HomeMy WebLinkAboutMiscellaneous - 545 SHARPNERS POND ROAD 4/30/2018 545 SHARPNERS POND ROAD Rd Road
—` 210/090.6-0040-0000.0
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Commonwealth..of Massachusetts iD
City/Town of I JUN 2 8 2006
System Pumping Record
Form 4 TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
DEP has provided this form for use by local Boards of Health.. The System Pumping Record must
be submitted to the:local Board of Health or other approving authority. .
X Facility Information
.Important:
When filling out 1. System Location, �� Q _�[�_ I/�P��►S�
forms on the �� 9,V��
computer,use
only the tab Key Address
� to move your t�-
cursor-do not
use the�retum Qityfrown State Zip Code
key.
2. System Own
an ep,/4_'
Name
` Address(if different from location)
City/Town Stat
Zip Code
Telephone Number
B. Purnping Record
1: Date.of Pumping Date 2. Quantity Pumped:
Gallons
3. Type of system: ❑ Cesspool(s) Septic'Tank- ❑ Tight_Tank
❑ Other(describe)-
Effluent Tee Filter present? ❑ Yes (moo If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System:
tAl
6: Sys em Pumped
Na rte, Vehicle License Number
Company --
Z.
LocaUQn where cont6nts w7,a�disposed:
d.
Ana f Hauler Date
h.ftp://www.mass.govidep/water/approval.t/t5forms.htm#inspect
t5form4.doc•06103 System Pumping Record•Page 1 of 1
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_ 180000
ELEYADONS
TOP rN0 130.39
t ►IML' OUTLET 127.55
f 5 T INLET I26,93
S T OUTLE T 126,73 c
D-BOX It`LET -,.125.38
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D-BOK OUrTLET 126.20 i
PIT 1 125.92
PIT 2 126.10 t
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Pcn�lD ROAD
I CEFMFY THATTHE SEPTIC V(STEMVAS INSTALLED AS SFS. WN. � MP05AL AS-BUILT
PIAN t5 NOT It►lT hlGF,Q as a v RR�',r�ttYOt"THE 5Y51'E.1 Li, POND RD,
DATF 10-25-85 AL i
I FAkEC ICY " __. _... _ _'__
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+
180000
ELEVA71ONS
10P R40 130.3
I+SSL OUTU-T 1?4 1�5
S T INLET 12r-,93
5T OUTLET 121�r13
1 D-bOY INL[-.T 12&38
D-13OK OU7 ET 126.20
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y PL�t�J 101'4.1 l�t SOBSURFACE W:Wi;1 �
I CERTIFY THAT THE SEPTIC SYSTEMvAAS,INSTAUZI) AS SHOWN. DISPOSAL SYSTF p ^(-3UILT
THIS PLAN IS NOT INTENDED AS.A WARPANTYCF THE SYSTEM.
p `.LOCATION -LOT ? SWPNE#S POND RD. 1
Oar
DAVEY
1 .DATA 10-25-85 _ _._..._ _SCALE 1 40r
PP,EPAaEU gy—
C
a Desio En Oeers A,.;oc.P 0. Box- 5/C)
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Nodh- Afl6b et'
i
W
BOARD OF HEALTH C _.
No.Andover, Mass .
' r
SUBSURFACE DISPOSAL DFMGN CHECK LIST DgUEy
LOT
APPROVED DATE 5-�j 8Jr DISAPPROVED DATE_, _ r�
Provided: Reasons ,� i
S
Title V FAIL 09
Reg 2.5 The submitted plan must show as a minilmrm;
a) the lot to be served-area,dimensions lot #,abutters
location and log deep observation hoes-distance to ties
c location and results percolation tests-distance to ties
d design calculations & calculations showing required leaching area
(e) location and dimensions of system-including reserve area
f) existing and proposed contours
(g) location any vet areas within 100' of sewage disposal system or
disclaimer-check vel2ands mapping
(h) surface and subsurface drains within 100' of sewage disposal
system or disclaimer
(i) location any drainage easements within 1001 of sewage disposal
system or disclaimer-Planning Board files
(J) known sources of water supply .within 2001 of sewage disposal e
system or disclaimer
(k) location of any proposed well to ser Te lot-100 from leaching facili
(1) location of water lines on property-'O I from leaching facility
(m) location of benchmark
(n) driveways
(o) garbage disposals
(p) no PVC to be used in constructioL.
(q) profile of system-elevations of vase -nt., plumb, pipe, septic tank,
distribution box inlets and outlets, cLitribution field piping and
Other elevations
(r) maximum ground water elevation in area sewage disposal system
(s) plan must be prepared by a Professional Engineer or other
professional authorized by lax to prepare such plans
Reg 6 Septic Tanks
(a) capacities-150% of flow, water table, tees, depth of tees,
access, pumping
(b) cleanout
(c) 101 from cellar t„-all or inground svimming pool
(d) 251 from subsurface drains
-Reg 10.2 Distribution Boxes
(a) s ope greater 0.08 w.
Reg 10.11 b) ,sump
TOWN OF NORTH ANDOVER Ot HORTH
Office of COMMUNITY DEVELOPMENT AND SERVICES
HEALTH DEPARTMENT
400 OSGOOD STREET ", . • +�
NORTH ANDOVER, MASSACHUSETTS 01845 'sS�cMuset
978.688.9540—Phone
Susan Y.Sawyer,REHS/RS 978.688.9542—FAX
Public Health Director E-MAIL: healthdept@townofnorthandover.com
WEBSITE:httg://www.townofnorthandover.com
April 11, 2005
To all Sharpeners Pond Road Residents:
Please note that it has come to the attention of the Health Department that many residents are
leaving their trash barrels and trash bags out at the curbside for days, or weeks at a time.
Empty trash barrels blowing about in the road are a safety hazard, and trash and debris along the
roadway is a health hazard. Please be mindful of this, as the Health Department will conduct
periodic inspections of the area to determine who is in violation,and fines will be issued if
protocol is not followed.
The Board of Health follows the State Sanitary Code regarding Human Habitation,
105.CMR.410, Section 1:
410.600
(A): Garbage or mixed garbage and rubbish shall be stored in watertight.receptacles with tight-
fitting covers. Said receptacles and covers shall be of metal or other durable, rodent-proof
material. Rubbish shall be stored in receptacles of metal or other durable, rodent-proof material.
Garbage and rubbish shall be put out for collection no earlier than the day of collection.
(B): Plastic bags shall be used to store garbage or mixed rubbish and garbage only if used as a
liner in watertight receptacles with tight-fitting covers as required in 105 CMR 410.600(A),
provided that the plastic bags may be put out for collection except in those places where such
practice is prohibited by local rule or ordinance or except in those cases where the Department of
Public Health determines that such practice constitutes a health problem. For purposes of the
preceding sentence in making its determination the Department shall consider, among other
things, evidence of strewn garbage, torn garbage bags, or evidence of rodents.
410.602
(A)Land. The owner of any parcel of land, vacant or otherwise, shall be responsible for
maintaining such parcel of land in a clean and sanitary condition and free from garbage, rubbish
or other refuse. The owner of such parcel of land shall correct any condition caused by or on
such parcel or its appurtenance which affects the health or safety, and well-being of the
occupants of any dwelling or of the general public.
(D) Common Areas. The owner of any dwelling abutting a private passageway or right-of-way
owned or used in common with other dwellings or which the owner or occupants under his
control have the right to use or are in fact using shall be responsible for maintaining in a clean
and sanitary condition free of garbage, rubbish, other filth or causes of sickness that part of the
passageway or right-of-way which abuts his property and which he or the occupants under his
control have the right to use, or are in fact using, or which he owns.
Residents should know the following:
• The Town has a mandatory paper and cardboard recycling ordinance that requires
residents to separate these items from their household trash. Paper and cardboard are
collected every other week on the same day as the household's normal trash. Residents
can call the DPW at 978.685.0950 to get their recycling schedule.
• Residents are responsible for picking up loose trash left at the curb after collection.
Banned Items and Recycling Requirements:
Please refer to the DPW website for a complete list of all the recycling requirements:
http://www.northandoverrecycles.com.
Please contact the Health Department if you have any additional questions. Thank you.
Sincere
San Y. Sawyer, REHS/RS
Public Health Director
File
<n:�N Commonwealth of Massachusetts RECEIVED
City/Town of
System Pumping Record 2004Form 4
he
ANDOVERDEP has provided this form for use by local Boards of Health. Othet�,binformation must be substantially the same as that provided here. Brm, he
c ec 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;useonly the tab key Address
to move your
cursor-do not City00 State Zip Code
use the return
key. 2 System Owner.
Na
Address(if different from location)
City/Town State Zip Code
2�1 J°) ,�l
Telephone Number
B. Pumping Record
1. Date of Pumping G ` Gallo
2. Quantity Pumped: �n�
Date ns
3. Type of system: ❑ Cesspool(s) ❑/Septic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? Yes ❑ No If yes,was it cleaned? ❑ Yes ❑ No
5. Condition,of System:
i`
6. System Pumped By:
N�/�s� S -
Vehicle license Number
Company
7. Location where contents were disposed:
Signature of Hauler `Date
t5form4.docc 06103 System Pumping Record•Page 1 of 1
Commonwealth # ss chu tts
CityCit /Town of ( E®
/Town
Pumping Record
Form 4 NOV - g ZUU4
�y
DEP has provided this form for use by I I Boards of Health. Other for 's(r11'ay be used, but the
L-er ISL) \/r.o
information must be substantially the sa le as that provided here. Befor,_ using�this form, ehecv✓Ith your
local Board of Health to determine the fo m they use.The System Pumping Record must'bff-submitted to
the local Board of Health or other approving authority.
A. Facility information
Important:
When filling out 1. System Location-
forms on the
computer,use
only the tab key Addy
to move your
cursor do not Zi Code
State
use the return C /Town
Sta
key. 2. Sy m Owner.
Name
1
Address(d different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
1. Date of Pumping �a 2. antity Pumped: albns
3. Type of system: ❑ Cesspool(s) Septic Tank ❑ Tight Tank
❑ Other(describe):
4. Effluent Tee Filter present? 0<YesE] No If yes,was it cleaned? ❑ Yes ❑ No
5. Condition of ystem:
6. Sy tem Pumped By:
Vehicle License Number
Qbmpany /
7. Locatio where contents were disposed:
Signature of Hauler Date
t5form4.doa 06/03 System Pumping Record•Page 1 of 1
VjSaDd uA-A LEVIL J4 CCc I aAJ
,houtewe`t ',Cabratory, Avc. _
66 LITTLETON RD. -WESTFORD, MA 01886 (617)692-8395
Report Number: C-059-9381 Report Date: May 9, 1985
Client: Sample Taken at:
ATTN: Mike McIntyre Paul Ravi-&s- DaQ eY
Merrimack Well & Pump Sharpners Pond Road
Tinker Rd. North Andover, Mass. 01810
Merrimack, NH 03054
Sample Taken by: Requester On: May 6, 1985
CERTIFICATE OF ANALYSIS
Test Parameter: Results:
UNITS Sample 1
Coliform Bacteria per 100cc 0
Sodium mg/1 58.
Alkalinity mg/1 NT
Ammonia(as N) mg/1 NT
Acidity Value SU 7.4
.Arsenic /1
NT
Barium mg/1 NT
Cadmium mg/l NT
Chromium mg/1 NT
Color CPU . 0
Chloride mg/1 NT
Hardness mg/1 2.
Iron mg/l <'.005
Manganese mg/l <.002
Nitrates(as N) mg/1 NT
Nitrites (as N) mg/1 . NT
Odor M1114 NT
Selenium mg/i NT
Sulfates mg/1 NT
Turbidity NTU AT
Total Organic Carbon mg/1 NT
NT = Not-Tested
The items listed above meet or exceed the EPA quality standards
for potable water; those marked "#" fail the EPA quality standard.
Massachusetts State Certified
Microbiological Drinking Water Peter T. Thorstensen, for
Laboratory #33051 Thorstensen Laboratory, Inc.
i
i
Town of, North Ai)(lovcr ,t'SriI's
-
Date =9�I
�-� APPLICATION FOR WELL :& PUMP P ERMIT
A p1 cat- •n'is` hereby made for permit, to drill a well (_) . Application s
to 4p§t:all ( ) a , pi.)mp system.
Loan* ion: Ad3d2'ess- Lf ��"S �2� -. T,o t -u _ . .
---y.- --- u - - -------
OwneY Ad rens- C�7 �q�Cr/�G� - -_--__—Tel _------
.':'ell Cont_r.<ictor -- C "ess" eL�
^.ump Contractor _--Address ----- - - ---- ------- —Tel :__
- -
W' LL CON'Pg-,CTOR ("I'_o--.bUe_.. completed at time of pump - test )
Type of tiJCIJ We 11 used for - - ---
Ir
i _ameter, (_f hlell f� l Si ze of Ca sing
Dent',z of E.ed Rock De th casin > into Bed Rock
Was Seal tested? Yes ( No (-) Date of Testi_ngp�� --- S.
Depth of Wq1---��zS Q -- Well Ended in What iiateri.al
Depth to U t e r Q C Delivers Cal- s . Per I'lin . .for 4 h--urs
ra feet laftepumping-�(jr _hours at=
Date of (,orpletion .
-
-',mature i:ell Co rac -o= _•_-
PUMP INSTALLF�R �To be filled -in before installation)
I'- Size S Namepump- Pump Type Used
wive s; iM ;. - 5i'ze of `I'a11.k—
Dine ';ateriaiUsed in V.7e1.1 : Cast Iron ( . ) Ca]_v nixed ( ) Plastic { )
Pit( ) or Pi_t].ess Adapter ( _).
s si.eev�-.usedto protect jai pe? -Yes ( _) NO('' ) .' "I}'Pe of :;� me ';ell Scal-----
W.:�� i +lr Vit:Iii��(�:'Si-�� i. �:at. i,ti r. � 3.t, .. ., .. ..:.:. .. ��'in n .i t. �1(: OTl
'date t'atera_nalysis report sumitted ' t.o T3oar of health -�---_--_
Date re leas egi.ven tD 01,n('r Of rpCO3_d c 131 (1- ., 'T)1Sp - .-__-__.-- -- --- -----------------
i
l;c,alt:h T»spector
Board of Health r sEPTIC SISTEK Z
North AndoverZNmas.
w INSTA'.LATIM CHBCB LISP LOT ' �' D
;__ Or�VED DATE DI SUM
DAT X AVATI�I OK FAIL '
eauonst 55
pwL,
FAIL OK
1. Distance Tot
a. Wetlands
b. Drains
c.. Well
2. Water Line Location
3• No PPC Pipe
�c. Septic Tank
a. Tees -_Length & To Clean Out Covers
b. Cement Pipe .to Tank On Both Sides of Tank
5. Distribution Box
a. Covers do Box - No Cracks
b. All Lines.Flowing Equal- Amounts
c. No Back Flow
6. Leach Field or Trench
a. Dimensions
b. Stone Depth
c. Capped Ends
d. Clean Double Washed Stone
7. Leach Pits
a. Dimensions
b. Stone Depth
c. Splash Pads
d. Tees
e. Cement Pipe to Pit - Both Sides
f. Clean Double Washed Stone
8. No Garbage Disposal
9. F nal Grading Inspection
10. Barricading Covered System
'r 11. As Built Submitted
i l�,25 a. Lot Location
/ b. Dimensions of System
c. Location with Regard-to Pere Test
d. Elevations
e: Water Table
�� ... .• .. -r-r-.� - .. r -.�- ... .�-. _. � -.._r.+. .-�- w+.•vr uf-.r.... .+. ..�..r n Vin. - rti..-.... •r� .w-��.f._r'....r•+w o• �.a.'4... �w-.-� . .n•+• -.
l
1
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f
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I ELEVATIONS +
,OP FN
OUTLET 12 7., '
5 T NL,ET 12E.93 I "
ST OUTLET 12'x.73 3
D+ox INLET 12wa t
D•eO'<Ot, LjE T 126,20 '
PIT 1 121411;; '.
PIT 2 126.10
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CZ
('7
44 r
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C Sr.� ,l' 0 e - �fl ����-.'' {j�",ice' 1-��•,iv V.,? If \�I .t rr ...•1 .��Y�� Y-4n" �i 1
I CERTIF'+ THAT TI-F SEPT?C ;TEt,. MAS ,15TALLrU AS SHOWM. � :��i;it
THIS PLAN 15 N0T It.) DF AS A WARPANTr Of"n It SYSTDJ. �,Se�3�'+.1 _ ; i' P[ Ir'kFPCND RC-
01Aj �C 14-(),A,\,'�y
(71ll
...,.__... I
Nor, Ancil er, tvb,s,UM?-
� I
Commonwealth of Massachusetts
W City/Town of North andover RECEIVED
System Pumping Record
Form 4 OCT '1 81012
M
DEP has provided this form for use by local Boards of Health. Other formT 4M 1111MMER
information must be substantially the same as that provided here. Before 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 within 14 days from the pumping date in
accordance with 310 CMR 15.351.
A. Facility Information
Important:When
filling out forms 1. System Location:
on the computer,
use only the tab 545 Sharpers pond
key to move your Address
cursor-do not North Andover Ma
use the return
key. City/Town State Zip Code
t�
2. System Owner:
Davey
Name
renon
Address(if different from location)
City/Town State Zip Code
Telephone Number
B. Pumping Record
000
1. Date of Pumping pap 27 2. Quantity Pumped: Gallons
3. Type of system: ❑ Cesspool(s) N Septic Tank ❑ Tight Tank ❑ Grease Trap
❑ Other(describe):
4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No
5. Condition of System.-
good
ystem:good
6. System Pumped By:
Name Vehicle License Number
Stewart's Septic Service
Company
7. Location where contents were disposed:
Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835
Signature of Hauler Date
Signature of Receiving Facility Date
t5form4.doc•03/06 System Pumping Record•Page 1 of 1
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