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HomeMy WebLinkAboutMiscellaneous - 90 PENNI LANE 4/30/2018 (2)P N r O o" p r w-.- vr� ; + 107 wrest St. FOR -41 4, SYS'C I PU11'LPWG.rRECQRI Middleton, MA 01940 (508) 7742772 5�P Sv`C� Co o wealth of Massachusetts �w,►,. t x �. J ' Ft -�, Massachusetts System Pum�inE Record -stem %%mcr System Location p�r Date of Pumping: --� ---- Quantity Pumped: gallons spool: Cesj�'0 i Yes Septic Tank: No �] Yes Sy,by: k .t Sstem Pumped by ' 4 License #: o qtr Contents transferred try° Date Inspector OW Vt {` ,f s• ;.s.d • THE PROFESSIONAL EXPERTS IN THE SEPTIC ANO GRAIN WDUSTRY Commonwealth of Massachusetts T0Wj►-0� tt�R�tt'�;N��{"� 4t _� x Of HAT Jkly;d)rll Massachusetts �VSteg Panna Record-= 'stem er ystem Location Z Date of Pumping: Quantity Pumped: �llons,` x k Cesspool; No Yes, ❑ Septic Tani:: No ❑ Yes SN stem Pumped by: j,' License #: _ Contents transferred to: L S " Date Inspector - .���' p•*+qtr a� • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY .41 107 Forest St: d FORM 4. SYSTEM PUMPING Middleton, MA 01949 QRS (508) 774.2772�G� v • 5 SE a.. t*, �.,� *� v Commonwealth of Massachusetts T0Wj►-0� tt�R�tt'�;N��{"� 4t _� x Of HAT Jkly;d)rll Massachusetts �VSteg Panna Record-= 'stem er ystem Location Z Date of Pumping: Quantity Pumped: �llons,` x k Cesspool; No Yes, ❑ Septic Tani:: No ❑ Yes SN stem Pumped by: j,' License #: _ Contents transferred to: L S " Date Inspector - .���' p•*+qtr a� • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY cif8 toy Forest St. �N FORM 4. SYSTEII.1 PLTAIPNG RECORD„; ' Mlddteton,.MA 01848 (Sp 8) 7742772, �a ,4 Commonweglth of Massachusestti 1 Massachusetts . ter•' ,rte �s n; k A-9 - ear ystem"cation, W0 ; st 'I Er wU//CCJJ �� Vic. Date of Pumping: Quantity Pumped gallons Cesspool: NoYes ❑ Septic Tank: No ❑ / Ye SNIstem Pumped by: C License #: ' Contents transferred to: Date Inspector is f Ny ••1 l IV • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRYal • c fit.. 107 Forest St. Middleton, MA 01949 (508) 774-2772 •stem FORM 4 - SYSTFA1 PUMPING RECORD 0 onwoWth of Massachusetts r , Massachusetts 'k IS Date of Pumping: .C' Quantity Pumped:/2� Qallons Cesspool: No ❑ Yes ❑ Septic Tank: No Yes [�— System Pumped by: �( ���.` � �' fI.i Contents transferred to: C License #: ` Date / Z,.��/�►/ Inspector M 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 Y.;Jll c LL / 1 'k IS Date of Pumping: .C' Quantity Pumped:/2� Qallons Cesspool: No ❑ Yes ❑ Septic Tank: No Yes [�— System Pumped by: �( ���.` � �' fI.i Contents transferred to: C License #: ` Date / Z,.��/�►/ Inspector M 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 107 Forest St. Iddleton, MA 01949 (508) 774-2772 FOM 4 - SYSTEM PnIPNG RECORD a z wealth of Massachusetts Massachusetts System Pumnin� Record yste m ���ner e ystem ocat-on (% %3 L G 06 Date of Pumping: _L. L/� S—� Quantity Pumpe�. -----gallons Cesspool: Igo Yes ❑ Septic Tank: No ❑ Yes System Pumped by: Contents transferred to: License #: Date 12 — S - Inspector • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY • J 107 Forest St. N FORM 4. SYSTEM PLJM]PNiG RECO Middleton, MA 01949 (508) 7742772 S�Q.�S�av�GE !' ` A -1111a ConunonweAlth of Massachusetts en� Massachusetts j; ,;?, ra "le ,ocation �q _e oao Date Of Pumping: ? Quantit)' Pumped: allons -cesspool: No ❑ Yes El Septic Tank: No ❑ Y.-. Svstem Pumped by: Contents transferred to: A License #: C DateYee, ............... Inspector • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY innnw. FORM 4 - S.YST'E111 PU1 lNq G 6 of Massachusetts r ) Massachusetts r .......... Y1�1� Date of Pumping• 9 0 ' e Quantity Pumped: .152)0flons ❑;; Cesspool: 1\'o Yes ❑ Se tic Ta •. y P nl., No ❑ Yes [J SPumped kv: U t -e. S , C µ, ConteAts transferred to:j i License #i {! Inspector'"`.• t VA • THEPRO$ip ERTgIN tW0U8 EXP THE SEPTIC TRY ' 4 1 AND ORAW • : '.. 3N HAUL LIC # 777 $100 1996 INST LIC # 659 $200 1996 NO ANDOVER BOH TOWN HALL ANNEX 120 MAIN STREET NO ANDOVER, MA 01845 PH# 508-682-6483 508-688-9540 ** FAX 508-688-9556 Dear SIRS: STEWART'S SEPTIC TANK SERVICE 47 RAILROAD STREET BRADFORD, MA 01835 508-372-7471 November 4, 1996 The following is a list of properties that we pumped in your town. In accordance with TITLE V regulations, we are complying by sending you the following on a monthly basis, if need be. If we didn't pump, you will not be notified. PUMP DATE ADDRESS 10-16-96 79 SALEM STREET 30 VEST WAY 10-17-96 197 WINTER STREET 10-18-96 44 MARION DRIVE 10-21-96 598 SALEM STREET 10-24-96 45 RUSSETT LANE 77 BRUIN HILL ROAD 10-25-96 99 WOODCREST DRIVE 234 DALE STREET 10-26-96 3 ELLIS STREET 10-30-96 1615 OSGOOD STREET (MAR.M0TORS) 1,000 1,500 1,500 1,000 1,000 1,000 1,000 1,000 1,500 1,500 500 0 Hp,UL LIC #-777 $100 1996 INST LIC # 6591$200.1996 No ANDOVER BOH MW HALL ANNEX 120 MAIN STREET No ANDOVER, MA 01845 PH# 508-682-6483 508-688-9540 ** FAX 508-688-9556 STEWART'S SEPTIC TANK SERVICE 47 RAILROAD STREET BRADFORD, MA 01835 508-372-7471 Dear SIRS: The following is a list of properties that we pumped in your town. In accordance with TITLE V regulations, we are complying by sending you the following on a monthly basis, if need be. If we didn't pump► you will not be notified. t47Trm1C rinmments PUMP DATE ADDKE55 la t- 641)cQ 16d5r16 /rI� n e C' /M L01 �/-�'c� -- 1 wo 16 -d6`76 136 (5k) C �Pq Ue R % 66 (?6- ClanJ19 666 10 -&Z6-q6 Sea lem Sv. 1566 /0 A7- 6 906 67req f" Pahl Rd 01566 _ _I® -36-g6 ab/ Req . _ . i 6-31-1 c351 1u,a®o Ib'3/ 9� Jr- '9 �ee✓�wa d0 �� I Uo 0 I 1 HAUL LIC # 777 $100 1996 j- INST LIC # 659 $200 1996 NO ANDOVER BOH TOWN HALL ANNEX 120 MAIN STREET NO ANDOVER, MA 01845 PH# 508-682-6483 508-688-9540 ** FAX 508-688-9556 Dear SIRS: STEWART'S SEPTIC TANK SERVICE 47 RAILROAD STREET BRADFORD, MA 01835 508-372-7471 The following is a list of properties that we pumped in your town. In accordance with TITLE V regulations, we are complying by sending you the following on a monthly basis, if need be. If we didn't pump, you will not be notified. !'_ATXMIC r n mm a n4S AA TucKer rrn Rd 156c� qgz 3Xarpner Dona( Ad, is©o !a 5 q6 I Brec Kih,j R IdSa 156U a48 13n Ja es� Lot n e i boo 10-'7-1G � 5 PRrnvyn ts�' IDeo L/� D u fCes �� 1 OD(J MOO 15-r-16 � .k(sh 1600 C'©ach /ins Lo iie �s6U Ja-9-q6 d4b cc, nj/eC-K 1660 is ea-�b l I rid le Pq ao�o ' HAUL LIC # 777 $100 1996 y MST LIC # 659 $200 1996 '. NO ANDOVER BOH TOWN HALL ANNEX 120 MAIN STREET NO ANDOVER, MA 01845 PH# 508-682-6483 508-688-9540 ** FAX 508-688-9556 Dear SIRS: S`I'EWART' S SEPTIC TANK SERVICE 47 RAILROAD STREET BRADFORD. MA 01835 508-372-7471 The following is a list of properties that we pumped in your town. In accordance with TITLE V regulations, we are the following on a monthly basis, if need be. I�ldidn'ty sending you will not be notified. Pte. you !� 94, ifzl' Ns 'omm�n�s 1001.E ...10 ��' A/ 10 GG ./�' 1017-�� 197 TOUInler )0 /7-016/l6 �� /ems 5f Sao /0-17`16 53 ./I grlain t�1' I Doa _._.. Qc K Cine 1S6d _ 1540 I`500 ID -q6 o? 1?9 le, m S1. /0'033 6 1356 Pg l eL�h T vara Li, 9d SSU al. to d y� 07a9 Fr SJ -- f _ 16 - iwo FORM U — VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *************��**'*Applicant fills out this section***************** APPLICANT: C��l"V Phone 509J'70 .352- f LOCATION: Assessor's Map Number 1D7,.17 Parcel 006Z Lots) Street St. Number C O. ************************Official Use Only************************ RECOMMENDATIO S T AGENTS: Conservation Administrator CommentsOY- Town Planner Comments Food Ins ctor-Health r 'Sepeic Inspector_Health Comments Date Approved 71)1% Date Rejected 15SV7eti 4 Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected cDuor)s,,41_- <I Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date V � ,e FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ************/*****A'pplicant fills out this section***************** APPLICANT: (�l aJ P666Y 0'644D�l Phone 4' 35z� GaL,ry LOCATION: Subdivision Street Assessor's Map Number Parcel Lots) 70 St. Number ************************Official Use Only************************ RECON24MATIONS OF TOWN AGENTS: Conservation Administrator Comments Town Planner Comments Food Inspector -Health ,ZjXa_—��u Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date ( I r i 4/ W► <Z�41 Y' 0 Q ( I r i 4,1 LIJ 1� 7r 107 Forest St.FORIN-1 4 - SYSTEINJ WltM iUorl, MA 01949 1, lox i-50'8) 7-14-2772 ���p � w�C,� -: pl V r lcommopwealth of Massachusetts Massachusetts System Pumping Record 7!D0\jEVj/ 6, ' System Location --------- Of Pumping - --------------- Quantity itv Pumped: -',-SSPC)01: No [J' Yes El Septic Tank: No ElYes 1",)jnped bv: fZ7-,x, '7 License 9: ontent transferred to: Inspector 8 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY , 5 1, G U 'D?� 019" 9 ��� S��J\C FORM 4 - SYSTEM 1 —,..Commonwealth of Massachusetts Massachusetts System Pumping Record F_S7vs,lern 0_Avner ystem Location Pumpingoi Quantity Pumped: gallons C S S.c C) 0! No ❑ Yes D Septic Tank: No 0 Yes El- PUMPed bv: License 4: s transferred to: Inspector -0'. rF-v 17, OF VjF1LCA -41996 107 Forest St. eiiddlelon, MA 01949 p�P'`N (508) 774-2772 5�Q5E�v`G� FORM 4 - SYSTEM PUMPING RECORD r-7 nwealth of Massachusetts !?. Vv , Massachusetts System d astern ow er ystem anon Date of Pumping: - �U/ � 7 l� �U Quantity Pumped: alions i Cesspool: No ❑ Yes ❑ Septic Tank: No ❑ Yes System Pumped by: (\= Contents transferred to: �---- License #: Date Inspector✓1 b - 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 107 Forest st.FORM 4 - SYSTEM PLTINIPL1G RECORD Middleton, MA 01949 (508) 774-2772 soxQ �R��Oa EEt/ �6 VVI OF k Commonwealth of Massachusetts Massachusetts System_ Pumping Record ystem r, ystemocatlon Sept <`� _Sp C c Ix- Pr—cej - A,f4 Date of Pumping: �� ! / C IV �"Obtr == ��----��---- Quantity Pump allons Cesspool: No Yes ❑ Septic Tank: No ❑ Y� "l f' System Pumped by: � License Contents transferred to: Date �i!% ,� Inspector r 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 Date of Pum in Pumping. Quantity 'Pumped. ---gallons Cesspool. No p Yes, ❑ Septic Tank,:' No El Yes, SN'stem "Pumped by. contents., transferred to:: License Date. 9 Inspector LL i4 ? THE PROFESSIONAL EXPERTS IN THE'SEPTICAN 9) DRAINDRAININDUSTRY • 107 Forest St. N FORM 4 - SYSTEMWIN PING RECORD Middleton, 9 (508) 774-2772 stem er Commonwealth of Massachusetts Massachusetts 11 x_11 / 1 �' v -fop 'V'� • on Date of Pumping: l� Quantit)' Pumped: ls=m gallons Cesspool: No Yes ❑ Septic Tank: No ❑ Yes Svstem Pumped by: Content: transferred to: License #: Date /v/ Inspector • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 t 07 Forest st.FORM 4 - SYSTEM PUMPING RECORD rAiddlelon, MA 01949 Q��N (508) 774-2772 Comm --- onwealth of Massachusetts � .........� -•-�-- Massachusetts T°r 3OF-Co`'�`f System PumpingRecord stem ystem Location �2aaz2— �Gco 639sii Date of Pumping: �� G d 6-0 Quantity Pumped: gallons Cesspool: No Z YesC ❑ Septic Tank: No ❑ Yes System Pumped bv: �Lj��License #:.. Contents transferred to: Date /(J g�/�(y Inspector 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 101 Forest Sl. Middleton, MA 01949 (508) 774.2772 C FORM 4 - SYSMI PITiAPLN'G RECORD Commonwealth of Massachusetts Massachusetts >. stem Owner `AI). Location �irjp� tF.R/ 4 Date of Pumping: Quantity Pumped:,Z�alIons Cesspool: No [ Yes ❑ Septic Tan].. No ❑ Yes L� c SYstem Pumped by: e/'( Contents transferred to: � License #: L_ • THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY • 107 Forest St. Middleton, MA 01848 F'OM14 - SYSTFA..1 PnI1PNG RECORD System Location �a W7 Ov f �7 Date of Pumping: Quantity Pumped: allons i Cesspool: 'No ❑ Yes ' Septic Tank:. No ❑ Yes D System Pumped by: License M 107 Forest St. FORM 4 - SYSMI PLJI�IPLNG RECORD Middleton, MA 01949 (508) 774-2772 ��G� �,1 0 5 5 Commonwealth of Massachusetts TOWN OF W) 37'� ;,"F)OVFR✓ Massachusetts.^ stem Pum in x _-mg Record stem «'ner ystem ocation j. j Date of Pumping: �, Quantity Pumped: gallons Cesspool: No ❑ Yes ❑ Septic Tank: No ❑ Yes L� I SN'stem Pumped by: License Contents transferred to: Date Inspector f 1 N FORAZ 4 - SYSMI PLTNIPNG RECORD 0 01. 500 Commi0W!C�Fi7H ANDQVFVI/ on ealth of Massachusetts es��, D of PF,ktiT Massachusetts y - 4 iCo; Forest St. PSN u; iUe;on, MA 01949 Q�l (iQ8) 7 74.2772 ?.4 NPS of �\ stem U��-ner FORNI 4 - SYSTEM PUNIPLNG RECOIu) Commonwealth of Massachusetts Massachusetts SVW Pumping Record m Location r I OWN' OF r,!r, ;TH `N Q0VE -4 1995 Date of Pumpino:-7,-- Quantity Pumped:gallons Cesspool: No ❑ S\ stem Pumped by: _ onlents transferred to: Yes ❑ Septic Tank: No ❑ Yes Er- --- License #: Inspector 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 ,07 Forest St. Middleton, MA 01949 (508) 774-2772 R-111* FORM 4 - SYSTEAf-PL-A -foWN C Ri'N �`AlC�ovc►' eo1 ,Rr 01-- ' 11996 Commonwealth of Massachusetts JUAWJO� . V, , Massachusetts 'G RECORD 9�- ',vstem Uwner C' ystem Ste'©/�26 G�iw.��Gv Date of Pumping: —�- Quantit} Pumped:als Cesspool: No Yes ❑ Septic Tank: No ❑ Yes System Pumped by: License #:.. Contents transferred to: DateqInspector 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY. 0 107 Forest St. Middleton, MA 01949 (508) 774.2772 �EQ��iAv�C�C. FORM 4 - SISTEAI PU7MPLiG RECORD Connyonwealth of Massachusetts Massachusetts-fAwN o Ne �a *y 5�; � OF >\ stem U��M System Location ck, �? �Si,P�� Date of Pumping: Quantity Pumped. ----gallons Cesspool: No Yes ❑ Septic Tank: No ❑ Yes ff System Pumped by: License #: Contents transferred to: Date --/6 - 713 -.,-?-9& Inspector 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 107 Forest St. Middleton, MA 01949 (508) 774.2772 C ystem Rwo �EQ� aR O 40, FORM 4 - SYSTEl11 PUl111PLNTG RECORD Commonwealth of Massachusetts tKe TOWIM OF NSR }r p.. `ti Massachusetts �r1�� cF:. JA Svs_tem Pum in ystem Ludiduon 7jk7f ve. Rh� FlitOOR-6 Date of Pumping: Quantity Pumped: '' gallons Cesspool: No Yes ❑ Septic Tank: No '❑ Yes [ .3.. r . System Pumped by: License #: _ Contents transferred to: Date 12 - Z� -/6" Inspector e` THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY }�� S a k M" 4. I Watershed Septic System -�� � TOWN OF NQR Servicing Report BOARD OF -HEALTH � o Date: J���j���. _ "7199 Homecwner: Street Pumper - �'-���'►' Address: Phone -- -� Phone ( <6 4' Nature of Service: Observations: Routine Emergency GO()d Condition Fu:_ 1 to Cover -�- Baffles in Place Leachfield Runback - V0 Excessive Solids 04 Heavy Grease AV Roots M6 Other (Explain) Description of Work: i Comments: 107 Forest St. PSN FORM �0 14 - SYSTEM Pnj VING RECORD Middleton, MA 01949 Qa (508) 774-2772 _w SEBA algo �'stem U%wiefr _7 7 Commonwealth of Massachusetts ,Massachusetts vstem Pumping Record ystem Location �-o Date of Pumping: Quantity Pumped: gallons Cesspool: No Yes El Septic Tank: No ❑ Yes ❑ System Pumped by: License Contents transferred to: /Z:'r Date x Inspector 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 107 Forest St. Middleton, MA 01949 (508) 774-2772 }stem J FORM 4 - SYSTEM PLWIPING RECORD nunonwealth of Massachusetts Aj-,(11A,,Lz%--ems, Massachusetts Svaem Pumping Record ystem Date of Pumping: - Quantity Pumped: gallons Cesspool: Igo ❑ Yes --❑ Septic Tank: No ❑- Yes ❑ /1 Svstem Pumped bv: License #:.. Contents transferred to: Date Inspector 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 107 Forest St.V PSN FORM 4 - SYSTEM PiJNIPING RECORD Middleton, MA 01949 R (508) 774-2772 w SeLP 221;1 E stem mer( b1i , Qo onw th of Massachusetts ssachusetts S. stem Pum ink Record system Location j /f Date of Pumping: Quantity Pumped: `%:gallons Cesspool: No El"" Yes ❑ Septic Tank: No p ❑ Yes System Pumped by: ` �� ` ' \�' Vii'' i_. License #:.. Contents transferred to I Date r Inspector /( r� 0 THE PROFESSIONAL EXPERTS IN THE SEPTIC AND DRAIN INDUSTRY 0 w TOWJ14 OF ANDOVER SEP`.PIC SYSTEM SERVICING Date :No-�-�� Homeowne r : C — Stree': 010 Phone Nature of S,:�rvice: Routine Emery:?ncy REPORT TOW BOARD OF HEALTH � 4 Ib 1996 y Pumper m _ Address: r )Igay Phone _(90-/,/ Observat ton:..;: Good Condition Full to Cover Baffles in Place Leachfield Runback 0 Excessive Solids &/ Heavy Grease AlV Roots V--0 Other (Explain) Description of Work: Comments. rjo?'4� TOWN OF ANDOVER SEPTIC SYSTEM SERVICING Date:t`�(� Homeowner:_. Street Phone � _7 _ Nature or Service: Observations: Description of. Work: Comments; Routine Emergency REPORT i 1996 Pumper1 Address: I L KSS' Phone Good Condition Full to Cover Baffles in Place Leachfield RunbackY Excessive Solids Heavy Grease _kVQ Roots !V® Other (Explain) Board of Health North A402Xer Haas.' OLID DATE - eapj!. st nn il! i. 2 } SEPTIC SISTER INSTALLATIM CHECS LIST SS V/ AVATIM OK FAIL r 1. Distance To: a. Wetlands b. Drains c.. Well 2. Water Line Location 3. No PVC Pipe %. Septic Tank a. -Tees -_Length & To Clean Out Covers. b. Cement Pipe to Tank -- On Both Sides of Tank. 5• Distribution Box a. Covers & Box - No Cracks b. All Lines Flooring Equal Amounts C. No Back Flow b.. 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. Cement Pipe to Pit - Both Sides. f. Clean Double Washed Stone 8. No Garbage Disposal 9. Final Grading Inspection lA. Barricading Covered System 11, As Built Submitted a. Lot Location b. Dimensions of System c. Location -4th Regard -to Pere Test d. Elevations e: Water Table t Board of Health N Nor;.Y..`i ndover,Mass SUBSURFACE DISPOSAL DESIGN CHBCK LIST i LOT #A_/Q APPRMED DiT Provided: {./ DISAPPROVED DATE Reasons: 55 30; DwG 30� Title V Reg 2.5 ---"� - -- FAIL OK The submitted plan must show as a minimum: a) the lot to be served -area dimensions lot .abutters b location and log deep observation holes -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 wet areas within 1001 of sewage disposal system or disclaimer -check wetlands mapping (h) surface and subsurface drains within 100' of sewage disposal system or disclaimer (i) location any drainage easements within L00' of sewage disposal system or disclaimer -Planning Board files (j) known sources of water supply within 2001 of sewage disposal e . system or disclaimer . (k) location of any proposed well to serve lot -1001 from leaching facility (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 construction (q) profile of system -elevations of 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 Septic Tanks (a) capacities -150% of flow, water table, tees, depth of tees, access, pumping (b) cleanout (c) 101 from cellar wall or inground s-,rimmfng pool (d) 25+ from subsurface drains Reg -10.2 Distribution Boxes 1(a) slope greater ME 0.08 Reg 10.11 b) sump .. N: N rA N- ., 's- .sF.-'.:`�"-'V+.'°"�`p"` ,.e ."4Rs,..,,.,,,k .-+-3..-« . a !1..rS'9G Z - .w ` � .. �... _ .. ^+Cl'. ,.-,•.s+. r � .. .r', rr+.. r +,r. -ti � - . 'n°�/� .. - �. +m v 1 I �o f � I � � 0 v 1 v TOWN OF NORTH ANDOVER SYSTEM PUMPING RECORD DATE: 12 -S OWNER & ADD TO (example: left front of house) DATE OF PUMPING: S'l QUANTITY PUMPED GALLONS CESSPOOL: NO i YES NATURE OF SERVICE: ROUTINE OBSERVATIONS: GOOD CONDITION HEAVY GREASE ROOTS EXCESSIVE SOLIDS SOLIDS CARRYOVER SYSTEM PUMPED BY: SEPTIC TANK: NO YES EMERGENCY FULL TO COVER BAFFLES IN PLACE LEACHFIELD RUNBACK FLOODED OTHER (EXPLAIN) Y -k �U COMMENTS: of NOR,�:,r�,.i a DEC Z I "Z001 CONTENTS TRANSFERRED TO: 6 - - . • ,, C►�ut�au�ttr�nitlt ur f1laRrdtbuselU ruing and lusetto i $j11t>tli"tltrlt0 '-5�i'e►i� Luciii'o►� r l V Pe VI ✓11 L1. /V. Ao Date of loul"IfIll'o �j` I (1��i1►��,�?� ��U��It1�Ii� i Ces��►uul► t:►► , � yes U ales n License #t 5�•stettl 1 un►t►rJ b� , � i L S. n Cunle��ls.lrmisle►reJ Ir; , Dote I�Is�►erlut . I . , r • I