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Miscellaneous - 82 PADDOCK LANE 4/30/2018 (2)
Driving Directions from 400 "�C)cgood St, North Andover, MA to 82 Pad,Aock Ln, North A... Pagel of 3 Start: 400 Osgood St North Andover, MA 01845-2909, us End: 82 Paddock Ln North Andover, MA 01845-6313, us I GRADUATED IN AL A -'±Zj AR CA CO CT DE 2! J FL GA HI ID ±j IN I lA K5 KY LA ME I MD MAI MIMN MS MO MT NEI NV I NHI NJ I NMI NY I NC ND OH OK OR PA Rl _SCj 5D TN I TX UT !TivAj WA I WV WI WY 0 clasSmates•com- Directions Distance 1: Start out going SOUTHWEST on OSGOOD ST toward 0.3 miles MILL POND. 2: Turn RIGHT onto BEACON HILL BLVD. 0.1 miles 3: Turn LEFT onto MA -133 / CHICKERING RD / MA -125. 1.2 miles Continue to follow MA -133 / MA -125. 4: Turn LEFT onto MA -114 / MA -125 / TURNPIKE ST / 2.6 miles SALEM TURNPIKE. Continue to follow MA -114 / TURNPIKE ST / SALEM TURNPIKE. 5: Turn SLIGHT RIGHT onto BOSTON ST. 1.1 miles 6: Turn RIGHT onto PADDOCK LN. 0.1 miles 7: End at 82 Paddock Ln North Andover, MA 01845-6313, US Total Est. Time: 13 minut s Total Est. Distance: 5.76 miles X10 � 1v � 5 http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&2si=navt& 1 gi=0&un=m... 7/21/2005 Driving Directions from 404 7c�ood St, North Andover, MA to 82 Pad;? �ck Ln, North A... Page 2 of 3 North Anda, Q'.,�`Q �S W Vemon St, ��ol 133 �y 93 ■ % �> ivans Crot � , r 3haarthra"n�J'll'fago .. Andover .� a ftp C Andov St 1 -, Batlardvate Rd uestcom, Inc. Start: 400 Osgood St North Andover, MA 01845-2909, US 1a�00n a 1N A. 5 .. -•� ark $t I feaa►t1 sr � ,.--�, ' 'hey Stevens Crossingo 1\ 01 Lcoo NSA d I \ `` St�� Pond - MapQuestcom, Inc. 02005 NAVTEQ 0 Notes: k�0��lrni �l 02005 NAVTEQ End: 82 Paddock Ln North Andover, MA 01845-6313, US M ; S/ 300 r zay— r-G'sv. Rd Q?� e � x+2005 MapQuestcom, Inc, 02005 N-AVTEQ Fm—AV T—E 0 All rights reserved. Use Subject to License Copyri ht These directions are informational only. No representation is made or warranty given as to their content, road conditions or route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&2si=navt& 1 gi=0&un=m... 7/21/2005 North Andover Board of As ...ssors Public Access Page 1 of 1 l Q Parcel ID: 210/107.D-0009-0000.0 Community: North Andover SKETCH Click on Sketch to Enlarge PHOTO No Picture Available Location: 82 PADDOCK LANE Owner Name: DEAN, JOHN P JULIE G DEAN Owner Address: 82 PADDOCK LANE City: NORTH ANDOVER State: MA ZIP: 01845 Neighborhood: 7 - 7 Land Area: 1.29 acres Use Code: 101 - SNGL-FAM-RES Total Finished Area: 2236 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 487,100 465,900 Building Value: 286,700 275,100 Land Value: 200,400 190,800 Market Land Value: 200,400 Chapter Land Value: LATESTSALE Sale Price: 1 Sale Date: 03/08/1992 Arms Length Sale Code: Y -YES -VALID Grantor: WU, YIH P Cert Doc: Book: 03415 Page: 0052 http://csc-ma.us/NandoverPubAcc/jsp/Home jsp?Page=3&Linkld=468662 7/21/2005 F-a� c ,O C W � jc Q o U J OUB.. 3 m m ��JS Y V O G D un r N d o0 N O U O C, W 0 m 4) Uof 0� maU " O U ¢ 0 a w _ U co CQ M 2 moa>� o a M mcimv_ i.: c 0 -Op oo a) cu wm� U) (nU)toU O J C>CD CM t0 O r M N 0 Y a� -j0 ¢ m m¢c U V E J y 0 ~ �F' F- 0 a Q o Z OO O H O of O m NIc J_ m E O U —I I0 Qf 00 cc cc 0OLL ' o VL ooc o Z O J W ZZ Q' c J > N V aZ Ya = W V G of a 00 oa ci w z v,4 Q�aa J Q 3Gn'accoo2 a 0 ¢ 0 CD cm m a 00 ' VL ooc N H O 0) t0 N ci � J J Y Y > O O 0 a0 Z o0 } ZN� O 7 ZN ~ � Q Ww J J w M p rn O ON Q�-o LL Z 00 ty� �iLi — ( 1� z ? � .+O Q IL f0 L Z cD C\j 0 NN 0 .. Z N rnLr) M Q U o0 jmm C= m mgym¢ 0000 00 CC Opp �t V n U W o o a �° m U Paa F --F- O D c o F- 2 Z U a r- 04 o DO co ti It O <D N CO co N r N m m ¢ » 0 ¢ E0 p� CO O J¢ c � Em E Z 7in00o LL N ur c UY o o: o Qml.Lm fnU¢¢� d C7 '` Z 0o co ti L a co en 00 00 t m O > �0 N ��C9C� ` - ao N ao LA io ai W � a) LCL. � m � N 0 •- �; Q C O a � U- :¢ c m m i6 :O 0 Val 3 Z cLL v m O C � O U N0 W V O O CD 27)<Z) w>-C7Uao cc gra R m W D ti-wNV- F -F- 0 16,0 6.M n x Cow s 0 LU W cn uj to LL .. • • U cn LL0 o aN o m �6C3 . UmUm� ocpm X�- caw 1-0mli2wmYw mmQ N VNC9m U SC9NZ E P)H o 45 i6 aj U = me 2 mo Ham m ai Zai 0 t H W i) w w 2 t° M LmL ow a° 3: t) 0 CD cm m a Commonwealth of Massachusetts City/Town of NORTH ANDOVER MASSACI WSET System Pumping Record Form 4 TOWN OF NORTH A HEALTH DEPARTM DEP has provided this form for use by local Boards of Health. The System Pumping Re 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 n computer, use only the tab key Ad ress�— to move your ndmrr jnn 0 cursor - do not �-►-�1 1 t�_t l use the return Cityrrown State key. 2. System Owner: Name ISI Address (if different from location) Cityrrown State Telephone Number Zip Code Zip Code B. Pumping Record (� 1. Date of Pumping f 2. Quantity Pumped: Date Gallons 3. Type of system: ❑ Cesspool(s) T- Septic Tank ❑ Tight Tank •Q Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No 5. Condition of System: , 6. System Pumped By: t a e < �'-�� I C Company 7. Location where contents were disposed: Signature of Hauler http://www.mass.gov/deptwaterlapprovals/t5forms.htm#inspect t5fonn4.doc- 06/03 If yes.'was it cleaned? ❑ Yes ❑ No Vehicle License Number Date must System Pumping Record • Page 1 of 1 El 1�n-\ Commonwealth of Massachusetts City/Town of System Pumping Record Form 4 M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check 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 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: CJ on the computer, n use only the tab 6 r�- L=n key to move your Add es cursor - do notR-eo VQ Ma use the return key. Ci y/Town State Zip Code 2. System Owner: -fk-n Name rerun Address (if different from location) City/Town State Zip Code Telephone Number B. Pumping Record (o 2 1. Date of Pumping 2. Quantity Pumped: ' Date Gallons 3. Type of system: ❑ Cesspool(s) 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: 6. � m Pumped By: Name Stewart's Septic Service Company 7. Location where contents were disposed: Vehicle License Number Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Vnature Hauler DaReceiving Facility Date t5form4.doc• 03/06 System Pumping Record • Page 1 of 1 Important: When filling out forms on the computer, use only the tab key to move your error - do not use the return key. Commonwealth of Massachusetts City/Town of No Andover t1Ay 19 2014 System Pumping Record TOWN OF NORTH ANDOVER Form HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check 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 within 14 days from the pumping date in accordance with 310 CMR 15.351. A. Facility Information 1. System Location: Address No Andover Ma City,rr( n 2. System Owner: J4 et) Name Address (if different from location) State Zip Code City/Town State Zip Code Telephone number B. Pumping Record 1. Date of PumpingDate ' 2. Quantity Pumped: I sod Gallons 3. Type of system: ❑ Cesspool(s) ❑Septic Tank El Tight Tank F-1GreaseTrap ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Name Stewart's S t5tic Se ice Company Vehicle License Number 7. Location where contents were disposed: Stewart's Pre-treatment Plant, 20 So. Mill Bradford, Ma 01835 Signature of Hauler Signature of Receiving Facility Date Date t5forrn4.doc 03/06 System Pumping Record • Page 1 of 1 MF HANCOCK ASSOCIATES Civil Engineering Land Surveying Wetland Science Landscape Architecture of Transmittal GCT - '12010 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 185 Centre Street, Danvers, MA 01923 (978) 777-3050 / Fax (978) 774-7816 www.hancockassociates.com To: N. Andover Board of Health Date: Sept. 28, 2010 Job #: 16006 1 1600 Osgood Street From: Alan D. Roscoe, P.E. Bldg 20, Suite 2-36 Re: 82 Paddock Lane MassGIS Wetlands Mapping indicating Testing Area Locations N. Andover, MA 01845 Soil Observations • We are sending you: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Other COPIES DATE DESCRIPTION 1 Soil Test Application 1 Soil Test Application Fee (Check No. 103) $360.00 1 Residential property record Card (Documenting Ownership) I MassGIS Wetlands Mapping indicating Testing Area Locations • These are transmitted as checked below: ❑ For Approval ❑ Approved as submitted ❑ Resubmit _ copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ PRINTS RETURNED AFTER LO,, TO.U� i KC REMARKS: Susan and/or Pam — TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Our goal here is to examine the edges of the existing leaching system to determine saturation levels, and simultaneously perform soil observations and percolation testing in the event we need to design a replacement leaching system at this address. / /1 Copy To: I I Signed: If enclosures are not as noted, kindly notify us at once. 4 TOWN OF NORTH ANDOVER „owT,# Office of COMMUNITY DEVELOPMENT AND SERVICES F?�� ��oa' HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 ► o..t NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS, RS Public Health Director APPLICATION FO/ SOIL TESTS DATE: /0 / 0/ 6-) LOCATION OF SOIL TESTS: Front Yard OWNER: Kristin & Neil Hentschel 978.688.9540 — Phone 978.688.8476 — FAX healthdepta(�townofnorthandover com www.townofnorthandover.com MAP & PARCEL: Lot 210/107D Block 9 Contact #: 978-975-2319 APPLICANT: same Contact #: ADDRESS: 82 Paddock Lane ENGINEER: Hancock Associates Contact #: 978-777-3050 CERTIFIED SOIL EVALUATOR: VaclaV Talacko or Alan Roscoe Intended Use of Land: Residential Subdivision Single Family Home ommercial Is This: Repair Testing. IZIUndeveloped Lot Testing Upgrade for Addition: In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ 8.5"x 11 "Plot plan & Location of Testing (please indicate test nit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or upgrades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ 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). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: i / O Signature of Conservation Agent: Date back to Health Department: (stamp in): = OD; O 1z 1OOi too 7 m wig O m Thi o'er pc ii } ly cu U Oy0 faNiC= 0 to O wC oft* CD f o N � c LLq m: � . . Woi2i �� Z '}}�'U W �m ID � q L V to eta i i0 n n Y H. u O m; a aU fm L } e '.z �x O j o:o J .o.o;.. Z O N Q o GOP Lu GOI mecca ! m m,(U, mks - 10) fn ;(A U) tt(9 t: tti CU N .. {O co Na'C! �Ccu { x'- - # r� cu."Ot O. Z O a O LL Z J W V a 0 W O O 000 0 N f U, cc N N N (10 �� F. O ri CL ?�L°o 22 CO i0 N N C N N O O CL 00 O O } Z N N O ZN c Q Co W..' J Zc o -0O WNg uooory mU. O LO 000 I fQ�o Z Z I" uS NM _0 Q~ 1L CCD O C — U) U) Z tC'M Q Qy tAvo J J .. J iT iT c.)IO . Q ate; � m m u)< 00 o m Z F: o0 co 00 E LO Cli LOLO Voo W U m m V FLLO F09 O a .. C.0 F CD � �. C O 0o Z. -NEE Ua d 4 ~ �• C 0 c C,4 00 M t U)E•. Nl iN ai':3. Vii., CO u co O N is cc '. _: N a") -75 -p.m �.� W EPy y U, 'a)10) o O�O=,= Q MILL m, af 2- U) sC) Q 41 Z iL II lab C� O N N itp. 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OF 11 tT IL ioqo 10 lot, Ln oo✓r r 4 1V] &n �.���� �� •l���y^`�Y�,1� � ;.^''` ;� •fin * � or HA DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Wednesday, October 06, 2010 4:38 PM To: 'Daniel Ottenheimer'; 'Isaac Rowe'; Peters, Marianne; 'Randy Burley' Subject: FW: Soil Test Application - 82 Paddock Lane Attachments: 20101004162407161. pdf Hello, All set with Conservation. Please call the engineer to schedule soil testing at this site. Thank you so much! Best Regards, Pamela DelleChiaie Departmental Assistant lCommunity Development I Health Department Town of North Andover 1600 Osgood Street I Bldg 20 1 Suite 2-36 North Andover, MA 01845 N Office - 978-688-9540 9 Fax - 978-688-8476 9 Email - pdellechiaiegtownofnorthandover.com ; Website http://www.townofnorthandover.com/Pages/index "We can never see the path of our life if we are too busy focusing on the pebbles under our feet."—Anonymous -----Original Message ----- From: DelleChiaie, Pamela Sent: Tuesday, October 05, 2010 9:19 AM To: Gaffney, Heidi; Hughes, Jennifer Subject: FW: Soil Test Application - 82 Paddock Lane Hello Heidi, Attached is a soil test application for 82 Paddock Lane. I gave you the hard copy yesterday. Please let me know when all set with Conservation, and if you have any comments, and I will send on to Mill River to schedule soil testing with the engineer. Thank you. -- :) --Pamela -----Original Message ----- From: noreply@townofnorthandover.com [mailto:noreply@townofnorthandover.com] Sent: Monday, October 04, 2010 4:24 PM To: DelleChiaie, Pamela Subject: Soil Test Application - 82 Paddock Lane This E-mail was sent from "RNPOA428C" (Aficio MP C5000). Scan Date: 10.04.2010 16:24:07 (-0400) Queries to: noreplygtownofnorthandover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. r HANCOCK ASSOCIATES Civil Engineering Land Surveying Wetland Science Landscape Architecture %1"%0*P""etter of Transmittal OCT ~ 12010 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 185 Centre Street, Danvers, MA 01923 (978) 777-3050 / Fax (978) 774-7816 wim. hancockassociates. com To: N. Andover Board of Health Date: Sept. 28, 2010 1 Job #: 16006 1600 Osgood Street From: Alan D. Roscoe, P.E. Bldg 20, Suite 2-36 Re: 82 Paddock Lane N. Andover, MA 01845 Soil Observations • We are sending you: ❑ Prints ❑ Pians ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Other COP -777 =.TIO RII' 1 Soil Test Application 1 Soil Test Application Fee (Check No. 103) $360.00 1 Residential property record Card (Documenting Ownership) 1 MassGIS Wetlands Mapping indicating Testing Area Locations . i arae are transmiueu as cneexeu De1ow: ❑ For Approval ❑ Approved as submitted ❑ Resubmit _ copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ PRINTS RETURNED AFTER LOAN-TO..US REMARKS: OCT -. '1 2010 Susan and/or Pam — TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Our goal here is to examine the edges of the existing leaching system to determine saturation levels, and simultaneously perform soil observations and percolation testing in the event we need to design a replacement leaching system at this address. it _ A Copy To: Signed: f111 , U / If enclosures are not as noted, kindly notify us at once. TOWN OF NORTH ANDOVER Office of COMMUNITY DEVELOPMENT AND SERVICES •`` �•" HEALTH DEPARTMENT 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 NORTH ANDOVER, MASSACHUSETTS 01845a�'s'' Susan Y. Sawyer, REHS, RS 978.688.9540 - Phone Public Health Director 978.688.8476 - FAX healthdeplQto ofnorthandover,com www.townofnorthandover.com APPLICATION FO SOIL TESTS DATE: !� 7 olo MAP & PARCEL: Lot 210/107D Block 9 LOCATION OF SOIL TESTS: Front Yard OWNER: Kristin & Neil Hentschel APPLICANT: same ADDRESS: 82 Paddock Lane ENGINEER: Hancock Associates Contact #: 978-975-2319 Contact #: Contact #: 978-777-3050 CERTIFIED SOIL EVALUATOR: Vaclav Talacko or Alan Roscoe Intended Use of Land: Residential Subdivision SingAFamil:yH:oMe�forAddttlon-[:j rcial �s This: Repair Testing:© Undeveloped L,ot TestinUpgrade In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) AI" x H"Plot Plan A Location of resting (Please indicate tat nit sites on the Plan) ➢ Fee of g42s.0o per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of H60,00 per lot for feu&A or mgerades. GENERAL INFORMATION Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. 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). Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent: Date back to Health Department: (stamp in): 0 a N �N a o!'':' -Z i.c4 IEf' 2 1 LL I co a N m E do P6 4h w N 6 rn if Fes.: � Oit ,�' •S,•., � m �3 E F .�r Z W � O o O z W g O F z D 3 LL gO Z .J W 2 [ Ul W� Z t' 0 w O Y v In u X z Lu i L!Z IL� LU I N O xvaoz Q 0 a N �N a o!'':' -Z i.c4 IEf' 2 1 LL I co a N m E do P6 4h w N 6 rn if OW DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, October 05, 2010 9:19 AM To: Gaffney, Heidi; Hughes, Jennifer Subject: FW: Soil Test Application - 82 Paddock Lane Attachments: 20101004162407161.pdf Hello Heidi, Attached is a soil test application for 82 Paddock Lane. I gave you the hard copy yesterday. Please let me know when all set with Conservation, and if you have any comments, and I will send on to Mill River to schedule soil testing with the engineer. Thank you. -- :) —Pamela -----Original Message ----- From: noreply@townofnorthandover.com [mailto:noreply@townofnorthandover.com] Sent: Monday, October 04, 2010 4:24 PM To: DelleChiaie, Pamela Subject: Soil Test Application - 82 Paddock Lane This E-mail was sent from "RNPOA428C" (Aficio MP C5000). Scan Date: 10.04.2010 16:24:07 (-0400) Queries to: noreplyktownofnorthandover.com Please note the Massachusetts Secretary of State's office has determined that most emails to and from municipal offices and officials are public records. For more information please refer to: http://www.sec.state.ma.us/pre/preidx.htm. Please consider the environment before printing this email. IV I HANCOCK RECEIVED . Sept, 28, 2010 1 Job #: etter of Transmittal ASSOCIATES OCT -12010 From: Civil Engineering Land Sw-ve in Y g TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 185 Centre Sheet, Danvers, MA 01923 Wedmid Science 82 Paddock Lane (978) 777-3050 / Fax (978) 774-7816 LandscapeArchilechwe ivlvlv.hancockassociates.com To: N. Andover Board of Health Date: Sept, 28, 2010 1 Job #: 16006 1600 Osgood Street From: Alan D. Roscoe, P.E. Bldg 20, Suite 2-36 Re: 82 Paddock Lane N. Andover, MA 01845 Soil Observations • We are sending you: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Other 0>? 1 Soil Test Application 1 Soil Test Application Fee (Check No. 103) $360.00 1 Residential property record Card (Documenting Ownership) 1 MassGIS Wetlands Mapping indicating Testing Area Locations • 'l"nese are transmitted as clleciced below: ❑ For Approval ❑ Approved as submitted ❑ Resubmit _ copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ PRINTS RETURNED AFTER LOANjD_LLQ REM Susan and/or Pam — OC -12010 TOWN OF NORTH ANDOVER Our goal here is to examine the edges of the existing leaching system to determine saturation levels, and simultaneously perform soil observations and percolation testing in the event we need to design a replacement leaching system at this address. It /1. Copy To: Signed: If enclosures are not as noted, kindly notify us at once. TOWN OF NORTH ANDOVER oRrs Office of COMMUNITY DEVELOPMENT AND SERVICESo%%�� �y HEALTH DEPARTMENT, 1600 OSGOOD STREET; BUILDING 20; SUITE 2-36 `►'� uu,..1 «* NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS, RS Public Health Director APPLICATION FO SOIL TESTS DATE: (>©/? LOCATION OF SOIL TESTS: Front Yard OWNER: Kristin & Neil Hentschel 978.688.9540 - Phone 978.688.8476 - FAX h a llideptO.townofnorthandover com www.towtiofnorthandover.com MAP & PARCEL: Lot 210/107D Block 9 Contact #: 978-975-2319 APPLICANT: Same Contact #: ADDRESS: 82 Paddock Lane ENGINEER: Hancock Associates Contact#: 978-777-3050 CERTIFIED SOIL EVALUATOR: Vaclav Talacko or Alan Roscoe Intended Use of Land: Residential Subdivision Single Family Home mmercial Is This: Repair Testing;© Undeveloped Lot Testing Upgrade for Addltion:F In the Lake Cochichewick Watershed? Yes Nn THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter atom owner permitting test) ➢ 8.5"x 11"Plot plan 8 Location ofTesdne (ykasE udicat- taut pit sita oil the plan) Fee of $QM. per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of S360,00 per lot for feaairs or uperades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area, ➢ Repairs require at least two deep holes and at Ieast one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ 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). Within 64 days of testing soll evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation agent: Date back to Health Department: (stamp in): N aL N1 U-0 cl, IE co 0. 12, 3: T CL ;t k if V- 09 lz Cq N aL N1 U-0 cl, IE co 0. 12, 3: T CL ;t k if V- 09 lz C CD W In U.' ":V: 6 CU. O 12 Lb co UJ of Ul C!z 0 U) 0 In ? m 5 gz N aL N1 U-0 cl, IE co 0. 12, 3: T CL ;t k if C! C CD In O 12 Lb C!z 0 ul 0 Z ? m 5 to I? o LL. ul z Ul C3 j y 0 T x z 0 IL ui urL: Z x a) w 0 N aL N1 U-0 cl, IE co 0. 12, 3: T CL ;t k if Of NORTH 1M of Permit or License: (Check box) O p Town of North Andover Animal $ SACMUSt HEALTH DEPARTMENT CHECK #: �Q� TE• LOCATION: 53,� H/O NAME: CONTRACT( 4901 Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTI stems: Septic - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other. (Indicate) $ i Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer 4901 Town of North Andover `�'• „'. HEALTH DEPARTMENT ,ss�CHUSt� CHECK #: �D..3 D TE: LOCATION: H/O NAME: CONTRACTOR NAME: Type of Permit or License: (Check box) ❑ Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service - Type. $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal (Septic) Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTI stems: Septic - Soil Testing $� ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other: (Indicate) $ Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer r 4 HANCOCK ASSOCIATES Civil Engineering Land Surveying Wetland Science Landscape Architecture of Transmittal OCT - 12010 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT 185 Centre Street, Danvers, MA 01923 (978) 777-3050 / Fax (978) 774-7816 www.hancockassociates.com To: N. Andover Board of Health Date: Sept. 28, 2010 Job #: 16006 1 1600 Osgood Street From: Alan D. Roscoe, P.E. Bldg 20, Suite 2-36 Re: 82 Paddock Lane MassGIS Wetlands Mapping indicating Testing Area Locations N. Andover, MA 01845 Soil Observations • We are sending you: ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Other COPIES DATE DESCRIPTION 1 Soil Test Application 1 Soil Test Application Fee (Check No. 103) $360.00 1 Residential property record Card (Documenting Ownership) I MassGIS Wetlands Mapping indicating Testing Area Locations • These are transmitted as checked below: ❑ For Approval ❑ Approved as submitted ❑ Resubmit _ copies for approval ® For your use ❑ Approved as noted ❑ Submit copies for distribution ® As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ PRINTS RETURNED AFTER LO N�TO.Uti REMARKS: Susan and/or Pam — TOWN OF NORTH ANDOVER HEALTH DEPARTMENT Our goal here is to examine the edges of the existing leaching system to determine saturation levels, and simultaneously perform soil observations and percolation testing in the event we need to design a replacement leaching system at this address. /? A Copy To: Signed: If enclosures are not as noted, kindly notify us at once. r" TOWN OF NORTH ANDOVER MOR*w Office of COMMUNITY DEVELOPMENT AND SERVICES °f •'�� `� ��° HEALTH DEPARTMENT �? } 1600 OSGOOD STREET; BUILDING 20• SUITE 2-36 + " NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS, RS Public Health Director APPLICATION F07 SOIL TESTS DATE: O / 02 O/ (� LOCATION OF SOIL TESTS: Front Yard 978.688.9540 — Phone 978.688.8476 — FAX healthdeptna townofnorthandover.com www.townofnorthandover.com MAP & PARCEL: Lot 210/107D Block 9 OWNER: Kristin & Neil Hentschel Contact#: 978-975-2319 APPLICANT: Same ADDRESS: 82 Paddock Lane Contact #: ENGINEER: Hancock Associates Contact #: 978-777-3050 CERTIFIED SOIL EVALUATOR: VaclaV Talacko or Alan Roscoe Intended Use of Land: Residential Subdivision Single Family Home ommercial Is This: Repair Testing: Undeveloped Lot Testing Upgrade for Addition In the Lake Cochichewick Watershed? Yes No THE FOLLOWING MUST BE INCLUDED WITH THIS FORM ➢ Proof of land ownership (Tax bill, or letter from owner permitting test) ➢ &5"x 11 "Plot plan & Location of Testing (please indicate test nit sites on the plan) ➢ Fee of $425.00 per lot for new construction. This covers the minimum two deep holes and two percolation tests required for each disposal area. Fee of $360.00 per lot for repairs or w2rades. GENERAL INFORMATION ➢ Only Certified Soil Evaluators may perform deep hole inspections. ➢ Only Mass. Registered Sanitarians and Professional Engineers can design septic plans. ➢ At least two deep holes and two percolation tests are required for each septic system disposal area. ➢ Repairs require at least two deep holes and at least one percolation test, at the discretion of the BOH representative. ➢ Full payment will be required for all additional tests within two weeks of testing. ➢ 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). ➢ Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.A. Conservation Commission Approval Date: Signature of Conservation Agent. Date back to Health Department: (stamp in): C c LL N is o m o m O (6 C C D UU,- J E Q �m 0 0 w O LL Z W V Z O _Z 0 ~ w W oY o Q Z J W� J W Z w Z� go Y0 W V CL V 0Q L: Z CO CL a)w 'NO O 2 'D co Z f _ LO N co) CO) �l N !Q h � :- Iii 00 0 0 N(0 O O a0 0 i t0 - c A ice>�>O 0 G O f i.> m (�0 N N - ,0 0 Cm i (n�OQ� W ii"), tiPrN N �� O J J (U Q) m sm't Y Y N OO C ! a hh 0 O 010 C 2w0_ OZ i r`� `�. N N O 1 O H I� F- dLU �_ • • m m + QZ X00 JJ 0 nil ON Z o0 — iH 0 L:'� m LL j Ln co :.i !E d 3 7 Ir O N M �lY�f-�cn ZNh �Qm Q i v)vo f QN I JV;S J m ' ik + >mm M m i�(nQ 00 G It I Z M O U O r LO N u O o O P �r (n . s 0) �mdU U p d CL ol O O u� �� O D = c `o m O~ asI N 14 .W m m z to�N =a U 2 n. N is o m o m O (6 C C D UU,- J E Q �m 0 0 w O LL Z W V Z O _Z 0 ~ w W oY o Q Z J W� J W Z w Z� go Y0 W V CL V 0Q L: Z CO CL a)w 'NO O 2 'D co Z f _ LO N co) CO) �l N LU ium�Qm =:: 114 Of)LL afQ 2 k9.:3 o'Cd LL ' C ��► m m � �U 0 fo :r,,, �� N (6 C ,n,, ooco tN�o�UU U `a o I r IVNr1OF-4- Nf y vi 6 iL .. , � U rcn E tE :S (u, mco $�10 mjiv C'I;U' w! C9iC9 m` �m mt;VY '-g(D to mLL2Wmle wf MMQ O aLL Vi 2,ONZ r E rn F= o (.D. CL 2 io r�, y 7 s N C (0 t 0 d N m h z M a'1 NV !Q h � :- Iii 00 N(0 CD (0 i t0 - c o1 ice>�>O 0 m Z 7 m - m Cm (n�OQ� (o ii"), tiPrN :� T- Q LU ium�Qm =:: 114 Of)LL afQ 2 k9.:3 o'Cd LL ' C ��► m m � �U 0 fo :r,,, �� N (6 C ,n,, ooco tN�o�UU U `a o I r IVNr1OF-4- Nf y vi 6 iL .. , � U rcn E tE :S (u, mco $�10 mjiv C'I;U' w! C9iC9 m` �m mt;VY '-g(D to mLL2Wmle wf MMQ O aLL Vi 2,ONZ r E rn F= o (.D. CL 2 io r�, y 7 s N C (0 t 0 d N m h z M a'1 NV W N h � e N � c 0 W N 1.. O U c9p L, r un a t m N O Q a �I aa� € E1p .0 u u fi� f f u U fic'9II c m we m r 3 3° m m m. m m m m m m m m M m sn F mto 'mm n en cn Mtn t� c� t� chi a m n ii v� u u v D s. •.�� M � . •� r tire. ) ! r a , Iw` . 3t p C 4 N s - �, TV&ac, r �' --� --, — FF ' � "�:: +ir'il► moi"" t. _O O N 00 N O\ dd H _O "C) 0 0 z a� U W c� .may CQ 0 Ld Cd v� CCS C7 Town of North Andover Office of the Health Department Community Development and Services Division 400 OSGOOD STREET North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/RS Public Health Director 978.688.9540 - Phone 978.688.8476 - Fax CWA6. J 9 Wq ICA?E OAF C091AL'GIA9VC'E As of: .august 12, 2005 This is to cert that the individuafsu6surface disposal system (RfPaired (X� — Full System by ,dim pueCCett a 82 PaddockLane North Andover, JKA 01845 Yfas been installed in accordance with the provisions of Titfe v of the State Sanitary Code and with the North Andover Board of Ifeafth regulations. She Issuance of this cert ate shaft not 6e construed as a guarantee that the system will function satisfactorify. S an �Y. Sawyer, REE9 S/W,S Pu6Cc Wealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 FINAL GRAD INSPECTION Date: $ DSS Address: LOAMED? ❑ SEEDED? ❑ COVER PER PLAN? Other -) MIM A. �. �� , Town 44ed_ Andover Health Department ate: Location: C_ -4--'L4.2 (Indicate Ad esss,/, if Residential, or Name of _Check #: /t0 Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing $ ❑Septi esign Approval $ eptic Disposal Works Construction (DWC) $ ❑ i Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ �➢ Well Construction $ .. l ➢ OTHER: (Indicate) —1.2 E Z Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer 1 .6 Grant, Michele From: Andy McBrearty [amcbrearty@millriverconsulting.com] Sent: Thursday, August 11, 2005 12:18 PM To: DelleChiaie, Pamela; Grant, Michele; Sawyer, Susan Cc: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail) Subject: Re: FW: 82 Paddock Lane - Final Const. Inspection Request Hi Pamela, Page 1 of 1 Final Construction Inspection for 82 Paddock attached. Only one issue to be checked at final inspection - D - box was leaking at one or two outlets. Installer did not have hydraulic cement on hand to repair, and so needs to be verified at final grade. Will call Jim, just to make sure that he knows you'll be looking at this... Regards, -andy 8/12/2005 1 fl Town of North Andover Office of the Health Department Community Development and Services Division 400 OSGOOD STREET North Andover, Massachusetts 01845 Susan Y. Sawyer, REHS/RS Public Health Director NORTI� Of,�tN° r°1ti0 �SACHUgE 978.688.9540 - Phone 978.688.8476 - Fax CPPq11ICA2E Off' C091rJ'GIANCE As of: .August 12, 2005 ,This is to cert that the individual subsurface dz rposafsystem Repairedi " — Full System ll by ,dim Kellett At 82 PaddockLane North Andover, 31A 01845 yfas been installed in accordance with the provisions of Title v of the State Sanitary Code and with the JVorth Andover Board of Yfealth regulations. ,The Issuance of this certificate shall not 6e construed as a guarantee that the system will function satisfactorily. S an Tr Sawyer, RE S19U TuRic Ifealth Director BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 0 0 -------______--T03d�N _OE�10ItT_A1VI)OR SEEMISPO -SAL SYSTE�Vi -- INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( ) constructed; (A repaired; by 14 ELL E -TT located at 02 FA D Deas 'K i -A U C • was installed in conformance with the North Andover Board of Health'approved plan, System Design Permit .# , plan dated &1A 7/45- 12Fy 7/26-5 , with a design flow Of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title S and local regulations,. and the final grading agrees substantially with the approved plan. All work is accurately represented on the As built which has been submitted to the Board of Health. Bed inspection date: �01910-5- Final inspection date: _ S / ! I lot f r� 3 7W Engineer Representative Bei -TA. Engineer Representative Date: Date: It 6 RECEM AUG 1 2 2005 TOWN OF NOPTH A ,C'OVER HEALTH DEPA'Pl - -T(I_ VN-OF_NORT-H-ANDOVER=SE-W-AGE-DISP-OSAL=SY-STEM --- -- INSTALLATION CERTIFICATION The undersigned hereby certify that the Sewage Disposal System ( ) constructed; (gyp repaired; be L- L -t Ti 14 SCL. E ? T located at 92 FA D Poc'K I—A A) A.I of e Avy pwte was installed in conformance with the North Andover Board of Health approved plan, System Design Permit .# , plan dated �2s 1 7/2�, with a design flow of gallons per day. The materials used were in conformance with those specified on the approved plan; the system was installed in accordance with the provisions of 310 CMR 15.000, Title 5 and local regulations,. and the final grading agrees substantially with the approved plan. All work is accurately represented on the As -built which has been submitted to the Board of Health. f Bed inspection date: _ S/ g c� S S 3 ! t7• Engineer Representative Final inspection date: Bei -PA- Engineer A - Engineer Representative Date: Date: 901/6 RECEIVED AUG 1 2 2005 TOWN OF NO`S T H A; DOVER HEALTH UEFART'l -NT NEW ENGLAND ENGINEERING SERVICES INC August 11, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 82 Paddock Lane, North Andover, MA Septic System As -Built Plan Submittal Dear Ms. Sawyer, REC IN ED tNO UG 1 Q' T0WF0RT AND, HEALTH DEPARTME The following Septic As -Built plans for the above referenced property are being submitted for approval. Enclosed are the following: 1. (3) Copies of the Septic System As -Built Plan. 2. Copy of Designer's/Installer's Certification Form. Please contact this office with any questions or concerns. Sincerely, J Thomas Hector Project Engineer cc: Homeowner 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 DelleChiaie, Pamela Subject: Susan&Michele-FINAL GRADE INSPECTION Location: 82 PADDOCK LANE Start: Fri 8/12/200510: 0 AM (► End: Fri 8/12/2005 11: 0,AM VQ, Show Time As: Tentative Recurrence: (none) r Meeting Status: Not yet responded Required Attendees: Sawyer, Susan; Grant, Michele Per Steve @ NEES, this will be ready for a Final Grade tomorrow (Friday) morning. 1 Page 1 of 1 DelleChiaie, Pamela From: Andy McBrearty[amcbrearty@millriverconsulting.com] Sent: Thursday, August 11, 2005 12:18 PM To: DelleChiaie, Pamela; Grant, Michele; Sawyer, Susan Cc: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail) Subject: Re: FW: 82 Paddock Lane - Final Const. Inspection Request Hi Pamela, Final Construction Inspection for 82 Paddock attached. Only one issue to be checked at final inspection - D -box was leaking at one or two outlets. Installer did not have hydraulic cement on hand to repair, and so needs to be verified at final grade. Will call Jim, just to make sure that he knows you'll be looking at this... Regards, -andy 8/11/2005 82 Paddock Lane - Final Const—Inspection Request Page 1 of 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, August 09, 2005 4:01 PM To: 'Daniel Ottenheimer (E-mail)'; 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: Grant, Michele; Sawyer, Susan Subject: FW: 82 Paddock Lane - Final Const. Inspection Request Hello, , Attached are the construction notes from the'Bed Bottom inspection done on 8/5, to take with you to the Final tomorrow. -----Original Message ----- From: Lisa LeVasseur [mai Ito: Iisal@mill riverconsulting.com] Sent: Tuesday, August 09, 2005 1:45 PM To: DelleChiaie, Pamela Subject: FW: 82 Paddock Lane - Final Const. Inspection Request All set for Thursday 8:00. Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.corn -----Original Message ----- From: DelleChiaie, Pamela [mailto:pdellechiaie@townofnorthandover.com] Sent: Tuesday, August 09, 2005 11:29 AM To: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail); McBrearty Andrew (E-mail) Cc: Sawyer, Susan; Grant, Michele Subject: 82 Paddock Lane - Final Const. Inspection Request Steve from NEES called, and said that the above is ready for a Final. Please schedule with Jim Kellett, 781.953.7146, and let me know day and time of inspection. Thank you. 8asf Raga. -ds, PA�yal�a DaBBaG�lfiwia Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http:j/www.townof iorthandover.com healthdept@townofnorthandover.com 8/9/2005 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, August 09, 2005 11:51 AM To: Sawyer, Susan Subject: RE: 82 Paddock Lane - Final Const. Inspection Request Thanks for keeping me in the loop --=-Original Message ----- From: Sawyer, Susan Sent: Tuesday, August 09, 2005 11:48 AM To: DelleChiaie, Pamela; 'Daniel Ottenheimer (E-mail)'; 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: Grant, Michele Subject: RE: 82 Paddock Lane - Final Const. Inspection Request Dan, I know you are going to be suprised about Paddock, so I will tell you what happened at the BOH meeting. The Board did not grant the 36 inch variance. What they did was allow that upon installation a second deep hole was to be done in the area of the system. Michele and I did that, and though it was marginal soil, they did get the 4 feet of naturally occuring soil in the area of the system. Just so you know, the other items on the agenda that night. Ben did not get his reduction to the dwelling on Boxford Street, he had to redesign and Greg Saab redesigned using a request for a size reduction of 25% rather than the reduction to ground water. Susan -----Original Message ----- From: DelleChiaie, Pamela Sent: Tuesday, August 09, 2005 11:29 AM To: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail); McBrearty Andrew (E-mail) Cc: Sawyer, Susan; Grant, Michele Subject: 82 Paddock Lane - Final Const. Inspection Request Steve from NEES called, and said that the above is ready for a Final. Please schedule with Jim Kellett, 781.953.7146, and let me know day and time of inspection. Thank you. 91 0s, Pwiw¢�Q D¢BB¢G�liiwi¢ Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townoftiorthandover.com healthdept@townofnorthandover.com 0 TOWN OF NORTH ANDOVER E NORTa Office of COMMUNITY DEVELOPMENT AND SERVICES ,rr "OOH HEALTH DEPARTMENT ~ _ p 400 OSGOOD STREET ► ", vi NORTH ANDOVER, MASSACHUSETTS 01845 �'ss"„CN„St`y Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX SEPTIC SYSTEM CONSTRUCTION NOTES ADDRESS: 82 Paddock Lane MAP: 107.D LOT: 9 INSTALLER: Jim Kellett — 781-599-7934 DESIGNER: New England Engineering Services PLAN DATE: 6/27/05 BOH APPROVAL DATE ON PLAN: 7/29/05 DATE OF BED BOTTOM INSPECTION: 8/5/05 - Michele Grant DATE OF FINAL CONSTRUCTION INSPECTION: 8 10 05 -MR DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION E>PRESSURE DISTRIBUTION PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN E>GALLON TANK = 1,500 LOADING OF SEPTIC TANK = 1,000 E>GALLON PUMP CHAMBER = 440 LOADING OF PUMP CHAMBER = - IDTYPE OF SAS = Infiltrator DIMENSIONS AND DETAILS OF SAS: 12.83 x 37.5 SITE CONDITIONS 2> Existing septic tank properly abandoned ElInternal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: 2nd Test pit conducted in NE corner of system, 4 feet of soil under the fill found. OK to fill. Page 1 of 4 TOWN OF NORTH ANDOVER 0 NCR7H Office of COMMUNITY DEVELOPMENT AND SERVICES a of`•,.o '���� HEALTH DEPARTMENT 41 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 +SS;��MUs S� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX SEPTIC TANK Comments: PUMP CHAMBER — N/a Comments: ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (Monolithic or 2 -piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (1-1-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Page 2 of 4 0 TOWN OF NORTH ANDOVER M°RTN Office of COMMUNITY DEVELOPMENT AND SERVICES ,r?°�' HEALTH DEPARTMENT * Fa 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845CN„s t� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX D -BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: None. SOIL ABSORPTION SYSTEM U Bottom of SAS excavated down to 6 inches into C soil layer, as provided on plan 0 Size of SAS excavated as per plan ❑ Tide 5 sand installed, if specified on plan ❑ 3/4-11/2" double washed stone installed ❑ 1/8-1/2" (Peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravel -less disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: One load of sand on-site — some fines, but looks okay. Sieve analysis is provided to inspector. PRESSURE DISTRIBUTION 11 Comments: inch manifold laterals installed with end sweeps size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Page 3 of 4 0 TOWN OF NORTH ANDOVER Of NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET * ",. A• +* NORTH ANDOVER, MASSACHUSETTS 01845 CHuse� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX CONTROL PANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: ❑ Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN ELEV TOP OF INVERT PLAN PIPE ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D -Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 i ++ TOWN OF NORTH ANDOVEROf NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES �O HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845CH s ett' �CNUS Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX SEPTIC SYSTEM CONSTRUCTION NOTES / ADDRESS: �d� AP:_ LOT: V INSTALLER: , L r DESIGNER: J5, , /� PLAN DATE: �, J BOH APPROVAL DATE ON PLAN: I?Z�a -5 DATE OF BED BOTTOM INSPECTION: DATE OF FINAL CONSTRUCTION INSPECTION: DATE OF FINAL GRADE INSPECTION: SELECT SYSTEM TYPE GRAVITY DISTRIBUTION PRESSURE DISTRIBUTION/ PRESSURE DOSING HOLDING TANK ADVANCED TREATMENT OTHER COMPONENT SUMMARY FROM PLAN GALLON TANK =�l9L7 LOADING OF SEPTIC TANK= l a v z7 GALLON PUMP CHAMBER =[9 LOADING OF PUMP CHAMBER = TYPE OF SAS DIMENSIONS AND DETAILS OF SAS. /Z-1 p 3 �.at �»� cr•� I� d C -:.-1C .� ,X• -T7. 5 % /` SITE CONDITIONS LI' Existing septic tank properly abandoned ❑ Internal plumbing all to one building sewer ❑ Topography not appreciably altered Comments: Page 1 of 4 ' TOWN OF NORTH ANDOVER f NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET",..": NORTH ANDOVER MASSACHUSETTS 01845 �cHu� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX SEPTIC TANK Comments: PUMP CHAMBER Comments: ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon tank has been installed (H-10 or H-20) (monolithic or 2 piece) ❑ Water tightness of tank has been achieved (Visual or Vacuum Test or Water held for 24hrs) ❑ Inlet tee installed, under access port ❑ Outlet tee (gas baffle or effluent filter) installed, under access port ❑ inch cover to within 6" of final grade installed over one access port, must be over outlet of tank if effluent filter is present ❑ Hydraulic cement around inlet & outlet ❑ Bottom of tank hole has 6" stone base ❑ Weep hole plugged ❑ gallon Pump Chamber installed (H-10 or H-20) (monolithic or 2 piece) ❑ Inlet tee installed, under access port ❑ Pump(s) installed on stable base ❑ Alarm float working ❑ Pump On/Off float working ❑ Drain hole in pressure line ❑ inch cover to within 6" of final grade installed over one access port ❑ Water tightness of tank has been achieved Visual or Vacuum Test or Water held for 24 hrs ❑ Hydraulic cement around inlet & outlet Page 2 of 4 •+ TOWN OF NORTH ANDOVER t N°RTFj Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET► NORTH ANDOVER MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX D -BOX ❑ Installed on stable stone base ❑ Inlet tee (if pumped or >0.08'/foot) ❑ Hydraulic cement around inlet & outlets ❑ Observed even distribution ❑ Speed levelers provided (not required) Comments: SOIL ABSORPTION SYSTEM Bottom of SAS excavated down to soil layer, as provided on plan Size of SAS excavated as per plan ❑ Title 5 sand installed, if specified on plan ❑ 3/4-1 %" double washed stone installed ❑ 1/8-1/2" (peastone) double washed stone installed ❑ laterals installed and ends connected to header (and vented if impervious material above) ❑ Orifices @ 5 & 7 o'clock positions ❑ Gravelless disposal systems: type, number and location as per plan ❑ Elevations of laterals installed as on approved plan ❑ 40 Mil HDPE barrier installed ❑ Retaining wall (boulder / concrete / timber/ block) ❑ Final cover as per plan Comments: PRESSURE DISTRIBUTION ❑ inch manifold ❑ laterals installed with end sweeps Comments: size: material: ❑ Squirt test ft in height ❑ Equal distribution to all laterals ❑ orifice size inch as per plan Page 3 of 4 SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D -Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 ,. TOWN OF NORTH ANDOVER NORTH Office of COMMUNITY DEVELOPMENT AND SERVICES o< , HEALTH DEPARTMENT 400 OSGOOD STREET �'�Sa NORTH ANDOVER, MASSACHUSETTS 01845 ,CR„s Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.9542 — FAX CONTROLPANEL ❑ Alarm & Pump are on separate circuits ❑ Alarm sounds when float is tripped ❑ Location of control panel: - El Rated for exterior if placed outside Comments: SYSTEM ELEVATIONS Benchmark: Rod at Benchmark: Height of Instrument: INVERT ON DESIGN PLAN ELEV TOP OF PIPE INVERT ELEVATION Building Sewer OUT Septic Tank IN Septic Tank OUT Pump Chamber IN Pump Chamber OUT Distribution Box IN D -Box OUT Manifold Lateral 1 HIGH Lateral 1 LOW Lateral 2 HIGH Lateral 2 LOW Lateral 3 HIGH Lateral 3 LOW Lateral 4 HIGH Lateral 4 LOW Lateral 5 HIGH Lateral 5 LOW Page 4 of 4 S �. ' S 4 .. o {' !: Town dt-North Andover c� Heath Department Date: Location: % Gr"j `/ 7C!fs' (Indicate Address, if Residential, or Name of Bus`i�ess) Check #: Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing $ ❑ Septic - Design Approval $ W,.-SepticDisposal Works Construction (DWC) $ SC% ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrasIVSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) 927 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer SOWN OF NORTH ANDOVER N°RTN Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT p 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 '�',s"�*�•''t�' 8wCWWI 5t 978.688.9540 — Phone Susan Y. Sawyer, REHSIRS 978.688.9542 — FAX Public Health Director healthdept(iZtownofnorthandover.com - e-mail www.townofnorthandover.com - website DATE: 'g:"5 AUG 0 1 2005 IHEALTH ��PARTMENT TOWN OF i fH ANDOVER LOCATION: C7� � Dp4 e_j-c' Z,41v "I LICENSED INSTALLER NAME: ✓E'd12 LD' PLEASE PRINT 1�5' SIGNATURE: TELEPHONE# 4 CHECK ONE: FULL SYSTEM REPAIR: COMPONENT REPAIR (indicate what parts): * NEW CONSTRUCTION: * If NE CONSTRUCTION, please attach the Foundation As -Built Plan. $250.00 or $125 Fee Attached? Project Manager Obligation From Attached? Foundation As -Built? Floor Plans? Yes No Yes No Yes No Yes No ($250) ($125) Approval of Health Agent Date: 9/2,�2 �/ �_) 46. i INSTALLER PROJECT MANAGEMENT OBLIGATIONS As the North Andover licensed installer for the construction of the septic system for the property at � Z Pa i?0d-r-k LANC relative to the application 04/n, Kellfff dated -'Juts Z-7 �—for plans by and dated with revisions dated I understand the following obligations for management of this project: 1. As the installer I am obligatedto obtain all permits and Board of Health approved plans prior to performing any work on a site. I must have the approved plans and the permit on site when any work is being done. 2. As the installer I must call for any and all inspections. If homeowner, contractor, project manger, or any other person not associated with my company schedules an inspection and the system is not ready then item three shall be applicable. 3. As the installer I am required to have the necessary work completed prior to the applicable inspections as indicated below. I understand that requesting an inspection, without completion of the items in accordance with Tile 5 and the Board of Health Regulations may result in a $50.00 fine being levied against my company. a) Bottom of Bed - generally first inspection unless there is a retaining wall which should be done first. Installer must request the inspection but does not have to be present. b) Final inspection — Engineer must first do their inspection for elevations, ties, etc. As -built or verbal OK from engineer must be submitted to Board of Health, after which installer calls for inspection time. Installer must be present for this inspection. With pump system all electrical work must be ready and able to cause pump to work and alarm to function. c) Final Grade — Installer must request inspection when all grading is complete. Does not have to be on site. 4. As the installer I understand that only I may perform the work (other than simple excavation) required to complete the installation of the system identified in the attached application for installation. I further understand that work by others unlicensed to install septic systems in North Andover can constitute reasons for denial of the system, and/or revocation or suspension of my license to operate in the Town of North Andover; significant fines to all persons involved are also possible. 5. As the Installer I understand that I must be on site during the performance of the following construction steps: a) Determination that the proper elevation of the excavation has been reached. b) Inspection of the sand and stone to be used. c) Final inspection by Board of Health staff or consultant. d) Installation of tank, D -box, pipes, stone, vent, pump chamber, retaining wall and other components. 6. As the installer I understand that I am solely responsible for the installation of the system as per the approved plans. No instructions by the homeowner, general contractor, or any other persons shall absolve me of this obligation. Unde s ned Licensed -eptic Installer Date:r� Di osal Works Construction Permit # 1 TOWN OF NORTH ANDOVER NORT1� Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH :"'.�RTMENT 400 OSGO' , , OTREET .......r NOR'1 ANDOVER, MASSACHUSETTS 01845 �'ss�CwU t� Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX July 29, 2005 James & Julie Dean 82 Paddock Lane North Andover, MA o1845 RE: Septic System Design, 82 Paddock Lane, North Andover- Map 107.D, Lot Q Dear Mr. & Mrs. Dean: The North Andover Board of Health has completed the review of the Proposed Subsurface Sewage Disposal System for the above referenced property, submitted on your behalf by New England Engineering. Services, Inc. dated June 27, 2005, last revision dated July 29, 2005. ➢ The design has been approved for use in the construction of an upgrade onsite septic system for a four (4) bedroom home, total nine -room maximum. ➢ Please refer to the plan Design Data, Percolation Test, General Notes, and Construction Notes for additional details of your septic system upgrade. ➢ This approval is generally valid for three years from the date of the approval. ➢ The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid This approval is subject to the following conditions: 1. At a Board of Health meeting held last night on July 28, 2005, the Board of Health members determined that the plan should be approved with the requirement that a second test hole be conducted at the time of installation of the system to determine that four feet of parent material lies beneath the entire system. This was due to the fact that only one test hole was located within the proposed leaching area. 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe or imply compliance with any of the aforementioned requirement. July 29, 2005 Septic System Design — Approval — 82 Paddock Lane Page 1 of 2 4. The plan does not call Po.-che installation of a septic tank effluent filte out one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use if you choose to install one. Installation process: ➢ During the above mentioned three year period, a Licensed Septic System Installer, licensed by the Town of North Andover Health Department, must apply and obtain a Septic Works Disposal Construction Permit, complete an Installer Project Management Obligation form, and complete the installation satisfactorily according to state and local regulations. ➢ There is a three step process during the installation of any septic system: o A) Bottom of Bed — generally, this is the first inspection unless there is a retaining wall, which should be done first. The Installer must request the inspection, but does not have to be present. o B) Final Inspection — the Engineer must first do their inspection for elevations, ties, etc. A verbal approval from the Engineer that the system has been installed correctly or a hard copy As -Built (Final Plan of the Septic System) must be received by the Health Department after which the Installer calls for an inspection time. The Installer MUST be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. o C) Final Grade — the Installer must request this inspection when all grading is complete. The Installer does not have to be on-site for this inspection. ➢ A Town of North Andover Sewage Disposal System Installation Certification Form must be signed by the Design Engineer, signed by the Installer, complete with appropriate dates of plan approval, number of gallons per day, and inspection dates. This must be submitted to the Health Department along with a hard copy As -Built Plan with all the required information. ➢ Once all the paperwork has been submitted, the Town of North Andover Health Department will issue a Certificate of Compliance form stating the date of completion, the Installers name, and location of the system. It will then be signed off by the Public Health Director. The septic installation will not be considered approved until this last piece is complete. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you may have. Sincerely, Susan Y. Sawyer, REHS/RS Public Health Director Encl: List of licensed septic system installers Cc: New England Engineering Services, Inc. File July 29, 2005 Septic System Design — Approval — 82 Paddock Lane Page 2 of 2 0 0 LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax healthdent(a�townofnorthandover.com - E-mail www.townofnorthandover.com - Website Page / of &. d • ' '.1-0 ) O3� ti"- - cecwiww�c« _ 1/ TO: Benjamin C. Osgood, Jr., P.E. DATE: ///07 COMPANY: FROM: Pamela DelleChiaie, Health Dept. Assistant New England Engineering Services, Inc. RE: /o�' Phone: 978.686.1768 Fax: 978.685.1099 We are sending you: ZVi lan Review Letter NAPPROVED ONOT APPROVED OSystem Construction Follow -Up These are transmitted as checked below: OOther ®For your File OAs Required OAs Requested OFor Your Use COP COPY TO: COPY TO: �1 TRANSMISSION VERIFICATION REPORT TIME 07/29/2005 16:36 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 07/29 16:35 FAX NO./NAME 89786851099 DURATION 00:01:06 PAGE(S) 03 RESULT OK MODE STANDARD ECM U TOWN OF NORTH ANDOVER Of NORTH 1 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET NORTH ANDOVER, MASSACHUSETTS 01845 'SSC USss Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX July 29, 2005 James & Julie Dean 82 Paddock Lane North Andover, MA o1845 RE: Septic System Design, 82 Paddock Lane, North Andover- Map lo:z.D, Lot 4 Dear Mr. & Mrs. Dean: The North Andover Board of Health has completed the review of the Proposed Subsurface Sewage Disposal System for the above referenced property, submitted on your behalf by New England Engineering Services, Inc. dated June 27, 2005, last revision dated July 29, 2005. ➢ The design has been approved for use in the construction of an upgrade onsite septic system for a four (4) bedroom home, total nine -room maximum. ➢ Please refer to the plan Design Data, Percolation Test, General Notes, and Construction Notes for additional details of your septic system upgrade. ➢ This approval is generally valid for three years from the date of the approval. ➢ The time period for which this plan is valid is reduced to two years from the date of a septic system inspection that did not meet the acceptable criteria in the state regulations. In the event an imminent health problem such as sewage backup into the dwelling is occurring, the North Andover Board of Health may reduce the time period for which this plan is valid This approval is subject to the following conditions: 1. At a Board of Health meeting held last night on July 28, 2005, the Board of Health members determined that the plan should be approved with the requirement that a second test hole be conducted at the time of installation of the system to determine that four feet of parent material lies beneath the entire system. This was due to the fact that only one test hole was located within the proposed leaching area. 2. If site conditions are found in the field to be different from those indicated on the design plan and/or soil evaluation, the originally issued Disposal System Construction Permit is void, installation shall stop, and the applicant shall reapply for a new Disposal Systems Construction Permit. 3. It is the responsibility of the applicant and/or the applicant's septic system designer, septic system installer or other representative to ensure that all other state and municipal requirements are met. These may include review by the Conservation Commission, Zoning Board, Planning Board, Building Inspector, Plumbing Inspector and/or Electrical Inspector. The issuance of a Disposal System Construction Permit shall not construe or imply compliance with any of the aforementioned requirement. July 29, 2005 Septic System Design — Approval — 82 Paddock Lane Page 1 of 2 r) r 4. The plan does not call f he installation of a septic tank effluent fil& ut one is recommended. Please be advised that only certain brands of filters are permitted for use in Massachusetts and each is required to follow certain approval criteria. Your designer or installer should work with you to assure a licensed brand is selected for use if you choose to install one. Installation process: ➢ During the above mentioned three year period, a Licensed Septic System Installer, licensed by the Town of North Andover Health Department, must apply and obtain a Septic Works Disposal Construction Permit, complete an Installer Project Management Obligation form, and complete the installation satisfactorily according to state and local regulations. ➢ There is a three step process during the installation of any septic system: o A) Bottom of Bed — generally, this is the first inspection unless there is a retaining wall, which should be done first. The Installer must request the inspection, but does not have to be present. o B) Final Inspection — the Engineer must first do their inspection for elevations, ties, etc. A verbal approval from the Engineer that the system has been installed correctly or a hard copy As -Built (Final Plan of the Septic System) must be received by the Health Department after which the Installer calls for an inspection time. The Installer MUST be present for this inspection. With a pump system, all electrical work must be ready and able to cause pump to work and alarm to function. o C) Final Grade — the Installer must request this inspection when all grading is complete. The Installer does not have to be on-site for this inspection. ➢ A Town of North Andover Sewage Disposal System Installation Certification Form must be signed by the Design Engineer, signed by the Installer, complete with appropriate dates of plan approval, number of gallons per day, and inspection dates. This must be submitted to the Health Department along with a hard copy As -Built Plan with all the required information. ➢ Once all the paperwork has been submitted, the Town of North Andover Health Department will issue a Certificate of Compliance form stating the date of completion, the Installers name, and location of the system. It will then be signed off by the Public Health Director. The septic installation will not be considered approved until this last piece is complete. Your effort to provide a properly functioning septic system for your dwelling is greatly appreciated. The Health Department may be reached at 978-688-9540 with any questions you may have. Sincerely, Susan Y. Sawyer, REHS/RS Public Health Director Encl: List of licensed septic system installers Cc: New England Engineering Services, Inc. File July 29, 2005 Septic System Design — Approval — 82 Paddock Lane Page 2 of 2 0 0 NEW ENGLAND ENGINEERING SERVICES INC July 29, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 82 Paddock Lane, North Andover, MA Septic System Design Re -Plan Submittal Dear Ms. Sawyer, TH ANDOVER 'CONE O�D� ARTMENj The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. The only change to this revised plan was the removal of the note regarding the Title 5 Variance request. This office hereby requests that the Title 5 Variance request be disregarded. Please contact this office with any questions or concerns. Sincerely, —/—/to*– //a� Thomas Hector Project Engineer 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 O NEW ENGLAND ENGINEERING SERVICES lk INC jm!(05, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 82 Paddock Lane Septic system repair design Dear Susan: jUU 2 5 2005 S'Lir'Ci"t'IANDOVER WEALTH DEPARTMENT Enclosed are revised plans for the above referenced property The changes which were made address your comments as follows: 1. Although this note has remained the same on our plans for the past several years and certainly during all of the tenure of Mill River Consulting a clarification has been requested. I disagree that the note needs to be changed, however to avoid any delay we have changed construction note # 10 to read "...disposed of properly off site". 2. The profile on sheet 1 has been revised to indicate a minimum of 9" and a maximum of 36" of cover over the distribution box. The same comments from item 1 apply here. 3. I believe that this situation warrants the request for a variance. The system is located primarily in the area of the test pit with the proper amount of soil. The balance of the system is located in the area of the existing system and thus could not be tested. Both of the original test pits which were performed on the site when it was developed were on the high side of the lot close to the cul-de-sac where the existing system is now and both of those tests had the required amount of soil. The second test pit for this design was dug in the only location available and is not directly under the system and is located downhill from all of the other testing. I believe that the proposed leach area contains the proper amount of soil under at least 75% of the system if not 100%. I will be at your meeting on the 28th to address the variance issue further. Sincerely, I C OV, Benjarm Osgood, JKP.E. President 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 n TOWN OF NORTH ANDOVER `� °t NO:t7111 Office of COMMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 400 OSGOOD STREET w ",- NORTH ANDOVER, MASSACHUSETTS 01845 Susan Y. Sawyer, REHS/RS 978.688.9540 — Phone Public Health Director 978.688.8476 — FAX July 21, 2005 Benjamin Osgood, PE New England Engineering Services 60 Beechwood Drive North Andover, MA 01845 RE: 82 Paddock Lane, North Andover, MA, Map 107D, Parcel 9 Dear Mr. Osgood, The proposed septic system design plans for the above site dated June 27, 2005 and received on June 28, 2005 has been reviewed. Unfortunately, the plans cannot be approved as submitted. The following items are in need of attention prior to approval, with the section of Title 5 (3 10 CMR 15.000) noted: 1. The note on abandonment of existing septic tank should be more specific on the procedure. As stated in 310 CMR 15.345(3)(c): "The tank shall be excavated and removed from the site, or the bottom of the tank ruptured after being pumped of its content so as to prevent retain age of water and the tank be completely filled with clean sand." 2. The maximum (36") and minimum (9") depth of fill over the distribution box should be specified on the plan. 3. A variance is requested from Title 5 of the Massachusetts Environmental Code for lack of suitable depth of naturally occurring pervious soil (48" depth is required, 36" was obtained). This variance should not be sought when a system in full compliance with Title 5 can be provided (15.404(1)). Only when full compliance as specified in 15.404(1) cannot be achieved then a variance may be sought pursuant to 15.405(3). In this instance a pre-treatment device (I/A treatment) would be allowed to be utilized under Remedial Use Approval and meet all the requirements of Title 5. In addition to the regulatory requirement for use of a pretreatment system, the nature and poor quantity of the existing fill material on this site indicates pretreatment of the wastewater prior to dispersal would be prudent. Please feel free to contact the office with any questions you may have. We look forward to working with you to obtain a replacement septic system which will be in compliance with all regulations and assure protection of public health and the environment of North Andover. ySincerelywyer, REHS/RS Public Health Director cc: Homeowner File r Page 1 of 1 DelleChiaie, Pamela From: Dan Ottenheimer [info@millriverconsulting.com] Sent: Friday, July 22, 2005 12:44 PM To: amcbrearty@millriverconsulting.com; Lisa Kozel LeVasseur; DelleChiaie, Pamela; Sawyer, Susan Subject: 82 Paddock Lane Plan review for 82 Paddock Lane is attached. You likely should not schedule this item for the BOH meeting next week. The variance they are requesting should not be applied for as Title 5 provides for a mechanism to gain full compliance at this site. Once they re -design it can be approved by the Department without having to go to the Board for a variance. Dan 0 Daniel Ottenheimer, President Mill River Consulting, Inc. Septic System Management Services 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com dano@millriverconsulting.com 7/28/2005 Page 1 of 1 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Friday, July 22, 2005 11:59 AM To: 'Andy McBrearty' Subject: RE: Septic Plan Follow-up Hi Andy, For 82 Paddock Lane there is no 9a form needed. It is a Title 5 variance request to allow the leach field to be located in ana area where the depth of the pervious c layer material is 36" in lieu of 48' required by Title 5, Section 15.24)1). Please let me know if you need any other information. Thanks, P -----Original Message ----- From: Andy McBrearty [mailto:amcbrearty@millriverconsulting.com] Sent: Friday, July 22, 2005 9:58 AM To: DelleChiaie, Pamela; Sawyer, Susan Cc: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail) Subject: Re: Septic Plan Follow-up Hi All, Here are the plan reviews for 94 Boxford and 240 Famum. Both requested 3' separation to Groundwater, and both were rejected. Farnum may be able to make a case, as they are already using a wall, but the plan has additional technical issues to address. Both cite an alternative system as being cost prohibitive, which may, or may not, be valid since they'd reduce the amount of fill and/or wall height, and they are both already using a pump chamber/pump. We have finished the review for 82 Paddock Lane as well, but did not seem to have the Form 9a (Local upgrade Approval form). Can you FAX that over to us at your convenience, so that we can complete the review letter (FAX: 978-282-0012)? They only have 36" of soil, and the LUA form will tell us why they are not proposing I/A. thanks, -andy 7/22/2005 C LETTER OF TRANSMITTAL North Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax healthdent(a,townofnorthandover.com - E-mail www.townofnorthandover.com - Website Page / of OF VtORT� q VL Z� i�l��"�ie► tea" � 4_ cocwcw«ia« . TO: Benjamin C. Osgood, Jr., P.E. DATE: xz� (%g — COMPANY: FROM: Pamela DelleChiaie, Health Dept. Assistant New England Engineering Services, Inc. or RE: Phone: 978.686.1768 � Fax: 978.685.1099 Fax # We are sending you:Ian Review Letter OAPPROVED T APPROVED OSystem Construction Follow -Up OOther These are transmitted as checked below: OForour File 04 -s -'Required uired OAs Requested OFor Your Use y q 9 REMARKS: COPY TO: Fax # or Mailed COPY TO: Fax # or Mailed COPY TO: Fax # or Mailed �1 TRANSMISSION VERIFICATION REPORT TIME 07/22/2005 13:41 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 07122 13:40 FAX NO./NAME 89786851099 DURATION 00:00:40 PAGE{S} 02 RESULT OK MODE STANDARD ECM f , Page 1 of 1 r DelleChiaie, Pamela From: Andy McBrearty[amcbrearty@millriverconsulting.com] Sent: Friday, July 22, 2005 9:58 AM To: DelleChiaie, Pamela; Sawyer, Susan Cc: Daniel Ottenheimer (E-mail); Lisa LeVasseur (E-mail) Subject: Re: Septic Plan Follow-up Hi All, Here are the plan reviews for 94 Boxford and 240 Farnum. Both requested 3' separation to Groundwater, and both were rejected. Farnum may be able to make a case, as they are already using a wall, but the plan has additional technical issues to address. Both cite an alternative system as being cost prohibitive, which may, or may not, be valid since they'd reduce the amount of fill and/or wall height, and they are both already using a pump ch ber/pump. We have finished the revie or 82 Paddock. L as well, but did not seem to have the Form 9a (Local upgrade Approval form). C `ou that over to us at your convenience, so that we can complete the review letter (FAX: 978-282-0012)? They only have 36" of soil, and the LUA form will tell us why they are not proposing I/A. thanks, -andy 7/22/2005 ru Um GU CO nj A@V[F IF I Ln Ln Postage $ rq 1:3 Certified Fee M M Retum Redept Fee (End orsement Required) E3 Restricted Delivery Fee -0 (Endorsement Required) r9 Total Postane & Fees IAL USE 0w37 1 UNIT ID: 0630 2.30 PoStma* 1.75 Here — Clerk: KTYKBG 07/16/05 C -ge—n 3 C3 REETA HORTON -------------- [�- 1� 8 OLYMPIA WAY orF MA 01810 -------------- ANDOVER, Gily Certified MaIRriovides: (memd) a= eunr'coge wjo:j Sd • A mailing receipt • A unique identifier for your mailpiece • A record of delivery kept by the Postal Service for two years Important Reminders: n Certified Mail may ONLY be combined with First -Class Maile or Priority Maile. Certified Mail is not available for any class of international mail. NO IN611AANCE . - CO . VERAGE IS PROVIDED vdth Certified Mail. 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Internet access to delivery information is not available an mail addressed to APOs and FPOs. Er r=l ru CC) co ru I HOH FNDfiRj C 48k L U S E. , Ln Postage $ 0.37 UNIT ID: 0630 r=l M Certified Fee 2.30 E3 M Return Reciept Fee 1.75 Postmark Here (Endorsement Required) C3 Restricted Delivery Fee Clerk: KTYKBG —0 (Endorsement Required) r=1 r-9 4.42 07/16/05 .:I- -- PETER DELANEY 72 PADDOCK LANE ------------ NORTH ANDOVER, MA 0 1845 Certified Mah._ ovides: (es array) aooz eunp'ppet uuo� sd ■ A mailing receipt ■ A unique identifier for your maflpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mails or Priority Mails ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE'IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. 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I RECEIPlm'r (Domestic. .- ca ru u1 Postage $ 0.37 UNIT ID: 0630 a O Certified Fee 2.30 O ReturnReciept Fee (Endorsement Required) 1.75 Park O Restricted Delivery Fee Clerk: KTYKBG -0 (Endorsement Required) rR r9 T • Q 4.42 07/16/05 M 79 C3 JOSEPH MC CARTHY 0 543 BOSTON STREET NORTH ANDOVER, MA 01845 -------------- i Certified rovides: ■ A mailing receipt (--aLl) zoos eunr'ooec w,od sd ■ A unique identifier for your niailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mails or Priority Mails. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. 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Internet access to delivery information is not available on mail addressed to APOs and FPOs. ru ,1 Ln Postage $ 0.37 LWIT ID: 0630 r=1 O Certified Fee 2.30O Q Retum Reciept Fee (Endorsement Required) 1.75 E3 Restricted Delivery Fee -0 (Endorsement Required) r -q Total Pestaaa & Faas 4. 4.42 S C3 Sei C3 PHILLIP PIERCE �r 12 OLYMPIA WAY ori ca ANDOVER, MA 01810 Postmark Here Clerk: KTYK8G 07/16105 Certified Mair"Provides: ■ A mailing receipt (--ea) Zooz eunr'ooee mod Sd ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: E Certified Mail may ONLY be combined with First -Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. e For an additional fee, a Return Receipt may be requested to provide proof of delivery. 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M ru CO co u7 Postage $ 0.37 UNIT ID: 0630 ra p Certified Fee 2.30 p Postmark C3 Retum Reciept Fee 1.755 Here (Endorsement Required) C3 ResMcted DeliveryFee Clerk:: KTYKBG -0 (Endorsement Required) r-9 Total Postage & Fees 4.42 07/16/05 C3 ent 7 p JEFFREY SARKISIAN s4ree1 6 RACHAEL ROAD or Po cny, ANDOVER, MA 01810 ---------- Certified M(a r rovides: ■ A mailing receipt (—eneb) Zooa eunr'oo8c uuod Sd ■ A unique Identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Mail& e Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE ISIPROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. 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Ln .a rq ca co ru 1*7s 0 Ilia A L U 8 iEZ Ln Postage $ 0.37 UNIT ID: 0630 r -i E3 Certified Fee 2.30 E3 Return Reciept Fee 1.75 P Herostme (Endorsement Required) C3 Restricted DeliveryFee Clem.: KTYK86 -0 (Endorsement Required) Total Pnntana R Fnan -It 4.42 1 07/16/05 O e o MICHAEL & JANET BRINK 10 OLYMPIA WAY or ANDOVER, MA 0 18 10 •------------ 1� Certified M lrProvides: A mailing receipt (es�anab) zppz eun!'�e u++od sd ■ ■ A unique Identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. 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Internet access to delivery information is not available on mail addressed to APOs and FPOs. o I JOHN FOUHY r` 71 PADDOCK LANE NORTH ANDOVER, MA 01845 pfil) BUTS " ru ru .. . , cc For delivery information visit our at rruu website N i 084 L U S,H Ln Ln Postage $ 0.37 UNIT ID: 0630 pCertified Fee 2.30 M ReturnReciept Fee 1• Postmark Here (Endorsement Required) o Restricted Delivery Fee Clerk: KTYKBG —0 (Endorsement Required) � _ _ th 4.42 07/16/05 o I JOHN FOUHY r` 71 PADDOCK LANE NORTH ANDOVER, MA 01845 pfil) BUTS " Certified MaUrovldes: ■ A mailing receipt (esianay) ZppZ eunr'ppgE uuo=i sd ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Maile or Priority Malt®. r Certified Mail is not available for any class of international mail. e NO INSURANCE COVERAGE' IS `PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Retum Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811), to the article and add applicable postage to cover the fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is required. - • 1 , ' - ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted -Delivery'. ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. to O rU ro co L U � � L! 0.37 UNIT ID: 0630 Postage $ rq O Certified Fee 2.34 M C3 Return RecieptFee 1,755 Postmark Here (Endorsement Required) O Restricted Delivery Fee Clerk: KTYKBG —D (Endorsement Required) r9 r-9 4.42 07/16/05 Total Postage & Fees $ O C3 MARY COHEN r 6 GEORGE AGGOTT ROAD NEEDHAM, MA 02492 t P �9 Certified Ma0rOvides: (--ad) aooz sunr'0096 uuo� Sd ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Mail®.! ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is required.—, � ' ;1' - - ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized aggant. Advise the clerk or mark the mailpiece with the endorsement RestrictedUelivery° ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. �1 0 t L NEW ENGLAND ENGINEERING SERVICES INC 19 July 2005 North Andover Board of Health 400 Osgood Street North Andover, MA 01845 RE: 82 Paddock Lane North Andover, MA Abutter Certified Mail Notification Dear Sir or Madam: RECEIVED 'JUL 2 1 2005 TOWN OF NO ;, y �, r r HEALTH DEPA' r,"T ° Enclosed are the Certified Mail Receipts for the above referenced property. If you have any questions or require further information, please call this office at (978) 686-1768. Sincerely, imbekOkk yB n Assistant to Benjamin C. Osgood Jr., P.E. 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 DelleChiaie, Pamela From: DelleChiaie, Pamela Sent: Tuesday, July 19, 2005 3:54 PM To: 'Daniel Ottenheimer (E-mail)'; 'Lisa LeVasseur (E-mail)'; 'McBrearty Andrew (E-mail)' Cc: Osgood Ben (E-mail) Subject: Septic Plan Follow-up Importance: High Hello all, Just want to be sure our records are up to date..... My log book indicates that the following new plans were submitted for review, and I just wanted to have an estimated done date for each: 6/28/05 240 Farnum-Se et E&S - 21 days 6/28/05-8215idock Lane NEES - 21 days 7/1/05 94 Boxford Street NEES - 18 days I know, I know, we have the 45 days :), but customers still get impatient..... also, our next Board meeting is on July 28th - next Thursday, and Ben was hoping to get feedback before then, as he is requesting an LUA and Local Bylaw Variance on 94 Boxford Street. Thank you for your assistance.:) 8a81 Ro#afd8, Pay .0010 ZPAW04 0!!fa/a Health Department Assistant Town of North Andover 400 Osgood Street North Andover, MA o1845 978.688.9540 - Phone 978.688.8476 - Fax http://www.townofnorthandover.com healthdept@townofnorthandover.com r � Town of North Andover�,� �� Health Department ate: j'f Location: (Indicate Address, if Residential, or Name of Business) Check #: ©QD Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: ❑ Septic - Soil Testing !ictict Design Approval $ �• ,-❑Se^�" $� ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER: (Indicate) 3 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer a Town of North Andover O • HEALTH DEPARTMENT 27 Charles Street RECEIVE 7./, North Andover, MA 01845 978.688.9540 ��n healthdeptnatownofnorthandover.com N 2 7 2005_.,�l T (F QRTH ANDi� OVER HEALTH DEPARTMENT SEPTIC PLAN SUBMIT'T'AL FORM DATE OF SUBMISSION: --W-77,/65 SITE LOCATION: 8a -PacUock, Cane &)o(4 -k 14ndoyer MA ENGINEER:11 LJ I�Pa.�� �� d �-t 141►'�2Pa't ►'LQ `Gtr ! C2� NEW PLANS: YES—Z $225.00/Plan Check #: (Includes 1'(' E` and one Re -Review Only) REVISED PLANS: YES S 75.00/Plan SITE EVALUATION FORMS INCLUDED: LOCAL UPGRADE FORM INCLUDED: Check #• YES NO YES NO Telephone #: 979- tog -/ 7%tq Fax #:_I Ik - L?S - /,0" E-mail: HOMEOWNER NAME: Ta.n OFFICE USE ONLY When the submission is complete Including check): 1.`" D �P plans lans and letter. 2. CCo tete and attach Receipt 3. t/ Cop File; Forward to Consultant 4. t/ Winter on Log Sheet and Database 11 June 27, 2005 X N NEW ENGLAND ENGINEERING SERVICES INC Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 82 Paddock Lane, North Andover, MA Septic System Design Plan Submittal Dear Ms. Sawyer, The following plans and enclosures for the above referenced property are being submitted for approval. 1. (3) Copies of the Septic System Design Plans. 2. (2) Copies of the Form 11 Soil Evaluator Sheets. 3. (2) Copies of the Form 12 -Percolation Test Sheets. 4. (1) Copy of the Septic System Submittal Form. 5. Letter to Town requesting to be put on agenda for the next BOH meeting. 6. Check for the Town approval fees. Please contact this office with any questions or concerns. Sincerely, 4 - Thomas Hector Project Engineer 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 0 0 NEW ENGLAND ENGINEERING SERVICES INC June 27, 2005 Susan Sawyer North Andover Board of Health 400 Osgood Street North Andover, MA 01845 Re: 82 Paddock Lane, North Andover, MA Title 5 Variance Request Q Dear Ms. Sawyer, The purpose of this letter is to request that the above referenced property be included in the upcoming Board of Health meeting agenda to discuss the following Title 5 variance request: Title 5 Variance Required 1. Allow leach field to be located in an area where the depth of pervious "C" layer material is 36" in lieu of 48" required by Title 5, Section 15.240(1). If you have any questions or comments, please do not hesitate to contact this office. Sincerely, Thomas Hector Project Engineer 60 BEECHWOOD DRIVE - NORTH ANDOVER, MA 01845 - (978) 686-1768 - (888) 359-7645 - FAX (978) 685-1099 V 00' SZz 00,szz 0008 00'SZz m A, C e 'Vi M1NINd 6690-Z89 (8L6) SOIHdVUD OdNfrl� Ianopud glaoN `auE1 Iooppud Z8 ON Junozddu LmId SOOz/SI/8 3dOl3AN3 6L£6 H11M 3sn o9011'11on(IOHd gvolquug - 8u11oa4z) 13AOPUV glJoNJo UMO.L 0NI `S30IA83S 9N1833NION3 ONnDN3 M3N quoujuug - 8uiloago 00'9Zz Ianopud TION `auu-1 )Iooppud Z8 30J Iunozddu uuld SOOz/S I/8 13AOpud 1411oN Jo Uh%.O , 0008 'SNI `SDIAMS 9NI833NIDN3 UNMN3 M3N f -� New ���� ►tis��� ' e V e Stevens Water Analysis 38 Montvale Avenue • Stoneham, MA 02180 • Mass. (617) 438-6114 • Salem, N.H. (603) 893-3106 LABORATORY NUMBER: 14542 SAMPLE DATE: 3/10/85 SUBMITTED BY: YOUNG BROS PUMP 36 Pelham Road + Salem, NH 03079 SAMPLE SOURCE: New Well - Sam Dagata, No. Andover, MA 10 ANALYSIS: According.to Standard Methods of Water and Wastewater Analys,�s, 15th Ed. Total Coliform . . . . . . . . . 0 per 100 ml Chlorides . . . . . . . . . . . . pH. . . . . . . . . . . . . . . Hardness . . . . . . . . . . . . Manganese. . . . . . . . . . . . Sodium . . . . . . . . . . . . . Iron . . . . . . . . . . . . . . Nitrate . . . . . . . . . . . . . Nitrite . . . . . . . . . . . . . Arsenic . . . . . . . . . . . . . 7 mg/L 6.4 62 mg/L less than 0.005 mg/L 5.0 mg/L 0.01 mg/L 0.20 mg/L less than 0.10 mg/L less than 1.0 ppb COMMENT: The results of these analyses meet the federal and state standards for drinking water. Chemis/Micro iologist Did 1yrw, a .ter �.�e� AZ 1 f,,5 -Cly /,'-'l- ---- - 19>1 I J�(/-t� Ns. nam i PAGE II SM -WART'S SEPTIC TANK SERVICE (CONT'D) 04-22-96 A 31 STONE CLEAVE ROAD 1,800 201 BRADFORD STREET 11000 04-23-96 585 BOXFO.RD STREET 1,500 HEAVY A 175 GREAT POND ROAD 2,000 04-24-96 1615 OSGOOD STREET 500 FLOODED A 122 OLYMPIC LANE 1,500 A 1116 SALEM STREET 750 04-25-96 A 75 FORREST STREET 11000 04-26-96 550 BOSTON STREET 2,000 2-1,000 TANKS 04-27-96 A 1015 JOHNSON STREET 11000 175 FOREST STREET 11000 350 SHARPNER'S POND ROAD 1,500 04-29-96 A 18 STEVENS STREET' 11250 A 100 FOREST STREET 1,500 A 82 PADDOCK LANE 1,500 04-30-96 A 133 SUMMER STREET 11000 A 347 HILLSIDE ROAD 11000 L" r u w Board of Health V Nor;.t::+ndover,Kass i SMMFACE DISPOSAL DESIGN CHECK LIST LOT APPROVkM DATE 3 lay -5 DISAPPROVED DATE_ Provided: Reasons: - �, AT ii S-A 1_2 +1�5T' f O Title V FAIL Reg 2.5 The submitted plan must show as a mdnimams a) the lot to be served-area,dimensions lot #,abutters b 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 vot areas within 1001 of sewage disposal system or . disclaimer -check wetlands mapping (h) surface and r.ibsurface drains within 100' of sewage disposal system or M >laimer (i) location arx hminage easements within 100' of sewage disposal system or e-laimer-Planning Board files (j) known sour;. of water supply -within 2001 of sewage disposal e system or & ,claimer (k) location of arr proposed well to serve lot -1001 from leaching facilit3 (1) location of water lines on property -101 from leaching facility (m) location of benchmark (n) driveways (o) garbage disposals (p) no PVC to be used in con... (q) profile of system-elevationz.. basement, plumb, pipe, septic tank, distribution box inlets and outlets, distribution 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 law to prepare such plans Reg 6 Reg 10.2 . _.._Reg.1094 Septic Tanks a) capacities -1507- of flow, water table, tees, depth of tees, access, pwaping b) cleanout --- c) 101 from cellar wall or inground suLmvdmg pool d) 251 from subsurface drains Distribution Boxes a) slope greater than 0.08 b) sumo Board of Health North AndoverZHaas- CNFD DATE DI SUPRCVED ea ins t OK r� SEPTIC SZSTM INSTA.S.ATICK CHBiCK. LIST W49 LOT �7 AVATICN Ob FAIL 7--1 qf' 1. Distance To: a. Wetlands b. Drains c.. Well 2. Water Line Location 3. No PVC Pipe 4. Septic Tank a. Tees -_Length & To Clean Out Cuv'er_ b. Cement Pipe to Tank - on Both Sides :f Tank 5. Distribution Box a. Covers & Box - No Cracks b. All Lines Flo -ging 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. Cw,,ent Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No Garbage Disposal 9. Final Grading Inspection 10. Barricading Covered System 11. As Built Submitted a. Lot Location b. Dimensions of System c. Location with Regard -to Pere Test d. Elevations e.' Water Table 0 to A � �� -- std say ”'++ s.aTL OT 6 SZSas NOIS oomi tunq-ga UO -E, oZ OT Ul bade v u )T 5 uot��naT� _,�z2uzuauag S"3 VG agid02id 'IIOs .zae,zasgo ���/✓ aog88iq.sanul j .aaumo P Td 'nTpgng/aoq ON 'po i —7 n6i L ON gaa.zq-g • ssiew 'saAopuv xa oN VIVC1 ssM NOlsvqoouad :9 aqiaoxd zi0s oaa PuZ • sum - - - doap- q.sl • su"©N aazTZ-,.g 30 o.aa curry -„C jo do-T(I sa!:�num-Neog uox! .Vjn ps q avq g z T a9CLUMN -� Td std say ”'++ s.aTL OT 6 SZSas NOIS oomi tunq-ga UO -E, oZ OT Ul bade v u )T 5 uot��naT� _,�z2uzuauag S"3 VG agid02id 'IIOs .zae,zasgo ���/✓ aog88iq.sanul j .aaumo P Td 'nTpgng/aoq ON 'po i —7 n6i L ON gaa.zq-g • ssiew 'saAopuv xa oN VIVC1 ssM NOlsvqoouad :9 aqiaoxd zi0s 0 Page 1 of 1 ,a A DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Tuesday, June 14, 2005 1:11 PM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: 82 Paddock Lane soils Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 6/14/2005 y i,. m k 4 -:n- 4", � 1 i 3 3 C-( r-� 1 Page 1 of 1 DelleChiaie, Pamela From: Lisa LeVasseur [lisal@millriverconsulting.com] Sent: Thursday, May 26, 2005 12:51 PM To: Sawyer, Susan; amcbrearty@millriverconsulting.com; DelleChiaie, Pamela; dano@millriverconsulting.com Subject: Soil Test Dates Here are some additional dates: June 9 9:00 1500 Forest Street, then 82 Paddock Lane June 29 9:00 55 Oakes Drive Lisa LeVasseur Mill River Consulting Your Complete Source for Onsite Wastewater Management 2 Blackburn Center Gloucester, MA 01930-2259 978-282-0014 or 1-800-377-3044 fax: 978-282-0012 www.millriverconsulting.com 5/26/2005 Commonwealth of Massachusetts City/Town of �Jor-klr, ,Av�awer- Percolation Test Form 12 M liercolation test results must be submitted with the Soil Suitability Assessment for On-site Sewage Disposal. DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with the local Board of Health to determine the form they use. Important: When filling out A. Site Information forms on the computer, use John Dean only the tab key Owner Name Date to move your 82 Paddock Lane PT1 cursor - do not use the return Street Address or Lot # Depth of Perc key. North Andover MA 01845 Start Pre -Soak 12:49 1:42 City/Town State Zip Code 1:04 1:57 Time at 12" (978) 686-8220 1:57 Contact Person (if different from Owner) Telephone Number B. Test Results 2:13 Time at 6" - Benjamin C. Osgood, Jr. Test Performed By: Andrew McBreary, Mill River Consulting Witnessed By: Comments: PT1 aborted due to test pit collapsinq. t5form12.doc• 06/03 Perc Test • Page 1 of 1 Date Time Date Time Observation Hole # PT1 PT2 Depth of Perc 96'715" 96'714" Start Pre -Soak 12:49 1:42 End Pre -Soak 1:04 1:57 Time at 12" 1:04 1:57 Time at 9" 1:15 @ 10" 2:13 Time at 6" - 2:36 Time (9"-6") - 23 Min. Rate (Min./Inch) - 8 Min. Per Inch Test Passed: ❑ Test Passed: Test Failed: ❑ Test Failed: ❑ Benjamin C. Osgood, Jr. Test Performed By: Andrew McBreary, Mill River Consulting Witnessed By: Comments: PT1 aborted due to test pit collapsinq. t5form12.doc• 06/03 Perc Test • Page 1 of 1 FORM 11. -SOIL EVALUATOR FORM �E r Page 1 of 3 R. JUN 7 2005 No. { l Iva Towly OF NORTH Ards � ✓EF', Date: d l aS HEALTH DEpAFZTtl4EsV7 Commonwealth of Massachusetts /A AvN AvJDvpr, Massachusetts Soil Suitabilitv Assessment for On-site Sewage Disposal ttjPerformed By: . enyw'm......,...... _0 S.Qo..od.+... r.-.. Date: Witnessed By:. ries.3.... .�c..�C '�1cr.A"Al...Rkle '....CPA+5 .1+1.A�................. '....... ............ �_. L=ation Address a SA V4. d d o c k i1 a owners blame. To �h 'eavi l'0f Address, aid ,V�j 1 o� AvvA bve P' 8A Fgk"ock L, ane Telephone 0 - �l1or}tn �Kdpver New Construction ❑ Repair 0 78) 68( - Office Review Published Soil Survey Available: No ❑ Yes Year Published �.�.... Publication Scale Drainage Class 1Ve Soil Limitations ►.�Jr� e�fa Soil Map Unit surficial Geologic Report Available: No K Yes ❑ Year Published Publication Scale «.,.... . Geologic Material (Map Unit) Landform.................................... Flood Insurance Rate Map: Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No El Yes ❑ -- Within 100 year flood boundary No ❑Yes ❑ Wetland Area: National Wetland Inventory Map (map WIA unit) Wetlands Conservancy Program Map (map unit) -44X Current Water Resource Conditions (USGS): Month J"►.R.vp2 Range :Above Normal Normal ❑ BeIr—w Normal ❑ Other References Reviewed: kiDEP APPROVED FORD! - 12/0719S R J FORM 11 SOIL FVAL UATOR FORM Page 2 of 3 Location Address or Lot No. AA QaAADCk-cL G�(tp, t Or-oA .2 yliter On-site Review Deep Hole Number TP�:..:.. Date:.. :.6 :9 . Time::..:.i:a�.o0 Weather a {�. O ve rca& :$o Location (identify on i* e Ian) p II Land Use ..., ::.t.Sl.rltr�:..�:a:.:::::..:...... Slope (%) ..51+.. Surface Stones .::......:......: Vegetation.......-.... . ...... Landform l'+R,tI�Q_::.:...::::::::.:::.:::. .:.......:::. ..::......::....::.,... Position on landscape (sketch on the back) Distances from: t1 Open Water Body :.:1.1 feet Drainage way --)ow 9::.::.....:.:. feet Possible:Wet; Area :.;:.rte.. .:.: feet Property Line .... I..,,r....::. feet Drinking Water Well feet Other..............:...:.:v........:...:.. DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Surface (triches) Soil Texture (USDA) Soil Color (Munsell) Soil Mottling Other (Structure, Stones, Boulders, Consistency, °k Gravel) L S 1 oYR �� I AnK ISM. Sly Parent Material (geologic) TAN ��5��1��� N DepthtoBedrock: Depth to Groundwater: StandingWater in the Hole: It --• �� Weeping from Pit Face: �r Estimated Seasonal High Ground Water._$. DEP APPROVED FORM - 12/07/95 :;FOR.Mi 11 - SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.f(' On-site Review beep Hole Number T�Date:.l1 Weather 0"t 60" ...60 o Location (identify on site plan) ......:.:.:::..:.:,:.:::....::: Land Use :....F�.:S:! �aa.�..:..... Slope M) ...: o. Surface Stones ... '',::.:: ::::....::...: Vegetation Landform..:/ofivtt:..:.::..::.:...:..:.::.:............::::.v:::.,.:..::.:..........:.:::.:................ . Position on landscape (sketch on the back)....�G»iC,.:.:S�4.o�t..:..:...::..........,.:::..W::.:V..:::::,:.:.:.:`.:..:::,:....'. ,..........' .:.._,._.:....... Distances from: Open Water Body JSfeet Drainage way../90 q feet PossibleMet Area :5P�9.::: feet Property Line .:.� ...::. feet Drinking Water Well 1M.— feet Other DEEP OBSERVATION HOLE LOG* Depth from Soil Horizon Soil Texture Soil rnl2� Soil n...__ V N Irl Surface. (inches) OS.DA) (Munsell)* Mottling (Structure, Stones, Boulders, Consistency, °k Gravel tweter XI �oYR SY X13 17 Parent Material (geologic) _A14,14 bh DepthtoBedrock: ^ .Depth to Groundwater: 'Standing Water in the Hole: Weeping from Pit Face: ^' Estimated Seasonal High Ground Water:__ DEP APPROVED FORM - 12/07/95 0 c FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No. OC� Rt4uoaak, "Ae .Al+k .3,410er Determination for Seasonal High Water Table Method Used: ❑ Depth observed standing in observation hole .................. inches ❑ Depth weeping from side of observation hole ............... inches WDep,th to soil mottles - inches ($o'% TPI)(Qbn Tfa) ❑ Ground water adjustment ................... feet Index Well Number .................. Reading Date ................... Index well level ................... Adjustment factor ................... Adjusted ground water level Depth 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? Yes If not, what is the depth of naturally occurring pervious material? Certification I certify that on AJO4. 1 99jf' (date) I have passed the soil evaluator 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. Signature C Date z 70 DEP APPROVED FORM - 12/07/95 �J BOARD OF, HEALTH NORTH ANDOVER, MASS. 01845 978-688-9540 �RE�EIVED APPLICATION FOR SOIL TESTS ((��,, MAY 2 3 2005 DATE: z3 ��� MAP &PARCEL: I '�pWN OF NOR ANDOVER PARTMENT LOCATION OF SOIL TESTS: Z PnvcK. Ln -t; OWNER: J ct-P--) Oe -4N TE).,. NO.: i%B- lv8% f5ZZ O ADDRESS: 8 Z- i�2 20C -e—' ENGINEER: W kl�l(rtltllEfj lc/�(sJti(,Qinl(� TEL.NO.: CERTIFIED SOIL EVALUATOR: AlaWIAI K&000 �/1 11—Hotplv Intended use of land: Residential Subdivision Single Family Home Commercial Is This: Repair testing X Undeveloped lot testing Upgrade for addition In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes. and two percolation tests required for each disposal area. Fee of $360.00 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. N.A. Conservation Commission Approval: Date Received: Check Amount: Check Date: �✓ �¢{�"au�s pl (Ik� NM Y< (>� ftln 17k&u I a SR, 0 OD m 0t 1 i 1 1 1 1 Nr CD �0 0 Na N 1 O o Z z P � s0 f% aap . 0 SR, 0 OD m 0t 1 i 1 1 1 1 Nr CD �0 ` s� N 1 O o Z Z -i 39 (so' wioE) 4'S' LAINE 11 y 1``"5 b e . , fi-2 ( 7 /0,--) reer Y ,,2t-) ty) c,I{ i 1—�4,J DA l u Nom_ CD ` � N 1 O o Z Z -i P � s0 Cd aap m < D � m p l u Nom_ CD ` N s � G Qm P � 0 m rm m m Town of Worth Andover Health Dep 4rtment Date: Location:G� (Indicate Address, if Residential, or Name of Business) Check #: / �/ Type of Permit or License: (Circle) ➢ Animal $ ➢ Dumpster $ ➢ Food Service - Type: $ ➢ Funeral Directors $ ➢ Massage Establishment $ ➢ Massage Practice $ ➢ Offal (Septic) Hauler $ ➢ Recreational Camp $ ➢ SEPTIC PERMITS: � m.,eS� ict - Soil Testing $ ❑ Septic - Design Approval $ ❑ Septic Disposal Works Construction (DWC) $ ❑ Septic Disposal Works Installers (DWI) $ ➢ Sun tanning $ ➢ Swimming Pool $ ➢ Tobacco $ ➢ TrashlSolid Waste Hauler $ ➢ Well Construction $ ➢ OTHER (Indicate) 6-30 Health Agent Initials White - Applicant Yellow - Health Pink - Treasurer LETTER OF TRANSMITTAL 'Pv- , th Andover Health Department 400 Osgood Street North Andover, MA 01845 978.688.9540 - Phone 978.688.8476 - Fax healthdept(a,townofnorthandover.com - E-mail www.townofnorthandover.com - Website 1-4 Page / of 17 NORTh i► a �a TO: Daniel Ottenheimer DATE: � � � 0 COMPANY: FROM: Pamela Delle hiaie, Health Dept. Assistant Mill River Consultin SIGNED: �� Phone: 1.800.377.3044 or 978.282.0014 RE: c� Fax: 978.282.0012 10-�---' i r We are oil Test These are transmitted as checked below: 9_ �:ej�'L;��'�SZ� Other fill in below) OFor Review and comment OAs Requested OAs Required OFor Your Use REMARKS: COPY TO: COPY TO: SIGNED: �� COPY TO: r' h TRANSMISSION VERIFICATION REPORT TIME 05/2612005 10:35 NAME HEALTH FAX 9786888476 TEL 9786888476 SER.# 000B4J120960 DATE DIME 05126 10:32 FAX NO./NAME 819782820012 DURATION 00:01:08 PAGE{S} 06 RESULT OK MODE STANDARD ECM U BOARD OF HEALTH NORTH ANDOVER, MASS. 01845 978-688-9546 APPLICATION FOR SOIL TESTS DATE: Z3 4vMAP & PARCEL: _ LOCATION OF SOIL TESTS: Z j�r4 i�Dy�G L�- RECEIVED MAY 2 3 2005 Q 9 I) ^ I �PAvVN OF NORTH ANDOVER OWNER:J o trt-v., D eqtj TEL. NO.: 9%�' �i8(o iW-o ADDRESS: 8 Z- �:> Poch L,41U6_ ENGINEER: NEcUt�la(:(t fl ISD ppl�(il A(k Rl tiILT TEL. NO.: ' c/ 7B- (98Co – / 16 e CERTIFIED SOIL EVALUATOR: OYe—Arz Al Z -fL�dd �i� T �✓ f� Intended use of land: Residential Subdivision Single Family Home Commerciale Is This: Repair testing X Undeveloped lot testing Upgrade for addition T In the Lake Cochichewick Watershed? Yes No X THE FOLLOWING MUST BE INCLUDED WITH THIS FORM: 1. Proof of land ownership (Tax bill, deed, or letter from owner permitting tests) 2. Plot plan 3. Fee of $425.00 per lot for new construction. This covers the minimum two deep holes. and two percolation tests required for each disposal area. Fee of $360.00 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 114001) 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. Please Do Not Write Below This Line NA. Conservation Commission Approval: Date Received: Check Amount: Check Date: OG K cso• w�vE LANE �n� if z F aD Z ZS r n r 0 0 p N �m _ tv m -ri 01� Y - I'M ��z O N w OG K �50� W1DE� LA.twE. If % 50. CeO.pO ,122 ✓Y) t,✓l i l,�+') -J)S. a Nom_ .D � � G A/ i I - I i z 1 I 0 / fv 0 tm Q m N rn N y r � / 01� Y - I'M ��z O N w OG K �50� W1DE� LA.twE. If % 50. CeO.pO ,122 ✓Y) t,✓l i l,�+') -J)S. a Nom_ .D � � G 0 tm m rn 11 ICI, 1 1 �I�N���C�.!L.'4 .�•`'? I �G%;: ,.,:.•, a. ';. I It , t 't'i ! Pith: '•. �.: ..: ... .� ,.. ':: '.•:•��••, .. ANDOVER—, ---MASSACHUSETTS �, 4RThl r S!e ;:Rumplt�`g'`Record' `•':i`, / ,0't.iT�:l'�,�y •:!. x � :I'l.l.. IF;�sj�r)�! c l.^ 1 3 �,�,1\.•.aJ'r r ' •{r ..,.,I�it�i�r::.i t� r t>j1V1:H• fi 1, l„n 4,, Dt:P..has proJlded thwi is suform for use by local Boards.of Health. The System Pumping Record mss: be bml�ted to the.Iocal*Board of Health or other approving authority, ..:A: Fpcilityinfornation tvu v V 5 Luui �;;,yyt1el1' filum out :1.. System LocaUon' i o%vN 1 7()VFR on only the tab key NT Ad ------------ dress to move your:: air:or • do dot _ �� ' al the rotum';�:'. City(Town Stat ka Code Sys tam Owner, , jt ) .+.�,y,i : G: ' i'••fs L.'i}'%r;. •�.�.P �'1(t �.: ,, v ;,n:n�',l.a.•y :, 'r+, ' •:y . �,;': , ;�r'<. Name . ', '.,•..,. ;... At0 Addraas (If different from location) . �:`. .. �. Cltylrown; � ; r: • State Zip Code —. Telephone Number -- --- -- .L:y. . -P;UMPI g.Re,�ord ,. yip: :p il:;'r:;sllwy.C'i;'}:,.r�;lAi,;.:a1iLi i1�•,'.f`• Dats of Primping`)` Dae 2, Quantity Pumped: ':� ::; •,•.:..::..:.... : .. Gallons :.TYPa 4f system; ; [] Cesspool(s) eptic Tank ❑ Tight Tank •.Other (describe), ;,:; Effliierit Tee Filter present? . ❑ o Yes If yes, was it cleaned? Cl Yes ❑ N on 0 Pumped !v� cense Number `'ST. VehIGeL! 6•.;:.:.,• ,.J` �, �' d,•t• '(yrs•, i;'"�: 'i.'� �'.y �C, Ad Hrpk )i•i r)•.•:+lH. /,F .1, .1 Conten-Yere'.di�posed: ..;:•;:,;�::;-r':.�;;r�','.;:'���^'r�...::.SlpnalLreo(Hauler;,� '; ,'. , Date Y.: httpJ/www.mass.8ov/dep%wafer/a pprCvaJs/t5(orms,htm#In spect . , t5forrM.doa!gNQJ :. .�" r Sy:tam Pumping Record Page 1 01 . TOO OF �f- kLA-1�-a� SYSTEM PUMPING RECO DATE: SYSTEM OWNER & ADDRESS RECEIVED MAY 3 12005 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT SYSTEM LOCATION (example: left front of house) DATE OF PUMPING: QUANTITY PUMPED: i '-S GALLONS CESSPOOL: NO YES SEPTIC TANK: NO YES NATURE OF SERVICE: ROUTINE el EMERGENCY OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) SYSTEM PUMPED BY: Bateson Enterprises, Inc. COMMENTS: CONTENTS TRANSFERRED TO: G.L.S.D / Lowell Waste COMMONWEALTH EXECUTIVE DEPARTMENT OF OF ENVIRONMENTAL AFFAIRS AL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 82 Paddock Lane_ _ North Andover_ Owner's Name: _John Dean_ Owner's Address: 82 Paddock Lane_ North Andover, MA 01845_ Date of Inspection 5/20/2005_ Name of Inspector: Neil J. BBateson_ Company Name: ateson Enterprises Inc._ Mailing Address: _111 Argilla Road_ _Andover, Ma. 01810_ Telephone Number: j 978 ) 475-4786_ RECEIVED MAY 2 5 2005 TORE(LTH C)' -,TM - TER CERTIFICATION STATEMENT I certify that I 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 Needs Further Evaluation by the Local Approving Authority X_ ails • ' � f � Date: 5/20/2005 Inspector's Signature: _ 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. Notes and Comments. ****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. Page 2 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _82 Paddock Lane_ _ North Andover_ Owner: _Dean Date of Inspection: 5/20/2005_ 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. Answer yes, no or not determined (Y,N,ND) in the 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _82 Paddock Lane_ _ North Andover_ Owner: _Dean Date of Inspection: _5!20/2005_ 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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: Page 4 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _82 Paddock Lane _ _ North Andover Owner: _Dean Date of Inspection: _5/2012005_ D. System Failure Criteria applicable to all systems: You must indicate "yes" or `no" to each of the following for all inspections: _Yes_ _ Backup of sewage into facility or system component due to overloaded or clogge`.d SAS or cesspool _ _No_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _Yes_ _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ _No_ Liquid depth in cesspool is less than 6" below invert or available volume is 1/2 day flow. No Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). T Number of times pumped _ No Any portion of the SAS, cesspool or privy is below high ground water elevation. _No_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ _No_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _ _No Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ _No 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] _Yes (Yes/No) 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 gld- You must indicate either `yes" or "no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 82 Paddock Lane _ North Andover — Owner: _Dean Date of Inspection: 5/20/2005 Check if the following have been done. You must indicate "yes" or "no" as to each of the following: Yes No _Yes_ _ Pumping information was provided by the owner, occupant, or Board of Health _No Were any of the system components pumped out in the previous two weeks ? Yes ` Has the system received normal flows in the previous two week period ? No Have large volumes of water been introduced to the system recently or as part of this inspection ? _N/A _ Were as built plans of the system obtained and examined? Yes_ — Was the facility or dwelling inspected for signs of sewage back up ? Yes _ Was the site inspected for signs of break out ? Yes _ Were all system components, excluding the SAS, located on site ? _Yes_ _ 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 ? _Yes_ _ 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: Yes no _Yes_ Existing information. _Yes_ _ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [3 10 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 82 Paddock Lane _ _ North Andover — Owner: _Dean _ Date of Inspection: _5/20/2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms (design): _4_ Number of bedrooms (actual): _4_ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): _660_ Number of current residents: _2 Does residence have a garbage grinder (yes or no): —No— Is laundry on a separate sewage system (yes or no): _ No— Laundry system inspected (yes or no): _ Seasonal use: (yes or no): No_ Water meter reading: _On well water _ Sump pump (yes or no): _No_ Last date of occupancy: _Current COMMERCIAIA NDUSTRIAL Type of establishment: _ _ Design flow (based on 310 CMR 15.203): _gpd Basis of design flow (seats/persons/sgft,etc.): Grease trap present (yes or no): _ Industrial waste holding tank present (yes or no): _ Non -sanitary waste discharged to the Title 5 system (yes or no): Water meta readings, if available: _ Last date of occupancy/use: OTHER (describe): GENERAL INFORMATION Pumping Records Source of information: Pumped 5 years ago, owner _ Was system pumped as part of the inspection (yes or no): Yes— If yes, volume pumped: _1500_ gallons -- How was quantity pumped determined? _Measured tank_ Reason for pumping: _Inspect tank & tees _ TYPE OF SYSTEM X 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/Altemative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank _ Attach a copy of the DEP approval _ Other (describe): _ _ Approximate age of all components, date installed (if known) and source of information: 20 Years old, 5/2/1984, design plan _ Were sewage odors detected when arriving at the site (yes or no): _No Page 7 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _82 Paddock Lane_ _ North Andover _ Owner: _Dean Date of Inspection: 5/20/2005_ BUILDING SEWER _ X _ (locate on site plan) 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.) SEPTIC TANKS: X 4" PVC thru wall, 3" PVC in house _ 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: 101x 5' x 4' Sludge depth24"_ Distance from top of sludge to bottom of outlet tee or baffle: 3"_ Scum thickness: _12" _ Distance from top of scum to top of outlet tee or baffle: _8" _ Distance from bottom of scum to bottom of outlet tee or baffle: 9" _ How were dimensions determined: _Tape measure_ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.)_ Pumped septic tank. Inlet tee ok. Outlet tee ok. Depth of liquid above outlet invert. Found outlet pipe full of liquid & collapsed pipe. Fixed collapsed pipe._ 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 baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Page 8 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _82 Paddock Lane_ _ North Andover— Owner: _Dean Date of Inspection: 5/20/2005_ 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/day Alarm present (yes or no): Alarm level: Alarm in working order (yes or no): Date of last pumping: Comments (condition of alarm and float switches, etc.): DISTRIBUTION BOX: X Depth of liquid level above outlet invert: _2"_ 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.):_D-box level & distribution equal. No evidence of leakage. Evidence of carryover. Liquid above outlet invert. _ PUMP CHAMBER: _ (locate on site plan) Pump in working order (yes or no): Alarm in working order (yes or no): Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Page 9 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _82 Paddock Lane_ _ North Andover _ Owner: _Dean Date of Inspection: _5/20/2005_ SOIL ABSORPTION SYSTEM (SAS): X If SAS not located explain why: (locate on site plan, excavation not required) Type _X leaching pits, number: _5 pits in gallery_ _ 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.): _ Soil ok. Vegetation ok. No sign of ponding to surface. Camera pits thru outlet in d -box. Liquid above invert of pits. _ 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 sludge layer: _ Depth of scum layer: _ Dimensions of cesspool: Materials of construction: . Indication of groundwater inflow (yes or no): 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.): Page 10 of 11 UBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _82 Paddock Lane_ _ North Andover_ Owner: _Dean _ Date of Inspection: _5/20/2005_ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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 ente7:7LVI� Well head To well Driveway A B Septic Tank A to Tank = 40'5 A to D -Boa = 54'5" B to Tank = 2017" B to D -Bog = 40' I Boz Page 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _82 Paddock Lane_ _ North Andover– Owner: _Dean Date of Inspection: _5/20/2005_ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to groundwater _10'_ Please indicate (check) all methods used to determine the high ground water elevation: _X_ Obtained from system design plans on record - If checked, date of design plan reviewed: _5/2/1984_ 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: As per design plan_ Tel: (978) 475-4786 Fax: (978) 475-5451 BATESON ENTERPRISES, INC. Excavating -Water.& Sewer Lines -Septic Systems & Pumping Service 111 Argilla Road Andover, Mass. 01810 Title 5 Inspection Report Property Address: 82 Paddock Lane, North Andover Owner: Dean Date of Inspection: 5/20/2005 My report contained herein does not constitute a guarantee of future usage and the functionality of the existing septic system. Such report issued herewith is merely based upon my observations, and I hereby disclaim any further operation of your current septic system. i Neil J. Ba eson Bateson Enterprises, Inc.