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Home My WebLink AboutFail - Title V Inspection Report - 190 GRAY STREET 5/22/2024 15�1,11� Commonwealth of Massachusetts I� w 1�S(, Title 5 OfficialInspection - Subsurface Sewage Disposal System Farm - Not for Voluntary Assessments 4 190 Gray St Property Address ,.. . Kevin Finnegan Owner — ---. � . _ --- .... _ — Owner's Name information is required for every North Andover MA 5/14/2024 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, 'I�Sp11eC$CDr itl'ft�rfYtal�IClCI filling out forms on the computer, use only the tab Warren R. Pearce Jr. key to move your Name of Inspector cursor-do not Pearce Construction use the return _...------ key. —.._. Company Name 196 Park St — — — rab pang Address North Reading — MA 01864 ...... City/Town — . State ZipCod...—_ e 97$-664-5264 511959 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 Inspector'sSignature .. _ _.. p 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 Yof inspection and under theFY _... 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. e5wsp.doc-rev.7 12 612 01 8 T'itle.5 OffIc6al Bnspect[Ort Form:Subsurface Sewage bisposa0 System.page I of 18 Commonwealth of Massachusetts Title 5 Offi i l l p f n Foy } Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 190 Grav St _ _........ .. Property Address Kevin Finnegan - - Owner Owner's Name information is d North An dover MA 5/14/2024 required far every No_.. ___. ___.. _ ....... .... 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 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: 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, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/2612018 1 itle 5 Official Inspection Form.SubSUrface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts i l p Title 5 Official Inspection Form k _.... Subsurface sewage Disposal System Form - Not for Voluntary Assessments Property Address ... _ _ _..... - _ Kevin Finnegan Owner _- Owner's Name ..... ..... ___ _- ,..----... information is eve required for North Andover Ip q every - —. . 5/14/2024 —._... _...... .. ...._.__ . page. I y own State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Fusses (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 static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s), The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: 15insp.doc-rev.7126/2018 Title 5 Official Insaedion Form,Subsurface Sewage Disposa8 System-Page 3 of IS elk Commonwealth of Massachusetts Title 5 Official Inspection Form is Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 190 Gray St Property Address Kevin Finnegan Owner Owner's Name information is North Andover MA 5/14/2024 required far every - - ..._.. _.... .,..._ ...__._ - page City/Town - State Zip Code Date of Inspection ^^ C. Inspection Summary (cunt.) ❑ 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 Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the 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 water analysis, performed at a DFP 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 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 M ❑ 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 t5insodoc•rev.7/26/2015 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systern.Faye 4 of 18 � Commonwealth of Massachusetts m 11-W Title 5 Official Inspection Form in Subsurface sewage Disposal System Form Not for Voluntary Assessments roi 190 Gray St..—__. Property Address Kevin Finnegan - .......... .._. Owner Owner's Name _ information is r North Andove required for every _.. ._...... ....... -- MA 5/14/2024 page. City/Town_ _ State Zip Code — Date of Inspection C. Inspection _.Summary (cant.) _. 4) System Failure Criteria Applicable to All Systems: (coat.) Yes No ❑ z 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 '/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. ❑ z 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. M 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 DER 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.] ❑ Z 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 a5rrusu.aoc•rev.7f26/201E3 'ritle 5 Official Inspection Farm:Subsurface Sewage Disposal System-Page 5 of 18 f bn Commonwealth of Massachusetts T -le 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 190 Gray St - Property Address Kevin Finnegan Owner Owner's NJarne infom^at on is North Andover MA 5/14/2024 required for every .. .... page. City/'town _ State Zip Cade Date of Inspection C.Inspection Summary (cant.) 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 0.4 shall upgrade the systern 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? 0 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. El approximation 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)] t5 nsp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 6 of 18 Commonwealth of Massachusetts I Ti'le 5 'ffidal Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 190 Grav St Property Address Kevin Firjnegap,'_, Owner Owne.r-'s I Name information is required for every North Andover MA 5/14/2024 page. CityfTown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 GPD Description: ........... ............ Number of current residents: 4 Does residence have a garbage grinder? M Yes El No Does residence have a water treatment unit? El Yes E No If yes, discharges to: . ...... Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) Yes No Laundry system inspected? U Yes ❑ No Seasonal use? El Yes M No Water meter readings, if available (last 2 years usage (gpd)): -498 GPD Detail: 4/19/2022 to 4/18/2024 363,500 Gallons see attached ----- Sump pump? El Yes No Last date of occupancy- corrent Date t51n*p.dm;-rev.7126/20 16 T[fle 6 Official tnSPBCtiOn FOME Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ill Subsurface Sewage Disposal System Form Not for Voluntary Assessments �y f, 190 Grist Property Address Kevin Finnegan Owner ..-.-._ ...---- _.-.. Owner's Name information is required for every North Andover MA 5/14/2024 -....._ --- - _----- ----- page. Cltyf Fown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: _ ......... Design flaw(based on 310 GMR 15.2 ---- Gallons per day(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: - - - -- Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: -__ __._---- last date of occupancy/use: Cate Other(describe below): 3. Pumping Records: Source of information: Pumped 1 year ago...by..Bateson 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..7/25/2018 Title.5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts T'tIe 5 Official Inspection Form M Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 190 Gray St Property Address Kevin Finnegan Owner ...� .... —_.._.. —..._ Owner's Name information is North Andover required for every —_. MA 5/14/2024 ..--.. page. I y own _. State dip Code Date of Inspection D. System Information (cont.) _ _ 4. Type of System: ® Septic tank, distribution box, soil absorption system El 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.- Installed 7/27/2005 Per the engineer drawn as built. Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): 1 lk Depth below grade: -�4(`j-jj feet Material of construction: ❑ cast iron Z 40 PVC ❑ other(explain): — - Distance from private water supply well or suction line: Comments (on condition of joints, venting, evidence of leakage, etc.): All appears in g od shape inside the house.. CSinsp.doc•rev.7/2612 0 1 5 Title 5 Official Inspection Form.Subsurface Sewage disposal system.-page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form it Subsurface Sewage Disposal System Farm -Not for Voluntary Assessments 190 Gray St Property Address Kevin Finnegan owner Owner's Name information is North Andover MA 5/14�/2024 required for every _ ._._.._ --- ------ page, City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 8 Depth below grade: feet Material of construction: concrete El 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) ❑ Yes d No 10'6" X 68"X 5'deep 1500 gallon Dimensions: _ 8" Sludge depth: _ .........._._ $ 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 6 14 Distance from bottom of scum to bottom of outlet tee or baffle -- How were dimensions determined? Tie Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): When opened the tank was full and overtopping the outlet tee. The filter was plugged and was forced out of the tee. After cleaning and reinstalling the filter the levels returned to normal. The measurments were taken at that time. The tees are in place the liquid level was proper.The tank appears in good shape with no evidence of leaks. t5lnsp.doc-rev 7/26/2018 Title 5 Official Inspection Form SubWrfaCP.sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts } e y Subsurface Sewage Disposal System Form - Not for Voluntary or Y Assessments <7> 190 Gray.St Property Address Kevin Finns an Owner -Name— information - . .- .. —.. Owner's _....._ - —_.,. ....-- is required for every North Andover MA 5/14/2024 page. City/Town State Zip Code Date of Inspection SystemD. Information (cant.) 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 top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: — ... -- Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): & 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 ❑I other (explain): Dimensions: _ ......_-._,.. _— . Capacity: gallons Design Flow: _ gallons per day 5inspxJoc-rev.7/2612 0 1 5 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts (p Title 5 Official Inspection Form ii Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a% 190 Gray St Property Address Kevin Finnegan --- Owner cwner's Name information is required for every North Andover MA 5114f2024 -..-..._ _.... - page City/Town state Zip Code Date of Inspection D. System Information (cone.) 8. Tight or Holding Tank(cant.) Alarm present: ❑ Yes ❑ No Alarm level: - - — Alarm in working order: ❑ Yes No Date of last pumping: Cate Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract (required). Is copy attached` Q Yes ❑ No 9. Distribution Sox (if present must be opened) (locate on site plan): 0" Depth of liquid level above outlet 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.): The distribution box is level and the distribution appears equal. There are speed levelers in use.There are 2+ inches of solids in the d-box. The distribution box is in fair shape. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal Systern^Page 12 of 18 Commonwealth of Massachusetts - Inspection m } Subsurface Sewage Disposal System Farm - Not for Voluntary Assessments 190 Gray St Property Address Kevin Finnegan Owner _. Finnegan Owner's Game information is required for every North Andover MA 5/14/2024 page. City/Town _ —_.._ -- ---_ _..-..—..... _ State Zip—Go—de— Dat-e of Inspection D. System Information (cant.) _ 10. Pump Chamber(locate on site plan):. Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition 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: �4) 38 ft -- ❑ leaching fields number, dimensions: _...._._. overflow cesspool number: _ ❑ innovative/alternative system Type/name of technology: — �5wsp doc.rev,7126120 18 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts Title 5 Off 01clal Inspection Form i` Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 190 GraY...St _--- Property Address Kevin Finnegan Owner Owners Name information is North Andover MA 5/14/2024 required for every _ ..__ _...__ - ...._.__ ..___.. page. City/Town __. State Zip Code __..Date of Inspection D. System Information (coat.) 11. Soil Absorption System (SAS) (cant.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): There is surface sign of breakout. Camera inspection of the leach trenches found them packed with solids. 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 soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev 7/2612 01 8 Title s official Inspection Form:Subsurface Sewage Disposal System-Faye 14 of 18 Commonwealth of Massachusetts c1 =innInspectionr k Subsurface Sewage Disposal System Forma - Not for Voluntary Assessments 190 Gray St Property Address Kevin Finnegan Owner _ __.__ —_.. Owner's Name information is North Andover required for every __-,. MA 5/14/2024 page. City/Town State Zip Code - Date of Inspection D. Sys Information (cont.) 11 Privy (locate on site plan): Materials of construction: Dimensions Depth of solids -.__. - ___- .. _ Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc rev.712612018 Title 5 Official Inspection room SubsurfaLm,Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts = rTitle 5 Official Inspection Form m m Iii, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 190 Gray St Property Address Kevin Finnegan Owner 6wner's Name information is required for every North Andover MA 5/14/2024 _.— __ -- page. City/Town _ State Zip Code Date of Inspection D. System Information (cunt.) 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 t5lnsp.doc•rev.712612016 mm Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 16 of 18 Commonwealth of Massachusetts -: s(f Title 5 Official Inspection Form =W �' Subsurface Sewage Disposal System Form Not for Voluntary Assessments � a. <� 190 Grp St Property Address Kevin Fan Owner O .wner'sName information is required for every North Andover __...._.r... MA _. _ _._-- 5/14/2024 page. City/Town State Zip Code Date of Inspection D. stern Information (cant.) __.._. 15. Site Exam: ❑ Check Slope ® Surface water Check cellar Shallow wells Estimated depth to high ground water: 7+ ft 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: 4/11/2002„ revised 7/2/2004, 3/24/2005 — —_..._ Date —. ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: Review Files ❑ Checked with local excavators, installers - (attach documentation) El Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test hole data from the design plan dated 4/11/2002. Test holes ffrom 3/21/2002. Site is up on a hill that drops down well below the bottom elevation with no evidence of standing water. Before filing this Inspection Report, please see Deport Completeness Checklist on next page. #541sP.duc=rev.7(1,612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 aCommonwealth of Massachusetts ,Y Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 190 Grp St Property Address Kevin Finnegan Owner Owner's Name information is North Andover MA 5/14/2024 i required far every . _ .__---.. -- _.,_.. .. _.... page Cty/Tow- n - 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 & Bated 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 5 official Inspection Form.Subsurface Sewage Disposal System•Page 18 of 18 Summary Record Card generated on 5/13/2024 12:35:25 PM by Karen Hanlon Page� Town of North Andover Tax Map # 210-107.D-0130-0000.0 Parcel Id 22686 190 GRAY STREET CYNTHIA LINGLEY 190 GRAY STREET NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type Size Total I Acres I Residential FY 2024 UB Mailinq Index Name/Address Type Loan Number Active/Inact, From CYNTHIA LINGLEY Owner Active Until 190 GRAY STREET NORTH ANDOVER,MA 01845 LITCHFIELD CO. Previous Customer Inactive 202006 190 GRAY STREET NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Active/Inactive Bldg Id. 18797,0-190 GRAY STREET Last Billing Date 5/6/2024 1090509 01 Cycle 01 Active UB Services plaint. Account No, 1090509 Service Code Rate Charge Multiplier/Users MISCFEEADMIN FEE 0,635/8 7.82 1/1 WTR WATER 01 ALL METER SIZE 10335 UB Meter Maintenance Account No.1090509 Serial No Status Location Brand Type Size YTD Cons 29324292 a Active 00 b Badger w Water 0.625 0.625 809 Date Reading Code Consumption Posted Date Variance 4/18/2024 4434 a Actual 25 5/13/2024 -29% 1/1812024 4409 a Actual 35 2/15/2024 -27% 10119/2023 4374 a Actual 48 11/21/2023 5% 7120/2023 4326 a Actual 46 8/1412023 42% 4/19/2023 4280 a Actual 32 5110/2023 -116% 1118/2023 4248 a Actual 36 2/14/2023 -72% '10/1912022 4212 a Actual 127 11/912022 -6% 7/20/2022 4085 a Actual 137 8116/2022 3 D ne 4/19/2022 3948 a Actual 33 5/12/2022 0% 1/20/2022 3915 a Actual 34 2/16/2022 10/20/2021 3881 a Actual 81 11122/2021 -59% 7/2212021 -16% 3800 a Actual 99 8/24/2021 158% 412112021 370, a Actual 38 5/181200211 1/2012021 3663 a Actual 38 2123/2021 11% 1012012020 3625 a Actual Ill 11/1212020 -64% 7116/2020 3514 a Actual 150 8f12/2020 -36% 4/24/2020 3364 a Actual 38 5/13/2020 366% 1/17/2020 -5% 3326 a Actual 37 2/10/2020 2% 1011812019 3289 a Actual 35 12/18/2019 -27% 712212019 3254 a Actual 51 8/13/2019 25% 4/19/2019 3203 a Actual 40 5115/2019 8% 1/17/2019 3163 a Actual 35 2/18/2019 -36% 10122/2018 3128 a Actual 60 11/19/2018 -32% 7/19/2018 3058 a Actual 86 8/15/2018 134% 4/1812018 2982 a Actual 36 5/17/2018 2% 1/18/2018 2946 a Actual 36 2120/2018 -41% 10/18/2017 2910 a Actual 60 11/13/2017 -5% 7/19/2017 2850 a Actual 63 8/15/2017 78% { A ✓ t' C mrc� A�F�d^r Wtl, �M.r..,A.+'w N u .a;)rJ qQQ I � B ^,r..,_.....,. ,x"✓4 a%�' ... 7 ry m1...lK a^m;rmr r: � d� f r 4)RWv } i 7614 M4 M11ii..1 r1S&B'INf [AN6 Ih4GF;"I"CCFVfl;f£ 48' eA Sd R'p4C.`TAPPd,.CiC111,..EC 4QYV&a;R2V A DI 3 DOX 26,S A BEG, C ENC'H 1 2,4' ABYXr.4134:: NCH 2 A B f, 9RENCIC 4 40 g A-BF f 1 tZB;NG 4 4 1 52, p i B-SETIICTANK INI D'COV It 13 SVP NC TANK O nx 1(()VER 49' $)MG TRENCH 3' d;i31(„T 7"dCfk`1+YC:1 1 :'� ;fib" t fSl Ci #ttl..NC'4-! 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