HomeMy WebLinkAboutPass - Title V Inspection Report - 444 SALEM STREET 7/19/2021 Commonwealth of Massachusetts RECE�vED
- � Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments VER
100 oftNpEP R Mej
�,.., 444 Salem Street H�L
Property Address
Tim Armstrong
Owner _ -
Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. City/Town 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 -- - — --------- --
ra Company Address
Lynnfield Ma _ 01940
City/Town State Zip Code
,eua 508-726-9935 _ S112837
Telephone Number License Number
B. Certification
I certify that: 1 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. ❑ Fa's
In ector's Signa ure 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.
t5insp.doc•rev.7/26/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 1 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
Information is required for every North Andover Ma 01886 6/11/2021
page. CitylTown 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:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
3 bedroom septic system in working order
2) System Conditionally Passes:
❑ One or more system components as described in the "Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND) for the followin tatements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tan hether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank11ure is imminent. System will pass
inspection if the existing tank is replaced with a complyin ptic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is s cturally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less th 20 years old is available.
❑ Y ❑ N ❑ ND (Ex ain below):
t5insp.doc•rev.7126=18 Tito 5 Ofrcdal Inspection Form:Subswface Sewage Disposal System•Page 2 of 18
Commonwealth of Massachusetts
1 = ,� Title 5 Official Inspection Form
J' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street
Address
— ---
Property Address
Tim Armstrong _
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. CltylTown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
2) System Conditionally Passes (cont.):
❑ Pump Chamber pumps/alarms not operational. System will pas ith Board of Health approval if
pumps/alarms are repaired.
❑ Observation of sewage backup or break out or igh static water level in the distribution box due
to broken or obstructed pipe(s) or due to a ken, settled or uneven distribution box. System will
pass inspection if(with approval of Boar f Health):
❑ broken pipe(s) are replac ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is remo d ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution b is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstru pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ (Explain below):
❑ obstruction is removed ❑ Y ❑ ❑ ND (Explain below):
3) Further Evaluation is Required by t Board of Health:
❑ Conditions exist which requir urther evaluation by the Board of Health in order to determine if
the system is failing to prot t public health, safety or the environment.
a. System will pass less Board of Health determines in accordance with 310 CMR
15.303(1)(b) that th system is not functioning in a manner which will protect public health,
safety and the a ironment:
15insp.doc•rev 7/2 6120 1 8 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
444 Salem Street _
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. CitylTown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wet d or a salt marsh
b. System will fail unless the Board of Health (and Public ter Supplier, if any)
determines that the system is functioning in a manner t t protects 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 S and the SAS is within 50 feet of a private water
supply well.
❑ The system has aseptic tan nd SAS and the SAS is less than 100 feet but 50 feet or
more from a private water sup y well**.
Method used to determine stance:
**This system passes i the well water analysis, performed at a DEP certified laboratory, for fecal
cofiform bacteria in ' ates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 m, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to is form.
c. Other,
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
❑ ® 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.7/2812018 Title 5 Off vial Inspedw Form:Subsurface Sewage Disposal System•Page 4 of 18
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street _
Property Address
Tim Armstrong
Owner Owners Name
information is required for every North Andover Ma 01886 6/11/2021
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
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 Y2 day flow
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® 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 form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd-
10,000 gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
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
t5insp.doc•rev.7/2612018 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
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
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 CA 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 CA 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
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® 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?
® ❑ 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:
® ❑ 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 15.302(5)]
t57nsp.doc•rev.7/2 612 01 8 Tdte 5 Oft'ddal Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. CityfTown State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Description:
3 Bedroom system with 1500 gallon tank and pipe in stone trenches
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)): < 230 gpd ave—
Detail:
see attache
Sump pump? ® Yes ❑ No
Last date of occupancy: current
Date
l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18
Commonwealth of Massachusetts
fUtTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. City/Town 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): Gallon rday(gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Water treatment unit present? ❑ Yes ❑ No
If yes, discharges to:
Industri>rye
ing tank pres ? ❑ Yes ❑ No
Non-saischar d to the Title 5 system? ❑ Yes ❑ No
Water if available:Last dacy/use: Date
Other( w):
3. Pumping Records:
Source of information: Homeowner/ Board of Health
last pumped q months ago per homeowner
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
t5insp.doc-rev.7/262018 Title 5 Gffwc zl Inspection Forth:Submeace Sewage Disposal System-Page 8 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
444 Salem Street
v Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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/Alternative 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:
2000 as per permit on file
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
Depth below grade: 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.7126=18 Title 5 Ofrrcial tnspection Form:Subsurface Sewage Disposal System-Page 9 of 18
Commonwealth of Massachusetts
r Title 5 Official Inspection Form
_ (a
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
1� 444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
_
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank (locate on site plan):
Depth below grade: 5
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ 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 5'8"
Sludge depth: 5
Distance from top of sludge to bottom of outlet tee or baffle
30"
Scum thickness 0 2
Distance from top of scum to top of outlet tee or baffle 6
Distance from bottom of scum to bottom of outlet tee or baffle 13"
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 leakeage
outlet cover 6" to grade
Recommend pumping every two to three years depending on usage and number of occupants
t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is North Andover Ma 01886 6/11/2021
required for every
page. CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
7. Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
El concrete ❑ metal Xfirglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of s m to top of outlet tee or baffle --
Distance from b om of scum to bottom of outlet tee or baffle
Date of la pumping: Date
%W
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 Holding Tank (tank must be pumped at ' e of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons per day
l5insp.doc-rov.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street
v Property Address
Tim Armstrong
Owner Owners Name
information is required for every North Andover Ma 01886 6/11/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank (cont.)
Alarm present: ❑ Yes o
Alarm level: Alarm i orking order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float sw es, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ 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.):
6 outlet concrete D box level with 2 outlet pipes/little evidence of solids carryover / no evidence of
leakage into or out of box
D Box is 8" below grade
d box in good conditon
t5insp.doc•rev.712 6 72 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
Commonwealth of Massachusetts
- Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. Cityrrown 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: El Yes ❑ No*
Comments (note condition of pump chamber, conditi of pumps and appurtenances, etc.):
*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:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number.
® leaching trenches number, length: 2 @ 50
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
t5insp.doc•rev.726M18 Tilts 5 Ofrrial tnspodion Form:SuCsicface Sewage Disposal System•Page 13 of 18
Commonwealth of Massachusetts
1= i� Title 5 Official Inspection Form
5 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner
Owner's Name
information is North Andover Ma 01886 6/11/2021
required for every _ —
page. Cityrrown 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.).-
Trenches found in lawn area/ soils in good condition / no signs of hydraulic failure/ no ponding/ no
damp soil/
trenches constucted of pipe in stone
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 s i, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
15insp.doc-rev.7126f2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18
Commonwealth of Massachusetts
1 - Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
i
13. Privy (locate on site plan).-
Materials of construction: ----------- ---
Dimensions — --
Depth of solids --
Comments (note condition of soil, signs of draulic failure, level of ponding, condition of vegetation,
etc.):
l5insp.doc•rev.7/26Ml8 Title 5 Official Inspection Form-Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
<i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. Cityrrown 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
r
J
'2 -
t5insp.doc•rev.71 WOI8 Tale 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owner's Name
information is required for every North Andover Ma 01886 6/11/2021
page. City/Town 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: 48" as per plan on file
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: 2000
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:
Plans on file checked with health dept dated 2000
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5insp.doc•rev.7r2&2018 Title 5 Ofridal Inspection Form:Subsurface Sewage Disposal System•Pago 17 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
444 Salem Street
Property Address
Tim Armstrong
Owner Owners Name
information is required for every North Andover Ma 01886 6/11/2021
page. City/Town State Zip Code 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 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 We 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
00
ca x r�
z
rl'A��• ' S � ��� r
�£ ev"Or
i x
4i �
i,.•5 ireo `a d Y ..; •^'AC 2y�s,��.- +s7 �`N 1 � rYri � �t d:4�i 2 1 � W +x! ✓L ay`.� „t_+"� ��� 7�
t � n'a?�'
�sy�j xA k��A ��s ,a zt 4 t G ty;/ r
�yh h,rf``aY� +� I t,,`°e �` r, � •. ` i�.tvr.' � 3i,1{ xt,vi y�{ �r, ny 2i 1. t R
(rl� 37.i N .} \ iR ai `ti/� ���'�x .{♦"i 44{;t a.i"V
r tA��, +`F;Yt i it it r i 'fit obi` �. ,ry'..,1��3�yy�� ' �L ?a��`�+�?✓'i3��i�;�
l y �._if .k � � v.t'd� '4'•h`�.
-P 1 gg tir;
*' Lld
Al
t -
r�
�y ii����•. � � W��'# 'Mf^.`":� *\ i�M! 'f} C� ��r« �� �Y y�i .
4011,
•� Opp( 1
—40
vial
'r
b' $
Summery Record Card generated on a117rMl 8:10:57 W by Sheron Cow Page 1
Town of North Andover
Tax Map # 210-037.B-0053-0000.0
Parcel Id 14807
444 SALEM STREET
TIMOTHY ARMSTRONG
444 SALEM STREET
NORTH ANDOVER MA 01845
Class 101 Single Family. Property Type 1 Residential
Size Total 1.44 Acres
FY 2021
UB Mailing Index
Name/Address Type Loan Number Activellnact. From Until
TIMOTHY ARMSTRONG Owner Active
444 SALEM STREET
NORTH ANDOVER MA 01845
SPICER,BEVERLY Previous Customer Inactive 8/27/2014
444 SALEM STREET
N.ANDOVER,MA
01845
UB Account Maint.
Account No Cycle Occupant Name Active/Inactive
Bldg Id. 16081.0-444 SALEM STREET Last Billing Date 4/15/2021
3160122 03 Cycle 03 Active
UB Services Maint.
Account No.3160122
Service Code Rate Charge Muttipller/Users
MISCFEEADMIN FEE 0.63 5/8 7.82 1/
WTR WATER 01 ALL METER SIZE 68.40 /1
UB Meter Maintenance
Account No.3160122
Serial No Status Location Brand Type Size YTD Cons
16336771 a Active 00 METE METE w Water 0.63 0.63 50
Date Reading Code Consumption Posted Date Variance
6/2/2021 2992 a Actual 31 67%
3/2/2021 2961 a Actual 18 4/21/2021 -42%
12/3/2020 2943 a Actual 32 1/13/2021 -22%
9/2/2020 2911 a Actual 34 10/14/2020 98%
6/18/2020 2877 a Actual 24 7/15/2020 13%
3/4/2020 2853 a Actual 18 4/8/2020 -30%
12/5/2019 2835 a Actual 24 1/15/2020 46%
9/12/2019 2811 a Actual 52 10/10/2019 56%
6/5/2019 2759 aActual 31 7/25/2019 1%
3/5/2019 2728 a Actual 30 4/16/2019 -35%
12/5/2018 2698 a Actual 46 1/22/2019 -22%
9/6/2018 2652 a Actual 61 10/15/2018 60%
6/5/201 G 2591 a Actual 39 7/23/2018 51%
3/2/2018 2552 a Actual 24 4/23/2018 -48%
12/4/2017 2528 aActual 47 1/25/2018 -13%
9/6/2017 2481 a Actual 58 10/18/2017 77%
612/2017 2423 a Actual 31 7/25/2017 30%
3/3/2017 2392 a Actual 23 4/12/2017 -39%
12/5/2016 2369 a Actual 40 1/23/2017 -34%
9/2/2016 2329 a Actual 57 10/24/2016 38%
6/6/2016 2272 a Actual 45 8/2/2016 56%
3/2/2016 2227 a Actual 27 4/22/2016 -48%
12/3/2015 2200 aActual 53 1/20/2016 -8%
9/3/2015 2147 a Actual 58 10/16/2015 6%
6/3/2015 2089 a Actual 54 7/24/2015 55%
3/4/2015 2035 a Actual 34 4/28/2015 -12%
12/5/2014 2001 a Actual 40 1/15/2015 9%
Caring for your Septic System: A Reference Guide for
Homeowners
Caring for Your Septic System (Conventional Septic System, Innovative/Alternative (I/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
F�
o`" gi , ' y5# f �,;;;:Z ri`rf i� jt <;" •�;I;P l-.t
t'I!.S cat r + •' r it{- . c' � •� , .,p' 1 d
Tips to Avoid Trouble
• DC have your tank pumped out and system inspected every 3 to 5 years by a licensed septic
contractor (listed in the yellow pages).
https://www.townofrieyfbury.org/prinU471 1/3
10/M020 Caring for your Septic System:A Reference Guide for Homeowners
• 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.
• DON'T 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/altemative (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 and purified (secondary treatment).A properly
functioning septic system does not pollute the groundwater. _ —