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HomeMy WebLinkAboutMiscellaneous - 8 LACONIA CIRCLE 4/30/2018 (2)I 4���5��°� ��'�'���`��� °moi ERMASSACHUSETTS-.:..` is .•. Ir /. �,. LLt i ,�.. r - ,QED DEP, has provided this form for use by local Boards of Health. The ystem Pumping Record ust be submitted to the local'Board of Health or other approving autho ty. iuN -4 2007 A: Facility Information trnjtortant. TOWS ��`HANDOVER s HE,, JEPARTMENT .; ,TYn filunfl out 1. ;. System Location computer, use `D only the tab key Address to move Your.,'.Al cursor • do not0,/�/ _ use the return CltyPfown Sate Zip Code t-�Y•''.System Owner r Mt f .:,.: � Name . •., , , r'. AW . ..� Address (if different from location) City/Town State 9� Telephone Number f®c�_9 Gallons rF+v Yj sysR11m; tJ twesspool(s) 4f-Zeptic Tank ❑ Tight Tank C' Other (describe); 4.'.;* °Effluent Tee Filter present? . ❑ Yes. Flo Ifyes, was if cleaned? ❑ Yeso {I { Condition of;SysfOm:" _4S 6 Sy ern Pumped By Kki 1 Name. Vehicle Ucen#e Number �1r Ity Company ! i- j:+L t 1..in�+Jl� 1 7 Locaflon where contents yvere disposed; f r j L, z„ S1, Sbnature Date httpJlwww.mass. gov/dept.water/approvals/t5forms, htm#inspect t5fomA.doc-.06/03 System Pumping Record • Page 1 of 1 ^6 f)T A7RO ED E r_xCAVATIUN OK PAID OK U Di s ,ance To: ✓/ ':11 et1ands Dr:.ins Well 2. V pater Line Location 3. No PVC Pipe `4. Septic Tank Tees - Length & To Clean Out Covers Cement Pipe to Tank - On Both Sides of Tank Distribution Box Cover & Box - No Cracks All Lines Flowing Equal Amounts No Back Flow Leach Field or Trench Di - ensions S I :°i LPep I'n Capped Ends Clean Double '.cashed Stone 7. Leach Pits Dimensions Stone Depth SplaGh- Pads T e✓� S ement Pipe to Pit - Both Sides / Clem DoWlil_e ;'a,-, ed S11,one 8. '.-,o Ga --'-.-.:Ce Disposal �. ina1 _-yad-_, Inspection ''i 0. Bari c 3. 1-n r C o :Tered S sIFe;m 11. As - Bul It Subrni teed Lot Loca,,i_on Dimensions. of Sysiem Loca,len -,Ii'(-.h Regard �o ecc Test Elev<,. -or s 'r:'ater ;-.ble 1. SUBSURFACE DISPOSAL SYSTEM CHECK LIST NORTH ANDOVER BOARD OF HEALTH t APPROVED DATE PROVIDED DISAPPROVED DATE TIME REASON P --7 Title 5 Reg. 2.5 Reg. 6 Fail 1OK1 The submitted plan must show as a minumum: )—the lot to be served (area,dimensions,lot #,abutters) (Planning Board files) j` location and log of deep observation holes -distance to ties location and results of percolation tests -distance to ties j—design calculations & calculations showing required leaching area )---location and dimensions of system (including reserve area) existing and proposed contours location of any wet areas within 100' of the sewage disposal system ot- disclaimer (check wetlands mapping) surface and subsurface drains within 100' of sewage disposal system or disclaimer location of any drainage easements within 100' of sewage disposal system or disclaimer (planning board files) known sources of water supply within 200' of sewage disposal system or disclaimer location of any proposed well to serve the lot (100' from leaching facility) }- location of water lines on property (10' from leaching facilities) )--location of benchmark �— driveways garbage disposers )- no PVC is to be used in construction )—a profile of the system (elevations of basement, plumbers pipe septic tank, distribution box inlets and outlets, distribution field piping and any other elevations) )- maximum ground water elevation in area of sewage disposal system plan must be prepared by a Professional Engineer or other professional authorized by law to prepare such plans Septic Tanks (a) Ca cities - 150% of flow, water table, tees, depth f tees, access, pumping, Cleanout c) 10' from cellar wall or inground swimming pool d) 25' from subsurface drains North Andover Subsurface disposal system check list - Page 2 ail Reg.10.2 Reg.10.4 Reg.11.2 Reg.11 .4 Reg.11 .1 f Reg.11 .1' Reg. 15.1 Reg. 15.1 Reg. 15.4 Reg. 15.8 Reg. 3.7 Reg.14.1 Reg.14.3 Reg.14.4 14.5 Reg.14.6 Reg.14.7 Reg. 14.1C Reg. 9.1 Reg. 9.6 Distribution Boxes Slope greater than 0.08 b Sump - Leaching Pits Leaching pits are preferred where the installation is possible (a) Calculations of leaching area (minimum 500 S.F.) (b Spacing (c Surface drainage 2% d Cover material e 2 i2"W, p(asl� � A k �- P .1 w. Leaching Melds (a) reater than 20 minutes/inch (b Area (minimum 900 S.F.) C Construction of field MSurface drainage 2% 20' from -cellar wall or inground swimming pool Leaching Trenches (a Calculations of leaching area (min. 500 S.F.) (b Spacing (4 ft. min. 6 ft. with reserve between) (c Dimensions (d Construction (e Stone (f) Surface drainage 2% Dowr xkill Slope a) Slope y/x = (to be shown) (b) y/x X 150 = (to be shown) Pumps (a Approval (b Stand-by power SOIL PROFILE & PERCOLATION TEST DATA Town/City 0 . No.&Street L s.CoNiA Ct��-L� Lot No. -7_ Loc./Subdiv. ��C�AI:�S �( �lGPIan Owner Investigator _= SA28AGA_t t,n Observer TR CoS4.:tW4 TE -C&r= SOIL PROFILES -DATE 8 /77 � 9 16 (7g r. Elev. 3. Elev. 4'Elev. 0 di S a? E 0 0 1 f 1 1 2 3 4 5 7 A 9 2 3 4 5 M 7 1 M'. M 2 3 4 5 6 7 91 Lv Lo -T - 7 o7 -7 Q �o .10 Q, vU oL`IMP%L L41,3E .+ T F ----T P k -r 10 1.__J 10 f 1 10 1 1 1 . Benchmark Location Elevation Datum Percolation Tests -Date `J Pit Number 1 2 3 4 S Start Saturation Soak -Mins. Start Test -Time PrOP of 3" -Time Drop of 6 "-Time Mins.lst 311Dro 2-� Mi.ns.2n0 3"Dro 4S Notes & Sketche.S ori Back Frank C. Gelinas & Associates, North And. r 00 i 5 -31. 15 All Dcj �d o c+ Goo k— . 4 -_5 Cad, i i E L€ VAT i D ty'S. �J I NY PIPE OUT OF N5E ' ©(+_ I N V. PIPE INTO _7AIAV- ib,w PIPE. OUTOFT-,n-, V- ;NV Pi PE INTO D. Box INV. PIPE. OUT D.psnX As 6uiL-r SY�T EM IN /611 ti�rao, , i Ft2,At11C. G�E��+.iL�.S � ASSVGIA,T"ES � �1 Q.N ncr✓�c2 �-[' N cam. Art l�o�E-� . L_E \/A'T t O f-415. NV PIPE.QU"T OF H5E - NJ V .PIPE. NTO V- PIN-10 �oX -c- V. Pi RE QUT 1�)nX 4. A u I L -T �YST �M ♦ 4 • -ate+ ``.`! / � � - � 1 v 3 i \ 1 �4 \ t a. R L_E \/A'T t O f-415. NV PIPE.QU"T OF H5E - NJ V .PIPE. NTO V- PIN-10 �oX -c- V. Pi RE QUT 1�)nX 4. A u I L -T �YST �M ♦ 4 • -ate+ ``.`! / � � - � 1 4, L_E \/A'T t O f-415. NV PIPE.QU"T OF H5E - NJ V .PIPE. NTO V- PIN-10 �oX -c- V. Pi RE QUT 1�)nX 4. A u I L -T �YST �M ♦ 4 • -ate+ ``.`! / � � - � 1