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HomeMy WebLinkAboutMiscellaneous - 54 LONG PASTURE ROAD 4/30/2018 LONG PASTURE ROAD ] 210/106 0000.0 .rc=- Com' �.. �' I Town of North Andover °f NORTH , Office of the Health Department ,«eo °p wo Community Development and Services Division 400 OSGOOD STREET North Andover,Massachusetts 01845 SwCMUs Susan Y. Sawyer,REHS/RS 978.688.9540-Phone Public Health Director 978.688.9542-Fax f RTIEICArr O F CO�Vl�1'GIA�CE As of: December 10, 2004 This is to cert that the individuafsu6surface dzsposalsystem repaired 'X' - Full System 6y .Geo :Virnelli at 54 (Got 3) .Gong Pasture North Andover, 31A 01845 has been instalfed in accordance with the provisions of Titfe v of the State Sanitary Code and with the North Andover Board of9fealth regulations. The issuance of this certificate shall not.be construed as a guarantee that the system will function satisfactorily. Susan T Sawyer (Public Yfealth Director BOARD OF APPEALS 688-954.1 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I TOWN OF NORTH ANDOVER SEWAGE DISPOSAL SYSTEM i INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( 'constructed; ( )repaired; by located at -� Safi And ver oard of He was installed in conform ce with the North alth approved plan, System Design Permit# �O/ ,plan dated , with a design flow ofd 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 CMR 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. i i Bed inspection date: j Engineer Representative j I Final inspection date: Engineer Representative Installer: �/i "o` Lic.#: Date: � c► T Engineer: Date: i AS-BUILT CHECKLIST LOT NUMBER STREET NAME ASSESSORS MAP & PARCEL NUMBER LOT LINES & LOCATION OF DWELLINGS LOCATIONS &DIMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES &DWELLING, WELLS I a. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION LOCATIONS OF WELLS, DRAINS, WATERCOURSES 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. NORTH ARROW LOCATION & ELEVATIONS OF BENCHMARK USED INSPECTION CHECKLIST FOR SEPTIC SYSTEMS 1R Yes NO Initials A. Bottom of Bed 1. Excavation to proper depth 2. With trenches,sides of excavation are beneath B horizon �� 3. Edge of excavation specified distance from foundation,etc. Comments: i B. Retaining Wall 1. Wall height and width as'specif,ed 2. Waterproofed 3. Wall minimum 10'to leaching fa ''ity 4. Wall meets specifications of plan Comments: C. Building Sewer 1. Pipe diameter minimum 4" 2. Schedule 40 pipe •✓ 3. Watertight joints ✓ 4. Inlet to tank cemented 5. Slope minimum 0.01 or 1/8"per foot minimum 6. Pipe properly set on compact firm base 7. Pipe laid on continuous grade in straight line 8. Cleanouts precede all change in alignment and grade 9. Manholes at any 90°change 10. 10' minimum offset to water line Comments: D. Septic Tank 1. Level 2. 1,500 gal minimum ✓ �/3 3. Gas baffle present on outlet 4. Manhole to grade 5. Manholes over center and each tee 6. 3-20"manholes 7. Inlet tee minimum 12"under invert 8. Outlet tee minimum 14"under invert 9. Outlet line cemented 10. Air space 3"above tees 11. 2"-3"drop from inlet to outlet 12. Pipe set 13. Compact base with 6"of/4"crushed stone under tank .s/3. - 14. Tank is watertight Comments: Yes NO E. Pump Chamber 1. If separate from tank,com act base 6"of/<"stone underneath p ,,, 2. Minimum 2"pipe to d-box if gravity•s}�st 3. 20"access manhole \`� 4. Tank level 5. Watertight 6. Tank size agrees with plan specification 7. Manhole to grade 8. Check valve and bleeder hole present 9. Alarm in building on separate circuit 10. Alarm functions 11. Manual operating switch 12. Pump delivers liquid to d-box Comments: F. Distribution Box 1. D-box level ✓ 2. Minimum 0.17'(2")drop from inlet to outlet 3. Minimum 6"sump 4. Outlet pipes show equal distribution 5. Compact base with 6"of stone beneath box 6. Box is watertight 7. All lines cemented with hydraulic cement 8. Schedule 40 pipe Comments: G. Soil Absorption system 1. All stone double-washed-'/4"- 1 '/2" -pea stone Bucket test done? 2. Minimum 2",ofpea stone above distribution lines 3. Minimum 6"stone beneath pipe 4. Distribution lines capped or connected together 5. Grading meets 3:1 slope 6. Minimum of 9"of fill graded over system 7. Toe of slope stops minimum 5' from edge of property, if not,then swale. Comments: H. Leach Trenches 1. Minimum 2 trenches 2. Length of trenches agree with plan. (Max. length 100') 3. Width of trenches agree with plan-Minimum 2';maximum-4'. 4. Vent present if<50 feet or specified ✓r� 5. Distance between trenches minimum 4'and maximum of 6' -� 6:• Minimum distance between trenches 10' 7. Pipe slope minimum 0.005 or 6"per 100' 8. Depth of trenches below outlet invert minimum of 6". os/ Yes NO 9. Pipes set on stable base. Comments: 1. Leach Field 1. Maximum length of field 100' 2. Pipe slope minimum 0.005 or 6"per 100' 3. Separation between pipe 6'maximum 4. Pipes connected at end 5. Separation between adjacent fields 10' minimum 6. Pipes set on stable base 7. Maximum 4' separation from edge of field to first line 8. Minimum two distribution lines 9. Maximum perc rate 20 mpi Comments: J. Leaching Pits 1. Minimum inlet pipe 4" 2. Pits of concrete 3. Sidewall between 12"and 48"wide 4. Access manholes on each pit 5. Pipes cemented with hydraulic cement Comments: K. Final Grade 1. Slope over soil absorption system minimum 0.02 2. All system components covered by at least 9"soil 3. Cover soil free of stones larger than 6" 4. Grading slopes away from dwelling 5. No areas over system that may pond Town of North Andover, Massachusetts F°""No.a e AORTH BOARD OF HEALTH p t��eo 6. O 9 �off_<«A<'«:�:.�+�• DISPOSAL WORKS CONSTRUCTION PERMIT 9SgAC1K4USE'� Applicant NAME ADDRESS / TELEPHONE / - •-- G. Site Location .�C'� /7 Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN,BOARD OF HEALTH Fee 42,7 D.W.C. No. /'` BOARD OF HEALTH t NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: /3 Q CURRENT INSTALLER'S LICENSE# LOCATION: .P LICENSED INSTALLER: SIGNATURE: / TELEPHONE# CHECK ONE: REPAIR: NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As-Built? Yes v No Floor Plans? Yesy No Approval Date: 0/ 0 INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at Aa Z,e relative to the application of ,-o dated_ © b 0 for plans by&R�, ,-4 f fern i' and datedwith revisions dated o I under *dthefollowing obligations for manajerrknt of this project: 1. As the installer I am obligated to call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item two shall be applicable. 2. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a$50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As-built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade—Installer must request inspection when all grading is complete. Does not have to be on site. 3. As the installer I understand that persons or companies not associated with my company may not perform the work required by my company to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license in the Town of North Andover plus significant fines to all persons involved. 4. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff. d) Installation of tank, D-box, pipes, stone, vent, pump chamber, retaining wall and other components. 5. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Undersigned Licensed ep ' Installer Date: Disposal Works Construction Permit# SEPTIC PLAN SUBMITTAL FORM LOCATION: d1 NEW PLANS: YES $125.00/Plan REVISED PLANS: YES $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES NO DATE: /26 /00 DESIGN ENGINEER:—C N C S i k �-)\i 5axi fi S t'S I 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. SEPTIC PLAN SUBMITTAL FORM LOCATION: J� !.d>?� p, y � 4)61- Grte' 2 NEW PLANS: YES $125.00/Plan REVISED PLANS: ( YES2- $ 60.00/Plan SITE EVALUATION FORMS INCLUDED: YES DATE: 10 dZ49620 26 DESIGN ENGINEER: k 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. i Town of North Andover, Massachusetts Form No.2 G�NORTN 1 BOARD OF HEALTH c7' o DESIGN APPROVAL FOR ss"C""SE` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant i f yd'OhIAk 1 �r-DrYUQ Test No. 9Z7 Site Location LOT � 3 • Reference Plans and Specs.— ENGINEER pecs. ENGINEER DESIGN DTE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. J/� CHAIRMAN,BOARD OF HEALTH : Fee ��lJ Site System Permit No. a NORrN a TOWN OF NORTH ANDOVER BOARD OF HEALTH49 27 CHARLES STREET NORTH ANDOVER,MASSACHUSETTS 01845 �9s»�,•o Eta saC U SANDRA STARR,R.S., C.H.O. Telephone(978)688-9540 Health Director FAX(978)688-9542 October 27, 2000 Phil Christiansen Christiansen& Sergi 160 Summer Street Haverhill,MA 01830 Re: Lot 3 Long Pasture Dear Phil: This is to inform you that the revised septic system plans dated 10/20/00 for the site referenced above has been approved for a maximum eleven-room house. 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., C.H.O. Health Director SS/smc cc: Crowley File rr y R CHRISTIANSEN & SERGI, INC. PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830-6318 (978)373-0310 FAX: (978)372-3960 October 20, 2000 Ms. Sandra Starr, Health Director North Andover Health Department 27 Charles Street North Andover, MA 01845 Re: Lot 3 Long Pasture Dear Ms. Starr: We have received a copy of your October 13, 2000 letter of disapproval for the Septic System Design for the above referenced lot, and we have revised the plans accordingly. The following is a list of our responses to each of your reasons for disapproval. To facilitate your review of this information, I have reproduced each of your reasons for disapproval in Italics, and my response to each comment immediately follows. 1. Assessor's Map Number and Parcel Number not shown as required by NA 8.02a. The Assessor's Reference has been added to Sheet 1. 2. Names of abutters from recent tax map not shown as required by NA 8.02j. The names of the abutters have been added to sheet 1. 3. The controlling ESHWT elevation shown on deep hole 96-16(111.5) does not correspond with the ESHWT elevation shown on the system profile (112.5). The ESHWT listed on the profile is an extrapolation of the ESHWT recorded in the test pit. The elevation of the existing ground at Trench#1 is one foot higher than the elevation of Test Pit 96-16;therefore we have assumed the ESHWT at Trench 1 to be one foot higher than the ESHWT recorded in the test pit. 4. The surface elevation of 110.3 for deep hole 96-17 does not correspond with the contour elevation of 112.3 +/-shown in plan view. The proper surface elevation for Test Pit 96-17 is 112.3. The elevations listed in the test pit log have been revised accordingly. s 5. The limit of excavation shown in the profile and section views appears to be 1'-6" deep by scale, which does not provide for the removal of the subsoil as required by CMR 15.240 (1). The average depth of the subsoil is 2'-2"according to 96-16 and 96-17 deep hole logs. The approximate limits of excavation indicated on the system profile and cross- section have been revised to indicate the 2'-2" depth. 6. Engineer's stamp and seal is not original. The enclosed copies of the plans have original stamps and signatures. I trust that these responses, along with the revisions made to the plan, fully address all of your reasons for disapproval. Please contact me if you have any questions regarding this matter. I y youeiansen s ORTM a -Town Of North Andover :�4 a vo+eq�ooA Community Development & Services William J. Scott 27 Charles Street Director North Andover, Massachusetts 01845 (978)688-9531 ss.,cHU Fax 978-688-9542 October 13, 2000 Board of Appeals Steve Crowley (978)688-9541 Crowley Construction, Inc. 138 Virginia Avenue Building Lowell, MA 01852 Department (978)688-9545 Re: Lot 3 Long Pasture Conservation Dear Steve: Department (978)688-9530 This is to inform you that the proposed plans for the site referenced above have been disapproved and have technical deficiencies as followed: Health (978) Department 40 1. Assessor's Map Number and Parcel Number not shown as required by NA 8.02a. Public Health 2. Names of abutters from recent tax map not shown as required by NA 8.02j. Nurse (978)688-9543 3. The controlling ESHWT elevation shown on deep hole 96-16 (111.5) does not match the ESHWT elevation shown on system profile (112.5). Planning Department (978)688-9535 4. The surface elevation of 110.3 for deep hole 96-17 does not correspond with the contour elevation of 112.3 +/- shown in plan view. 5. The limit of excavation shown in the profile and section views appears to be 1'-6"deep by scale, which does not provide for the removal of the subsoil as required by CMR 15.240 (1). The average depth of the subsoil is 2'-2" according to 96-16 and 96-17 deep hole logs. 6. Engineer's stamp and seal is not original. If you have any questions,please do not hesitate to call the Board of Health Office. Sincerely, Sandra Starr, R.S., C.H.O. Health Director Oct-11-00 04i01P Paul D. Turbide, PE/PLS 978-465-0313 P.04 September 18,2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover, MA 01845 RE: Title V review for new construction at Lot 3 Long Pasture Road Dear Sandra, Enclosed find our review of the"Checklist for North Andover Septic System Plans"for the septic system design at the above-mentioned site. The following is a list of technical deficiencies that Port Engineering has found. ❑ Assessor's Map Number and Parcel Number not shown as required by NA 8.02 a. o Names of abutters from recent tax map not shown as required by NA 8.02j. o The controlling ESHWT elevation shown on Deep Hole 96-16(111.5)does not match the ESHWT elevation shown on system profile(112.5). o The surface elevation of 110.3 for Deep Hole 96-17 does not correspond with the contour elevation of 112.3 +/-shown in plait view. ❑ The limit of excavation shown in the profile and section views appears to be 1'-6" deep by scale,which does not provide for the removal of the subsoil as required by CMR 15.240(1). The average depth of the subsoil is 2'-2"according to 96-16 and 96-17 Deep Hole logs If you have any questions or comments please feel free to contact us. PORT it I For Port Engineering Associates,Inc Civil Engineers& Pard D. Turbide,PE/PLS Lend Surveyors One Harris Street Newburyport,MA 01950 (978)465-8594 M6D fM8841GraetviUC 119—00AU9M-d0C Town of North Andover E NORT,y , OFFICE OF 3?0 '6*sy�oL COMMUNITY DEVELOPMENT AND SERVICES p 30 School Street North Andover,Massachusetts 01845 WILLIAM J.SCOTT SSACHU Director July 8, 1997 Christiansen & Sergi 160 Summer Street Haverhill, MA 01830 RE: Long Pasture subdivision i Dear Phil: This letter is to inform you that the proposed septic plans for Lots 3 & 4 Long Pasture Road have been approved. _ 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 cc: Wm. Scott, Dir. CD&S File Steve Crowley Robin Barclay Book i CONSERVATION 688-9530 HEALTH 688-9540 PT:AVWWC 69Q-9535 CHRISTIANSEN & SERGI, INC. PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830 (508)373-0310 FAX: (508)372-3960 March 6, 1997 Ms . Sandra Starr ; Board of Health 146 Main St . No. Andover, MA 01845 RE: Long Pasture Road Lot 3 Dear Ms . Starr: In response to your letter of Feb 19, 1997, attached is a revision to the above referenced Septic System Design Plan. The following items have been added to the plan: 1 . Wetlands disclaimer j 2 . D-box pipe statement 3 . Assessor' s map and parcel . V r u ,y Php G. Christiansen PGC;lc Town of North AndoverNORTH OFFICE OF 3�O4 1 BOOL COMMUNITY DEVELOPMENT AND SERVICES A 146 Main Street North Andover,Massachusetts 01845 ��"°•,..°�.P'��y WILLIAM J. SCOTT S$AGMUS� Director February 13, 1997 Christiansen& Sergi 160 Summer Street Haverhill, MA 01830 Re: Lot #3 Long Pasture Dear Phil: This is to inform you that the proposed plans for the site referenced above have been disapproved for the following reasons: 1. Wetlands Disclaimer missing. 2. Map & Parcel missing. 3. First 2 feet out of D-box to be level statement required. 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: Applicant William Scott, Director, P&CD File BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 k NORTH ANDOVER BOARD OF HEALTH DESIGN REVIEW REPORT DATE a ,r 197 FEE: PERMIT # DATE RECEIVED a oh 7 AP P L I CANT ZnJ6 'P/7SrU,PE G/6V MAP PARCEL ADDRESS-PU,8 343LOT ## 5 STREET ## ENG. STREET ENGINEER' SADD. 1,66) JUMMI=� �T /TSV PLAN DATE /I17/94� REV. DATE 1� 3 , �/Ie5 r our oc D-Bob( TO 8E LEvEL APPROVED DISAPPROVED REASONS FOR DISAPPROVAL: I I=/GG CHRISTIANSEN & SERGI, INC. PROFESSIONAL ENGINEERS AND LAND SURVEYORS 160 SUMMER STREET HAVERHILL, MASSACHUSETTS 01830 (508)373-0310 FAX: (508)372-3960 T0: Ms . Sandra Starr Board of Health North Andover i RE : Septic System Design Plans qjgj�& Date : FS Attached are plans for -- to-t 3 Lon, Aas4v ^e— This 'design is a new submittal a revision with the following changes t FORM 11 - SOIL EVALUATOR FORM Page 1 of 3 Date: ///7/f No. ' Commonwealth of Massachusetts t/6jt M ti�vv t , Massachusetts Soil Suitability Assessment for On-site Sewage Disposal C.rv�✓ Date: 5Y1 .�........... By: ...................I............. Performed B �^! �-......rr?.............................. � . N� .................................................. ........................... WitnessedBy: ................f....:.......Y.........S.1lgJ2 .....:;............................................................... A r- Owner's Na .meLOAI�j oq_S 1-41z4E �Gr4 /'/�E✓VT�4 /s°t Uation Address or l/� Address.and l ,dp V ) A Lot I Telephone I 1�,U J t. o 34 3 (OFf r6wconstruction I?Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes Soil Map Unit C 60............ Year Published .bj.. Publication Scale 5�.�� .............................. ................. Drainage Class Wf LL Limitations ....................................................... Surficial Geologic Report Available: No E?" Yes : ❑ Year Published Publication Scale Geologic Material (Map Unit) ............................:............................................................... ................... ......... Lacidform ................... .................................................................................. Flood Insurance Rate Map: Above 500 year flood boundary No ❑Yes Q Within 500 year flood boundary No ❑Yes Within 100 year flood boundary No ❑Yes ❑ Wetland Area: ............................ National Wetland Inventory Map (map unit) ........................................................................ ................................................................................................. Wetlands Conservancy Program Map (map unit) Current Water Resource Conditions (USGS): Mont Range :Above Normal ❑Normal ❑Belc-v Normal ❑ Other References Reviewed: DEP APPROVED FORM-12/07/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 i Location Address or Lot No. On-site.Review S L¢ 6Z:/S� Weather 5'5'1441-VY-V7� Deep Hole Number '�::� Date:...::.a:...::. Time:.. Location (identify on site plan) _ ., Land Use .:....:.W 0 Slope (%) -f Surface Stones c"Mr,�J Vegetation . .tJ...::Plnif�} ol4Kl: Landform IyU.::. ::...::...::.. .. . . - Position on-landscape (sketch on the back) Distances from: Open Water Body feet Drainage way feet Possible Wet Area feet Property Line feet Drinking Water Well feet Other , DEEP OBSERVATION HOLE _OG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % Grave�S(- luyt2Z/Z VC FK40Y L Z 9 F S L . 2T.K/6 54�(3 mw5stvg, r-Pvvrt-f_ G Z-� ��. 9G C( fSC, 2,S4 4¢1 Zg' (,f F(" (" Pu4 GF„ L C,o lq�Lt,t It LQ Kf r Parent Material (geologic) [[ Depthto8edrock: 7 96 Depth to Groundwater: Standing Water in the Hole: q Z Weeping from Pit Face: 60 `f Estimated Seasonal High Ground Water: DEP APPROVED FORM- 12107/95 FORM 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No. U7- 3 L Oa& On-site Review Deep Hole Number._ SI ./ Time:.. ..PS-0 %S� Weather S �`� 70 1..� Date:.::.::.. Location (identify on site plan) -. _ Land Use ...... L.J.v o b$ Slope (%) �S'ZS Surface Stones f30171v4F­� Vegetation 'pi 7.1 plw� f..:K�13�:..f3Cy r31e✓�in:K _:,.... Landform Position on-landscape (sketch on the back) i Distances from: Open Water Body _ feet Drainage way feet Possible Wet Area . . . ....... feet Property Line 40 feet Drinking Water Well feet Other DEEP OBSERVATION HOLE _OG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(Inches) (USDA) (Munsell) Mottling (Structure,Stones, Boulders, Consistency, % 0-C, S L •IoY 12z./2 mo�f,�.K f2o rs016f.>L yY L lo'f�¢�G� ImY12S'/8 Mwss fvc, r'-►uw/3 r C Z-1) c�tit M c,� F-O o 7� Cf 1,,s%(T/4, rr P?&ss've- C,0MML)N fZ dvTS iU 36 / W Parent Material (geologic) T( L�— DepthtoBedrock: 7 Sb Gf �Zrl Depth to Groundwater: Standing Water in the Hole: gam_ Weeping from Pit Face: rf Estimated Seasonal High Ground Water: f`1 DEP APPROVED FORM-12107/95 v FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 i Location Address or Lot No. (Al 3 CCAJG- PtiSTUYZ.C�E' Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing'in observation hole.............:..... inches Depth weeping from side of observation hole................... inches Eg-Depth to soil mottles;...:j.:. ::' inches ❑ Ground water adjustment .....:..:.......... feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor ................... Adjusted ground water level ....................................................... j Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area:proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certification = I certify that on (date) I have passed the soil evaluator examination approved by the=Depart ent 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-12/07195 r , v FORM 12 - PERCOLATION TEST Location Address or Lot No. UT- i A%TUarL COMMONWEALTH OF MASSACHUSETTS �Clk ll( 41V O UVEA , Massachusetts Percolation Test* Date: Observation Hole Depth of Perc 510 Start Pre-soak /11131. 3 0 �! 7 End Pre-soak0 '. Time av 12" 10 ' 3 If ; � Time at 9" Time at 6" Time (9"-6") ® l Rate Min./Inch i( * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Passed Site Failed ❑ ..............................................................................................:......................................_....._................ Performed By: t iv t "t: O`er NNS U Witnessed By: /v 01 51`0 G /tel" &4-t4F0-:q:.5 a? Comments: .:..:::..:.:.::.:::::::::::::..::::.................::::...:::.::.:::::.._::.::::..:..::::::.::....::::::::..::::.::..::..,::::::::.:..:............._.:::.. :.::::.:.:::,.:..:.:.::::::::.::::.........,........ DEP APPROVED FORM-12/07/95 // PLAN REVIEW CHECKLIST ADDRESS � l!rD7- 3 1-4V6 lyigSTU/lE ENGINEER GENERAL / 3 COPIES STAMP L/ LOCUS 4---' NORTH ARROW v SCALE CONTOURS PROFILE ✓ SECTION C/� BENCHMARK SOIL & PERCS Q--f ELEVATIONS WETS. DISCLAIMER WELLS & WETS WATERSHED?-J/--O DRIVEWAY t/ (Eley) WATER LINE (,� FDN DRAIN SCH40 TESTS- CURRENT? SOIL EVAL D © ICU,VNELG C SEPTIC TANK MIN 150OG ie� . 17 INVERT DROP GARB. GRINDER,&0 (2 comps +200) 10 ' TO FDN u,-' MANHOLE QK- ELEV L-- GW # COMPS.L GB ✓ D-BOX SIZE # LINES FIRST 2 ' LEVEL STATEMENT INLET I ,LO - OUTLET .II 7. / (2" OR .17 FT) TEE REQ'D? !y 0 LEACHING MIN 440 GPD? L--' RESERVE AREA l/ 4 ' FROM PRIMARY? "'' 2% SLOPE 100 ' TO WETLANDS ✓ 100 ' TO WELLS &"" 4 ' TO S.H.GW z-' (5 ' >2M/IN) 20 ' TO FND & INTRCPTR DRAINS L/- 400' TO SURFACE H2O SUPP C,--" 4 ' PERM. SOIL BELOW FACILITY MIN 12" COVER c--'I FILL?_ (15 - ) BREAKOUT MET? TRENCHES MIN 440 gpd L'/ SLOPE (min .005 or 6"/100 ' ) L--�SIDEWALL DIST. 3X EFF. / ? &- --"--MUST OR D (MIN 6 ) RESERVE BETWEEN TRENCHES. IN FILL.? MUST BE 10 ' MIN. 1//c4" PEA STONE? 1,-' VENT? L-� (>3 ' COVER; LINES >501 ) BOT �� + SIDE 96/ X LDNG S = TOT 7 (L x W x #) (DxLx2x#) (G/ft2) Copyright 0 1996 by S.L. Starr Town of North Andover, Massachusetts Form No. 1 1 NORTHA. 6 40 BOARD OF HEALTH �/} O ISLE° , 6 /`i/. 3� h� OL g z^� o °fir..;: r 191-0 - ��7 °°° E~°• " APPLICATION FOR SITE TESTING/INSPECTION �95SACHU5E� Applicant _...h$t 4 NAME !/ ADDRESS TELEPHONE Site Location /� ��. -i',�'",Gt►•��,J�_.!1 I' Engineer ( A. A,-,UI rl �C NAME ADDRESS U TELEPHONE Test/Inspection Date and Time r t� 'CHAIRMAN,BOARD OF HEALTH Fee C / Test No. `7fe r y' i S.S. Permit No. 9b/ D.W.C. No./c� l C.C. Date Plbg. Permit No. I Sent by:G May-18-ee 08:57 from 97SZ7239604508 688 9542 cage 2i 2 Received May-121-00 14:17 from 508 688 9542 -► G May-12-00 14:08 North Andover Com. D@v. 508 688 9542 P.02. BOARD OF HEALTH NORTH ANDOVER, MA 01845 978-688-9540 APPLICATION F R SOIL TESTS DATE: /P Do MAP & PARCEL: /4 G LOCATION OF SOIL TESTS: T� _ E OWNER: _ r TEL NO. ADDRESS: / r 4.� � r ENGINEER: C/�.. TEL.NO.: CERTIFIED SOIL EVALUATOR: Intended Use of Land: Residential SubdivisionIngle family Some Commercial d8 Is This: Repair Testing; Undeveloped lot testing: -- - ------- - In the Lake Cochichewick Watershed' Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM 1. Proof of land ownership(Tax bill,or letter from owner permitting test) 2. Plot plan & Location of Testing 3. Fee of S ?� 5.04 per lot for new ntc _consttion. This covers the minimum two deep Motes and two percolation tests required for each disposal area- Fee of$75.Q0 per lot for rena+*s or uoartides. GENEg,AL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections_ 2. Only Maas.Registered Sanitarians and Professional Engineers can design septic plans. 3. At least two deep holes and two percolation tests are required for each septic system disposal area. 4. Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH representative. 5. Full payment will be required for all additional tests within two weeks of testing. 6. Within 45 days of testing, a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health showing the location of all tests(including aborted tests). 7. Within 60 days of testing soil evaluation forret shall to submitted. Please Do Not Write Below This Line N.A.Conservation Commission Approval: r0 Date Received: Check Amount. Check Date: Jun-23-00 08:35A Paul D. Turbide, PE/PLS 978-465-0313 P.01 Facsimile Cover Sheet i To: SANDRA STARR Company: NORTH ANDOVER BON Phone: 978-688-9540 Fax: 978-688-9542 From: Carlton A. Brown Company: Port Engineering Associates, Inc. Phone: (978) 465-8594 Fax: (978) 465-0313 Date June 22, 2000 Pages Including This Cover Page: df + Comments: Sandy, Enclosed are results of testing for Lot 3 Long Pasture Road Thanks, Carlton 1 Jun-23-00 08:35A Paul D. Turbide, PE/PLS 978-465-0313 P_02 June 22, 2000 Sandra Starr North Andover Board of Health Administrator Office of Community Development and Services 30 School St. North Andover,MA 01845 RE: Soil testing on Lot 3 Long Pasture Road Dear Sandra, Section 7.05 of the"Town of North Andover Minimum Requirements for the Subsurface Disposal of Sanitary Sewage"states"The results of the Deep Observation Holes shall expire two years from the date conducted unless the Board of Health or its agent determines that the existing soil logs are sufficiently comprehensive so as to not require additional testing, and the site had not been altered. Retesting of expired results shalt require a new testing pursuant to the current fee schedule." The Town has design plans prepared by Christiansen and Sergi of a proposed septic system for Lot 3 Long Pasture Road. These plans rely on a soil evaluation performed using the standards of the current Title 5,but were performed more than two years ago. I find that the soil logs are sufficiently comprehensive so as not to require additional testing, however the site may have been altered. On June 22,2000 I met at the site with Gene Willis, soil evaluator for Christiansen and Sergi. He had prepared deep tests(and I observed as agent of the Board of Health)in the area of the proposed leaching bed to determine whether the site had been altered. As outlined below,I find that the receiving layer for the proposed leaching bed(the C horizon shown on the design plans)has not been altered, and therefore that the existing soil logs shown on the design plans are adequate for the design even ffough they are more than two years old. Christiansen and Sergi staked the proposed trench leaching bed on the ground with beanpoles. As shown on the enclosed field notes,we found that half of the proposed leaching field area has not been altered, and has 6 inch to 15 inch trees over and in the immediate vicinity. We did dig Test Pit 3A to evaluate the area that had been disturbed. We found that there was an existing A horizon, an undisturbed existing B horizon, and an undisturbed existing C horizon. The A and B horizons still had undisturbed root growth. My professional opinion is that the disturbance over half of the receiving layer POFT consisted only of grubbing and stumping the land. There was still a thin layer of A horizon left, which would be consistent with grubbing and stumping. ENGINEERING Civil Engineers& Land Surveyors One Harris Street Newburyport,MA 91950 (978)465-8594 Jun-23-00 08:35A Paul D_ Turhide,. PE/PLS 978-465-0313 P_03 In conclusion, I find that the receiving layer for the proposed teaching bed(the C horizon shown on the design plans)has not been altered, and therefore that the existing soil logs shown on the design plans are adequate for the design even though they are more than two years old. If you have any questions or comments please feel free to contact me. Sincerely Carlton A. Brown,PE/PLS Longpasturelot1doc I 1 r � c c , mm "PRmm r�rr. �:� r-�w�la�.�w■��1�!! rays T■!`IC9. ripw !!!� r!!mmilL"Ww w�■W-�� !li�w�:smm ilwi! =i WFm �i!! �;s�acw�ar�ii�i■!lrwr�r■ ! !!m!!!r! !� �!l � ��rsil�r■�rmmwrw ■�� !! �wlrmm m iii _