HomeMy WebLinkAboutMiscellaneous - 338 ABBOTT STREET 4/30/2018 (3)i
lig"\ Commonwealth of Massachusetts
City/Town of RI�CE11l®
System Pumping Record OCT 2- 2012
Form 4
`M TOWN OF NORTH ANDOVER
'DEP has provided this form for use by local Boards of Health. Other HEALTH EPART N
T.
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location: Left side of house, Right side of hous eft front of hous Right front of house,
Left rear of house, Right rear of house. Left rear of building. Ig r uilding.
Address F5 AW
City/Town State
2. System Owner:
,t7�-�Ic) \4 A--,,
Name
Address (if different from location)
Cityrrown
Zip Code
State Zip Code
6� �
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes No
5. Condition of System:
6. System Pumped By
If yes, was it cleaned? ❑ Yes ❑ No
\ uf�" 407�z-
Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7. Location Wtere contents were disposed:
G1 Dn „ Lowell Waste Water
Date
v -0 IAO - � �-
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
Commonwealth of Massachusetts
_ City/Town of .
System Pumping. Record REcrzrvEo
Form 4 JUN 0 1 2015
DEP has provided this form for use=by local Boards of Health. OtherTfaiq' @%1 b640 i Et1ut the
information must be substantially the same as that provided here. BeMF4 r WE , check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System LocationoR Rigl9i ont of , Left / Right rear of house, Left / right side of house, Left /
Right side of building, Left / Right front of building, Left / Right rear of building, Under deck
Address
City/rown State Zip Code
2. System Owner.
Name `
Address (if different from location)
Cityfrown � '. State � !p � e ,
s � '
Telephone Number
z
B. Pumping Ripcord
1. Date of Pumping Date 2. Quantity Pumped:
Gallons
3. Type of system: ❑ Cesspool(s) ptic Tank El Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No:
5. Condition ofsten (j
6.- System Pumped By.-
Nell.
y:
Neil. Bateson
Name
Bateson Enterprises Inc
Company
7. Lo mere contents -were disposed:
Lowell Waste Water
F5821
Vehicle License Number
IF
Date
t5form4.doo• 06/03 System Pumping Record • Page 1 of 1
_b
Blackburn, Lisa
From: Sawyer, Susan
Sent: Tuesday, October 22, 2013 11:04 AM
To: Blackburn, Lisa
Subject: FW: North Andover WTP Lab - WELL TESTING RESULTS
Attachments: Ippolito WELL.pdf
From: Mary Ippolito [mailto:mt ippolito@)verizon.net]
Sent: Thursday, October 10, 2013 12:25 PM
To: Sawyer, Susan
Cc: Hughes, Jennifer
Subject: Fw: North Andover WTP Lab - WELL TESTING RESULTS
Hi Sue,
Attached is the test results for my well, Tested positive for Total Coliform, but negative for E.coli. Otherwise, my well is in
good shape. I'm having my well flushed tomorrow afternoon, then I'll have it re -tested at the lab again to make sure it's
cleared up. Although Mr.Foster said the school is only digging within the original foot -print, I still can't take the chance that
their escavating hasn't contributed to this problem. I've left a phone message for him asking for consideration in this
matter until I can get my well flushed and re-trested.
I think that's the only way that I'll have peace of mind. .
Mary Ippolito
----- Original Message -----
From: Giglio, Julie
To: mt i polito verizon.net
Sent: Thursday, October 10, 2013 11:32 AM
Subject: FW: North Andover WTP Lab - WELL TESTING RESULTS
From: Giglio, Julie
Sent: Thursday, October 10, 2013 10:32 AM
To: 'mt ippolito@verison.net'
Subject: North Andover WTP Lab - WELL TESTING RESULTS
Attached you will find the results for the sample you collected on 10/8/13. Please feel free to contact me via email or
call me with any questions.
Julie A. Giglio
Lab Director
Town of North Andover
Drinking Water Treatment Plant
420 Great Pond Road
North Andover, MA 01845
Phone 978.688.9574
Fax 978.688.9575
Email igialio@townofnorthandover.com
1
Linda M. Hmurciak
WTP Superintendent
October 10, 2013
Dear Mary 1ppolito,
TOWN OF NORTH ANDOVER
DIVISION OF PUBLIC WORKS
WATER TREATMENT PLANT
420 GREAT POND ROAD, 01845-2909
Julie A. Giglio
LAB DIRECTOR
Telephone (978) 688-9574
Fax (978) 688-9575
Please find below the results of general analysis conducted on the samples you collected from your private well
on October 8, 2013. The first column is the item analyzed, the 2nd column is the result from the water sample
you provided.
PARAMETER
RESULT
MCL
H
7.58
Color
2 cu
15 cu
Temperature
N/A
Turbidity
0.43
Iron
0.045mg/L
0.3mg/L
Manganese
0.002mg/L
0.05mg/L
Total Coliform
+
E. coli
cu = color units
mg/L = milligrams per liter = ppm (parts per million)
MCL = Maximum Contaminant Level
Your well tested POSITIVE for total coliform bacteria. Total coliform bacteria are used as an indicator
organism in microbiology analysis. What this means is that the presence of total coliform means there could be
other potentially harmful bacteria present. In this case E.coli, the more harmful bacteria that we test for is NOT
present in this sample.
Our recommendations would be to disinfect the well with household bleach. When this is done we could retest
your well if you wish. Until your well is disinfected and retested, we would not recommend your well water be
used for consumption. If you have any further or concerns, please contact us at 978-688-9574
Julie A. Giglio
Lab Director
North Andover Water Treatment Plant
MA Certification # for BACTERIOLOGICAL ANALYSIS: MA 21054
Lind
a
R'TpS ' Hnzztr�zq
uAez�jzjtenden
I October 16 2013
Dear 1Llary Ippolito
DI V IS ON o oRTH AND
OVER
420 GSA LIC
R ONDA `4B]'T PLW�RKS
JulieA. READ 01 g4S. 909
LA$ D Giglio
�CCTOR
OF NOgr
* shy G
SgCN'U SEZZ9
Te1ePhone
F (978i 988 9574
Please
on Octo nd bel°w the
er 16,
You Provided, 2013 The first f b'eneral
I coranalysis
n is the ite conducted o
TfRAMETER m analyzed heh2 samPlesYou
E e p1rColifarm INSULT colun� is thel 'result o m Yot.Priv
m the ate well
Ifor °co Well testedne MCL ' (� MCS Fater sample
mption gative for total coli form ba Maxmum Contaminant
Le
Laie A Giglio teria and negative for E epV el
Ib DAncto la T
North r r W This
means that r Water
MA Certifi ve water Treatment I, You ter is safe
cation # for our
BACTEP1,OLOGICAL AN
AL ySIS: MA 21054
Commonwealth of Massachusetts
City/Town of RECEIVED
System Pumping Record
Form 4 JUS( 2 3 2014.
DEP has provided this form for use -by local Boards of Health. Other fAMWMaybeAisedbutAhe
information must be substantially the same as that provided here. Befbr .Wib6 tl is�f:b f!`-Hic-ktwith your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Locatio . LL' Rig front of hou , Left/ Right rear of house, Left/ right side of house, Left/
Right side of building, Left / Right front of building, Left / Right rear of building, Under deck
Address
Cityrrown State Zip Code
2. System Owner. � �h
Name 1
Address (if different from location)
City/Town State lC,
Telephone Number
i'.
B. Pumping Record
1. Date of Pumping
3. Type of system. ❑
❑ Other (describe):
46 -Pf
Date 2. Quantity Pumped: Gallons
Cesspool(S) Septic Tank ❑ Tight Tank
4. Effluent Tee Filter present? ❑ Yes No If yes, was It cleaned? ❑ Yes ❑ No;
5. Condition ts �U`
V �
6. System Pumped By.-
Nell
y:Neil Bateson F5821
Name Vehicle License Number
Bateson Enterprises Inc
Company
7.
contents were disposed:
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
Commonwealth of Massachusetts
City/Town of
W° System Pumping Record
Form 4 DEC,; 4
M
DEP has provided this form for use by local Boards of Health.
information must be substantially the same as that provided h `tt1�1
local Board of Health to determine the form they use. The System Pumping Recor
the local Board of Health or other approving authority.
A. Facility Information
1. System Location' ront of
rear of house, riahf rear of ho
City/Town
but the
check with your
be submitted to
Wight front of house, left side of house, right side of house, Left
left side of building, right rear of building, under deck.
/VeD it _ + 4vo--r4
State
2. System Owner. ^ �
Name
Address (if different from location)
City/Town
Zip Code
State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped:
3. Type of system: ❑ Cesspool(s) eptic Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No
5. ConditiAn of System:
( Ua�v� ('PSC/ � Vx
Gallons
❑ Tight Tank
6. System Pumped By:
Neil J. Bateson
Name
Bateson Enterprises Inc.
Company
7. Location where contents were disposed:
.L.S. LONelyJGVaste Vyater
Signature
F5821
Vehicle License Number
Date
t5form4.doc• 06/03 System Pumping Record • Page 1 of 1
�L\ Commonwealth of Massachusetts
City/Town of
System Pumping Record
w
Form 4
Important:
When filling out
forms on the
computer, use
only the tab key `
to move your
cursor - do not
use thereturn
key.
ie.�. ,•,_..
SEP 14 2006
TOWN OF NORT-i A :DOVER
HEALTH CEPA.RT JiFN7
ur-r nas provlaea ]MIS corm Tor use by local Boards of Health.. The System Pumping Record must
be submitted to the local Board of Health or other approving authority. .
A. Facility Information
1.
Address
Cityrrown
2. System Owner:
a�z
Sta Zip Code
Name-- --
Address (if different frorn location)
City/Town State Zip —ode
Telephone Number
B. Pumping Record
-t a
J. Date of Pumping Date 2. Quantity Pumped.
Gallons
3. Type of system: ❑ Cesspool(s) Septic Tank- ❑Tight Tank
❑
Other (describe):
4. Effluent Tee Filter present? ❑ Yes ONo If yes, was it cleaned? ❑ Yes F1 No
5. Condition offS.
st !m;�: ��% ✓\ C
6. System m e . y:
c
:Name
Company -
.7. LocatioKOhere cont wer osed:
Signat of ul r v
http://www.mass.goyidep/water/approvals/t5forms.htm#inspect
Vehicle License Number
Date
t5forn4.doc• 06103 System Pumping Record • Page t of 1
TOWN OF /V • JVJ(�lr d-
SYSTEM PUMPING RECORD
DATE: (9 "V
SYSTEM OWNER & ADDRESS
1� L �—V
A�b4�
JAN - 2 N&
SYSTEM LOCATION
(example: left front of house)
l� -4 � ov� kov�c
DATE OF PUMPING: I ( QUANTITY PUMPED : GALLONS
CESSPOOL: NO V/— YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTBER(EXPLAIlN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: 6! ` `5
Commonwealth of Massachusetts
/v
,Massachusetts
System Pumping Record
System Owner
-1-4
Date of Pumping: 6 --
Cesspool: No Yes [ ]
System Location
3b�r>�
Quantity Pumped: allons
Septic Tank: No [ ]
System Pumped by: &&"W License #
Contents transferred to: Greater Lawrence Sanitary District
Date:
Inspector:
Yes W--/
Commonwealth of Massachusetts
414r&)_, Massachusetts
System Pumping Record
System Owner
fi0o /f 4G(
Date of Pumping:
Cesspool: No 1.,+' Yes []
System Location
Quantity Pumped: 0 gallons
Septic Tank: No U Yes H
System Pumped by: Sitcom License #
Contents transferrred to : Greater Lawrence Sanitary District
Date:
Inspector
JUIV 16 /999
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE: f
---I, - AD
?PZA'
J,�64�
OCT 2 5 2001
(example: left front of house)
-Tfov+t, k qous�
DATE OF PUMPING: — 1—d ( QUANTITY PUMPED (e)DC� GALLONS
CESSPOOL: NO ZYES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE Z'EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
SYSTEM PUMPED BY:
COMMENTS:
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
CONTENTS TRANSFERRED TO: F Z-- .5-- Z)
TOWN OF c
SYSTEM PUMPING RECORD
DATE: -d-1- 3 �
NOd �
SYSTEM OWNER & ADDRESS SYSTEM LOCATION
(example: left front of house)
33� Q�
l
fib� �+'
DATE OF PUMPING: QUANTITY PUMPED: 1;()b0 GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER (EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: G.L.S.D__LL Lowell Waste
TOWN OF
SYSTEM
DATE:
SYSTEM OWNER & ADDRESS
j4p�1
L" 1114 DClLIJ:1 j
SYSTEM LOCATION
(example: left front of hou")
G
DATE OF PUMPING: QUANTITY PUMPED: GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
HEAVY GREASE
ROOTS
EXCESSIVE SOLIDS
SOLIDS CARRYOVER
FULL TO COVER
BAFFLES IN PLACE
LEACHFIELD RUNBACK
FLOODED
OTHER(EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: G.L.S.D Lowell Waste
L\- Commonwealth of Massachusetts RECEIVE
City/Town of
System Pumping Record APR 2 2008
F 4
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor- do not
use the return
key.
"ISI
IG�I
ornl TOWN
OF NORTH ER
DEPARTMENT
DEP has provided this form for use by local Boards of Health. Other forms may u ,
information must be substantially the same as that provided here. Before using this form, check with your
local Board of Health to determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or other approving authority.
A. Facility Information
1. System Location:
2. System Owner:
Name
Address (if different from location)
City/Town
Code
State p "C ��
Telephone Number
B. Pumping Record -;, I CD
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes El -o If yes, was it cleaned? ❑ Yes ❑ No
5. Conditio Syst m:
N
7.
e.�
Date
t5fonn4.doc• 06/03 System Pumping Record • Page 1 of 1
\ Commonwealth of Massachusetts RETE
City/Town of
F
System Pumping Record NOV 1 O 2009
Form 4 , , .; NORTH ANWVEtt
r� _ �TH DEPARTMENT
DEP has provided this form for use by local Boards of Health. Other forms may be used, but the
information must be, substantially the same as that provided here. Before using this form, check with your
local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to
the local Board of Health or-otkter approving authority.
A. Facility Information
1. System Location: Left side of house, Right side of hous Left front of ho Right front of house,
�_
Left rear of house, Right rear of house. Left rear of building. Ig rear of building.
Address
City/Town State Zip Code
2. System Owner:
Po (
Name
Address (if different from location)
City/Town State Z- ode
&&'6 �8
Telephone Number
B. Pumping Record
1. Date of Pumping Date 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank
❑ Other (describe):
4. Effluent Tee Filter present? ❑ Yes No
5. Condition of System:
6. System Pumped By:
Neil Bateson
Name
Bateson Enterprises Inc
Company
7. Location where contents were disposed:
'1 .L.S. , Lowell Waste Water
Signature of Hauler
If yes, was it cleaned? ❑ Yes ❑ No
V eow,-A a 1 d g
F5821
Vehicle License Number
lc_�
Date
t5form4.doc• 06/03 System Pumping Record . Page 1 of 1