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HomeMy WebLinkAboutMiscellaneous - 50 ROCKY BROOK ROAD 4/30/2018 50 Rocky Brook Road C " I i ' I I a r '60 LOT & STREET LIDT ?X �Tv MAP/PARCEL_20,�E/3� CONSTRUCTION APPROVAL HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN APPROVAL: DATE APP. BY ,4,D DESIGNER: �, (�25b PLAN DATE CONDITIONS WATER SUPPLY: TOWN WELL WELL PERMIT DRILLER WELL TESTS: CHEMICAL DATE APPROVED BAC IA I DATE APPROVED BACTERIA DATE APPROVED PLUMBING SIGNOFF WIRI G SIGNOFF COMMENTS: FORM U APPROVAL: APPROVAL TO ISSUE YES NO DATE ISSUED BY CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID YES NO WELL CONSTRUCTION APPROVAL NO SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO OTHER YES NO ANY VARIANCE NEEDED YES 0 FINAL BOARD OF HEALTH APPROVAL: DATE: 6 Y: i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms r7RECon the computer,use only the tab 1. Inspector:key to move your cursor-do not Neil James Bateson use the return key. Name of Inspector TOWN OF NORTH ANIbOVER Bateson Enterprises Inc. 4nMALTH DEPART 111 Company Name 111 Argilla Road A If Company Address Andover MA 01810 Citylrown State Zip Code 9784754786 SI-15 Telephone Number License Number B. Certification 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 the 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 ❑ Conditionally Passes ❑ Fails ❑ Needs Further.Evaluation by the Local Approving Authority OVA,I 10/15/2011 lnip4bolKsignatW Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable; and the approving authority. ****This report only describes conditions at the time of inspection and under the 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. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any.information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist: Any failure criteria not evaluated are indicated below. Comments: � I 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. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 ears old*or the septic tank whether metal or not is structural) � r y ' ( ) v unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing 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. ❑ Y N ❑ ND(Explain below): l5ins•11/10 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is North Andover MA 01845 10/15/2011 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed. ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ 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): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 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 public health, safety or the 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: ❑ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh ❑ P p Y 9 9 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Cityrrown State; Zip Code Date of Inspection B. Certification (cont.) 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: ❑ 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 a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You.must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® 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 than Y2 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of 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 1 of a public well. ❑ ® Any portion 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 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 certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ 0 the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection 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 large 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. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is North Andover MA 01845 10/15/2011 required for every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 8 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Yes Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): I General Information Pumping Records: Source of information: Pumped 2009, owner Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Measured tank Reason for pumping: Inspect tank 8r tees Type of System: ® Septic tank, distribution box, soil absorption system I ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ 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 system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): i t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System m Form Not for Volunta Voluntary 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA01845 10/15/2011 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 11 years old, 7/20/2000, as bulit plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below rade: 1.8 P 9 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): 4" PVC thru floor to septic tank, 3" PVC in house, no leaks visible Septic Tank(locate on site plan): Depth below rade: .5 P 9 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age:° years I . .Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'x 5'x 4' 4" Sludge depth: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 21" 3.. Scum thickness Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? Tape measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumped septic tank. Inlet tee ok. Outlet tee ok. Depth of liquid at outlet invert. No evidence of leakage. Tank partially located under driveway. Inlet cover has riser with exposed cover in driveway. Outlet cover located off the driveway in the grass. Grease Trap(locate on site plan): Depth below grade: feet 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 bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No i t5ins•11/10 Tide 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box level&distribution equal. No evidence of leakage. Evidence of fight carryover, pumped d-box to clean. i Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 2 trenches 63' long ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil ok.Vegetation ok. No sign of ponding to surface. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is North Andover MA 01845 10/15/2011 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 117 } Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below 0 drawing attached separately I i fall�I C = 3� Il D- � tr f t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover MA 01845 10/15/2011 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water : ® Check cellar ® Shallow wells Estimated depth to high ground water: >4 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 9/1/1999 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health—explain: Design plan I ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test pit data on design plan shows no water 4'deep. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 50 Rocky Brook Road Property Address Peter Catalano Owner Owner's Name information is required for every North Andover NIA 01845 10/15/2011 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 Commonwealth of Massachusetts City/Town of System Pumping Record 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 house, Left/Right rear of house, Left/ ht sideof house Left/ Righ side of building, Left/Right front of building, Left/Right rear of building, Under deck c/*-- Address Sp City/Town State Zip Code � 2. System Owner: Name I Address(if di Brent fro ocatio n l 1 cr��' City/Town State —I S.2i Telephone Number B. Pumping Record to- tom= t 1 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 0'No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: ill o�'w l�v 21 ti v-\ 4eAAA-�,- 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company . 7. jSigt ' where contents were disposed: G. : Lowell Waste Water Haule Date t5fortn4.doc•06/03 System Pumping Record•Page 1 of 1 Summary Record Card generated on 10117120112:43:00 PM by Karen Hanlon Page 1 Town of North Andover Tax Map # 210-090.A-0039-0000.0. r Parcel Id 14407 50 ROCKY BROOK ROAD PETER CATALANO 50 ROCKY BROOK ROAD NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Zoning2 1 Residential Zoning3 1 Residential Size Total 2.11 Acres FY 2012 UB Mailing Index Name/Address Type Loan Number Active/Inact. From Until PETER CATALANO Owner 50 ROCKY BROOK ROAD NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/inactive Bldg Id.21244.0-50 ROCKY BROOK ROAD Last Billing Date 10/4/2011 3180755 03 Cycle 03 Active UB Services Maint. Account No.3180755 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 85.56 /1 UB Meter Maintenance Account No.3180755 Serial No Status Location Brand Type Size YTD Cons 99885653 a Active 00 METE METE w Water 0.63 0.63 194 Date Reading Code Consumption Posted Date Variance 9/16/2011 575 a Actual 22 10/13/2011 39% 6/13/2011 553 a Actual 15 7/20/2011 -55% 3/15/2011 538 a Actual 33 4/13/2011 94% 12/15/2010 505 a Actual 17 1/12/2011 4% 9/16/2010 488 a Actual 17 10/15/2010 59% 6/14/2010 471 a Actual 10 7/15/2010 -24% 3/18/2010 461 a Actual 14 4/14/2010 47% 12/14/2009 447 a Actual 9 1/12/2010 -24% 9/16/2009 438 a Actual 13 10/15/2009 3% 6/10/2009 425 a Actual 11 7/20/2009 8% 3/17/2009 414 a Actual 11 4/29/2009 -2% 12/15/2008 403 a Actual 11 1/20/2009 20% 9/16/2008 392 a Actual 10 10/10/2008 798% 6/10/2008 382 a Actual 1 7/16/2008 0% 3/14/2008 381 a Actual 1 4/11/2008 -85% 12/17/2007 380 a Actual 7 1/22/2008 -73% 9/14/2007 373 a Actual 24 10/12/2007 79% 6/20/2007 349 a Actual 15 7/20/2007 82% 3/16/2007 334 a Actual 8 4/16/2007 4% 12/13/2006 326 a Actual 7 1/19/2007 -25% 9/19/2006 319 a Actual 10 10/20/2006 1% 6/20/2006 309 a Actual 10 7/10/2006 -25% 3/20/2006 299 a Actual 11 4/17/2006 14% 1/3/2006 288 a Actual .14 1/17/2006 -66% 9/15/2005 274 a Actual 35 10/14/2005 281% 6/14/2005 239 a Actual 8 7/15/2005 -38% 3/25/2005 231 a Actual 16 4/5/2005 -41% 12/15/2004 215 a Actual 24 1/14/2005 60% 9/17/2004 191 •a Actual 16 10/8/2004 9% 6/14/2004 175 . a Actual 18 7/30/2004 10% 4/23/2004 167 a Actual 17 5/17/2004 0% 12/23/2003 150 n New Meter 0 12/23/2003 0% COMMONWEALTH OF MASSACHUSETTS etcP� EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 50 Rocky Brook Road_ _North Andover_ Owner's Name:_Peter Catalano _ Owner's Address:_50 Rocky Brook Road— RECEIVED _North Andover,MA 01845_ Date of Inspection:_6129/2007_ Name of Inspector: Neil J Bateson_ J U L 0 5 2007 Company Name: Bateson Enterprises Inc._ ,E Mailing Address:_111 Argilla Road_ TONE LTHDDEPAANDOVER ADO z R _Andover,MA 01810 Telephone Number:_(978)475-4786_ 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 the 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: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fail ' ' Date: 6/29/2007 Inspector's Signature: _ _ The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 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 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 at the time of inspection and under the 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. Page,2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:_50 Rocky Brook Road- - North Andover — Owner:_Catalano_ Date of Inspection:_6/29/2007_ Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated 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.Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain._ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing 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: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed 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): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_50 Rocky Brook Road- - North Andover— Owner:_Catalano_ Date of Inspection:_6/29/2007_ 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 public health,safety or the 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: _ Cesspool or privy is within 50 feet of a 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 is functioning in a manner that protects the public health,safety and 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 a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_50 Rocky Brook Road- - North Andover — Owner:_Catalano_ Date of Inspection:6/29/2007_ D. System Failure Criteria applicable to all systems: You must indicate"yes"or`�no"to each of the following for all inspections: _No_ Backup of sewage into facility or system component due to 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 No Liquid depth in cesspool is less than 6"below invert or available volume is''/z day flow. No Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of timesum ed P P No Any portion of the SAS,cesspool or privy is below high ground water elevation. No Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. No Any portion of a cesspool or privy is within a Zone 1 of a public well. _ No Any portion of a cesspool or privy is within 50 feet of a private water supply well. No 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 certified 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure E. Large Systems: To be considered a large system the system must serve 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 large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone Il 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 large 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. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_50 Rocky Brook Road_ _North Andover_ Owner:_Catalano_ Date of Inspection 6/29/2007 Check if the following have been done.You most indicate"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 flows 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? _Yes— — Was the facility or dwelling inspected for signs of sewage back up? for signs Yes Was the site inspected f of break out? Yes _ Were all system components,excluding the SAS,located on site? _Yes_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _Yes_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage 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. _Yes_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_50 Rocky Brook Road- - North Andover – Owner:_Catalano_ Date of Inspection:6/29/2007_ FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_4_ Number of bedrooms(actual):_4_ DESIGN flow based on 310 CMR 15.203_440_ Number of current residents:_2 Does residence have a garbage grinder(yes or no):_No Is laundry on a separate sewage system(yes or no): No_ Laundry system inspected(yes or no): Seasonal use: (yes or no): No_ Water meter reading:_Yes_ Sump pump(yes or no):_No Last date of occupancy:_Current_ COMMERCUTANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203):_gpd Basis of design flow(seats/persons/sgft,eto.): 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): GENERAL INFORMATION Pumping Records Source of information: Pumped last year,owner_ Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_1500_gallons--How was quantity pumped determined?_Measured tank Reason for pumping: _Inspect tank&tees_ TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system Single cesspool_Overflow cesspool _ Privy 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 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_7 Years old,7/20/2000,as built plan._ Were sewage odors detected when arriving at the site(yes or no): No Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 50 Rocky Brook Road_ _North Andover Owner:_Catalano_ Date of Inspection:6/29/2007_ BUILDING SEWER_X_ (locate on site plan) Depth below grade:_18" Materials of construction _cast iron _X 40 PVC other Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.) _4"PVC thru floor,3"PVC in house,no leaks visible SEPTIC TANK: X Depth below grade:_6"_ Material of construction: X concrete,metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):,(attach a copy of certificate) Dimensions: 10'x 5'x 4' Sludge depth3"_ Distance from top of sludge to bottom of outlet tee or baffle: 22"_ Scum thickness:_3" Distance from top of scum to top of outlet tee or baffle:-811— Distance affle_8"Distance from bottom of scum to bottom of outlet tee or baffle: 19"_ How were dimensions determined:_Tape Measure_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc _Pumped septic tank.Inlet tee ok.Outlet tee ok.Depth of liquid at outlet invert.No evidence of septic tank leaking.Septic tank in driveway,inlet cover is exposed, outlet cover in grass._ 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 bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 50 Rocky Brook Road- - Andover– Owner:_Catalano_ Date of Inspection:6f29/2007 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: i Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX X (locate on site plan) Depth below grade _12"_ Depth of liquid level above outlet invert: 0_ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.)_D-bog level&distribution equal.No evidence of leakage.Evidence of light carryover,pumped d-bog to clean_ PUMP CHAMBER:_(locate on site plan) Pump in working order(yes or no):— Alarm in working order(yes or no):_ Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): I Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 50 Rocky Brook Road_ _North Andover_ Owner:_Catalano_ Date of Inspection:_6/29/2007_ SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type _ leaching pits,number: _ leaching chambers,number:— leaching galleries,number: X_ leaching trench,number,length:_2 trenches 63'long_ — leaching field,number,dimensions: overflow cesspool,number: innovativetaltemative system Typetname of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.):—Soil ok.Vegetation ok.No sign of ponding to surface._ CESSPOOLS: Number and configuration: Depth—top of liquid to inlet invert:_ Depth of sludge layer:— Depth of scum layer:_ Dimensions of cesspool:_ Materials of construction: _ Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 50 Rocky Brook Road_ _North Andover_ Owner:_Catalano_ Date of Inspection: 6/29/2007 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building House Septic A W Tank ter Meter JD-Boz A to Inlet=2712" A to Outlet=34'2" A to D-Boz=4118" B to Inlet=3119" B to Outlet=38'2" B to D-Boz=5516" Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_50 Rocky Brook Road_ _North Andover – Owner:_Catalano_ Date of Inspection-6/29/2007_ SITE EXAM Slope_No_ Surface water_No_ Check cellar _Dry_ Shallow wells_No_ Estimated depth to ground water >4'_ Please indicate(check)all methods used to determine the high ground water elevation: X Obtained from system design plans on record-If checked,date of design plan reviewed:_9/1/1999 Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain:__ Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: _ You must describe how you established the high ground water elevation:_As per design plan,No water 4'deep_ Summary Record Card generated on 7/3/200710:30:05 AM by Use Warren Page 1 Town of North Andover Tax Map # 210-090.A-0039-0000.0 50 ROCKY BROOK ROAD PETER CATALANO 50 ROCKY BROOK ROAD NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 2.11 Acres FY 2007 UB Mailing Index Name/Address Type Loan Number Active/lnact. From Until PETER CATALANO Owner 50 ROCKY BROOK ROAD NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Activelinactive Bldg Id.2280.0-50 ROCKY BROOK ROAD Last Billing Date 4/2/2007 3180755 03 Cycle 03 Active UB Services Maint. Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.635/8 7.82 1/ WTR WATER 01 ALL METER SIZE 25.04 /1 UB Meter Maintenance Serial No Status Location Brand Type Size YTD Cons 99885653 a Active 00 METE METE w Water 0.63 0.63 0 Date Reading Code Consumption Posted Date Variance 6/20/2007 349 a Actual 15 82% 3/16/2007 334 a Actual 8 4/16/2007 4% 12/13/2006 326 a Actual 7 1/19/2007 -25% 9/19/2006 319 a Actual 10 10/20/2006 1% 6/20/2006 309 a Actual 10 7/10/2006 -25% 3/20/2006 299 a Actual 11 4/17/2006 14% 1/3/2006 288 a Actual 14 1/17/2006 -66% 9/15/2005 274 a Actual 35 10/14/2005 281% 6/14/2005 239 a Actual 8 7/15/2005 -38% 3/25/2005 231 a Actual 16 4/5/2005 -41% 12/15/2004 215 a Actual 24 1/14/2005 60% 9/17/2004 191 a Actual 16 10/8/2004 9% 6/14/2004 175 a Actual 8 7/30/2004 10% 4/23/2004 167 a Actual 17 5/17/2004 0% 12/23/2003 150 n New Meter 0 12/23/2003 0% li i i i Ili Commonwealth of Massachusetts City/Town of System Pumping Record 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 Important: When filling out 1. System Location: forms on the computer,use 1 only the tab key Address to move your --T cursor-do notState Zip Code use the return CdylToum key. 2. System Owner: Ak ICI Name Address(if different from location) Stat FZip Code City/Town I �s Telephone Number I B. Pumping Record6 SSG 1. Date of Pumping bate 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes �o ' If yes,was it cleaned? ❑ Yes ❑ No 5. Condit* n of System: 6. Systein P mpqd By: Name Vehicle License Number g; Company 7. Location"e contents_Wer posed: Signature H I Date t5form4.doc•06/03 System Pumping Record•Page 1 of 1 Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating-Water& Sewer Lines-Septic Systems &Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 50 Rocky Brook, North Andover Owner: Catalano Date of Inspection: 6/29/2007 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. Neil J. Bateson Bateson Enterprises, Inc. i TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE DATE OF COMPLIANCE: 7/26/00 This is to certify that the individual subsurface disposal system constructed (X) or repaired () by Peter Breen at 50 (Lot 23A) Rocky Brook has been installed in accordance with the provisions of Title V of the State Sanitary Code and with the North Andover Board of Health regulations. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. Board of Health Inspector I NORTH Town of � EAndover o dove>� Mass. O� COCHICHEWICK ' ' AORATED PPa\ BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System / 71� BUIL ING INSPECTOR THIS CERTIFIES THAT ....................... ..........................P........................... ,.O.. ............... .................................. oundation . has permission to erect...............�............ ......... buildings on ..��..��..3.. vi- 5d. 7..... l�. K ough rd0 �� S�� ' N h ������ Chim� tobe occupied as......... .............. . ... ,... .............................../.............................. ................................,............................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. � n � t 3 1 n� now PLUMBING INSPEC�OR+ VIOLATION of the Zoning or Building Regulations Voids this Permit. ou -7— 2 6�-G` Final PERMIT' EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S TC6 Rough ... ... .... .............................. ... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERESIDE smoke Det. AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ASSESSORS MAP &PARCEL NUMBER LOT LINES &LOCATION OF DWELLINGS LOCATIONS &DIMENSIONS OF SYSTEM, INCLUDING RESERVE t/ TIES TO LOT LINES & DWELLING, WELLS a. FROM SEPTIC TANK A b. FROM LEACH AREA (/ LOCATIONS OF DEEP HOLES &PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM V TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES WITHIN 150' OF SYSTEM LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK& D-BOX ORIGINAL STAMP & SIGNATURE (/ IMPERVIOUS AREAS - DRIVEWAYS, ETC. v NORTH ARROW LOCATION&ELEVATIONS OF BENCHMARK USED PLAN REVIEW CHECKLIST ADDRESS 1�� /Z ENGINEER. GENERAL ' 3 COPIES STAMP _ LOCUS NORTH`. ARROW SCALE L CONTOURS PROFILE 'S SECTION �� ' -BENCHMARK.. SOIL. & EROS ELEVATIONS WETS DISCLAIMER -�'� WE -L& & WETS WATERSHED? Y ,DRIVEWAI' (Elev): WATERS q LINE FDN DRAIN SCH40 CURRENT?' ;C� SOIL` EVAL,.. � 'l�2SC7 SEPTICATK x .r .y !i �) 5 ` f ^1 4F<}' 7' z13 a SkL MIN 15000 ':� t 17 INVERT DROP GARB t GRINDER{2 rcomps 42-00) -.t 10' TO FDN MANHOL 4 ELEV GW _COMPS GBS r Dit6Xr' SIZE ��3 '] A ; # °LI E z A ,FIRST 2 ' LEVEL STATEMENT' � f Nfi $ : INLE'i' OUTLET 1cl{� 'f 3i �� {2" OR -1 17 _FT) _ .3'EE REQ.' LEACHING •" ` A :, -. P A`Y•P'/� i. # M MIN' 440 GPD RESERVE AREA 4 ' FROM PRIMARY 2'% SLOPE 777 100 TO WETLANDS .���100`' TO WELLS'l; "4 k TO 5:.H GW (5.' >2M/1N.) ¢ , �s a y 20' TO FND & INTRCPTR *DRAIN.S `,_ ~400 ', TO SURFACER H2O SUPP k 4 9 PERM SOIL SE LO FACILITY �! MIN �12" COUER^ci" FILL? 15' ) ; r k BREAKOUT `MET T z F ' 15 `'TRENCHES } ,i MIN 440 gpd SLOPEi,(min'° 005: Qr 6 /1fl0 ) SIDEWALL.;,DIST..• 3X EFF; W OR. D .{MIN 6'") ✓ RESERVE BETWEEN TRENCHES IN FILL 'MUST. BE .10.' MINS VENTS + (:>3 ' COVER;,. LINE5 >50 '_) y t R .,.._ 44 BOT: y' + SIDE ' X LDNG TOT (.'L x W r x #)`; (DxLx2x#.). (.G/ft2:)'. t -.Copyr-i ght' © 19969 by S':G: Si ,kr f ` { if 4 - . iu.:.C... 1-,-..-L' _.s �" , TI 3 x d r ,_,,,..a......_... s .. w t' k > 5 , f�t , ';f x Y 7 if r7:, ^i,4,v^ ',e_e�<2::., =:_bd:r:.zc.,i:.,; t ,.R 5S.s+a*ai3N=otu'.l..a.. ...•,'^• 1 7 , ^°i Form No.3 t t' + a .. § Town of North Andover, Massachusetts d �. , E,f � `x BOARD OF HEALTH � ; ,� j.s{x• ORTH 1 •, c r, +x,, t.. r i - Frx t N 19.1 t { t oe ��.° r,�a ' t t N.— . G 0 k Fct c x- �"� " DISPOSAL WDRKS'CONSTRUCTION PERMIT �_, , fi 1 - t ` - t TELEPHONE (f. ,I£ •'` Applicant 1 ADDRESS ; NAME t a t���, - _ ite Location E - y+ S 1*11 k Tib 3,; . I r +-, 1. ffii ! P . �r ( ' �= Permissi on is hereby granted to Construct ( or Repair ( ) an Individual Soil.Absorption osai S stem asfshown on the Desi n Approval S.S. No. 90� . 11. 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J -:k .�G t f # r11 r r,h`7t r y 1 1 xg ` { i t r 5 J !+ _ E r a:. . ...� r Kjj:, '� { -„ Ivi r - 'fs Lm.,c �s5 7Fh :.._�{t i's-.:xu.�,w'`�6s, .I*� 3 i { f.t '.i .r-i z .: c. '�� xg.; - .. -r. ,i t r ,�^a z�,.to -, i -I, { ZT ?° i — - - TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System (A) constructed; ( ) repaired; by_ �rC ee«A located at _5e rd-r6 Z., 7,2...3 was installed in conformance with the North Andover Board of Health approved plan, System Design Permit # dated with an approved design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CNIR 15.000, Title 5 and local regulations, and the final grading agrees substantially with the approved plan. All work is accurately represented on the As-built which has been submitted to the Board of Health. Bed inspection date: 1_ ZT f 99 Engineer Representative Final inspection date: 7/19/00 ,�,� �•yL. .yyt� ,,,� Engineer Representative Installer: 61:2z Lic.#: Date: 7 OU Design Engineer: 'lam e.�,�,,,. Date: `7/Z4 J0 i' 11 JUL 2 4 i r APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE:Z'/ CURRENT r STALLER'S LICENSErr LOCATION: A 7 A LICENSED INSTALLER: SIGNATURE: ��=' _ l G�'�— TELEPHONEn CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only 575.00 Fee Attached? Yes L".,/ No Foundation As-Built? Yeses No Floor Plans? Yes , No i ApprovaDate: /l /l/ t Town of North AndoverQt „ORTN '.0 1 OFFICE OF a y`' a,a 1O L COMMUNITY DEVELOPMENT AND SERVICES ° A 27 Charles Street `►a North Andover, Massachusetts 01845 sgc,Hue���y WILLIAM J. SCOTT Director (978)688-9531 Fax (978)688-9542 September 10, 1999 Steven D'Urso 22 Lilly Pond Road Boxford,MA 01921 Re: Lot 23B Rocky Brook Road No. Andover, MA 01845 Dear Mr, D'Urso: This is to inform you that the proposed septic system repair plans for the site referenced above dated 9/1/99 have been approved for a house with a maximum of nine rooms. If you have any questions, please do not hesitate to call the Board of Health Office at 978-688-9540. Sincerely, Sandra Starr,R.S. Health Administrator SS/Smc cc: Dave Kindred File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Sep-08-99 02:37P Paul D. Tut-bide, PE/PLS 508-465-0313 P.02 September 8, 1999 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE; Title V second review for Lot 23a Rocky Brook Road Dear Sandra, t have reviewed the revised design plans for the above-mentioned project with revision date of 9/1199. All the concerns outlined in my report dated August 11, 1999 have been addressed except the following. o My report requested that a 6" stone base be shown beneath the septic tank and dbox. A 6" rg,avel base is shown on the revised plans. The gravel base should be changed to a stone base. (If this minor revision is made 1 do not have to review the plans again.) If you have any questions or comments please feel free to contact me. Sincerely Carlton A. Down,PEIPLS Rockybrooklot23 a2.doc PORT ENGINEERING Civil Engineers& Land Surveyors One Harris Street Newburyport,NIA 01950 (978)465-8594 it r: Town of North Andover NORTH , OFFICE OF Og6S t l t D �'"y 0 COMMUNITY DEVELOPMENT AND SERVICES A 27 Charles Street ".t North Andover,Massachusetts 01845 WILLIAM J. SCOTT SSACHUS�� Director (978)688-9531 Fax(978)688-9542 August 11, 1999 Steven D'Urso 22 Lilly Pond Road Boxford, MA 01921 RE: Lot 23A Rocky Brook Road Dear Mr. D'Urso: This letter is to inform you that the proposed septic plan for Lot 23A Rocky Brook Road, North Andover has been disapproved for the following reasons: 1. Septic tank missing manhole to within 6" of final grade. (310 CMR 15.228(2)) 2. Septic tank and d-box missing six-inch stone base. (310 CMR 15.221(2)). 3. Septic tank inlet tee does not extend minimum of 10" below flow line. (310 CMR 15.227(6)). 4. Septic tank outlet tank does not extend minimum of 14" below flow line. (310 CMR 15.227(6)). 5. Because of proximity to driveway, septic tank should be H-20. 6. Soil tests were performed more than two years ago. (NA 7.05) 7. Street number,map and lot number missing from plan. (310 CMR 220(4)(u)). 8. Names of abutters missing. (NA 8.02j) 9. Distances from tank,leaching area and reserve to property line missing. (NA 8.03b) 10. Limits of excavation around leach area missing. (NA 8.02z) 11. Toe of fill slope must stop 5' from the property line or a Swale must be installed. (310 CMR 15.255(2)). 12. Both trench distribution lines must be connected to vent. (310 CMR 15.152(9)). 13. Leach area less than 4'above ESHW adjusted for high point of existing grade. (310 CMR 15.212). Highest,elevation 126'. ESHW 24" down. Thus elevation under leach area should be 128'. 14. If leach area raised 1' to meet separation to groundwater,building sewer will be above ground unless garage floor and driveway are raised. 15. Impervious barrier appears to be needed on easterly property line for slope or a slope easement needs to be obtained and filed. 16. Final grading on south side of system not legible on plan. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Please do not hesitate to call the Health Department at 978-688-9540 if you have any questions. Sincerely, Sandra Starr,R.S. Health Administrator Cc: D. Kindred H. Griffin File i i Town of North AndoverNORTN OFFICE OF 3�01 4"e o ,e ,Soot e 1" COMMUNITY DEVELOPMENT AND SERVICES A . . 146 Main Street "` t � • North Andover,Massachusetts 01845 ."c.1 WILLIAM J.SCOTT SSACMUSE Director January 6, 1997 Mr. Steve D'Urso 22 Lilly Pond Road Boxford, MA 01921 Re: Lot 23A Rocky Brook Road Dear Steve: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. Benchmark within 75 feet of system missing. (3 10 CMR 15.220(q)) 2. Foundation drain missing. '(N.A. 6.020) 3. Gas deflector/baffle missing from outlet tee of tank. (3 10 CMR 15.227(4)) 4. Add note: First 2 feet of pipe from D-Box to be level. (3 10 CMR 15.232(c)) If you have any questions, please do not hesitate to call the Board of Health Office at the number below. Sincerely, Sandra Starr, R.S., Health Administrator SS/cjp cc: Flintlock, Inc. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING} 688-9535 DATE 1101177 Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEE XZOO PERMIT # DATE RECEIVED APPLICANT�,--/-//!)rG(x,C ASSESSOR' S MAP PARCEL # ADDRESS /(J, /9, LOT # STREET ENGINEER Jam" . ��/ 56 1� tb ADDRESS Z/GG X� 9al PLAN DATE /� Q REVISION DATE CONDITIONS OF APPROVAL: APPROVED DISAPPROVED l r.� <s 0 S ,57'E .ter ve/�-�� ;phi'/:s..���v� C/I/• l9. o� o urc&r S FE 61 7-A.v,C (,3/0 Al l Xs a a 7 (¢)) q RA b N DTc ; t/�e 5 T a ' aL -7711-2C �,�a�t ro (3�Q ew fu`-, ? (co SEPTIC PLAN SUBMITTALS LOCATION: 4 cir17 NEW PLANS: YES $60.00/Plan 4,—' REVISED PLANS: YES $25.00/Plan DATE: I c DESIGN ENGINEER: 11 A,/00 When the submission is all in place, route to the Health Secretary SEPTIC PLAN SUBMITTAL FORM LOCATION: NEW PLANS: YES $125.00/Plan REVISED PLANS: C SS/ $ 60.00/Plan t,� SITE EVALUATION FORMS INCLUDED: YES O DATE: '" ._..._ .l`i't fel r-F''lf't•:_.✓. ^.�/ DESIGN ENGINEER: � p ILII 3 0 P 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 lace route to the Health Secretary. place, rJ' SEPTIC PLAN SUBMITTAL FORM LOCATION: L c NEW PLANS: YES $125.00/Plan REVISED PLANS: YES $ 60.00/Plan / Y SITE EVALUAT ON ORMS INCLUDED: YES NO DATE: DESIGN ENGINEER: / `�� )DO e SCD 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. r M Town of North Andover, Massachusetts Form N°,s l pf NpRTM, 91 BOARD OF HEALTH 16 DESIGN APPROVAL FOR ss"CMSOIL ABSORPTION SEWAGE DISPOSAL SYSTEM i 771 }' Test No. • Applicant r Site Location i Reference Plans and Specs. 4: ENONEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. t {' CHAIRMAN,BOARD OF HEALTH F 4; Fee Site System Permit No. a _ r Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH OF neo i q� 61 6 9 -av Tom *�RA�gATEDWPQpy^`y* APPLICATION FOR SITE TESTING/INSPEC D�SSACHUS��. Applicant a ;v-vl I jjz �� _ NAME ff ADDRESS TELEPHONE Site Location 1. Engineer " NAME �y /ADDRESS TELEPHONE Test/I nspection Date and Time II J4 �4'1z-4 i CC AIRMAN,BOARD OF HEALTH Fee D , Test No. 1 S.S. Permit No. D.W.C. No... . C.C. Date Plbg. Permit No. i i i JT�ti • ..> ._. b. .« :M k_.._....:y, .� 4� ., a __,__ �.r'. _ ;.._— ___. FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 TO BOPOf Ru No. Commonwealth of Massachus tts �• , Massachusexs Soil Suitability Assessment for On-site Sewage Disposal r Performed By: � Date: 3 Witnessed By: � __ l.earron Address a Owrcr'r Name. Addrus.aid L'W A ,,, Telepinre / � Z3 pew Construction Repair ❑ `6 &/a Office Review Published Soil Survey Available: No ❑ Yes r. t Year Published Publication Scale / �'jj—/�G G.9 Soil Map Unit W Soil Limitations __l!/ G..... . _ . . ........ Drainage Class , Surficial Geologic Report Available: No ❑ Yes ❑ Year Published Publicatic.i Scale GeologicMaterial (Map Unit) .................................................................................................................. ..._........................... t Landform ........................................................ Flood Insurance Rate Map: Above 500 year flood boundary No ❑YYes Within 500 year flood boundary No UYes ❑ Within 100 year flood boundary No UYes ❑ Wetland Area: National Wetland Inventory Map (map unit) .... ........................................................................................... Wetlands Conservancy Program Map (map unit) ..............:................................................................................._ Current Water Resource Co itions (USGS): Month Range :Above Normal Normal ❑Below Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 y FORM 11 SOIL EVALUATOR FORM Page I of 3 Location Address or Lot Ivo. 23 On-site Review Deep Hole Number Date: 3o o�a YG Time: OU Weather 03-ba-C Location (identify on site plan) Land Use Slope (°o) -,73 Surface Stones Vegetation � � xz, Landform Position on landscape (sketch on the back) Distances from: Open Water Body ,�� feet Drainage way,?/4() feet Possible Wet Area 7 v feet Property Line _,5Y- feet Drinking Water Well feet Other i� DEEP OBSERVATION HOLE OG' Deoth fromI Soil Horizon Soil Texture I Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel) ✓F2 / PROPOSED l Parent Material (geologic) /[_(_ DepthtoBedrock: rr c! Depth to Groundwater: Standing Water in the Hole: ZG Weeping from Pit Face: 76 Estimated Seasonal High Ground Water: 2 L 5 i DEP APPROVED FO"I-12/07/95 03-21-1996 14:36 617 932`7615 DEP- NORTHEAST-REGION4C P 02 FORM 12 PERCOLATION TEST-, I! Location Address or Lot No. COMMONWEALTH -OF MASSACHUSETTS V Massachusetts Percolation Test' Deter 30 �� Time: <C� Observation Hole Depth of Perc { S Start Pre-soak End Pre-soak / Time at 12" Time at 9„ y 0'- Time at 6" Time (9"-6") Rate Min./inch Minimum of 1 percolation test must be performed in both the primary area AND reserv7ite Site Passed Failed ❑ .................. .... Performed By: Witnessed By:"',. Comments: _.. FORM 11 SOIL EVALUATOR FORM Pagc - of 3 Location Address or Lot Ivo. 23 On-site Review Deep Hole Number Date: .30�. & Time: Aoe) Weather aZwe-C, Location (identify on site plan) �__((Wmo< Land Use lit Slope (°o) Surface Stones %fa Vegetation G�lr'iyte l` �-o�t�DdGL/Jo� Landform Position on landscape (sketch on the back) — Distances from: Open Water Bodyfeet Drainage way/ O feet �/00' Possible Wet Area feet Property Line 30 feet Drinking-Water Well NIA feet Other DEEP OBSERVATION HOLE _OG' Depth from Soil Horizon Sod Texture `Soil Color Soil Other Surface (Inches) I (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % . Gravel) t . rSL MINIMUM OF 2 i EVERY PROPOSEDAREA Parent Material (geologic) z/G,/-_ DepthtoBedrock: u tr Depth to Groundwater: Standing Water in the Hole: �G Weeping from Pit Face: QGG Estimated Seasonal High Ground Water: �� y DEP APPROVED FOFNt- 12107195 03-21-1996 14:36 617 932 7615 DEP NORTHEAST REGIONAL P.02 FORM 13 - PERCOLATION TEST Location Address or Lot No. Z3 COMMONWEALTH OF MASSACHUSETTS Q�d j6e , Massachusetts Percolation Test' Date: .�D Time: Observation Hole # Depth of Perc � `r Start Pre-soak / / 50 Er►d Pre-soak Time at 12" Time at 9" , Time at 6" Z Z Time (9"-6") 1 Rate Min./Inch * Minimum of 1 percolation test must be performed in both the primary area AND reserve area.ar/ea. Site Passed LJ Sits Failed ❑ . .................. ....... ... .............. .. Performed By: A- Witnessed 8y:�• �s Comments: _.. Dip AMOY=VO AA-W"1911 � Y FORM I1 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. 03 Determination for Seasonal High- Water Table - Method Used: 74 I-1 Depth observed standing in observation hole ,inches 9--DDepth weeping from side of observation hole 74 e 96 inches.' 9 Depth to soil mottles z-//-""inches ❑ Ground water adjustment .... feet Index Well Number Reading Date .__... .. Index well level Adjustment factor Adjusted ground water level Depth of Naturally Occurring Pervious Material Does at least four feet of- naturally occurring pervious material exist inII areas. observed throughout the area proposed for the soil absorption. system? V If not, what is the depth of naturally occurring pervious material? Certification I certify that on J/ (date) I have Passed the soil. evaluator examination approved by the Dep rtment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature Date DEP APPROVED FORM• 12/07/95 TA i COLO TIO n TE5T ,DA . l./2/S T/A S,EIZ4, < PT DATE /v� /� � DATE /ol ola(. DATE w f5ATE- Mt lN/ IN RATE 9 MIN //A) HATE 11 2g '3 44 4811 s /6 /7 k 1 x� _ TE5 T P17- ,DA TA TP /Z & TP TP / z+ DATE .5 /,6 DA7E DATE 5 file(v o - 24 0- 24 " TDP "1 r�N LJ ij, Y !L z4 - M Lq za 70' s T l LL -5ANW/ V q: ¢ . U4f � wV 60 _0 s TOP EL. WATER EL 11914 //9. 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