HomeMy WebLinkAboutMiscellaneous - 263 JOHNSON STREET 4/30/2018I
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CONSTRUCTION APPROVAL
Has plan review fee been paid 4P NO
Plan Approval: Date: IZ_h.�q Approved by:..._
Designer: .1) -5 6 Plan Date:
Conditions:
Water Supply: (Town Well
Well Permit: Driller:
-Well Tests: Chemical Date Approved,
Bacteria I Date Approved
'Bacteria 11 Date Approved
Plumbing Sign -Off: -�off:
Wiring Sign
Comments:
form t"Approval: roval to Issue: YES
,Date Issued By:
Conditions:
Final Approval:
All Permits Paid?
Well Construction Approval?
Septic System Construction Approval?
Certification?
Other?
Any Variance Needed? . .
FINAL BOARD�. 9f H�ALTH APPROVAL:
DATE: // 0
APPROVED bY:
NO
S)
NO
CY Es-
N 0',
�?_E�S
NO
YES
NO
NO
3,
SEPTIC SYSTEM INSTALLATION
CONDITIONS:
As Built Plan Satisfactory:
YES:
Approval of Backfill:
Final Grading Approval:
pq Iq
Date:
Date:
By:
BY:
Final Construction Approval: Date: /Az'y//00 By:
/
Certificate of Compliance: Approval: D ake: 111,A
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600 .,
01 0, 'S
D
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Is the installer licensed?
YES
NO
Type of Construction:
NEW
New Construction:. Certified Plot Plan, Review.
YES
NO
Floor Plan Review
YES
NO
Conditions of Approval frorn Form"U
YES
NO
Issuance of DWC permit:,
YES
NO
DWC Permit Paid?
-YES
NO
DWC Permit Iristaller:.
Begin Inspection.
CES
NO -
Excavation Inspection:
Needed:
Passed: By:
Construction Inspection:
Needed:
As Built Plan Satisfactory:
YES:
Approval of Backfill:
Final Grading Approval:
pq Iq
Date:
Date:
By:
BY:
Final Construction Approval: Date: /Az'y//00 By:
/
Certificate of Compliance: Approval: D ake: 111,A
I ) � r- I
600 .,
01 0, 'S
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0
Commonwealth of Massachusetts
-North Andover
CitylTown of
Syst M Pumping Record
e
Form 4
m for use by local Boards of Health. Other forms may be used, but the
DEP has provided this for ovided here. Before using this form, check with your
information must be substantially the same as that pr
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.
A. Facility Information
Important When
1. System Locatiom
filling out forms
on the computer,
use only the tab
key to move your
cursor - do not
North Andover
use the return
CityfTown
key -
VQ
2. System Owner:
i %eg__
Name
Address (if different from location)
city[Tow n
—n -vu 01886
Ma -
State Zip Code
state Zip Code
-fe--Iephone Number
B. Pumping Record
2. Quantitypumped: '��,allons
1. Date of Pumping _Eite 16 5
3. Type of SYStern: F� Cesspool(s) Septic Tank Tight Tank E] Grease Trap
F� Other (describe):
4. Effluent Tee Filter present? 0 Yes E] No .1f.yes, was it clearied? El Yes [] No
5. Condition of
6. System Pumped By:
lh'q� —Ve--
ice 1:,cense Number
Name
Stewart's Septic Service
Company
7. Location where contents were disposed:
StewarVs Pre-tre
Date
Signature of Receiving Facility Date
t5form4.doc- 03/06
System Pumping Record - Page
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TON" OF
SYSTEM PUMPING REC0jjfyffCE1VED
DATE: ((0 -0s
SYSTEM OWNER & ADDRESS
FEB 2 3 2005
TOWN OF NORTH ANDOVER
HEALTH DEPA��T-MENT
SYSTEM LOCATION
(example: left front of house)
DATE OF PUMPING: QUANTITY PUMPED: GALLONS
CESSPOOL: NO YES SEPTIC TANK:5NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
C---�o
COMMENTS: V11-
coNTENTs TRANsFERRED To: G.L.S.D Lowell Waste
777
TH,
N C,
71 -1 7 1-1
RD S y LOW,
c4,G3
.41 Abu
o".
QUANTITY
y F 5 SEPTIC'
K ERMICEn"
T'i R C� 0.' S 7ROUTINE
m E R
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TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECO"
DATE:
SYSTEM OWNER & ADDRESS
, 6"ZZ&Ajo"
C)6,5
fi al? d, C) 2" rev
SYSTEM LOCATION
(example: left front of house)
DATE OF PUMPING: -0/"9v/z0—QUANTITY PUMPED GALLONS
CESSPOOL: NO �ZYES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
CONTENTS TRANSFERRED TO:
z
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
NEW ENGLAND ENGINEERING
INC
North Andover Board of Health
Town Hall Annex
27 Charles Street
North Andover, MA 0 1845
RE: TITLE V REPORT: 263 Johnson Street, North Andover, MA
Dear Sirs:
SERVICES
rr t
January 8, 2004
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. Osgood, Jr.
60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7845 - FAX (978) 685-1099
COMMONWEALTH OF MASSACHUSETTS
ExEcuTivE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
T' OF '3 OF VjFAj-VV1
BOA3-
zp%
TITLE 5
-OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY -A . SSES . SMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address- _ Z &3 3-0 4 it C
NO R51� AlovnuEg- wttl�
Owner's Name: T7) C) A-) ip��A pbc�p�'j
Owner's Address: b7 Z I -e-- A L- E:,oW
ce"I
A
Date of Inspection: -g 1/0
I
Name of Inspector: (please print) -Ben-jamin C. Osgood, Jr.
CompanyNaxne:New England Engineering Services Inc.
Mailing Address: 60 Beechwood Drive,
ljorth Andover- MA 01945
Telephone Number: 978-686-1768
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at 1his 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� ne system
—)Z"'�P-asses
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Fails
InsP�CtOr's Signature: Date: i,;z 110,3
1he system inspector shall submit a copy of " inspection report to the Approving Authority (Board of Health or
DEP)widiin30daysofcomplefing sinsP ion-Ifthe lem is a shared system orhas a design flow of 10,000
thi ect Sys
9Pd 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
PART A
CERTIFICATION (continued)
Property Address: ;� 4v 3 tj �j s 0 Kj
- EJ OL -)-d AA -J -D ou&
Owner: 001-j � 2SON-)
Date of Inspection: - - i 2-1 11 C'
Inspection Summary: Check ABCD or E / ALWAYS complete all of Section D
A. . System Passes:
-ZI have not found any informationwhich indicates aw any of the failure criteria described in 3 10 CMR
15.303 or in 3 10 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
JVa one or more system components as described in fhe -conditional Pass" section need to be replaoed or
repaired. The system, upon completion of die replacement or repair, as approved by the Board of Health, will pass.
Answer yes, no or not determined (YNND) in the for the following statements. If -not determineV 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 diat the tank is less &an 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 fim 4 times a year due to broken or obstructed pipe(s). 1he system will
ias-S-7mspection if (with approval of the Board of Health):
broken pipe(s) are replaced
obstruction is removed
ND explain:
Pagel of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: �2 t--- 3
tA k4
Owner: Q 0 �'j PCC,&- P",ON-j
DateofInspection:— fxktdos
C. Further Evaluation is Required by the Board of Health:
—&—)— Conditions adst which require fiirther evaluation by the Board of Health in order to determine if the system
is fitiling to protect public health, safety or the environment
L. 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
CM
— V001 or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2- System Win fan unless the Board Of Health (aad 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
surfitce water supply or tributary to a surface water supply.
— The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply.
— The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
— 1he 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 colifom
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 &an 5 ppm, provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
I Other:
Page 4 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address; Z&3 5;-j
&209714 .
Owner: PC)"
Date of Inspection: - 19.1 -3 4/0,3,
D. System Failure Criteria applicable to all systems:
You must indicate "yes" or "ad' to each of the following for jH_inspections:
Yq No
Backup of sewage into fiLcility or system component due to overloaded or clogged SAS or cesspool
Discharge or ponding of effluent to tile swfice of the ground or surfitce 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 1/2day flow
Required pumping more than 4 times in the last year PLOT 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.
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 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. ghis 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.]
(YesNo) The system LajL& I have determined that one or more of the above failure criteria exist as
described in 3 10 CMR 15.303, therefore the system Ms. The system owner should contact the Board of
Health to determiaewhat will be necessary to correct the failure.
F. 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-
Youmustm�! teeither "yes" or "ne'to each of the following:
(Ibe following aika!pply to large systems in addition to the criteria a
yes no
the system is within 4(�-&�tof a surfac� drinidag water supply
the system is within 200 �fqa tri��q,
f a lo a surface drinking water supply
the system is I W in a Tnfiiitrogen sensitive ar��ted�m Wellhead Protection Area - IWPA) or a mapped
li�ta r supply w
'st �public water supply well
Zone I
If you-Ka-ve answered "Yes" to any question in Section E the system is con'sli ed a significant threat, or answered
Yee' in Section D above the large system has failed. The owner or operator o y large system considered a
jtor%,�
significant threat under Section E or failed under Section D shall upgrade the sYst" accordance with 3 10 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: 3-- -�j j,3s 0 ju c -t(Z,!� C --T
zyORTH At-j-DouEe-
Owner: POLO E -,'k Zg'- 0AJ
Date of Inspection: - - 03
Check if the following have been done. You must indicate "yee or "noP as to each of the follom*g:
Yes No
— Pumping information was provided by the owner, occupant, or Board of Health
V'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 idle system recently or as part of this inspection ?
Z— Were as built Plans of the system obtained and examined? (If they were not available note as N/A)
Was the fiLcility or dwelling inspected for signs of sewage back up ?
Was the site inspected for signs of break out ?
Were all system Components, excluding the SAS, located on site ?
Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition
of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum ?
Was the facility owner (and occupants if different from owner) provided with information on the proper
maintenance of subsurffice sewage disposal systems ?
The size and tocation of the Soil Absorption System (SAS) on the site has been determined based on:
yz no Existing information. For example, a Plan at the Board of Health.
— -ZDetemined in the field (if any Of the failure criteria related to Part C is at issue approximation of distance
is UnAcceptable) 13 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: 21-5
0 �j �57%-
Owner:
Date of Inspection: i;;k)
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms (design): i�� Number of bedrooms (actual): c:'
DESIGN flow based on 310 CMR 15203 (for example: 110 gpd x #of bedrooms): 6-pZ>
Number of current residents: tl
Dom residence have a garbage grinder (yes or no):
Is laundry on a separate sewage- system (yes or no): AV [if yes separate inspection required,
Laundry system inspected (yes or no): —
Seasonal use: (yes or no) -
Water meter readings, if available Oast 2 years usage (gpd)):
Sump pump (yes or no): jVp
Last date Of occuvancv-
I
COMMERCIAL11NDUMIAL
Type of establishment:
Design flow (based on 3 10 CMR 15.203): 2nd
Basis of design flow (seats/persons/sqftetc.):
Grease trap Present (yes or no): —
Industrial waste holding tank present (yes or no):
N011-sanitaly waste discharged to the Title 5 system (yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER (describe):
Pumping Records GENERAL INFORMAJION
Source of information: !:�1;2 ql() g
Was system pumped as part of 6e kspedtiomn es or no):
If yes, volume pumped:
Reason. for pumping: ____gallons — How was quantity pumped determined?
TYPE OF SYSTEM
Septic tark distribution box, soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system (yes or no) (if yes, attach previous inspection records, if any)
InnovativdAlternative technology. Attach a copy of the currerit operation and mamtenance contract (to be
obtained from system owner)
— Tight tank Attach a copy of the DEP approval
— Other (describe):
Approximate age of all components, date instaUed (if known) and source of information:
z000
Were sewage odors detected when arriving at the site (yes or no): &0
Page7 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: ;:Z (v 3 J-6 H t,3so tj S�
Owner:
Date of Inspection: 0
BUILDING SEWER (locate on site plan)
Depth below grade: Ig �
Materials of construction: cast iron L-"40 PVC 9(her (explain) -
Distance from private water supply well or suction line: ff
Comments (on condition ofjoints, venting, evidence of leakage, etc.):
PiR4F- 1-D o A 3 F-�' 0 -*./ - I , ')
SEPTIC TANK. -4 (locate on site plan)
Depth below grade: /;2 ' 0& -)�/ s
Material of construction: v" concrete metal -fiberglass --j)o1yethylene
--pther(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 -
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness; /YZ &
Distance from top of Scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee oi-b-affle: /-�r
How were dimensions determined: a e- r--rle 14,
Comments (on pumping recommendations� inlet and outlet tee or baffle conditioij, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
0-1-k T-,4 Aa 0-..5 A.J^
O. -A- --
s7l o,A.,
GREASY, TRAP: jV_"ocate on site plan)
Depth below grade: _
Material of construction: —concrete metal fiber
(explain): glass .. 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 oi-b—affle
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 I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 2&.3 J&H/usoj,-)
tV o 4- 77-( A — P a)
Owner: P -0 xj
Date of Inspection:
17IGHT or HOLDING TANK*./YA (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: _
Material of construction- concrete mew fiberglass --Polyethylene ----9ffier(aqP1ain):
Dimensions:
Capacity:
Design Flow- gallons/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.):
DISTRIKIMONBOX: (If Present must be openedXlocate on site plan)
Depth of liquid level above outlet invert- 0 "
17
Comments (note if box is level and di*i6�t On to outlets equal, any evidence of solids carryover, any evidence of
leakage into or out of box, etc.):
9b,K I e-11. -ti-00 Q - z- -sTAt (3 L'?OVA
j^j O -S
,
PUW CHAMER. Ak(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 I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: Q & 3 �j _5 -(
. - o -'0A ^ 14
Owner:
Date of Inspection:
-
SOIL ABSORPTION SYSTEM (SAS): — (locate on site plan, excavation not required)
If SAS not located explain why:
Type
leaching pits, number:
leaching chambers, number:
leaching galleries, number:
leaching trenches, number, length:
leaching fields, number, dimensions: S j. -j f -I c�t, t�,)
overflow cesspool, number:
innovativetalternative system Type(name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,
etc.):
CESSPOGISW
J4- (cesspool must be pumped as part of inspectionXiocate on site plan)
Number and configuration:
Depth - top of liquid to
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 A�L (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.):
0
Page 10 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: .2&,.3
P - fz�, A^j 0
Owner: r,>0 j F>C&9S-0xj
Date of Inspection: �Z 13 11 c,3�
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 withm 100 fed. Locate where public water supply enters the building.
, 1-- OE7De,�OAA
rl 1 -4 -r z
(3
19
A- 17
6--r/
.
Z-7.0"
S71
Page 11 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
I PART C
SYSTEM INFORMATION (continued)
Property Address: -2(6-3
- N
Owner: C
Date of Inspection:
SIn EXAM
Slope
Surface water
Check cellar 5.
Shallow wells
Estimated depth to ground water C, feet
Please nidicate (check) all methods used to determine the high ground water elevabon:
Obtained from system design plans on record - If checked, date of design plan reviewed:
Observed site (abutting property/obswration hole witlik ISO feet of SAS)
Checked with local Board of Health -explain:
Checked with local excavators, instalier,,, (attach documentation)
Accessed USGS database-evlain: —
You must describe how you established the high ground water elevation:
- - LIL, �a �,- 02-- -7 —1- -;-r- ;7, 7--5 — I/,., X> I C H . c� P —1 -74",
TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE:
January 25, 2000
This is to certify that
the individual subsurface disposal system
constructed ( ) or repaired ( X )
by
John Shaw
at
263 & 265 Johnson Street
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
1�6-ard of Health Inspector
TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM
INSTALLATION CERTIFICATION
The #ersigned hereby certify that the Sewage Disposal System constructed;
( L,�iepaired:
by—
located at Z-(, 15 0-. 577t 7—
was installed in conformance with the North Andover Board of Health approved plan,
System Design Permit #&a dated__,& &Jg with an approved design
. _,Z ,
flow OfL4:V gallons per day. The materials used were in confonnance with those
specified on the approved plan; the system was installed in accordance with the provisions
of 3 10 Ma 15.000, Title 5 and local regulations, and the final grading agrees -
substantiafly with the approved plan. AU work is accurately represented on the As -built
which has been submitted to the Board of Health.
Bed inspection date:
Engineer Representative
Final inspection date:
Engineer Representative
Instafler: Lic.#: Date:
Design Engineer: Date:
X4 , P
AS -BUILT CHECKLIST
LOT N_U�VIBER, STREET NAME
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WIIN 150' OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
STAMP & SIGNATURE
UVIPERVIOUSI AREAS - DRIVEWAYS, ETC.
NORTH ARROW
FINAL CONTOU
LOCATION & ELEVATION OF BEN
�CHIMARK USED
LOCUS PLAIN
ASSESSORS MAP & PARCEL NU-N/IBER
LOT LINES & LOCATION OF DWELLINGS
LOCATION & DENIENISIONS OF SYSTEtvf,
INCLUDING RESERVE
TIES TO LOT LINES
& DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVXTIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WIIN 150' OF SYSTEM
LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
STAMP & SIGNATURE
UVIPERVIOUSI AREAS - DRIVEWAYS, ETC.
NORTH ARROW
FINAL CONTOU
LOCATION & ELEVATION OF BEN
�CHIMARK USED
LOCUS PLAIN
AS-RUILT01-1-ECKLIST
LOT NUMBER, STREET NAME
ASSE�SORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATION & DEMENSIONS OF SYSTEM.
INCLUDING RESERVE
TIES TO LOT LMS & DWELLING, WELLS
a. FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVATIONS OF DISPOSAL SYSTEM
TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
WAN 150'OF SYSTEM
LOCATION OF WATER, GAI, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D -BOX
STAMP & SIGNATURE
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
FINAL CONTOURS
LOCATION & ELEVATION OF BENCHMARK USED
LOCUSPLAN
J912 A
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT I
I I
DATE: CU'RRENT INSTALLER'S LICEINSErr_
LOCATION: 57 4 -
LICENSED INSTALLER: Z, �) IZ,, 0
14 �_S: f—ra- U0,
SIGNIATURE-,:�_���_ TELEPHONErlrl
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT.
S75.00 Fee Attached?
Foundation As -Built?
i
A�rninistrative Use Only
Yes No
Yes No
Floor Plans? Yes No
Approval
Date: —
099
PAGE I OF 5
Commonwealth of Massachusetts
Application for Ucal Upgrade Approval
Title 5, 310 CMR 15.000
DEP Approved form required by 310 CMR 15.403(l)
To be submitted to lmgl &Wroving Authority/Board of Health: For the upgrade of a failed or
nonconforming system with a design flow of < 10,000 gpd, where full compliance, as defiried in
310 CMR 15.404(l), is not feasible.
To be submitted to DEPi For the upgrade of a failed or nonconforming system with a design flow
of 10,000 up to 15,000 gpd. and/or for upgrade of a state or federal facility, where full
compliance, as defined in 310 CMR 15.404(l), is'not feasible.
NOTE; Local upg . rade approval shall not be granted for an upgrade proposal that includes the
addition of new design flow to a cesspool or privy or'the addition of new design flow above the
existing approved capacity of a system constructed in accordance with either the 1978 Code or 3.10
itMR 15.000.
FacUity/system owner
Name "AK.I( A&AI HoWA 0 - -
Address 7-5�5 - jv"ws,:;,0 -5,,rj4rc--r- uygrt4 Ak)g:;yf--Y-,
Phone # 6e75- 0-75;-?
Address of facility 46-3P k Z& 5E 4
2) Applicant '(if different from above)
Name 41AA or
Address
Phone #
3) Type of facil'
!q-
L,fesidential commercial school
institutional
IQ Mll
DEP AFMOVED FORM - U117195
1—j:—r-,-w-W-oF �NORTH —AINIJ-D"OV�E�R/
BOARD OF HEALTH
rA,,,.I-, 2 6 i1goo
PAGE 2 OF 5
4) Type of existing system
_____privy ___�cesspool(s) /conventional system
Other (describe)
Type of soil absorption system (trenches, chambers, pits,etc.)
I- fdaL plr�p
5) Design flow based on 310 CMR 15-203
a) Design flow of existing system Lia-ta. gpd
Approved? yes approval date
no why?
b) Design flow of proposed upgraded system 6-�C gpd
c) Design flow of facility_6e�
,0 gpd
6) Proposed upgpde of existing system is
a) Voluntary
Required by order, letter, etc. (attach copy)
Required following inspection required by 310 CMR 15.301 (provide date
inspection form was submitted to the approving authority) (date)
b) , Describe the proposed upgrade to the system
KAU i, 12"f
c) Which of the following are applicable to the proposed upgrade?
M_ Reduction of setback(s) (list setbacks to be reduced with proposed setback distances)
A[& Percolation rate of 30-60 minutes per.inch (state actual perc rate)
iiDEP APPROVED FORM - 12/07195
PAGE 3 OF 5
Up to 25 % reduction in subsurface disposal area design requirements (state required
& proposed size)
M Relocation of water supply well (identify well, describe relocation)
Reduction of required separation between bottom of SAS & high groundwater
(specify proposed reduction & perc rate) kp-
I
Other requirements of 310 CMR 15.000 that cannot be met (specify sections of the
Code)
System upgrades that cannot be performed in accordance with 310 CMR 15.404 &
15.405, or in full compliance with the requirements of 310 -CMR 15.000, require a
variance pursuant to 310 CMR 15.410-15.417.
7) If the proposed upgrade involves -a reduction in the required separation between the bottom
of the soil absorption system and the -high groundwater elevation, an Approved Soil
Evaluator must determine the. high ground water elevation pursuant to 3 10 CMR
15.405(l)(i)(1). The evaluator must be a member or agent of the local approving authority:
Distance from soil absorption system to high groundwater
�i, I �k feet
As determined by:
Evaluator's name , 7 -
f,6z P'�P'
Evaluator's signature
Date of evaluation -2-:22
aDEP APPROVED FORM - 12107/9S
8)
PAGE 4 OF 5
Notice to Abutters
No application for upgrade approval in which the setback from property lines or a
private water supply well is reduced shall be complete until the applicant has
notified all abutters whose property or well is affected by certified mail at least ten
days before the Board of Health meeting at which the upgrade approval will be on
the agenda. Such notice shall include the date, time and place where the upgrade
approval will be discussed.
If the Department is L approving authority, then such notice to abutters must be
completed prior to the date of submission of the application to the Department.
The notices to abutters shall include a copy of the completed application form and
shall reference the standards set forth in 310 CMR 15.402 through 15.405.
List of affected Abutters:
Abutter Name Date notified
Address
Abutter.Name—
Address
A I butter Name
Address
Date notified
Date notified
Abutter Name Date notified
Address
9) Explain why full compliance, as defined in 310 CMR 15.404(l), is not feasible (each
section must be completed):
?10. a) an upgraded system in full compliance with 310 CMR 15.000 is not feasible:
b) an alternative system approved pursuant to 310 CMR 15.283-15.288 is not feasible:
WDEP APPROVED FORM - 12107/9S
p, c) a shared system is not feasible:
W d) connection to a sewer is not feasible:
PAGE 5 OF 5
10) An application for a disposal system construction permit, including all required attachments
(e.g. plans & specifications, site evaluation forms), must accompany this application. Is the
DSCP application attached? —yes %-4o
11) Certification
1, the facility owner, certify under penalty of law that this document and all
attachments, to the best of my knowledge and belief, are true, accurate, and
complete. I am aware that there may be significant consequences for submitting
false information, including, but not limited to, penalties or fine and/or
imprisonment for knowing violations."
Facility —owRefs signature Date
�-I A VY -A Q 0 Lkrz,-]
Print Name
Z,
Name of preparer Date
Parl't- 2rCY?,rrT- /(J� tLo
Telephone # & address of preparer
NOTE: Title 5, 3 10 CMR 15.403(4), require& the system owner or operator to submit to the
Department a copy of the local upgrade approval upon issuance by the Board of Health and prior
to commencement of construction.
aDEP APPROVED FORM - 12/07195
Town of North Andover, Massachusetts Form No. 2
BOARD OF HEALTH
DESIGN APPROVAL FOR
ACH SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant Test No.. �116
Site Location '-�4 3 V4- ',1- 6 5 -
Reference Plans and Specs
1�
/'q- 16 A
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
Fee. lall*,—
CHAIRMAN, BOARD OF HEALTH
Site System Permit No. la(F
Town of North Andover a T 16 41
OMCE OF '6 0
0
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 0 1845 .4.". 00'1� C2
WMLJAM J. SCOTF '7SACH
Director
(978) 688-9531 Fax (978) 688-9542
October 29, 1999
Mr. Bill Dufresne
MerrimackEngmeering
66 Park Street
Andover, MA 01810
RE: Proposed Septic Plan at 255 Johnson Street
Dear Mr. Dufresne:
I am in receipt of a plan drawn by your engineering fiTm for a proposed septic repair at 255 Johnson Street.
Please be advised that performing this work would require a watershed special permit from the North
Andover Planning Board due to the fact that the proposed work is located within the Non -Discharge Buffer
Zone of the Watershed Protection District As such, a speciW permit is required for work that involves
any surface or sub -surface discharge.
Please contact this office if you have any questions regarding the application process and procedure(s).
Tbank You,
Heidi Griffin
Town Planner
cc: Sandra Staff, Health Administrator
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
(20
Town of North Andover
OFMCE OF
COMMUNITY DEVELOPMENT AND SERVICES
WU,LJAM J. SCO17
Director
(978) 688-953)l
August 27, 1999
Bill Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 0 1810
Re: 263-265 Johnson Street
Dear Bill:
27 Charles Street
North Andover, Massachusetts 0 1845
to
Fax (978) 688-9542
This is to confirm that on August 26, 1999, at their regularly scheduled meeting the North
Andover Board of Health considered variances requested for the repair of a septic system
at 263-265 Johnson Street. The following variances were granted by a vote of the Board.
I
Depth to ground water, 4 feet to 3 feet.
With this variance, the proposed septic plan dated August 23, 1999 is approved.
Please feel free to call the Health Department at 978-688-9540 if you have any questions
concerning this action.
Sincerely,
Sandra Starr, R.S.
Health Administrator
cc: Mary Ann Morin
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS 0 LAND SURVEYORS 9 PLANNERS
66 PARK STREET - ANDOVER, MASSACHUSETTS 01810 - TEL (978) 475-3555, 373-5721 - FAX (978) 475-1448 - E-MAIL: merreng@aol.com
August 19, 1999
Ms. Sandy Staff
Director of Public Health
27 Charles Street
North Andover, MA 0 1845
RE: 598 Salem Street
263/265 Johnson Street
Dear Ms. Starr:
This office has prepared septic system upgrade plans for the two sites referenced above.
The plan prepared for 598 Salem Street requires a variance from the local regulations allowing
a design for a 3 bedroom dwelling while the plan for 263/265 Johnson Street requires a local
upgrade approved allowing the system to be less than 4.0 ft. from the estimated seasonal
water table.
We ask that these items be placed on your earliest available meeting agenda so that we may
discuss these matters in more detail with the Board.
We thank you for your attention to this matter.
Very truly yours,
MERRIMA�K ENGINEERING SERVICES
a�6z�/�o
William Dufresne
Project Manager
cd
T 11M 0 F N 0 RTH P�- H
OARI) OF
Aug -25-99 12:31P Paul D. Tuvbide, PE/PLS 508-465-0313 P.02
August 25, 1999
Sandra Staff
North Andover Board of Health Administrator
Office of Community Development and Services
30 School St.
North Andover, MA 01845
RE: Title V second review for 263-265 Johnson Street
Dear Sandra,
I find that the revised design plans dated 08-20-99 adequately address the concerns
outlined in my report dated August 6, 1999.
If you have any questions or comments please call me. Thank you.
Sincerely
CaTlton Brown, PE/PLS
PORT
INGINIFRING�
Civil Engineers &
Land Surveyors
One Harris Street
Newburyport, MA
005o
(978) 465-8594
F NOR '41 AVD011---i'll
�W
PAGE I OF 5
Commonwealth of Massachusetts
Application for Local Xjpgrade--Annroval
Title 5, 310 CMR 15.000
DEP Approved form required by 310 CMR 15.403(l)
To be submitted to L=al &proving Authorily/Board of Heal : For the upgrade of a failed or
nonconforming system with a design flow of < 10,000 gpd, where full compliance, as defined in
310 CMR 15.404(l), is not feasible.
To be submitted to D For the upgrade of a failed or nonconforming system with a design flow
of 10,000 up to 15,WO gpd and/or for upgrade of a state or federal facility, where full
compliance, as defined in 3 10 CMR 15.404(l), is* not feasible.
NOTE:. Local upgrade approval shall not be granted for an upgrade proposal that includes the
addition of new design flow to a cesspool or privy orthe addition of new desip flow above the
existing approved capacity of a system constructed in accordance with either the 1978 Code or 3.10
tMR 15.000.
Facility/system owner
Name 0A
Address jo"Wyo 9,rjZC-f'
Phone # &*5- o'75;-? -
Address of fkcility__ZZ��G-P/kk Z& 5� ja4aaea 5-r-
2) Applicant '(if different from above)
Name
Address
Phone #
3) Type of faciliy
L,16idential commercial school
institutional
(Specify)
DEP AMOVIM FORM - UW195
ICVVN OF NORTH ANUkJVr-I
r
,,nARD OF HEALTH
LAUG 2 31999
PAGE 2 OF 5
4) Type of existing system
____privy ___.cesspool(s) V/Conventional system
Other (describe)
Type of soil absorption system (trenches, chambers, pits,etc.)
udel RJCLR
5) Design flow based on 3iO CMR 15.203
a) Design flow of existing system tia-ti. gpd
Approved? yes approval date
no why?
b) Design flow of proposed upgraded system 6�0 gpd
c) Design flow of facility_jjW gpd
6) Proposed upg de of existing system is
a) 7voluntary
Required by order, letter, etc. (attach copy)
Required following inspection required by 310 CMR 15.301 (provide date
inspection form was submitted to the approving authority) (date)
b) . Describe the proposed upgrade to the system
Le-Aell El MIP -'72F�qt F,
KAU L 'S"i SIP
c) Which of the following are applicable to the proposed upgrade?
WL Reduction of setback(s) (list setbacks to be reduced with proposed setback distances)
Af& Percolation rate of 30-60 minutes per.inch (state actual perc, rate)
kiDEP APMOVED FORM - 12107195
PAGE 3 OF 5
pA Up to 25% reduction in subsurface disposal area design requirements (state required
& proposed size)
& Relocation of water supply well (identify well, describe relocation)
L."I/Reduction. of required separation between bottom of SAS & high groundwater
(specify proposed reduction & perc rate)
Other requirements of 310 CMR 15.000 that cannot be met (specify sections of the
Code)
System upgrades that cannot be performed in accordance with 310 CMR 15.404 &
15.405, or in full compliance with the requirements of 310 -CMR 15.000, require a
variance pursuant to 310 CMR 15.410-15.417.
7) If the proposed upgrade involves.a reduction in the required separation between the bottom
of the soil absorption system -and the -high groundwater elevation, an Approved Soil
Evaluator must determine the. high ground water elevation pursuant to 3 10 CMR
15.405(l)(i)(1). The evaluator must be a member or agent of the local approving authority:
Distance from soil absorption system to high groundwater
�P, I �E feet
As determined by:
Evaluator's name
Evaluator's signat
Date of evaluation 7- -2-:22
aDEP APPROVED FORM - 1210719S
8)
PAGE 4 OF 5
Notice to Abutters
No application for upgrade approval in which the setback from property lines or a
private water supply well is reduced shall be complete until the applicant has
notified all abutters whose property or well is affected by certified mail at least ten
days before the Board of Health meeting at which the upgrade approval will be on
the agenda. Such notice shall include the date, time and place where the upgrade
approval will be discussed.
If the Department is L approving authority, then such notice to abutters must be
completed prior to the date of submission of the application to the Department.
The notices to abutters shall include a copy of the completed application form and
shall reference the standards set forth in 310 CMR 15.402 through 15.405.
List of affected Abutters:
Abutter Name
Address
Date notified
Abutter Name Date notified
Address
A 0 butter Name Date notified
Address
Abutter Name
Address
Date notified
9) Explain why full compliance, as defined in 310 CMR 15.404(l), is not feasible (each
section must be completed):
�,,k a) an upgraded system in full compliance with 310 CMR 15.000 is not feasible:
A b) an alternative system approved pursuant to 3 10 CMR 15.283-15.288 is not feasible:
WDEP APPROVED FORM - 12107/95
Vjp, c) a shared system is not feasible:
W d) connection to a sewer is not feasible:
PAGE 5 OF 5
10) An application for a disposal system construction permit, including all required attachments
(e.g. plans & specifications, site evaluation forms), must accompany -this application. Is the
DSCP application'attached? —yes %-40
11) Certification
1, the facility owner, certify under penalty of law that this document and all
attachments, to the best of my knowledge and belief, are true, accurate, and
complete. I am aware that there may be significant consequences for submitting
false information, including, but not limited to, penalties or fine and/or
imprisonment for knowing violations."
Facility owner's signature Date
vty A tj rtl 4)
Print Name
EZI L-1— )�Lj F rzi*oe 9_Z13_Tf
Name of preparer Date
&(," PAKL- �'rrzzr-
Telephone # & address of preparer
NOTE: Title 5, 3 10 CMR 15.403(4), require& the system owner or operator to submit to the
Department a copy of the local upgrade approval upon issuance by the Board of Health and prior
to commencement of construction.
WDEP APPROVED FORM - 12107195
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
WILLIAM J. SCOTT
Director
(978) 688-9531
August 11, 1999
William Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 0 18 10
RE: 263-265 Johnson Street
Dear Mr. Dufresne:
27 Charles Street
North Andover, Massachusetts 0 1845
9 D
Fax (978) 688-9542
This is to inforra you that the proposed plans for the repair of the septic system
located at 263-265 Johnson Street, North Andover, have been disapproved for the
following reasons:
Local Upgrade Application form missing.
Bottom of the system is less than 3' to groundwater. High point of existing grade
(919'r above leaching field has elevation 977. ESHW in Pit T-2 was 72". Thus ESHW for
high point of field is about 91.7'. System must be raised 0.5'.
Raising field will result in fill extending onto right of way.
d00,55 A statement should be added that no garbage disposal is to be installed and all
existing garbage disposal are to be removed. (3 10 CMR 240(4)).
The ends of the distribution lines are not connected with solid pipe. (NA 15.01)
*'6. Note 13 should be changed by deleting the words "... and either punctured at the
bottom and filled with clean sand or...
The benchmark is missing from the plan section,
If you have any questions, please feel free to contact the office at the number below.
Sincerely,
Sandra Starr, R.S.
Health Administrator
Cc: M. Morin
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Town of North Andover
OMCE OF
COMMUNITY DEVELOPMENT AND SERVICES
WU,LIAM J. SCOTr
Director
(978) 688-9531
August 11, 1999
William Dufresne
Merrimack Engineering
66 Park Street
Andover, MA 0 18 10
RE: 263-265 Johnson Street
Dear Mr. Dufresne:
27 Charles Street
North Andover, Massachusetts 0 1845
,to ,
10
Fax (978) 688-9542
This is to inform you that the proposed plans for the repair of the septic system
located at 263-265 Johnson Street, North Andover, have been disapproved for the
following reasons:
I . Local Upgrade Application form missing.
2. Bottom of the system is less than 3' to groundwater. High point of existing grade
above leaching field has elevation 97.7'. ESHW in Pit T-2 was 72". Thus ESHW for
high point of field is about 917. System must be raised 0.5'.
3. Raising field will result in fill extending onto right of way.
4. A statement should be added that no garbage disposal is to be installed and all
existing garbage disposal are to be removed. (3 10 CMR 240(4)).
5. The ends of the distribution lines are not connected with solid pipe. (NA 15. 0 1)
6. Note 13 should be changed by deleting the words "... and either punctured at the
bottom and filled with clean sand or... ".
7. The benchmark is missing fTom the plan section.
If you have any questions, please feel free to contact the office at the number below.
Sincerely,
Sandra Starr, R.S.
Health Administrator
Cc: M. Morin
File
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Aug -06-99 08:14A Paul D. Turbide, PE/PLS 508-465-0313 P-02
I
August 6, 1999
Sandra Staff
North Andover Board of Health Administrator
Office of Community Development and Services
30 School St,
North Andover, MA 0 184 5
RE: Title V review fbi`-255 Johnson Street
Dear Sandra,
Enclosed find the "Checklist for North Andover Septic System Plans" for the above-
mentioned site. The following is a list of all the 'Problem' areas and deficiencies Port
Engineering has found.
• The high point of the existing grade above the proposed leaching field has elevation
97.7+'� ESHW in Pit T-2 was 72" down. Thus ESHW for the high point of the
field is about 917. The system must be raised 0.5' above those elevations on the
design plan to maintain the 3' vertical separation between the ESHW and the
bottom of the field.
• Raising the elevation of the leaching field by 0.5' will result in some of the required
fi I ' I to spill out onto the Johnson Street right-of-way. However, in my opinion this
minor fill encroachment will have no effect on the paved portion of the street,
Because there is a natural "hill" (with a top elevation of about 100Y) adjacent to
the system that runs to the pavement, the minor fill encroachment will not be
noticeable.
• A statement should be added that no garbage disposal is to be installed, and all
existing garbage disposals are to be removed. 3 10 CMR 240(4)
• The ends of the leaching field distribution lines shall be interconnected with solid
pipe. NA15.01
• Because the proposed design shows new septic tanks being installed in the same
location as the existing septic tanks, Note 13 should be changed by deleting the
words: "...and either punctured at the bottom and filled with clean sand or..."
• The benchmark, while shown on the profile, should also be shown on the plan
section.
PORT If you have any questions or comments please call me. Thank you
it it Sincerely
Carlton A. Brown, PE/PLS
Civil Engineers &
Land Surveyors
One Harris SLreet
Newburyport, MA
01950
(978) 465-8594
FORM 11 - SOEL EVALUATOR FORhl
Page I
No . ...................................... Commonwealth of MassaChusetts
Ale- Massachusetts
Soil Suitabilitv Assessment far :lite -,Sew= ftosal
Perfomed BY: ............................
witnessed By:
.. ......... . ........................ I ............................................................................. : .................... . . ......................................................................................................................
r Lem" AA&M of I -e&-; ot,
WSCAI 1$14-y 14PO /4 -
La 8 2j�5r jews" Smf-r-r
New construction D
lei 10 M;
Repair 9/
Published Soil Survey Available: No Yes /A/—
Year Published .12 ... Publication Scale 111�TYc Soil Map Unil
4
Drainage Class ....... �q Soil umitations .................................................... 04 ......... ?
Nex...
Surficial Geologic Report Available: No Yes El
Year Published ................... Publication Scale ..................
GeologicMaterial (Map Unit) ......................... . .......................................................................... . ....................................................
Landform...................................................................................................................................................................................................................
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes 9/
Within 500 year flood boundary No Yes 1:1
Within'100 year flood boundary' No Yes 11
Wetland Area:
National Wetland Inventory Map (map unit) ................................................................. . . . ...........................................
Wetlands Conservancy Program Map (map unit) ...................................................................................... . .... .....
..........
Current Water Resource Condition's (USGS): Month ...Jl/ .....
Range : Above Normal Normal 0 Below Normal
Other References Reviewed: . V yof4o -- 1.
4 .
Ir
Vool it - SO% EVALUTOR VORM
Page 2
-7 p.!' ... . . ...........
D88P Hole Number Data: —0jIf Time:-/ ,��004t Weather
v
Location (Identify on site plani ---- )"
Land Use slope (%I _jL-3-I& Surface Stbnas .......... 00
Vegetation. ....... .......... . ............... . . ....... . .
Landform. . ........ . . . . . . . ................... . ........... .. .................... . ............. .
pogition.on landscape (sketch on thiback) ------
Distance$ from:
open Water Body feet Drainage
possible Wet Area feet Property Una feet
Drinking Water Wall feet Other
a
F9;;wam sudace Gov H&*m Gas Tax"* 60 C0.1w 1`4 1 ONO.,
..M., . MGDM
4'1_=r!alw F.M.-
0'_ -1
Ab ��31_
Lv e -
gr
Parent Material (goologici L_ Depth to Bedrock:
DaRth to Groundwj= Standing Water In the Hole: ..4_k4�-.�Waaping from Pit Face:
Estimated Seasonal Hign Ground Water:
VORM 11 - SOEL EVALUATOR WRM
PARC 2
On-site ReWeH!
Deep, Hole Number J�L Date: Z-- Time: Weather
AI&A, ........... .......................
Location (Idandfv on site Plani . . . .......
Land Use Slope (%I Surface Stories ..............
Vegetation
L&ndf orm . . ...... .................. . . ........... ......................
pogitionon landscape (sketch on the back) . . . . ............ . . . . . . . . . ........
Distance$ from:
open Wit" Body feet Drainage feat'
possible Wet Area feet PropartV Una feet
Drinking Water Wal feet Other
DEEP OBSERVXTION ROLE 1MG
Sol 1"ItIt1w
Mpth(=SUfftC8 I SON HNWM Sol Uftwe
1uSDM
9%�Iammw 4L ft.m—ft
parent Material 19801091cl -�, L, (� . ..... ......... . ............ Depth to Bedrock:
p.antb to Groundw&= Standing Water In the Hola: 11.1.7e—Weaping from Pit Face:
Estimated Seasonal High Ground Water:
lox
7,
-7-Z,
7
C -z-
parent Material 19801091cl -�, L, (� . ..... ......... . ............ Depth to Bedrock:
p.antb to Groundw&= Standing Water In the Hola: 11.1.7e—Weaping from Pit Face:
Estimated Seasonal High Ground Water:
Ll � 4
FORM 11 - SOEL EVALUATOR FORM
PAge 3
4-17, Tf I I M
DDepth observed standing In observation hole ..... . __ Inches
0 Depth W8eping from side of- observation hole Inches
-7(o *' (�_�
[]'**Depth to soil mottles Inches
0 Ground water adjustment . feet
index Well Number .......... ...... Reading. Date Index well level
Adjustment factor Adjusted ground water level . ........
Does at least four feet of naturally occurring pervious material exist In. all areas
observed throughout the area proposed for the soil absorption system?
If not, what is the dept6 of naturally occurring pervious material?
4 QMHOM
I certify that on (date) I have passed the examination approved by the
Department of Environmental Protection and that the above analysis was
performed by me consistent with the required training, expertise and experience
described In 310 CMR 16.017.
Signature 1-44YMA�� C - ate 7,4z�—ff
FORNI 12 - PERCOLATION 1UT
COMMONWEALTH'OF MASSACHUSETTS
Massachusetts
Percolation Test
Date: T1
Observation Hole #
Depth Of Pere
start Pte-sook
:5
End Pr8-soak
6-2
Tim . a at 120
0(e
Time at 9*
Time at 6"
-L
Time (9'-6'1
Rate Min./inch
/-9
A
a .... ... .........................
a
11
U
Site Passed B/ Site Failed 0
.... .............. ............... ......... ............. ........... ...................
performed BY:
Witnessed By: r2 -
comments: ........................................................... . ..................... ............. ............... .............................................................................. ...... . ............... . . . ..
FORM — U — LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all -necessary ap'roval / permits from
p
Boards and Departments having junisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
2 9 8 0 2 a a a a 0 a a a a a a 0 a a a a a a a a 0 0 a a a 0 a 0 a 0 0 0 a a a a 0 a a a a a a 0 a a a 0 0 a 8 0 a a 8 A 0 a A a 6 a O's A A a A a 0
APPLICANT PHONE 9 C
ASSESSO . RS MAP NUMBER 97 LOT NUMBER
STREETNUMBER
STREET —2�rj, —
I a as and an ass A 9 a a am *0 0 am am a an ASSN a am 0 a am a am a. 0 a a a am am 4 a a an a a a a A A A A A A A A A A A A 0
OFFICIAL USE ONLY jE,>e1*0a_c_ %�g (e
A a a sj�o
a ;��
0 0 9 a 0 0 0 a a 0 a a a a 0 a a a a 0 0 a a a a a a a a 9 a a a 0 0 a a a a a a a a a a a 0 0
RECOMMEINDATIONS OF TOWN AGENTS / X/
I a "�n a 0 21 a 0 0 0 8 a 0 0 0 4 0 a a a a a a 0 0 0 a a a 2 2 a a a a a a a a a a a 4 a a a a a a a A a 0
DATE APPROVE
D.6)
CO&SERVATION ADMIMSTRATOR
DATE REJECTED
COMMENTS -1—AJ
DA'17APPROVED
TOWN PLAN#Y DATE REJECTED
COMMENTS,
DATE APPROVED
FOOD INSPECTOR - HEALTH DATE REJECTED I
, J, 4 _7a'1___1, - A_:� DATE APPROVED _Z:4�0
SEMZ�INSPECTOR - HEALTH
DATE REJECTED
COMMENTS
j
PUBLIC WORKS - SEWER / WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
COMMENTS
RECEIVED BY BUILDING INSPECTOR
bla;4 9-�'b
JIL -EWV
MORTGAGOR a6ft li&p2ro
ADDRESS OF PRINCIPLE BUILDING
r.o3-Z&r MWA60YJ�T_-
-AL Afflfff4 6611
TW A) -5 0 A)
E K SURVEY INC
4 HAVERHILL, MA #
Phone 978-469-1985 4 Fax978-4E&7046
DEED REF. 5V ge- PG. ae
PLAN REF.
DATE OF INSPECTION rdOgL4 ab, Zoop
SCALE: 1"=1/61
�or
31,100 S.f-
Qi
�6-' � 5 X
C'
-9.24.3 - _v so,
%,A
_5rrreji�T_
RUDEL al
No- 368�0
CERTIFICATION TO: NoOI'40449 94AUX 0 17 The location of the principle 5tructurels
This Mortgage Plot Plan was prepared specifically for ' Ir -fec S I codob&K
mortgage purposes only and it is not intended or represented 1p, 10 with the local zoning bylaws in effect when constructed
to be a prop" line or land survey. This plan is vot to be used and/ or is exempt from violation enforcernnent
to establish any of the property lines for any purpose. No action under Mass B_L_ Title V11. Chap. 40A, Sec. 7.
responsibillty is extended to the land owner or occupant. 0 Subject building is not in a Flood Hazard Area.
This certification is based on the location of survey marWer 0 Subject building is in a Flood Hazard Area.
a( others. Flood Hazard determined from the FIRM map#_
Dated
-S-
SEPTIC PLAN SUBMITTAL FORM
LOCATION: Z-6 1014 04,gpo —T-�e2-
NEW PLANS: (!�S $125.00/Plan
REVISED PLANS: YES $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED: NO
DATE: --,Z-
DESIGN ENGINEER: rmolw'-V"
DATE TO CONSULTANT:
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
4
When the submission is all in place, route to the Health Secretary.
TC
��ULO 19-�9
0
Applican
Town of North Andover, Massachusetts
BOARD OF HEALTH
ZA 1977
Form No.1
APPLICATION FOR SITE TESTING/INSPECTION
Site Location
Engineer
. — &a
Test/Inspection Date and Time
CHMRMAN, BOARD OF HEALTH
Fee— P7,6� Test No. 91�
S.S. Permit No.—D.W.C. No. C.C. Date—Plbg. Permit No
Town of North Andover, Massachusetts Form No.1
,�kORTH BOARD OF HEALTH
"ED '6 16 0 19
f
APPLICATION FOR SITE TESTING/INSPECTION
Applicant I f -
NAME ADDRESS TELEPHONE
Site Location
Engineer NAME ADDRESS TELEPHONE
Test/inspection Date and Time
F
CHAIRMAN, BOARD OF HEALTH
Test No
S.S. Permit No.-D.W.C. No. C.C. Date-Plbg. Permit No.
BOARD OF HEALTH TEL. 688-9540
RECEIVED NORTH ANDOVER, MASS. 01846
JUN 2�1999 APPLICATION FOR SOIL TESTS
GWOVC5011- TESTS:
Assessor's map & parcel number 9-7 s�;
OWNER:—".,,.%,cmH "0 HPIZ4 0 TEL. NO.: -0 -7
ADDRESS:
ENGINEER: Pea17-10A�ct-'- E�S 6P. TEL. NO.:
CERTIFIED SOIL EVALUATOR: -21rft-e�;t�Y
Intended use of land residential subdivision, single family home, commercial
Repair testing A2 Undeveloped lot testing
N. A. Conservation Commission Approval: -��2
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM:
1 . Proof of land ownership (Tax bill, deed, or letter from owner permitting
tests)
2. Plot plan
3. Fee of �275.00 per lot for new construction. This covers the minimum two deep holes
and two percolation tests required for each disposal area, Fee of $75.00 per lot for
repairs or upgrades.
GENERAL INFORMATION
1 . Only Certified Soil Evaluators may perform deep hole inspections.
2. Only Mass. Registered Sanitarians and Professional Engineers can design septic
plans.
3. At least two deep holes and two percolation tests are required for each septic system
disposal area.
4. Repairs require at least two,,deep holes and at least one percolation test, at the
discretion of the BOH representative.
5. Full payment Wil be required for all additional tests within two weeks of testing.
6. Within 45 days of testing, a scaled plan (no smaller than 1 0-100') shall be submitted to
the Board of Health showing the location of all tests (including aborted tests).
7. Within 60 days of testing soil evaluation forms shall be submitted
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LOT 2 Jobnson St. Duplex House
B. Coco
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
Y
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
Lot 2 Johnson St. 0 1 will install this system in ac-
cordance with all the laws of the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre-
ceding the sePtic2t%�Jkehere the grade shall not exceed 2%. 1 will install a con-
crete septic tank of 1000 each in size. A manhole (s) permitting easy cleaning
will be provided with� removable cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed Pinud laid in a series of trenches, the bottom of which will pro-
vide a minimum o 180 ea lineal (square) feet of effective absorption area*
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches ab-;ve the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/81, to 1/41, (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 -feet from any dwelling or 10 feet from any property line.
Ifurther agree not to cover any portion of this installation until approved by the
inspection officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE 10/20/71 3 feet gravel under each bed
ibnature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE 10/20/71
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
Percolation Test 8 Minutes Soil: Clay
Garbage Grinder
Signature o�Jnspecting Officer
-r- � r - 13r %
Lot #2 Johnson Street
Benny Coco
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
T,Qt # 2 Johnson Street 9 1 will install this system in ac-
cordance with all' the laws of the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2%. 1 will install a con-
crete septic tank of in size. A manhole (s) permitting easy cleaning
will be provided with removabl; —cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of lineal (square) feet of effective absorption area.
The pipes will be laid on a 6 inch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/811 to 1/4t, (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
I further agree not to cover any portion of this installationuntil approved by the
inspection officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE July 22 1970
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
*4_ 11 __41 It
Lot #2 Jobneon Street
Benny Coco
APPLICATION FOR SEWAGE DISPOSAL INSTALLATION
HEALTH DEPARTMENT - NORTH ANDOVER, MASS.
I hereby make application for a permit for a sewage disposal installation at
0 1 will install this system in ac-
cordanV�i* tJ�ft8Ta1_w2:7-o!the Commonwealth of Massachusetts and regulations of
the Board of Health of the Town of North Andover.
Further, I will construct the house sewer of bell and spigot pipe, the minimum
diameter being 4 inches, and will maintain a minimum grade of 1% until 10 feet pre-
ceding the septic tank, where the grade shall not exceed 2%. 1 will install a con-
crete septic tank of in size. A manhole (s) permitting easy cleaning
will be provided with removable cover (s) of iron or concrete within 12 inches of
the ground surface. I will provide subsurface disposal field with 4 inch perforated
or open jointed pipe and laid in a series of trenches, the bottom of which will pro-
vide a minimum of lineal (square) feet of effective absorption area.
The pipes will be laid on a 6 i—nch layer of washed gravel or crushed stone ranging
in size from 3/4 to 1-1/2 inches (dia.) and the pipes will be surrounded by similar
material to a height of 2 inches above the crown of the pipe. The joints of these
pipes will be protected from clogging and before filling the trench, 2 inches of
gravel or stone 1/811 to 1/4" (dia.) will be placed over the course gravel or stone.
The disposal field will be installed at a grade of 4 to 6 inches/100 feet. No single
tile line will exceed 100 feet in length and in any case, two lines of tile will be
installed. A minimum of 6 feet will be maintained between the center lines of the
disposal field trenches and the average depth of trench shall not exceed 36 inches.
No part of the installation will be less than 100 feet from any private water supply,
25 feet from any stream, 20 feet from any dwelling or 10 feet from any property line.
Ifurther agree not to cover any portion of this installation until approved by the
insp ction officer, as provided below, and to incorporate any additional requirements
that may be attached to the permit. Plot Plans must be submitted with application.
DATE till= 90-1920
Signature of Applicant
I hereby issue the above permit for the Board of Health of the Town of North
Andover, Massachusetts.
DATE
Signature of Health Agent
I have inspected the uncovered system indicated above and find everything done
as described.
DATE.
Signature of Inspecting Officer
Percolation Test
Garbage Grinder
BOARD OF HEALTH
TOWN OF NORTH ANDOVER, MASS.
T
QN1.
Ci-
"?- - ) ir- 0-0 GAL Tt-, k)
Lot #2 Johnson Street
Benny Coco
1.
NAME_
DATE
2.
A]�DRESS Ah
') k (,-! 24d--Y�
j;'
LOT NO. TEL.
7
--
3.
NO. OF BEDROOMS
DEN YES NO
4.
GARBAGE GRINDER YES
5. SHOW DIMENSIONS OF HOUSE
6. SHOW DISTANCES OF HOUSE TO ALL PROPERTY LINES
7. SHOW DIMENSIONS OF LOT
8. SHOW LOCATION AND SIZE OF SEPTIC TANK OR CESSPOOL
9. NOTE LOCATION AND DISTANCE OF WELL FROM SEWERAGE SYSTEM
10. SHOW LOCATION OF BROOKS, STREAMS, DITCHES, LEDGE OUTCROP, ETC.
11. SHOW DISTANCE OF SEPTIC TANK OR CESSPOOL FROM HOUSE
NOTE: LOCAL REGULATIONS SHOULD BE READ CAREFULLY.
'r * - A#
BOARD OF HEALTH OF NORTH ANDOVER) MASSACHUSETTS
SEWAGE DISPOSAL
DATE
NAME OF APPLICANT Mr- RAnng COCO
IF —
LOCATION si-rAot
Address of lot no,
BUILDING: Dwelling X -Other DuDl-eX
SYSTEM: New- y, Repair
GENERAL DESCRIPTION OF LAND_ H18b
� SUBSOIL: Clay___Z Gravel Sand
PERCOLATION TEST -8 minutes per inch.
MINIMUM INSTALLATION RECOMMENDATIONS
2 CONCRETE SEPTIC TANK,S 1,000 -gallon capacity -each.
LEACH FIELD 360 lineal feet of drain pipe -2 lines each 180
William J. DrAs�oll, Engin er-'��—
Board of HealtY
C-0
Please forward us as much of the followlIng information that is possible;
1. Type of system
—c Th
2. Age -!�evelv
3. Location
�m cz-
4- Maintenance records and date Of last pumping out
5. Documentation of repairs and reconstruction
A), o A) e--
6. Site conditions U
7. 13,Alder of system
8. Engineer who approved;
— Site
— S-ystem
-rfiAjk i
4
C2 9
k
5. Documentation of repairs and reconstruction
A), o A) e--
6. Site conditions U
7. 13,Alder of system
8. Engineer who approved;
— Site
— S-ystem
- 21 -
9. Tnstallation Procediirp.
10. 'ProblF-mc,
WATERSHED RESIDENTS Q'UESTIONNAIRE
1. Name !.2 ; C C 0 Cc
V_
2. Street Address (Q,5 ch /y -s T.
3. How many members are in your household? U
4.
What type of sewage disposal system do you have?
El cesspool
X septic tank and leaching area CA..,�Z CM -1.4
El connection to municipal sewer
El other (describe)
El do not know
4M -
AO 77- 160 C /?A
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
Rf ves El no El do not know.
11-20 years
6. How old is your sewage disposal system? 0 0-5 years
EJ over 20 years El do not know
7. Has your sewage disposal system been rebuilt or repaired?
El yes 9 no El do n6i know
If yes, approximately how long ago?
El 6-10 years
years. What was done?
8. How frequently is your sewage disposal system pumped out? El annually
every 2-4 years El every 5-10 years El over 10 years El never
Z -A - 9 i, bz�7
9. Have you had any problems with your sewage disposal system? 0 yes no
If yes, what problems?
repeated pump -outs needed
system clogs, backs up, or drains slowly
El odors
sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub
11. Please state the b?Xand and type (liquid or powder) of detergent you use for:
dishwasher 0 S CA 3 L'
clotheswasher _S%EA&S 'R,67-Sj'_ —&et?cgj�'b
C
12. Does your property have a lawn? X yes 0 no
If yes, approximately what size?
El less than 1/4acre 0 1/4 acre 1/2acre El 3/4acre El 1 acre
El more than I acre (Specify) - acres
13. How often do you fertilize your lawn?
No. of applications per year &OA,;t3
Season(s) of the year A&M.,�Z"
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
Check here if your lawn is maintained by a professional landscape contractor.