HomeMy WebLinkAboutMiscellaneous - 268 DALE STREET 4/30/2018m
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.SEPTIC SYSTEM INSPECTION FORM
ADDRESS 1�z 6�8 1E)a(j2
DATE INSPECTED <? - ��&
PROPERLY FUNCTIONING? N
WEATHER CONDITIONS
COMMENTS:
14ATIER QUALITY TESTEJ�.' JZESUL-rS�.
DYE TEST PERFORMED? Y N
DATE?
SKETCH:
-31 42,1,,�
A,
Pl.ease forward us as much of the following information that is possible;
1. Type of system
2. Age
3. Location,
4- Maintenance records and date of last pumping out
114,,,e, A? -,(I *
I
5. Documentati,-on of repairs and reconstruction
6. Site conditions
7. Biiilder of system
8. Enzineer who approved,
— Site
— System.
- 2 -
9. Installation Procedure
4
10. Problems
JOHN J. DANAHY
400 DALE STREET
NORTH ANDOVER, MA
01845
Please forward us as much of the following information that is possible;
Type of system
4 Id
2. Age IVA
3. Loc, at ion A/
4- Maintenance records and date of last pumping out
ve,
C�
j)ocumenta-t-Ion of repairs and reconstruction
6. Site conditions
7. Builder of system
8. Engineer who approved'.
— Site
— System
- 2 -
9. Installation Procedure
10. Problems,
?A/6
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name i 701A 11 /F. I- ' a n S9 IF, 11,rn 71, Y7 r)
j Z & 9 'D
2. Street Address
3. How man y members are in your household?
4. What type of sewage disposal system do you have?
7 cesspool
Z septic tank and leaching area
F� connection to municipal sewer
El other (describe)
El do not know
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
yes El no F� do not know
6. How old is your sewage disposal system? El 0-5 years El 6-10 years EJ 11-20 years
R� over 20 years FI do not know
7. Has your sewage disposal system been rebuilt or repaired?
0 yes 5;K no ' F do not know
If yes, approximately how long ago? years. What was done?
8. H frequently is your sewage disposal system pumped out? El annually
7every 2-4 years El every 5-10 years El over 10 years El never
9. Have you had any problems with your sewage disposal system? 0 yes F�no
If yes, what problems?
repeated pump -outs needed
system clogs, backs up, or drains slowly
F-1 odors
El sewage surfaces through ground
10. How many of each appliance are connected to your 5ewage disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain — sump pump toilet
roof/pavement drains — showerlbathtub _L_
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher Caq c a ele-
clotheswasher /A- I I
12. Does your property have a lawn? Vyes 0 no
If yes, approximately what size?
El less than 1/4 acre El 1/4 acre acre El 3/4 acre El 1 acre
F-1 more than 1 acre (Specify) — acres
13. How often do you fertilize your lawn?
No. of applications per year
Season(s) of the year
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
L'o �t /10 - 6 - �K
0 Check here if your lawn is maintained by a professional landscape contractor.