent
MJR/rel
c.c. J.J. & E Realty Trust
BOARD OF HEALTH
120 MAIN STREET TEL. 682-6483
NORTH ANDOVER, MASS. 01845 Ext. 32
June 3, 1992
Edward Plugis
J J & E Realty Trust
9 Garden Road
Pinehurst, MA 01866
RE: Lot 4 Turnpike Street
Dear Mr. Plugis:
This is to notify you that before the Board of Health can
sign off on a Certificate of Occupancy on the dwelling at Lot 4
Turnpike Street, North Andover, there must be a record of a new
water test on file in the Board of Health office. The test that
was done in 1986 does not fulfill current requirements for
drinking water tests.
me.
If you have any questions, please do not hesitate to call
Sincerely,
Sandra Starr
Health Agent
-�--� _-_ - - l
,� ���
BOARD OF HEALTH
Town of North Andover,Mass. Ft!l
rmit 19APPLICATION FOR WELL & PUMP PER
application is hereby made for permit to.drill a well (_). Application is
Wade to i%stall ( ) a pump system".
.ocation: Address f0selob
LoC ##
Dwner/y///�f-,� I- r/,12r Address S106LiY1NGS7' 0& f��/�SSpiT,�l.
Gell Contractor V'✓�' 11�� Address �1 Tel. `�–
/ &03
Pump Contractor �C Ga Address %� aK Tel . -5a-3
aELL CONTRACTOR (To be completed at time of piunp test)
Type of Well Well used for
�, o
Diameter of Well LC _Size of Casing
r
Depth of Bed Rock Depth casing into Red Rock
Was Seal Tested? Yes (_) No (–) Date. of Testing r
Depth.. f IJP i-3 – Well Ended in What. Material
Depth to Water- Delivers S Gals.Per Min. for 4 hour,
Drawdown Jars feet after pumping --Y--7 hours- at CPM
Date of' Completion/
Signature lJe`11 Contractor
.��r X k�:r:ti:Y:Ysc•::ir;r..�r...ct::S; '{%::'c.:iksc'c;ccx:... ...................... ...r........ ,. ,..... ,. ,. ,..... .. ,... ,. ..
PUMP INSTALLER (To be'- filled in before i nstal lati_on)
Size & Name Pump 1,� 'c. --,_..___._.__Pump Type Used
Water Pump Delivers S GPM Size of 'Tank _ Gv�f a
Pipe Material Used in Well: Cast Iron (_) G1I vrini zed (_) Plastic i
Well Pit (_) or Pitless Adapter (io) \ Was sleeve used to protect pipe? Yes (_) NO(X) Type or Name Well Seal
McKINNEY ARTESIAN WELL ` ,I �/•
Date .� – – & pUMP SUPPLY CO. INC.
��'r�r�t>4it��t�M�r���r�1r�4iM�M�M�M�M�4t4tM�4tk�th�MtY*'PLr.�.wton Rd Rt.Q3�F4'ri'r1.1 a''�DGn%D�;��,
(Date Water analysis.report •submitted to hoard of Ilealth__
'Date release given tD owner of record & Bldg. Insp
Health Inspector
7houtemen .C'aloratory, Am
66 LITTLETON RD. - WESTFORD, MA 01886 (617) 692.8395
Report Number: C-059-9167 Report Dater July 25, 1986
Client: Sample Taken at:
ATTN: Mike McIntyre Ed Pluges
Merrimack Well & Pump Rte. i i -i
Tinker Rd. North Andover, MA
Merrimack, NH 03054
Sample Taken by: Requester On: July 23, 1986
CERTIFICATE OF ANALYSIS
TEST PARAMETER
EPA MAX
RESULTS
UNITS
Coliform Bacteria
2
0
per 100cc
Total Plate Count(aerobic)
Not Specified
NT
per 100cc _
"Acidity Value
5-9
6.7
SU
Alkalinity
Not Specified
NT
mg/l
Arsenic
.OSO
NT
mg/l
Carbon Dioxide
Not Specified
NT
mg/l
Chromium
.050
NT
mg/l
Chloride
300
NT
mg/l
Chlorine(total)
.7
NT
mg/l
ChlorineCresidual)
No Taste
NT
mg/l
`Conductivity
Not Specified
NT
mhos/cm
Copper
1.,0
NT
mg/l
Dissolved Oxggen
Not < 5
NT
mg/l
Flouride
3.0
NT
mg/l
Hardness
No Limit
NT
mgt
`Iron
.3
< .02
mg/l
Lead
.050
NT
mg/l
`Manganese
.OSO
.025
mg/l
\Nitrates(as N)
10
NT
mg/l
"Nitrites(as N)
< .1_
NT
mg/l
Ph05phate5(a5 P)
.025
NT
mg/l
Selenium
.010
NT
mg/l
Soap
.1.
NT
mg/l
Sodium
20
NT
mg/l
`Sulfide
No Odor
NT
mg/l
'-Turbidity
0
NT
NTU
NT ® Not -Tested
# - Value Exceeds EPA STD
Massachusetts State Certified
Microbiological Drinking Water
Peter T. Thorstensen,
for
Laboratory #33051
Thorstensen
Laboratory, Inc.
Department of EnvironmeQ'Aanagement/Division of Water Resources
1
WATER WELL\6OMPLETION REPORT
WELL LOCATION
Address ut e 114
City/Town N. Andover, .lass . -
G.S. Quadrangle Map
Grid Location
Owner Ed Flu pis
Address 9 Garden Rd. Pinehurst. 1.1.
WELL USE
Domestic Q Public ❑ Industrial-❑
Other
Method Drilled _ 1Sf 7r�r
Date Drilled 7-_22-86
CASING
Length 501 Diameter 611
Type Steel
CONSOLIDATED WELL
Type of Water -bearing Rock Gran] tP
Water -bearing Zones
1) From "x.901 To q l; n 1
2) From To
3) From To
4) From To
Depth to Bedrock ;9/
UNCONSOLIDATED WELL
STATIC WATER LEVEL Water -bearing Materials
Feet below land surface 30t Sand: fine ❑ medium ❑ coarse❑
Date measured 7-22-86 Gravel: fine ❑ medium ❑ coarse E)
GRAVEL PACK WELL
Yes ❑ No Q
Screen:
slot # length from
Split Screen (or 2nd screen)
WATER QUALITY TESTS MADESlog length from
Chemical ❑ Biological ❑ I Depth To Bedrock
PUMP TEST
Drawdown feet after pumping days hours at 4 GPM.
Howmeasuredair C0MT)rP.SSFTe6overy feet after hours.
to
to
LOG of FORMATIONS COMMENTS: (On well or water)
Materials From To
,14\)o
K, n4e 3a' Go' Cb
DRILLER
Cb
Firm k7-� �_ _tt!`c 1lr Son-, n T n n .,
Address 1-4 PrOCtOr R0,9d
City Grp. rhPITnc - 7.ac^ _
Registration No. )701
"""'Y BOARD OF HEALTH COPY 25M-10-85-807101
Ic
Department of Environmen'�aJ,Management/Division of Water Resources
WATER WELL C-QMPLETION REPORT
1 WELL LOCATION X N
s
Addres' l�li��l L I L` -A
City/Town�'�/���{)�----
G.S. Quadrangle Map
Grid Location
Owner [---,4 01 tc, I
, WELL USE
Domestic lXl Public ❑ Industrial ❑
Other
Method Drilled(I�-
Date Drilled
r^ CASING
Length "w Diameter ((�
Type 5 „L
4 to
STATIC WATER LEVEL
Feet below land surface��
Date measured -;'�-.,2 —',)-
GRAVEL PACK WELL
Yes ❑ No ^L
WATER QUALITY TESTS MADE
Chemical ❑ A/,:) Biological ❑
CONSOLIDATED WELL
Type of Water -bearing Rock 07,ran't e
Water -bearing Zones /
1) From—To
2) From To
3) From To
4) From—To—
Depth
romToDepth to Bedrock 3 Aj
UNCONSOLIDATED WELL
Water -bearing Materials
Sand: fine ❑ medium ❑
coarse❑
Gravel: fine ❑ medium ❑
coarse ❑
Screen:
Slot# length from
to
Split Screen (or 2nd screen)
Slot # length from
to
Depth To Bedrock
PUMP TEST
Drawdown feet after pumping days hours at GPM.
mm t^� r
How measuredA �iYX9 i J_ ecovery feet after hours.
LOG of FORMATIONS COMMENTS: (On well or water)
Materials From To
I DRILLER
Address /
Firm...�C/lI//./`'�i�')/.�%���.,i�/��.-P .
'4/�1.)i
City_.. CXft,614.J.
Registration No.
1 grint firmly eneon ne UCA1 Tu !`nOV
1/
Lure
25M.10 -S5.807101
Lor
Na��ti �OVEI
MA,
SS (� s�PT'�c sY s ►�,�, vEs�t�J
11
D 154PPRCb VCD
R�ASoNS
p4r6'
/PR?oviNG Aurhoi?iry
cotlivi-CO105 --
Flaw D.4 TI
Dw� � 1 � ScPT'� c SySTEtit � � SQA t-1,A7'ioi,,� `
4 X4v4TcON )AJSPt�-6 i Ioti
�iNAL lVSPEcrlo�
4 PPROOEP
94rc
�4DP(T(oMAL- 1A)5P6C.j RNs (1p A^'y)
Dt�� PPKUv�i7 D� TC
JzC,6,50 NS
Q 1`45S El FAIL
AP12MovI"vG AUTHo/-�ay -�
1 NSML-LC-(-i ; 2z.vG)5
FML APPF16VAL D,oi� J-,5-�7
.� APP)3wvJ6 6u i Hog11 y
I
`
-NAa
•�
04)
qAlp
gel
�n
o
�t'v wiz Jvi
06�n��a:Mo
4q
O p WQ4
4 Q
?
14
a
Q�
w o� w�9
oaW 1. 1,
o
Q�oc
o
lot
Q
qta
�a�►
°
?
O
�.
1
1,
N
I
0
Y
N
TOWN OF
SYST:
DATE:
SYSTEM OWNER & ADDRESS
C-) t
0
G RECO
SYSTEM LOCATION
(example: left front of house)
jjERCEIVED
MAY 2 5 2005
TOHEAOLT" DE ARTME TER
DATE OF PUMPING:�a QUANTITY PUMPED: GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: G.L.S.D Lowell Waste
f, ' Health,
....tudover,Mass
SUBSURFACE DISPOSAL DESIGN CHECK LIS
APPROM DATES G DISAPPROVED
Provided: Reasons:
ritle V
Reg 2.5
FAIL 1O5 r
DATE.
.LOT
F.
The submitted plan must show as a' ndr n umi
a) the lot to be served -area dimensions lot #,abutters
b location and log deep observation hoes -distance to ties
c location and results percolation testa -distance to ties
d design calculations & calculations showing required leaching area
e) location and dimensions of system -including veserve area
f) existing and proposed contours
g) location any wet areas within 100' of sewage disposal system or
disclaimer -check wetlands mapping 06
h) surface and subsurface drains within 100' of sewage disposal.
system or disclaimer
i) location any drainage easements within 110' of sewage disposal
systems or disclaimer -Planning Beard file'
J)
known sources of water supply within 200 of sewage disposal eL_
system or disclaimer
Q location of any proposed well to serve l(t-1001 from leaching facility
1) location of water lines on property-) )tom leaching facility,
m) location of benchmark
n) driveways
o) garbage disposals
p) no PVC to be used in construction
q) profile of system -elevations of basement, plumb, pipe, septic tank,
distribution box inlets and outlets, distribution field piping and
etker elevations
r) maximum ground water elevation in area sewage disposal system
s) plan must be prepared by a Professional Engineer or other
professional authorized by law to prepare such plans
Reg b (
Septic Tanks
(a) capacities -150% of flow, water table, tees, depth of tees,
access, pumping .
(b) cleanout
(c),101 from cellar wall or inground swims n' , pool
(d) 250 from subsurface drains
Seg 10.2 Distribution Boxes
(a) slope greater than 0.08
Seg 10.4 b} susrp
G
Q-
3.3 z z6z 44S -•S
/i Y n Lf -?R
9
miOt
art`
x
COMAI
%w d .tea
miOt
FORM 4 - SYSTEM PL�iPD;G RECORD
Commonwealth of Massachusetts
, Massachusetts
System Pumping Record
N•stem Owner
BOARDf
AUG -~ 8
Date of Pumping: / i (� Quantity Pumped: 1/���gallons
71
Cesspool: No Yes ❑ Septic Tank: No ❑ Yes
J7�
System Pumped bN-: rr ___ License #:
Contents transferred to: • l, -
Date Inspector
KNELL DAT_A.BASE
ADDRESS:
t-�
AGE OF 7
WELL LOCATION: �
- ALL PERLyQT DATP� 2-* V4 DEP71 OF L? v
TUE OF W=. D b. UG O71 " -.- —_
TYPEOFWASEiZEELRINCROCK-
WA=ALYAT-Y=DA -- v c% HIGE`tifA�ICrAN SE: Y �; z
=IRON: Y OTE £CQNiAMNANIS Y " N _
W ET—L.DATA3�A=
ADDRESS:
AGE OF W=- WEEL 1, DRILL�"�
V
..WELL. PER1ti�I'T: '7Y= L`U.CATTON:
WELL PER�tiLTDAI DEP"'ri 0 TELL:
TYPE OF WELL: a.- DRI'i.LED b. DUCT c. UNKN,407 N
TYFE OF WATER BEAKN, G ROCK:
NATER ANALYSIS DATE: NDGlH tiLlNtGA?TESE: Y
IIGH LRON: Y N OTHER CONTA-iN/CNAMTS: Y N