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HomeMy WebLinkAboutPass - Title V Inspection Report - 113 BRIDGES LANE 6/9/2021 Commonwealth of Massachusetts - Title 5 official Inspeotion Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:when A. Inspector Information filling out forms on the computer, use only the tab Dean Dynan key to move your Name of Inspector cursor-do not Dean Dynan use the return Company Name key. 2 Suntaug Street Q Company Address Lynnfield Ma 01940 Cityfrown State Zip Code 508-726-9935 S112837 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails /? 513 I or's Signature Date 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 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 form should be sent to the system owner and copies sent to . the buyer, if applicable, and the approving authority. Please note: 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. 15insp.doc rev.712612018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 18 4�\ Commonwealth of Massachusetts i? Title 5 Official In4p ot-ion Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner Owners Name Information is required for every North Andover Ma 01845 5/12/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3,or 5 and all of 4 and 6. 1) System Passes: 1 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: 4 Bedroom septic system in working order 2) System Conditionally Passes: El one or more system components as described in the"Conditional Pass"section need be replaced or repaired. The system, upon completion of the replacement or repair approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N. ND)for the follow* statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic to (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tan ailure is imminent. System will pass inspection if the existing tank is replaced with a complyi septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it i ructurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less an 20 years old is available. 0 Y E] N ❑ ND xplain below): t5insp.doc•rev.7126/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts n Title 5 Official Inspection rrn Subsurface Sewage Disposal System'Form - Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner `— Owner's Name information is North Andover Ma 01845 5/12/2021 required far every �. _ _..__ ._._._.....---__._...._�_. page. Cltyrrown State Zip Code Date of Inspection C. Inspection Summary (cant.) 2) System Conditionally Passes (cant.); ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high sta �'❑er level in the distribution box due to broken or obstructed pipe(s) or due to a broken,,�dttled or uneven distribution box. System will pass inspection if(with approval of Board of H fh): ❑ broken pipe(s) are replaced 111, ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): El distribution box ' eveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to bra eri or obstructed pipe(s). The system will pass inspection if(with approval of the Board of He ❑ broken pipe(s)are replaced ❑ Yam(2 N ❑ ND (Explain below): El obstruction is removed l ❑ N ❑ ND (Explain below): 3) Further Evaluation is/require the Board of Health: El Conditions exist wrther evaluation by the Board of Health in order to determine if the system is failinblic health, safety or the environment. a. System wi pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b hat the system is not functioning in a manner which will protect public health, safety a the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts . . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ❑ � 113 Brid es Lane Property Address Amy Freund Owner —_......___..,.__.._.___.__ Owner's Name information is North Andover Ma 01845 5/12/2021 required for every _.�._.._....__....._. ____� _ _ page. City/Town Stater Zip Code Date of Inspection C. Inspection Summary (cant.) ❑ 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 b. System will fail unless the Board of Health (and Public Wateil"�Supplier, if any) determines that the system is functioning in a manner thy, rotects the public health, safety and environment: ❑ The system has a septic tank and soil absorpti system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to, surface water supply. ❑ The system has a septic tank and SAS a the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and Sr S and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tan and SAS and the SAS is less than 100 feet but 50 feet or more from a private water su ly well". Method used to determin istance: ** This system passe if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria i icates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than pm, provided that no other failure criteria are triggered. A copy of the analysis must be attached this form. c, att� r: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El 0 Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 rr Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner information is North Andover Ma 01845 5/12/2021 requiredd for every ._.___..._...__ .._._.__.---__.._..._._ _-- _----- _ page. Cltyffown State Zip Code date of Inspection C. Inspection :summary (cant.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No © Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® Liquid depth in cesspool is less than 6" below invert or available volume is less than "/2 day flow ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: 0 M Any portion of the SAS, cesspool or privy is below high ground water elevation. N Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. El N Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 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 fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this forma El ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® The system falls. 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. 5) 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 gpd. For large systems, you must indicate either"yes"or"no" to each of the following, in addition to the questions in Section CA. 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 15insp.doc•rev 7f26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 113 Bridges Lane ................. Property Address Amy....Freund Owner owner's Name information is required for every North Andover__........ Ma 01845 5/12/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section C.4 above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section C.4 shall upgrade the system in accordance with 310 CMR 15.304, The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes"or"no"for each of the following for all inspections: Yes No 0 El Pumping information was provided by the owner, occupant, or Board of Health El E Were any of the system components pumped out in the previous two weeks? E R Has the system received normal flows in the previous two week period? El E Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined? (If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? E El 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? 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: E El Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15M2(5)] t5insp.doc-rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form Y Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner Owner's Name information Is required for every North Andover Ma 01845 5/12/2021 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 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): 440 Description: 4 bedroom infiltrator drainfield Number of current residents: 3 Does residence have a garbage grinder? ® Yes ❑ No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): < 160 GPD ave Detail: see attached Sump pump? ❑ Yes ® No Last date of occupancy: current Y Date t5insp.doc•rev.7t2612016 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Pago 7 of 16 Commonwealth of Massachusetts Ulv f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments e 113 Bridges Lane Property Address Amy Freund Owner Owner's Name Information Is required for every North Andover Ma 01845 5112/2021 page. City frown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seatstpersons/sq.ft., etc.): Grease trap present? El Yes ❑ No Water treatment unit present? rl Yes ❑ No If yes, discharges Industrial waste holdin nk present? D Yes El No Non-sanitary wa discharged to the Title 5 system? [I Yes El No Water me readings, if available: Last ate of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Homeowner/Board of Health pumped 12 months ago as per homeowner Was system pumped as part of the inspection? n Yes No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doe-rev.7IM2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pap 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021 page. City/Town state Zip Code Date of Inspection D. System Information (cost.) 4. Type of System: ® 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)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 11/2004 as per info on file Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 20"feet Material of construction: ®cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): sewer pipe in good condition/ no evidence of leakage t5insp.doc•rev.712612018 This 5 official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts x =, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Brid es.Lane - -- - - Property Address Amy Freund Owner Owner's Name information is North Andover _Ma 01845 5/12/2021 required far every __. page. City/Town_ State Zip Code Date of Inspection D. System Information (cant.) 6. Septic Tank (locate on site plan): Depth below grade: 121"_..___...._...__...._.__.........____ feet Material of construction: ® concrete ❑ metal ❑ fiberglass M polyethylene ❑ other(explain) 1500 gallon septic tank If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes No Dimensions: 10'X 5'X 468" .___._.-.-------___... 5 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 29" -- - --- Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6,b Distance from bottom of scum to bottom of outlet tee or baffle 14" -- How were dimensions determined? in field with measure stick and tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1500 gallon concrete septic tank with PVC inlet and outlet T / Tank in working order with separation from inlet to outlet / no evidence of leaketage cover 12" to grade recommend pumping every two to three years depending on usage and number of occupants 15insp.ddc-rev,7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form 4 - - Ii Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a, ,f 113 Bridges Lane Property address _ Amy Freund �. __... _-..- Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021_ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan):. Depth below grade: feet --..--.....__ Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Jam/ Scum thickness ❑ —_-----__ Distance from top of scu to top of outlet tee or baffle Distance fromzmping: m of scum to bottom of outlet tee or baffle Date of last/pDate Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Bolding Tank (tank must be pumped at time,,of inspection) (locate on site plan): Depth below grade: -- Material of constructionZmetalE01 ❑ concrete ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: ,❑ ___ __ --.---....___ _ Capacity; gallons Design Flow; ---.-- --___ gallons per day t5insp.doc•rev.712 612 01 8 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts M Title 5 Official Inspection Form -' r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner _._ Owner's Name information is North Andover Ma 01845 _5/12/2021_ required for every __......r._.___....._..__.__....____�._._ �.�__ page. CIjj own State Zip Code Date of Inspection D. System Information (cant.) 8. Tight or Holding Tank (coot.) Alarm present: ❑ Yes ❑„-No Alarm level: — -- -- Alarm' w king order: ❑ Yes ❑ No Date of last pumping: r Date Comments (condition of alarm and float itches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes El No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert liquid at 0" above invert 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.): 10 Outlet concreteHD box level with 8 outlet pipes / little evidence of solids carryover / no evidence of leakage into or out of box/d box in good conditoin D box in working order D Box has diffuser T D Box is 8" below grade 4Sinsp.doc-rev.7/2 6120 1 8 Title 5 official Inspection Farm:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts mm� - -------- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 113_�BrdqesLane Property Address Amy Owner Owner's Name information is North Andover Ma 01845 5/12/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: Yes No* Alarms in working order: E Yes 0 No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 1000 gallon pump chamber 12" from grade cover 2" to grade Pump chamber in working order If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: El leaching pits number: El leaching chambers number: R leaching galleries number: D leaching trenches number, length: E leaching fields number, dimensions: 1 Rj41—6s,91— M overflow cesspool number: —----- 0 innovative/alternative system Type/name of technology'. 15insp.doc-rev.7/26f201 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts . Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS)(cont.) Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Infiltrators found in lawn area/ soils in good condition / no signs of hydraulic failure/ no ponding/ no damp soil/ Mound system 12. 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 solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of so',signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7QW018 Title 5 OTTictal Inspection Form:Subsurface Sewage Disposal System•Page 14 of 10 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments 113 Bridges Lane `-' Property Address Amy Freund Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic fai e, level of ponding, condition of vegetation, etc.): t5insp.doo•rev.7128t2t11 8 Titte 5 Offdal Inspection Form:Subsurface Sewage Disposal System•Page 16 of IS el Commonwealth of Massachusetts 17 M . Title 5 Of Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 113 grid qes Lane Property Address Amy Freund Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view 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 enters the building. Check one of the boxes below: ❑ hand-sketch in the area below drawing attached separately t5insp.doc-rev.712612018 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts mm Title 5 Official Inspection Form - = in Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Bridges Lane Property Address Amy Freund Owner Owner's Name information is North Andover Ma 01845 5/12/2021 required far every �._._.._._.._. _,�... _. page. Cityrrown State- Zip Code Date of Inspection D. System Information (cons) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 28 + feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 2004 Date ❑ 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: System Plans on file at BOH dated 2004 System is a mound system built above grade as per plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments " 113 Bridges Lane Property Address Amy Freund Owner Owner's Name information is required for every North Andover Ma 01845 5/12/2021 page. Cityfrown State Zip Cade Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed& Dated and 1,2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 6 Official Inspection Forth:Subsurface Sewage Disposal System•Page 18 of 18 N/F KUROWSK[ 113 BRIDGES LANE ASSESSORS MAP 104D, LOT 115 sY@'4@�l 44.351 SQ. FT. 0.00' \ SItE :S'ra astwe mlre �3W No ego ao»E N/F CAMMARATA N/F COLARUSSO /W a OrEA zow( \ 1REE uxe �( \ \\ LOCUS MAP NOT TO SCALE This is to certify that Now England Engineering Services \ Inc, has inspected the subsurface sewage disposal system installed at 113 Bridges Lane, North Andover, MA. The system has been constructed in compliance with 310 CMR 15,00. the approved design plans doted 9/30/2004. \ and local requirements, except as noted herein. w w owrmlous swram ostmou m sox Iv2 �• 1P1/Pn rS�PIA: INVERT ELEVATIONS ACTUAL DESION FOUNDATION 100.86 100.12 atNomuer SAM.w/r ouu TRm /• TANK IN 100.58 99.92 aLY.tdiAO(e�wrtW aeteml. TANK OUT I00.15 90.62 400Ri[a� ` PUMP O 100.11 99.37 o e e o n o vaa PUMP OUT 100.11 99.37 saroaa.$I= 0-BOX IN 104.73 104.72 RMIAM WALL D-Box our 104.56 104.55 Pa03(trod .o4.tr �' 1low CALM)" w� aPUMP A 104.44 104.45 O{ C 104.44 104.45 D 104.44 104.45 DaC� p low PUMP 2011E E 104.45 104.43 ••-.-..�, c 1�TAM F 104.44 104.45 p Elates MAPS 0 104.44 104.45 /• r /04.40 104.45 i �pppy IKNtE K 104.44 104.45 ftx S4a. tW.44 d 104.45 104.45 K 1W.44 104,45 L 104.44 104.45 M 104.44 104.45 N 104.44 104.45 0 104A4 104,45 P 104.43 104.45 Aft y BOTTOM OF 0(FtITFATORS 103.90 103.91 0Sir#.sr p c r BtRD�2aR `Dr r ' SYSTEM TIES x 3 TO TANK 27.8' / 2 TO TANK IOW a 3 TO PUMP 39.8' 2S•x0 2 TO PUMP 12.4' Comm tare 1 TO 0-BOX 49.5' TW Itre r '\ 2 TO 0-BOX 50.1' :Ft t F i TO I 9.0 �.* w 2 0 A 60.6' 2 TO I 25.8' 1 TO H 49.3' 1 TO P 20.4' So{ r' \ 2TOH 45.5' 2TOP 8.0' s,wm y. INSPECTION PORTS OEML IR4C I TO Y 17.9' 1 TO 2 25.7' SeiMCE f "#s 2 TO 2 17.5' .µfs.s 0f0000,At 2 TO Y 30.0' r 40.Y1/t 1 20' 0 20' 40' 60' sr 1,t CEIVED • �z ixI xs g:,l "= IN wAmt sTRwcc s AS-BUILT SEPTIC SYSTEM"' 1105 113 BRIDGES LANE i0t""'MW�q,, �r NrM.1'MOQPfRTNP,M �r, NORTH ANDOVER, MA, " ' ASSESSORS MAP 104D, PARCEL 115 SCALE: I" = 20' APRIL 22. 2005 � r# L a 160.00' k '` NEW ENGLAND ENGINEERING SERVICES, INC. R = 240.18' -^~ 60 BEECHWOOD DRIVE NORTH ANDOVER, MA 01845 `•> (978j 686-1768 E BRID`+('�ES BAN PLAN r937SAB^4-22-05 EDr�""S.G.B.I eft TX.H. & B.C.O. Jr. �� r ,�� �w ���� �� �� �i � �� i� "�*„�,^�� , �r � �"' „ �, � �� � � � r7' r - iH _;p � �Wa�i � � W VNQ "�" � Y „G +' � Ago ,,,�3� vl, '� � � n � S"l �,'�' ' C" Qf I 1, � ,� l f,� ,1 ,,�Mw,, � !„,� �v �'`�,s, �; 'r: r are � "�"�z r IJ r ,✓ w ro v�? � �. V i �r 1 IA; " ✓ /' ��yyti9 a"i'd p / �, ( tf/f�//r f:i ✓i $ �' tau F r n�'' ?d'r v v r ✓ r „ r d �! 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Account No. 3170415 Service Code Rate Charge Multiplier/Users, MISCFEE ADMIN FEE 0.63 5/8 7.82 1/ WTR WATER 01 ALL METER SIZE 60.80 /1 UB Meter Maintenance } 4ccount No. 3170415 Serial No Status Location Brand Type Size YTD Coj 32154144 aActive ERT HH b Badger w Water Q63 R63 33 Date Reading Code Consumption Posted Date V 319/2021 1467 a Actual 16 4/21/2021 1219/2020 1451 a Actual 17 1/1312021 12 9/912020 1434 a Actual 16 10/14/2020 615/2020 1418 a Actual 23 7/15/2020 22% 3/912020 1395 a Actual 19 4/8/2020 1 Y. 12/11/2019 1376 a Actual 18 1/15/2020 22 0 9/17/2019 1358 a Actual 17 10/10/2019 -27% 6/11/2019 1341 a Actual 22 7/25/2019 1 V. 3/11/2019 1319 a Actual 19 4/16/2019 -60/. 12/11/2018 13M a Actual 20 1/22/2019 47Y 9/13/2018 1280 a Acted 15 10/15/2018 -37Y 6/7/M18 1265 a Actual 22 7/2312018 -3; 3/9/2018 1243 a Actual 23 4/23/2018 09% 12l8/2017 1220 a Actual 22 1/25/2018 73 0 9/12/2017 1198 a Actual 14 1011812017 -34% 61812017 1184 a Actual 20 7/25/2017 24% wse 3/9/2017 1164 a Actual 16 4/12/2017 .1 12/9/2016 1148 a Actual 19 1/23/2017 -12' 9/712016 1129 a Actual 20 10/24/2016 -27° 6/13/2016 1109 a Actual 30 8/2/2016 o PrkttAQ B tCum!nt gptlon Ej fi,.h Page2 <Q EVt j Caring for your Septic System: A Reference Guide for Homeowners Caring for Your Septic System (Conventional Septic System, Innovative/Alternative ([/A) System, or Cesspool) The accumulated solids in the bottom of the septic tank should be pumped out every three years to prolong the life of your system. Septic systems must be maintained regularly to stay working. Neglect or abuse of your system can cause it to fail. Failing systems can • cause a serious health threat to your family and neighbors, • degrade the environment, especially lakes, streams and groundwater, • reduce the value of your property, • be very expensive to repair, • and, put thousand of water supply users at risk if you live in a public water supply watershed and fail to maintain your system. Be alert to these warning signs of a failing system: sewage surfacing over the drainfield (especially after storms), sewage back-ups in the house, lush, green growth over the drainfield, slow draining toilets or drains, sewage odors AA-A,jh.AftWAU1jAh .7 lns'Pt`n*v era,o'd 110d Tips to Avoid Trouble DO have your tank pumped out and system inspected every 3 to 5 years by a licensed septic contractor (listed in the yellow pages). i,tips://www.townofnewbury.org/print/4`71 1/3 10/5/2020 Caring for ycur Septic 8j stem:A Reference Guide for Honseavmers • DO keep a record of pumping, inspections, and other maintenance. Use the back page of this brochure to record maintenance'dates. • DO practice water conservation. Repair dripping faucets and leaking toilets, run washing machines and dishwashers only when full, avoid long showers, and use water-saving features in faucets, shower heads and toilets. • DO learn the location of your septic system and drainfield. Keep a sketch of it handy for service visits. If your system has a flow diversion valve, learn its location, and turn it once a year. Flow diverters can add many years to the life of your system. • DO divert roof drains and surface water from driveways and hillsides away from the septic system. Keep sump pumps and house footing drains away from the septic system as well. • DO take leftover hazardous household chemicals to your approved hazardous waste collection center for disposal. Use bleach, disinfectants, and drain and toilet bowl cleaners sparingly and in accordance with product labels. • DON'T allow anyone to drive or park over any part of the system. The area over the drainfield should be left undisturbed with only a mowed grass cover. Roots from nearby trees or shrubs may clog and damage your drain lines. • DON'T make or allow repairs to your septic system without obtaining the required health department permit. Use professional licensed contractors when needed. • DONT use commercial septic tank additives. These products usually do not help and some may hurt your system in the long run. • DON'T use your toilet as a trash can by dumping nondegradables down your toilet or drains. Also, don't poison your septic system and the groundwater by pouring harmful chemicals down the drain. They can kill the beneficial bacteria that treat your wastewater. Keep the following materials out of your system: Nondegradables grease, disposable diapers, plastics, etc. Poisons gasoline, oil, paint, paint thinner, pesticides, antifreeze, etc. Septic System Explained Septic systems are individual wastewater treatment systems(conventional septic systems, innovative/alternative (I/A) systems, or cesspools)that use the soil to treat small wastewater flows, usually from individual homes. They are typically used in rural or large lot settings where centralized wastewater treatment is Impractical. There are many types of septic systems in use today. While all systems are individually designed for each site, most systems are based on the same principles. Your septic system treats your household wastewater by temporarily holding it in the septic tank where heavy solids and lighter scum are allowed to separate from the wastewater. This separation process is known as primary treatment.The solids stored in the tank are decomposed by bacteria and later removed, along with the lighter scum, by a professional septic tank pumper. After partially treated wastewater leaves the tank, it flows into a distribution box, which separates this flow evenly into a network of drainfield trenches. Drainage holes at the bottom of each line allow the wastewater to drain into gravel trenches for temporary storage. This effluent then slowly seeps into the subsurface soil where it is further treated eate and Purified (secondary treatment).A properly functioning septic system does not pollute v _ g