HomeMy WebLinkAboutPASS - Title V Inspection Report - 7 SULLIVAN STREET 9/11/2025 Commonwealth of Massachusetts
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1-1.
Subsurface Sewage Disposal System Form ..Not for Voluntary Assessments
Y rY
7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every p
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 Information1OW/7
filling out formsOf Northon the computer,
"Jamie"
use onlythe tab Benjamin Jamle Prescott d0vnr
key to move your Name of Inspector
cursor-do not Down East Title V Inspections, LLC SEA
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use the return Company Name Uej
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Po Box 81 An
r Company Address V%ocwn DePP%&__#
Rowley MA
City/Town State Zip Code
f (351)444-7672 S113851
Telephone Number License Number
B. Certification
I certify that: l 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
-s- September 11, 2025
Inspector' 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
101000 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
-- Official Fors
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
a
-„ ,%jV 7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 21 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:
THIS SYSTEM MEETS THE REQUIREMENTS FOR A PASSING TITLE V AS DESCRIBED IN
310 CMR 15.303.
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 El N ❑ ND (Explain below):
tainsp.doc•rev.7/26/2018 Title 5 official Inspection Farm:Subsurface Sewage Disposal System•Page 2 of 18
� Commonwealth of Massachusetts
, ------------
Title 5 Official Forl'1�1
T Subsurface Sewage Disposal System Form • Not for voluntary Assessments
4
a
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. 7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA O'1845 September 11 2025
required for every p
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cant.)
2) System Conditionally Passes (cont.):
El Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
El 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):
E:1 broken pipe(s)are replaced [:] Y N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y [] N ❑ ND (Explain below):
El distribution box is leveled or replaced ❑ Y El 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):
El broken pipe(s) are replaced OY 0 N ❑ ND (Explain below):
❑ obstruction is removed [1 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(i)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
t5insp.doc•rev.7126/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
Commonwealth of Massachusetts
Title 5 Official Form
y°
Subsurface Sewage Disposal System Foram - Not for Voluntary Assessments
: 7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every
page. CitylTown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
El Cesspool or privy is within 50 feet of a surface water
El 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:
El 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.
Ej 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
El
® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
El N Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
t5insp.doc■rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18
Commonwealth of Massachusetts
Title
w w Official Inspection ors
Y
}
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
7 Sullivan Street
Property A�,dress
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every p
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cant.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than l2 day flow
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipes). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ N Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® 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.
El N 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-
101000 gpd.
El N 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 C.4.
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
El 1:1 the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area-- IWPA) or a mapped Zone 11 of a public water supply well
t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18
Commonwealth of Massachusetts
- � Title 5 Official Fors
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
? Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every p
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
If you have answered"yes"to any question in Section C.5 the system is considered a significant
threat, or answered "yes"to any question in Section C.4 above the large system has failed. The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section C.4 shall upgrade the system in accordance with 310 CM R 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 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:
® El Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
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Commonwealth of Massachusetts
MTitle 5 Official Form
Y
Subsurface Sewage Disposal System Form w Not for Voluntary Assessments
7 Sullivan Street
Property Address
Thornton
Owner Owner's Name
information
ormation is North Andover MA 01845 September 11, 2025
required for every
page. CitylTown State Zip Code Date of Inspection
D. System information
1. Residential Flow Conditions:
Number of bedrooms(design): THREE Number of bedrooms (actual): THREE (3)
(3)
DESIGN flow based on 310 CMR 15.203 (for example: 110 d x#of bedrooms): 330 gpd
gp }
Description:
PER THE DESIGN PLAN DATED MAY 251 2001 (REVISED JUNE 21, JULY 13 AND SEPTEMBER
11, 2001) PREPARED BY NEW ENGLAND ENGINEERING SERVICES.
NIA
Number of current residents:
.
Does residence have a garbage grinder? ❑ Yes E 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 Yes No
information in this report.) El
Laundry system inspected? El Yes ❑ No
Seasonal use? El Yes E No
Water meter readings, if available Mast 2 ears usaged : SEE ATTACHED
y �gp }} REPORT
Detail:
SEE ATTACHED REPORT
Sump pump? ❑ Yes ❑J No
Last date of occupancy, DECEMBER2024
t5insp,doc-rev.7/2612018 Title 5 official Inspection Form:Subsurface Sewage Disposal System■Page 7 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection For
_ Subsurface Sewage Disposal System Form Not for Voluntary Assessments
Y
r Y,: 7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every p
page. CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
2, Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seatslpersonslsq.ft., etc.):
Crease trap present? El Yes [:1 No
Watei treatment unit present? El Yes 0 No
If yes, discharges to:
Industrial waste holding tank present? ❑ Yes El No
Non-sanitary waste discharged to the Title 5 system? El Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: Date
Other(describe below):
3. Pumping Records:
Source of information: THE SYSTEM WAS LAST PUMPED IN OCTOBER
2024 PER THE HOMEOWNER.
Was system pumped as part of the inspection? El Yes Z No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
t5insp.doc•rev.7/25/2018 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
FA Title 5 Official Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
N
s 7 Sullivan Street
............?
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every p
page, City/Town State Zip Code Date of Inspection
D, System information (cont.)
4. Type of System:
z 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.
El Other(describe):
Approximate age of all components, date installed (if known) and source of information:
THE AS--BUILT ON FILE IS DATED MAY 101 2002.
Were sewage odors detected when arriving at the site? ❑ Yes Z No
5. Building Sewer(locate on site plan):
Depth below grade:
feet
Material of construction:
0 cast iron Z 40 PVC El other(explain):
Distance from private water supply well or suction line: NIA
feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
THE BUILDING SEINER PIPE IS IN GOOD CONDITION WITH No EVIENCE OF LEAKAGE.
t5insp.doc-rev,7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System►Page 9 of 18
Commonwealth of Massachusetts
of w
. __ Title 5 Official For41 m
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
? Sullivan Street
Property Address
Thornton
Owner Owner's Name
information is North Andover MA 01845 September 11, 2025
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
5. Septic Tank(locate on site plan):
Depth below grade: '33
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
Dimensions:
1 0' L x 5'W x 4' D
Sludge depth: Oil
Distance from top of sludge to bottom of outlet tee or baffle NIA
Oil
Scum thickness
Distance from top of scum to flop of outlet tee or baffle NIA
Distance from bottom of scum to bottom of outlet tee or baffle NIA
How were dimensions determined? TAPE MEASURE AND SLUDGE
JUDGE
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
THE SEPTIC TANK IS 4" BELOW THE CURRENT GRADE. THE LIQUID LEVEL IS NORMAL AND
EQUALS THE OUTLET INVERT, THE INLET AND OUTLET PVC TEE'S ARE IN PLACE. THE
SEPTIC TANK IS A TWO COMPARTMENT TANK WITH A FILTER BETWEEN THE TWO
COMPARTMENTS. THERE IS NO EVIDENCE OF LEAKAGE AND THE SEPTIC TANK APPEARS
TO BE STRUCTURALLY SOUND. PUMPING IS NOT REQUIRED BASED ON THE GUIDELINES IN
310 CMR 15.351.
t5insp.doc-rev.7126«018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
Title 5 Official Form
-- 's Subsurface Sewage Disposal System Form Not for Voluntary Assessments
.. 1
7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11 2025
required for every p t
page. CitylTown State Zip Code Date of Inspection
D. System Information (cant.)
7. Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete El 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.):
8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
El concrete El metal fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons per day
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 11 of 18
Commonwealth of Massachusetts
?� Title Official ors
h
W -- Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required for every p
page. CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
S. Tight or Holding Tank(cost.)
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: El 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 Ej No
9. Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert Orr
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 (D--BOX) IS IN FAIR CONDITION, 5" BELOW THE CURRENT GRADE
AND MEASURES 16"x 16". THE LIQUID LEVEL IS NORMAL AND EQUALS THE OUTLET
INVERTS. THERE IS MINIMAL EVIDENCE OF SOLIDS CARRYOVER. THERE IS EQUAL
DISTRIBUTION BETWEEN THE THREE (3) LINES LEAVING. THERE IS NO EVIDENCE OF
LEAKAGE OR INFILTRATION AND THE D-BOX APPEARS TO BE STRUCTURALLY SOUND. THE
OUTLET INVERTS ARE 12" BELOW THE CURRENT GRADE.
t5insp.doc rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
Commonwealth of Massachusetts
Y _ Title 5 Official Forr�
-� a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
7 Sullivan Street
Property Address
Thornton
Owner owner's Name
information is North Andover MA 01845 September 11, 2025
required
for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
10. Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes El No*
Alarms in working order: El 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) allocate on site plan, excavation not required):
If SAS not located, explain why:
Type:
❑ leaching pits number:
❑ leaching chambers number:
El leaching galleries number:
El leaching trenches number, length:
® leaching fields number, dimensions:
ONE (1) 15' x42'
❑ overflow cesspool number: W
❑ innovative/alternative system
Type/name of technology:
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18
Commonwealth of Massachusetts
Title 5 Off Forrl�l
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
4+
7 Sullivan Street
Property Address
Thornton
Owner Owner's Name
information is North Andover MA 01845 September 1'1 2025
required for every }
page. City/Town State Zip Code Date of Inspection
D. System Information (cant.)
11. Soil Absorption System (SAS) (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
THE SYSTEM IS IN THE FRONT YARD. THERE IS NO PONDI NG OVER OR SIGNS OF
HYDRAULIC FAILURE WITHIN THE SAS. THE VEGETATION IS CONSISTENT WITH THE
SURROUNDING AREA. THE SAS CONSISTS OF A LEACHING FIELD MEASURING 1 5' x 421
.
THERE WAS NO EVIDENCE OF SOLIDS CARRYOVER WHEN THE PIPES WERE INSPECTED
BY CAMERA. THE BOTTOM OF THE SAS IS 18" BELOW THE CURRENT GRADE.
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 El Yes ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
Commonwealth of Massachusetts
Title 5 O Forl'�1
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
V
7 Sullivan Street
Property Address
Thornton
Owner Owner's Name
information
ormation is North Andover MA 01845 September 11, 2025
required for every p
page. City[Town State Zip Code Date of Inspection
D. System Information (cunt,)
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.):
t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18
Commonwealth of Massachusetts
y fTitle 5 Off Forb
�- -- Subsurface Sewage Disposal System Form .�Not for Voluntary Assessments
� p Y ry
YJ
7 Sullivan Street
Property Address
Thornton _
Owner pwner's Name
information is North Andover MA g1845 September 11 2025
required for every p
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
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t5insp.doc rev.7126/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System■Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Form
--- o Subsurface Sewage Disposal System Form Not for Voluntary Assessments
, .� 7 Sullivan Street
Property Address
Thornton
Owner Owner's Name
information is North Andover MA 01845 September 11, 2025
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
15. Site Exam:
® Check Slope
Surface water
Z Check cellar
Z Shallow wells
Estimated depth to high ground water: 4
feet
Please indicate all methods used to determine the high ground water elevation:
z obtained from system design plans on record
If checked, date of design plan reviewed: MAY 2512001
g p 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)
El Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
SOIL TESTING WAS PERFORMED ON MAY 4, 2001 BY RICHARD C. TANGARD AND
WITNESSED BY SANDRA SRARR OF THE BOARD OF HEALTH. TWO (2)TEST PITS WERE DUG
AND OBSERVED To A DEPTH OF 96" WITH ESHGW DETERMINED TO BE AT ELEVATION 97.00
IN TP--1. PER THE DESIGN PLAN THERE IS S OF SEPERATION BETWEEN ESHGW AND THE
BOTTOM OF THE SAS AT ELEVATION 100.00. THE CELLAR WAS DRY. DURING THE
INSPECTION THERE WERE No SHALLOW WELLS ENCOUNTERED OR SURFACE WATER
OBSERVED. THE DWELLING SITS HIGHER IN ELEVATION THAN THE SYSTEM ON ONE SIDE
AND ROUTE 114 ON THE OTHER.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5insp.doc•rev.7/26/2018 Title 5 Official inspection Farm:Subsurface Sewage Disposal System•Page 17 of 18
Commonwealth of Massachusetts
iK Title Official Inspection ors
�h
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
yI
7 Sullivan Street
Property Address
Thornton
Owner Owner's Name
information is North Andover MA o 845 September 11, 2025
required for every p
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 4 checked
® C. Inspection Summary:
11 21 3, or 5 completed as appropriate
4 (Failure Criteria) and 5 (Checklist) completed
® D. System Information:
For 8: Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 15 or attached
For 15: Explanation of estimated depth to high groundwater included
t5insp.doc rev.7126/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
Summary Record Card generated on 913i2025 12:25:42 Pik by Nancy Viens Page i
Town of North Andover
Tax Map # 210,,107,B-001 6,,000000
Parcel Id 18129
7 SULLIVAN STREET
KENNETH THORNTON
7 SULLIVAN STREET
NORTH ANDOVER, MA 01846
Class 101 Single Family Property lype 1 Residential
Size Total 1.02 Acres
FY 2026
UB Mi iling Index
InoNrrrrirrnN//{
Narne/Address T pa Loan Number Activeflnact,, From Until
KENNETH THORNTON owner Active.
7 SULLIVAN STREET
NORTH ANDOVER,MA 01845
SORGOSH,ARI.&MARGRET Previous Customer Inactive 9/10/2004
7 SULLIVAN STREET
ND.ANCOVER,MA
01846
3
UB Account Maint,
Account N Cycle Occupant Name Aotivellnacti►e
Bldg Id. 13229.0-7 SULLIVAN STREET Last filling Date 613f2025
2100014 02 Cycle 02 Active
f
UB Services Maint,
Account No.2100014
Service Code Rate Charge Multiplier/Users
MISCFEI ADMIN FEE. 0.63 518 7.82 1f
WTR WATER 01 ALL METER SIZE 7.60 !
U B Meter Maintenance
Account No.2100014
Serlal No Status Location Brand 1 pe Size YTD Cans
36388068 a Active ERT HH b Badger w Water 0.625 0.625 183
Data .Reading Code Consumption Posted Date Variance
8f112025 773 a Actual I -53%
51112026 772 a Actual 2 6f 1212025 -68%
214f2025 770 a Actual 7 3/13/2025 .44%
11f112024 763 a Actual 12 21121202 0%
8f1 i2024 751 a Actual 12 9/1212024 �2%
511/2024 739 a Actual. 12 6/13/2024 -6%
2f1f2024 727 a Actual 13 3f14f2024 18%
11 f 112023 714 a Actual 11 12/13/2023 1
8/112023 703 a Actual 11 9/18/2023
51212023 Opt a Actual 11 6/14/2023 2%
211f2023 681 a Actual 11 3f14f2023 21°
1111 f2022 670 a Actual 9 12/19/2022 .9%
8f2f2022 661 a Actual 10 9/20/2022 �2%
5f2f2022 651 a Actual 10 6/21/2022 2%
2f 112022 641 a Actual 0 3f 15l2022 °Io
11/112021 531 a.Actual 10 12/13/2021 ,17%
81212021 621 a Actual 12 9/21 f2021 17%
5I3f2021 609 a Actual 10 6/15/2021 4%
21312021 599 a Actual 10 3/1612021 M2%
11f2f2020 689 a Actual 10 12116f2020 3°l
81312020 579 a Actual 10 9f912020 .6%
511/2020 559 a Actual 10 6110f2020 19%
202020 559 a Actual 9 3/16/2020 .2%
11t112019 550 a Actual 9 12/23/2019 0%
8f 1 f2019 541 a Actual 9 9/26/2019 -27%
5f 1 f2019 532 a Actual 12 6/13/2019 13°l
2f 112019 520 a Actual11 3119f2019 %