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Home My WebLink AboutMiscellaneous - 420 GREAT POND ROAD 4/30/2018 (4) r 420 GREAT POND ROAD �+' 6 G'i 0 Pf 10R7.,y O • Town of North Andover HEALTH DEPARTMENT ,SSACM�St4 CHECK#: DATE- 5[�?Jjq LOCATION: Ulm! H/O NAME: CONTRACTOR NAM& I(IA' l N) Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing $ ❑ Septic-Design Approval $ ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ Other:(Indicate) $ 1 / . V 1 01-2 Health Agent Initials White-Applicant Yellow-Health Pink-Treasurer qAo �Ye �Y � Town of North Andover Pursuant to Policy &Town Bylaw Chapter 161-3 Street Excavation permit (as amended) With PERFORMANCE BOND AGREEMENT AND The Commonwealth of Massachusetts Jackie's Law—Trench Permit Pursuant to G.L. c. 82A§1 and 520 CMR 14.00 et seq. (as amended) PERMIT APPLICATION — Street Opening Permit Wor Trench Permit Permit Number: Applicant: East Coast Excavating Inc. Dig Safe Number: 20142113672 Date Issued: SITE EMERGENCY CONTACT: EMERGENCY NUMBER: 508-328-7267 SECTION 1 -SITE INFORMATION-PRINT OR TYPE IN BLUE OR BLACK INK 1.1 Property Address: 1.3 Description, location and purpose of proposed Pump Station, Riverview and N. Main St. street opening and trench: use back of page if needed Test Pit for Plant Water Leak 1.2 Map/Parcel Number: Builder's Lot No: Block: 1.4 Anticipated D to to Begin Operation Begin: �/� �c End: GIS Property ID: 1.5 Anticipated Date to Conclude Operations Provided by the Town t SECTION 2 - PROPERTY OWNERSHIP AND PERMIT HOLDER INFORMATION-PRINT OR TYPE IN BLUE OR BLACK INK 2.1 Owner of Record: GLSD-North Andover, MA Printed Name & Address Signature Telephone 2.2 Excavator Permit Holder Information: Michael Alesse P.O. Box 95, Groveland, MA Printed Name1/ & dress ky 508-328-7267 Sign Telephone / Emergency Contact Number 2.2 Excavator Permit Holder Information-continued 1 I Competent Person as defined by 520CMR 7.02 Michael Alesse Printed Name: Massachusetts Hoisting License#:HE-104377 License Grade: 2A License Expiration Date: 0612014 2.3 Name and Contact Information of Insurer: Gerald McCarthy Insurance 92 North St., Salem, MA 978-744-6433 Company Name Address Telephone Insurance Certificate#: Policy Expiration Date: Whereas pursuant to the provisions of Chapter 161 Section 161-3 of the North Andover Town Bylaws, the grantee agrees to provide a plan and a bond in the sum of $10,000.00 bound unto the Town of North Andover and an additional refundable amount of $ to assure proper performance and completion as defined in the general specifications and conditions below and as attached. By signing this form, the applicant/excavator and owner, acknowledge and certify that they are familiar with, or, before commencement of the work, will become familiar with, all laws and regulations applicable to work proposed, including OSHA regulations, G.L. C. 82a, 520 CMR 7.00 et seq., and any applicable municipal ordinances, by-laws and regulations and they covenant and agree that all work done under the permit issued for such work will comply therewith in all respects and with the conditions set forth below. The undersigned owner authorizes the applicant/excavator to apply for the permit and the excavator to undertake such work on the property of the owner, and also, for the duration of construction, authorizes persons duly appointed by the municipality to enter upon the property to monitor and inspect the work for conformity with the conditions attached hereto and the laws and regulations governing such work. The undersigned applicant/excavator and owner agree jointly and severally to reimburse the municipality for any and all costs and expenses incurred by the municipality in connection with this permit and the work conducted thereunder, including but not limited to enforcing the requirements of state law and conditions of this permit, inspections made to assure compliance therewith, and measures taken by the municipality to protect the public where the applicant owner or excavator has failed to comply therewith including police details and other remedial measures deemed necessary by the municipality. The undersigned applicant/excavator and owner agree jointly and severally to defend, indemnify, and hold harmless the municipality and all of its agents and employees from any and all liability, causes or action, costs, and expenses resulting from or arising out of any injury, death, loss, or damage to any person or property during the work conducted under this permit. In Jness wh re f those signed below have here unto xecute t is reement. A A RE Date C VATOR SI ATURE Date OWNER'S SIGNATURE(IF DIFFERENT) Date F Zity/Town us r o not write in this section PERMIT APPROVED BY r PERMITTING AUTHORITS' Date ACp° CERTIFICATE OF LIABILITY 706/28/2014 E 1MAtvDmmI �-- INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcylies) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: (978)7445+133 Fax.. (978)744.3575 CONTACT Deb Tournas NAME_ GERALD T MCCARTHY INSURANCE AGENCY,INC PHONE 92 NORTH ST i c,NOLE� (978)744-6433 Nat, (978)744-3575 E-MAIL .. P O BOX 839 ADDRESS: debbiet@gtmccarthy.com PRODUCER . . ._ _. - SALEM MA 01970 cus?oMER to._2448 _ _ INSURER(S) AFFORDING COVERAGEINSURED M NAIC EAST !� AST COAST EXCAVATING INC INSURERA Arbella Insurance Group E P 0 BOX 95 INSURERS Arbella Insurance Group GROVELAND MA 01834 IN$URERC AIM Mutual Insurance Company wsURERO Arbella Insurance Group INSURER E INSURER F ' COVERAGES CERTIFICATE NUMBER: 26183 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLW51QNS AND CONDITIONS OF SUCH POI-ICIES.LIMITSAHnWN M6Y HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADD'L SUER POLICY EFF POLICY EXP LTR _INSR,VNO POLICY NUMBER _IMM ODmrY) tMMroD LIMITS _.. _�.. ._ NYM ., _ A GENERAL uaealTY 8500048539 10/02/13 10/02/14 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 04"oe To REnirEo PRSMIS9S Ee,o=en¢e) 5 100,000 CLAIMS MADE X OCCUR MED.EXP(Any one person) $ 51000 PERSONAL&ADV INJURY _ S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPtOP AGG $ 2,OOO,000 X POLICY PRO- _ LOC JECT. -- .AUTOMOBILE LIABILITY _ $ 1020005717 09114113 09/14/14 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) ' 1,000,000 ALL OWNED AUTOS BODILY INJURY(Per person) S X SCHEDULED AUTOS e61LY INJURY 1Per accidents s X HIRED AUTOS PROPERTY DAMAGE__ - _ (Par accident) $ X NON-OWNED AUTOS -- S 5 D UMBRELLA LIAR —-_ --. — .... OCCUR 460004$541 10/02/13 10/02114 EACH OCCURRENCE S 1,000,000 EXCESS LIAR CLAIMS-MADE. �............. -- AGGREGATE a 1,000,000 DEDUCTIBLE S RETENTION $ C WORKERS COMPENSATION AWC40070001842013A 07113113 07/13114 X wocRVTi Mms.__ s AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERlEXECUTlVE """"" E.L EACH ACCIDENT 600,000 OFFICERIMEMBER EXCLUDED? NIA .._ $ if y S, (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S ._._ S00,000 II yes,CesrnCe unalr DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 5 600,000 DESCRIPTION OF OPERATIONS!LOCATtONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) LAND GRADING&EXCAVATING CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:LISA-HEALTH DEPT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVR,MA ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Attention: FAX 978 686-8476 ACORD 9) @1988- 09 ACOWYCORI The ACORD name and logo are registered marks of ACORD II rig !s reserved. TOWN OF NORTH ANDOVER DIVISION OF PUBLIC WORKS WATER TREATMENT PLANT 420 GREAT POND ROAD, 01845-2909 BRUCE D. THIBODEAU, P.E. DIRECTOR Dennis L. Bedrosian NORTH Telephone (978) 688-9574 Szrper iratendent Fax (978) 688-9575 O A RECEIVED �'ohieD nPPy,(� TOWN OF NORTH ANDOVER December 7. 2010 HEALTH DEPAR mw Susan Sawyer, Director North Andover Dept. of Public Health 1600 Osgood Street Bldg. 20, 2—36 North Andover, MA 01845 Re: Sodium Dear Ms. Sawyer, The drinking water supplier for the Town of North Andover is required to notify the DEP,the state Board of Health and our local Board of Health of our results whenever we test for sodium. This letter will fulfill these requirements. Enclosed is a copy of the report stating that the latest level of sodium in our drinking water which was collected on November 16, 2010, is 27 mg/l. If you have any questions or concerns please call us at 978 688 9574. Sincerely, Linda Hmurciak Assistant Superintendent/Lab Director North Andover Water Treatment Plant RECEIVED GROUNDWATER DEC `I U 2010 ANALYTICAL TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Massachusetts Department of Environmental Protection - Drinking Water Program S ------ Sodium Report Ll-..PWS INFORMAT10N Please refer toLLyour DEP Water Quality Sampling Schedule(WQSSj to help complete this form_ _ PWS ID#: $210000 City/Town: NORTH ANDOVER PWS Name: North Andover Water Dept PWS Class: COM M NTNC❑ TNC❑ DEP LOCATION 'DEP Location Name Sample Information Date (LOC)ID# P Collected, Collected By A 10280 WTP-FW ❑(M)ultiple ❑(R)aw 11/16/2010 Matthew O'Boyle ®(S)ingle ®(F)inished y B ❑(M)ultiple ❑(R)aw ❑(S)ingle ❑(F)inished C ❑(w)ultiple ❑(R)aw ❑(S)ingle ❑(F)inished D ❑(M)ultiple ❑(R)aw ❑(S)ingle ❑(F)inished Routine or Original,Resubmitted or if Resubmitted Report,list below _.._ - ..- -- — - --- - - Special.Sample Confirmation (1)Reason for Resubmission (2)Collection Date of Original Sample A ®RS ❑SS ❑Original❑Resubmitted❑Confirmation ❑Resample❑Reanalysis❑Report Correction B ❑RS ❑SS ❑Original❑Resubmitted❑Confirmation ❑Resample❑Reanalysis❑Report Correction C [IRS ❑SS ❑Original❑Resubmitted❑Confirmation ❑Resample❑Reanalysis❑Report Correction D ❑RS ❑SS ❑Original❑Resubmitted❑Confirmation ❑Resample❑Reanalysis❑Report Correction SAMPLE NOTES-(Such as,if a Manifold/Multiple sample,list any sources that were on-line line during sample collection). A B C D 1.11.ANALYTICAL LABORATORY.INFORMATIO_N Primary Lab MA Cert.#: M-MA-103 I Primary Lab Name: Groundwater Analytical,Inc. Subcontracted?(Y/N) F Analysis Lab MA Cert.#: Analysis Lab Name: SODIUM MCL MDLLab wethod'_ Date Analyzed Lab Result(mgfL) (mg/L) (rng/L) Sample 10# A 27 None 1 EPA 200.7 11/18/2010 137977-1 B None C None D None There is no MCL for sodium,however the DEP Office of Research and Standards has established a guideline(ORSG)limit of 20 mg/I based on an eight(8)ounce serving. All detections of sodium must be reported.Please refer to 310 CMR 22.06A for specific requirements. LAB SAMPLE NOTES A B C D I certify r under,penalties of law that f am the person Primary Lab Director Signature: authorized to fill out this form and the information contained herein is true,accurate and complete to the best extent of my knowledge. Date: 12/2/2018 If not submitting these results electronically,mail TWO copies of this report to your DEP Regional Office no later than 10 days after the end of the month in which you received this reportor no later than 10 days after the end of the reporting period,whichever is sooner. DEP REVIEW STATUS(Initial&Date) Review ❑WQTS Data ❑Accepted ❑Disapproved Comments Entered Page 4 of 17 r LIST OF PWS's IN YOUR.TO WN NORTHANDOVER PWSID SYSTEMNAME ADDRESS] ADDRESS2 TOWN STATE ZIP 3210000 NORTH ANDOVER WATER DEPT DPW 420 GREAT POND RD NORTH ANDOVER MA 01845 Thursday,January 11,2001 t 1 97& V•y. - V DEQE is NOW DEP THE DEPARTMENT OF ENVMIONMENTAI Daniel S. Greenbaum � (� O/sO> PROTECTION Commissioner (617) 935-2160 Division of Public Works RE: N. ANDOVER - Metropolitan 384 Osgood Street Boston/Northeast Region North Andover, MA 01845 310 CMR 7 . 02 - Plans Approval Application No. MBR-89-COM-139 FINAL APPROVAL Attention: Mr. Paul S. Niman, Director Gentlemen: The Metropolitan Boston/Northeast Regional Office of the Department of Environmental Protection (pursuant to Stat. 1989, c. 240, Sect. 101, " . . . the department of environmental quality engineering shall be known as the department of environmental protection" , hereinafter in this document referred to as the "Department") , Division of Air Quality Control, in response to a request dated December 7, 1989 and a supplement dated March 19 , 1990, has reviewed the information relative to the proposed installation of a new natural gas, emergency generator set at the North Andover Water Treatment Plant located at 420 Great Pond Road, North Andover, Massachusetts. The submittal bears the seal and signature of Alan M. Silbovitz, Massachusetts P.E. No. 30498 . This review of your submitted information by Department engineers indicates that the proposed 1075 kilowatt natural gas fired emergency generator set will be used to provide emergency power at the North Andover Water Treatment Plant. The proposed emergency generator will only be operated during emergencies and for normal engine testing and maintenance. The new generator set will consist of a Waukesha Model No. P9390GU engine and a Waukesha Model No. VHP950OG generator. The maximum energy input rating for the proposed Waukesha engine will be 11, 844 , 000 B.t.u. per hour. The normal fuel firing rate for the Waukesha engine will be 3754 cubic feet per hour of natural gas; natural gas will be the only fuel of use. Original Printed on Recycled Paper 5 North Andover Water Treatment Plant Page 2 The proposed Waukesha engine will also be equipped with a Donaldson Model No. TCU-12 exhaust silencer or equivalent for noise suppression. The products of combustion from the new emergency generator will be emitted vertically through a new 12 inch diameter stack. The maximum stack gas exit velocity will be 173 feet per second at 1190 degrees Fahrenheit. The height of the stack will be 6. 0 feet above the roof of the building, or 31 feet above ground level. The Department is of the opinion that the plans, specifications, and the Standard Operating and Maintenance Procedures pertinent to the submittal are in conformance with current air pollution control engineering practice, and hereby grants FINAL APPROVAL for the proposed installation, as submitted, with the following provisos: 1. ) That the Metropolitan Boston/Northeast Regional Office shall be notified in writing when the installation is complete, and the unit is ready for continuous operation. 2 . ) That the proposed emergency generator shall only be operated during emergencies and for a total of 2 hours per month for normal engine testing and maintenance. 3 . ) That the proposed emergency generator shall not be utilized in any energy assistance program, or as a peak shaving unit, unless the proponent submits a detailed Best Available Control Technology Analysis and is subsequently granted written approval to do so by the Department. 4 . ) That should any nuisance condition(s) be generated by the operation of this facility, then appropriate steps shall immediately be taken by the Town of North Andover to abate the nuisance condition(s) . 5. ) That the Town of North Andover shall maintain a copy of this Final Approval letter and the operations and maintenance manuals for the emergency generator at the facility. Failure to comply with any of the above stated provisions will constitute a violation of the "Regulations" , and can result in i North Andover Water Treatment Plant Page 3 the revocation of the approval granted herein to operate the described facility. This approval may also be revoked if the construction work does not commence within 2 years from the date of issuance of this approval or if the construction work is suspended for one year or more. For Air Quality Control purposes, an Environmental Notification Form is not required to be submitted for this project since it is categorically exempt pursuant to the Regulations Governing the Preparation of Environmental Impact Reports as adopted by the Secretary of Environmental Affairs. Please be advised that this approval does not negate the responsibility of the Town of North Andover to comply with this or any other applicable federal, state, or local regulations now or in the future. Nor does this approval imply compliance with any other applicable federal, state, or local regulations now or in the future. Should you have any questions concerning this matter, please do not hesitate to contact Mr. James E. Belsky, Air Quality Section Chief, Metropolitan Boston/Northeast Region, 5 Commonwealth Avenue, Woburn, Massachusetts 01801. Very truly yours, edward H. MacDonald Regional Engineer for Waste Prevention EHM/Emw/mw Enclosure cc: Board of Health, Town Building, North Andover, MA 01845 Fire Headquarters, 124 Main Street, North Andover, MA 01845 DAQC, One Winter Street, Boston, MA, 02108 - 8th Floor Weston & Sampson Engineers Inc. , 5 Centennial Drive, Peabody, MA 01960 ATTN: Mr. James Finegan -67-944648 THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF -= W PUBLIC HEALTH STATE HOUSE, BOSTON 02133 JMw 28p 1968 Board of Public 't"crks Re: 1d0�i i AMM-Public Cttr Sarth Andover Sum Approval of Plans 1%s=CbUsetts for "ell Mtar Pining Attn: 1-t. Uillim Duffy, Sum Station Gem: The Dapartmt of Public Health bas received a OW of tba plans and specificatione for the two rells and the Vater treatment atatiaa proposed to be built near the M=jmwk River the vicinity of the Larrence Airport. This vwk is designated as ProJoct zoo. US-1-22-0M. i2:e ply provide for the ran P�6D� e4 t to bo located in rater tight vaults. All rater pfd from the Us is to be treated for corrosion control and thea abl � to flow. Tbo trent YdU be done in a separate building. A simultaneous 30 day Aa st be conducted on the cells before they are p=Ved into stems. Deet must be notified well in advance of the start a p toast. The Department is of the t the plans and gpeolfications have been drain in accordance wS Gamitary engines practice and gives its approval very truly yours, X129 C/&d John C. Collins Director C-Board th Division of Sanitary mowing North over is Camomatins One Center Plana Boston, Hassachusetts COMMONWEALTH OF MASSACHUSETTS f EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS r d DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 � I M s�° WILLIAM F.WELD �p1 ; TRUDY COXE Governor ti Secretary ARGEO PAUL CELLUCCI DAVID•B.STRUHS Lt.Governor �" Commissioner NORTH ANDOVER WATER DEPT DPW Date: May, 1, 1997 PWSID: 3210000 Re: Verification of Emergency Source Status AT POND ROAD R,MA 01845 Dear Public Water Supplier, In order to verify the information in our records and to ensure the viability of EMERGENCY sources of drinking water,the Department is requesting that you complete and submit the attached Emergency Source Preparedness Plan(s). Attached you will find one copy of the plan for each of your EMERGENCY sources. This information is required for every EMERGENCY source listed by the Department in your system's inventory. This information will help all of us at the state and local levels target our limited resources to protect viable water supply sources. EMERGENCY sources receive the same protections as ACTIVE sources(formerly called: PERMANENT, BACKUP,SEASONAL,PROVISIONAL,or INTERIM). This preparedness plan will spell out those steps which ensure that the source can produce drinking water in time of crisis. This plan must include at a minimum: (1)a regular schedule-of source maintenance and,(2)a routine inspection of the surrounding protective Zone I or Zone A,as appropriate. Although routine water quality testing is not required at EMERGENCY sources,it is recommended. If the source cannot produce water(if,for example,the well screen has collapsed)the source should not be listed as an EMERGENCY source unless you include plans,including completion dates,for upgrading the source. The Department may require you to upgrade the source to a viable EMERGENCY source which may include some level of repair and maintenance. Failure to submit this preparedness plan by June 30,1997,may result in the Department downgrading your EMERGENCY source to ABANDONED(see definition at 310 CMR 22.02). ABANDONED sources must be physically disconnected from your distribution system. Decommissioning(removal of pump works and appropriate filling to protect groundwater)is recommended but may not be required. Decommissioning will be discussed by the Department staff at your next scheduled survey. EMERGENCY sources that are downgraded to ABANDONED will no longer appear on Department GIS protective maps and will not receive special protection. These maps are used by state programs in implementing a variety of programs which accord water supply recharge areas special protection. As you consider allowing your source(s)to be downgraded,you should be aware of the reduced protection that will be afforded to your source by state programs. Local protections could still apply. Printed on Recyded Paper The list below provides a few key examples of the ways in which state program protection changes when a source is ABANDONED. Refer to regulations for more details. IF YOU DOWNGRADE YOUR SURFACE WATER SOURCE FROM EMERGENCY TO ABANDONED: • Title 5 setbacks for septic tanks and leaching fields will be reduced from 400 ft. around reservoirs and 200 ft. from tributaries to setbacks from surface waters of 25 ft. for septic tanks and 50 ft. for leaching fields. • Hazardous Waste Disposal Facilities may be allowed within the source's water supply watershed. • Landfill siting setbacks of 0.5 mi.upgradient and 500 ft. downgradient of the source will be eliminated.A 250 ft.buffer around lakes and rivers will remain in place. • Hazardous Waste Site Cleanups within 400 feet of the source and its tributaries will no longer be required to meet GW-1 standards(at least as stringent as drinking water standards). • The source will lose protection under the 401 Water Quality Certificate which prohibits discharge of dredge or fill material within 400 ft. of a reservoir and restricts such discharge into tributaries. IF YOU DOWNGRADE YOUR GROUNDWATER SOURCE FROM EMERGENCY TO ABANDONED: • Zone I setbacks for septic systems will be eliminated. • Hazardous Waste Site Cleanups within Zone II/IWPA will no longer be required to meet GW-1 standards. • Landfills,other solid waste facilities,and hazardous waste facilities will no longer be prohibited/restricted within Zone II/IWPA(some protection is retained for abandoned sources in Sole Source Aquifers). Your submittals will be reviewed for Department approval and you will be notified of any official changes in source status. We appreciate your cooperation in helping us update our records. If you have any questions,please contact Damon Guterman at(617)574-6811. Sincerely, David Terry,Director Drinking Water Program cc. Regional Office Correspondence File . NORTH ANDOVER Board of Health NORTH ANDOVER Board of Selectmen NORTH ANDOVER Planning Board NORTH ANDOVER Conservation Commission NORTH ANDOVER Fire Department P:\DGUTERMA\SRCEAPPR\ESRC-PLN\ENERGPLN.CVR Emergency Source Preparedness Plan (Submit one copy of this page for each EMERGENCY source) Mail this form to your Regional DEP Office at: DEP Drinking Water Program, 10 Commerce Way,Woburn,MA 01801 PWSID: 3210000 PWS Name: NORTH ANDOVER WATER DEPT DPW Town: NORTH ANDOVER Source Name: MERRIMACK RIVER WELL#1 Source Id#: 3210000-OIG 1. Would you request that this source be downgraded from EMERGENCY to ABANDONED? Yes (please explain then go to question 7) No (please answer the remaining questions,2-7) 2.Are the pump works in place and in working order so that the source could produce water? Yes No Not Applicable(explain here,example-gravity fed surface water) If No,and you plan to correct this,please detail the steps you will take and the dates by which these steps will be completed: 3.Are treatment works to disinfect in place or readily available at the source? Choose one: In Place Available (describe here) 4. Describe the types and schedule of source maintenance(e.g.auxiliary power;pumps and valves exercised;vegetation removed; etc.). 5.What is your annual schedule of protective zone(s)inspections/surveys?(It is recommended that surface water sources complete a DEP/DWS Watershed Self Audit Survey every three years.Groundwater sources should,at a minimum,perform annual inspections) 6.Describe other steps taken to protect or maintain this source:(include protection bylaws,postings,notification of surrounding neighbors,voluntary water quality testing,fencing around pump house,etc.). 7.List the date(s)the source was last used,the reason(s)for its use and the length of time it was in use. Name: email address: Phone#: Fax#: Signature: Date: P:\DGUTERMA\SRCEAPPR\EMERGPLN.SR3 Emergency Source Preparedness Plan (Submit one copy of this page for each EMERGENCY source) Mail this form to your Regional DEP Office at: DEP Drinking Water Program, 10 Commerce Way,Woburn,MA 01801 PWSID: 3210000 PWS Name: NORTH ANDOVER WATER DEPT DPW Town: NORTH ANDOVER Source Name: MERRI.MACK RIVER WELL#2 Source Id#: 3210000-02G 1. Would you request that this source be downgraded from EMERGENCY to ABANDONED? Yes (please explain then go to question 7) No (please answer the remaining questions,2-7) 2.Are the pump works in place and in working order so that the source could produce water? Yes No Not Applicable(explain here,example-gravity fed surface water) If No,and you plan to correct this,please detail the steps you will take and the dates by which these steps will be completed: 3.Are treatment works to disinfect in place or readily available at the source? Choose one: In Place Available (describe here) 4.Describe the types and schedule of source maintenance(e.g. auxiliary power;pumps and valves exercised;vegetation removed; etc.). 5. What is your annual schedule of protective zone(s)inspections/surveys?(It is recommended that surface water sources complete a DEP/DWS Watershed Self Audit Survey every three years.Groundwater sources should,at a minimum,perform annual inspections) 6.Describe other steps taken to protect or maintain this source:(include protection bylaws,postings,notification of surrounding neighbors,voluntary water quality testing,fencing around pump house,etc.). 7.List the date(s)the source was last used,the reason(s)for its use and the length of time it was in use. Name: email address: Phone#: Fax#: Signature: Date: P:\DGUTERMA\SRCEAPPR\FAERGPLN.SR3 _ Q VT'117 NOTICE (v 5 TO: (Choose One) [ ] Massachusetts Department of Public Health, Bureau of Environmental Health Assessment _ �4 ,0,- 1-� �40 01/� le— Board of Health (AY-Town) FROM: 412- 7-ti 4/1f Q d V 15�— (ctty at Town) IqI'o d L) -e- WA-ytE4 DPS (Nun.of Punic Wuu Syq.m(PWS)) (PWS a I) i (Choose one) Community PWS ( ] Non transient noncommunity PWS L ] Transient noncommunity PWS MUP-Ci /4 Nun@ of PWS 0AT"f or tP&spomlbN Puton Submitting Womrlion DATE: SUBJECT: Sodium Notification for Massachusetts Public Drinking Water Systems In accordance with Massachusetts Department of Environmental Protection, Division of Water Supply regulations 310 CMR 22.06(A), please find attached the sodium results for the ' 46 2T 14 )q AJ 0 y if E/�— public water system, (PWS num) located at �c � �2 EAT , 'b AJZ k " The attached i...) sodium results are for the period 1 �— Please contact ( mhanng Puiod) at SO 8' !o e' if you have questions. (Oont.ct Paton Num) jPttom.) d i ct, y; L, F' .9 Attachment woodnot.not 3/11/93;ed.5/24/93 MASSACHUSETTS DEP/DMSION OF WATER SUPPLY IOC INORGANICS REPORT (FORM #1A.1) I. %PWS INFORMATION: r] 1. PWS IDN : 32�0co0 _ _ 2. City/Town: IUIX•� M 3. PWS Name: Nar'r� ��1" lU� t,Je✓ �./L� 4. Source ID# 5. sample Location 6. Date collected 7. Collected by A 2.104-04> - 0 Z$ L ILe-Goc.,.l JLAL i cls wT? 218115- K.gyp( ��q -- 8. Routine r" special � (explain below) 9. sample: ( ) Raw Water (X I Finish Water 10. Composite (or multiple) sample?(Y,N) If Y, list the multiple or composited sources (ID#s/sample locations) : Notes: II. LABORATORY ANALYTICA` INFORMATION: Lab Name: Q e-r+es-1 Colt r'aI=CIQ�Lab Cert.#: /4- M D (3 Subcontrac ed? Yea No I If Yes please provide name and'certlllcaUon below. �C 0.w►i M 335.3 ubco f' cfi i o v M-MA06LP Lab S Fp- a IDi : -TO 2.-D I IFe Notes: Compound Sample Lab Sample Result MCL Detection Analytical Date (regulated) IDN (*) ID# mg/L mg/L Limit mg/L MethodAnalyzed Arse:.ic J'-p�IZ$ Al 10 0.05 0. OOo-?- Ao0.�+a Barium //p 2.0 0. 10 aOO,�A cadmium AID 0.005 0. 001 aoo.--A Chromium ./VA 0.1 0. 601 i A00.4 A Fluoride** �� 4.0 0. 1 3LO.o1 4F l5 Mercur 0.002 00 OZ 45-. D- y rfl O. �- Z I 9S AID 3 Selenium NP 0.05 0. 00x. sodium Jy,O none �, () 0200-4A Antimony ^/Q 0.006 0. 0401 X04. 1- Beryllium Np 0.004 0.0003 a 00 L 7/J,5- Nickel JJS-Nickel ,�✓A� 0.1 (). 601 01:00 $� Thallium NQ 0.002 0. 001 ��9. 1L 2114 VS Cyanide Alio 0.2 Q, C) I 3:357.3 4171f6- compound sample Lab sample Result MCL Detection Analytical Date (unregulat) ID# (*) ID# mg/L . mg/L Limit mg/L Method Analyzed sulfate S6-1012,9 1.2. 5 5-. 0 `f 2 13��15 * Different samples are required for several of these analytes since ample preservation requirements vary with analff a to grcu (e.g., metals) . ** There is also a secondary MCL for flui 2.0 mg Laboratory Director signature and Date Z/ 5 Attention: Mail TWO copies of this repot to DEP DWS; 1 Winter Stree 9 F oor; Boston, Y.A 02108; Attention: WQA-sAMP; within 30 days of receipt of results and no later than 10 days after the end of the reporting period. FOR DEP7DWS USE ONLY:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Accepted: Rejected: Other: Date: DWS Staff Computer Entered: a:lnorg.wp 12/01/93 4 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION Metropolitan Boston—Northeast Regional Office MITT ROMNEY Zulvy �D ELLEN ROY HERZFELDER Governor 2004 Secretary KERRY HEALEY ROBERT W. GOLLEDGE,JR. Lieutenant Governor ANDOVER H DEPARTMENT Commissioner AR , 004 William Hmurciak Re: City/Town:North Andover Nott—A—n over ater Department PWS Name:North Andover Water Department 420 Great Pond Road PWS ID#: 3210000 North Affd-o3er M 01845 Program:Enforcement Action:Notice of Noncompliance Activity No.:NON-NE-04-5D020 Dear Mr.Hmurciak: The Department's review of your system's 2003 Annual Statistical Report revealed that your Public Water Supply is in noncompliance with one or more laws,requirements,orders,licenses,permits or approvals enforced by the Department. Attached hereto is a written description of(1)each activity referred to above,(2)the requirements violated,(3)the action the Department now wants you to take,and(4)the deadline for taking such action. Civil administrative penalties may be assessed for every day that you are in noncompliance with the requirements referred to in this notice as provided in G.L.C.21A, §160. Notwithstanding this Notice of Noncompliance,the Department reserves the right to exercise the full extent of its legal authority in order to achieve full compliance with all applicable requirements including,but not limited to, criminal prosecution,court-imposed civil penalties,or civil administrative penalties. Please note that the signature on this cover letter indicates formal issuance of the attached document. If you have any questions regarding this letter,please contact Nick Zessoules at(617)654-6613. Very Truly Yours, Madelyn Morris Deputy Regional Director Bureau of Resource Protection MM/cm/de/nz Northeast Regional Office .cc: DEP Drinking Water Program/WQA, 1 Winter Street,Boston MA(no attachment) North Andover Health Department,27 Charles Street,North Andover MA 01845 File name:Y:\DWP Archive\NERO\North Andover-3210000-Enforcement-2004-07-12 Pagel of 3 This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171. One Winter St. Boston,MA 02106 • Phone(617)654-6500 • Fax(617)556-1049 • TTD#1-800-298-2207 DEP on the World Wide Web: http://www.mass.gov/dep 0 Printed on Recycled Paper City/Town:North Andover Notice of Non-compliance PWS:North Andover Water Department NON-NE-04-5D020 j PWS Id: 3210000 July 12,2004 NOTICE OF NONCOMPLIANCE NONCOMPLIANCE SUMMARY THIS IS AN IMPORTANT NOTICE. FAILURE TO TAKE ADEQUATE ACTION IN RESPONSE TO THIS NOTICE COULD RESULT IN SERIOUS LEGAL CONSEQUENCES. NAME OF ENTITY IN NONCOMPLIANCE: RECEIVED North Andover Water Department(PWS ID#: 32 10000) LOCATION WHERE NONCOMPLIANCE OCCURRED OR WAS LAST OBSERVED: JUL 13 2004 North Andover,Massachusetts TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DATE WHEN NONCOMPLIANCE OCCURRED OR WAS LAST OBSERVED: January 1,2003 through July 12,2004 DESCRIPTION OF NONCOMPLIANCE: The North Andover Water Department(PWS)does not have appropriately licensed personnel serving as primary and secondary operators of its distribution system. The PWS owns and operates a water distribution system that, according to the PWS's 2003 Annual Statistical Report,provides service to 29,700 people. The Massachusetts Drinking Water regulations define a distribution system that provides service to between 15,001 and 50,000 people as a Class III-D system.On the 2003 Annual Statistical Report,the PWS listed Timothy Willet as the primary distribution operator and James Marshall as the secondary operator. For licenses,the PWS reported that Mr.Willet as having a 4D in-training license and Mr.Marshall as having a 1D license. A check of the Board of Registration's licensee database found that the license information provided on the report was accurate and that the personnel did not have other licenses. On July 2,2004,a discussion with a representative of the PWS confirmed that the personnel listed were acting as the primary and secondary distribution system operators. From the information provided,the Department has concluded that North Andover is operating its distribution system with a primary operator who does not have a full license and a secondary operator who has a license that is two classes below the classification of the distribution system. DESCRIPTION OF REQUIREMENTS NOT COMPLIED WITH: 310 CMR 22.11 (1)Operation.Every public water system shall be operated at all times by a Primary and Secondary Operator for the treatment and distribution of drinking water,unless otherwise authorized in writing by the Department. 310 CMR 22.11B(2)(c)Distribution-Primary Operator.Public water systems having a water distribution system shall be operated by a certified operator who has a certification of grade level at least equal to the classification of the distribution portion of the system during at least one daily working shift per work week and shall be available to respond to emergencies within one hour at all other times,unless otherwise authorized in writing by the Department and/or as exempted by 310 CMR 22.11B(5). 310 CMR 22.11B(2)(d)Distribution-Secondary Operator.Public water systems having a water distribution system, shall have a certified operator present during at least one daily working shift per work week to serve as the Primary Operator in his/her absence and shall have a certification not less than one grade lower than the classification of the system,unless otherwise authorized in writing by the Department and/or as exempted by 310 CMR 22.11B(5). ACTION TO BE TAKEN,AND THE DEADLINE FOR TAKING SUCH ACTION: 1. By July 31,2004,submit an application for Temporary Emergency Certification to the Board of Certification of Drinking Water Operators.The application shall be complete and acceptable to the Board. File name:Y:\DWP Archive\NERO\North Andover-3210000-Enforcement-2004-07-12 Page 2 of 3 Y City/Town:North Andover Notice of Non-compliance PWS:North Andover Water Department NON-NE-04-5D020 PWS Id: 3210000 July 12,2004 2. By July 31,2004,submit a plan and schedule for bringing the staffing of the North Andover Water Department into compliance with 310 CRM 22.11B(1)and 310 CMR 22.11B(2)to the Department for its review and approval. Thereafter,implement the plan and schedule as approved by the Department. File name: Y:\DWP Archive\NERO\North Andover-3210000-Enforcement-2004-07-12 Page 3 of 3