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Miscellaneous - 25 TURTLE LANE 4/30/2018 (2)
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'sem' �yc►•'�.el'1���3i� ♦••r!�►"��•T'�i«♦ ,�j�i_��,.�f."; •'`y. .' � � .'4,•. ,f • to lot t �� N4�a I+,y. :^Y{, a •'1r 1 � . �...� ► Yot ti,Y �iy y^.. , � \ T " Page 1 of 1 http://images.kodakgallery.com/photos1709/3/40/82/94/45/6/645948240303_0_ALB.jpg 11/28/2005 0 Page 1 of 1 http://images.kodakgallery.comiservletllmages/photos 1709/3/40/82/36/81 /5/5813682403... 11/28/2005 Page 1 of 1 AmA 61 ur Mv jr http://images.kodakgallery.com/servlet/Images/photos 1709/3/40/72/9/84/2/28409724030... 11/28/2005 i• J >.., 0-41 vx k t:`•� f AmA 61 ur Mv jr http://images.kodakgallery.com/servlet/Images/photos 1709/3/40/72/9/84/2/28409724030... 11/28/2005 ..a�■�s.� ... --_ - Y Page 1 of 1 http://images.kodakgallery.com/servlet/Images/photosl 709/3/40/82/95/7/9/90795 824030... 11/28/2005 Town of North—Andover Health Department Date: Location: �� �1,1;L67 (Indicate Address, if Residential, or Name o usiness) Check #: /;/ Y Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing $ ❑ �ticDisposal ign Approval $ Works Construction (DWC) $ 11915-10 ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Trash/Solid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) 1115 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer TOWN OF NORTH ANDOVER OFFICE OF TOWN MANAGER 120 MAIN STREET NORTH. ANDOVER, MASSACHUSETTS 01845 Mark H. Rees Town Manager To Whom It May Concern: pit- TOWN z 'Telephone (978) 688-9510 A FAX (978) 688-9556 4SgACHUSE� February 23, 2006 Please be advised that the Board of Selectmen has approved representatives from Turtle Lane Maple Farm to research, tap and harvest maple sap frw maple trees located on town property. If there are any questions and/or concerns, pleasntact the Town Manager's office. `Mar+ic H. Town M Contact information: Paul Boulanger Kathy Gallagher Turtle Lane Maple Farm 25 Turtle Lane North Andover, MA 01845 978-258-2889 978-590-8437 (cell) Do, you know you have a great natural resource in your yard? You are receiving this because you have what we are looking for. We are looking for maple trees, but not just any maple trees. We are looking for large healthy maples'trees that are conveniently located near the road and have relatively easy access. The reason for seeking such trees is that we make maple syrup. About us... We live on a quiet little cul-de-sac in North Andover. Behind our home we make maple syrup. What started out as an experiment after a trip to the NH Maple Sugar Festival has turned into an annual hobby that the entire family participates in. Each year our operation expands as we learn more and involve others. We are not "professional" producers, rather we are known as "backyard sugarers." We enjoy the science and mechanics of bringing the natural resource of maple sap to the final yummy product of maple syrup. The production of maple syrup is full of physics, chemistry, biology, engineering, and Yankee Ingenuity. In order to be a successful sugarer you must be patient, persistent and clever as there is a fair amount of trial and error. This year as a gesture of giving back to the community, we are having the entire 3'd grade at Sargent Elementary School and two of the 6' grade classes at NAMS come to our house for field trips to see how maple syrup is made. If you are interested in seeing our operation, feel free to call and we will let you know when we are boiling. When is maple season?, In general the season starts between mid-February and the end of February. The season ends between mid- March and the end of March. A good season can last as long as six weeks and a bad season (like last year) can be as short as two weeks. The season is totally dependent on the weather. In order for sap to flow it needs to be warm during the day (38 — 48) and cold at night (20 — 32). What is sap? . Sap is the life -blood of the tree. It is in the tree all the time. but during the spring time, in connection with the weather, there is a physiological change that makes the sap travel from one end of the tree to the other. Many people think that in the winter the sap is stored in the roots, but actually the opposite occurs. The sap is stored in the canopy (branches) in the winter and the roots in the warmer months. In the spring, after a few warm days, the tree changes and starts to move the sap towards the roots. What is tapping? On those warm spring days, when the sap travels from'the branch system to the roots, it passes down the trunk._ When the air cools at night the sap moves up the trunk to the branches. Tapping is simply the drawing off of some of the sap as it moves down and up the trunk. Tapping is drilling a small hole in the trunk, gently inserting a spile (tap), and collecting the sap. Traditional taps are 7/16 and have been used for the last century. In the recent past the use of "health spouts" has become more common as they have less impact on the tree. In most instances we use health spouts. What is proper tapping procedure? A tap hole should be about 1" to 1 %Z" deep for a health spout and 2" to 2 V2" for a standard spile. It should only be within the white wood ("sap -wood") part of the tree and should not enter into the red wood ("heart wood"). A tap hole should be at least 6" from any tap hole within the last several years and slightly above or below the previous tap holes. A proper tapping pattern over many years will be a spiral up the tree. Taps are NOT driven into the tree, they are tapped in. Health spouts are inserted into the trunk about 3/8ths of an inch depending on the thickness of the trunk. It is also important not to split the bark when tapping a tree, as this will cause the sap to leak around the tap and it also injures the tree more. , . Does it hurt the tree? , In a simple answer, no, so long as proper procedures are followed. Think of tapping a healthy maple tree in the same way that a healthy person gets blood taken. Its sap is easily restored by the tree in a short period of time. As far as the tap hole, the tree recovers from that just as we would from a small cut. By the summer time holes starts to fill in, by the next year it starts to scab -over, and with 3 years you shouldn't be able to tell there was a hole. Studies have shown that a healthy tree can be tapped for over 100 years without issue. How much will a tree produce? Just like every person is different so is every maple tree. Certain types of trees produce more sap than others. Sugar Maples produce the most sap. On our property we have all Red Maples which produce slightly less sap. On average when the conditions are right,, a tap will produce about 1 gallon of sap per day. It is amazing to think this happens one drip at a time. Are there attributes to sap? Yes: The most important attribute of sap is the sugar content. The reason this is so important is because the more sugar the sap has, the less processing has to occur. Conversely, the less sugar in the sap, the more work for us. Different trees produce sap with different amounts of sugar. Sugar Maples produce the most as you might think. Red Maples as we have produce slightly less sugar. On average sap is about 2% sugar and 98% water, finished syrup is 67% sugar which is achieved through the boiling and evaporation process. How do we collect the sap? There are basically two ways to collect sap at the tree. The first method uses buckets. Although the more traditional bucket method uses metal buckets hanging on trees, we don't use often do this: We use plastic ' buckets which sit on the ground at the liase of the tree and are connected to'the tap by a short piece of tubing. We believe the plastic buckets are safer and cleaner. The second method is the one we use more often which is tubing. This method uses a network of tubing to connect all the taps'on a group of trees io a single collection spot. Although it takes slightly more effort to set this system up it is much easier over the course of the season since there are fewer collection points. Generally every day we empty the buckets into a larger tank in the van. We generally collect in the evening after work. Sometimes one of us will go and collect after the kids are in bed: When collecting off of our property, we -will absolutely respect the land owners property and privacy and will make sure that we coordinate within the owners comfort level.- What evel. What do we do with the sap? Once we collect the sap it needs to be processed relatively soon. Sap is like milk in that it goes sour with a short period of time. Sap under standard conditions will last about 2 or 3 days at most before the bacteria starts to grow and makes the sap unusable. We filter the sap and run it through a UV sterilizer to help kill bacteria prior to transferring it into storage tanks. This is adds nothing to the sap but does improve the quality of the final syrup. The "processing" of sap is simply boiling water off and leaving the remaining sugary water. The sugary water becomes syrup when the sugar level becomes 67% of the solution. Real maple syrup (not Aunt Jemima) contains only condensed maple sap and NOTHING else, so it is all natural and 100% organic. We hope that you have found this informative and interesting. If you are interested in allowing us to tap your great natural resource we would be happy to work with you. r Please feel free to contact us, Paul Boulanger & Kathy Gallagher (Siobhan, Meaghan, Kara and Kaleigh too!) 25 Turtle Lane, North Andover, MA 01845 (978)258-2889 or info@lurtlelanemgplefann.com For more information please visit: www.turtlelanemaplefarm.com ` Town of North Andover Office of the Health Department Community Development and Services Division 400 OSGOOD STREET North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/RS Public Health Director 978.688.9540 - Phone 978.688.8476 - Fax C�9WTrCA� 0 coaY(PEPrAM-CE As of: November 29, 2005 This is to cert that the individual su6surface disposal system was Septic 2'ankReplacement by James Kellett At 25 Turtle Lane North Andover, 911A 01845 alas been installed in accordance with the provisions of Title v of the State Sanitary Code and with the North Andover Board of Yfealth regulations. 'The issuance of this certiftate shall not 6e construed as a guarantee that the system will function satisfactorily. usAITYSaw:yer,,�= 1� E3fS/R5 Public Yfealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ocrvivED NOV % S C� � TOWN OF NORTH ANDOVER HEALTH DEPAR ssoaa pa -d uVailauiv 6ao•alllanl6•n MM JIsln ao ( USE -M-009- 0 3JI1 3AIJ-008-� Ileo aseeld `poolq ajeuop of }uawlulodde ue alnpops of «awe f) eqj 10 aouoa p90l8„ se SOP!; XOS PH WM Q; JOIU3 a3WOM ai anvA aanopud y:PoN `IaaaIg uieW OU as;u83 aoivas aanopud u}JoN 'w'd 001- 'w'd oo:Z qoozl6aunr Aepsoupom 8AlPa Poom Apunwwoo JOAOPUV 4:PON < //2�z Town of North Andover Healt�_ Date: ' Location:✓��/ �I C// A (Indicate Address, if Residential, or Name dfBusiness) Business) 1 Check #: Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ " ➢ Food Service - Type. $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ �tic isposal Works Construction ❑ (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ Trash lSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer Town of North Andover, Massachusetts Form No. 3 BOARD OF HEALTH �7J NORTH O �,'•�,.,,p�.�`� DISPOSAL WORKS CONSTRUCTION PERMIT ,SSACMUS�t Applicant —Z --'VA M E / AME Site Location / lz Permission is hereby granted to Construct ( ) or Repair +-<an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. a_'� - HAI RMAN, BOAf D OF HEALTH Fee D.W.C. No. H°TH Application for. Septic Disposal System OE ,1Uco ie 9ti 6oAConstruction Permit - TOWN OF x 9 ...y."" NORTH ANDOVER, MA 01845 .c o - t 'ss^cHUSEt Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. ras Application is hereby made for a permit to: ❑ Construct a new on-site sewage disposal system* ❑ Repair or replace an existing on-site sewage disposal system* pair or replace an existing system component A. Facility Information Address or Lot # City/Town 2.- *TYPE OF EPTIC SYSTEM*: ❑ Pump [9'Gravity (choose one) ***If pump system, attach copy of electrical permit to application*** dConventional System (pipe and stone system) TODAY'S DATE $ 250.00 — Full Repair omponent ❑ Infiltrator or Biodiffuser (Gravel -Less) (Attach a copy of your certification to install this type of system. ❑ Pressure Distribution S.A.S. (No D -Box) (Attach Draft Maintenance Agreement) ❑ Pressure Dosed (D -Box Present) S.A.S. 2. a Name (�- S Ttrrr<l� lit Address (if different from above) City/Town 3. Installer Information lee&i�e Name Address City/Tow a. Designer Information ds 5 Name Address City/Town W State Telephone Number Zip Code llPl/.r' r/� ��« 4, �i s Glc Name of Company State Zip Code 21-11- SS -3_ 71 y-6 Telephone Number (Cell Phone # if possible please) Name of Compa StateZip Code Telephone Number (Best # to Reach) Application for Disposal System Construction Permit • Page 1 of 2 Z 1 Z 96ed .;iuuad uoilonilsuoo wa;sAS jesodsiQ aol uoi;eogddy : (Aluo uoij3najsuo3 Mau) 2 suvldjoolI •s (un1d pasocddn sn ajnos awns) :(Aluoa uo!jonajsuoo Mau) zil!ng-sy uoiinpunoI -p saA ;zuuag jnauiaaj.7o oa yan.1W `osfj zwais s wng •£ —ON S 3 Zpaganlly uuol uoilr�zlg0 .cagnuvN lialocd •z ON ssA zpaganllV aaj •j duo asn aoijjo ao=i :suoseaJ 6u1nn0jl0j au; a01 pano.iddesiddy a;ea aweN Sd / / (anile;uasaadaa y;1eej4 jo p r)As pan V uoi;eoilddy aged // y;/ea�j o p�eo8 shy; �(q panssi k�aaq ey aoueydwo3 jo o;eoi,;!pa3 a 1►;un uo►;eaado ut wo;s ay; a end o; jou pue `aanopud y�oN jo umol ay; aoi suopejn8aa jesodsio ooeunsgnS leoo ay; se 110M se `ap03 le;uawuoJInu3 ay; jo 9 op!.L jo suoisinaid ay; y;!M eouepi000u! wa;s�(s jesodsip 96emes a;is-uo paquosep-ero,;e ay; jo ao uop3misuoo ay; ino; saai6e pau6isiapun ayl juawaa.16br •8 leiojawwooEl ao 6uwilam(i 1ei,uapisa4k: ulpjln8;o GdA.L •9 ••••penu!luoo uo!jew3opi j!I!3e3 'd ZJOZ3DVd jueuodwoC) - 00.9Z 6$ medaM 11n.1 – 00.09Z $ M10 VW `T IAO(I V 1`TO 31da 1d401 30 N&01 — 4!LUJGd uoi ona suo Z—) /'0 ,? uj9js S peso SIQ oi4 aS J01 U01je3liv MISON �° INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North -Andover licensed installer for the construction of the septic system for the property at Z ( V a" _ relative to the application ofy f'� K�tC l— date ' / for plans by and dated0 2 1 with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done fast. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Licensed Septic Date: �` TOWN OF NORTH ANDOVER t NpRTN , Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS Ol 845 �,SSwCMUS �� 978.688.9540 — Phone Susan Y. Sawyer, REHS/RS 978.688.8476= FAX Public Health Director E-MAIL: healthdeptp_townofnorthandover.com _ WEBSITE: http://v; .townofnorthandover.com 1 SEPTIC PLAN SUBMITTAL FORM i OCT 3 1 2005 Date of Submission: I O � Zg jn— J Site Location: Engineer: New Plans? Yes $225/Plan Check # review only) Revised Plans? Y es an Check `valuation Forms Included? Yes No_ Lo Upgrade Form Included? Yes No_ Telephone #: b k� –)7(ok Fax #: E-mail: Homeowner Name: -- ` OFFICE USE ONLY When the submission is complete (including check): ➢ Date stamp plans and letter ➢ pee an a ac ecetpt ➢ o onsu nt ➢ Enter on Log Sheet and Database rav" L- C..7,1 (includes Is' submission and one re - MQ �_ C -L_1 P 115 PP fiL_.7 �K, 1�1t� A�z vou&j p ' TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT ~ ' 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS Ol 845 �'SS�cHus 978.688.9540 — Phone Susan Y. Sawyer, REHS/RS 978.688.8476-= FAX Public Health Director E-MAIL: healthde t n,townofnorthandover.com_ WEBSITE: httQ//www.townofnorthandover.com SEPTIC PLAN SUBMITTAL FORM OCT 3 1 2005 Date of Submission: ! I ZgjnS— a Site Location: 2 S T Engineer: New Plans? Yes $225/Plan Check # review only) Revised Plans? Yes an Check '__ t,valuation Forms Included? Yes No �Oupgrade Form Included? Yes No Telephone #: & h – Fax #:— E-mail: Homeowner Name: OFFICE USE ONLY (includes 1St submission and one re - MQ �_LL__' L / TT / _'Sfi - When the submission is complete (including check): ➢ Date stamp plans and letter ➢ pjlete andta ac Receipt ➢ e; o onsu ant ➢ Enter on Log Sheet and Database OA 01 FAX 8784618631 Monscer.com 10 002 (_QM:�t04VY��. P•4�'C H GF iv�li.3�i�C s.tU `�� � ' � � S4�°'JS-20 1`i h' t 'J 1 r, S ► ,Y d { y 0 40 rn 47 � 4 ` es Id 6 533��7=o�"E,rS f ! J v� z� 461) 4 ! X22 I —F st s 15.7 I L£RTLFY THA1''i. ri AvE CoNF Ot2M�U w,'r}t 'r�+E. tcu1.l=S ANO REGCLaT,©NS OF TtaE KEC�:STERSOF l^_,�tSS IN i-•rcErAR•ty C�TH:S ✓,. A:.i. tp0 SO O tCC c ScAL6 t Ftt-T LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax healthdeptA..townofnorthandover.com - E-mail www.townofnorthandover.com - Website Page / of �yy1 ,T *NORTfy 1 O 16V tiQ t p n 0 eh O CoC.pCNl WICM �I• T Ar TO: Benjamin C. Osgood, Jr., P.E. DATE: %C9 4�1Q� COMPANY: FROM: Pamela DelleChiaie, Health Dept. Assistant New England Engineering Services, Inc. or RE:17 r D Phone: 978.686.1768 Fax: 978.685.1099 Fax # We are sending you: OPlan Review Letter 17APPROVED ONOT AP RO OSystem Construction Follow -Up then These are transmitted as checked below: OFor your File OAs Required As Requested OFor Your Use REMARKS: COPY TO: Fax # or Mailed COPY TO: Fax # or Mailed COPY TO: Fax # or Mailed TRANSMISSION VERIFICATION REPORT TIME 10/28/2005 10:55 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 10128 10:53 FAX NO./NAME 89786851099 DURATION 00:00:51 PAGE{S} 03 RESULT OK MODE STANDARD ECM COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TSA dvVN OF NORTH ANDOVER/ BOARD OF HEALTH 7 JUN 19 2001 TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Addre, Owner's Name: Owner's Addres Date of Inspectii Name of Inspector: (please print) !rZ ,y, 5 S r... Company Name•. Se ry L Mailing Address: 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 function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuantt�tion 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 :_/� //yr, 414 -.moi. Date: (j c The system inspector shall subm�a copy of tVs inspectioi�port to the Approving Authority (Board of Health or DEP) within 30 days of completi g this insp tion. 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 hpw the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 10 of 1 I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: M 11CKkxkQ-,x J" Owner: Date of Insp tion: 1 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. -150- /T1 10 Page 2 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 057 LLC%. VW -ilf Owner: Date of Insp tion: Inspection Summary: Check A,B,C,D or E / ALWAYS complete all of Section D A. S em Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One ormore 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 PART A CERTIFICATION (continued) Property Address: L: - 3a 'k t, "t. Owner: Date of Insp tioet n: _ 1 WjAj 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 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: Lft tk&4 Mk Owner: etsu a�_" Date of Inspe tion: im D. System Failure Criteria applicable to all systems: You must indicate "yes" or "no" to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool . Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ _✓Liquid depth in cesspool is less than 6" below invert or available volume is less than''/: day flow ,/Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number — 4z—,"Any of times pumped . Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surfac.•, water supply. y 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.] (Ye The system . I have determined that one or more of the above failure criteria exist as �ri fails bed 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 "no" 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. 4 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 Inspec ion: i n 1 It ► ��� Check if the following have been done You must indicate "yes" or "no" as to each of the following 17rNo _ 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 ? ZHave large volumes of water been introduced to the system recently or as part of this inspection ? _ „Were as built plans of the system obtained and examined? (If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up ? �Z'_ Was the site inspected for signs of break out ? Were all components, system Y p ents, excluding the SAS, located on site ? Were the septic tank manholes uncovered, opened, and the interior of the es or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth oof the condition _ 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. _ Determined in the field (if any of the failure criteria related to Part G is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)) 5 • Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Insp ction: FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): L4 Number of bedrooms (actual): '7 DESIGN flow based on 310 CN& 15.203 (for example: 110 d x # of bedrooms): ygo Number of current residents: 9_ Does residence have a garbage grinder (yes or no): QUYNOJO Is laundry on a separate sewage system (yes or no): yes separate inspection required Laundry system inspected (yes or no): Seasonal use: (yes or no): Water meter readings, if available (last 2 years usage (gpd)): Sump pump (yes or no): Last date of occupancy: . COMMERCIAL/INDUSTRIALA Type of establishment: Design flow (based on 310 CMR 15.203: sad Basis of design flow (seats/persons/sgtetc.): 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: Was system pumped as art o the inspe o�(yes or o): If yes, volume pumped: allons — Hquant pumped Bete ined? ,�fC Reason for pumping: TE TYP F 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) _ 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): jb Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Ln Owner:. Date of Insp ction: BUILDING SEWER (locate on site plan) Depth below grade: 9,V" Materials of construction: _cast iron 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: i (locate on site plan) Depth below grade: L� N 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: Sludge depth: y �� Distance from top of sludge to bottom of outlet tee or bathe: Scum thickness: a " Distance from top of scum to top of outlet tee or bathe: (0 Distance from bottom of scum to bottom of outlet tee or battle: How were dimensions determined: Comments (on pumping recommendation , inlet and outlet tee or Uffle condition, structural integrity, liquid levels as related to outlet invert, : evidence of leakage, etc.) - _ _ _ -.-10%._ _ 6 f _ n_ _ � _ - _ _ _ GREASE TRAP: 00cate 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 battle: 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 bathe 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: A5 lij�ClAr% Owner: -`'uft Date of Ins pec on:�( / d) 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: aallons/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: �/ (if present must be o ened locate on site P )( a plan) Depth of liquid level above outlet invert: _0L - 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, etr,.): A 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.): Pape 9 of i 1 . OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: DCDJ Date of Insp ction: 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, number, length: �Ieaching 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: tkocate 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 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: laq T1tl-" Owner: Z,%kr Date of Ins action: SITE EXAM ]� Slope Sytface water heck cellar Shallow wells Estimated depth to '' p ground water 5/a7 .feet Please indicate (check) all methods used to determine the high ground water elevation: OO' ed from system design plans on record - If checked, date of design plan reviewed: bserved 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: It 11 va ;i vi IL -L utf:o3 rAA 876 d 6 6 8573 { NORTH ANDOVER DPW J rcg1�?r?? a M• f I`N1;Nnd O NLA L7 t7©u» } Iaoede0*-, o W Ofa000©o ac I r W e O m p O p O O I W ►� c; a; rr %01 1� I Q� rNNNNNN W �• 1010O0 01:010 m eeeemop '_ = ©©eeiaci mOGIf rNNLr! C W W N 1- W C'9M.0a.c�a W J 1 H rItiNLAr•OLA w TNW Nmnoch4m m 1 } Tcm0 a6 Q O ba' W I} W N +r r N w r 0 0 0 0 0 0 10 J W W N N N N N N U.1 3 I !! rNt9MLAAD1+ O W S� O.ONLALANLA W O� O.N0 r{q� NNNNNNN N~OWC y O LA OG py w N •j 1 v © mO•ONLALAN W O S LAL11b•O�n I� O N N N N N N N } Iaoede0*-, ti ac I apopOGo O I W 00C20a00 %01 1� I Q� rNNNNNN S 1 S mOGIf rNNLr! V J 1 w TNW m 1 W Tcm0 a6 Q V ba' W I} 0 0 0 0 0 0 10 Ro \ W N N N N N N U.1 3 I !! rNt9MLAAD1+ O W 16001 c N O h'OhmA Nll I f mfh Zed Z w �m o!�mZ�^ 7Dm fs Qi (A W N Qc�T=/Zy 33 '1 W dv /N. =/zi. 57� L o /29. 73 -f4 ° a rn a ti n n o � � C II 0 y N O h'OhmA Nll I f mfh Zed Z w �m o!�mZ�^ 7Dm fs Qi (A W N 10 -f4 ° a rn a ti n n o � � C II 0 y n o n � r a y o kl- "rn Z b y 6- mi 10 C C � r kl- i _g7j>O(/_ -2t) is th rp 'I, IN 'A 'i T4 IA R IA L4 - 0 � E a TOWN OF' NORTH ANDOVER REPORT OF PERC TEST NORTH ANDOVER BOARD OF HEALTH ADDRESS OF SYSTEM � r Ile A4,1,1 er`� c rr.��,n-, _ c � DATE Ay ME NAOF PROFESSIONAL ENGINEER. Cit SANITARIAN CONDUCTING TESTS l5!�1�6t�& oa-lle) NAME OF LOT OWNER_j .aA /j adl.�C ADMESS _ z Sq SHOW APPROXIMATE LOCATION OF PITS ON SKETCH ON REAR OF THIS SHEET 3//`S7G Total Soil o�: Topsoil Subsoil Depths & TSroes Water T.P�.P� P4 +- nm,+�, Peri T�� S7` Depth Other Considerations: Saturation Time C-),-. mac/ Time to Recommendations: Xv Z>.— Time to Drop 911 _ 61, f Signature r a , '2�5 NORTH ANDOVER, MASS c 19 7 BOARD OF HEALTH N FROM: \ DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at �a ?' % T u R %LL L ItIvE North Andover, Mass. SITE LOCATION The grades and construction are as specified in my plans and specifications dated C 1-- /S 19 76 eg. P of. gineer/Re anitarian „4 or -,i -o �YIr� � Aht�JER/ SYSTEM YUPJNC � Gn.,_, C ---C - 5 2002 V—zZi, a51�l� Zane. W6, JU Ao YES SEPTIC 1r IR tel” ��.1'.�!��._r. I{.0�,� L �_�'j !'�l� 1� • RUC"S CXCE'SSIYE SOLIDS SOL .JS CARRYOVER - 11 . _� ; � TZANSFCRRED I U b Ai 5 - -- FLOODED . f TOWN OF NOR SYSTEM puMp ly SYSTEM OWNER &ADDRESS /va. 00 VAN'DOVEP, Q RECORI) SYSTEM LOCAT70N �i3ac�C. �-F�, DATE OF PU N mp, PUMPED:j;7....- 1-:LWOOL: NO YES Sop(jcl'&nk: NU. ----YES ; NA rVRE OF SERVICE: ROu'rINE..v. DEC 0 7 2004 ObURVATIONS: TO' i OF `:C' -N7: OWD CONDITION PU L1r TO COVER .HRAVY OXWE BAFFLES IN PLACL ROOTS LEACKFIELD RUNBACK 8XCUSIVE SOLIDS lOLMCAKRYOVF_R JLOODED OTHER EXPLAIN System Puinpod by ol�l 0 '' Ina. I/ WMMENTS. cuN rhm's rmissybxuo 1,L) w