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Miscellaneous - 32 CRICKET LANE 4/30/2018 (2)
32 CRICKET LANE 210/107.A-0213-0000.0 w ' T z tIf 6 r r,> V M 4 A 1 QF INV PIPE Q•S,1TQF HSE E5 L) i u- 1 lKlPteE (.baro Tom- 141- AL/ RITE aum2E rAbiL �- 1 N V_ Pi PE NTo 0,2)0)( a1Z. 1 '. ' ►� paL.-�. op- pipa. cT• - , c� AO' _ '5C-A _M s + a DATE, A`b5UCt4TE� Commonwealth of Massachusetts tRECEIVED Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments MAR 2 8 2016 32 Cricket Lane TOWN OF NORTH ANDOVER Property Address HEALTH D&ARTME-NT Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not James R. Kellett use the return Name of Inspector key. Kellett Excavating LLC ,Q Company Name 400 Salem Street Company Address rem Lynnfield MA 01940 City/Town State Zip Code 781-599-7934 S113463 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 3/3/2016 ector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: system still working properly B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): ` t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 1 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ® N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ® N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ® N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Cricket Lane �M Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 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 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ® the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ❑ ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts == , Title 5 Official Inspection Form 1=I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments . � 32 Cricket Lane Property Address Richard Adams Owner owner's Name information is MA 01845 2/17/2416v N.Andover _ required far every _. __. _ ._ _.. _ page, City1rown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? 2 ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? © ® Were as built plans of the system obtained and examined?(If they were not available note as N/A) Z ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? Z ❑ Were all system components,excluding the SAS, located on site? 0 ❑ 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 subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: (� ❑ Existing information. For example, a plan at the Board of Health. o z Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 -- Number of bedrooms(actual): ------- DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 15ms-3113 Title 5 Qfftoal Inspection Form..Subsurface Sewage Disposal System•page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Detail: Sump pump? ® Yes ❑ No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: over 25 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 20"feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: other side of dwelling feet Comments (on condition of joints, venting, evidence of leakage, etc.): only viewed 1' of building sewer pipe at inlet when digging up cover and it looks fine. Septic Tank(locate on site plan): Depth below grade: 13"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) tank looks solid outlet side baffle fell off and a pvc tee put in place. the covers to the openings are getting worn but for age of tank they usually are. No visual signs of leaking. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No Dimensions: 8 x 5 x 5 Sludge depth: 6" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 . i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 18" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 14" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? mearuseing stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): outlet baffle fell off and pvc tee was installed, liquid levels all at proper elevation @ invert of outlet pipe. no evidence of leakage stuctural integrity still. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 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 or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ® No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): d box in good condition no soilds, no leakage, liquid right to invert elevation Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 4 laterals,52'x20' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): soil conditions perfect, all under grass, no ponding, no wet soil when dug down for dbox top of system down 18"to stone Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts u . Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) i Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 3'feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 2007 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: pulled off from soil testing from across street septic in 2007 Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Cricket Lane Property Address Richard Adams Owner Owner's Name information is required for every N. Andover MA 01845 2/17/2016 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 1/2f012016 IMG_0488.JPG w � It I � a 3 3 sr .-A 9 tj ` j o 'UP, —41 to t E • E t: s M� iV I �.t-" ��s' Y H .{* �`. Y LI � J httpsY/mail.google.comlmail/u/O/?tab--wn inboWl525d28Mf8bO4ae?projector=l 111 3/16'�j0 t' i Town of North Andover Mail-Re:Title V filing NOR RANDOVER E" Lisa Hadge <Ihadge@northandoverma.gov> 6fassachus-S Re: Title V filing richadamsdesign <adams444@comcast.net> Wed, Mar 16, 2016 at 2:15 PM To: "Kellett, Jim" <jim.kecorp@gmail.com> Cc: Tanuele, Coletta" <coletta.fanuele@nemoves.com>, Ihadge@northandoverma.gov Jim, I am following up from the voice mail I just sent you with information I've received from North Andover Health Department. The Mass. Dept. of EPA for the Northeast Region states that you are in violation of Title V if report is not submitted within 30 days. I am not sure where that leaves us but I suggest you at the very least submit the report ASAP to avoid any penalties that may occur. I cannot stress the urgency enough not only with the potential legal ramifications but what it may cost us personally with the timing in listing our home for sale. Please give this your immediate attention. Rich Adams 32 Cricket lane North Andover, MA 01845 From: "Jim Kellett" <jim.kecorp@gmail.com> To: "richadamsdesign" <adams444@comcast.net> Sent: Monday, March 14, 2016 11:11:31 AM Subject: Re: Title V filing I'm so sorry Rich. I have actually took leave of absence from work since about December. Between my daughter and my mother I have been a sole care giver to my mother and dealing with my 10 year old needing surgery on 28th of this month. I am back as of tomorrow (crossing fingers). I will finish 17 page report when I get to office tomorrow. Now to make this easy on both of us now I need to say that inspection was done less than a month ago or have to reinspect. Do you know when the first time you contacted Lisa on this matter so I can make sure dates work? So sorry for complicating things. Thank you Jim On Monday, March 14, 2016, richadamsdesign <adams444@comcast.net> wrote: Jim, per my phone message earlier, talking to Lisa at the North Andover Health Department pertaining to our Title V filing, they have not received anything to date. On March 3, you responded to them that you would tend to this that weekend. We are now coming up to 3 months since completion (and passing) of the inspection date. My understanding is that filings have to be submitted within 30 days. We are currently in the process of putting our home for up sale after Easter but cannot do https://mail.goog le.com/mail/ca/u/0/?ui=2&ik=46857787d0&view=pt&search=inbox&msg=l 5380a42e7f0306a&sim1=15380a42e7f0306a 1/2 3/16/2f It Town of North Andover Mail-Re:Title V filing this until filing has been submitted. This ultimately could cost us several hundred thousands of dollars due to the timing in the current real estate market. I need to have you tend to this matter this week as to move forward with our plans. I cannot stress enough the timing of this matter and that you give this your most immediate attention. Please respond to let me know when you have filed the appropriate forms. Sincerely, Rich Adams 32 Cricket Lane North Andover, MA https://mail.google.com/mail/ca/u/O/?ui=2&ik=46857787dO&view=pt&search=inbox&msg=l 5380a42e7fO3O6a&siml=l5380a42e7fO3O6a 2/2 3/16/2016 Town of North Andover Mail-Re:Title 5 NORT� AN ROVER Lisa Hadge <Ihadge@northandoverma.gov> Massachus" Re: Title 5 Home <ada ms444@comcast.net> Wed, Mar 16, 2016 at 2:56 PM To: Lisa Hadge <Ihadge@northandoverma.gov> Thank you Lisa. You've been so very helpful with this matter. Hope we're in touch soon. Sent from my iPhone On Mar 16, 2016, at 2:50 PM, Lisa Hadge <Ihadge@northandoverma.gov>wrote: Hi Rich, If you need information regarding Title 5, you can find it here on the mass.gov website: http://www.mass.gov/eea/agencies/massdep/water/wastewater/septic-system-inspections.html# Submittinganinspection report Submitting an inspection report If an inspection is required, the information must be recorded on the MassDEP-approved inspection form and submitted within 30 days of the inspection. Failure to submit the form within 30 days is a violation of Title 5. Forms are also available from your local Board of Health. Other forms or reports will not be considered valid by MassDEP or the Board of Health. Using the MassDEP-approved form ensures that all the information required for a valid inspection is obtained and reviewed. For most systems, the System Inspector is responsible for submitting the inspection report directly to the Board of Health. The buyer must also receive a copy from the seller of the property. In some cases, inspection reports must be submitted to authorities other than the Board of Health: • Inspection forms for State and Federal facilities must be submitted to MassDEP instead of the local Board of Health. • Reports for large systems and shared systems must be submitted to both the local Board of Health and MassDEP. Lisa Hadge Health Department Town of North Andover 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone 978-688-9540 Fax 978-688-8476 Email Ihadge@northandoverma.gov Web www.northandoverma.gov https://mail.goog le.com/mail/ea/u/O/?ui=2&ik=46857787dO&view=pt&search=inbox&msg=1538Oc9449867ddc&siml=1538Ocg449867ddc 1/2 3/16/2016 Town of North Andover Mail-Re:32 Cricket Lane NOUft' .OVER Massachus #ts Lisa Hadge Ihadge@northandoverma.gov> Re: 32 Cricket Lane Lisa Hadge <Ihadge@northandoverma.gov> Tue, Mar 15, 2016 at 8:13 AM To: Jim Kellett<jim.kecorp@gmail.com> Well if it isn't the elusive Mr. Kellette! I'll be on the lookout for the Title 5 report(although I won't be holding my breath). Gary would need to submit the attached application and make sure he has all his paperwork before Michele can set up a date for him to take the installers test. The fee for the test is$100. The test consists of written and practical questions (it's not an engineer's test). On the day of the test he would bring survey equipment with him since he will be shooting a few grades. I've also attached our septic regulations so he can review them. He can give us the $80.00 for the permit once he passes the test. Please make sure the following is submitted with the application. First time applicants include: eCopy of Heavy Equipment Operators License *Proof of$100,000 General Liability Insurance *Three(3)letters of reference •Copies of licenses from other towns On Mon, Mar 14, 2016 at 5:18 PM, Jim Kellett<jim.kecorp@gmail.com>wrote: Yea yea yea lol Get you guys that tomorrow. Can u tell me when the installers exam is this year. I would like to get GARY licensed up there? On Monday, March 14, 2016, Lisa Hadge <Ihadge@northandoverma.gov>wrote: Hi Jim, I received another call from Mr. Adams regarding his Title 5 report. He needs the report to list his house and isn't happy he hasn't received it yet. Any way you can get that out to him and a copy to us? Sorry to be emailing you again but get on the ball Kellette (hehe). a Lisa Hadge Health Department I Town of North Andover 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone 978-688-9540 Fax 978-688-8476 Email Ihadge@northandoverma.gov Web www.northandoverma.gov i 1 https://mail.google.com/mail/ca/u/0/?ui=2&ik=46857787dO&view=pt&q=kellette&qs=true&search=query&msg=1537a31 ce9093bOa&siml=1537831 ce90... 1/2 3/16/2016 Town of North Andover Mail-32 Cricket Lane NQR AN ;0VER Lisa Hadge <Ihadge@northandoverma.gov> Massachusat#s .1 32 Cricket Lane Lisa Hadge <Ihadge@northandoverma.gov> Thu, Mar 3, 2016 at 10:21 AM To: Jim Kellette <jim.kecorp@gmail.com> Hey Jim, Not sure if you received my last email or not. We are looking for a Title 5 report you did in December for 32 Cricket Lane. Can you let me know if you have mailed it out to us yet? Thanks! Lisa Hadge Health Department Town of North Andover 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone 978-688-9540 Fax 978-688-8476 Email Ihadge@northandoverma.gov Web www.northandoverma.gov https://mail.google.com/mail/ca/u/0/?ui=2&ik=46857787d0&view=pt&q=kellette&qs=true&search=query&msg=1533d 11 ba353b71 d&siml=1533d 11 ba35... 1/1 i 3/16/2016 Town of North Andover Mail-32 Cricket Lane NOR1 A�ItOVER ov> Lisa Hadge <Ihad a northandoverma. Massachus,is g g @ g 32 Cricket Lane Lisa Hadge <Ihadge@northandoverma.gov> Tue, Mar 1, 2016 at 9:34 AM To: Jim Kellette <jim.kecorp@gmail.com> Cc: Michele Grant<mgrant@northandoverma.gov> Hi Jim, Just another reminder that we need the Title 5 report for 32 Cricket Lane. The homeowner called again asking if we received it. He's getting his house ready to put on the market and needs the Title 5 report. Lisa Hadge Health Department Town of North Andover 1600 Osgood Street, Suite 2035 North Andover, MA 01845 Phone 978-688-9540 Fax 978-688-8476 Email Ihadge@northandoverma.gov Web www.northandoverma.gov s R-- https:Hmail.goog le.com/mail/ca/u/O/?ui=2&ik=46857787dO&view=pt&q=kellette&qs=true&search=query&msg=153329a43ceOf8l 7&siml=153329a43ceO... 1/1 �,0'1� P 7�3 OV ED DATE DI S.Q 1-2OVF.D �?��VA1I�i OK . �ascnst A." � a s �� r - r J OK `� /27/71 ol 1. Distance Tot a. 'Wetlands.- - b. Drains 0. Wen 2. Water Line Location j - 3- No FPC Pipe- Septic i a=Septic Tank - a. Tis Length & To-Clean-Out Ca ;B:=_ - - - -- - - = - be Cement Pipe to Tank = Oh Both Sides of Tank -...---. - 5- Distribution Box a. Covers & Box - No Crack$ r b- All Lines Flo,,-,'ng Equal Anounts- Pdo Back Flow _ b. Leach Field or Trench - a. Dimensions b- Stone Depth c. Coed &ds - d. Clean Double Washed Stone - 7. Leach Fits _ a. . Dima, S1O - b. StAne epth - c. sh Pads dC-es C6_�3 I-fCle�---n nt Pipe to Pit t - Both Sides Double Washed Stone 8. No Garbage Di.spo sal 9- Tzinal Grading Inspection 10.- Barricading- Co-mred System _-- ll. As BMt Submitted . a. Lot Location _ be Dimensions of System c. Location -4th Regard-to Pere Test d. Elevations e. Eater Table 'inrth ndover,Fiass SUBSURFACE DISPOSAL DESIGN Ch?XK LIST a LOT # APPRUM DATE DISAPPROVED DATE_ Provided: Reasons: y Nle V FAIL OK Reg 2.5 , 'The submitted plan must show as a minirmm: a).,,the lot to be served-area,dimensions lot #"abutters ` ,location and log deep observation hoes-distance to ties location and results percolation tests-distance to ties design calculations & calculations slmd ng required leaching area location and dimensions of system-including reserve area- f existing and proposed contours g) location any wrt areas vdthin loot of sere di6posal system or - diselainter-checkwetlands mapping 7(h)- surface and subsurface drains vitiun loot of sevage disposal system or disclaimer ( ) location my drainage eaEements i4thin 1001 of aevtge disposal system or disclaimer-Planning Board files know sources of tster supply vd.thin 200, of sewage disponal system or disclaimer k) location of any proposed well to servo lot-1001 from leaching facility l< location of water lines on property-10 from leaching facility location of benchmark P drivers Eo} garbage disposals p} no FVC to be used in construction (q) profile of system-elevations of basement, plumb, pipe, septic talc, / distribution box inlets and outlets, distribution field piping and ! btlier elevations maxi=m ground nater elevation in area sewage disposal system (s) plan must be prepared by a Professional Engineer or other professional authorized by lair to prepare such plans Reg 6 Septic Tarxs eapaeit es- 50% of flow, water table, tees, depth of tees, access, pumping (b) cleanout lot from cellar wall or ingrroun,d sed. .ng pool d) 25f from subsurface drains Reg 10.2 Distribution Boxes a) slope greater than 0.08 Reg 10.1 b) SUV UYiIYY-Y��tY W�ii wuu.. ► ,wa.y rr - FMIL OK Leaching Pits A Leaching pits , a preferred where the installation is possible Red 11.2 a) calculations of leaching area-minimm 500 sq ft 11.4 b) spacing/- 11.10 c) surface drainage 2% 11.11 d) cove,*teriai e) 2 1 = 1x4" splash pad f) a at elbow g) bends in pipe from d-box to pipe Leaching Fields Reg 15.1 no greater than 20 mutes/inch area-minim= 900 sq ft 15.4 construction of field 15.8 surface drainage 2 % 3.7 e_ ) 20.1 from cellar wall. or inground mdmrdng pool Leichia fiches _ - Reg 14.1 a) c r••�A__mss of _eaGig area 500 sq ft 14.3 - b) spacing�I ft min 6 ft with reserve betwsen 14.4 c) dii ons 14.6 d) construction 14.7 le) s e 114.10 f) v fa.e a 2% Do_i �t_o_�_e_ _ a) sloe F� = (to be shown) b) y/x/;i 150 = (to be shown) Pu►r�s Reg 9.1 a) approval 9.6 b) stand-by poorer r Q. V Bogard of Health North Andcvor,Mass SUBSURFACE DISPOSAL DF..S`IGN CHECK LIST LOT APPROVED DATE DISAPPROVED DATE Provided: Reasons: Title V FAIL CK Reg 2.5 a submitted plan roust show as a minimum: the lot to be served-area,dimensions lot # abutters I/ " location and log deep observation Mes-distance to ties location and results percolation tests-distance to ties design calculations & calculations showing required leaching area location and dimensions of system-including reserve area existing and proposed contours (g) location any vet areas idthin 1001 of sewage disposal system or disclaimer-check wetlands mapping (h) surface and subsurface drains within 1001 of sewage disposal system or disclaimer (i location any drainage easements within 1001 of sege disposal system or disclaimer-Pl=i1mg Board files ( kno= sources of vater supply within 200' of sewage disposal system or disclaimer Ll location of any proposed well to serve lot-100' from-leaching facility ) location of water lines on property-101 from leaching facility ) location of benchmark driveways ) garbage disposals no PVC to be used in construction (q) profile of system-elevations of basement, plumb, pipe, septic oItaralc, distribution box inlets and outlets, distribution field piping and Other elevations maxim:am ground water elevation in area sewage disposal system (s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6Septic Tanks capacities--150% of flow, water table, tees, depth of tees, 4access, pumping b) cleanout c) 101 from cellar wall or inground sul= ng pool (d) �5f from subsurface drains Reg 10.2 Distribution Boxes 4b)) slope greater 0.08 Reg 10.4 sump Subsurface'Desi Check List Pae 2 FAIL OK Leaching Pits Leaching pits are p erred where the installation is possible Reg 11.2 a) calculations leaching area-m�.nim�m 500 sq ft '4 11.4 b) spacing 11.10 c} surfac a 2% 11.11 d) cov material e) 'x4a splash pad f - e at elbow no bends in pipe from d-box to pipe Leaching Fields Reg 15.1 4uP-- ) no greater than 20 udmutes/inch ) area-mi.nimam 900 sq ft 15.4 ) construction of field 15.8 ) surface drainage 2 % 3.7 ) 201 from cellar call or inground swimni ng pool Leaching TrMwICS Reg 14.1 . a)Mof-leaching area-min 500 sq ft 14.3 b) spacing- ft min 6 ft with reserve between 14.4 G) dimet� ons 14.6 d) Fnfacecdr tion 14.7 e)ll;.10 f) ge 2% Do Sl e A) slope = to be shown) b) y/x = (to be shown) s Reg 9.1 a) roval 9.6 b) d-by power