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HomeMy WebLinkAboutMiscellaneous - 62 CARLTON LANE 4/30/2018 62 CARLTON LANE 2101106.C-0093-0000.0 I 1 w Lot & Street & Ma /Parcel P CONSTRUCTION APPROVAL Has plan review fee been paid: YES. NO Permit# Plan Approval: Date: Approved by: / Designer: -Plan Date: Conditions: Water Suppl : Town _ __.. Well - Well Permit: _.Driller: Well Tests: Chemical Date Approved 'I Bacteria I - roved Bacteria II Date Approv Plumbing.Sign-Off: Wiring Sign-Off- Comments: Form"U" Approval: Approval to-Issue: YES NO Date Issued By: - Conditions: Final Approval: All Permits Paid? YES NO Well Construction Approval? YES NO Septic System Construction Approval? YES NO Certification? YES NO Other YES NO Any Variance Needed? YES NO FINAL BOARD OF HEALTH APPROVAL: DATE: APPROVED BY: ti SEPTIC SYSTEM INSTALLATION f Is the installer licensed? NO Type of Construction: NEW �FpAIR New Construction: .-Certified Plot Plan Review YES NO --Floor Plan Review YES NO - _— Conditions of Approval from Form U _YES NO Issuance of DWC permit: NO _DWC Permit Paid? —. M-8-D NO . ----DWC_Permit Installer: -- ---- Begin-Inspection:_ S NO _ -Excavation Inspection: -Needed: —Passed. By: -Construction Inspection: Needed: Built_Plan Satisfactory: S. _— Approval of Backfill: Date: By: --Final Grading Approval: Date: By: Final Construction Approval: Date: ` l By: Certificate of Compliance: Approval: Date: Address !!!L C-'tRz--!—dTitle of File Page of Date File Open: Date fie closed: Doc Document/Action Title Date of Refer to other Purpose of Docume�ntjAction and nates action Document) document/ fWum. Action Department Board of Appeals — Board of Health �- Plannmg.Board _ Conservation Commission — Building Departmernt -- FORM it - SOIL EVALUATOR FORM Page 1 Date.....�.6za�..:. ..... Commonwealth of Massachusetts Massachusetts Sol Suimbilio Assessr nn-site Sew gr Digposid (1 ................ '................................................ Performed By: .......�........ . WitnessedBy. 5 S ........:..::.. _. ..:.....: ......:._:..�:.::.�MV....:w..v.:.�...........,........ .............................. (y�..... . LOWIM eea�a. &rl �1^*^�^ oww'sNm. f.J�i.yt{.+i l'c •`a`t err (s 7r Cti.r L& 4.-�4 z-05- New construction ❑ Repair Office Review Published Soil Survey Available: No ❑ Yes r Year Published ....lf. � Publication Scale ..� . Soil Map Unit .. .J4 Drainage Class ......... . Soil Limitations ................ ................&.4 ....�. .... S urficial Geologic Report Available: No Yes ❑ Year Published Publication Scale Geologic Material (Map Unit) ............................................................ . ............................................................................................... Landform ................................................................................................................................................................................................................... Flood Insurance Rate Map: Above 500 year flood boundary No ElYes Within 500 year flood boundary No E 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): Month "'` Range : Above Normal ❑ Normal Below Normal ❑ er References Reviewed: I nae 0th .�� I-oRNI 11 - SOIL EVALUATOR FORM Page 2 on-site-Review Deep Hole Number f�.... Date, Time: Weather .'<Imov A 1AY Location (identify on site plan) ............. .. •.. ................ ......­................. ....................I................. Land Use ......A.",................................ Slope(%I .&ft Surface Stones .................................................................................... vegetationWLVP.Af,.O................................................................................................................................................................................................ Landform .......... ..................................................................................................................................................................... Positionon landscape (sketch on the back) ........................................................................................................................................................ Distances from: open Water Body feet Drainage way.74 feet, Possible Wet Area .. feet Property Una ...q'R- feet ......... Drinking Water Well feet Other ......................................... DELT OBSEWATION HOLE LOG Soil Mottling Other Depth from Surface Soil Harizor. Soil Texture Soil Color Faep;�m�u (Munsell) (Structure,Stones,Boullers, (inches) (USDA) ConsistenTi.16 Gravel) Ar,6 0 5-Y Y/I 1 1577 V Parent Material (geologic) .............2%.(1.............................................................................. Depth to Bedrock: .......... Death to Groundwater, Standing Water in the Hole, .. I... Weeping from Pit Face: ..........$•y Estimated Seasonal High Ground Water: FORA4 11 - SOIL EVALUATOR FORM Page 2 On-site Review Deep Hole Number .....t.:.z- Data:.f�"..�� Time:..l.d�� Weather .............. ...... . .5x(p 0 .......................................................................................I........... Location (identify on site pian) •••�•••••y-��!���'!'�-�•-••--•••••••-............................ Land Use .........R f ,................................ Slope (%) .Q..'' ��r Surface Stones ...............................-'.•.•-• ............................................. Vegetation .... Landform ................ ....kI� � l.............................................................................................................................................................. Positionon landscape (sketch on the back) ......................................................................................................................................................... Distances from: Open Water Body feet Drainage way.>i.4P-0! feet, Possible Wet Area ..;;r( 2`. feet Property Line L5.1.. feet Drinking Water Well ( E• feet Other ......................................... DEEP OBSERVATION HOLE I Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other llnchesl (USDA) IMunsell) (Struct 6i tend 96 OBo ellre, Con�s.t. �tN � Parent Material (geologic) ...•...•....•••••• • .......... Depth to Bedrock: ..' Death to Groundwater: Standing Water in the Hole: /U'.9 Weeping from Pit Face: ....24 -�...T- �� Estimated Seasonal High Ground Water: ......... .. • M FORM 11 - SOIL EVALUATOR FORM Page 3 Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole................... inches ❑ Depth weeping from side of observation hole................... inches l� Depth to soil mottles ... . .. inches ❑ Ground water adjustment feet Index Well Number ................... Reading.Date ................... Index well level ................... Adjustment factor .................. Adjusted ground water level ........................................................ Death 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? Ll"--S If not, what is the depth of naturally occurring pervious material? Certification I certify that on (date) I have passed the examination approved by the Department 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. Signatur�/� "''ti Date ��'� Town of North Andover, Massachusetts Form No.1 NORTH BOARD OF HEALTH nnQQ�� oz_ 19� O A °BATED PP,E 0 P`y � APPLICATION FOR SITE TESTING/INSPECTION a �y �9SSACHUSE� Applicant, :eo ne. p� NAME ADDRESS TELEPHONE Site Location Lo �)- Engineer U\k \ lam& e-s n f-- NAME G ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF HEALTH Fee—:q! Test No. gISO S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. Town of North Andover, Massachusetts Form No. 1 NORTH BOARD OF HEALTH OF�t IE❑ 16��� 19 q(1 R °Ew° ' APPLICATION FOR SITE TESTING/INSPECTION �9SSAC HU5���y Applicant Wpm�Me— t''sZi Chi NAME' ADDRESS TELEPHONE Site Location co ,; Engineer k�L1� '��'2 'f NAME ADDRESS TELEPHONE Test/Inspection Date and Time CHAIRMAN,BOARD OF'HEALTH Fee -'(:� Test No. S6) S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No. 40 •` °p BOARD OF HEALTH isS^CHU'53 30 SCHOOL STREET 1,__TEL- 688=9540 NORTH ANDOVER, MASS. 01845 APPLICATION FOR SOIL TESTS DATE: LOCATION OF SOIL TESTS: c�` Assessor's map & parcel number: OWNER:. -4 TEL. NO.: 21-C��7� ADDRESS: b2- C-A et,,TQL l )� ENGINEER: Q, UL&ttb� VH yva�A�teI.�f � EL. NO.: Q-22 t � CERTIFIED SOIL EVALUATOR: (2 aFy k)e, Intended use of land: residential subdivision, single family home, commercial Eal e- Phi JL Cx 15'(: 120 Uw)b 6 THE FO LOWING MU T BEINCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3.. Fee of$175.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of$75.00 per lot for repairs or upgrades. GENERAL INFORMATION 1. Only Certified Soil Evaluators may perform deep hole inspections. 2. Only Mass. 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 forms shall be submitted. L c - • l� a 0 ry�G s.6 0 Ea \ i j L o`r Z z 4 Lo T �4- '.'�_ Ili 1�' CrC}'���f�U1, `3`i"n►t 6 t / `X 1 =�O► *h � ?X V / 'Oa' i L.EVAT tjj wise A. S . f5ut t� 1 tniT,D D�Calc �'i t 52 0 5 V5—5 Tr AM � � PIPE INTa D.6oXW� ) SZ. ,•3) -- ..f ;���� '• au-r--o'6oX~z v 7 � }�to r / �LV717 s .. `.r w �'fi =d 1 - rf I1 ': '1 :r(.' 1 t y3'�.�'!+Ar✓��.. 7! fIN .fir r'YJR"EH, 1 ,, v �i 'f WE r.4 r ,004^� � _. � ,"• � J�51'l i�✓o� - � � '�1��M;� ti i r '' r4,S ��.. �f :.Y .�,,�s r t � � .�/jh��i1_C. �r�" ��.rl�`CJ�©►�y�.� ? yl '�`S.. ,�r*'�'�� '�� -c �eY"3#'�'���s:},r'�.. i 1 i`. � rtz�-�..4�"�v1'.}�S•�,�Y s;�y+'�v moi:'1���i"i• ;i L. - S.k., -N +.Sw,.b,ry F. ,t, � t '?1,5"`• �"u'(.'��� �Y' = s� 1 � �,t fid,;��t` r`�{r y Z - 't �•'� i"�;a' y �..IFa,.. ... �i..'0'�i':s.� _ v.. ..._... . v..4.. _. .. � 'V7 rl t...,_ w+r tt':' Y .S'>ce. L•:e F_w,. --� .. ..'S. ,.� 1. .- .. .. FROM : SOUCY'S SEWER SEWICE INC* PHONE NO. Aug. 26 199; 01:35AM P2 Aug-Z:b- 98 i2 : 04P worth AndovQr Ccm. r)pv . 50£s 68H 95az P.Ul FILE i TOWN OF NORTH ANDOVER SEWAGE DISPOSAL.SYSTEM IN!rFALLATION CFRMCATION ne undcrsipd'd hae7y=tiff that the Sow qe Disposal Sy6kw t )Gommmted; /lepaired; by waste it=f==e with tha North Andover Board of Health approved plan,System 13asip Petaxit d '(.dated I I'i witlE mt.appzoved deriga flow Df s'�O .gations PerdaY• 'nO msteaials ase3 sirtii oonfeMMM with those speoWed oa the appw6d pian;the system wan iristSlled ia.accordwce with the provisions of 310 Chit 15.000,Title S end lovd reg%Woes,ta>d the fins:gra&ng'agrees substartially with tho approved plan. All work is •eccarately repremated on the As-built Wkch has boon submitted to the Board of health. Daiba E. ea: Late: "J� o � Pio. O J FILE TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE This is to certify that the individual subsurface disposal system constructed ( ) or repaired ( X ) by North Andover Licensed Installer John Soucy at 62 Carlton Lane, North Andover, MA 01845 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 as described in the Design Approval Site System Permit Number 987-1 dated July 21, 1998. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. oard of Heath I ctor e TOWN OF NORTH ANDOVER BOARD OF HEALTH CERTIFICATE OF COMPLIANCE This is to certify that the individual subsurface disposal system constructed ( ) or repaired ( X ) by North Andover Licensed Installer John Soucy at 62 Carlton Lane,North Andover, MA 01845 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 as described in the Design Approval Site System Permit Number 987-1 dated July 21, 1998. The Issuance of this certificate shall not be construed as a guarantee that the system will function satisfactorily. i Bo rd of Health Inspe or Town of North Andover,Massachusetts BOARD OF HEALTH 19 � DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant %/g VA)6-- 7- 77 4 71p5 Test No. Site Location (O Reference Plans and Specs/LG 7 AJ/9� ENGINEER DESIGN DATE Permission is granted for an individual soil absoprtion sewage disposal system to be installed in accordance with regulations of the State and the Board of Health. OARD OF HEALTH FeeDa Site System Permit No. AS-BUILT CHECKLIST LOT NUMBER, STREET NAME ✓ ASSESSORS MAP&PARCEL NUMBER 71 LOT LINES & LOCATION OF DWELLINGS i✓ LOCATION& DEMENSIONS OF SYSTEM, INCLUDING RESERVE TIES TO LOT LINES &DWELLING, VNIELLS 1. FROM SEPTIC TANK b. FROM LEACH AREA LOCATIONS OF DEEP HOLES & PERC TESTS ✓ ELEVATIONS OF DISPOSAL SYSTEM TOP OF FDN ELEVATION i LOCATIONS OF WELLS, DRAINS, WATERCOURSES W/IN 150' OF SYSTEM ✓ LOCATION OF WATER, GAS, ELECTRIC LINES, CABLE _ DISTANCES FROM CORNERS OF HOUSE TO CENTER OF TANK&D-BOX STAMP & SIGNATURE IMPERVIOUS AREAS -DRIVEWAYS, ETC. NORTH ARROW FINAL CONTOURS LOCATION& ELEVATION OF BENCHMARK USED LOCUS PLAN SEPTIC PLAN SUBMITTALS LOCATION: NEW PLANS: YES $125.00/Plan PD 7/Mie REVISED PLANS: YES $ 45.00/Plan DATE: 71,1/99 DESIGN ENGINEER: /G L �J U�•�cS iV DATE TO CONSULTANT: Ili A? When the submission is all in place, route to the Health Secretary Town of North Andover, Massachusetts Form No.3 Of �40RTH BOARD OF HEALTH .. O•tt�•o tl•'�.y0 0 G 2' z- C M19 � DISPOSAL WORKS CONSTRUCTION PERMIT nl SgtHUSE Applicant NAMEy ADDRESS TELEPHONE Site Location ,,2 Z 4� 2—•-,r 111 Permission is hereby granted to Construct ( ) or Repair (,j an Individual Soil Absorption Sewage Disposal System as shown on the Design Approval S.S. No. `1P 7 –/ HAIRAN,B ARD OF HEALTH Fee D.W.C. No. 1b� `� _ APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT DATE: - r-1- �,e CURRENT INSTALLER'S LICENSE# LOCATION: � G r - LICENSED INST ER: - SIGNATURE: All TELEPHONE# ,Z - 7! 7 CHECK ONE: REPAIR: j/'J NEW CONSTRUCTION: IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT. Administrative Use Only $75.00 Fee Attached? Yes No Foundation As-Built? Yes No Floor Plans? Yes No Approval Date: r �� f�� I I Town of North Andover HORTh OFFICE OF 3�oma`,"`° ,°,�o L COMMUNITY DEVELOPMENT AND SERVICES t 30 School Street WII LIAM J.SCOTT North Andover,Massachusetts 01845 "ssgc,HusEt`y Director July 30, 1998 Mr. William Dufresne Merrimack Engineering 60 Park Street Andover, MA 01810 Re: 62 Carlton Lane This is tc inform you that the proposed plans for the site referenced above 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 SS/cjp cc: Wayne Peters BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 `JUL l 4 - i July 9, 1998 .---- --- � 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 62 Carlton Lane Dear Sandra, Enclosed find the"Checklist for North Andover Septic System Plans" for the above- mentioned site. The following is a list of all the `Problem' areas and deficiencies Port Engineering has found. General Information • No deed references are shown on the plan. 220(3) On-site Soil and Groundwater Review • Only one perc test was performed and it is 17 years old. 101(4) The BOH representative on site may have waived this requirement. Distribution Box • No stone is specified beneath the d-box. 221(2) Leaching Facility PORT • No orifice size is specified for the system. 251(8) • Toe of fill slope is less than 5' from property line and no swale is shown. 255(2) ENGINEERINGIf you have any questions or comments please feel free to contact us. Civil Engineers& Sincerely Land Surveyors One Harris Street Newburyport,MA 01950 (978)465-8594 Carlton A. Brown,PE/PLS t CHECKLIST FOR NORTH ANDOVER SEPTIC SYSTEM PLANS The following is a checklist that incorporates all Title 5 and local regulations for septic plans. Name ofApplicant:WAYtJ'i-- .?ET-s4zs NameofDesigner: Plan Date� Revision Date: — DateofReview. 7 T qg Property Address: 6Z 2C1u t-� Nlap: ld(bLot:Z3 BOH Reviewer: %A-7 Type of Plan(new or upgrade): 6,� QA0E- Number of Bedrooms in Assessor's Records: 4 gpd)Garbage Disposal .Allowed: tva General Information: N.A. = North Andover Septic Regulations Other numbers refer to Title 5 OK Problem N/A Street number and map/lot-220(4)(u) Maximum scale of 1 "=40' for plot plan-220(4) _ Maximum scale of 1 "=20' for profile and component details- 2?-0(4) _ Legal boundaries of the facility being served - '_20(4)(a) —r Names of abutters from recent tax map - NA 3.02j _ Number of bedrooms, design talcs., -NA 3.02i _ Name& address of record owner&applicant - NA 8.02k Name& address of designer -NA 8.021 — Holder and location of all easements-220(4)(b) Date plan drawn& any revision date- NA 8.02m _f All dwellings and buildings, existing and proposed -220(4)(c) f Location of all existing or proposed impervious areas - 220(4)(d) All distances on site plan-NA 3.03a-c Elevation of proposed driveway -NA 8.02t _ Location and elevation of foundation drain - NA 3 02y Location and dimensions of the system incl. reserve(new const.) - 220(4)(e) — Limits of excavation of leach area on site plan- N.A 8 02z Locus plan -220(4)(t) — North arrow-220(4)(g) Existing and proposed contours -220(4)(8) Locations and logs of deep holes-220(4)(h) _ Locations and logs of percolation tests-220(4)(i) _ Date(s)of soil testing -220(4)(h)&(i) Existing grade elevation of each deep hole -220(4)(h) Elevation of percolation tests- N.A. 8.02n Name of approving authority representative - 220(4)(h)& (i) _ Name of soil evaluator-220(4)0) Soil logs and pert test logs match BOH records _ Locations of waterlines, drains, and subsurface utilities-220(4)(m) Observed and adjusted g.w. elevation in the vicinity of the system - 22-1)(4)(n) — Complete profile of the system to scale- 220(4)(o),NA 8 02c Cross section of leaching facility -NA 3.02w Location of benchmark(s)within 50-75 feet of facility - 1-20(4)(q) Note listing all variance requests with proper citations - 2-20(a)(p; tical upgrade approval request form.vtbintued- 4030, �_ _ Original R.S.T E stamp, signature& date - 2200)& (2; sfc. supplies(w/in 400'), pub. wells(whit 250'), pvt. wells (w/in 150@) - 220(4)( _ Location of watercourses, wetlands, wells, etc. w/in 150'of system - NA 8.02r Wetland disclaimer-NA 8.02s �— Land surveyor plan reference required (property line setbacks)- 220(3) Plan contains designer's certification statement _ -7 Use approvals/standards checked for UA system - DEP docs., Perc rate>30 MPI- not allowed for new, LUA for upgrade- 245(1)&('3) _ Perc rare > 60 MPI-must use modified right tank or I.A Technology- 4j(4) Proposed system qualifies as "shared" system- 002(definitions) T Flow is over 2,000 ()Pd-No R.S. allowed -220(1) Y__ Design now was set in accordance with code-203 JJ�. Existing system location and note on proper abandonment- 600.3. 1 M, 354 _ Leaching facility at least I' above Base Flood elevation- NA 9.05 All piping Sch 40 minimum -NA 10.01 Basement floor minimum I' above groundwater elevation-NA 5 04 On-site Soil and Groundwater Review OK Problem N1A �/ Proper deep observation hole logs on plan-220(4)(h) _ Soil evaluation Forms submitted within 60 days of Field work -0 1 8(2) Proper percolation test log- 220(4)(i) ,-ample deep observation holes in primary disposal area(minimum 2) - 102(2) Ample deep observation holes in secondary disposal area (minimum '_) - 102(2) Ample pert testing(one in each disposal area, 3 in pnm. > 2,000 gpd) - 10 40) Hole Identification Numbers: — T Z 9 ground elevation el. acceptable soil el. Leach facility invert el. ground water el 1�,3 7913 refusal el bottom of leach facility el. �3 . g3.3 `5L, thickness of acceptable soil Com_ 0�5 before & aiier soil R&R separation to groundwater t'( separation to refusal soil class pert rate loading rate 6v _ septic tank below g w table —�J6 (yes or no) pump tart_` below g.,,v table (yes or no) in till 255(1) Setback Distances (Given in feet) 15.21 1 OK Problem N/A Is the lot in the Lake Cochiewick Watershed? NA 6.00& 5.02 Septic Tank Leach Facility Property line 10 10 J Cellar wall 10 20 Inground pool 10 20 Slab foundation 10 10 �I Deck,on footings, etc. 5 10 JWaterline 10 10 _ ! Private drinking well 75 100 _ J Irrigation well 75 100 Wetlands 75 100 Public well 400 100 _ J Wetlands bordering surface 150 150 water Supply or trib. (in Watershed) Thb. To Surface Water supply 325 325 Reservoirs 400 400 Tributaries to reservoirs 200 200 Drains(wat. supply/crib.) 50 100 Drains(intercept g.w.) 25 50 _ J Foundation drains 10 20 ✓ Drains(Other) 5 10 _ J Drywells 20 ^5 J Downhill slope ►S to 3.1 slope w/o barrier Building, Server OK Problem N/A _ Grease trap required for certain uses(check 230 for details) — Pipe diameter listed(4" minimum)-222(1) Pipe schedule listed - 222(3) Pipe cast iron or Sch 40 PVC–NA 11.02 7 Watertight joints specified-222(3)&(4) Pipe laid on compact, fin base -222(5) — Pipe laid on continuous grade in straight line-222(7)@ Cleanouts precede all changes in alignment and grade-222(3) / Cleanout provided every 100 feet -222(8) — Manhole at any 90 degree alignment change- 222(8) — Invert elevation at building:q1.9 y Invert elevation at septic tank: Length of run: f b Slope: ,ell (minimum of 0.01 - 0.02 desired) -222(6) _ 10'offset to private well or suction line-222(2) Septic Tank OK Problem N/A _ Tank is accessible-228(3) Tank can accommodate both primary& reserve–NA 9.04 200%of flow(required& provided given. 1500 min.)-220(4)(0 & 223)(1)(3) 2-3" drop from inlet to outlet-227(5) Minimum of 4' liquid depth-223(2) 3" air space above tees/baffles(minimum)- 227(4) 9"air space above flow line(minimum)-227(4) Tees are not to be replaced by baffles-227(1) _ Tees extend 6" above flow line-227(1) _ Inlet tee extends 10" below flow line(minimum)-327(6) _ Outlet tee extends 14" below flow line(more for deeper tanks) - 227(6) _ Gas baffle installed on outlet-227(4) Access manhole cover above center of tank& each tee(except 2 compart) 223(2) _ 3-20" manholes-228(2) I childproof, 24" riser/manhole to final grade if<1000gpd-223(2) _ Inlet and outlet tees on center line-227(1) Soil compaction below tank specified(if soil is non-native) -221(2) _ 6" of<=3/4"stone beneath tank specified -221(2)&22 8(I) If> 1,000 gpd AND not a single fam. dwell. must be 2 tks or 2 comp. -223(1)(b) If plan specifies disposal must be 2 tanks in series or 2 compan tank - 223(I)(c) _ Buoyancy calcs. required if tank at or below water table-221(8) — Tank is watertight-221 (t) _ 9" of cover over tank(minimum)-228(1) H- 1 0 loading(min.) -H-20 if traffic-226(3) Top of tank <=36" below grade-22 1(7) All pumping to tank(if applies) in accordance with - 229 Tank is set to keep old system in service during install if possible Tig,ht Tank(Check here if not present: _ J/� Distribution Box(Check here if not present: OK Problem N/A _ Inlet elevation: g� / Outlet elevation: _ `(,00 -T 0.17'drop from inlet to outlet(minimum)-232(3)(b) 6" sump(minimum)-232(3)(e) All outlets at same elevation-232(3)(b) Outlet pipes laid level for first 2 ft. -232(3)(c) _ Pipe Sch 40-NA 10.01 rr ,J Number of outlets: _ Number of laterals: b _ Size of outlets:/T» Inlet baffle/tee min. V over outlet invert for all d-boxes-232(3)(a), Soil compaction below distribution box specified(if soil is non-native) -221('_') 6" of stone beneath distribution box specified -221(2) Box is watertight-221 (1) Top of box<=36" below grade-221(7) Buoyancy calculations required if box is at or below water table-221(8) Pump Chamber(Check here if not present: OK Problem N/A Volume specified:_ _ 220(4)(r) Pump on elevation- _220(4)(r) Pump off elevation: - 220(4)(r) Alarm on elevation: 220(4)(r) Number of cycles per day-220(4)(r)(also 254(I)(d)if gravity from d-box) Minimum 2" delivery line to d-box if gravity-254(l)(c) Pressure dosed IT if flow>=2,000 gpd- 254(I)(a)& 254(2)(a) Cycles per day is consistent with chamber volume-23 1 _ Volume calculations include Elowback volume-2') 1(2) 24 hour storage capacity above pump on elevation- 23 1(2) _ Number of pumps: 2 if system serves>2 dwelling units -23 1(6) Capacity of pump(s)- gpm @ 'TDH 220(4)(r) Pump can pass 1 1/4"solids(minimum)-231(7) Pump controls specified-220(4)(r) _ Alarm equipment specified- 231(2) Alarm is in building and powered on separate circuit from pump- 2') 1(9) Pump sequence correct(off-lead on-lag on-alan-n on) - 23 1(8) Pump performance curves included -220(4)(r) Manual operating switch-NA 12.01 Check valve, bleeder hole-NA 12.01 I childproof, 24"riser/manhole to final grade- 2'31(5), Soil compaction beneath pump chamber specified(if soil is non-nauve)- 6"of<=3/4"stone beneath chmbr. specified -221(2)& 228(1), Buoyancy calculations if chamber is at or below water table - 221(8)@ 9" of cover over chamber(minimum)- 228(1) H- 10 loading(min.)-H-20 if traffic-226(')), Chamber is watertight- 221 (1) Top of chamber<=36" below grade - 221(7) Leaching Facility(general -complete for all designs) OK Problem N/A _ 50% larger if garbage disposal-240(4) _ Trenches to be used whenever possible-240(6) No vehicle access or imperv. area above I.f unless unavoidable -240(7) Vented if under impervious cover-241 (1) Vented through same pipes as distribution system-241 (1)(a) Vent protected from precipitation/animal entry-241 (1)(b) Vent is placed beyond traffic or impervious area- 24 1 (1)(c) All lines connected to vent if bed or trenches- 241(I)(d) 9" cover over peastone-240(9) Reserve area provided(new construction)-248(1) Reserve 4' From-primary leach area—NA 9.04 4'(5' if Perc rate<=2 MPI)separation to 1-.w. -212(a)&(b) 4'(down to 2' with variance or UA-upgrades only)of natural soil under I.t: GW separation is adjusted to highest existing grade if facility cuts into a hillside Pipe slope minimum of 0.005 -251(9) Require 5'removal and replacement if in fill-255(5) Top of leach facility<=36"below grade-221(7) = Final grade over 11 minimum 0.02 ft/ft-240(10) Surface& subsurface drainage away from I.f. -240(1 l)&245(5) �— 3/8"-5/8" orifices specified(gravity system)-251(8) Minimum design flow 440 gpd without deed restriction—NA 13.01 3:1 slope where grading required -255(2) Toe of fill slope stops 5' from property line or Swale installed -255(2) Impermeable barrier if<3:1 slope or< 15 feet to—3:lslope-255(2) Impermeable barrier/retaining wall poured concrete—NA 9.02 Retaining wall stamped by P.E. -255(2)(b) Top of retaining wall >=top of peastone elevation- 255(2)(0 _ 10'offset from edge of leach facility to edge of ret. wall - 255(2)(1-) Perc test(s) done in most restrictive layer- 104(2) Perc test 4' below leaching elevation—NA 7.06 7 Design flow listed and required/provided leach area given - '_20(4)(0 _ Leach pipes SCH40 PVC—NA 10.01 Leach pipes minimum 4" diameter except for dosed system—NA 14.04 Leach lines capped, vented, or connected together-25 1(9) Pressure dosing guidance followed if pressure distribution- 254(2)(c), Pressure dosing required over 2,000 gpd or with I/A remedial use-231(1) Leaehina Trenches(Check here if not present: V ) OK Problem NIA Number of trenches: Minimum of 2 trenches-NA 9.01(2) _ Depth of trenches(max eff. 2'): -247(l) Width of trenches(2' min., 4' max.): -251 (1)(b) Length of trenches(100' max.): -25 1 (1)(a) Trenches are vented (when> 50') - 251 (11) Trenches follow contour lines-25 1(2) Trench spacing 3 times effective width or depth-251 (1)(d) _ In till or reserve between trenches, 10' min. -NA 14.01& 14.03 Available leach area given(Min. 500 s.f.)-NA 9 01(2) Bottom=L x W x# Sidewall =L x x# x2 = s f. Effective leach area given Loading factor: Effective area= total area s.f, x LTAR = g/day Effective area is>=design flow of facility being served 2"of 1/8% 1/2"2x washed peastone.-247(2) Trench depth of 3/4" to 1 2" double washed stone -247(1) Leaching PitS(Check here if not present: ) OK Problem N/A of pits/pit systems: (dosing chamber if>t, 231 (1)) Dimensions of each pit or system: L W D Depth of pits(max eff. 2'): - 253(I)(a) Available leach area given Bottom= L x W x 4 of systems = s.C. _ Sidewall = L x D x#of systems= s.f. Total area=bottom + sidewall = s.f. Effective leach area given Loading factor: Effective area=total area s.f. x LTAR = W day Effective area is>=design flow of facility being served Minimum oft pits at least 13'X16'—NA 9.01(3) Dist6bution for galleries/chmbrs. in trench contig. - pipe every 20'-253(6) Distribution for galleries/chmbrs. in bed contig.-ea.pipe serves<=40 s.f.-253(6) Spacing- 2 times the effective width or depth(the eater)-253(l)(c) 2"of US% 1 /2" 2x washed peastone.-247(2) 3/4" to 1 1/2"double washed stone-247(1) Each pit has at least one 20" access cover. 24" Cl to grade over 2,000 gpd -253(3) Surrounding aggregate thickness between l'(min.)and 4'(max.)-253(1)(b) Vents, if necessary, extend under covers of pit(s)- 241 (e) Leach Fields(Check here if not present: OK Problem N/A Number of fields: ) (need dosing chamber if> 1, 231 (1)) Length(100' max.): _ -252(2)(b) _ Width: 3& Total area: L x W 'T(X—) s. IF I Minimum 900 square feet-NA 9.01(1) J _ Distribution lines connected with solid pipe—NA 15.01 Effective leach area given = Loading factor: a-w Effective area= total area qYj s.fx LTAR O.6" _ 5`40 g/dav Effective area is>=design flow of facility being served Minimum of two distribution lines-252(2)(a) 6'line separation(max.) 252(2)(d) 4' maximum separation from edge of field to line-252(2)(e) 10' minimum separation between adjacent leach fields - 252(2)(t) = Between 6" and 12" of 314 - 1 1/2" stone beneath field - 252(2)(;)& 247(21 2"of 118"-1/2" 2x washed peastone.- 247(2) ' • - I f tJ O � i j I irx�y�♦ 1� ft � i � • r -41 � N 1` L o-r Z Z 4 ,c L-o T Z4 jl 6 EXIST D , Q 3`6�..� Aj P L; MO t l�tu j}�"= 1NTd TI4il1L `�L� �J� �+ :�b��.Qll���7L�T d�'��►�. {Co"7:OS � � L mg el P �� l��1.:PIPE INTO �.80X'�Z• I SZ 3� * f INV. Plpr- OUT Dj!>Ox"Z 15Z ,Z) IvC�,_ �F.�}i� LW��� � MA. I NV. EOF Pt PE I SZ .p - � L . ' t til At L L E-T- r r;" •: .as'°t4. '•.ifiv.. r' ,..." .. � ._�-.�^.�.Ss"..,,.fir.-_ �_,�. ♦ ,�4,1 1 ♦ �3 t � r r i 1 ' ' N i' 01 Lo-r ZZA N ! 1 L.o T Z G} 500 GAL E x i s-r D�LL i • Lc�-7- Z 4"3,gaol S F .. _ P�,v ( 4TE ti S'�WlDE� �Ht � n S` ,lwy 121PR OUT OF HSE - A P,, �J 0 L-: I A11/ enc- IAtT�j-f;Q.1�tJ 1 t,0y] �� ��1lI r�"�I`lC IaiT��Sd�fa i I SZ, 7Q 1L1S�tit•Y C.7t�'JF [�t�T C� x'+.n�t`�a I `�Z Co�a \amu PIPE INTO D 130XrL I SZ • '�1 - IMV. PtPE UUT D.go4' 7- SZ r-Ll Na. ,o.t�� 11 ji I My EijD OF Pi PE ►SZ .a7 ►sre+niu., ALV 1,tiJ Al LL�.� nom, G; APZI L Z�4`Vab iFFJ-t---^^^ ���....'///i ST �`'.:•' (F 2LY.��. �.�3'E.l�!h�J3r:`.a �f �asb`3�3�v�LS"T„t.~�` °� �``_.j 4�t t�+it•j L3�C.7r'►!�.#��3"T' �1 cam,A�1,��°d; _ 412z1az . _ r. . _ - f U u w. n0 ra t* j LOT 24 ,4 .• • '�a bi4a_ �k1ST• p,,,,et.,- , 't-47E S'�Wtp ,.,.7- tom � �_> L r-s�, � •..._. j�jJ1"A ,t�y►T t'�fr,tr`�t t S'Z - '~ Pip tevY� o p>ox"L M A, INV PIPE OUT 17.goXrZ 1 SZ .'Z.1 1 1 f\t`! EtitD OF �t M. Sz � } VI• I LL e-7 ' + 77 °s i ., +i•-�"' �f..'t�+.L.C� 1 ry Y:tl,(] L�A^i'1 �v�'...i L L L.� 1`�. • t .. ct�t��r��.��>��-.:• fir%,—i� + .�� ._ '� 4�."i:{�-•iS+'SW'9.y.�.'..R Z.pky:taS.i .' .:-. ��. _.� _ . -_ _ _ f r. Y F L �� �� . ��;�. �� NORTH ANDOVER, MASS. APP,_ l L- ZZ Y9 8 Z TO: � BOARD OF HEALTH o l� FROM: UT DESIGN ENGINEER Re: Soil Absorption �� •��' r` Sewage Disposal System This is to certify that I have inspected the construction materials of said disposal system at L.o'T Z-3" C-A 2L- o O LANE Site Location North Andover, Mass . The grades and -construction materials are as specified in my plans and specifications dated A Z) 11198Y and As-Built App_rL. zz. 19OZ. . Reg.Prof.Engi eer/Reg.Sanitarian Board of Health North An4over�Hase. _ SEPTIC SISTEX INSTALLATICH CHECK LIST Lar WID DATE iffu REED XV OK OCL FAIL 4: eagcnsl - � f. FM OrC 1. Distance Tot- �'' a. Wetlands b. Drains c. Well 2. Water Line Location j 3: .No PSCC Pipe $. Septic Tank--` a. -Tess t..-Length & To Clean Oat Govers. b. Cement Pipe to Tank- On Both Sides of Tank i 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flowing E4iial Amounts C. No Back Flow i 6. Leach Field or Trench a. Dimensions i b. Stone Depth c. Capped Inds _ d. Clean Double Washed Stone' -7. Leach Pits _ a. Dimensions b. Stone Depth ,✓A c. Splash Pads d. Tees ' e. Cement Pipe to Pit - Both Sides j, f. Clean Double Washed Stone os . 8. -moo 9. -glnal Grading Inspection 10. Barricading Covered System 11. As Built Submitted - -- a. Lot Location - _ b. Dimensions of System c. Location Kith Regard-to Perc Test d. Elevations i e; Water Table � I E Ploard of Health . North Andawro ass SUBSURFACE DISPOSAL DE-SICK CHECK LIST LOT ` APPROVED DATE DISAPPROVED DATE Provideds Reasonss ax", TWA V FAIL bg Reg 2.5 The submitted plan must show as a minimums < lfb-11 ) the lot to be served-area,dimensions lot #,abutters 'location and log deep observation hoes-distance to ties location and results percolation tests-distance to ties 'design calculations & calculations showing required leaching area ) location and dimensions of system-including reserve area existing and proposed contours ) location any vat areas vithiu 1001 of sewage disposal system or disclaimer-check wetlands mapping ) surface and subsurface drains within loot of sewage disposal /system or disclaimer (i) location any drainage easements within 1001 of sewage disposal /system or disclai rer-Planning Board files (3) knom sources of inter supply within 2001 of sewage disposal system or disclaimer (k) location of aw proposed Well to serve lot-1001 from leaching facility (1) location of water lines on property-10from leaching facility (m) location of benchmark _ (a}�driceWVS o garbage disposals no PVC to be used in construction q) profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and �E3ther elevations mmdmam ground water elevation in area sewage disposal system s) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 / S tictic Tanks (a) capacities-T50%cities-T50% of flow, eater table, tees, depth of tees, access, pining (b) cleanout c) lot from cellar gall or inground suLmadng pool - d) 25+ from subsurface drains Reg 10.2 % -Distribution Boxes s pe greater than 0.08 Reg 10.4 b) sump h 711atd,&ss F, iltb Korf;h SUBWRFACE DISPOSAL DF,1'j M CHWK LIST LOT APPROVED DATE DISAPPROVED DATE Provideds Reasonss Title V FAIL jcbb) � pp Reg 2.5 a submitted plan must show as a duns ern fi s'�. `L� �► � , y the lot to be served-area:dimensions lot #, abutters slocation and log deep observation hoes-distance to ties location and results percolation tests-distance to ties design calculations & calculations showing required leaching area location and dimensions of system-including reserve area 17 existing and proposed contours g) location any vat areas within 1001 of sewage disposal system or disclaimer-check wetlands mapping (h surface and subsurface drains within 1001 of sewage disposal system or disclaimer ( ) location any drainage'easevents within 100, of sedge disposal system or disclaimer-Planning Board files ( ) know sources of tster supply within 2001 of sewage disposal e system or disclaimer location of any proposed well to serve lot-1001 from leaching facility location of water lines on property-101 from leaching facility ") location of benchmark )- driveways garbage disposals ( 'no PVC to be used in construction q) profile of system-elevations of basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution field piping and Outer elevations ry maAmam ground water elevation in area sewage disposal system L==L�ts) plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Reg 6 Septic Tanks () capacities-150,% of flow, water table, tees, depth of tees, access, pumping __4(b) cleanout (6) l01 from cellar wall or inground swimming pool (d) 251 from subsurface drains Reg 10.2 Distribution Boxes (a) slope greater 0.08 Reg 10.4 / b) sump , i - • � I HuHlu►Ilii/NIlI1 bi'A�p��dtililttill �OV�N OF moss °'dRDQRr q.^'a0+ ' J co • igjliairrutr��or � f , 1 , a ,+ —= i V�ieillll�' fsuli1p.dl Dole or I111lhl hid 1 � 1�Gt; �S � _ Licellre NI S)-eleM Punyled Wit r` ' Cu��lelils.11n�ielet►r�l 1�+! �-V--- _' { ' Ills�,�rlut Unl! { it _ =1,. c i . TOWN OF SYSTEM PUMPING RECORD u ,�- ,-� �P DATE: SYSTEM OWNER& ADDRESS SYSTEM LOCATION (example:left front of house) i �0 (C� V�� C - cC0 o- 6� � DATE OF PUMPING: 9- 6--d3 QUANTITY PUMPED: GALLONS CESSPOOL: NO YES SE TANK: NO YES NATURE OF SERVICE: ROUTINE EMERGENCY OBSERVATIONS: GOOD CONDITION FULL TO COVER HEAVY GREASE BAFFLES IN PLACE ROOTS LEACIDULD RUNBACK EXCESSIVE SOLIDS FLOODED SOLIDS CARRYOVER OTHER(EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: