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Miscellaneous - 455 CHESTNUT STREET 4/30/2018 (2)
�5� �� � (�� Siwe-f � �;�� ��.�� �-.� ��� Commonwealth of Massachusetts City/Town of . System Pumping-Record Form 4 DEO has provided this form for use.-by local Boards of Health. Other forms may beused,but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of house, ee /Right a of h u , Left 1 right side of house, Left/ Right side of building, Left/Right front of builtfing, Left/Right rear of building, Under deck Address CWrown ` State Zip Code 2. System Owner. Name Address(if different from location) RC EIVE- Cityrrown S Zip Code APR 2 'I 2015 � rqtf.. Telephone Number TOWNOF NORTH ANM W R B. Pumping Record 1. Date of Pumping Date �2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of s m: 1 6. System Pumped By: Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc- Company ncCompany 7. Location Xhere contents were disposed: S. Lowell Waste Water q-t6 Sign Haule Date t6form4.doo-06/03 System Pumping Record•Page 1 of 1 > , y - . . r. ',+! 'w S vx + 4 t :y,n -i ?• ,L,yJ • t �.t" F• _'.� t• .. n, +,r . . t x icy ♦ `« S - i F f 4 r `,.t 4y "`:fP4 .� A+• i't,Jw'. ° s;J I '. -- J++ - - - - _- - - - - - . -, �. �.... .e,...". '^E a., ._�,_ `t � Y �,- ,a,7F:. u �. ^!; ,`.sc',XJ'' �. 4'}':. s`'- ,"..•[.. _�:s y r w,,f,:. .- ,- •,� r „. t ru,.. 7'�... ' ,r,;.. c:;. `� - 4,4,I'. - ;.. - a,.+„✓,q F ..y 6'._ - €r<.;:" L'3 4 V c+ : _ 1. ,.`,.• . r ".r, }y j, ,.. 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'� L j. v .y y..1. .v M t r r 't• }' "a J .z, r y.f � , - >t f S'' .� ; '?' y _ e ,,,,•_��t r __�,..,___.._._.- __,_ ._X.._ ..,�,. -- .tf :].= -»_.--"-=...:c_,_..t'.=-L ^z:::-y.. - .r:^a:._ -�,. -. .,.�.,.._...� ._•....r,..,.._^._:_._�.,...-..:..o.__._,.- qr ,.ti-<,_-..,_.-,Ji.i...r,. � _ \ �' Uo 0 `� `� ., � J 1 I �. _ - �_ _ _ . _ �. ��� � � : �� �� `� ,. ., . 6 1' i /// DelleChiaie, am.ela From: Sawyer, Susan ����/✓�0©�� Sent: Wednesday, February 22, 2006 7:30 PM To: DelleChiaie, Pamela Subject: RE:455 Chestnut Street think I understand the question. OkG C� It is a simple answer. They do not have a Title V subsurface disposal system. No insp. needed. If they are on town sewer, they do not need a title V.They just could not get a gravity system, so the contractor installed a tank and a pump. The home inspector may want to check out these components, but that is the prospective homeowner's decision. Susan -----Original Message----- From: DelleChiaie,Pamela Sent: Wednesday,February 22,2006 2:35 PM To: Sawyer,Susan Subject: FW:455 Chestnut Street Importance: High Hi Susan, I did a little research on this before asking you about it. So now, the question is, if the homeowners want to sell, are they required to have a Title 5 done? There is no information in our file about below or a statement certifying that they are excluded from a Title 5. Please let me know how to answer the realtor's question. Thanks. Pam -----Original Message----- From: Willett,Tim Sent: Wednesday,February 22,2006 1:58 PM To: DelleChiaie,Pamela Subject: RE:455 Chestnut Street Hi Pam, I do not have plans for the type of sewer system anywhere in our records, but the property has been billed for town sewer since 1987. 1 do recall some people having this type of system in that area, but whether#455 is one of them, I don't remember exactly. -----Original Message----- From: DelleChiaie, Pamela Sent: Wednesday, February 22, 2006 1:32 PM To: Willett,Tim Subject: 455 Chestnut Street Hi Tim, I received a call from a realtor asking about above property owned by Barry and Marie O'Hagen. She was told that this property has a"Wastewater Ejection System"that flushes out to the Blueberry Hill area, and the solids are kept in a holding tank which is pumped once a year. Therefore, the homeowner is telling her that they do not require a Title 5, as there are no leaching beds, etc., as there are in a regular subsurface disposal system setup. Will you please verify that this home indeed has a flushout through town sewer to the blueberry hill area, and any thoughts you have on this. Thanks. BBsf R¢gaods, Pu�ye�u DaQ�aG�l�iaia Health Department Assistant Town of North Andover 1 'C�x Commonwealth of Massachusetts RE EIVED City/Town of System Pumping Record f ' APR ► Form 4 V - M , TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Hea th. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left front of house, right front of house, left side of house, right side of hous Left rear of hou , right rear of house, left side of building, right rear of building, under deck. L4SS 611��'�A� a4,�2� k Citylrown State Zip Code 2. System Owner: (�� Name Address(if different from location) Cityrrown State6e�B �3CJjpgde Telephone Number Q B. Pumping Record 1 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: � � p 6. System Pumped By: Neil J. Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc. Company I� 7. 'o ere contents were disposed: G.L.S. L ell Wa to er Signatu o a er Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts f = City/Town of y t � System Pumping Record �v Form 4 DEP has provided this form for use-by local Boards of Health. Other forms may be*used, but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of housc '`/R' t ar' e, Left/right side of house, Left/ Right side of building, Left/Right front of building, Left/Right rear of building, Under deck Address / ,5 n, `1 City/Town lel uU`� State tJ _ Zip Code 2. System Owner. Name Address(if different from location) City/rows State� •-�� Zio Co e Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes 2-N-0 – If yes,was it cleaned? ❑ Yes ❑ No. 5. Conditi n f S m: 6. System Pumped By: Neil Bateson F58 Name VehiG License Number Bateson Enterprises Inc ITR 16 2013 Company 7. Lo cat re contents were disposed: TOWN OF NORTH ANDOVER HEALTH DEPARTMENT aLS_Q Lowell Waste Water Signitule I Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts City/Town ofVJ s System Pumping Record Form 4 x0 DEP has provided this form for use,by local Boards of Health. Other forms may be'used,but the information must be substantially the same as that provided here. Before using.this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility. Information 1. System Location: Left/Right front of Nous , Le Righ r of house Left/right side of house, Left/ Right side of building, Left/Right front of bu ing, Left/Right rear of building, Under deck Address Cityrrown state Zip Code 2. System Owner. RECEIVED Name APR;.1 Address(d different from location) tCt Citylrownp„ Telephone Number B. Pumping Record 1. Date of PumpingQuantity Pumped: f--= Date Gallons 3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes a-60 If yes, was it cleaned? ❑ Yes ❑ No. '5. Condition of Syste m: 1 �� 6. System Pumped By. Neil.Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. 7GL"LSQ7 e contents were disposed: Lowell Waste Water Lf Sign Haule Date t5form4.doc-06/03 System Pumping Record•Page 1 of 1 Commonwealth of Massachusetts DECEIVED City/Town of SEP 14 2007 System Pumping Record Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form,check with your local Board of Health to determine the form they use.The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: forms on the computer,use only the tab key Address L+55 to move your cursor-do not Cityfrown State Zip Code use the return key. 2. System Owner: VQ Name Address(if different from location) CitylTown State<a--3--C-)tfOZip Code Telephone Number U¢ B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) tic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes [3-14o— If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: V-"'"A o 6. System Pumped By, Name 1 Vehicle License Number e, Company 7. Locatiga where coTentwere disposed: �—4' Sig Hauler Date t5fomA.doc-06103 System Pumping Record•Page 1 of 1 ids ;,'sH Aivi:�'JVER BOARD Op ii r,!,L'�H GGT* pPJVED D!�'i'E PROVIDED DISAPPROVED DATE TIME REASON Fvi ' TReg. . 5 Fail OK The submitted plan must show as a minumum: (a) the lot to be served (area,dimensions ,lot //,abutters) b) (Planning Board -files) - location and log of deep observation holes-distance to ties location and results of percolation tests-distance . to ties ( design calculations- & calculations showing required leaching area (e location and dimensions sf system (including reserve area) f existing and proposed contours location of any wet areas within 100' of the sewage disposal system ot-• disclaimer (check wetlands mapping, (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) % _ -',}- known.- sources-_of=Writer supply within 200' of sewage disposal=-system_ or_-_disclaimer (k)- location of any proposed-well to serve= the- lot ('100' from leaching- facility) (1 location of water lines on property (10' from. leachin. facilities) - - location of benchmark driveways o garbage disposers no PVC is to be used in construction �q) a profile of the system (elevations of basement , plum pipe septic tank, distribution box inlets and outle:,s � distribution--field piping and any other elevations) f_ maximum ground water elevation in area of selvage dish system (s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Se 'c Tanks Reg. 6 (a) Capacities - 150% of flow, water table, tees, depth of tees, access, pumping, - - leanout 10' -from cellar wall or inground swimming pool (d 25' from subsurface drains 97ail- Distribution Boxes r, 0.2 a Slope greater than 0.08 !g.10.4 (b� Sump Leaching Pits Leaching pits are pr rred where the installation a,s possible ;g.11 .2 (a) Calcul ons of leaching area (minimum 500 S.F.) ;g.11 .4 (b) Spacg ;g,11 ,1 c S ace drainage 29� ;g,1'I .11 d Qver materiald e_ 2 12'r¢" 55plask ` £e a tY cibo tz �t Le ing Fields `J I ,8,15,1 :Greater than 20 minutes/inch ;g,15,1 rea (minimum",900 S.F.) �g,15.4 c Construction of field ,g,15.$ d Surface drainage 2% ,g,•- 3,7 e 20' from- cellar wall or inground swimming pool - Leaching Trenches :g.14,1 (a) Calcizlati s of leaching area (min. 500 S.F.) �g.14,3 (b Spacin 4 ft. min. 6 ft. with reserve between). �g.14.4 (c Dime Ions 1. 5- 4. -_ - 3g I4:6`' _. - (d . C structiori.-.__:- 2g.14.7- (e,): tone- �g.14,1 _Surface- drainage 2% _ Downhil-1-Slope_ Slope y/x = to be shown b y/x X 150 = to be sliown� Pumps eg, 9,1 (a Approval eg, 9.6 (b� Stand-by power Pl�UJID ffk E DIS O��D DAT —'� �Y.CA�'A9Z�1 Og FAIL Ga-&-pns t OK 1. Distance Tot ( � y 7 a. Wetlands - b. Drains 0. Wel]. 2. Vater Line Location No FSC Pipe° - m — 7 7 Septic, Tank a._ ..Tees _-_Length & To Chan Out Co� �s b. -Cement Pipe to Tank -.OnBoth Sides of Tank = - 5. Distribution Box _ a. Covers & Box - No Cracks b, All Lines Flo,Jng Fqual A=unts- - - = c. Ido Back Leach Field or Tre`ich a. Dimensions - b. Stone Depth -- _ c. Cawed Rids .. , = d. Clean Double'.L'ashed- Stone-'_ 7. tone==7. Leach Fits a. Dieio _ b. Stone epth ` = Pads d. EeS e. Ce�mt Pipe to Pit - Both Sides f. Clem Double I,'ashed Straus - 8. No Garbage Disposal 9. Final Grading Inspection - 10.- Ba.rricading-..Covered System --- 11. As Built Submitted a. Lot Location b. Di.xaensi.on,s of System c. Location -ith Regard_to Pere Test d. Elevations e. hTeter Table - c TOWN OF N- . Jh Q)e,(- SYSTEM PUMPING RECO R-� RECEIVED DATE: �r�'0 AUG 0 5 2005 TORE�TH,DEPARTr'j TANDOVORTH ER SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of house) DATE OF PUMPING: D QUANTITY PUMPED : GALLONS CESSPOOL: NO YES EPTIC TANK: NO YES , NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.L.S.D1 Lowell Waste TOWN OF SYSTEM PUMPING RECORD DATE: SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of house) O V,\ � DATE OF PUMPING: 1 QUANTITY PUMPED : GALLONS CESSPOOL: NO YES ZSEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: �- CONTENTS TRANSFERRED TO: TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: 6�— SYSTEM OWNER&ADDRESS SYSTEM LOCATION (example: left front of house) Ck ct4� '[S5 DATE OF PUMPING: ' H UANTITY PUMPED t � GALLONS CESSPOOL: NO IYES SEPTIC TANK:-NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACHFIELD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: COMMENTS: CONTENTS TRANSFERRED TO: / d"d ress C--N r'-5-7-,AI U l— Title of Fire Page of Date File Open: Date file closed: ----------------- Doc Document/Action Title Date of -� action Refer to other Purpose of Document/Action and notes Document/ document/ --- IWum. Action Department E:I - ------------ Board of Appeals - Board of Health - Planning Board _Conservation Commission - Building Departrrien,t ��-- r - ('on non ealth of Massachusetts f P , Massachusetts stem Purn�ing Record System Owner System Location Date of Pumping: Quantity Pumped: C�iallons Cesspool: No Yes U Septic Tank: No Yes System Pumped by: Farwort Srfe t,64. a License# Contents transferrred to : Greater Lawrence Sanitary District Date: Inspector: rr � t - v Commonwealth of Massachusetts City/Town of i System Pumping Record OCT - g 2008 Form 4 i -y ANDOWER zr;.. ijt DEP has provided this form for use by local Boards of Health. Other forms,mayTbe-used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping.Record must be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: Left front, Gr left sid of house Right front, right rear, right side of house. forms on the computer,use only the tab key Address to move your cursor-do not use the return Cityfrown State Zip Code key. 2. System Owner: ®V� Name Address(if different from location) City/Town States, Zipe Telephone Number B. Pumping Record 1. Date of Pumping Date 2• Quantity Pumped: Gallons 3. Type of system: Q Cesspool(s) _ eptic Tank [] Tight Tank rl Other(describe): 4. Effluent Tee Filter present? Yes 0-K-0 If yes,was it cleaned? Yes No 5. Condition em: 6. System Pumped By: Neil Bateson F 5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location where contents were disposed: Aure Lowell Waste Water Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 FORM 4- SYSTEM PL7IPM RECORD TOWN OF NORTH ANDOVERf BOARD OF HEALTH Commonwealth of Massachusetts AUG Massachusetts System Pumping Record -stem Owner Systern Location ?)Cuvu �f A/- Date of Pumping: �� ' Quantity Pumped: /05j- gallons Cesspool: No ,® Yes :❑ Septic Tank: No 7 Yes R System Pumped by: _ License 4: Contents transferred to: Date Inspector Commonwealth of Massachusetts City/Town of RECEIVED System Pumping Record Form 4 OCT 3 0 2009 DEP has provided this form for use by local Boards of Heal II To'hth�er,'fbr'i , y_�I se , but the information must be,substantially the same as that provided There-�efor�uslr�this orm,check with your local Board of Health tQ determine the form they use.The System Pumping Record must be submitted to the local Board of Health ouothef approving authority. A. Facility Information 1. System Location: Left side of house, Right side of house, Left front of house, Right front of house, CLeTfr'e ous fight rear of house. eft rear of building. Right rear of building. "(S5 rk—e4y'%" Address Cityrrown State Zip Code 2. System Owner: Name Address(if different from location) Cityrrown State Zip Code Telephone Number B. Pumping Record q 1. Date of Pumping a l 2. Quantity Pumped: p C.)Date Gallons 3. Type of system: ElCesspool(s) ptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Location wh.Qre contents were disposed: G.L.SLowell Waste Water Signature of 11auler Date t5form4.doc•06103 System Pumping Record•Page 1 of 1