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WATERSHED RESIDENTS QUESTIONNAIRE
1. Name IIt RICH EHRM M
87 WOODCREST DRIVE
2. Street Address NORTH ANDOVER, MA 01845
3. How many members are in your household? 4
4. What type of sewage disposal system do you have?
❑ cesspool
[� septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Ar
wr the plans (drawings) for your sewage disposal system on file with the Board of Health?
yes ❑ no ❑ do not know, -
6. How old is your sewage disposal system? ❑ 0-5 years LR 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your se7no
disposal system been rebuilt or repaired?
❑ yes ❑ do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? LAY annually
❑ every 2-4 years ❑ every 5-10- years ❑ over 10 years ❑ never
O9. Have you had any problems with your sewage disposal system? d yes ❑ no
_ If yes, what problems? _
❑ repeated pump -outs needed
❑ system clogs, backs up, or drains slowly
[� odors
[� sewage surfaces through ground
10.
How many of each appliance are connected to your sewage disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet 3
roof/pavement drains shower/bathtub_
11.
Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher CAxADE SAN Ll�t•tT
clotheswasher
12.
Does your property have a lawn? [yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre CR" 1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13.
How often do you fertilize your lawn?
No. of applications per year K I
C)
Season(s) of the year S FV;M G
14.
Please state the brand and type (liquid or granular) of lawn fertilizer you use:
(� Check here if your lawn is maintained by a professional landscape contractor.
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If you have any questions regarding technical issues related to
this project, please contact Mr. Wensley at (617) 727-2660.
If you have questions regarding fiscal issues, please contact
Carol Weisberg at (617) 727-7099.
HW/ch
cc: Carol Weisberg
SEPTIC SYSTEM INSPECTION FORM
ADDRESS 1�d CfL6i— 414)
DATE INSPECTED 'l `
PROPERLY FUNCTIONING?---Y�
WEATHER CONDITIONS
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DATE?
SKETCH:
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OFFICES OF: o °� Town of
AI201EALs NORTH .ANDOVER
BUILDING
CONSERVATION se„"U$ DIVISION OF
.-IEALTH
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIRECTOR
July 15, 1987
5
Mr Ulrich Ehrig
87 Woodcrest Drive
North Andover, MA 01845
Dear Mr. Ehrig:
120 Wfln Street
North Andover,
MaSS�aChusetts 01845
(G 17) (385-4775
Your septic, system was inspected on July 13, 1987 and
was found to be malfunctioning. You will be required to
abate this problem as soon as possible. Please have a liscensed
installer contact the Board of Health by August 7, 1987 with
your plan of action so that a repair permit can be issued.
This repair is.in compliance with Commonwealth of Massachusetts
Regulation 310 and the recommendations of the Watershed Study
Committee.
Thank you for your cooperation.
Sincerely,.
Michael Graf,
Director of Public Health
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name III RICH F:MRI ' u n
a 87 WOODCREST DRIVE
c
2. Street Address NORTH ANDOVER, MA 018x5
3. How many members are.in your household? 4
4. What type of sewage disposal system do you have?
❑ cesspool
septic tank and leaching area
❑ connection to municipal sewer
❑ other (describe)
❑ do not know
5. Ar the plans (drawings) for your sewage disposal system on file with the Board of Health?
yes ❑ no ❑ do not know'--
' 6. How old is your sewage disposal system? D 0 -5 -years- LvJ 6-10 years D 11-20 years~-
❑ over 20 years ❑ do not know
7. Has your se7no
disposal system been rebuilt or repaired?
El yes ❑ do not know
If yes, approximately how long ago? years. What was done?
I 8. How frequently is your sewage disposal system pumped out? annually
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system? yes ❑ no
If yes, what problems? ----
repeated pump -outs needed
❑ system clogs, backs up, or drains slowly
Lg' odors
L� sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet _3
roof/pavement drains shower/bathtub_
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher CAx AP S-uN t -16+.+T
clotheswasher TIDE
12. Does your property have a lawn? yes ❑ no
If yes, approximately what size?
L7
❑ less than 1/4 acre 1/4 acre ❑ 1/z acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year K
Season(s) of the year S M;4 G
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
Check here if your lawn is maintained by a professional landscape contractor.
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BOARD OF HEALTH
146 MAIN STREET
TELEPHONE# (508) 688-9510
APPLICA TION FOR ABANDON:! :tEVT
OF SUBS (-,RFACE DISPOSAL SYSTEM!
!SEPTIC SYSTEM)
Pursuant to Section 310 CMR 15.3.54
of the State Environmental Code, Title V
Name
Address Pi
Contractor !tired for work:
Phone -
Name G i e,e Phone q 78 o (— ZC 5
Address by( -0 ew s r
Date for scheduled abandonment to, 7 —T 0o
The septic system at the above addr a been abandoned according to
Title V specifications.
Signature f Contractor
Method of septic tank abandonment (check one). (} removal () sandfill
W crush ( ) other
Name of Offal Hauler -e/
This form must be returned to the North Andover Board of Health.
PLEASE DO NOT WRITE IN THE SPACE BELOW FOR HEALTH
REPRESENTATIVE'S USE ONLY.
Id. Ile'#- co -
04 1
Inspecting Agent, Date
7J�C �ivdT,
(CIRC OP �H
NoI�TH �1NIi0U�l�, MA,
SS
�ISAPPRpVEp
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I..ar �7-SCI -
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FIS AL APPIZVAL
DwTe-
ATS APPRwtnJG
TO: NORTH ANDOVER, MASS 19
BOARD OF HEALTH
FROM: DESIGN ENGINEER Re: Soil Absorption Sewage
System I nspection
This is to certify that I have inspected the construction of the said disposal system at
L 6 -t ZY 7 11V00,0 CA L_ - % AP - North Andover, Mass.
SITE LOCATION
The grades and construction are as specified in my plans and specifications dated
19 .
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NORTH ANDOVER BOARD OF HEALTH
. INSTALLATION CHECK LIST
AP OVED DATE DISAPPROVED DATE hXCAVATION OK
RFASONS:
FAIL I
OK
1. Distance To:
Wetlands
Drains
Well
2. Water Line Location
No PVC Pipe
4. Septic Tank
Tees - Length & To Clean Out Covers
Cement Pipe to Tank - On Both Sides of Tank
5. Distribution Box
TVAer & Cracks
Flowin Equal Amounts
6. Leach Field or Trench
Dimensions
Stone Depth
Capped Ends
Clean Double Washed Stone
7. Leach Pits
l�� ensions
Stone Depth - <
ent Pipe to Pit - Both Sides
c Glean Double Washed Stone
No Garbage Disposal
Final Grading Inspection
_10.--Barracad�Covered
System
11. Qs-�Bu:ilt LS-�bmitted
Dimensions of System
Location with Regard to Pere Test
Elevations
Water Table
SOIL PROFILE & PERCOLATION TEST DATA
Town/City No.&Street &j0 CC1 C�- e1 Z Lot No. -�'f
Loc./Subdiv /� Plan Owner
l
Investigator 0�- Z6z!2C A) Observer
oe
SOIL PROFILES -DATE
1' E ev. 2-Elev. 3' Elev. 1--Elev,.
OIJ2977
1
2
3 3
�4 4
�i 5 5
6 ` 6
2
3
4
°5
M
Start --Saturation
1
2
3
4
6
Soak -Mins. /
Start Test -Time
Drop of 3" -Time /
DroD of 6 -"-Time
Mins.-ls-t 311Dro - Z
Mins e 2nd 311Drop 1
7
Start --Saturation
Soak -Mins. /
Start Test -Time
Drop of 3" -Time /
DroD of 6 -"-Time
Mins.-ls-t 311Dro - Z
Mins e 2nd 311Drop 1
7
7
7
7
8
8
8
9
9
--9
9
10
10
10
s_
10
Benchmark
Location
Elevation
Datum
Percolation
Tests -Date
U 77
Pit Number
1
2
3 4 5
Start --Saturation
Soak -Mins. /
Start Test -Time
Drop of 3" -Time /
DroD of 6 -"-Time
Mins.-ls-t 311Dro - Z
Mins e 2nd 311Drop 1
Notes & Sketches on Back Frank -C. Gelinas.& Associates, North -And.
/0
CC 1210,
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