HomeMy WebLinkAboutMiscellaneous - 59 ROCKY BROOK ROAD 4/30/2018 (27) Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 59 Rocky Brook Road—
North
_
_North Andover_
Owner•_Powell_
Date of Inspection:_9/27/2003_
BUILDING SEWER(locate on site plan)X
Depth below grade: 24"_
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 wall to septic tank. 3"PVC
in house,no leaks
SEPTIC TANK: X lute on site plan)
Depth below grade:_12"
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 depth-0"_
Distance from top of sludge to bottom of outlet tee or baffle: 26"_
Scum thickness:_1"
Distance from top of scum to top of outlet tee or baffle:_6"
Distance from bottom of scum to bottom of outlet tee or baffle:_20"
How were dimensions determined:_Difference in sludge&scum depth to tee length_
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):_Inlet tee ok.Outlet tee ok.Depth of liquid at outlet invert.
No evidence of leakage._
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 bale condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
i