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Home My WebLink About- Miscellaneous - 204 MILL ROAD 5/6/2019 i TOWN OF NORTH ANDOVER Community & Economic Development HEALTH EIS TMEN " 120 Main Street 978. ItBw9540- Phone 7&t.688,9 42—FAX E-MAIL Beals:lidept@northat'idov,ei°ma.gov i Iwl 1..wlr&tl)//% �° now hararloverina„ a SEPTIC PLAN SUBMITTAL FORM Date of Submission: May 6, 2019 Site Location: 204 Mill Road Engineer: Jack Sullivan New Plans? Yes x 275/Flan Check# (includes I"submission and one re- review only) Revised Plans?Yes 125/Plan Check# Site Evaluation Forms Included? Yes x No Local Upgrade Form Included? Yes No x Telephone#: 781-854-8644 Fax#; E-mail: jacksu1153@comeast.net Homeowner Name: Frank Ventola OFFICE USE NLY When the Submission is complete(including check): Date stamp plans and letter Complete and attach Receipt > Copy File; Forward to Consultant > Enter on Log Sheet and Database 8 6 0 Town of North,Andover HEALTH DEPARTMENT psSACHU CHECK#: 786 DATE: -`6, (')1 ko" LOCATION: H/O NAME: 4 X.X- CONTRACTOR NAME: . Type of Permit or License:(Check box) • Animal • Body Art Establishment • Body Art Practitioner 0 Dumpster $ • Food Service-Type: $ • Funeral Directors $ • Massage Establishment $ 0 Massage Practice $ • Offal(Septic)Hauler $ • Recreational Camp 0 Sun tanning 0 Swimming Pool $ 0 Tobacco $ • TrasWSolid Waste Hauler $ • Well Construction SEPTIC Systems: 0 Septic-Soil Testing $ Septic-Design Approval $ 0 Septic Disposal Works Construction(DWQ $ 0 Septic Disposal Works Installers(DWI) $ 0 Title 5 Inspector $- 0 Title 5 Report $ 0 Other(Indicate) a6h Agent Initials White-Applicant Yellow--Health Pink- Treasurer ""Commonwealth of Massachusetts o City/Town of NORTH ANDOVER Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal A. Facility Information FRANK L.VENTOLA Owner Name 204 MILL ROAD MAP 107A LOT 63 Street Address Map/Lot 9 NORTH ANDOVER MA 01845 City state Zip Code B. Site Information 1. (Check one) E] New Construction rX Upgrade El Repair 2. Soil Survey Available? [] Yes F No If yes: NRCS website 31 Ic Woodbridge Sandy Loam Source Soil Map Unit Soil Name Soil Limitations Coarse Loamy Till Ground Moraine Geologic/Parent Material Landform 3. Surficial Geological Report Available?El Yes [A No If yes: Year Published/Source Publication Scale Map Unit 4. Flood Rate Insurance Map Above the 500-year flood boundary? Yes [I No Within the 1 00-year flood boundary? [] Yes [K No If Yes,continue to#5. 5. Within a velocity zone? ❑ Yes No 6. Within a Mapped Wetland Area? 0 Yes No MassGIS Wetland Data Layer: Welland Type 7. Current Water Resource Conditions(USGS): Range: F Above Normal F Normal El Below Normal Month/Year 8. Other references reviewed: t5form1 1.doc•rev.8M 5 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 1 of 8 Commonwealth of Massachusetts p Cityl-town of NORTH ANDOVER _ Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review(minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: 1 4/13/19 9:00 AM 50 DEGREES Date Time Weather 1. Location Right side of driveway Ground Elevation at Surface of Hole: 96.65 Latitude/Longitude: / feet Description of Location: See Sheet 8 2. Land Use Grassed-Residential Few 1-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope(%) Grassed Ground Moraine Vegetation Landform Position on Landscape(SU,SH,BS,FS,TS) 3. Distances from: Open Water Body a 200 Drainage Way a 200 Wetlands >200 feet feet feet Property Line 12 Drinking Water Well N/A Other feet feet feet 4. Parent Material: Coarse Loamy Till Unsuitable Materials Present: ❑ Yes ® No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: [] Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 70(Refusal) 90.82' inches elevation t5forml 1.doc-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover Form I I - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review(continued) Deep Observation Hole Number: Redoximorphic Features Coarse Fragments Volume Soil Soil Horizon/Soil Matrix:Color- Soil Texture %by Depth(in.) Layer Moist(Munsell) (USDA) Cobbles Soil Structure Consistence Other Depth Color Percent Gravel I&Stones (Moist) 0-7 A 10 YR 3/3 SL 7-16 BW 10 YR 6/8 LS 16-70 C 2.5 Y 5/4 LS 5 15 Additional Notes: REFUSAL @ 70" NO GROUNDWATER OR SOIL MOTTLES OBSERVED t5forml 1.doc-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal <Page 3 of 8 �L\ Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form 11 ® Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2 4/13/19 9:00 AM 50 DEGREES Date Time Weather 1. Location SEE SHEET 8 Ground Elevation at Surface of Hole: 96.2 Latitude/Longitude: feet 2. Land Use Residential few 1-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) slope(i/—.) Grassed Ground Moraine Vegetation > Tandform >200 Position on Landscape(SU,SH,BS,FS, 3, Distances from: Open Water Body 200 Drainage Way Wetlands >200 feet feet feet Property Line 20 Drinking Water Well N/A Other feet —feet feet 4. Parent Material: Coarse Loamy Till Unsuitable Materials Present: ❑ Yes 0 No If Yes: [I Disturbed Soil 171 Fill Material 171 Impervious Layer(s) 171 Weathered/Fractured Rock El Bedrock 5. Groundwater Observed: El Yes F&I No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 77"(refusal) 89.8 inches elevation t5form1 I.doc-rev.8/15 Form 11-Soil Suitability Assessment for On-Site Sewage Disposal -Page 4 of 8 Commonwealth of Massachusetts City/Town of NORTH ANDOVER s Form 1 - Soil Suitability Assessmentr On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2 Redoximorphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Cbblas Soil Structure Consistence Other a Depth Color Percent ravel (Moist) Stones 0_6 A 10 YR 3/3 6-21 Bw 10 yr 6/8 21-77 C 2.5 Y 5/4 10 Additional Notes: REFUSAL @ 77" NO GROUNDWATER OR SOIL MOTTLES OBSERVED t5forml l.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Z-\ Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form I I - it Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Obs.Hole# 1 Obs.Hole# PQ Depth observed standing water in observation hole 70"(REFUSAL) Inches inches ❑ Depth weeping from side of observation hole Inches inches ❑ Depth to soil redoximorphic features (mottles) inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) (USGS methodology) inches Inches Index Well Number Reading Date Sh=Sc—[Sr X(OW.—OWmaxyowr] Obs.Hole 9 Sc — Sr — Owo — Owmax— Owr Sh Obs.Hole# Sc — Sr — owl — Ow—— Owr Sh E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? [X Yes n No b. If yes,at what depth was it observed? Upper boundary: 16 Lower boundary: 70 inches inches c. If no,at what depth was impervious material observed? Upper boundary: - . Lower boundary: inches inches t5forml 1.doc-rev.8/16 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 6 of 8 Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form I I - it Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness ERIN KIRCHNER REPRESENTATIVE FOR THE TOWN -flame of Board of Health Witness Board of Health FNORTHANDOVER G. Soil Evaluator Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training,expertise and experience described in 310 CMR 15,017. 1 further ertify that the results of my soil evaluation,as indicated in the attached Soil Evaluation Form, are accurate and in actor7 further is/wilh "';�MR 15.100 through 15.107. 5-1-2019 Signature of Soil Evalu Date JOHN trlGrU�VAN III SE:2378 JUNE 30, 2019 Typed or Printed Name of Soil Evaluator I License# Expiration Date of License Note:In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Forrn...'l 2. t5forml 1.doc-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 7 of 8 Cit Co y/Town ofmmonwealth of ssach,.usetfts Form I I - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: EX. DECK 960 9791 96xs 97Xg Inv.=9 .2 984. 97%4 97x2 TOP OF FOUNDATION x2 dotion ELEV=100.0' is no fours EX, 4 BEDROOM HOUSE There jM eter drain 96X65 or perimeter 1 Car 97%9 H-1 Garage 795 9 x2 96 8 96X6 95)(9 Q PT-1 96X55 12" Ex. Bit. Conc 96XB 96 3 �nlW Driveway 96,,2 to 9 960 95XS " S78' 9 00 2 96%0 5.93 96X4 99 . 12 95 84i, 78. D_ t5form1 1.doc M LL &OAAD Vosal -Page 8 of Commonwealth of Massachusetts City/Town of NORTH ANDOVER Percolation Test For 12 Percolation 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 FRANK L. VENTOLA computer,use .......... only the tab key Owner Name to move your 204 MILL ROAD cursor-do not use the return Street Address or Lot# MA 01845 key- NORTH ANDOVER City/Town State Zei Code 978-771-519 Contact Person(if different from Owner) Telephone Number B. Test Results 4/13/19 9 : 00 AM Date Time Date Time PT-1 Observation Hole# 29-47 Depth of Perc 8 :53 AM Start Pre-Soak 9: 08 End Pre-Soak 9: 0 8 Time at 12" 9 :20 Time at 9" 9 :3 5 Time at 6" 15 MIN Time(9"-6") 5 MPI Rate (Min./Inch) ------- Test Passed: Test Passed: F-1 Test Failed: ❑ Test Failed: ❑ JOHN D. SULLIVAN III Test Performed By: ERIN KIRCHNER, REP, FOR THE NA BOH Witnessed By: Comments: t5form 1 2.doc-06/03 Perc Test-Page 1 of 1 Commonwealth of Massachusetts e City/Town of NORTH ANDOVER r it Suitability Assessment for On-Site Sewage Disposal A. Facility Information FRANK L.VENTOLA Owner Name 204 MILL ROAD MAP 107A LOT 63 Street Address Map/Lot# NORTH ANDOVER MA 01845 City State Tip Code B. Site Information 1. (Check one) ❑ New Construction Upgrade ❑ Repair 2. Soil Survey Available? ❑ Yes ❑ No If yes: MRCS website 311 C Source Soil Map Unit Woodbridge Sandy Loam Soil Name Soil Limitations Coarse Loamy Till Ground Moraine Geologic/Parent Material Landform 3. 5urficial Geological Report Available?❑ Yes ® No If yes: Year Published/Source Publication Scale Map Unit 4. Flood Rate Insurance Map Above the 500-year flood boundary? ® Yes ❑ No Within the 100-year flood boundary? ❑ Yes ® No If Yes,continue to#5. 5. Within a velocity zone? ❑ Yes [ No 6. Within a Mapped Wetland Area? ❑ Yes ® No MassGIS Wetland Data Layer: Wetland Typo 7. Current Water Resource Conditions(USGS): Range: ❑ Above Normal ❑ Normal ❑ Below Normal Month/Year 6. Other references reviewed: t5formI I.doc,rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 1 of S Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form I I - it Suitability Assessment for On-Site Sewage Disposal C. On-Site Review(minimum of two holes required at every proposed primary and reserve disposal area) Deep Observation Hole Number: 1 4/13/19 9:00 AM 50DEGREES Date Time Weather 1. Location Right side of driveway Ground Elevation at Surface of Hole: 96.65 Latitude/Longitude: feet Description of Location: See Sheet 8 2. Land Use Grassed-Residential Few 1-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope Grassed Ground Moraine Vegetation Landform Position on Landscape(SU,SH,13S,FS,TS) 3. Distances from: Open Water Body >200 Drainage Way >200 Wetlands >200 feet feet feet Property Line 12 Drinking Water Well N/A Other feet feet feet 4. Parent Material: Coarse Loamy Till Unsuitable Materials Present: R Yes [R No If Yes: [I Disturbed Soil El Fill Material ❑ impervious Layer(s) ❑ Weathered/Fractured Rock El Bedrock 5, Groundwater Observed: El Yes ® No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 70(Refusal) 90.82' inches elevation t5formi1 1.doc-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 Commonwealth of Massachusetts City/Town of North Andover a - Form I 1 ® Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review(continued) Deep Observation Hole Number: 1 Redoximorphic Features Coarse Fragments Depth(in.) Soil Horizon/Soil Matrix:Color- Sall Texture %by Volume Soil Soil Structure Consistence Other Layer Moist(Munsell) (t1SDA) Cobbles Moist Depth Color Percent Gravel $Stones 0-7 A 10 YR 3/3 SL 7-16 Bw 10 YR 6/3 LS 16-70 C Z5 Y 5/4 LS 5 15 Additional Notes: REFUSAL @ 70" NO GROUNDWATER OR SOIL MOTTLES OBSERVED t5form1 l.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form 11 ® it Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2 4/13/19 9:00 AM 50 DEGREES Date Time Weather 1. Location SEE SHEET 8 Ground Elevation at Surface of Hole: 96.2 Latitude/Longitude: 2, Land Use Residential few 1-3 (e.g.,woodland,agricultural field,vacant lot,etc.) Surface Stones(e.g.,cobbles,stones,boulders,etc.) Slope Grassed Ground Moraine Vegetation Landform Position on Landscape(SLI,SH,BS,FS, 3. Distances from: Open Water Body >200 Drainage Way >200 Wetlands >200 feet feet feet Property Line 20 Drinking Water Well N/A Other feet feet feet 4. Parent Material: —Coarse Loamy Till Unsuitable Materials Present: El Yes FXI No If Yes: El Disturbed Soil El Fill Material f_1 Impervious Layer(s) E3 Weathered/Fractured Rock 171 Bedrock 5. Groundwater Observed: El Yes KI No If yes: Depth Weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater: 77"(refusal) 89.8 inches elevation t6forml I.doc-rev.8/16 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 4 of 8 At\- Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (continued) Deep Observation Hole Number: 2 Redoximarphic Features Coarse Fragments Soil Horizon/Soil Matrix:Color- Soil Texture %by Volume Soil Depth(in.) Layer Moist(Munsell) (USDA) Cobbles Soil Structure Consistence Other Depth Color IPercent Gravel &Stones (Moist) 0-6 A 10 YR 3/3 6-21 Bw 10 yr 6/8 21-77 C 2.5 Y 5/4 10 Additional Notes: REFUSAL @ 77" NO GROUNDWATER OR SOIL MOTTLES OBSERVED t5fon,n1 I.doe rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 5 of 8 Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form 11 - it Suitability Assessment for On-Site Sewage Disposal D. Determination of High Groundwater Elevation 1. Method Used: Obs.Hole# 1 Obs.Hole [X Depth observed standing water in observation hole 70"(REFUSAL) inches inches ❑ Depth weeping from side of observation hole inches inches ❑ Depth to soil redoximorphic features (mottles) inches inches ❑ Depth to adjusted seasonal high groundwater(Sh) (USGS methodology) inches inches Index Well Number Reading Date Sh=Sc—[Sr X(W-OWm.)/OWl Obs.Hole# Sc — Sr — Owo — Owlu— owl — Sh Obs,Hole# Sc — Sr — owl — OW..— OW, — Sh E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? EZ Yes ❑ No b. If yes,at what depth was it observed? Upper boundary: 16 Lower boundary: 70 inches inches c. If no,at what depth was impervious material observed? Upper boundary: Lower boundary: inches inches t5form1 I.doc•rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 6 of 8 -C-\ Commonwealth of Massachusetts City/Town of NORTH ANDOVER Form 11 - it Suitability Assessment for On-Site Sewage Disposal F. Board of Health Witness ERIN KIRCHNER REPRESENTATIVE FOR THE TOWN Name of Board of Health Witness Board of Health OF NORTH ANDOVER G. Soil Evaluator Certification I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CIVIR 15.017 to conduct soil evaluations and that the above analysis has been performed by me consistent with the required training,expertise and experience described in 310 CIVIR 15.017. 1 further certify that the results of my soil evaluation,as indicated in the attached Soil Evaluation Form, are accurate and in accord e with 310 CIVIR 15.100 through 15.107. 1 5-1-2019 Signature of Soil Evaluator Date JOHN D. N III SE:2378 JUNE 30, 2019 Typed or Printed Name of Soil Evaluator License# Expiration Date of License Note:In accordance with 310 CIVIR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Forrr '12. t5forml 1.doc-rev.8115 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 7 of 8 S—\ Commonwealth of Massachusetts uCity/Town of ,p Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: t5form11.doe-rev.8/15 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 Commonwealth of ssachusetts City/Townof 14 s r 11 it ifi all it is posal Fief Diagrams µ Use this sheet for field diagrams: 20 EX. DECK 971" 96x7 97x1 � x1 96x8 97x9 Inv.=9 .2 ' 970 974 TOP OF FOUNDATION I 980 ELEV=100.0' x2 There is no faun daotion EX. 4 BEDROOM (HOUSE or perimeter 96x6 1 Car 97x9 TH-1 Garage 98x2 7x5 96 8 PT-1 960 g5x9 v ` Ex. Bit. Conc. 96x55 12" 96x5 S cnl Driveway 96 g5x9 cu TH-2 9sxa , W 9 9691 95x6 s n 96x1 S78" 9100 2 96xo > r 5.93 � � 96x4 Q9X 12" 95 $5.00' N7 001, t5forml l.doc posel <gage 8 of Commonwealth of Massachusetts City/T own of NORTH ANDOVER Percolation Test Form 12 Percolation 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 FRANK L. VENTOLA computer,use .............. only the tab key Owner Name to move your 204 MILL ROAD cursor-do not Street Address or Lot# use the return key. NORTH ANDOVER MA 01845 Cityfrown State 978-771-51R Code Contact Person(if different from Owner) Telephone Number aan B. Test Results 4 13/19 9 : 00 AM Date Time Date Time PT-1 Observation Hole# 29-47 Depth of Perc 8 :53 AM Start Pre-Soak 9: 08 End Pre-Soak 9: 0 8 Time at 12" 9 :20 Time at 9" 9 :35 Time at 6" 15 MIN Time(9"-6") 5 MPI Rate(Min./inch) Test Passed: Test Passed: ❑ Test Failed: ❑ Test Failed: E] JOHN D. SULLIVAN III Test Performed By: ERIN KIRCHNER, REP. FOR THE NA BOH Witnessed By: Comments: t5form I 2.doc-06/03 Perc Test-Page 1 of 1 Cornn-ionweaU-i of Massach.jsetts E'xeCLJtjve Offic,e Of 6, EnvuMF-flllE,,nfa� Aff6rs L ............... .......... .............- ............ .......... ...... Departrnent of Environmental 1`3rotection One Mriter 11�5treet Boston, MA 02 1013-617-292 5500 (3,N,ales D M:Aid 1(-'vv A, Fif,-"�,flan o V e I ro I K'al yin F, FloNo Maithn SmA,),Fr,J Governoi, Cc�i rn[ssk)ner. # APPROVAL FOR GENERAL USE Pursuant to Title 5, 310 CMR, 15.000 ` Name and Address of.Applicant: J Infiltrator Water Technologies,LLC. P.O. Box 768 6 Business Park Road Old Saybrook,CT 06475 Trade name of technology and model: High Capacity chamber, High Capacity H-20 chamber', Quick4 High Capacity chamber, Quick4 High Capacity 14D chamber, Quick4 Plus High Capacity chamber (fl- inch invert), Quick4 Plus High Capacity chamber (13-inch invert), Standard chamber, Quick4 Standard chamber, Quick4 Standard HD chamber, Quick4 Plus Standard chamber (5.3-inch invert), Quick4 Plus Standard chamber (8.0-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (3.3-inch invert), Quick4 Plus Standard LP (Low Profile) chamber (8-inch invert), Infiltrator 3050 (Storm Tech SC-740) chamber, Equalizer 24 chamber, Quick4 Equalizer 24 chamber, Equalizer 36 chamber, Quick4 Equalizer 36 chamber, Quick4 Equalizer 24 LP(Low Profile) chamber(6 inch invert), and Quick4 Equalizer 24 LP (Low Profile) chamber (2 inch invert) (hereinafter the"System7). Schematic drawings of the System and a design and installation manual are a part of this Certification. This approval allows the installation of the above identified chambers without aggregate. Transmittal Number: X259183 Date of Revision: February 19,2015,modified June 12,2015 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000,the Department of Environmental Protection hereby issues this Certification to: Infiltrator Water Technologies, LLC., P.O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein. The sale, design, installation, and use of the System are conditioned on compliance by the Company, the Designer, the Installer and the System Owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CM R 15.000. June 12,2015 David Ferris,Director Date Wastewater Management Program Bureau of Water Resources 1"hs nftmnadon¢s r`varC,..bt i.ni afternafe ti r mao Cat Nfkr hette D eirsity Director,at 6rP-292-5/,'51,17(#f/lassRlehay Sorvicr,�1-800,439-Z"iM Webs,,�Ie�wvvwxnass qcv/dkP Prinjud(w Rncydud Paj.rer Infiltrator Chamber,Infiltrator Water Technologies. Page 2 of 6 Approval for General Use—June 12,2015 1. Design Standards 1. The models listed in Table I are covered under this Certification. 'fable I: Chamber Dimensions Dimensions Invert Model WxLxH Height Inches Inches Equalizer 24 15 x 100 x 11 6 Quick4 Equalizer 24 16 x 48 x 11 6 Quick4 Equalizer 24 LP (6-inch invert) 16 x 48 x 8 62 Quick4 Equalizer 24 LP (2-inch invert) 16 x 48 x 8 2 Equalizer 36 22 x 100 x 13.5 6 Quick4 Eg4alizer 36 22 x 48 x 12 6 Standard Chamber 34 x 75 x 12 6.5 Quick4 Standard 34 x 48 x 12 8 Quick4 Standard HD 34x48x 12 8 Quick4 Plus Standard(5.3-inch invert) 34 x 48 x 12 5.3 Quick4 Plus Standard(8-inch invert) 34 x 48 x 12 8 Quick4 Plus Standard LP (3.3-inch invert) 34 x 48 x 8 3.3 Quick4 Plus Standard LP (8-inch invert) 34 x 48 x 8 83 Infiltrator 3050 or StormTech SC-740 51 x 85.4 x 30 22.254 High Capacity Chamber 34 x 75 x 16 11 High Capacity H-20'Chamber 34 x 75 x 16 11 Quick4 High Capacity 34 x 48 x 16 11.5 Quick4 High Capacity HD 34 x 48 x 16 11.5 Quick4 Plus High Capacity(8-inch invert) 34 x 48 x 14 8 Quick4 Plus High Capacity(13-inch invert) 34x48x 14 13' 1 This approval allows the use of the high capacity H-20 chambers but makes no determination as to the chambers meeting the H-20 loading requirements. 2 Includes Infiltrator Multiporfm invert adapter attached to the side of the end cap. 3 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in-One 8 Endcap. 4 Only systems installed with this invert height shall be allowed to use the effective leaching area associated with this model in Table 2. 5 Includes Quick4 Plus Periscope adapter attached to the top of the Quick4 Plus All-in-One 12 Endcap. 2. The System is an open-bottom leaching unit molded from polyolefin,resin. It can be installed without aggregate or distribution pipe as an absorption trench or as a bed or field. If the System is installed with stone aggregate then the "Effective Leaching Area" in Tables 2 and 3 is not applicable, and must be designed in accordance with the provisions of 310 CM R 15.000. Infiltrator Chamber,Infiltrator Water Technologies, Page 3 of 6 Approval for General Use—June 12,2015 3. The total effective leaching area for any Chamber Model shall be calculated by multiplying the Effective Leaching Area per square foot of chamber times the total length of chamber from end cap to end cap including end caps. 4. For new construction or upgrades, the applicant can size the System in a trench configuration,using the effective leaching areas presented in Table 2. Table 2: Effective Leaching Area in Trench Configuration for New Construction and Remedial Sites' Effective Effective Model Leaching7 Leaching 8 Area Area SFILF SF/LF Equalizer 24 3.76 N/A Quick4 Equalizer 24 3.90 N/A Quick4 Equalizer 24 LP (6-inch invert) 3.90 N/A Quick4 Equalizer 24 LP (2-inch invert) 2.78 N/A Equalizer 36 4.73 N/A Quick4 Equalizer 36 4.73 N/A Standard Chamber 6.53_ N/A Quick4 Standard 6.96 N/A Quick4 Standard HD 6.96 N/A Quick4 Plus Standard(5.3-inch invert) 6.20 N/A Quick4 Plus Standard(8-inch invert) 6.96 N/A Quick4 Plus Standard LP (3.3-inch invert) 5.65 N/A Quick4 Plus Standard LP (8-inch invert) 6.96 N/A Infiltrator 3050 or StormTech SC-740 N/A 6.719 High Capacity Chamber 7.79 N/A High Capacity H-20' Chamber' 7.79 N/A Quick4 High Capacity 7.93 N/A Quick4 Hi h Capac ty HD 7.93 N/A Quick4 Plus High Capacity(8-inch invert) 6.96 N/A Quick4 Plus High Ca acity(13-inch invert) 7.93 N/A 6 Effective April 21,2006, 310 CMR 15.251(1)(b)maximum trench width is 3 feet. 7 Effective leaching area is equal to 1.67(bottom width+(2x invert height)) for Systems 3 feet or less in width. Effective leaching area is equal to 1.0(3 +(2x invert Height))for Systems with a width greater than 3 feet. 9. The maximum trench width allowed to calculate effective leaching area is 3 feet. 5. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Tables 2 or 3, or additional reductions in soil absorption system may be allowed. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. Infiltrator Chamber,Infiltrator Water Technologies. Page 4 of 6 Approval for General Use—June 12,2015 6. For new construction or an upgrade,the applicant can size the System in bed or field configuration, using the effective leaching areas presented in Table 3. Table 3: Effective Leaching Area for Bed or Field Configuration New Construction and Remedial Sites Effective Model Leaching" Area SULF Equalizer 24 2.09 Quick4 Equalizer 24 2.23 Quick4 Equalizer 24 LP (6-inch invert) 2.23 Quick4 Equalizer 24 LP (2-inch invert) 2.23 Equalizer 36 3.06 Quick4 Equalizer 36 3.06 Standard Chamber 4.73 Quick4 Standard 4.73 quick4 Standard HD 4.73 Quick4 Plus Standard(5.3-inch invert) 4.73 Quick4 Plus Standard(8-inch invert) 4.73 Quick4 Plus Standard LP (3.3-inch invert) 4.73 Quick4 Plus Standard LP (8-inch invert) 4.73 Infiltrator 3050 or StormTech SC-740 7.10 High Capacity Chamber 4.73 High Capacity H-20' Chamber 4.73 Quick4 High Capacity 4.73 Quick4 High Capacity HD 4.73 Quick4 Plus High Capacity(8-inch invert) 4.73 Quick4 Plus High Capacity(13-inch invert) 4.73 zo Effective Leaching area is equal to 1.67 times bottom width only. 7. When the System is used with a secondary treatment unit approved in accordance with 310 CMR 15.284 or 15.288, additional reductions in soil absorption system may be allowed. In these situations the reduction in the SAS cannot exceed the maximum allowed under the secondary treatment units approval. In no instance shall the reduction in the soil absorption system area required in 310 CN4R 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CM R 15.284. 11. Special Conditions 1. The System is an approved Alternative Chamber for use as an Alternative Soil Absorption System. In addition to the Special Conditions contained in this Approval, the System shall comply with the"Standard Conditions for Alternative SAS with General Use Certification and/or Approved.for Remedial Use" (the Infiltrator Chamber,Infiltrator Water Technologies. Page 5 of 6 Approval for General Use—June 12,2015 'Standard Conditions'), except where stated otherwise in these Special Conditions. 2. New Construction This Certification is for the installation of a System to serve new construction or an existing facility with a proposed increase in flow, for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction, as provided in Paragraph 6 in section 11 Design and Installation Requirements of the Standard Conditions. 3. Remedial Site This General Use Certification also applies to the installation of a System for the upgrade or replacement of an existing failed or nonconforming system,provided that the facility meets the siting requirements for upgrades, as provided in Paragraph 7 in section 11 Design and Installation Requirements of the Standard Conditions 4. The System shall be exempt from the minimum inlet spacing requirements of 310 CMR15.253. 5. The System shall have a minimum of one inspection port through the top of one of the chambers. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. 6. When the System is installed in trench configuration, then the system shall comply with these requirements: a) Length (each trench) 100 feet maximum (3 10 CMR 15.25 1(1)(a)); b) Width(each trench)2 feet minimum to 3 feet maximum(3 10 CMR 15.251(1)(b)). - Chambers greater than 3 feet wide,when specifically approved, are subject to other Special Conditions and limitations; c) The minimum separation distance between any two trenches shall be two times the effective width or depth of each trench,whichever is greater, or where the area between trenches is designated as reserve area,three times the effective width or depth of each trench,whichever is greater(3 10 CNM 15.25 1(1)(d)); d) The effective leaching area shall be calculated using the bottom area and a maximum of two feet(per side) of side wall area for each trench(3 10 CMR 15.251(1)(e)); e) Trenches shall be situated, where possible, with their long dimension perpendicular to the slope of the natural soil. Where possible they shall follow the contour lines (3 10 CMR 15.25 1(2)); f) Trenches constructed at different elevations shall be designed to prevent effluent from the higher trench(es) flowing into the lower trench(es) (3 10 CMR 15.251(3)); 9) The area between trenches may be designated as system reserve area only where the separation distance between the excavation sidewalls of the primary trenches is at least three times the effective width or depth of each trench, whichever is greater(3 10 CMR 15.251(4))- Chambers greater than 3 feet Infiltrator Chamber,Infiltrator Water Technologies. Page 6 of 6 Approval for General Use—June 12,2015 wide,when specifically approved, shall be separated by three times the actual width and are subject to other Special Conditions and limitations; and h) Effluent distribution lines exceeding 50 feet in length shall be connected and venting provided in accordance with 310 CMR 15.241 (3 10 CNM 15.251(11)). 7. When installed in trench configuration, approved Alternative Chambers greater than 3 feet wide: a) shall be installed with a minimum separation distance between any two trenches of two times the actual width of the chamber, or where the area between trenches is designated as reserve area, three times the actual width of the chamber; and b) shall only be entitled to a maximum effective width of 3 feet for the purposes of calculating total effective leaching area. 8. When installed in a bed or field configuration,the System may be installed without distribution piping,but must comply with the following requirements in 310 CMR 15.252- a) the use of leaching beds or fields is restricted to systems with a calculated design flow of less than 5,000 gpd per leaching bed or field(3 10 CMR 15.252(1)); b) the maximum length of chambers in series shall be 100 feet(3 10 CNM. 15.252(2)(b)); c) separation distance between adjacent beds/fields shall be ten feet(3 10 CMR 15.252(2)(f)); and d) the effective leaching area shall include only the bottom area,not the sidewalls (310 CN4R 15.252(2)(i)). 9. For Systems constructed in fill and installed, the System shall be installed as specified in 310 CMR 15.255 Construction in Fill, except the minimum 15 foot horizontal separation distance to be provided between the soil absorption area and the adjacent side slope shall be measured horizontally from the top of the chamber. 10. The System is exempt from 310 CMR 15.287, specifically items: (5)requiring written notification of alternative system prior to property transfer, (6) need for a certified operator, (9) need for an operation and maintenance contract with an operator and (10)deed notice requirement. INVOICE April 30, 2019 John(Jack) Sullivan PO Box 2004 Woburn, MA 01888 781-854-8644 Frank Ventola 204 Mill Road North Andover, MA 01845 e. 204 Mill Road, NorthAndover Septic Design Frank; The following is a breakdown of engineering and survey services provided to date; Task: Cost: 1) Prepare Sewage Disposal upgrade plans $1,300.00 Total lDue: $ ,300.0 Please make cheek payable to: John Sullivan And mail to: PO Box 2004 Woburn, MA 01888