Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 37 CARLTON LANE 4/30/2018
N OO w n 0 D 6 O -f co O I -;,z .1; OZ o m 0 I Lot & Street Map/Parcel /e�� C I/ CONSTRUCTION APPROVAL Has plan review fee been- pai YESD NO Permit# /y� T G✓ , Plan Approval: Date: Approved by: Designer: AL �,C a2606 D:: y— Plan Date: Conditions: Water Supply: _ -o nD Well Well Permit: Driller: Well Tests: Chemical Date Approved Bacteria I Date Approved Bacteria II Date Approved Plumbing Sign -Off: Comments: Wiring Sign -off: Form "U” Approval: Approval to Issue: YES NO Date Issued By: Conditions: Final Approval: All Permits Paid? Well Construction Approval? Septic System Construction Approval? Certification? Other? Any Variance Needed? FINAL BOARS OF,H ALTH APPROVAL: DATE: 9 /�'Sj��3/ _ �- t" 4� NO AI/Y NO YES NO YES NO YES NO VA CONDITIONS: Is the installer licensed? Type of Construction: New Construction: Issuance of DWC permit: DWC Permit Paid? DWC Permit # Begin Inspection: Excavation Inspection: Needed: SEPTIC SYSTEM INSTALLATION NO NEW (-R PAR)aJd,f Certified Plot Plan Review YES NO Floor Plan Review C::YESD NO Conditions of Approval from Form U YES NO Passed:�! JZ! ©l By: Construction Inspection: Needed: NO NO Installer: M i K C - YES NO Approval of Backfill: Date: 71 By: Final Grading Approval: Date: 2h, By:� Final Construction Approval: Date: `/1/ b By: Certificate of Compliance: Approval: Date: / (� PETER F. REILLY 136 ANDOVER STREET ANDOVER, MA 01810 RECEIVED (978) 375-3750 4 2005 MAY TITLE V �SHE �THDEPAR MENTR OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART A - CERTIFICATION Property Address: 37 Carlton Lane, North Andover, MA 01845 Name of Owner: Yvette Dambach Address of Owner: same Name of Inspector: Peter F. Reilly Company Name: same Mailing Address: 136 Andover Street, Andover, MA 01810 Telephone Number: (978) 375-3750 CERTIFICATION STATEMENT 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. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) The system: ✓ Passes N/A Conditionally Passes N/A Needs Further Evaluation By the Local Approving Authority N/A Fails Inspector's Signature: Date: April 23, 2005 Peter'F. Reilly The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) 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 regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS ""This report only describes conditions a the time of inspection and under 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 (See attached Disclaimer). OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART A - CERTIFICATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 INSPECTION SUMMARY: A. SYSTEM PASSES: Check A, B, C, D, or E / ALWAYS complete all of Section D ✓ I 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. COMMENTS: The system met the Pass Criteria of Title V. B. SYSTEM CONDITIONALLY PASSES: N/A 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. Answer yes, no, or not determined (Y, N, ND). Describe basis of determination in all instances. If"not determined", explain why not) N The septic tank is metal, and over 20 years old* or the septic tank (whether metal or not) is 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 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. ND explain: N Observation of a sewage backup or breakout or high static water level 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): N/A broken pipe(s) are replaced N/A obstruction is removed N/A distribution box is leveled or replaced ND explain: 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): N/A broken pipe(s) are replaced N/A obstruction is removed OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART A - CERTIFICATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 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 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: N/A Cesspool of privy is within 50 feet of a surface water N/A Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh. 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: N/A The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. N/A The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply well. N/A The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. N/A The system has a septic tank and SAS the SAS is less than 100 feet but 50 feet or more from a private water supply well.**Method used to determine distance N/A This system passes if the water well water analysis, performed at a certified DEP laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. A copy of the analysis must be attached to this form. 3. Other N/A OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART A - CERTIFICATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 D. System Failure Criteria applicable to all systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. No Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. N/A Liquid depth in cesspool less than 6" below invert or available volume <'/ day flow. No required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: once No Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. N/A Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. N/A Any portion of a cesspool or privy is within a Zone I of a private water supply well. N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well. N/A 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 laboratory, for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen is less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form). N/A The system fails. I have determined that one or more of the above failure criteria exist as defined in 310 CMR 15.303, therefore the system fails. The property owner should contact the Board of Health should be contacted to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system mustserve a facility with a design flow of 10,000 gpd to 15,000 gpd. You Must indicate either "Yes" or "No" to each of the following: (The following criteria apply to a large system in addition to the criteria above) N/A The design flow 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: Yes No N/A The system is within 400 feet of a surface drinking water supply N/A The system is within 200 feet of a tributary to a surface drinking water supply N/A The system is located in a nitrogen sensitive area (Interim Wellhead 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 such 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. V OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART B - CHECKLIST Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 Check if the following have been done. You must indicate either "Yes" or "No" as to each of the following: Yes No Yes Pumping information was provided by the owner, occupant, or Board of Health. No Were any of the system components pumped out in the previous two weeks ? Yes Has the system received normal flow in the previous two week period ? No Have large volumes of water been introduced to the system recently or as part of this inspection? Yes Were as built plans of the system obtained and examined ? (If they were available note as N/A) Yes Was the facility or dwelling was inspected for signs of sewage backup ? Yes Was the site was inspected for signs of breakout ? Yes Were all system components, excluding the SAS, located on the site ? Yes Were the septic tank manholes uncovered, opened and the interior of the septic tank inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum? Yes Was the facility owner (and occupants of if different from the owner) provided information on the proper maintenance of subsurface sewerage disposal systems ? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: Yes No Yes Existing information. For example, a plan at the Board of Health. N/A Determined in the field if any of the failure criteria related to Part C is at issue (approximation of distance is unacceptable) [15.302(3)(b)]. OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C - SYSTEM INFORMATION Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 FLOW CONDITIONS RESIDENTIAL: Number of bedrooms (design): Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms: Number of Current residents: Does the residence have a garbage grinder (yes or no): Is the laundry on a separate sewerage system (yes or no): Laundry system inspected (yes or no): Seasonal use (yes or no): Water meter readings, if available (last 2 years usage [gpd]): Sump Pump (yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL: Type of Establishment: Design Flow gpd (based on 15.203): Basis of Design Flow (seats/persons/sq.ft., etc): 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/use: OTHER: (Describe) PUMPING RECORDS 660 gallons 5 no no (if yes, separate inspection required) N/A no about 350 gpd no current N/A N/A N/A N/A N/A N/A N/A N/A N/A GENERAL INFORMATION Source of Information: owner (about one year ago) Was system pumped as part of inspection (yes or no): no if yes, volume pumped (gallons): N/A How was quantity pumped determined ? N/A Reason for pumping: N/A TYPE OF SYSTEM ✓ Septic tank/distribution box, soil absorption system Single cesspool Overflow cesspool Privy NO 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 the system owner) Tight Tank Attach a copy of the DEP Approval Other (describe): Approximate age of all components, date installed (if known) and source of information: replacement system installed in 2001. Were sewerage odors detected when arriving at the site (yes of no): no OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C - SYSTEM INFORMATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 BUILDING SEWER: (locate on site plan) Depth below grade: about 6"-8" Materials of construction: cast iron ✓ 40 PVC other (explain) Distance from private water supply well or suction line N/A Diameter: 4" Comments: Condition of joints, venting, evidence of leakage, etc.) Building sewer was watertight and appeared sound at foundation. SEPTIC TANK: ✓ (locate on site plan) Depth below grade: about 6" Material of construction: ✓ concrete metal Fiberglass Polyethylene other (explain) If tank is metal, list age N/A Is age confirmed by Certificate of Compliance N/A (Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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 How dimensions were determined: Rectangular - 1,500 gallons (per plan) <1" 28" <1" 8" 16" observation Comments: (on pumping recommendations, of inlet and outlet tees or baffle condition, structural integrity, liquid level as related to outlet invert, evidence of leakage, etc.) Tank was watertight and appeared to be functioning properly. GREASE TRAP: N/A (locate on site plan) Depth below grade: material of construction: concrete metal FRP other (explain) Dimensions: N/A Scum thickness: N/A Distance from top of scum to top of outlet tee or baffle: N/A Distance from bottom of scum to bottom of outlet tee or baffle: N/A Date of Last Pumping: N/A Comments: (on pumping recommendations, of inlet and outlet tees or baffle condition, structural integrity, liquid level as related to outlet invert, evidence of leakage, etc.) N/A R-309-01 No ............................. DISPOSITION, REMOVAL AND TRANSPORTATION PERMIT This section to be returned immediately to the Issuing City?own, properly endorsed to ... BGG... ................... Office issuing permit) r City/Town of ....................... ....... ............................. Mass. Name of Decedent/6.Y.(. ... /./..f... 11!1 x .................... If a U.S. War Veteran, specify what war, organization, etc. ................................................................................................... -------------------------------- ------------------------------- ENDORSEMENT (To be filled in by cemetery or crematory official) I hereby certify that the body accompanying this permit was disposed of in accordance with its terms at ,.Spring Grove Cemetery Andover ..................... (Name of cemetery or crematory) (City/Town) on.................. AUil...15......... 2005....................................... Final Dispositioon%................�..BuI_ial....................................... Certified by .l�l.!h !.N� t! p . (Signature of Supe &et;dent, cemetery or crematory) If there is no officer in charge, funeral director must sign and return this stub. RECEIVED MAY 4 2005 TOW+yrH piv00VER NEALTt 1 CSEPARTiJvENT OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C - SYSTEM INFORMATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: N/A material of construction: concrete metal Dimensions: Capacity: Design Flow: Alarm Present (yes or no): Alarm level: Alarm in working order (yes or no) Date of last pumping: Fiberglass Polyethylene other (explain) N/A N/A gallons N/A gallons per day N/A N/A N/A N/A Comments: (condition of alarm and float switches, etc.) N/A DISTRIBUTION BOX: ✓ (locate on site plan) 0" depth of liquid above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc.) D -box was level. Two lines leading to SAS were accepting effluent evenly. D -box was about 6" below surface. Little solids carryover evident. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order (yes or no) N/A Alarms in working order (yes or no) N/A Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) not applicable J OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C - SYSTEM INFORMATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 SOIL ABSORPTION SYSTEM (SAS): ✓ (locate on site plan, if possible; excavation not required) If SAS not located, explain why: Type leaching pits, number leaching chambers and number leaching galleries and number leaching trenches, number, length ✓ leaching fields, number, dimensions overflow cesspool, number alternative system (name of technology) N/A N/A N/A N/A 1 field, 30' x 40' (6 lines) per "As -Built" Plan N/A N/A Comments: (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) Soils in area of SAS appeared normal, no signs of breakout. CESSPOOLS: N/A (locate on site plan) Number and configuration N/A Depth -top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow (cesspool must be pumped as part of inspection) N/A Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc.) not applicable PRIVY: N/A (locate on site plan) Materials of construction Dimensions Depth of solids N/A N/A N/A Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs, etc.) not applicable OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C - SYSTEM INFORMATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 SKETCH OF SEWAGE DISPOSAL SYSTEM: Provide a sketch of the sewerage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100'. Locate where public water supply enters the building. lqPP- WI-R . 2 • s-�y 1-s� y C J-S-fy I Deck „v% SEPTIC TANK TIES: A to Inlet (1) N/A B to Inlet C seP�it, fo h (c C N/A B to Outlet (0) 14.0' EPR 33.0' Y)9R P )roar.©� 55.5' 1=ie-Id rc „v% SEPTIC TANK TIES: A to Inlet (1) N/A B to Inlet N/A A to Center (C) N/A B to Center N/A B to Outlet (0) 14.0' C to Outlet 33.0' D -BOX TIES: A to Box 53.0' B to Box 55.5' NOTE: The system is in the rear yard. OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL INSPECTION FORM PART C - SYSTEM INFORMATION (continued) Property Address: 37 Carlton Lane, North Andover Owner's Name: Dambach Date of Inspection: 4/23/2005 SITE EXAM Slope flat in area of system Surface water none observed Check cellar dry Shallow wells none observed Estimated Depth to Groundwater 4' (below bottom of SAS) Please indicate (check) all methods used to determine the high ground water elevation: Y Obtained from Design Plans on record - if checked, date of design plan reviewed: 2001 Y Observed site (abutting property, observation hole within 150 feet of SAS) Y Check with Local Board of Health - explain: information on file Y Check local excavators, installers - (attach documentation) N Accessed USGS Database - explain: website too complicated You must describe how you established the high ground water elevation.* 2001 design plan indicates adequate separation. The soils and grade changes in the area indicate no groundwater in the SAS. However, the precise groundwater elevation cannot be determined for certain without a soil evaluation test. *Inspector's Note: Soil Evaluation is the currently recognized method for determining or establishing the high groundwater elevation. Since I am not a licensed or certified soil evaluator, I am not qualified to determine or establish the high groundwater elevation beyond the public information available, such as recent design plans of the site or the nearby area. My estimation of the high groundwater elevation is based on a due diligence effort to obtain all available information both on and off the site and my experience as a certified subsurface disposal system inspector. (see attached Disclaimer) DISCLAIMER This passing septic inspection under Massachusetts Title V is in no way a guaranty or warranty of the inspected septic system. The inspection is a "snapshot in time" and does not constitute a complete assessment of the quality or potential longevity of the septic system. The pass/fail criteria are specific and outlined in detail in this report. Under the limited criteria of a Title V inspection, it is impossible to determine how long any septic system will last. The inspector made a diligent effort to certify the septic system based on the criteria required under Title V. Under Massachusetts Title V, soil evaluation is the accepted method of determining the high groundwater elevation. This inspector is not a certified soil evaluator and is therefore not qualified under Title V to determine or establish the high groundwater elevation. The method used to estimate the high groundwater for this inspection was based on the public records and methods of observation described on the previous page. Groundwater levels can vary greatly from season to season, year to year and soil evaluation is considered the most reliable method of groundwater determination under Title V. Peter F. Reilly Inspector April 23, 2005 Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director June 14, 2001 Mr. Michael Dambach 37 Carlton Lane North Andover, MA 01845 Re: Application for 3 room in-law apartment Dear Mr. Dambach: Telephone (978) 688-9540 Fax (978) 688-9542 Your application for an addition at 37 Carlton Lane has been reviewed by the Health Department. The application was denied on May 17, 2001 for the following reasons: 1. b/ Missing information 2. ❑ Passing Title 5 inspection of septic system required To address the problem(s): If # 1 is checked, please supply: Floor plan of existing and proposed addition b. Certified plot plan showing house, septic system and proposed project in scale If #2 is checked: a. Have the septic system inspected by a certified Title 5 inspector to determine the size of the system and whether it is operating properly: OR b. Tie-in to municipal sewer If #3 is checked: a. Relocate the project Please feel free to call the Health Office at 978-688-9540 with any questions you may have. Sincerely, Sandra Starr, Health Director Cc: Building Department File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANVTNIG 688-9535 FORM - U - LOT RELEASE FORM iatX� {'� ivv INSTRUCTIONS: This form is used to verify that allnecessary approval/ permits from - Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT ' � Da m)W6THONE _�C �� -1Z 5 --C) k, ASSESSORS MAP NUMBER ( l6 C LOT NUMBER SUBDIVISION LOT NUMBER STREET (� � f `' U CN STREET NUMBER " ........................................................................... OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED ? CONSERVATION ADMINISTRATOR DATE REJECTED COMrffi-NIS TOWN PLANNER DATE APPROVED DATE REJECTED CONINffiXIS DATE APPROVED FOOD INSPECTOR -HEALTH DATE REJECTED -���L---' DATE APPROVED L� SEPTIC INSPECTOR - HEALTH CON vIENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DATE APPROVED DATE REJECTED CON*JENIS RECEIVED BY BUILDING INSPECTOR �. I SEPTIC PLAN SUBMITTAL FORM LOCATION: ";;'7 Al 00" A- RA; 12 NEW PLANS: (OS $125.00/Plan REVISED PLANS: YES SITE EVALUATION FORMS INCLUDED DATE: $ 60.00/Plan YES NO DESIGN ENGINEER: N I; vli EN & I -Aur,' k N CAA) C'1 1"L "- DATE TO CONSULTANT: *If you want your plans expedited, please. submit three plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in place, route to the Health Secretary., 0 Town of North Andover, Massachusetts Form No. 2 f MORTFI BOARD OF HEALTH O (J / o � DESIGN APPROVAL FOR asAC"USEt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicantri'L-1_� p y a��Vl� �1 �� Test No. y Site Location Reference Plans and Specs. Cyd 'ENGINEER DES N DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN, BOARD OF HEALTH Fee Site System Permit No. . ZZL//t' lk NEW ENGLAND ENGINEERING SERVICES INC April 3, 2001 Susan Ford North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 37 Carlton Lane Dear Susan: Enclosed are 5 sets of revised plans for the above referenced project. The water table has been adjusted and the system has been raised to comply with the request of the town consultant. It must be noted that this office disagrees with the way the water table was determined. The worst case test pit was used to determine the water table, however there are two test pits closer to the area of the system that have deeper water tables due to the amount of fill in the area. It is the feeling of this office that the approach being used is a CYA approach and does a disservice to the property owner. Sincerely, / ��2 (/-/ 69 - � ; Benjamin C. Os d, Jr., EIT President 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director April 6, 2001 Ben Osgood, Jr. New England Engineering 60 Beechwood Drive No. Andover, MA 01845 Re: 37 Carlton Lane Dear Ben: Telephone (978) 688-9540 Fax (978) 688-9542 This is to notify you that the revised plans dated 4/4/01 for the repair of the septic system for 37 Carlton Lane have been approved. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, L , 2 Sandra Starr, R.S., C.H.O. Health Director S S/smc cc: Dambach File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director March 30, 2001 Ben Osgood, Jr. New England Engineering 60 Beechwood Drive No. Andover, MA 01845 Re: 37 Carlton Street Dear Ben: Telephone (978) 688-9540 Fax (978)688-9542 This is to inform you that the proposed plans for the site referenced above have been disapproved and have technical deficiencies as followed: • Final grades must be adjusted to provide a minimum of 15 -foot horizontal separation between the soil absorption area and the adjacent side slope as required by CMR 15.255(2). • Groundwater separation not adjusted to the highest existing grade as required by 310 CMR 15.240(1). It appears that the leaching field needs to be raised by approximately 1.3 feet. You must use shallowest water table as found in test pit one (36 inches) and highest elevation point within the system which is estimated at 91.6. If you have any questions, please do not hesitate to call the Board of Health Office. Sincerely, ve_- Sandra Starr, R.S., C.H.O. Health Director cc: Dambach file BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 SEPTIC PLAN SUBMITTAL FORM LOCATION: '-3 ? act Q L 'Co N �-"j NEW PLANS: YES $125.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES NO DATE: 3, 2911 01 DESIGN ENGINEER: kLw N CSL A N ca DATE TO CONSULTANT: *If you want your plans expedited, please submit three plans and included a stamped envelope with the correct amount of postage to mail plans to Port Engineering. When the submission is all in place, route to the Health Secretary. NEW ENGLAND ENGINEERING INC Sandra Starr, Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 37 Carlton Lane, North Andover, Septic system design Dear Sandra: SERVICES March 26, 2001 Enclosed are the following documents concerning the above referenced property. 1. 5 sets of revised design plans, 1 with original signature. 2. Submittal form for approval. 3. Check to cover the fee. If you have any questions please do not hesitate to contact this office. Sincerely, Benjamin C. Osgood, r., EIT President v�A 2 9 SDI 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 Town of North Andover Office of the Health Department Community Development and Services Division William J. Scott, Division Director 27 Charles Street North Andover, Massachusetts 01845 Sandra Starr Health Director March 19, 2001 Ben Osgood, Jr. New England Engineering 60 Beechwood Drive No. Andover, MA 01845 Re: 37 Carlton Street Dear Ben: Telephone (978) 688-9540 Fax(978)688-9542 This is to inform you that the proposed plans for the site referenced above have been disapproved and have technical deficiencies as followed: Final grades must be adjusted to provide a minimum of 15 -foot horizontal separation between the soil absorption area and the adjacent side slope as required by CMR 15.255(2). Groundwater separation not adjusted to the highest existing grade as required by 310 CMR 15.240(1). It appears that the leaching field needs to be raised by approximately 1.3 feet. If you have any questions, please do not hesitate to call the Board of Health Office. Sincerely, Sandra Starr, R.S., C.H.O. Health Director cc: Dambach file BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 NURSE 688-9543 PLANNING 688-9535 Note to File: March 14, 2000 37 Carlton Lane New owner wants to add in-law apartment. Existing leach bed looks large enough to handle flow, however, system appears to be less than 4 feet to groundwater. For new construction the septic system must meet all requirements of Title 5 — in this case the 4 feet to groundwater and a reserve area. Suggested that deep hole test be done to ascertain groundwater and test for reserve area. Info. Confirmed by Claire Golden at DEP. S. Starr zi _tee s -1� cz —i L-1 cz G s :=t Z Ea SE ES E Z 7 S E 7—D ---4 7 ca i 0 U s �v f � „ C'. Y� Q f ° L Et) � 42 U R E ° E C 3 ,0 m O "0 - a s � o. C o s S5 fi L. �,� - - _ -- z� ��- - �, - -- _� � _. �.- -�'__ -- __ +_ _- --- , - - - -- �- - - ,- i- _ � � - - -- - -_ __ Mar -15-01 03:46P Paul D_ Turbide, PE/PLS 11Jfk r 1 VI I IK ' I 1 V its 1 G�I(:IAI��Rfall: UIU119t.LIUIVU Civil Engineers & Land Surveyors One Harris Street Newburypert, MA 01950 �g'f$l A�4_A494 January Gat, Lvvt Sandra Starr North Andover Board of Health Administrator ©Bice of Community Development and Services 10 Cchool Street V, rth _Andnvpr, MA 01845 978-465-0313 P.03 .,W.. T�.�_ v r— circ .�Cbroelp At A7 rorlmn 1,9ne 11G: l lllC ♦ 1 GV lcR sv■ v v , Dear Sandra, :• n ter. t = _ �__. = f -*:- C'.>e+gen Dle„e" fnr Enclosed find our review of the "Cheddist Por'Nor%n rittuvvct a1 -CF& , �y�*.=_. _ ...••� the septic system upgrade at the above-mentioned site. The fuilu`+virg i3 iz list of technical deficiencies that Port Engineering has found. n Final parades must be adiusted to provide a minimum of 15 -foot horizontal _epamtion between the soil absorption area and the adjacent side slope as required i,,. rXA7P r� a+ems eoner�+inn not nriu,gtPri to the highest existing grade as required by V VlVii<=N Yiul.va q\rYNa a.*.vu Jw y n, n nl ,m w r 7 A^ 4(1! i+nn„sers fi of the I~hin0 f F+.Id ne is to be raised by L V %-IVLA 1 J.L•TV `1 J. 1* apr*s a *ansa a..v ...��•••--O approximaiely 1.3 fect. If you have any questions or comments please feel free io con'taci rue. _Sixtseceiv t-:.3- nnrtn c Paul D IUSUluG, i i.w1 AV \\Server P\NAMP28M CARLTON LANE 37DDOC I i NEW ENGLAND ENGINEERING SERVICES INC January 17, 2001 Sandra Starr, Administrator North Andover Health Department Town Hall Annex 27 Charles Street North Andover, MA 01845 Re: 37 Carlton Lane, North Andover, Septic system design Dear Sandra: Enclosed are the following documents concerning the above referenced property. 1. 5 sets of design plans, 1 with original signature. 2. Submittal form for approval. 3. Check to cover the fee. 4. Soil evaluator sheets. If you have any questions please do not hesitate to contact this office. Sincerely, Benjafnin C. Osgood, Jr., EIT President JA01 S r a 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 FORM 11 - SOIL EVALUATOR FORM I Page I of 3 Date: No. -L, /,�/s„a Commonwealth of Massachusetts A/o. AvDoA4,;r-,, Massachusetts _& �jta �e en r -�0 .Seh=e Disvo�gl -�7 Performed By: ......... ......... Date: WitnessedBy: ........... ........... . ...... .................................... ................................................ ... . . . .... LoW100 A6ftN Of La 8 Addtas, and Tdqbm I • A,&. W14 (r,91,04-5- ew construction C1 Repair 10 1 97e 7057- pffice ReVITY Published Soil Survey Available: No ❑ Yes Year Published 1,7661 ................ Publication Scale Soil Map Unit 1�� . ........... Drainage Class /,4 4,.4........... Soil Limitations .......... ... ...... . Su . rricial Geologic Report Available: No 0 Yes ❑ Year Published Publication Scale 7 Geologic Mate" ..- (Map Unit) ............................................ .......................... ........ I ..................... . . ..... . .......... ........ ... Landform............... . .............. ....... ........ **"** ...... Flood Insurance Rate Map: Above 500 year flood boundary No RYes ❑ Within 500 year flood boundary No DYes ❑ Within 100 year flood boundary No 0Yes ED Wetland Area: National Wetland Inventory Map (map unit) Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Month ..... . Range :Above Normal ONormal PBelcw Normal 0. Other References Reviewed: DEP APPROVED FORM -12107195 6 FORM 11 - SOIL EVALUATOR FORA Page 2 of 3 Location Address or Lot No. 7.11 Gem '4/ ii �� IAZW06� Deep Hole Number ..� Date Time.. Time:. WeatherC5:2ZjV- 6r� Location (identify on site plan).Tl/t�ifG� Land Use Slope (%) .�.. Surface Stones . --..... ,.... . Vegetation Landform -.40; .� .:. �! .,.., /Ylm..�.v.�..,.. .......... Position on landscape (sketch on the back) :��.L•, .��. Distances from: Open Water Body -49%4�1 feetDrainage way 4� feet Possible Wet Area .44r'' feet Property Line ..,. .... feet Drinking Water Well ..(..OQ feet Other DEEP OBSERVATION MOLE LOG" Depth from Surface (Inches)per nches) Sall Horizon Sol[ Texture (USDA) Soil Color (Munsell) Soil Mottling (Structure, Stones, Boulders, Consiatencv, % Gravel) p --Ao 1 ., Parent Material (geologic) Wit_ hh to groundwoter• Standing Water in the Hole: " Estimated Seasonal High Ground Water.- DEP ater: DEP APPROVED FORM - 1210719S Weeping from Pit Face: -- � FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.Lf% X,C��� �n-sib Re_��yiew� Deep Hole Number aDate:. 1 � T(m /B. O'er ° .. Y '.'�•� e. ... Weathe��.� Location (idttlf�y_on site pian) Land Use �r4z5�j.� Slope (%i Surface Stones .. f , .. �..�...... ... . Vegetation .............. ..�.......... . �,.�. M� . ... . Landform ....... ., /�1.iv .: Position on landscape (sketch on the back) .. ��. . �„ ....,... Distances from: Open Water Body -�<406�* feet Drainage way.. feet Possible Wet Area feet Property Line ....- ... feet Drinking Water Well ,?!I�r feet Other DEEP OBSERVATION MOLE LOG` 5urDepth from Soil Horizon Soil Texture Soil Color Soil Other faae (Inches) (USDA) (Munsell► Mottling (Structure, Stones, Boulders, Consistency, % Gravel) Parent Material (geologicl CC.�C�G �G 4-- DePthtoBedrock: Deothto Groundwater: Standing Water in the Hole: -- Weeping from Pit Face: Esomated Seasonal High Ground Water._ DEP APPROVED FORM - 12107/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot Nor-�7_�TZ�jD,c/ Method Uqe�. ❑ Depth observed standing in observation hole .............. . ❑ Depth weeping from side of observation hole ............. . Depth to soil mottles ., .,: inches/- 36" ❑ Ground water adjustment .................. feet Index Well Number Adjustment factor ................... inches inches3_ �� r .;10- . 16 - Reading Date ................... Index well level ........... Adjusted ground water level ....... ............... ................ Depth of Naturally Occurring Pervr_'ous Mate Does four observed lth oughouteet of the area proposed for the pervious material exist in 11 areas soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification 7 I certify that on o' (date) I have passed the soil evaluator examination approved by theUdPhrtment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15 7. Signa#ur �— • Date DEP APPROVED FORM .12/07/93 v FORM 11- SOIL EVALUATOR FORRI Page 2 of 3 Location Address or Lot No. Deep Hole Number .. ¢. Date:. Tfine: �l , . 3� _ p r Location (identify on alts plant ' G Weather C Land Use ...�.. i`1�4G» Slope (t°�) w , �-- ....... .�..... �� •. • Surface Stones --- Vegetation Landform ... , pxe4 .�.... _ .� ., .. . . Position on landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possibiq Wet Area `9�r, feet Property Line.. --'� , , feet Drinking Water feet Other DEEP OBSERVATION HOLE LOQ* S (NSI Solt HorizonSon Texture 8oif CokeSon (USDA) IMuneegl odw Mottling (Stmeturs, Stones, OWders, Conalatency, 96 Oravep letsyr � 54 C Parent Material woologio — ��"¢�je - --..� �•• •, Depth to (trove* = • Standing water ire the Hole: fa WeeAing from Pit Fsoe• }irnated Seeaonal High Qround Water:_ --�� _ l& APMOVED W6►M . 12MM FORM 11 • SOIL EVALUATOR FORM . Page 2 of 3 Location Address or Lot iqo:-/��.l�.c/ �m Owe 1�eyrQu, 'Deep Hole Number _ ` Data• ���`� �� /m: 40 o Location (identtfon site pian) ,C„sT WeatherC-- 60? �: Lend UseSlope {951 •..�..�,.... �.�... •, •µ,•.w. .n.. .. , w Z vegetation, Surface Staves ... . , . Landform Position on lands �i "" Y"� µ •- cape (sketch on the back) Distances from: ,Y. ,Y........, Open Water Body • feet Drainage way feet Posslblo Wet Area feet Property Line ... . • feet Drinking Water Weli�' �.vo feet Other . -- .v,.,. DEEP OBSERVATION HOLE LOG' Depth from Son Horizon Soll Texture Soil Color Surface (htohes) (USDAI (Munnelq p � �r 8 (Structure. Stonea,o � , Congist� % T /LL 1pelf� * 40 LC dye 04 11121 NPOS11, Parent Mete w (61e0199MBedrock- ~-'�" (19oth to OroerndwaterSternfing Water Mthe hole: - E$VmetW Seesonel NO Ground Water. -4 . Weeping from Pit Faae• -�' .o. Form No. 4 Town of North Andover, Massachusetts BOARD OF HEALTH 11 fern �Vx CERTIFICATE OF COMPLIANCE This is to certify that the Individual Soil Absorption Sewage Disposal System constructed ( ) or repaired by ; Y INSTALLER / /� at 3 1r� ar l 4t R A irate, /�J+ort, Ay\d0 de-,- ✓'' A SITE LOCATION has been installed in accordance with Board of Health Regulations as described in the Design Approval Site System Permit No. fir' // dated 19 The issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. BOARD OF H HT,4t&hIf:k4r _ _ ! - �-`\ ....,�' "_ � ���:._• _ _�� �-��.�`J.��. _ It �• � �..--�� i�.`��� Nil\ %•i}�.4�ll� ��i �:_ � ..�. :kV�v• .�}.� J -ice- n <•�'` •�N 1"M�� - • . TOWN oF NORrfIJ ANDOVER SF VACYr' .�I: DISPO�SY'S`�E\-I I_ STALLA-rloN CERTIFICATION i The underswned !lerei-N eerily that the `ewaLc Disposal System. ! co: Sl:.lc.(: d. located at ,3 7 C AjqjTbAj t-eA/r2n-1b�NP6. �i _ was installed in cbrdumance with the Noah A_ndover Board of IieJth a-Jproved plan, Svstem Design Pe: -nit dated. a , an srcroved desi-n flow of gallons per day The mate a:s use- were in conformance :vith those specified oh the approved plan; the system was installed in accorddre_ ,,.ith the previsions of 3 10 CN,,fR 15.000, Title 5 and local re�uiatiors, and the final uadirg agrees substantially with the approved plan. .0 work- is accurateiv represented :)r, the As -built %vhich has been submitted to the Board c: Hezilth P -ed inspection date: 7/2��0/ 6 d Enp-ineer Rcprt e ;hive. Final inspection tate 6///C)/ e o /'�L., Engireer Represe^tat_ve Installer: — c Date: Design Engineer: '� ��- Date--- R113HAR� • � TANGARD € Tr CF Ps"."rH _9 NAL t a ' - C3 2001 R AS -BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS & DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES "'THIN 150' OF SYSTEM --ATION OF WATER, GAS, ELECTRIC LINES, CABLE TANCES-FROM CORNERS OF HOUSE TO CENTER OF 1K e -BOX GINAL TAMP & SIGNATURE IMPERVIOUS AREAS - DRIVEWAYS, ETC. _ NORTH ARROW LOCATION & ELEVATIONS OF BENCHMARK USED A INSPECTION CHECKLIST FOR SEPTIC SYSTEMS A. Bottom of Bed 1. Excavation to proper depth 2. With trenches, sides of excavation are beneath B horizon 3. Edge of excavation specified distance from foundation, etc. Comments: B. Retaining Wall 1. Wall height and ids th as speci 2. Waterpj�qed- 3. Wall inimum 10' to leaching 4. W_' meets specifications of pl C. Building Sewer 1. Pipe diameter minimum 4" 2. Schedule 40 pipe 3. Watertight joints 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8" per foot minimum 6. Pipe properly set on compact firm base 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90° change 10. 10' minimum offset to water line Comments: Yes NO Initials NAS D. Septic Tank 1. Level 2. 1,500 gal minimum 3. Gas baffle present on outlet y--' 4. Manhole to grade C Z--- 5. Manholes over center and each tee C acv G 6. 3-20" manholes v 7. Inlet tee minimum 12" under invert .i 8. Outlet tee minimum 14" under invert 9. Outlet line cemented 10. Air space 3" above tees 11. 2" - 3" drop from inlet to outlet 12. Pipe set 13. Compact base with 6" of 3/4" crushed stone under tank 14. Tank is watertight Comments: Yes NO E. Pump Chamber 1. If separate from tank, compact base with 6" of 3/4" 2. Minimum 2" pipe to d -box if gravity syst 3. 20" access manhole 4. Tank level 5. Watertight 6. Tank size agrees wi an specification 7. Manhole to gr 8. Check val and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d -box Comments: F. Distribution Box 1. D -box level ✓` 2. Minimum 0. IT' (2") drop from inlet to outlet v 3. Minimum 6" sump ✓ 4. Outlet pipes show equal distribution 5. Compact base with 6" of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double -washed - 3/a" - 1 ''/z" - pea stone Bucket test done? 2. Minimum 2" of pea stone above distribution lines 3. Minimum 6" stone beneath pipe 4. Distribution lines capped o �on�nected ether o j c 75. Grading meets 3:1 slope 1Q0 6. Minimum of 9" of fill graded over system 7. Toe of slope stops minimum 5' from edge of property; if not, then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan - Minim ', aximum - 4'. 4. Vent present if <50 feet or specifi 5. Distance between trenche Unum 4' and maximum of 6' 6. Minimum distan een trenches 10' 7. Pipe s mimum 0.005 or 6" per 100' 8. Depth of trenches below outlet invert minimum of 6. 9. Pipes set on Comments: base. Yes I. Leach Field 1. Maximum length of field 100' — 2. Pipe slope minimum 0.005 or 6" per 100' 3. Separation between pipe 6' maximum �- 4. Pipes connected at end r/ 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line �-- 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: I Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Side 11 be 12" and 4. Access oles on each// 5. Pine emented with hvd wide K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9" soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond M W C 2 Z O O i '- E w LO J V1 L LL �( w D :l S N W \ = O m D � c o W ro Z Q N Z Q v 2 f- L. ro v tA u o J N L ce Q w Q 2 N o O Q c LL b0 c O O ` y Q Q U Q -C N ce Y a� Z m O o c tA a c b N ro E w i o (A Q L V) N •x* C '�' p�Ea f0�.�p U O Q hMpy *i Q (n d V) LL INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at Q��U*ot-,n� k__Qe\,p relative to the application of dated k for plans by and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable. 2. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed Septic Installer Date: L);E)"� 5► Disposal Works Construction Permit # BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: (,— I;:) -C\ CURRENT INSTALLER'S LICENSE# LOCATION: LICENSED INSTALLER: -F— � P-'�Q� �\ *11 SIGNATURE: TELEPHONE# �►�-lfl.j "� CHECK ONE: REPAIR: � NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS -BUILT. $160.00 Fee Attached? Foundation As -Built? Administrative Use Only Yes No Yes No Floor Plans? Yes No Approval��j ct r L JUN l 2 2001 Date: ��� Town of North Andover, Massachusetts Form No., NORTN BOARD OF HEALTH ,O ��S lEO 16 tiO 4 Co ^ " APPLICATION FOR SITE \ TESTING/ INSPECTION Applicant NAME 'CDDRESS TELEPHONE Site Location d Engineer A E %ADDRESS TELEPHONE Test/Inspection Date and Time _74 CHAIRMAN, BOARD OF HEALTH Fee Test No. S.S. Permit No.AYX D.W.C. No._C.C. Datev% Plbg. Permit No. BOARD OF HEALTH t� NORTH ANDOVER, MA 01845 978-688-9540 ey APPLICATION FOR SOIL TESTS DATE: `1 _l MAP & PARCEL: )c. c-, C LOCATION OF SOIL TESTS: OWNER: /0, G' �_. TEL. NO.: ADDRESS: ? C A a t, -T,), -- ENGINEER: ENGINEER: f�l`e w L^,�;C. �t�C CG t2�w(r TEL. NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential Subdivision Single Family Home Commercial Is This: Repair Testing: Undeveloped lot testing: In the Lake Cochichewick Watershed? Yes No ✓ THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership (Tax bill, or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of $275.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $75.00 per lot for repairs or up rades. 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 I"-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: % (CN A) -- Date Received: Check Amount: Check Date: i. .: l� � � ; � �. .. :, 744 imp I -M �INI�II _ f 4.3--f..z� .may �_-C,OL=, i ICON i =S i I �; I Ez G I l� IM'J C I r= C I I 1_ � 4 I I N I r ;2.7 TNI ` n �. C- T illvi� T; IV A� iC n — 4 AAYY LCD C^ -10N: 41r i I N - E71.1l7 2 COL i ION iE i = ZG I 1 01y 7 1 , ill�lE..i :! • r -7 0�,'`=;VIS 10 N, 1- 00L -fir -:ZT al • o�j IINI=r.i ._ j 10 cot l i - ;, Z� 0L n, l ICON I I WE C, 3�0 Of IN ` 7; T LE01 II/Vi i N=" ift =, :C0L 4. i 10 i E Si = -- -- �C' I i 0Ni Jam- i„ C'r r_, C I �� I : ��` •.i"1 C"' i ( 11 TI NI E lC. J NEW ENGLAND ENGINEERING INC North Andover Board of Health Town Hall Annex 27 Charles Street North Andover, MA 01845 RE: TITLE V REPORT: 37 Carlton Lane, North Andover Dear Sirs: SERVICES February 15, 2000 Enclosed is a copy of the Title V report for the above referenced property. The systemap sses our inspection. If there are any questions please call me at my office, 686-1768. Sincerely Benjarhin C. Osgood, /IT. President _ 60 BEECHWOOD DRIVE -NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645- FAX (978) 685-1099 CbMMONWEALTH OF MASSACHUSETTS , EXECUTIVE- OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL MTF.CZZON ONE WINTER STREET, BOSTON MA 02108 (617) 292-6500 ARGEO PAUL CELL�CCI Governor • SUBSURFACE SEWAGE DISPOSAL SYSTEM-INSPECTION FORM PART A CERTIFICATION Property Address: 3 7 C t(ZL IJry J_Aj, 1U . igAjbc) j&C Name of Owner 21 1 c l {fi fL0 l�av�C t' 1 Address of Ownw:-3'7 r AeLTyN- L/� , AV _ AND Date of Inspection: Z ) 10 ! Oo Name of inspector: (Please Print) Benjamin C. Oagood,Jr. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310-CMR 15.000) Company Name: New England -Engineering Services Inc. MaXng Address: 60 Beechwood Drive North Andover, MA Telephone Number: 978-686-1768 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 Eveluation By the Local Approving Authority _ Fails Inspector's Signature: Date: / r The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)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*Environmentaf Protection. The original should 'be sent WtW system owner• and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page IofII A C.� Printed on Recycled Pape, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART•A Property Address: 37 Carlton Lane CERTIFICATION (fie North Andover, MA Owner; Richard Dooley Date of inspection: 2/10/00 INSPECTION SUMMARY: Check A, B, V, or D: A� SYSTEM PASSES: j have not found any Information which indicates that any of the failure conditions described in 310 CMR 16.303 exist. Any failure' criteria not ovalated are indicated below. COMMENTS: 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. Indicate yes, no, or not determined (Y. N, or NO). Describe basis of determination in all instances. If "not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the Inspectioh; or the septic tank, whether or not metal, is 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 complying septic tank as approved by the Board of Health. _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipes) 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 pumpirtMore thaniour'times n yeardue to broken or obstmcted pipe(s). The system V91111179as" inspection If (with approval of the Board of -Health): broken pipe(s) are replaced obstruction is removed revised 9/2/98 Page 2orIt "A ..l A......_..... . .... ' f a.Nby 2f rtiRst RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A Property Address: 37 Carlton Lane CERTIFICATION (continued) North Andover, MA Owner: Richard Dooley Date of Inspection: 2/10/00 ' -sa C. FURTHER E -11LUATiON IS REQUIRED BY THE BOARD OF HEALTH: CoAditiohs exist which require further evaluation by the Board of Health in order to determine If -the system Is fatting to protec't'Wl • public health, safety and the environment. • •.• r •,;, i 1) SYSTEM WiLL PASS UNLESS BOARD OF HEALTH DETERMiJES IN ACCORDANCE Wi7H 310 CMR 16.303 (1)(b)'THAT THE .'SYS: IS NOT FUNCTIONING iN A MANNER WH•ICt y=rRQTfCT• THE PUBLIC HEALTHAND SAFETY ANI2 THE EKWONMEHL. Cesspool.or privy is within 60 feetof 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 ANY) DETERMINES -THAT THE SYSTEM LS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 aseptic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well: _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 60 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. Method used to determine distance - (approximation not valid). 3) OTHER revised 9/2/98 Par 3ofit �f y. • SUBSURF�ICE SEWAGE DISPOSAL SYSTEM pVSPECTION FARM j i PART A CERTIFICATION (Continued) ' Property Address: 37 -Carlton Laae North Andover, MA Owner: Richard Dooley Date of Inspection: 2/10/00 D. SYSTEM FAILS: ' You must Indicate either -yes" or "No" to each of the following; I have determined that one or more of the following failure conditions exist as described In 310 CMR 16.303. The basis for thli determination is identified below. The Bpard of Health should be contacted to determine what will be necessary to correct the failure. Yes No. "Backup ofsewage Into 4acili"-erytemcomponent-cluetto an overloaded orciaggdd"S•or"sspooI. ' 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 then 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 porion 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 60 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 -cotiform bacteria, volatile organic- compounds• ammonia nitrogen -and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 1:0,000 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: Yes._ No the system Is within 400 feet of a surface drinking water supply the system-la-wltl4n200 (eat-0f-e44butary4oesurf000.ddnk4oy.wata oupoy-... -- — the system Is located in a nitrogen sensitive area (Interim Wellhead Protection Area ; IWPA) or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further Inforptation. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 37 Carlton Lane North Andover, MA V - Owner: Richard Dooley 1 • c"� Date of Inspection: 2/10/00 t Check if the following have been dodo: You must indicate either 'Yes" or "No" as to each of the following: ! Yeses. No I Purhping information was provided by the owner, occupant, or Board of Health. t }z •'^ ' — :None of the syctem,compopartic.{wual>wn pnatipsdLfnr+Rlaast two•a+ve&ks and•the'tryetem hasbweaseataiwg rwwcal J(ow v��;«�• rates during that period. Large volumes of water have not been introduced into the system recently or as part of'this Inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. _ -The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-senitary or industrial waste flow. _ The site was inspected for signs of. breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The 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. The size and location of the Soil Absorption System on•the site has been determined based on: _ Existing information. For example, Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C Is at issue, approximation of distance is unacceptable) / 115.302(3)(b)i The facility owner (and.occupants.if different tram outnet).wete,pro�ddad.wiih InformedotLan f• SubSurface Disposal Systems. revised 9/2/98 Pate 5 of 11 Property Address: 37 Carlton Line North Andover, MA Owner. Richard Dooley , Date of Inspection: 2/10/00 FLOW CONDITIONS RESIDENTIAL• Design flow: -,SO g.p.d.lbedroorri. Number of bedrooms !(design): -y— I ' Number of Bedrooms (actuaq� . Total DESIGN flow '00 P-0, Gh2mber of current residents: Z rbage grinder (yes or no):" Laundry (separate system) (yes or no):N0; If yes, sepaaate.inspaction-riqulred Laundry system Inspected (yes or no) Seasonal use (yes or not:�O Water meter readings, 0 available (last two year's usage (gpd): Sump Pump (yes or no):_ Last date of occupancy:_c COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: qpd ( Based on 16.203) Basis of design flow Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)— Non-sanitary waste discharged to the Title 6 system: (yes or no) Wpter meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: • Dr- N00 l q PP/2 O(A)AlCC System pumped as part of inspection: (yes or no)QLO If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM _ Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) Of yes, attach previous Inspection records, if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date Tnstalled{if known) -and source ofiitformetion: -- w---- - - Sewage odors detected when -arriving at the she: (yes or no) A�J revised 9/2/98 Page 6ofII i • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM j PART C Property Address: 37 Carlton Lane SYSTEM INFORMATION (continued) North Andover, MA Owner. Richard Dooley Date of Inspection: 2/10/00 BUILDING SEWER: (Locate on site plant Depth below grade: Material of construction: cast iron Z40 PVC other (explain) Distance from private.water supply well or su tion line Diameter Comments: (condition of Points, venting, evidence of feakage,-eta) 1-DO/iS &co D muR/r%S�g—:- -7T SEPTIC TANK•_ (locate on site plan) r Depth below grade: �• Material of construction: VI - Material _metal _Fiberglass _Polyethylene _other(explain) If tank is (natal, list age _ 1s.age.confirmed by Certificate of compliance _ lyesinoi Dimensions: ,�Or, G7�LLOrV Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: I Al u Distance from top of scum to top of outlet tee or baffle: �z_ Distance from bottom of scum to bottom of outlet tee or baffle:_ How dimensions were determined: 1I4gA5L 2E STic fG Comments: (recommendation for pumping, condition of inlet and outlet tees or -baffles, depth of liquid level in relation to outlet invert,• structur"tegrity, evidence of leakage, etc.) 3&A)A / /U 6-0o,->e'ON A /7)0AA (r�,.�c i2 GTF GREASE TRAP - (locate on site plan) Depth below grade:_ 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:bbttom of scum to bottom of outlet tee or baffle: Date of lest pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of Gquid.level In relation to outlet Invert, structural Integrity, evidence of leakage, etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOgM PART C ' I SYSTEM INFORMATION (continued) Property Address: 37 Carlton Lane North Andover, MA Owner. Richard Dooley Date of Inspection: 2/10/00 TIGHT OR HOLDING TANK;[ R(Tank must be pumped prior to,'or at time of, Inspectlon) (locale on site plan) Depth below grade:_ Material of construction: _06crete _metal _Fiberglass _Polyethylene _other(explein) Dinteni)ons• Capacity: gallons Design flow: gallons/day . ........... Alarm present Alarm level: Alarm In working order: Yes _ No_ Datil of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX-jaox % -S -Ce e 7 - (locate (locate on site plan) Depth of liquid level above outlet invert: Comments: (note If level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) — - — &PA /ti eIv^1101 T70/✓ '-01ZR r2,9<14ED, 9rPI-ecCo ifs" )A) -SF C-1211It/ Dcsi2115v77 .v norfL /t/,p Z eA A 11G -E IR Qdl 6,7.,4r _Snr_►o5 Cb09 21LyvL)F_9- PUMP CHAMBER.A A (locate on site plan) Pumps In working order: (Yes or No) Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) revised 9/2/98 Pate a of 11 Property Address: 37 Carlton Lane North Andover, M Owner. Richard Dooley Date of Inspection: 2/10/00 n C.18"^"BFACE SEWAGE DISPOSAL YSTEM INSPECTION FORM PART SYSTEM INFORMATION (continued) A 7 SOiL ABSORPTION SYSTEM (SAS): ' (locate on site plan, if possible; exci vntion not required, location may be approximated by non4n.truslve methods) If not located, explain. E Ty e: leaching pits, number:_ leaching chambers, number:_ ` leaching galleries, number: ' leaching trenches, number, length: , t leaching fields, number, dimensions: I rlaID e,s = / 4170 saFIT- overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) 6A D s VS ZE41 SNuI.�✓ r�7cllsYL� �= - CESSPOOLS: &/*Or (locate on site plan) Number and configuration: Depth -top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensloh's 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 she plan) Matedals of construction: Dimensions - Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation; etc.) revised 9/2/98 Ngt9ofit 1 +Yf SUBSURFACE: STAGE DISPOSAL SYSTEM INSPECTION FORM III PART C SYSTEM INFORMATION (Wntinus(il Property Address: 37 Carlton Lane North Andover, MA Owner: Richard.Dooley Date of Inspection: 2/10/00 ;SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least tko aermanent reference landmarks or benchmarks locate G revised 9/2/98 Page 10 of II S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FgRM PART C i SYSTEM WFORMATION (continued) Property Address: 37 Carlton Lane North Andover, MA Owner: Richard Dooley Date of Inspection: 2/10/00 NRCS Report name spry Q., eY ; �'ssL- x C,�,N?( MiF53 ►`� 144 E Tl3 X012 7N COA/ t� Soil Type_ C Z(z vr�N i Typical depth to groundwater i USGS Date website visit d Observation Well checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water iv„ N e Check Cellar N,., Sv�� Shallow wells NUNS Estimated Depth to Groundwater 0 Feet 3 i 15do✓ Lec.- be Please Indicate all the methods used to determine High Groundwater Elevation: Obtained from Desigri Plans on record Observed.Site (Abutting property, observation hole, basement sump etc.) Determined from Iota( conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers _ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) w�..ie(�� � d(cY r /L 8 — (� b (�...,. yro�nc./ ySlew, JIAs �ec.� revised 9/2/98 Page 11 of 11 L it A �4 4�. •s I! Q �,.OT Z-5 f% 50%YT Z, S.F. L � Z�- o ;...� �c A. j. to f � L NILUAAI - � C"... S OO 64,&L ., 6a PTIC, TA," IC. hl.1L P SPE NTlO i"Ah11 _ _ �L e-�e —•— _ _ . _ _ _ _ '' C F -�^ i , `!. I q• �. �l� t..t o PIP r - r.. �►j i ^ : �) �'�'�,,.`- � j""�3 ,� �. , x^*S <- •�^a,. , . �, '� "�C�E;'. QX _ ► X18mo POPE, A`1..11 Pte. QI.�T DD P�[�X 0 14g� Z ;N F -� e.h, t._:e t = 4l.� PAT , 4 14/8 e ,�t�►AC U P r is s t, K..; ,6 A,1>50 C)'aT c_ . � �.1 G 1 b.t is E �. S y !, � G t -=t t T E. G'T' S x.1.....1 N 1� P 1,. �. t.� �,;�: i (''. S ` ,(a, s.; p .i U �'_ �✓ Er 'f C] 2..5 NOWT N ,Ly` . ►�ICr'O .r� F� iG. C� F � �C.�. PLS tc k� t+�C T1 t �ti �Gv 'm,6.. G z h H x W EXISTING 0 Z 0 A O J A h 3¢ zLo L.J A to J z r,% z 3" Z F --A h � Q W z W Q W v Lo C3 "max Q p � Q3m PROPOSED Q z 9 QZ W®1 w Sow �L o a. i zQ'U ❑ Q . I j~~ �j i LDC iz o 3U Lo 3 I - no, 0-19 .0-,9 z HqJ _ Z w w�Q `0 3 3 I i` > _ LLJxoi �W= H St. v W H U • W W c I—piz¢ a_ Z W L---1 AcaQ<Wly 3 _ Li o ®® Le—& Dc L3 NWQ oZ a �- `"zLi � o, = z zz n I ®® �[ of �'¢ 3W� Q W w o W LIJ o � CY�A m I A to ❑ W 3Q U wa H Q F W Q 'X O U- z C3 Q p ui z -1 2: ., l7 U —� N F— Q �z� U SF W 0 Q JRaF-v Q A =)WL3 Q3z O 3z� z3w z 9 QZ W®1 w Sow �L o a. i zQ'U ❑ Q . I j~~ �j i LDC iz o 3U Lo 3 I - no, 0-19 .0-,9 z HqJ _ Z w w�Q `0 3 3 I i` > _ LLJxoi �W= H St. v W H U • W W c I—piz¢ a_ Z W L---1 AcaQ<Wly 3 _ Li o ®® Le—& Dc L3 NWQ oZ a �- `"zLi � o, = z zz n I ®® �[ of �'¢ 3W� Q W w o W LIJ o � CY�A m I U Q C3 Q W N �z� F- Q Q A z �— z > W 0 F > } rx z Q o U W Qom❑ � ' =mz U H z 9 QZ W®1 w Sow �L o a. i zQ'U ❑ Q . I j~~ �j i LDC iz o 3U Lo 3 I - no, 0-19 .0-,9 z HqJ _ Z w w�Q `0 3 3 I i` > _ LLJxoi �W= H St. v W H U • W W c I—piz¢ a_ Z W L---1 AcaQ<Wly 3 _ Li o ®® Le—& Dc L3 NWQ oZ a �- `"zLi � o, = z zz n I ®® �[ of �'¢ 3W� Q W w o W LIJ o � CY�A m I t O t ;t- K)P 50�77Zr• S.F. _ ��� ' *' ol ML11012 9051' , a � r � � � 1.•. e •} 1 .,rt a :t sat v .x � LN.�L�Ih a Mt Pi 14, L-2t A'4 4 od'4 i t tr t s Y 4 i u '�',: `G. '',�• � r,�l. � y .'.� ' t i yr ` • - _ y gG` }U "pEa� ,r t - tom' s t, � i nV��'� H. w.1 i�+�4�✓�. �h"(�fY !'1,+,1y�a'• 7"_�R+�,, t M !Y 1� t. t t � � -.f .. , 1 i •:1:' a' , f ) C rl 1 N ij t - {. ., � i i t 1 k .} ., r }i. � 1 1. p 1 '<Rri� i ti4i � u'� l;'t l"'•r ff„ .. ' '1 ♦y y ','���,:. {' 7 )! � Z t-♦ , Rf r„ ) r•- ry y.>. - l r� . f 1'T k l (,. -,+ ^Z, ' ::� ��!s' .?�`),, '4y 5 ra°j it4tt �,f..!` 1 , �.' ' 41..,,.''. r.15:��'1 _ �.>_t�:.. �. r, __ ,. r, �. i.�iF.)-..♦.:k '.":. as.�. .r *, �. t1 ��` 'a" i ,'. „�. i�ta��="4!'� .t. , \