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Home My WebLink AboutTitle V Inspection Report - Conditional Pass -2025-01-30 - Title V Inspection Report - 570 BOSTON STREET 1/30/2025 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I� 570 BOSTON STREET Property Address JAMES OWARA Owner Owner's Name information is requited for every NORTH ANDOVER MA 01845 JANUARY 30 2026 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 Town Of No filling out forms h Andover on the computer, Todd James Bateson I t use only the tab key to move your Name of Inspector cursor-do not Bateson Enterprises Inc. FEB . 07 use the return key. Company Name 111 Argilla Road 0 Company Address Health Andover MA �eNg�nt Cityrrown State Zlp Code rerun 978-475-4786 SI-16 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. ❑ Falls JANUARY 30, 2025 Inspegt is 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. Wnsp.doc•rev.7/2612018 Title 6 Offidal Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 r� Commonwealth of Massachusetts _ Title 5 Official inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 570 BOSTON STREET Property Address JAMES OWARA Owner Owner's Name information is required for every NORTH ANDOVER MA 01845 JANUARY 30 2026 .�_._.� 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): t5lnsp.doc•rev.7126/2010 Title 5 Official Inspectlon Farm:Subsurface Sewage Disposal Syslem Page 2 of 18 F Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !� 570 BOSTON STREET u Property Address JAMES OWARA Owner Owner's Name informa#ion is NORTH ANDOVER MA 01845 JANUARY 30 2025 required for every page. City/Town State zip Code Date of Inspection C. Inspection Summary (cons.) 2) System Conditionally Passes (cont.): ❑ 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): D-BOX IS DISINTEGRATED, LEAKING, AND NEEDS REPLACED ❑ 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: l5fnsp.doc rev.7I281201S TWO 5 Official Inspection Form:Subsurface Sewage 13Isposal System-Page 3 of 18 Commonwealth of Massachusetts # � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments z v% 570 BOSTON STREET W_ Property Address JAMES OWARA Owner Owner's Name requiratifo is NORTH ANDOVER MA 01845 JANUARY 30, 2025 required for every page. City/Town State Zip Code Date or Inspection C. Inspection Summary (cant.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public 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 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 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 El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool 15insp.doc•rev.712612018 Title 5 Offclel Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 i Commonwealth of Massachusetts Y Title 5 official Inspection Form m_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET Property Address JAMES OWARA information on is ry NORTH ANDOVER MA 01845 JANUARY 30, 2025 OwnerOwner's Name re ufred for eve page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cant.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow El ® 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. El ® 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 falls. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15,303, therefore the system fails, The system owner should contact the Board of Health to determine what will be necessary to correct the failure, 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 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 ❑ Elthe 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 Dispose!System-Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r° 570 BOSTON STREET Property Address w. JAMES OWARA Owner Owner's Name information is NORTH AND_OVER MA _ 01845 JANUARY 30 2025 required for every _ , page. CitylTown State Zip Code Date of inspection C. Inspection Summary (coat.) 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. 5. 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? ® El available as built plans of the system obtained and examined? (If they were not available note as NIA) ® ❑ 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)] tbinsp.doc-rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 6 of 18 1 Commonwealth of Massachusetts w. _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET Property Address JAME_S OWARA Owner Owner's Name - Information is NORTH ANDOVER MA 01845 JANUARY 30 2025 required for every _._.._.� page, Cityifown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 GPD Description: Number of current residents: .2- 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 Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): ATTACHED Detail: Sump pump? ❑ Yes ® No Last date of occupancy: CURRENT Date t5insp.doc rev.7/28/2018 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 570 BOSTON STREET Property Address JAMES OWARA Owner Owner's Name Information is NORTH ANDOVER MA 01845 JANUARY 30 2025 required for every _ page, City/Town State Zip Code Bate of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day t9Pd? Basis of design flow(seatslpersons/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: rate Other(describe below): 3. Pumping Records: Source of information: STEWART'S SEPTIC JANUARY 2023 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.712612018 Tit?e 5 OfCc{al Inspection Form:Subsurface Sewage Disposal System 4 Page a of 18 m, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET Property Address JAMES O'MARA Owner Owner's Name information is NORTH ANDOVER MA 01845 JANUARY 30 2025 _ required for every ___ _. _ n page. UyTown State zip Code Date of Inspection D. System Information (cons.) 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 IIA 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: 28 YEARS OLD, INSTALLED 1997, CONSTRUCTION PERMIT Were sewage odors detected when arriving at the site? ❑ Yes ® No 5, Building Sewer(locate on site plan): Depth below grade, 22"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.): JOINTS AND VENTING OK NO EVIDENCE OF LEAKAGE 15insp.doc-rev.7126J2018 Tit#e 5 Official Inspecllon Form:Subsu4ace Sewage Disposal System-Page 9 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 SOSTON STREET Property Address JAMES O'MARA Owner Owner's Name information Is NORTH ANDOVER MA 01845 JANUARY 30 2025 required for every _.__� page. Ciiyrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 10" feet Material 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) ❑ Yes ❑ No 10'X 5' X 4' Dimensions: - 12" Sludge depth: - 26" Distance from top of sludge to bottom of outlet tee or baffle m- 6" Scum thickness 611 Distance from top of scum to top of outlet tee or baffle - -- 8" Distance from bottom of scum to bottom of outlet tee or baffle ---- How were dimensions determined? SLUDGE JUDGE AND TAPE 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.): RECOMMEND PUMPING OLDER SYSTEMS YEARLY PLASTIC INLET AND OUTLET TEES OK TANK IS GOOD LIQUID LEVELS ARE OK t5insp.doc rev.712612016 Tille 5 OHiciai Inspection Form:Subsurface Sewage Disposal System Page 10 of 18 1 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET Property Address JAMES O'MARA Owner Owner`s Name Information is NORTH ANDOVER MA 01845 JANUARY 30 2025 required for every - , page, City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet mm Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scram 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.): 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: m Capacity: gallons Design Flow: gallons per day t51nsp.doc rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 11 of 18 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET mm Property Address JAMES OWARA Owner Owner's Name information is required for every NORTH ANDOVER MA 01845 JANUARY 30 2025 page. City/Town State Zip Code Date of Inspection D. System Information (corn.) 8. Tight or Holding Tank (cunt.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm In working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, 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 0 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,): D-BOX IS DISINTEGRATED AND LEAKING, NEEDS REPLACED DISTRIBUTION IS NOT EQUAL LIGHT EVIDENCE OF SOLIDS CARRYOVER Onsp doe-rev.712612018 TWo 5 4fficlal Inspection Form!Subsurface Soevago Disposal System Page 12 of 18 i i c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET m Property Address JAMES O'MARA Owner Owner's Name information is MA 01845 JANUARY 30 2025 required for every NORTH ANDOVER � _._ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10, Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ 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: 2; 62' LONG ❑ leaching fields number, dimensions: -- - - ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: - — t5insp.doc-rev.7)26/201 B Tilfe 5 Ofrcclal Inspection Form:Subsurface Sewage Disposal System Page 13 of i B Commonwealth of Massachusetts W =- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 570 BOSTON STREET Property Address JAMES OWARA Owner Owner's Name information is required for every NORTH ANDOVER MA 01845 JANUARY 30, 2025 .�. page, City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (coat.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): SOIL AND VEGETATION OK NO SIGN OF HYDRAULIC FAILURE OR PONDING 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 —W 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.712812 0 1 8 Title 6 official Inspection Form!Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Y - Y� Title 5 official Inspection Form....,, - a Subsurface Sewage Disposal System (worm - Not for Voluntary Assessments 570 BOSTON STREET Property Address _..__.. JAMES O'MARA Owner Owner's Name information is required for every NORTH ANDOVER _ MA 01845 JANUARY 30 2025 .... page. City[Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: - Dimensions _.._._.....__.. Depth of solids - -' Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). t5lnsp.doc•rev.7/26/2018 Tille 5 Official Inspection Form Subsurface Sewnga Msposal Syslem•Page 15 of la Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �t HEIDI JAMES O'MARA Property Address 570 BOSTON STREET Owner Owner's Name Inforrequired atIon Is NORTH ANDOVER MA 01846 JANUARY 3D 2026 required for every , page. City/Town State Zip Code Date of Inspection D. System Information-(cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, Including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below; ® hand-sketch in the area below ❑ drawing attached separately A { rj jj r4 t5lnsp.doc+rev,7126120fe Tills 5 Official InspBction Form:Subsurface Sewage Disposal System+Page 16 of 46 Commonwealth of Massachusetts a: Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y. 570 BOSTON STREET Property Address JAMES O'MARA Owner Owner's Name information is NORTH ANDOVER MA 01845 JANUARY 30 2025 required for every _. page. City/Town State Zip Code Date of Inspection D. System Information (cant) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 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; AUGUST 1996Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: PLANS ON FILE ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: DESIGN PLAN ON FILE SYSTEM 4`ABOVE WATER TABLE Before filing this Inspection Report, please see Report Completeness Checklist on next page. t6lnsp.doc-rev.7I2612M Title 5 Official Inspection Fofrn,Subsurface Sewage 131sposal System•Page 17 of 10 Commonwealth of Massachusetts y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments f �., 570 BOSTON STREET Property Address JAMES OWARA Owner _. _... Owner's Name — information is NORTH ANDOVER MA 01845 JANUARY 30, 2025 required for every _ page. City/Town State Zip Corte Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included l5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Summary Record Cord generated on 213/2026 9,09:27 AM by Karen Hanlon Page 4 Town of North Andover Tax Map # 210-109.0-0047-0000.0 Parcel Id 18861 670 BOSTON STREET O'MARA, JAMES & HEIDI 670 BOSTON STREET NORTH ANDOVER, MA 01845 Class 101 Single Family Property Type 1 Residential Size Total 0.998 Acres FY 2025 UB MaIlInn Index Name/Address Type Loan Number Activelinact. From Until OWARA,JAMES&HEIDI Payor Active 570 BOSTON STREET NORTH ANDOVER,MA 01845 UB Account Maint. Account No Cycle Occupant Name Activelinactive Bldg Id. 13780.0-670 BOSTON STREET Last Billing Date 1111/2024 1090457 01 Cycle 01 Active UB Services Maint. Account No.1090457 Service Code Rate Charge Multiptler/users MISCFEEADMIN FEE 0.63 5/8 7.82 1/ WTR WATER 01 ALL METER SIZE 336.85 /1 UB Meter Maintenance Account No. 1090457 Serial No status Location Brand Type Size YTD Cons 32938949 a Active 00 b Badger w Water 0.626 0,625 710 Date Reading Code Consumption Posted Date Variance 1/16/2025 3228 aActual 15 -78% 10/16/2024 3213 aActual 67 11/8/2024 6% 7/19/2024 3146 aActual 66 8/13/2024 308% 4/1812024 3080 aActual 16 6/13/2024 23% 1/18/2024 3064 aActual 13 2/16/2024 -56% 10/19/2023 3051 aActual 29 11/21/2023 .63% 7/20/2023 3022 a Actual 79 8/1412023 272% 4/19/2023 2943 a Actual 21 6/10/2023 -13% 1/18/2023 2922 a Actual 24 2/14/2023 -68% 10/19/2022 2898 aActual 75 11/9/2022 17% 7120/2022 2823 aActual 65 8/16/2022 173% 4/19/2022 2768 aActual 23 5/1212022 7% 1/20/2022 2736 aActuat 20 2/1612022 •56% 10/29/2021 2715 aActual 64 11/2212021 -49% 7/22/2021 2661 a Actual 98 8124/2021 182% 4/21/2021 2663 a Actual 34 6/18/2021 35% 1/21/2021 2529 a Actual 26 2/23/2021 -60% 10/20/2020 2503 aActual 67 11/12/2020 14% 7/16/2020 2430 aActuai 61 8/1212020 141% 4/24/2020 2385 a Actual 25 511312020 1% 1/17/2020 2360 aActual 23 2/10/2020 -70% 10/18/2019 2337 aActual 76 12/1812019 74% 7/2212010 2262 aActual 46 8/13/2019 105% 4/19/2019 22116 aActual 22 5/16/2019 -2% 1/17/2019 2194 a Actuat 21 2/18/2019 -38% 10/23/2018 2173 &Actual 38 11/19/2018 -51% 7/19/2018 2136 aActual 76 8/15/2018 233% 4/18/2018 2060 a Actual 22 511 MO18 .2% 1/18/2018 2038 aActual 23 2/20/2018 -77% 10/18/2017 2015 aActual 98 11/13/2017 216%