HomeMy WebLinkAboutMiscellaneous - 37 STONECLEAVE ROAD 4/30/2018 (2)0
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' ORTH A14DOVER BOARD OF HEALTHe7A��'
--
PPR0�1ED Dk`i'E PROVIDED) DISAPPROVED DATE TIME REASON
\ 71/ / ` . 114 c 4
Titlev 5
Reg. 2.5 IF
Reg. 6
ail
e submitted plan must show as a minumum:
s -5'
(a) the lot to be served (area, dimensions, lot //,abutters)
(Planning Board -files)
-(b) location and log of deep observation holes -distance
to ties
(c) location and results of percolation tests -distance
"� to ties
(dr)& calculations showing required
design calculations
_leaching area
(e) location and dimensions sf system (including reserve
area)*
existing and proposed contours
(( g) location of any wet areas within 1001 of the sewage
disposal system otr disclaimer (check wetlands mappinf
(,h) surface and subsurface drains within 100' of sewage
/ disposal system or disclaimer
(i) location of any drainage easements within 100' of
�,- sewage disposal system or disclaimer (planning board
files) -
j) known:- sources_ 200' of =eater supply- within of sewage
dispbsai_-.system_ o -r --_disclaimer --
.(k .location- of any Troposed-well to serve the lot (100'
from leaching facility)-
.(1) location. of water lines on property (10' from -leach!
facilities) —
m location of benchmark
n) driveways
garbage disposers
�q�no PVC is to be used in construction
a profile of the system (elevations of basement, ply_
pipe septic tank, distribution box inlets and outle`
distribution -field piping and any other elevations)
(r) maximum ground water elevation in area of sewage dig
� system
0,1 s) plan must be prepared by a Professional Engineer or
other professional authorized by law to prepare sucl
plans
Septic Tanks
(a) Capacities -. 150% of flow, water
of tees, access, pumping,
,.fib Cleanout
�c 10' from cellar wall or inground
d 25' from subsurface drains
table, tees, depth
swimming pool
Y\UL- LCY aiLIXJ.0 V KaL' a."W G-.
INSTALLATIal CIM�A LIST
ea�sonst�
LOT
'XCAPM04 VNFAIL
D?AILV
OK
Distance To:
. Wetlands
b. Drains
-
c. Well
t
2. Water Line Location
ipe
3 - No PPC. Pipe-
4. Septic Tank
4.-
a. Tees -- _Length & To Clean Out Cogs -
b. Cement Pipe to Tank - Cn Both Sides of Tank -_
5. Distribution Box
a. Covers & Box - No Cracks
b. All Limes Flowing Equal Amounts
j
c. No Back. Flow _
6.- Leach Field or Trench
a. Dimensions
b. Stone Depth
c. Capped Ends. I
d. Clean Double Washed _Stone
7• Leach Fits
a. s _
!
b. th
rStozznDep
c• ds
d.
e. pe to Pit - Both Sides
f. ble Washed Stone
8. No Garbage Disposal
i
9. Final Grading Inspection
14.- Barricading Covered System
I
-
U. As Built Submitted
^ ,
a. Lot Location
J
f b. Dimensions of System
C* Location with Regard -to Perc Test
E
d. Elevations
r
e: hater Table -
,r
E
.E
E
i
h',',! 0 14 m E' 3T DATA SOIL P'ZOF LE & PhIRUOIJ
'R n n, rl of UnnI i -Ii.
Ili v J. OL,-) 0
Street Lot No.
S,
ubdivision 0 vin(� r
Ob:;
Date*
7117
2.
E 1 e v
T n c hi e, s
SOIL PROFILES
Dat e.—.--- 3. Date..
Elev. Elev.---
I
t;e: Top & subsoil depth;
depth of refusal.
depths of othe'r Soil types;
4._ Date
Elcv____
Ties to Test Pits
1.
2.
4.
depth of water table;
PEIRCOLA'I'lON ']PESTS
Date 'ate Date Date
Date
-)it Number r 2 4
5
Mart
Saturation
3tart
Tes j j -g
t Te
Drop
0 311- I!-, me
-1--oP-,Of
6" P ilite
-
St 5" f)(,-C)T)
Late
-
n
SO11., 111�0FILE-k-PE WOLATION TEST DATA
Board of Health--Noril-h Andover Mass,
Street
Lo' No.
Subdivision'
Investigato-r W,�,G ^ . ____
Observer
SOIL PROFILES
ilate 2. Date
u 3. Dat e, 4.
Ylev. Elev.--- Elev.
10 e 0 t Inches
0 0
I OL--
iote:
2
8
2
84
Rol
20
Top & subsoil depth; depths of othe*r soil types;
depth of refusal.
PERCOLATION TESTS
Pit Ni
Start
ak-
T3 o
Mins.
Mins.
Date
Elev.--
Ties to Test Pits
2.
3.
4.
depth of water table;
Date Date Date Pate nate
,mber
2
3
4
Saturation
lins.
Test–Time —T --
if 3"–Td�me
if 6—" VIi i-ri e
I s' J)roT)
r*
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cv
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3
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E.
0
rol
A
WELL DATABASE
E OF �N� : ,,�
AC ' �� 7i ALL
WELL LOC
A.r1oNN: �3 (MT,-
a=
MT 5 w/
_-TSE OFWE, DRILLS b. DUG
aFA�E.RIN Races
_ _ EICEaI�I�f� �V LT' . _ • _
ACE OF W=' -L:- + WEE=
WELL PERi�rl�',-r: WLi.L LO.CATTIO?
WEi L PEI s D�_ DEETr 0'r w= l I
TYPE OF TELL: a. DRILLED b. DUG
TYPE OF WA=R EA:.RIL\iG ROCK:
WATER A`+=• YSIS DATE': PEGk ?�fAsVGA'vESE
NDGH LRON: Y N 0TN�R C0NTAYM, 4ANiTS: Y
N
JVStem
FORM 4 - SYSTEM PUMPL'�G RECORD
Commonwealth of Massachusetts
/tr -� I,Pllvt�. , Massachusetts
System Pumping Record
weer ystem ocatton
lk'4 1v p ve
f1v(tee. f U4
T`, Pi Emergency ❑ Routine -0�
LIM,4 -Q `1
P
❑ No Ye_
Cesspool. No ❑ Yes S� Ptic Tan}:: e C -c
6-15Date of Pumping:
"-1 I Quandt, Pumped: %� _ gallons
Pumped b Com anv): �� cZefC�s 5c 4 Permit
�� stem rump y ( �
Contents transferred to:
Contents disposed at:
er (.vyr (k/m C t
nate�i f Cl'�� Pumper Signature
Condition of system other comments:
/,-,o C- d
6;
DF—P APPROVED FORA 1:107195 JU� w 200
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