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HomeMy WebLinkAboutMiscellaneous - 595 BOXFORD STREET 4/30/2018 595 B AFORD STREET t 21DI105.C-0006-0000.0 - `1 > 1 Cl LLA i? Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 595 Boxford Street ' Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Cityfrown State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in way.Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Benjamin C.Osgood,Jr. use the return key. Name of Inspector none e Company Name 157 Bluff Street Company Address Salem NH 03079 Cityfrown State Zip Code 978-435-1324 870 Telephone Number License Number B. Certification I certify that 1 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 c 9-8-2015 Inspector's s4nature Data 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.3113 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System.Page t of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments b 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. City/Town 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: 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 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. ❑ Y ❑ N ❑ ND(Explain below): t5ins•3113 Title 5 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 M 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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).- El elow):❑ 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 15ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M ,•'°y 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is North Andover MA 01845 9-4-2015 required for every page. City/Town 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 ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 595 Boxford Street _ Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 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 ❑ ® 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-3/13 Title 5 Official Inspection Porth: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 w 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Cityrrown 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): Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5ins-3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. City/Town State Zip Code Date of Inspection D. System Information Descri tion: 1000fGallon Septic Tank, Distribution Box, 3-Leach Pits — / Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Well 9 ( y 9 (gP ))� 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-3113 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 ° 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped 2001 Per Board of Health Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? - Reason for pumping: Type of System: ® 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)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): t5ins•31113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed(if known)and source of information: 1994 Per BOH Approved Plan Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ® cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: 25 feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipe OK in basement Septic Tank(locate on site plan).- Depth lan):Depth below grade: 1.5' feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: 2 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ° M 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is North Andover MA 01845 9-4-2015 required for every 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 30" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle - Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Measure stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank in good condition. COncrete baffles intact, recommend installation of sch 40 PVC outlet tee 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•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Cityfrown 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 t5ins•3113 Title 5 Official Inspection Form: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 M 0 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. Cityfrown 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.): Box in OK condition. no evidence of solids carryover or leakage in or out. 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.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover- MA 01845 9-4-2015 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 3 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ 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.): Leach field area vegetation looks very dry. Opened one pit which was dry. 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•3/13 Title 6 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 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 page. City/Town 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 595 Boxford Street PropertyAddress Mark Wilson Owner Owner's Name information is North Andover required for every MA01845 9-4-2015 page. Ctty/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 ® drawing attached separately m WEt,t, o��T�atGr t J©t k 1_T,4NIc 1� 1 W 2-i ANI` /a I ` 129 17.5' f z-913 �� r Z-�itl ZRt I D-40Y tR�I� � .21vG 1 iT t5ins-3/13 Title 5 Official Inspection Form:Subsurface sewage Disposal System-Page 15 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 595 Boxford Street _ Property Address Mark Wilson Owner Owner's Name information is required for every North Andover MA 01845 9-4-2015 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: 8'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: 1994 no water to 10' Date ® 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: USGS maps indicate soil is Canton with a water table>80"below the ground. System built in a low area and filled. Basement dry with no sump pump approximately 8' below ground. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 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 r 595 Boxford Street Property Address Mark Wilson Owner Owner's Name information is North Andover MA 01845 9-4-2015 required for every page. Cityfrown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 ,&ORTH BOARD OF HEALTH # Y 120 MAIN STREET TEL. 682-6483 9SSACHUSES NORTH ANDOVER, MASS. 01845 Ext23 November 1, 1994 Joseph Barbagallo 1 Wedtward Circle No. Reading, MA RE: Repair at 595 Boxford Street Dear Joe: I have reviewed the plans for the proposed repair at 595 Boxford Street and have the following comments/requests: 1 - Please state that the claytill in test hole number 2 is to be removed and replaced with 2 minute per inch material. 2 - Please show the location of the existing leaching area. If you have any questions, please call the office at the above number. Sincerely, Sandra Starr, R.S. Health Administrator ,#ORTFr BOARD OF HEALTH N A 120 MAIN STREET TEL. 682-6483 F O'< o . SAcHU E�`y NORTH ANDOVER, MASS. 01845 Ext23 I November 1, 1994 Joseph Barbagallo 1 Wedtward Circle No. Reading, MA RE: Repair at 595 Boxford Street Dear Joe: I have reviewed the plans for the proposed repair at 595 Boxford Street and have the following comments/requests: 1 - Please state that the claytill in test hole number 2 is to be removed and replaced with 2 minute per inch material. 2 - Please show the location of the existing leaching area. If you have any questions, please call the office at the above number. Sincerely, Sandra Starr, R.S. Health Administrator NOTE TO FILE: Re:595 Boxford Street septic installation Tim Melvin was issued the disposal works permit to install this system. Actually someone called Anthony Curro did the work under Mr.Melvin's license. There were several problems with this. Curro did a very poor job,did not excavate to the proper depth and attempted to camouflage it. Even Mr.Melvin was unhappy with the effort. Tim.Melvin was admonished for subcontracting out since this violates the rules. Mr.Curro was found to be argumentative,aggressive and difficult to work with. The work that he did do was of poor quality and he attempted to mislead the inspector and cover up mistakes. Mr.Melvin was warned not to subcontract out to anyone not licensed as a septic installer in North Andover. S. Starr Town of North Andover, Massachusetts Form No.2 gORTp BOARD OF HEALTH M C w 9 DESIGN APPROVAL FOR SSACMUSES SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM (,83-,5l76- Applicant-....Z� A-L7-6'�C Z01666W Test No. Site Location �S9LJ"--Boxfoeb 3,7- Reference %Reference Plans and Specs.-J,Mae6/96j941_6 ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BO RD OF HEALTH Fee`,O Site System Permit No. Town of North Andover, Massachusetts Form No.3 NORTH BOARD OF HEALTH « 19C DISPOSAL WORKS CONSTRUCTION PERMIT SACMUSE Applicant / //P) NAME ADDRESS TELEPHONE Site Location ���jS ,�f��(`�,elj jJ Permission is hereby granted to Constructor Repair / ( ) p ( an individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. CHAIRMAN,BOARD OF HEALTH Fee—2L' D.W.C. No. r� Xj r¢ i TOWN OF NORTH COVER SYSTEM PUMPING RECORD DATE: SYSTEM OWNER & ADDRESS SYSTEM LOCATION (example: left front of house) DATE. OF PUMPING: QUANTITY PUMPED M0 _...LGALLONS CESSPOOL: NO YES�^ SEPTIC TANK: NO .1_ YES tiATURE OF SERVICE: ROUTINE L' EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE ROOTS BAFFLES IN PLACE EXCESSIVE SOLIDS LEACHFIELD RUNBACK =—_ SOLIDS CARRYOVER FLOODED vTHER (EXPLAIN) S Y STEM PUMPED BY: OMMENTS: © f�QRi 6;E6+iiia B©A�ID Ore �, 7 2002 i Oa'TENTS TRANSFERRED T0: Town of North Andover DRINKING WATER TREATMENT PLANT 420 Great Pond Road North Andover,Massachusetts 01845 Dennis L.Bedrosian Telephone(978)688-9574 Superintendent Fax(978)688-9575 o �o•Th�h 3:�`a V.",•OpL I. p i Y 7dS��gf May 27, 2005 Ms. Virginia Wilson 595 Bo:ord.Street" North Andover,MA 01845 Dear Ms. Wilson: Please find below the results of bacteriological analysis conducted on one sample collected from your residential well, at 595 Boxford Street, on May 26,2005, 2004. Total Coliform Bacteria: Positive E. coli: Negative I recommend that you collect another sample for analysis after chlorinating your well. Please do not hesitate to contact us at 978/688-9574 if you have any fiuther questions. Sincerely, Amy Planz Senior Water Analyst North Andover Water Treatment Plant MA Certification#for Bacteriological Analysis:MA 20154 cc: Susan Sawyer,Director,North Andover Board of Health .,y y SN a,1'"''D�•.>fJ t�*T§ 17 Yyf§< * s t y .. - '� Commonwealthof Massachusetts hq ✓ i T= dNORTH ANDOVER, MASSACHUSETTS System Pumping Record DEP.has provided this form for use by local Boards of Health. The Sys etrt`Pumping Record must be submitted to the local Board of Health or other approving ai ithority. IAN] 2 2 200Z A. Facility Information TOWN OF 1\10,i' ANDOVER Important: HEALTH DEPARTMENT ,..When ruing out 1 System Location: forms.on the95 ° �j computer,use ( only the tab key Address( d*2�bzl to move your cursor-do not use the return City/Town stare Zip Code ' .. ke 2 _System Owner: Name A(kkl�L) Address(if different from location) Cityfrown State Zip Code Telephone Number umping Record Date of Pumping 2. Quantity Pumped: Gallons Date Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑'Other(describe): 4 Effluent Tee Filter present? ❑ Yes, --- If yes,was it cleaned? El Yeo 5 Condition of System l3 Sy em Pumped By: Name Vehicle License Number 1H bc�.�Q; .Sf ac> otz>1f� Ma Company 7 Location where contents were disposed: Signature of Hauler . Date ' http:/twww.mass.gov/depfwater/approvalslt5forms,htm#inspect t5fonn4.doc,06103 System Pumping Record-Page 1 of 1 `i 7- A/'" OPOSE Q r'� D SU SaRFAGe� SEWA6� ` �ISPl2Ss;L .�STE�'f . 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