Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 32 CHRISTIAN WAY 4/30/2018
k. X 32 CHRISTIAN WAY 210/104.D-0140-000(3 10/104-p- 0140 0000.0 ( I' �i BSc�(�q 32 CHRISTIAN WAY JS-2004-0259 Proiect Detail Report Printed On:Fri Jul 30,2004 Project Name- GIS#: !6317 Project No: JS-2004-0259 Owner of Record�John T. Shaw Map: j 104.13 Date Submitted: Sep-08-2003 32 CHRISTIAN WAY Block: 10140 Status: :Open NORTH ANDOVER,MA 01845 Lot: Work Category: Work Location: 32 CHRISTIAN WAY Zoning: Proposed Use: District: land Use: 101 Proposed Use Detail Subdivision 1 Description File Inquiry ,Comments: of Work: 1 Department Status GeoTMS Module: ) / Status File No. Comments: LCDate: Board of Health !� / GREE LAG BHJ-2003-0126 1/12/04-DWC Construction approved by Consultant 11/26/03-DWC application paid for by h/o,and permit given to h/o. John Shaw needs to t' come to the office and fill out an application. 11/12/03-Application for Design Plan with plans delivered at 2:40 p.m.By homeowner, Connie Bonnano. She expressed her wish to have the plan reviewed asap,and also wanted to hand deliver it. Brian LaGrasse spoke with her about the normal processing procedures. The plan was mailed same day to consultant. 9/8/03-Soil Test Application received. Forwarded to Conservation and Consultant. Permit History Type: Permit No: Issue Date Status Work Category Contractor Project No: Description of Work: DWC-System Repair BHP-2003-0380 Nov-26-2003 SIGNED OFF JS-2004-0259 Construct-Complete Plan Review BHP-2003-0378 Nov-26-2003 SIGNED OFF JS-2004-0259 Plan Review-2nd , Plan Review BHP-2003-0367 DENIED JS-2004-0259 Plan Review Soil Testing-Repair BHP-2003-0275 Sep-08-2003 SIGNED OFF JS-2004-0259 Soil Testing Inspection History Inspection Type: Permit Type: Permit No: Insp Date: Status: Inspector: Project No: Comment: Final Inspection DWC-System Repair BHP-2003-0380 Jan-13-2004 APPROVED Dan Ottenheimer JS-2004-0259 / 111 c /�� ✓�TrG/:✓C��' �`-t( CJ'b �L ©�Q! �1.r Cr/`� O GeoTMS@ 2004 Des Lauriers Municipal Solutions,Inc. Page 1 of 1 A ~ tkoRTH !1 �• `.� Uf deo ,6'g1rO \_. f 0 '9 GOGM1C11EMC• q�^Arev �SSAC HUy�� PUBLIC HEALTH DEPARTMENT Community Development Division Constance Bonanno 32 Christian Way North Andover, MA 01845 August 15, 2006 Re: request for information Dear Ms. Bonanno, This correspondence is in response to your request to the Health Department for information regarding your septic system and the "custom cleaning" of a septic system. The following is a synopsis of the issue, as understood by the Health Department and based on the documents you provided,Health Department records and conversations. 1) As it is understood, you had an existing septic system servicing your home at 32 Christian Way, which was installed in 1986. In 1986 a 1500 gallon tank and a leaching field was installed, according to Health Dept. records 2) In 2003 the owner recalled that they observed foul odors and the ponding of liquid on the ground near the area of the septic system. This is a common problem relating to the failure of the septic system. At that time the owner hired Wind River Environmental, LLC. A licensed septic pumper in N. Andover. (See attached 15.303 (1)(2) 3) In 2003 records at the Health Office, submitted by Wind River, show that 3500 gallons of waste and liquid was pumped out of the tank at this property. As the tank was only 1500 gallon in size, it can be assumed that the increase of volume was caused by liquid running back from a flooded field, into the tank. This is an indication of a failed septic system. 4) According to an invoice, Wind River recommended a procedure and was hired to work on the septic system. 5) Please note that Wind River Env. is not licensed in N. Andover to conduct septic repairs or work on systems other than pumping. A separate license is needed for any work done on a system in N. Andover. 6) The Health Dept. staff did not visit this property until an engineer requested soil tests in September of 2003. At that time an engineering firm had been contacted, the engineer found the system to be in failure and they began the process of replacing the entire septic system. 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 fax 978.688.8476 Web www.townofiorthandover.com The Health Department does not know exactly what a "custom cleaning" entails, however the invoice indicated that a "septic scrub" was conducted, presumably for the purpose of restoring the septic. The MA DEP. 310 CMR 15.028 does not allow bringing a septic system out of obvious failure. (See attached)According to a conversation with DEP's Waste Water Division held on July 5, 2006, they are unfamiliar with this process and therefore it would not be allowed unless approval was sought at DEP. If you have any questions regarding this correspondence, please contact the Health Office. Zy, -r�awyer, RE S/RS Public Health Director Cc: File Encl. 310 CMR excerpts System pumping record, 6/20/03 1600 Osgood Street,North Andover,Massachusetts 01845 Phone 978.688.9540 Fax 978.688.8476 Web www.townofnorthandover.com ` 310 CI Z DEPARTMENT OF ENVIRONMENTAL PRO-.,,,CTION 15.302: continued 1. The inspector shall review local maps and records of groundwater elevation (previous deep hole observation tests or groundwater monitoring results)on the site or nearby properties,if available. 2. If the system includes a cesspool, the cesspool shall be pumped during the inspection and then examined to determine whether groundwater flows into the cesspool,indicating that the cesspool is below high groundwater elevation. 3. If the system includes a septic tank and distribution box,the condition of these components and the surrounding soil shall be observed for indications that groundwater has infiltrated the system. Care should be taken not to destabilize the distribution box or the piping to or from. These minimum requirements shall not prevent the use of additional methods. The elevation of nearby water bodies, or evidence of groundwater infiltration in other subsurface structures(for example,cellars),or hand augering to determine depth may aide in determining whether the system is located in the groundwater. The methods used to determine high groundwater elevation shall be described in the inspection report. A system owner may choose to have the high groundwater elevation determined by an observation well or deep hole observation test to confirm or disprove the results obtained by the minimum requirements of 310 CMR 15.302(3xa),or in place of the minimum requirements. (b) Location of soil absorption system. The location of any cesspool must be determined. For systems with a septic tank and distribution box, excavation is not required to determine the location of the soil absorption system. Reference may be made to as-built plans of the system(if any). Where the failure criteria specified in 310 CMR 15.303(1)(c)are not in issue,the location may be approximated by considering design flow,location of the distribution box and direction of outlet pipes,and physical condition of the site. The location may also be determined by running a metal snake or similar device from the outlet of the distribution box and using a metal detector,or use of similar methods. Nothing in 310 CMR 15.302(3xb)shall prevent an owner from choosing to establish the location of the leaching system through more intrusive methods. 15.303: Systems Failing to Protect Public Health and SafetN and the Environment (1) If one or more of the following conditions exist as documented by inspection by an approved System Inspector, or determined by the local approving authority or the Department,the system is failing to protect public health and safety and the environment and shall be upgraded in accordance with the timeframes of 310 CMR 15.305(1) and the standards of 310 CMR 15.404 and 15.405: (a) Criteria applicable to all systems: 1. there is backup of sewage into the facility served by the system or any component of the system as a result of an overloaded and/or clogged soil absorption system or cesspool; 2. there is a discharge of effluent directly or indirectly to the surface of the ground through ponding, surface breakout or damp soils above the disposal area or to a surface water of the Commonwealth; 3. the static liquid level in the distribution box is above the level of the outlet invert; 4. the liquid depth in a cesspool is less than six inches from the inlet pipe invert or the remaining available volume within a cesspool above the liquid depth is less than '/z of one day's design flow; 5. the septic tank or cesspool requires pumping more than four times a year; 6. the septic tank is made of metal,unless the owner or operator has provided the System Inspector with a copy of a Certificate of Compliance indicating that the tank was installed within the twenty year period prior to the date of the inspection;or the septic tank is cracked or is otherwise structurally unsound,indicating that substantial infiltration or exfiltmtion is occurring or is imminent; 7. a cesspool,privy or any portion of the soil absorption system extends below the high groundwater elevation; (b) Criteria applicable to cesspools and privies: 1. A cesspool or privy is located: a. within 100 feet of a surface water supply or tributary to a surface water supply; 12/27/96 310 CMR-548 • �1 f 1 310 Clo_1 DEPARTMENT OF ENVIRONMENTAL PRO,_'TION 15.027: continued (2) It shall be a violation of 310 CMR 15.000 for any person to add,place or introduce septic system additives to any system without the prior written determination of the Department that the additive has met the criteria set forth in 310 CMR 15.027(3). (3) The Department may allow a septic system additive when it is demonstrated to the Departments satisfaction that the additive will not: (a) harm the components of the system; (b) adversely affect the functioning of the system;or (c) adversely affect the environment. (4) A Department determination that the additive has met the criteria contained in 310 CMR 15.027 shall not constitute an endorsement or approval with respect to the effectiveness or performance of the additive. Representation by any person that such Department determination constitutes such endorsement or approval shall be a violation of 310 CMR 15.000. 15.028; Soil Absorption System Restoration (1) It shall be a violation of 310 CMR 15.000 for any approved System Inspector,Soil Evaluator,Licensed Installer or Septage Hauler to introduce or to recommend the use of any physical,chemical or biological treatment process to restore or condition a soil absorption system without the prior written determination of the Department that the proposed treatment process has met the crieria set forth in 310 CMR 15.027(3). Physical treatment is not intended to include pumping,flushing,and routing of pipes or any mechanical methods of repairing existing components. The Department shall maintain and publish a list of allowed treatment processes. (2) It shall be a volation of 310 CMR 15.000 for any person to use any physical,chemical or biological treatment process to restore or condition a soil absorption system without the prior written determination of the Department that the proposed treatment process has met the criteria set forth in 310 CMR 15.027(3). (3) A Department determination that the treatment process has met the criteria contained in 310 CMR 15.027(4) shall not constitute an endorsement or approval with respect to the effectiveness or performance of the treatment process. Representation by any person that such Department determination constitutes such endorsement or approval shall be a violation of 310 CMR 15.000. 15.029: Construction ol'Wells NearBsisting Systems Itis a violation of 310 CMR 15.000 for any person to constructor install a water supply well closer to a system component than the relevant setbacks set forth in 310 CMR 15.211. 15.030: [Records (1) The local approving authority shall maintain records for each system within its jurisdiction and shall keep on file copies of the following documents: (a) Applications,plans and specifications for the construction,upgrade or expansion of on-site subsurface sewage disposal systems,including all forms and data submitted by the applicant and Soil Evaluator, (b) Disposal System Construction Permits; (c) As-built plans indicating all modifications to the approved plans subsequent to the issuance of a Disposal System Construction Permit; (d) Reports of construction inspections made prior to issuance of a Certificate of Compliance; (e) Certificates of Compliance issued or denied; 12/27/96 310 CMR-502 56/Lo/Z T - w+ro j prno.iddy doq nom) :04 PIJ.MPUM a4W.W.,32 :#41u=d .777 !A9 p"dwnd Drnp43 suoIID9 5�- :p:du:nd A4µucrs�j p/(7� :r:edu:nd Pr:Q ® s-A= DN :NVDj aydos snA cN :load. -.0 WU, a�^nd ►':y7Cs ss�w rl3Dszc;� P Nm;d 6uldu:nd w use q -- y two:j Wind River Environmental LLC Invoice 577 Main Street rE N v I R o N M E NTA L Hudson MA 01749 Acquisition: Currier Septic&Drain Service ' ' z Billling Questions: 978-841-5080 Service Questions: 978-562-4500 BILL TO JOB SITE Customer Number: 1021000 Bonanno Connie Primary Home Connie 32 Christian Way 32 Christian Way North Andover, MA 01845 North Andover, MA 01845 Bonanno Service Date: 20-Jun-2003 Invoice Number: 2152470 Order Number:0222956097 LP.O.Number: na Invoice Date: 23-Jun-2003 Order Date: 17-Jun-2003 Quantity Service Type Amount Tax 16.00 Septic Scrubs $1,439.84 $71.99 1.00 CCLS $89.99 $4.50 1.10 Coupon or Discount $-11.00 $0.00 1.00 Pumping 1001-1500 $241.78 $0.00 1.00 High Velocity Water Snake Additional Hrs. $139.80 $0.00 1.00 Pro-Pump $89.99 $4.50 Subtotal Non Taxed: $370.58 Subtotal Taxed: $1,619.82 Tax: $80.99 Subtotal : $2,071.39 Credits: $0.01 Payments: $2,071.40 Credit Balance: $0.01 Payment Terms: Due on Receipt From: Please detach here and return the bottom portion with your payment. Customer Number: 1021000 Bonanno Connie 32 Christian Way -- ----� Order Number invoice Number Invoice Date Amount Due North Andover, MAO!845 0222956097 2152470 23-Jun-2003 $0.00 Remit To: ---- Wind —WiWind River Environmental LLC. If your payment is returned NSF it will be re-presented electronically, and you 'A'111 PO Box 4326 be assessed a processing fee,the maximum alloNN ed by lay.,'. Woburn, MA 01888-4326 WRE Internal Comments 6/21/03 Sat per Brad going and doing work today (TO) f 0222957004 -✓20/03 Fri install outlet baffle ob-Brad quoted 375-450$ 6/20/03 Fri AM Custom Clean sb-Kan V home check est 2077,91$ - ~ 2750.36$ ; > FN 8/31/02 Saturday AM; service system 1500ge1s; digging - few inches BG in back of house: owner will be home; HOMECHECK: (whm) A `'stem owner '. System Location Bonanno Connie Primary Home 32 Christian Way 32 Christian Way North Andover, MA, 01845 North Andover, MA. 01845 (978 )-681-5413 x (978) -681-5413 x Home ® Customer ID: 1021000 �/ Location Comments Technician /'� Clt f) � j Hoses Tank located in backyard System Type GtanriDepth C~rN (facing wOOds) on left side Previous Service 20-Jun-2003 Truck j-,:;2 approx.l0'cut; pls.draw Naxt Sorvice Data of Service 21-Jun-2003 AM f r_a ton S=viw Code Description Charga Outlet Tee --e Zl}JC � $0,00 sa <;> � ,1lelc_���� �.� .✓ 0��. CSCE J , Subtotal Type-� Cr art Card#: -Total - -e soeadireer Tctfneician Comartnts: _ Tank Obss;iotiorr. Good Condition Leachfield Runback f ? ✓ -�= Riding High(liquid level) i ( Excessive Solids(top/bottom) Use Plo Powdered Soap Heavy Grease Roots ' Outlats Baffle /Hissing Inlet Baffle Missing Wind River. Env, ror._. _�: . _._._ ..��� r'�-�....c Wit, �'-'= an, MA1949 {97? -�6�--� 50 Terms :Due on Rgceipt Customw Signage Wind River Environmental LLC Invoice ��'4 577 Main Street t N V 1 R O Hudson MA 01749 Acquisition: Currier Septic&Drain Service Billling Questions: 978-841-5080 Service Questions: 978-562-4500 „Y BILL TO JOB SITE Customer Number: 1021000 Bonanno Connie Primary Home Connie 32 Christian Way 32 Christian Way North Andover, MA 01845 North Andover, MA 01845 1 Bonanno Service Date: 21-Jun-2003 Invoice Number: 2152699 Order Number:0222957004 P.O.Number: na . Invoice Date: 23-Jun-2003 Order Date: 20-Jun-2003 Quantity Service Type Amount Tax 0.25 Coupon or Discount $-2.50 $0.00 1.00 Outlet Tee $315.00 $0.00 1.00 Labor per Hour $75.00 $0.00 Subtotal Non Taxed: $387.50 Subtotal Taxed: $0.00 Tax: $0.00 Subtotal : $387.50 Less : Adis: Qu.nn Payments: $387.50 Balance: $0.00 Payment Terms: Due on Receipt From: Please detach here and return the bottom portion with your payment. Customer Number: 1021000 Bonanno Connie 32 Christian Way Order Number Invoice Number Invoice Date Amount Due North Andover, MA 01845 0222957004 2152699 23-Jun-2003 $0.00 Remit To: Wind River Environmental LLC. If your payment is returned NSF it will be re-presented electronically, and you will PO Box 4326 be assessed a processing fee,the maximum allowed by law. Woburn, MA 01888-4326 North Andover Health Department "ORT1i O�tt�a° ,6q�0 1600 Osgood Street letter of Transmittal �? b °� Building 20, Suite 2-36 ° North Andover, MA 01845 1 ey 978.688.9540 - Phone °4A 000AC< 978.688.8476— Fax Page_� of ��SSACHUs`��C� healthdept(atownofnorthandover com-E-mail www.townofnorthandover.com-Website TO: DATE: COMPANY: FROM: e J h 21- R�— 2y RE: Phone: Fax: f 3 9 w We are sending you: O Copy of Letter O Plans O Other tfill in helow) These are transmitted as checked below: ➢ L74pvVealarfliow ➢ Okr*pvkd ➢ OlPesubrrrt ataiesfor ➢ L7*A? pzw ➢ Okrfi'evaewa�alminnncr�t agprorr� ➢ L7*Regimd ➢ L7 ryowyw ➢ L7&A7 t ataiesfbr&t REMARKS: S COPY TO: COPY TO: COPY T0: SIGNED: We are sending you: O Cony of Letter 0 Plans L7 Other(fill m below) • These are transmitted as checked below. ©, ovn aloeA l Y 0Par gwad C7J r►i, _ . c *r �i�slVf�agu p/ > 17Ax&Yuwanda=&# �gpl►grA� REMARKS: 5 COPY TO: COPY TO: COPY TO: SIGNEO: WO3 GdVGNb1S 3CIOW 90 (S)39V8 6S:00:00 NOIiv�jnQ 66b6b698L6t8 3WVN/'ON Xad 90:6I 901L0 3WI1°31bQ O960ZZPb9000 V H35 9Lb88898L6 X31 9Lb88898L6 xv H1-Id3H 3WdN 90:EZ 900Z/S0/L0 3WI1 1JOd3d N0IiV0IdId3n NOISSIWSNVdi FORM U - LOT RELEASE FORM .l �1''',�3as��L� INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ******APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT PHONE LOCATION: Assessor's Map Number - IJ PARCEL SUBDIVISION f/ LOT (S) STREET .3 Z 6,y "54-LL-r— ST. NUMBER ********OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEAL DATE APPROVED DATE REJECTED �f C INSPECTO -H LTH DATE APPROVED tj DATE REJECTED — COMMENTS PUBLIC WORKS -SEWERMATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm i h1� a 6 nn lel ✓li`1 ~� 7 y V6L� f s�4A : �vFo UGg ?004f�HT4"ENTER TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The,undersigned hereby certify that the Sewage Disposal System ( ) constructed-, ( 4repaired: b JOLA N S0A,,A J located at ?,7� Gb-� K-i�Tlicl�l wis Y was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # dated with an approved design flow of�Q gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: I Engineer Representative Final inspection date: a 't "-2, 4==, Engineer Represen ative Installer: Lic.#: Date: o�' Engineet,.' Date:ah 31w `� �.V UILDI :ES. cc�r nt►c�-ffe,,1 i� UOT d, 6'f.E' Ta,� Pt.�-� �r Ww* PDfI�• t- CxF A. I.1AW4&avjTY 0>:'r►)C �i�-►��711aC�� r�vy.L /7 19'S 4%k7 t:H , rT is ,A �EaoGa OF r4& taorb�l lz Id /_fF77" _.. A W E 1►E v�noLl OF IW E' C.w �re5 yY5t1'N -ri�S9•�s9own 1241;11315"9 4vHfOWL►4rti. 1_�'9,37 p /S9 rz h OF SYSTE:M TOWN OF NORTH ANDOVER S �RFACE DISPOSJkL HEALTH DEPARTMENT LOCATED IN AS PREPARED DATE: 9-6-9 I T L 1.40 U SCALE: / ""= 42) , MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 60 PARK STREET • ANDOVER. MASSACHUSETTS 01810 or TEL (617) 475-3553, 373-5721 1 r , Page 1 of 1 w � DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsulting.com] Sent: Monday,January 12,2004 4:18 PM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 32 Christian Way Construction Inspection Heidi, Brian and Pam, Attached please find the construction inspection form for #32 Christian Way. It was constructed by John Shaw without any problems identified. He was fortunately able to get it completed before this cold snap hit. Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultina.com info@_millriverconsulting.-Qom 1/13/2004 MILL RIVER CONSULTING Septic System Management Services TOWN OF NORTH ANDOVER SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 32 Christian Way MAP: 104D LOT: 140 INSTALLER: John Shaw DESIGNER: Merrimack Engineering PLAN DATE: 11/25/03 BOH APPROVAL DATE ON PLAN: DATE OF BED BOTTOM INSPECTION: 12/23/03 DATE OF FINAL CONSTRUCTION INSPECTION: 1/6/04 DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE X GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK = 1,500 LOADING OF SEPTIC TANK = H-10 GALLON PUMP CHAMBER = LOADING OF PUMP CHAMBER = TYPE OF SAS = field DIMENSIONS AND DETAILS OF SAS: 15' x 50' SITE CONDITIONS D Existing septic tank properly abandoned Internal plumbing all to one building sewer Topography not appreciably altered Comments: 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282.0014 info@millriverconsulting.com Page 1 of 3 MILL RIVER CONSULTING Septic System Management Services SEPTIC TANK 0 Bottom of tank hole has 6" stone base 0 Weep hole plugged El 1,500 gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) D Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) Inlet tee installed, over access port D Outlet tee (gas baffle or effluent filter) installed, over access port D 24 inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present D Hydraulic cement around inlet& outlet Comments: Manhole on center access port D-BOX El Installed on stable stone base El Inlet tee (if pumped or >0.08'/foot) O Hydraulic cement around inlet & outlets 0 Observed even distribution 0 Speed levelers provided (not required) SOIL ABSORPTION SYSTEM D Bottom of SAS excavated down to C1 soil layer, as provided on plan Size of SAS excavated as per plan M Title 5 sand installed, if specified on plan O 3/4-11/2" double washed stone installed 0 1/8-1/2" (peastone) double washed stone installed R1 laterals installed and ends connected to header (and vented if impervious material above) D Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder/concrete/timber/ block) ❑ Final cover as per plan Comments: 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282. 0014 info@millriverconsulting.com Page 2 of 3 MILL RIVER CONSULTING Septic System Management Services SYSTEM ELEVATIONS Benchmark: 166.5 Rod at Benchmark: 0.22 Height of Instrument: 166.72 INVERT ON DESIGN PLAN ELEV 0-TOP OF PIPE INVERT ELEVATION Building Sewer OUT 161.3 6.63 159.76 Septic Tank IN 159.75 6.84 159.55 Septic Tank OUT 159.50 Pump Chamber IN Pump Chamber OUT Distribution Box IN 159.35 7.04 159.35 Distribution Box OUT 159.18 7.21 159.18 Manifold Lateral 1 HIGH 159.15 7.20 159.19 Lateral 1 LOW 158.90 7.45 158.94 Lateral 2 HIGH 7.20 159.19 Lateral 2 LOW 7.45 158.94 Lateral 3 HIGH 7.20 159.19 Lateral 3 LOW 7.45 158.94 Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW 5 Blackburn Center, Gloucester, Massachusetts 01930-2259 toll free 1.800.377.3044 978.282. 0014 info@millriverconsulting.com Page 3 of 3 Page 1 of 2 DelleChiaie, Pamela From: Dan Ottenheimer[info@ millriverconsulting.com] Sent: Tuesday, December 23,2003 3:56 PM To: pdellechiaie@townofnorthandover.com Subject: RE: 32 Christian Way-Bed Bottom Inspection This was completed at 12:00 today (12/23). Dan Daniel Ottenheimer,President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.mil.1riverconsulfing.com info millriverconsulting.com -----Original Message----- From: Pamela DelleChiaie[mailto:pdellechiaie@townofnorthandover.com] Sent: Monday, December 22, 2003 4:04 PM To: Daniel Ottenheimer(E-mail) Subject: 32 Christian Way- Bed Bottom Inspection John from Vlfildwood Excavation is requesting a bed bottom inspection at 32 Christian Way. You can reac at: 978.815.7411. Thanks! Pam Pamela DelleChiaie, Health Dept. Assistant Town of North Andover Community Development& Services 27 Charles Street North Andover, MA 01845 pdellechiaie@townofnorthandover.com Tel. 978-688-9540 Fax 978-688-9542 12/23/2003 TOWN OF NORTH ANDOVE BOARD OF HEALTH �� �' Location (1"'Illzr Permit # Food Service $ Retail Food �/� $ Limited Retail $ Seasonal $ Disposal Works Installers $ t Disposal Works Construction 41 $ ,O Soil Testing $ Design Approval Permit $ Dumpster Permit $ Burial Permit $ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Well Construction Permit $ Funeral Directors Permit $ Massage Establishment License $ Massage Practice License $ _ Suntanning Establishment $ Offal/Trash Hauler $ Other. $ - l 1 9 Health Agent White - Applicant Yellow - Dept. Pink - Treasurer y Commonwealth of Massachusetts Map-Block-Lot 104.D-0140- Board Of Health -Permit NNo------------ North Andover -BHP-2003----------------------- P.I. FEE F.I. $250.00 ----------------------- Disposal Works Construction Permit Permission is hereby granted John T. Shaw III to(Construct)an Individual Sewage Disposal System. at No 32 CHRISTIAN WAY u -- - --.._ as shown on the application for Disposal Works Construction Permit No. BHP-2003-038 Dated November 26, 2003 ---------------------------------------------------- ------------ Issued On:Nov-26-2003 Board Of Health ............................................................................................................................................................................... Commonwealth of Massachusetts Map-Block-Lot 104.D-0140- Board Of Health North Andover Certificate of Compliance THIS IS TO CERTIFY,That the Individ age Disposal System (Construct) by John T. Shaw III ---------------------------------- ----------------------Installer- at No 32 CHRIS WAY has been ' ed in accordance with the provisions of TITLE 5 of the State Environmental Code as described in the appl' ation for Disposal Works Construction Permit No. BHP-2003-038 Dated November 26,2003 -------------------------------------------------------------- Printed On: Nov-26-2003 Board Of Health ............................................................................................................................................................................... N. t APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT �c Z6 b� DATE: CURRENT INSTALLER'S LICENSE# z� � t LOCATION: J Z_ CN'st-UOV LICENSED INSTALLER: ����^' S�^w(.' SIGNATURE: TELEPHONE#qK -6(5-ggq CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTRUCTION,PLEASE ATTACH FOUNDATION AS-BUILT. ¢� Administrative Use Only 5p4rFee Attached? Yes No Foundation As-built? Yes No Floor plans fil Yes No ��'L� Approv Date: GuRp Of' HGWTil �T S G�IRI�lI�UN UJ �wAS �T" No(�TM &POVEi-�, M,4, ApPU CAN I _ w TEf{ Sc��PL7 l T6wn1 ❑ UJEU— 6PFRO�EDWC- WrIC SY STEM PES16J 4Ppj�ovr=-v DArt' APR?OVIN6 /urryoI?ITy R�SoNS 5CPT'1 C 96TEM 1 j sTA t.L4Tlwj E U/J TroJ�1 �"�- _ S-l—�7 ?k_ J 1=rNAtr 1I✓SpFcrlon� �' u v�=�,�, �c;�� 4PFRdVEP 6DITIOMAL. IA15FbCi Ho"5 X11=A►-�Y) DtSAPPj?ovF,P D,arC Ri~p�JO NS' Ftti4L APPIZpVAL D,orE 'rc�F�� Get ,. APPRalv-G �v i Holli ry (BRIER FORM 4-SYSTEM PUMPING RECORD SEPTIC & DRA SERVICE FOREST STREET;MIDDLETON,MA 01949 (978)774-2772 COMMONWEALTH OF MASSACHUSETTS or&y e r ,MASSACHUSETTS SYSTEM PUMPING RECORD SYSTEM OWNER: f1 O-0 G\l �C) SYSTEM LOCATION: i le c� 07 s�� P 3 ), c i f I's k yj w&1 y d I- sYl3 ��u cin See G-raUKd 17 `� DATE OF PUMPING; QUANTITY PUMPED: /S GALLONS CESSPOOL: NO 0 YES El SEPTIC TANK: NOE:] YES SYSTEM PUMPED BY: CURRIER SEPTIC & DRAIN SERVICE CONTENTS TRANSFERRED TO: L Sl) DATE: INSPECTOR: y 4 i \ \ LATS Y \ 521970 ` 53 = 4 LEACH FIELD I I 48 t o A i3 37 ± pp Q, w EXISTING FND . a, 47 Li � ) 39'+_ Lel � i Lu 65't R=225.00 r��d��z:.L7:2f' CHRISTIAN WAY I CERTIFY THAT THE SEPTIC SYSTEM WAS INSTALLED AS PLAN SNOWING SUQSUREACE SEV'v`ERAGE SHOWN THIS PLAN IS NOT INTENDED AS A WARRANTY OF DISPOSAL SY,3TEM AS-BUILT THE SYSTEM, LOCATION LOTS CHRISTIAN WAY ELEVATION OWNER NORTH ANDOVER REALTY TRUST TOP FN 16660 „ HOUSE OUTLET -3-87163030 GATE F� SALE ST INLET 16&91 ST OUTLET 2 D-BOX INLET 162,41 D-BOX OUTLET 162 PREPARED BY- END FIELD / 161081 Design Enqlneers Assoc. P C, 'NN+�'"4 �� P 0, ,Box 516 o - A ol-M Andover, M,Oss4 01845 y \ %o VA \ LOT 5 52,970 t� LEACH FIELD 48i t k I I 24' i 13 37 t: s ILL i 65`+ � zzz AR " R=225-00 �, f ..r? per► f HRISTIAN SAY i 4 I CERTIFY THAI"7HC SEPI-IC SYSTEM WAS INSTALLED AS � PLAN SNOWING SUBSURFACE SEWERAGE SHOWN THIS PLAN IS NOT INTENDFD AS A WARRANTY OF DISPOSAL SYS7MI AS-BUILT THE SYSTEM, _ LOCATION L_JT 5 CHRISTIAN WAY ELEVATION OWNER NORTH ANDOVER REALTY TRUST TOP FND 166050 HOUSE OUTLET 163K30 DATE E7'3'87 SCALE J" -40'-- 91 ST INLET 162;91 r ST OUTLET I D-"INLET 62641 D-Box OUTLET 16 t PREPARED BY, END FIELD 1610 81 05 tf �' s(f6 d Design L sneers Assoc. P Co � C, POK 516 L of� - �,,orM��� Andover, MGss.01845 T'ai�'7 L 4-°7 LtD 7� 1r''"'-� S 4 `7 '^o I i Address Title of Fi°le P8ge of Date File Open: --_ Date file Closed: Doc Document/Action Title Date of Refer to other Purpose of Document , action Document/ docurnent/ Num. / coon and notes; -- Action De artment ------------ ------------ Board of Appeals — Board of Health Plannang Board _ Cons eruatiion Commission — Bu, ilding Department ---_�_ 3 eq@@-aAm 2 20Vjjae(;L--@4 002 lvddV4 4@-APLE 17wQalVO 32vCi&0*qj(; 47v-afA- qm@NV*(;00032VU&q*L.(;Lm'mWR*Qpn30viAa (;@m 51vaUU& ?—=IE 28viAa*QG@Dd @*P- P-60"@43 2v-dcl*L*Q-n @p L5 MERRIMACK r,NGINEER NG SERVICES (NC. 1121 LT IEL W Iff ° M 1�1v �`I IL `" Engineers • Surveyors • Planners --� C, 66 Park Street ANDOVER, MASSACHUSETTS 01810 DAT JOB NO. -7 (978) 475-3555 ATTENTION Vax (978) 475-1448 TO 11 RE: 12-7t rc ,n L-A.(; ►2A 5 5� G f WE ARE�SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 5 THESE ARE TRANSMITTED as checked below: ' For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use C Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS nll2Inr,), AL-L W vn)IS Ica t IA3Zj,-:� leic5l�N MA'r.-a Y.'t - �va Cx7THYl 1-4- U-A s y u WeO'- rA-+vblr,6TWX7 7-11e t-j A a';:�n?Al -1-0 -FAD S 7Z�ivy i S!rt ci 9 /1 LSo /t-, TlU N 129W T?�n1b c0 -1 i--1 r'U T 5 U `�'c�u tz L � /15; L CIV-W- Tk e&c t jTf I 6-� Fi r-1, 4-C 7- A-s e r� s Gb .ft 0 e2n t L Y AQt2 U n/eGPef to `f lcXT AfJ.12 /S�2r�Ic'4 fi et5e- :;w!"' _ Alp I- A-s -3j4eZC 11C r1&2 COPY TO Ali He ! NQS. SIGNED: �If o if enclosures are not as noted,kindly notify us at once. MERRIMACK F,,NGINEERING SERVICES INC. CSC v L llkn oOC Engineers • Surveyors • Planners 66 Park Street ANDOVER, MASSACHUSETTS 01810 DATE los No. (978) 475-3555 ATTENTibN Fax (978) 475-1448 TO � RE: ��+ ��`35� WE ARE SENDING YOU ❑ Attached ❑ Under separate cover via the following items: ❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 5� s Z0\1 ID 11, h THESE ARE TRANSMITTED as checked below: error approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE D PRINTS RETURNED AFTER LOAN TO US REMARKS1'��P( (��,�[f Cvtz.t-c.�G-►�b `t 1�e? l t tx�f'L`7' L�t��d�T'!a�' KF_cLt75E �i'a 2434eW,,.A , 65- 421 v s COPY TO y� SIGNED: O If enclosures are not as noted,kindly notify us at once. TOWN OF NORTH ANDOVER 6 BOARD OF HEALTH Location Permit # Food Service // $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers $ Disposal Works Construction $ Soil Testing $ r�eJ Design Approval Permit $ J. Dumpster Permit $ Burial Permit $ _ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Well Construction Permit $ Funeral Directors Permit $ Massage Establishment License $ Massage Practice License $ Suntanning Establishment $ _ Offal/Trash Hauler $ Other $ r nu Health Agent White - Applicant Yellow - Dept. Pink - Treasurer Town of North Andover HEALTH DEPARTMENT 27 Charles Street North Andover,MA 01845 978.688.9540 healthdent( lownofnorthandover.com SEPTIC PLAN SUBMITTAL FORM DATE OF SUBMISSION: SITE LOCATION: ��v `5 {� (•(��z�, /Vn i �� ENGINEER: NEW PLANS: YES $225.00/Plan Check#: (Includes 1'(NEwPLA19 and one Re-Review Only) REVISED PLANS: YES $ 75.00/Plan Check#: SITE EVALUATION FORMS INCLUDED: YES NO LOCAL UPGRADE FORM INCLUDED: YES NO Telephone#: Fax#: E-mail: HOMEOWNERNAME: OFFICE USE ONLY When the submission is complete(including check): 1. Date stamp plans and letter 2. Complete and attach Receipt 3. Copy File; Forward to Consultant 4. Enter on Log Sheet and Database a • \ \. / E ,TORT}, a' TOWN OF NORTH ANDOVER HEALTH DEPARTMENT4,00p 27 CHARLES STREET " r NORTH ANDOVER,MASSACHUSETTS 01845 ��$R•=�t�t sACHUs Telephone(978)688-9540 FAX(978)688-9542 FAX Bill Dufresne From: Pamela To: MERRIMACK ENGINEERING 66 PARK STREET Andover,MA 01810 978-475-1448 Pages: 2 Fax: 978-475-3555 Date: Phone: AR /l Septic Plan Response CC: Re: ❑ Urgent x For Review ❑Please Comment ❑ Please Reply ❑ Please Recycle • Comments: Attached is the response from the Health Agent regarding Septic Plans for the following property: PY A o has also been mailed to the homeowner. / copy Please call 978-688-9540 for assistance with any questions. Thank you. Cc: File Homeowner HP Fax K 1220xi Log for NORTH ANDOVER 9786889542 Nov 24 2003 2:06pm Last 30 Transactions Date Time L= Identification Duration Pages Result Nov 21 9:34am Fax Sent 89786641713 1:14 1 OK Nov 21 10:56am Received 9783563218 0:50 2 OK Nov 21 12:06pm Received 9783276544 0:37 4 OK Nov 21 12:17pm Received 0:38 3 OK Nov 21 1:02pm Fax Sent 89786889594 1:03 2 OK Nov 21 1:05pm Fax Sent 816173543347 1:22 1 OK Nov 21 1:32pm Fax Sent 89786860755 1:08 5 OK Nov 21 1:35pm Fax Sent 89786851099 1:33 2 OK Nov 21 1:39pm Fax Sent 819788873480 0:38 2 OK Nov 21 1:45pm Fax Sent 819785893100 0:52 2 OK Nov 21 1:46pm Received 2:19 4 OK Nov 21 1:49pm Received 6174893935 2:15 3 OK Nov 21 2:30pm Received 9788583851 0:32 1 OK Nov 21 3:18pm Fax Sent 89786851099 1:02 1 OK Nov 21 3:21pm Fax Sent 819788873480 0:49 2 OK Nov 21 3:24pm Received 0:38 0 No fax Nov 21 5:31pm Fax Sent 819788873480 1:52 5 OK Nov 21 9:25pm Received 0:51 2 OK Nov 21 11:39pm Received 1:25 3 OK Nov 23 10:36am Received 0:55 1 Error 244 Nov 23 10:39am Received 0:43 1 OK Nov 24 11:35am Fax Sent 819784549941 0:00 0 No answer Nov 24 12:29pm Received 0:23 0 Error 394 Nov 24 12:31pm Received 7812797993 0:25 2 OK Nov 24 12:43pm Fax Sent 819786889556 0:28 1 OK Nov 24 12:44pm Fax Sent 819786889556 1:38 5 OK Nov 24 1:O1pm Fax Sent 814104944976 0:30 1 OK - K Nov 24=1pm Fax 448 2:00 3 O pm Received 1978 649 3839 TOWN OF NORTH ANDOVER AORT#t Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT s " i F 27 CHARLES STREET NORTH ANDOVER, MASSACHUSETTS 01845 ,SSACHUSE< Heidi Griffin 978.688.9540—Phone Acting Health Director 978.688.9542—FAX November 24, 2003 Daniel Koravos Merrimack Engineering Services 66 Park Street Andover, MA 01810 RE: 32 Christian Way, Map 104D, Lot 140 Dear Mr. Koravos, The proposed septic system design plans for the above site dated November 4, 2003 have been reviewed. Unfortunately, the plans cannot be approved as submitted. The following items are in need of attention prior to approval: 1. The distances from septic system features to property lines are not all shown as required. (NA 8.03) 2. Indication of the presence or absence of public water supplies within 400' of the proposed soil absorption system is not indicated. (3 10 CMR 15.220) 3. Please indicate that removal of soil horizons A&B shall extend at least 6" into the suitable soil of the C horizon. (NA 9.02) 4. One of the existing grade contours appears incorrectly labeled as 160. 5. Trenches are to be used as the soil absorption system mechanism whenever possible. Please use trenches in this instance or explain why they cannot be utilized. (3 10 CMR 15.240) 6. The leach field is proposed to contain 10" of leach stone beneath when it is understood leach fields in North Andover are required to utilize 12" of leach stone. At the Board of Health meeting on October 23, 2003, the decision was to require 12" of stone beneath perforated piping. The plan dated November 4, 2003, depicts 6" of stone. Please revise the plan to reflect this. Additionally, though not a reason for plan disapproval, you may wish to consider the possibility of relocating the proposed soil absorption system to another portion of the parcel to facilitate ease of construction. It appears the current soil absorption system is proposed to be constructed in the same location as the current soil absorption system. This might pose construction difficulties and may also require more sand fill than another location on the parcel. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system that will be in compliance with all regulations and assure protection of public health and the environment of North Andover. Since)O� Brain LaGrasse Health Inspector cc: Homeowner CD&S Dir. File f f.� Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer[info@millriverconsuiting.com] Sent: Monday, November 24,2003 8:39 AM To: Heidi Griffin; Brian LaGrasse; Pamela Dellechiaie Subject: 32 Christian Way Heidi, Brian and Pam, We have completed review of the septic system design for 32 Christian Way. I will refrain from editorializing in this context except to say we were left with a dilemma. We have written both a plan approval letter and a plan disapproval letter for your consideration. The design plan disapproval letter contains 6 items. Four of these are pretty minor and could be addressed in some type of revision to the plan at some point in the future thus accommodating the needs of the Bonanno family who are anxious to get resolution to this matter. The second to last disapproval item relates to the Title 5 / requirement to use trenches whenever possible unless site constraints prohibit this. The parcel appears quite large, gravity flow could be achieved with trenches, and they frankly should be used on this site. The last disapproval item is from the Board of Health meeting of 10/23/03 when they indicated the allowance of the use of leach fields instead of trenches when 12" of stone is placed beneath the field. In this case, the design plan only proposes 10" of stone beneath the field. We do not wish to run counter to the desire of the North Andover Board of Health nor Title 5 but this design plan appears to not be in compliance with either. It does however appear to be in compliance with the spirit of what the Board of Health apparently indicated in their meeting last month and thus we were not sure what the Board of Health would desire in such an instance. I'd be glad to discuss this with you should it be desired. Dan Daniel Ottenheimer, President Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsultin(: .com info@miliriverconsultina.com 11/24/2003 �J f� �j TOWN OF NORTH ANDOVER Oe NORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT > . � ,. 27 CHARLES STREET •�, NORTH ANDOVER, MASSACHUSETTS 01845 'SS"CHUStt Heidi Gri in 978.688.9540—Phone Acting Health Director 978.688.9542—FAX November 24,2003 Daniel Koravos Merrimack Engineering Services 66 Park Street Andover,MA 01810 RE: 32 Christian Way,Map 104D,Lot 140 Dear Mr.Koravos, The proposed septic system design plans for the above site dated Nove r 4,2003 have been reviewed. Unfortunately,the plans cannot be approved as submitted. The folio g items are in need of attention prior to approval: 1. The distances from septic system features to prope lines are not all shown as required. (NA 8.03) 2. Indication of the presence or absence of public ter supplies within 400'of the proposed soil absorption system is not indicated. (3 10 CMR 5.220) 3. Please indicate that removal of soil horizo A&B shall extend at least 6"into the suitable soil of the C horizon. (NA 9.02) 4. One of the existing grade contours ap incorrectly labeled as 160. 5. Trenches are to be used as the soil ab rption system mechanism whenever possible. Please use trenches in this instance or explain y they cannot be utilized. (3 10 CMR 15.240) 6. The leach field is proposed to con n 10"of leach stone beneath when it is understood leach fields in North Andover are required to 12"of leach stone. Additionally,though not a reason for pl disapproval,you may wish to consider the possibility of relocating the proposed soil absorption system to ano r portion of the parcel to facilitate ease of construction. It appears the current soil absorption system is pro to be constructed in the same location as the current soil absorption system. This might pose constructi difficulties and may also require more sand fill than another location on the parcel. Please feel free to contact the ce with any questions you may have. We look forward to working with you to obtain a replacement septic stem which will be in compliance with all regulations and assure protection of public health and the environme of North Andover. Sincerely, �04 G `O( J�1,l� Brain LaGrasse rut e^e C\,"— Health Inspector cc: Homeowner CD&S Dir. f'(Z��� Fild TOWN OF NORTH ANDOVER NORTN Office of COMMUNITY DEVELOPMENT AND SERVICES 3 of`' •° •1y°c HEALTH DEPARTMENT « _ t 27 CHARLES STREET •" •- :• =• NORTH ANDOVER,MASSACHUSETTS 01845 •° '••�`� 1sS�cH � Heidi Griffin 978.688.9 0—Phone Acting Health Director 978.688 542—FAX November 24, 2003 Constance&Joseph Bonanno 32 Christian Way North Andover, MA 01845 RE: Subsurface Sewage Disposal System Plan for 32 Christian ay, Map 104D, Lot 140, North Andover, Massachusetts Dear Mr. &Mrs. Bonanno, The North Andover Board of Health has completed review of the septic system design plans for the above referenced property submitted on yo behalf by Merrimack Engineering Services dated November 4, 2003. The design has been approved for use in the construc ion of a replacement onsite septic system. This approval is valid for three years from t e date of this letter and during this time a licensed septic system installer must obtain permit and complete this work, and a Certificate of Compliance must be endorsed by t installer, designer and the Town of North Andover. The time period for which this, Ian is valid is reduced to two years from the date of a septic system inspection which dinot meet the acceptable criteria in the state regulations. The time period for which this plan is valid may be reduced by the North Andover Board of Health in the event an imminent health problem such as sewage backup into the dwelling is occurring. This approval is subject to the following;conditions: 1. If site conditions are found iii the field to be different from those indicated on the design plan and/or soilvaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit (3 10 CMR 15.020(1)). 2. It is the responsibility of the applicant and/or the applicant's septic system designer, septic systenlinstaller or other representative to ensure that all other state and municipal re uirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe and/or imply compliance with any of the aforementioned requirements. Your effort to provide a properly functioning septic system for your dwelling is eatly appreciated. The Health Department may be reached at 978-688-9540 with y questions you might have. Sincerely, Heidi Griffin, Acting Health Director encl: List of licensed septic system installers cc: file Merrimack Engineering Services Page 1 of 2 �i DelleChiaie, Pamela From: Dan Ottenheimer[info@milldverconsulting.com] Sent: Wednesday, November 12, 2003 10:28 AM To: pdellechiaie@townofnorthandover.com Subject: RE: 32 Christian Way-Plan Review Request Got it. I've been to the property and did not see any raw sewage at that point in time. If they have such a problem now they should be getting it pumped on a regular basis to prevent any public health threat. Regarding December 1St, see earlier e-mail about construction. Dan Mill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 info@milliiverconsulting.com -----Original Message----- From: Pamela DelleChiaie [mailto:pdellechiaie@townofnorthandover.com] Sent: Wednesday, November 12, 2003 10:12 AM To: Daniel Ottenheimer(E-mail) Cc: Lagrasse, Brian Subject: 32 Christian Way - Plan Review Request Importance: High Hi Dan, I received a call from a Christine Bonnano of 32 Christian Way. She asked if we received the plans yet from Bill Dufresne. 1 told her that no,we have not received them yet. She wanted to know what time we received our mail,who the consultant is,where he is, can she hand deliver them to you, etc. Anyway, I had Brian speak with her, because she wasn't hearing me with regard to what the normal processing procedure is. She seemed to be okay with his explanation. However, as soon as the plans come in today, I will be sending them on to you for review,and could you please put these plans on your priority list as well(after 15 North Cross). She states that the system is failed, and there is raw sewage in her back yard. Everyone is now panicking with regard to the Nov. 30th cutoff date. Thank you for your assistance. Pamela DelleChiaie, Health Dept.Assistant Town of North Andover Community Development& Services 27 Charles Street North Andover, MA 01845 pdellechiaie@townofnorthandover.com 11/12/2003 ` SEPTIC PLAN SUBMITTAL FORM_,_ T 2003 f LOCATION: 3 Z Y14':;;�1 a s L NEW PLANS: $225.00/Plan ✓ Check #:(Includes I"Re-Rev4!ESIX } REVISED PLANS: YES $60.00/Plan Check#: - SITE EVALUATION FORMS INCLUDED: NO LOCAL UPGRADE FORM INCLUDED: YES NO DATE: I I A-a72 DATE TO CONSULTANT: ,. DESIGN ENGINEER:1-1 MVM I IJOl Telephone# X—2� OFFICE USE ONLY When the submission is complete(including check): i. Date stamp plans 2. Complete the W DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM form 3. Attach file and route to the Health Director for review L ocation: l Owner's Name: �� Ip Addrestaller•. Tel#: - 1 Newtso (s ) Repatr Date: q' 7 Wetlaa �2,one II_Soll SymbolSott A'ame Soil Q /3 Deep Observation Hole Logs Elevation Depth Soil Horizon Sell Temre Soil Color Solt hhttl'tng. %Gravel,Stones,etc f HAeof Iva- rrLww 2.5`((O/q Low si 4,A ted �tN+Dr�vrrsrt N Patent hfateciat whce, Depth to Beat*& ^'— Stauftz water In the Hole: L w0e*g from Plt Faee LALEM ji ,r j-I*2, G 1.5. '2,I;Y&/w fZ�- ► h! —�wl+�!!!.�' glw o "V0L, PatYat Mateciai e•tt Depth to Betitodt_Staadttit water Lt the Hole: "` weepfa;Rota tlt Face ---• ESHGtY: (o'` Date I-Ili-03 Percolation Tests Observation Hole# • Depth of Perc Start Pre-soil: s S Time at 12" ' to Time at 9" 141 Time at 6" 15 711me(9"-6") 2 I -Rate MtnAnch--• 'I Performed Br'-4, t7U r� Witnessed Br- fA U TOWN 0 NORTH ANDOVER BOARD OF HEALTH Location / ,( Permit # Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers $ Disposal Works Construction $ Soil Testing $ Design Approval Permit $ Dumpster Permit $ Burial Permit $ Swimming Pool Permit $ Animal Permit $ Recreational Camp Permit $ Wel]. Construction Permit $ Funeral Directors Permit $ _ Massage Establishment License $ Massage Practice License $ Suntanning Establishment $ offal/Trash Hauler $ — Other $ 719 r % Health Agent White - Applicant Yellow - Dept. Pink - Treasurer Page 1 of 1 3 F Pamela DelleChiaie From: "Dan Ottenheimer"<info@milldverconsulting.cccn> To: "Heidi Griffin"<hgriffin@townofnorthandover.com>; <blagrasse@townofnorthandover.com>; <pdel lechiaie@townofnorthandover.com> Sent: Monday, September 29,2003 11:21 AM Attach: Christian Way#32 Soil Test.pdf Subject: Soil test-32 Christian Way Heidi, Brian and Pam Attached please find the soil test results for the property located at #32 Christian Way. Dan ANill River Consulting Septic System Management Services 5 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 info@milldverconsulting.com 9/29/2003 � o T--F V I I fill I 7F* 1 A I j = a) ryGj '- I I T • k Ste+ • f� � - iI I" 004 , 1 ,TOWN OF NORTH ANDOVER BOARD OF HEALTH Location ✓ % .���i7rr� �= / Permit # Food Service $ Retail Food $ Limited Retail $ Seasonal $ Disposal Works Installers $ Disposal Works Construction $ Soil Testing Ll� $ Design Approval Permit Dumpster Permit $ e_ Burial Permit $ Swimming Pool Permit $ _ Animal Permit $ Recreational Camp Permit $ Well Construction Permit $ Funeral Directors Permit $ Massage Establishment License $ Massage Practice License $ _— Suntanning Establishment $ _ Offal/Trash Hauler $ – Other $ r 7 Health Agent White - Applicant Yellow - Dept. Pink - Treasurer t e�1 BOARD OF HEALTH _. NORTH ANDOVER, MASS. 01845 978-688-9540 _ a 2003 APPLICATION FOR SOIL TESTS DATE: Yj MAP&PARCEL: '-1-M LOCATION OF SOIL TESTS: 52— u .),* OWNER: TEL.NO.: 6291-5-�P 3 ADDRESS: 7 GN 26 ENGINEER: ��r ce.c.,�(G in t i e�rti ti. TEL.NO.: `E7 5 `-3 5 5-!3— CERTIFIED SCERTIFIED SOIL EVALUATOR: �ai 1 U kL-e-A L.P/ Intended use of land: Reside�Subdivin Single Family Home Commercial Is This: / Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No 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$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$360.00 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 will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing,a scaled plan(no smaller than 1"-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. Please Do Not Write Below This Line N.A.Conservation Commission Approval: Date Received: Check Amount: Check Date: r . r f t 3 I F I I . j� fS \ Fi \ �2p�A f �\\ \ I_OT S I 52,970 - 53 � f -4J�( f 24A 13 A I Ll 65 4- I P A s � ♦►llltw,4�, a I CHRISTIAN Y t�1 g�•�:r sw�`" Z 6 - Z { I CERTIFY THAI'THF SE:.P11C SYSTEM WAS INSTALLED AS PLAID SHOWING SUBSURFACE: SEWFRAGE � SHOWN THIS PLAN IS NOT INTENDFG AS A WARRANTY OF DISPOSAL SYS7MI AS-BUILT'-- THE s rsrERlam---- LOCATION LOTS CHRISTIAN WAY ELEVATION TOP FNC} 166050 OWNER NORTH ANDOVER REi JY TRUST HOUSE OUTLET 163030 DATE 6-3-87 SCALE _I ST INLET I ,2-9I 5T OUTt LET t I D-BOX INLET 62�4I a-BOX OUTLET 16 < PREPARED 13Yti ENO FIELD 16(0 81 1(- Design EmIneers Assoc. C, [,4 1 t � Ln �! ✓ � O b ,/90K 516 t,,,"ol-M Andover Mcs&018zl\5 / \ / g f SEE PLAT 105D i.zo ac 53 1.03 ac 1.79 ac 57 3 SEE PLAT 105B - z 19 6A 1.25 ac z 2.29 ac 54 4 lA 36 4 9 1.15 ac 41 4.1 ac 168 ac 58 yob \ 8 4.6 ac a 37 35 1.01 ac 67.5 ac 38 - 1.59 ac 2.5 ac 59 ac 14 s , 55 SH HERS 1.28 ac PO 4.0 ac 42 39 60 3.0 ac 1_0 ac 56 > 1.06 ac 4.5 ac t 3 w y to O I I r�1 62 29 E I 17 18 4 66 s y 2.0 ac 43 1. 2.4 ac z a 35.3 ac I I 1.17 ac 63 65 GaLI I I , 404.0 ac 2.0 ac 7R. 6 JI I \ 1.24 ac - / z R / 5 90B 64 N 16 'a 2.2 ac -�.. 1.19 ac / / \ 12 44 . 18 ac 8 3 z / , 45 35.3 ac 49 4 1.02 ac o I1.09 46 1 p.02 ac � 7, �. - �SID��� � I / s 6 47 bl 13 1,02 ac / ac 50 48 p 4.38 1.0 ac Q to 1.02 ac 1 �52 519 1.07 a 1.02 ac per( \ P 1`�ERS - Bp�FORD.73. TH 2 A rTT1p�R 76 2.0 ac b 2.0 ac yit 4S 77bN'l 5 9 2.89 ac 6 75 4.54 ac 1IA SEE PIAN M132'!0 8 61 2 l 1.08 ac 1.03 ac 9 ` 59 ` 0 tzc 1.06 ac IOA 62 57 1.68 ac 3°� 55 o0 1.10 ac . ;, 1.27 ac�.^ 13B ! 53 1 6 60 ROCKY BROOK 1.0 1.0 ac ac o3 175' Cr 14 8 z s 'F r z 70 58 56 ;_ p 28 4A 1.17 ac 54 d n 3.44 ac 72 65 64 1.63 ac is 1.99 ac 52,582 s.f 40,302 s. 6 3-.6 ac 3A122.ac b 51 9 to 63 0 .•+ 3 SEE PL ,Y 13623 zA 52 1.14 ac 66 9g '�- 53,820 s.f 7 1.15 ac r a . Q 40,651 s.f a- SEEPLANN1309 1» Q o\ X35 zs 39 to c 6 $ROOKVIEW A 37 Z.11.ac 47 50 z4a DR1VEP-, L19ac W32 . �8 1.03 ac _37830 s.f. 4• v3.13 ac - 1.87 ac z3B %c ' 'Z0c3.7 ac B v �a 13a RO l0- 16r z4e ty 49 ,55 . 33,545 s.f. 33 i p, is O1.11 ac 43� t3 .1.94.ac 3� r. OOD Z / 3:� is 68 69 • 3IA D 19 y� .C\. X40. 277 48 11 ti SCALE. 1" = 400' 47 xy� 44 s 9��'�� 6 1.49 ac 30 2.16 ac 34 1.98 ac 45 z 28A 1.0 ac `� /,P; 40 a 2.77 ac 9 0 A 1.12 ac _ 1.0 ac 43 - (-g 0'j0 ac A 1.0 ac 41 21 - O 'EE PLAT 104B \ 46 1.06 ac 3 29 1.0 ac 42 1.0.ac O� • BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 APPLICATION FOR SOIL TESTS DATE: �i - v_0'� MAP&PARCEL:_1 (qp 1 LOCATION OF SOIL TESTS: 2- Ci-1 fLt 5T-1 OWNER: e–' y Lc4A TEL.NO.: � ADDRESS:A c -i R-t S'i t h vJ i.c.t l ENGINEER:-.H eq,r w.c ,.p TEL.NO.: 475 CERTIFIED SOIL EVALUATOR: i L Intended use of land: Residential Subdivi ' n Single Family Home g Y Commercial Is This: / Repair testing Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No 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$425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$360.00 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 representati 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health show location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forms shall be submitted. ' Please Do Not Write Below This Line �-��� VOW— CONSTANCE A. M. BONANNO 8/03 101 JOSEPH G. BONANNO 32 CHRISTIAN WAY L1-7017/2130 NORTH ANDOVER,MA 01845 Dat Pay to the 2 G0fy r C' order f Dollarsmt e� CITIZENS BANK Citizens Circle Account Massachusetts ' For - 1: 211 ?017 SI: 113963 17611' 0101 a r j i 3 I \ F Ks 4 \ I_OT'S c 52,970 L� }t 48 S I 24 j,4 47 i N # � I 65 I _L=!i6z8 I CHRISTIANI `4,AY -22 f^ 4Y 1 { I CERTIFY THAI THE SEP'!- -�--�- _ E 1G SYSTEM. WAS INSTALLED AS .J PLAN SHOWING SUBSURFACE SE�A F SHOWN. THIS PLAN IS NOT INTF-ND''D AS A WARRANTY OF THE SYSfEki, DISPOSAL SY37N.1 AS-BUILT n vATION LOTION LOTS CHRISTIAN WAY Tap FND I6c„50 OWNER NORTH ANDOVER REALTY TRUST HOUSE OUTLET 163030 ST INLET DATE 6-3-87 IG 91 SCALE 1" '40, ST ST OUTLET ; O-�DOX INLET i D-R-OX OUTLET 62,41 4 16 END FIELD PREPARED BY, y i 16(o8I 1 DesIgn Fnqlne ers-Assoc. P C' ' o p B0, X'o t N'orffi AnJovp. rA1jGss,018z15 �.J Town of North Andover, V sachusetts Form No. 1 NORTH A BOARD OF HEAD_-, f. Q��S IED ib q•Y� 19 O APPLICATION FOR SITE TESTING/INSPECTION 7 Q�gATED PPP\�y �SSACHUS�� Applicant NAME ADDRESS TELEPHONE Site Location Engineer NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee Test No. S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. 32 Christian Way North Andover, MA 01845 RECEIVED June 30,2006 JUN 3 0 2006 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Ms. Susan Sawyer Health Director Community Development Department 1600 Osgood Street North Andover, MA 01845 Re: Septic System—32 Christian Way, North Andover, MA Dear Ms. Sawyer: In regards to our conversation concerning septic systems which fail to protect the public health and specifically in regards to"custom cleanings", please see the attached summary of worts done to my septic system and invoice that was paid. Could you kindly review the enclosed information and respond with any state and local regulations or criteria used to determine if a septic system is in failure and what the required remedy is to such a situation. In addition, could you please tell me if"custom cleanings"are an accepted remedy for failed septic systems? I appreciate any information you can explain on this subject. Thank you. Sincerely, avt-084u..,� Constance A. M. Bonanno Enclosures TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: o r L SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example: left front of house) - 3 a Ca hr bq c(c CAP 405c 19ht-s� �o fin -e DATE OF PUMPING: QUANTITY PUMPED /Obn GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE aX ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER (EXPLAIN) SYSTEM PUMPED BY: • COMMENTS: //�e r� 19 Lal-) <�- CONTENTS TRANSFERRED TO: �Gr�`j �j/ �� �jC�q J 7'9 cc ���1 0v�� {u , ti p ;, Lr f' �,T'^ ��',�W n �� Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld Governor Trudy Coxe Ssentary,EOEA David B.Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 3 011 C/r f 5'i i 4 - LIJk �� Address ss of Owner: Date of Inspection: .: _ ,0 . "r (, / (If different) Name of Inspector: -- C�1� I, ( t V 1 "C le� Z a Company Name, Address anr�elephone Number: c 5C'RV tLIZ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ''Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: (/,., 4— Date: D The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and &pies.sent fo the buyer, if applicable and the approving authority. 7 INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why no The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 One Winter Street a Boston,Massachusetts 02108 a FAX(617)556-1049 9 Telephone(617)292-5500 %D Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:.'.) ��i t�'f CL f' L (� CL� /j o Owner: jic>C( ;-1 -(jq M Date of Inspection:,,, U B] SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM 15 FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system nas a septic tank and soil absorption system and is within 100 feel to a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system hab a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: t�T{S Ci 1 �, G.►r,c; /m 0 rio r' Owner: ;,Q!J 14--U� Date of Inspection: D] SYSTEM FAILS(continued): Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flmv of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Date of Inspection: Check if the following have been done: III-Pumping information was requested of the owner, occupant, and Board of Health. one of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates duan that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. A� s in, plans have been obtained and examined. Note if they are not available with N/A. Je4he facility or dwelling was inspected for signs of sewage back-up. t e s stem does not receive non-sanitary or industrial waste flow _>>fhe site was inspected for signs of breakout. system components, excluding the Soil Absorption System, have been located on the site. _kIle septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. J e size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. e facility &%ner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: ^j U N l v Date of Inspection: O �Z FLOW CONDITIONS RESIDENTIAL: Design flow: Aaljpr s Number of bedrooms: Number of current residents:`) Garbage grinder(yes or no): ' Laundry connected to system(yes or no): '�C� Seasonal use (yes or no):�V Water meter readings, if available: Last date of occupancy: r CJ i C!t COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING R CORDS and sPurce of informV,on:urn Syst m pumped as part of inspection: (yes or no) If yes, volume pumped �0 01 allons Reason for pumping. .R TYPE OFJVVITEM L.�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) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) I (revised 8/15/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: �i Le 1� �Nt :�.t a G`3 0.r~" Owner: l r cf'1-3 /._ " ; , Date of Inspection: / -7 t5 f U c� SEPTIC TANK:. -� (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP—other(explain) Dimensions: Sludge depth: Distance from top sludge to bottom of outlet tee or baffle: Scum thickness: ww �i Distance from top of scum to top of outlet tee or baffle: d . Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping, conditio� of inlet and outle�tees or baffles,'Oe* of li9�49 level in relatign to outlet invert, structural integrity, evidence of leakage, etc.) /0 C /��c..'= ;� !��'C- � i` 5.'ruc;-(� (� Citi.01 c GREASE TRAP:!i (locate on site plan Depth below grade: Material of construction: _concrete _metal _FRP_other(explain) Dimensions: Scum thickness. Distance from top of scum to top of outlet tee or baffle: Distance from bottom of From t- bottom of outlet tee or battle: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) C��f t J%Ctl l^� CL Property Address:�`.)G" ✓J Owner: �6 .] / •? r/C,, Date of Inspection: TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete_metal _FRP—other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert:;j or r1 tz k lid t `) — Comments: a! A f i �r_--�C r1 (note if leve and distribu.i^r :� equ,.., evidence o. _o.id. earn-ove•, evidence of leakage into or out of box, etc.) �r—L i'fo r 00, PUMP CHAMBER:A' if (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:_-Dy ' b Owner:J C-_`f• �. C lJ �-3 l♦`ti. Date of Inspection: P SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions:—z— n1O C f Is overflow cesspool, number: Comments: (noteC/,pndition of soil, sins of hydraulic failure, level of ponding, c�ditio ,of vegetation,etc.) IJd / jL' G 1'CLU(. f G a-r.'. t Cr U r /U C) !'�iV CESSPOOLS: _ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:_ (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 8/15/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) C!1 I r C Property Address:-;rte- i !-ry Owner: L—, �, i tr Q t., . Date of Inspection: , r SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks i locate all wells within 100' rr . . o' DEPTH TO GROUNDWATER Depth to-groundwater: / feet method of determination or approximation: (revised 8/15/95) 9