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HomeMy WebLinkAboutFail - Title V Inspection Report - 590 FOSTER STREET 2/5/2024 Commonwealth of Massachusetts Po vet ��- Title 5 Official Inspection For ,,,,\0A0 ' Subsurface Sewage Disposal S m- Not for Voluntary Ass ments p osal System For_._. E8 O 5 VIA Property Address G Owner Owner's Name lo( 1Tq A U1a V information is NWOWFA 1 `r'M'n 1 'f required for every 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 filling out forms A. Inspector Information on the computer, Wju use only the tab key to move your Name of Inspector t1 cursor-do not W 4 Q L,A (A`r cc �s use the return Company Name � ,,�c� key. ...... p�Oo R VC��--//��_3 hlVl�. e, U I c�l ✓�t�'P-� �13 «� Company Address City/Town !' `') 7 / State S/ #3661 Zip Code 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. ❑ N s Further Evaluation by the Local Approving Authority 4. Fails WJ8 I , 1� _ag Inspector'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. t5lnsp.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 — I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments [, o Property Address GIGAN;� Owner Owners Name information is ,r ri ooYQR �� I^I If required for every �`��V page. City/Town 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 ha v not found any information which indicates that any of the failure criteria de ribed in 31 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluat are indicate below. Comments: 2) System Conditionally Passes: ❑ One or more system components as desc ' in the"Conditional Pass" section need to be replaced or repaired. The system, upon co etion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not dete ined" (Y, , D) for the following statements. If"not determined," please explain. The septic tank is metal and over years old* or the septic nk (whether metal or not) is structurally unsound, exhibits substantial in ' ration or exfiltration or tank f 'ure is imminent. System will pass inspection if the existing tank ' replaced with a complying septic nk as approved by the Board of Health. *A metal septic tank ' pass inspection if it is structurally sound, not le ing and if a Certificate of Compliance indicati that the tank is less than 20 years old is available. ❑ Y ❑ ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments �,`��� 5�a �vS icy ►, `J Property Address �1 Gr�U 3 Owner Owner's Name / information is ` ANCIO�Z �� I—/b QY required for every — page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health proval if pumps/alarms are repaired. ❑ Observati of sewage backup or break out or high static water level in the d' tribution box due to broken or structed pipe(s) or due to a broken, settled or uneven distri tion box. System will pass inspection ' (with approval of Board of Health): ❑ broken pipe are replaced ❑ Y ❑ N D (Explain below): ❑ obstruction is re oved ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is le ed or replaced ❑ Y N ❑ ND (Explain below): ❑ The system required pumping more t n 4 times a ye r due to broken or obstructed pipe(s). The system will pass inspection if (with proval of the Boar of Health): ❑ broken pipe(s) are repla d ❑ Y N ❑ ND (Explain below): ❑ obstruction is remo d ❑ Y ❑ N ❑ ND (Explain below): 3) Furt/stem n is Required by the Board of Health: ❑ t which require further evaluation by the Board of Health in ord\todmine if ailing to protect public health, safety or the environment.l pass unless Board of Health determines in accordance with 310 CM /15.303(1)(b)that the system is not functioning in a manner which will protect public alth, safety and the environment: `u 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts r,� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address _ Owner Owner's Name information is Ar A D JV] (� �'��� ( _ r a, required for every l" N ���0 l �I ' �' `T page. CityfFown 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 wetland or a salt mar b. Syste will fail unless the Board of Health (and Public Water Supplier, if a ) determines Iiiat the system is functioning in a manner that protects the p is health, safety and environment: ❑ The system has eptic tank and soil absorption system (SAS) an e SAS is within 100 feet of a surface w er supply or tributary to a surface water s ly. ❑ The system has a sep ' tank and SAS and the SAS is with' a Zone 1 of a public water supply. ❑ The system has a septic to and SAS and the SAS ' within 50 feet of a private water supply well. ❑ The system has a septic tank a SAS and t SAS is less than 100 feet but 50 feet or more from a private water supply well Method used to determine distance: **This system passes if the well wat analysis, pe med at a DEP certified laboratory, for fecal coliform bacteria indicates absen nd the presence of monia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provide at no other failure criteri re triggered. A copy of the analysis must be attached to this 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.7/26/201B Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 1B Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments Property Address GLG�1ruT� Owner Owner's Name information is f, /' Q Ove b18q5 I— 16 —?L� required for every L�/ J 1�/►]v � 1 M�t9 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes o ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ❑ 4 Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow ElRequired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑NO 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 ❑ ❑NA tributary to a surface water supply. ❑ ❑NAAny portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ❑ P4 Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑4VA 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.] A/ 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 mu�tcility with a design flow of 1 gpd to 15,000 gpd. For large systems, you t indicate either"yes" or"no"to ea the following, in addition to the questions in Section C.4. Yes No s j� ❑ ❑ the sys m"is within 400 feet of-a surface drinking water supply tributary to a surface drinking water supply ❑ ❑ the system is within 200 feet of a y g pp y the system is located in a nitrogen sensitive area (Interim Wellhead Protection El the — IWPA) or a mapped Zone 11 of a public water supply well l5insp.doc•rev.7/26/2018 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 V Property Address G' Owner Owner's Name information is f1 ] �0� /► 11 y� required for every - �V� /� 1� 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 purnped 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? ❑ ❑,�j� Were as built plans of the system obtained and examined? (If they were not / �y available note as N/A) (—Q/ ❑ 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? L� ❑ 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? ❑ R("' 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)] t5insp.doc•rev.7/26/2018 Title 5 Official 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 Eu Property Address G l Gl�-N Tc3 Owner Owner's Name information is 1/�/'�V61 1 MH a� 1--• J�j a required for every ►V 1 +, v k� page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: a Number of current residents: Does residence have a garbage grinder? (AaC&j iNG Tv OCCVJ*eOT') 55"Yes ❑ No Does residence have a water treatment unit? ❑ Yes N No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes information in this report.) Laundry system inspected? ❑ Yes La"'No Seasonal use? ❑ Yes [V/No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? Yes ❑ No cyAggN7 Last date of occupancy: Date 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments O Property Address Owner Owner's Name information is t „ ,� required for every r, 1 ) IJCNtS{� NI ry d(06 la f page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 31 R 15.203): Gallons per (gpd) Basis of design flow (seats/person q.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No i Non-sanitary waste discharge51to the Title 5 system? ❑ Yes ❑ No Water meter readings,4vailable: - j Last date of occpp`ancy/use: Date Other(/s ribee below): 3. Pumping Records: iPtiN LASTSource of information: I � l l: C Was system pumped as part of the inspection? ❑ Yes 9/'No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's Name information is I l c)1,?,A . required for every /`� - 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: APP!�Ox,5-0 YRS, (I'"ysa 197Lf , No Gf?,409s ON Were sewage odors detected when arriving at the site? ❑ Yes lJ No 5. Building Sewer (locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron M 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Vow lr vrUOQY AAJO DDt.ehJU�11a& (3W`r1�{I wm US'p, 4 I6CVbg trymp t51nsp.doc•rev.7/26/2018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts �x 6 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Fosiea Property Address ^ I (v.`. Owner Owner's Name information is required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): l Depth below grade: feet 7Mat ial of construction: concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) [4--Fes-Q No Dimensions: �X Sludge depth: �t1 Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle + Distance from bottom of scum to bottom of outlet tee or baffle 0f$,! I�J/ Cot�CRt�icg- gAl L6 How were dimensions determined? s v — Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): NO APPK;�Wr UE-AKA GG C0 05AS OGY'R-9 L1=\#E=L IN ''PtNk AT I�JVt�T�ouit�i� K 1(Y'< OF-11' OF N11NAO L.IC, CURcc mom 6 t5insp.doc•rev.7/26/2018 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 Property Address GlWi- Owner Owner's Name information is I GPM required for every page. City/Town qStat 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: Scum thickness \ Distance from top of scum to�op of outlet tee or baffle - Distance from bottom of scum to bottom of outlet tee or affle - Date of last pumping: Date Comments (on pumping recommendations, inlet nd outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evic(enc of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time 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 t5insp.doc-rev.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 Property Address rr� Owner Owner's Name information is n)` m Doy,cfl M h v 1 t— required for every (`� �.1`� l3l'C _L1�� I 1 b •i / page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Ala resent: ❑ Yes ❑ No Alarm level: Alarm in w ng order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm floa itches, 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 -r Top op J�--e>c 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.): Spm6 c8RRy oUgR 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address 61 f i�- Owner Owner's Name _ information is /�/ / UO0,/� /� ( required for every f y � � 1' �kl V y� page. City/Town State Zip Code Da a of Inspection D. System Information (cont.) 10. Pump Chamber (locate on site plan): Pumps in wor order: Yes El No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber-, ondition 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: A"4 fXl MA I �ijRL) ©f� f4S= - U l�.T Oro Fi Type: ❑ leaching pits number: ❑ leaching chambers number: — ❑ leaching galleries number: — ❑ leaching trenches number, length: leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: 15insp.doc•rev.7/26/2018 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 V % SRO St Property Address G► Owner Owner's Name information is N PAOO Jf� required for every � page. City/Town 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.): Y OW DAM PAL_ ,►+A / S .S. ON 0I GNP t,ArNA) 13U i S-11U, I�W 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration -- Depth—top of liqui o inlet invert - Depth of solids layer Depth of scum layer P Y Dimensions of cesspool Materials of construction Indication of groundwater inflow j. ❑ Yes ❑ No Comments (note condition o oil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . Property Address <2 GAry ice" Owner Owner's Name information is t4 , / � /�,� 00UOR M,n 0)9'4— required for every �`� , „v I"I H J page. Cityrrown 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 o ydraulic fa e, level of ponding, condition of vegetation, etc.): i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address G1 C�✓�rN'1� Owner Owner's Name information is Afi y� D(S — I _'/ required for every ,V ��"w , �o J 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 ilding. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately r � w� s�PrfGA V-,5 C S� ►4.S �-;. e �a� (APPRox) I_ t5insp.doc•rev.7/26/2018 Title 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 Property Address Owner Owner's Name information is required for every yt page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. 7VChhj am: ck Slope ce water Check cellar ❑ Shallow wells 1 Estimated depth to high round water: / p g g 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: 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: LOW Aft44 41 % Fd v 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 t°\\ Commonwealth of Massachusetts �9 = � Title 5 Official Inspection Form - --- Subsurface Sewage Disposal System Form Not for Voluntary Assessments u vs c4Z z, Property Address Owner Owner's Name information is Q,n O()✓a2 required for every 1 , I� " 1 page. City[Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete II applicable sections of this form inclusive of: A. Inspector Information: Complete all fields in this section. Certification: Signed & Dated and 1, 2, 3, or 4 checked VC, Inspection Summary: 1, 2, 3, or 5 completed as appropriate (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 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 --.•..•.-.,•,-.,...........W""'c'cu on u[ot[V[q 1411:41 PM by Jennifer Bracer0 Town of North Andover Page Tax Map # 210-104.B-0181-0000.0 Parcel Id 16503 590 FOSTER STREET GIGANTE, CHRISTIAN Since Jan 2014 GIGANTE, SANDRA 590 FOSTER STREET NORTH ANDOVER MA 01846 Class 101 Single Family Property Type 1 Residential Size Total 1.01 Acres FY 2024 UB Mailing Index Name/Address Type Loan Number Active/Inact, From Until CHRISTIAN&SANDY GIGANTE Owner Active 590 FOSTER STREET NORTH ANDOVER MA 01845 GIGANTE,CHRISTIAN&SANDY Payor Inactive 9/25/2014 412 FOSTER STREET NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id.24949.0-590 FOSTER STREET Last Billing Date 1/8/2024 3180115 03 Cycle 03 Active UB Services Maint. Account No.3180115 Service Code Rate Charge Multiplier/Users MISCFEE ADMIN FEE 0.63 5/8 7.82 1/ WTR WATER 01 ALL METER SIZE 131.50 /1 UB Meter Maintenance Account No.3180115 Serial No Status Location Brand Type Size YTD Cons 0033223076 a Active 00 METE METE w Water 0.625 0.625 570 Date Reading Code Consumption Posted Date Variance 12/12/2023 4150 m Manual estimate 30 1/15/2024 6 MSG 5% 9/19/2023 4120 m Manual estimate 100 10/13/2023 227% 6/13/2023 4020 m Manual estimate 30 7/14/2023 _ MSG 5% 3/9/2023 3990 m Manual estimate 30 4/12/2023 _ MSG 7% 12/8/2022 3960 m Manual estimate 30 1/16/2023 MSG -66% 9/14/2022 3930 m Manual estimate 100 10/18/2022 MSG 213% 6/9/2022 3830 m Manual estimate 30 7/18/2022 -1% 3/10/2022 3800 m Manual estimate 30 4/13/2022 5 MSG 2% 12/10/2021 3770 m Manual estimate 20 1/17/2022 MSG 79% 9/10/2021 3750 m Manual estimate 100 10/15/2021 219% 6/8/2021 3650 m Manual estimate 30 7/27/2021 60% 3/10/2021 3620 m Manual estimate 20 4/21/2021 2% MSG 12/10/2020 3600 m Manual estimate 20 1/13/2021 ()% MSG 9/9/2020 3580 m Manual estimate 20 10/14/2020 46/°_ o MSG 6/9/2020 3560 m Manual estimate 30 7/15/2020 0 MSG 115/° Summary Record Card generated on 1/23/2024 12:11:41 PM by Jennifer Bracero Page 2 Town of North Andover Tax Map # 210-1043-0181-0000.0 Parcel Id 16503 590 FOSTER STREET GIGANTE, CHRISTIAN Since Jan 2014 GIGANTE, SANDRA 590 FOSTER STREET NORTH ANDOVER MA 01845 Class 101 Single Family Property Type Size Total 1.01 Acres 1 Residential FY 2024 3/27/2020 3530 m Manual estimate MSG 20 4/8/2020 -19% 12/12/2019 3510 m Manual estimate 20 1/16/2020 0 9/17/2019 3490 m Manual estimate 100 10/10/2019 78% MSG 68/o 6/15/2019 3390 m Manual estimate /60 7/252019 0 MSG 127/o 3/12/2019 3330 m Manual estimate 25 4/16/2019 0 MSG 24/o 12/12/2018 3305 m Manual estimate 20 1/22/2019 e 9/14/2018 3285 m Manual estimate 65/o MSG 60 10/15/2018 _2% 6/12/2018 3225 m Manual estimate 60 7/23/2018 3% MSG 3/12/2018 3165 m Manual estimate MSG 60 4/23/2018 53% 12/13/2017 3105 m Manual estimate 40 1/25/2018 1% MSG 9/13/2017 3065 m Manual estimate MSG 40 10/18/2017 30% 6/13/2017 3025 m Manual estimate 30 7/25/2017 0 3/15/2017 2995 m Manual estimate 107/o MSG 15 4/12/2017 -15% 12/12/2016 2980 a Actual 17 1/23/2017 0 9/13/2016 2963 a Actual 23 1/23/2017 -30% 6/20/2016 2940 a Actual 30 10/24/20 -12% 3/14/2016 2910 a Actual 15 4/2/2016 82% 12/16/2015 2896 a Actual 20 4/22/2016 19% 9/11/2016 2875 a Actual 23 1/20/2016 -17% 6/11/2015 2852 aActual 18 10/16201 12%u 3/18/2015 2834 m Manual estimate 20 7/24/2015 -2% MSG 12/16/2014 2814 aActual 20 1/15/2015 9/16/2014 2794 a Actual 2o�e21 10/15/2014 e 6/12/2014 2773 a Actual 23 10 15/201 -14% 3/14/2014 2750 m Manual estimate 17 7/11/2014 39%0 12/16/2013 2733 a Actual 20 4/11/2014 0 9/13/2013 2713 a Actual 35 1/17/2014 45% 6/14/2013 2678 a Actual 19 10/15 201 78% 3/18/2013 2659 a Actual 17 7/24/2013 21% 12/13/2012 2642 aActual 16 1/22/201 -5% 9/19/2012 2626 a Actual 26 10/15/2012 -33% 6/18/2012 2600 a Actual 17 10 15/201 43%0 3/20/2012 2583 a Actual 18 7/16/2012 -8% 12/19/2011 2565 a Actual 20 4/14/2012 -8% 9/16/2011 2545 aActual 22 1/17/2012 e 6/13/2011 2523 a Actual 19 10/13 20 10% 3/16/2011 2504 a Actual 19 7/20/2011 -170° 12/15/2010 2481 a Actual 19 1/13/2011 21% 9/16/2010 2462 aActual 22 1/12/20110 -12%0 6/14/2010 2440 a Actual 21 7/15/2010 7% 4/R Inquiry