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HomeMy WebLinkAboutPASS - Title V Inspection Report - 25 TURTLE LANE 5/22/2026 Commonwealth of Massachusetts icia i�on ...... . ........- T'tle 5 Off" I Inspect" Form ._. w Subsurface Sewage Disposal System Form Not for Voluntary Assessments 7 � ' 25 TURTLE LANE Property Address KATHYGALLAGHER Owner owner's Name information is required for every NORTH AN OV R IAA 01 5 MAY 1_9, 2026 page. City/Town State Zip Grade Cate of Inspection Inspection results must he submitted on this form. Inspection roans may not he altered in any way., Please see completeness checklist at the end of the form. of Nob Andover �n Important:when Information A. Inspector fillings out forms on the computer, use only the tab Todd Jane ate�on key to move your Name of Inspector _................... .._. .u_ cursor-do not Bateson Enterprises Inc.. use the return Company dame _._ .. _. _ _...._ key. Health 111 Argilla Road toib Company Address Andover MA 011810 City/Town State ,dip Code 97 -475-47 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 (310 CMR 1 . w I 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. E Passes 2. conditionally Passes 3, El Needs Further Evaluation by the Local Approving Authority 4. Fails . MAY 21, 20266 lnsp°6ctor's Sig ature 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 flog of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DER The original form should he 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 sunder 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., t insp. cc.rev.7/ Sl ta18 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System.Page 1 of 18 Commonwealth of Massachusetts M1 =rTitle 5 Off For I'M a Subsurface Sewage Disposal System Form Not for Voluntary Assessments t " - - ° 25 TURTLE LANE Property Address KATHY GALLAGHER Owner Owner's Name information is NORTH AN DOVER MA 01845 MAY 1912026 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 0. 1) System Passes: ® 1 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.7/26/2018 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 2 of 18 3 Commonwealth of Massachusetts itle 7 c1aInspectionFor1'Y1 ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments � 4 4 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH AN DOVE R MA 91845 MAY 19, 2025 required for every page. City/Town State Zip Code Date of inspection C. Inspection Summary (coat.) 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 El N ❑ ND (Explain below): EJ distribution box is leveled or replaced Y ❑ N F] ND (Explain below): El The system required pumping more than 4 times a year due to broken or obstructed pipes). The system will pass inspection if(with approval of the Board of Health): El broken pipe(s) are replaced El Y El N ❑ ND (Explain below): ❑ obstruction is removed D Y ❑ N El ND (Explain below): 3) Further Evaluation is Required by the Board of Health: El 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.7/26/2016 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts �t,,A Title 5 Official Forn� PeSubsurface Sewage Disposal System Form Not for Voluntary Assessments v°v 25 TURTLE LANE Property Address KATHY GALLAGHER Owner Owner's Name information is NORTH ANDOVER MA 01845 MAY 19 2026 required for every , page. City/Town State Zip Code Date of inspection C. Inspection Summary (cant.) 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: [:1 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. Ej The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. Ej 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 ❑ ® Discharge or ponding of effluent to the surface of the ground or surface wafers 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 i Commonwealth of Massachusetts M Ti icialForI'�1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments W Sl r r, 25 TURTLE LANE Property Address KATHY GALLAGHER Owner Owner's Name information is NORTH ANDOVER MA 01845 MAY 19 202E required for every page, City/Town State Zip Code Date of Inspection C. inspection Summary (cunt.) 4) System Failure Criteria Applicable to All Systems: (cant.) Yes No 1:1 ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool 0 ® Liquid depth in cesspool is less than 5" below invert or available volume is less than '/day flow 1:1 ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: El E Any portion of the SAS, cesspool or privy is below high ground water elevation. ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. EJ 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 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 forma ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 101000 gpd. ❑ ® The system fads. 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 1:1 1:1 the system is within 400 feet of a surface drinking water supply 1:1 EJ the system is within 200 feet of a tributary to a surface drinking water supply 1:1 El the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.dac•rev.7/26/2018 Title 5 official Inspection Farm:Subsurface Sewage Disposal System•Page 5 of 18 .;��, Commonwealth of Massachusetts Y a itle i ' For� Subsurface Sewage Disposal System Form Not for Voluntary Assessments � -, 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDOVER MA 01845 MAY 19 2020 required for every t page. City/Town State Zip Code 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 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 CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 0. You must indicate "yes" or"no"for each of the following for all inspections: Yes No E El Pumping information was provided by the owner, occupant, or Board of Health El E 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) E El Was the facility or dwelling inspected for signs of sewage back up? E El Was the site inspected for signs of break out? E El Were all system components, excluding the SAS, located on site? ® El 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? E El 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: E 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)] t5insp.doc•rev,7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts pTitle 5 Official Forrr, � Subsurface Sewage Disposal System Form Not for Voluntary Assessments 0-1 f� 25 TURTLE LANE Property Address KATHY GALLAGHER Owner Owner's Name information is NORTH AN DOVE R MA 01845 MAY 10 2026 required for every = page. City/Town 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 C M R 15.203 (for example: 110 gpd x#of bedrooms): 600 G PD Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ 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.) ElYes E No Laundry system inspected? ® Yes ❑ No Seasonal use? El Yes E No Water meter readings, if available Mast ears usage �gP }}d : ATTACHED Y g Detail: Sump pump? 0 Yes ® No Last date of occupancy: CURRENT Date t5insp.doc-rev.7/25/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts . W (F Title 5 Official Form ' > Subsurface Sewage Disposal System Form ., Not for Voluntary Assessments w t7 � 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH AN DOVE R MA 01845 MAY 19 2026 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM R 15.203): Gallons per day(gpd) Basis of design flow(seatslpersonslsq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? El Yes ❑ No If yes, discharges to: Industrial waste holding tank present? El Yes El No Non-sanitary waste discharged to the Title 5 system? El Yes [:1 No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: PUMPED BY OTHERS Was system pumped as part of the inspection? H Yes [] No if yes, volume pumped: 1500 gallons How was Y uantit pumped determined? TRUCK GAUGE q Reason for pumping: PUMPED TANK AND D-BOAC FOR MAINTENANCE t5insp.doc-rev,7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 o€18 Commonwealth of Massachusetts p Title 5 Offic*ial Forrn I �y , Subsurface Sewage Disposal System Form Not for Voluntary Assessments f. 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH AN DOVER MA 01845 MAY 19, 2025 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4, Type of System: 0 Septic tank, distribution box, soil absorption system El Single cesspool El Overflow cesspool 1:1 Privy 1:1 Shared system (yes or no) (if yes, attach previous inspection records, if any) 1:1 I nnovative/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 1:1 Tight tank. Attach a copy of the DEP approval. 0 Other(describe): Approximate age of all components, date installed (if known) and source of information. 50 YEARS, INSTALLED 1976, AS-BUILT, NEW 1500 g TANK INSTALLED 2005 Were sewage odors detected when arriving at the site? El Yes ® No 5. Building Sewer(locate on site plan): 3' Depth below grade: feet Material of construction: E cast iron El 40 PVC other(explain): Distance from private water supply well or suction line: feet Comments iron condition of joints, venting, evidence of leakage, etc.): JOINTS AND VENTING OK No EVIDENCE OF LEAKAGE t5insp.doc►rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System►Page 9 of 18 Commonwealth of Massachusetts = Official Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments � p Y ry 25 TURTLE LANE Property Address KATHY GALLAGHER Owner Owner's Name information is NORTH ANDOVER MA 51845 MAY 19 2025 required for every I page. City/Town State Zip Code Date of Inspection D. System In formation (cont.) 5. Septic Tank (locate on site plan): " Depth below grade: 24 feet Material of construction: ® concrete El metal ❑ fiberglass El polyethylene ❑ other(explain) OUTLET RISER UNDER PATIO BLOCK CUTS IN BLOCKS FOR ACCESS If tank is metal, list age: years Is age confirmed by a certificate of Compliance? (attach a copy of certificate) El Yes El No Dimensions: 15' x 5' x 4' Sludge depth: 411 Distance from top of sludge to bottom of outlet tee or baffle 34" r FI Scum thickness # II Distance from top of scum to top of outlet tee or baffle 6 r i Distance from bottom of scum to bottom of outlet tee or baffle 3 How were dimensions determined? SLUDGE JUDGE 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 RECOMMEND CLEANING FILTER YEARLY PLASTIC INLET AND OUTLET TEES OK TANK IS OK LIQUID LEVELS GOOD NO EVIDENCE OF LEAKAGE t5insp.dac-rev.7/26/2018 Title 5 official Inspection Farm:Subsurface Sewage Disposal System•Page 10 of 18 fe Commonwealth of Massachusetts � 4Title 5 Offic"ial Form h Y Q Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDOVER MA g1 845 MAY 1 9 2926 required for every I page. City/Town State Zip Code Date of Inspection D. System Information (cant,) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: El concrete El metal El fiberglass ❑ polyethylene El 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 Ej polyethylene El other(explain): Dimensions: Capacity. gallons Design Flow: gallons per day t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts zT Otle 5 Officmial Form w ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments N 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDOVER MA 01 845 MAY 1 9, 2025 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: El Yes ❑ No Alarm level: Alarm in working order. ❑ Yes El 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 [:1 No 9. Distribution Box (if present must be opened) (locate on site plan): q Depth of liquid level above outlet invert 0 p 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 LEVEL DISTRIBUTION IS EQUAL HEAVY EVIDENCE OF SOLIDS NO EVIDENCE OF LEAKAGE D-BOAC PUMPED AT INSPECTION t5insp,doc•rev.7/25/2018 Title 5 official Inspection Farm:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts �v Ti ic'ialForm .a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wu I. tea ° 25 TURTLE LANE ,rf t1 �.r Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDGVER MA 01845 MAY 19, 2025 required for every page. City/Town State Zip Code Date of inspection D. System Information (cant,) 10. Pump Chamber(locate on site plan): Pumps in working order: El Yes El No* Alarms in working order: El Yes D 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: EJ leaching chambers number: El leaching galleries number: [� leaching trenches number, length: ® leaching fields number, dimensions: 1; 2 0'X 45' overflow cesspool number: ❑ 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 Official Inspection For 47 ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments J+{{ 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDOVER MA 01845 MAY 19, 2026 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cant.) 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 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.7/26/2018 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System►Page 14 of 18 , Commonwealth of Massachusetts r uTitle 5 Offic"ial Inspection Form Its Im > Subsurface Sewage Disposal System Form Not for Voluntary Assessments g p Y rY r 25 TURTLE LANE Property Address KATHY GALLAGHER Owner Owner's Name information is NORTH ANDOVER MA 01845 MAY 19 2026 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cant.) 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.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts x Tl"tle 5 Off' i 'i itsecti'on n u 4 Subsurface Sewage Disposal System Form Not for Voluntary Assessments Ic I= • ,vtl''`'� 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDOVER MA required for every 01845 MAY 19, 2026 page. CitylTown 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 El drawing attached separately r r : o6y C: .......... ............................ 0 4 .. Y_ ..............._. ........... .w . a C is .w � 0 i Pp L_J t w f t5insp,doo-rev.7/26/2016 Title 5 Official inspection Form;Subsurface Sewage Disposal System o Page 16 of 18 Commonwealth of Massachusetts �xTitle 5 Off Forl� �7 1 �} r 10 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Z4�yY�4V 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH AN DOVE R MA Q 1845 MAY 19, 2925 required for every page. City/Town State Zip Code Date of inspection D. System Information (cont,) 15. Site Exam: Z Check Slope Z Surface water ® Check cellar El Shallow wells Estimated depth to high ground water: 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 fan reviewed: OCTOBER 1975 9 P Date ❑ Observed site (abutting property/observation hole within 159 feet of SAS) ® Checked with local Board of Health - explain: PLANS ON FILE ❑ Checked with local excavators, installers-(attach documentation) El Accessed USGS database -explain: You must describe how you established the high ground water elevation: DESIGN PLAN 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 Commonwealth of Massachusetts . :rOfficial Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments x g p Y ry �r 25 TURTLE LANE Property Address KATHY GALLAGHER Owner owner's Name information is NORTH ANDOVER MA 01845 MAY 19 2026 required for every 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 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.7/28/2018 Title 5 official inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Summary Record Card generated on 5/81202�6 8;16:37 AM by Nancy Viens Page I K I ill Town of iNj'ortn Andover Tax Map # 210-406.B-0103-0000aO Parcel Id 17507 26 TURTLE LANE GALLAGHER, KATHLEEN 2,15 TURTLE LANE NORTH ANDOVER, MA 01845 class 101 Single Family Property'rype 1 Residential Size Total 1.001 Acres FY 2,026 UB Malling Index Name/Address T'Ype Loan Number, Active/Inact. F'r,o til GALLAGHER,KATHLEEN Payor /\ctive 25 TURTLE LANE NORTH Al" 1 VER,MA 01845 ,UB Acl .c.ount"I'Maint, Account No Cycle Oiccupant Narne Activentiactive Bldg Id. 17438.0-25 TURTLE LANE Last Billing Date 4/7/2026 3170,108 03 Cycle 03 Active U13 Slervices, Maint. Account No.3170108 Setvicle Code Rate Charge Nitiltip tier/Usera MISCFEE ADMIN FEE 0.635/8 7.8,2, WTR WATER 01 ALL METER SIZE 34.20 UB Meter Mla, intenance Account No.3170108 Serial No Status Location Brand Type Size YTD Goes 44103818 a Active ERT HH b Badger w Water 0.6250.625 744 at Reading Code Consumption Posted Date Variance 3110/2026 1874 a Actual 9 4/14/2026 -71% 12/4/2025 1865 a Actual 28 1/12/2026 .68% 9/9/2025 18,37 a Actual 97 10/10/2025 27'2% 6/6/2,025 1740 a Actual 25, 719/2025 2,13% 31/7/2025 1715 a Actual 8 4/16/2025 -71'% 12/6/2024 1707 a Actual 28 1/14/2025 -71% 9/6/2024 1679 a Actual 94 10/8/2024 238% 6/10/2024 1586 a Actual 30 7/22/202,4 259% 3/7/2024 1555 a Actual 8 4/16/2024 -54% 12/7/2023 1547 a Actual 16 1/15/2024 -75% 9/14/2023 1531 a Actual 74 10/1 3/2 23 104% 6/7/2023 1457 a Actual 34 7114/2023 370% 3/6/2023 1423 a Actual 7 4/12/2023 -691% 12/6/2022 1416 a Actual 22 1/16/2023 -80% 9/8/2022 1394 a Actual 114 10/18/2022 177% 6/7/2022 1280, a Actual 42 7/18/20,22 327% 3/4/2022 1238 a,Actual 9 4/13/2022 -2,8% 12/7/2021 1229 a Actual 13 1/17/2022 -38% 9/7/2021 1216 a Actual 22 10/15/2021 42% 6/4/2021 1194 a Actual 15 7/27/2021 -111% 3/412021 1179 a Actual 16 4/2,11/2021 -48% 12/7/2020 1163 a Actual 33 1/13/2021 -60% 9/4/2020 11310 a Actual 79 10/14/2020 344% 6/6/2020 1051 a Actual 18 7/15/2020 113% 3/5/2020 1033 a Actual 8 4/8/2020 .60% 12/9/2,0!19 1025 a Actual 20 1/15/2020 -80% 9/13/2019 1005 a Actual 113 10/10/2019 1079% 6/7/2019 892 a Actual 9 7/26/2019 .,2% 3/7/2019 883 a Actual 9 4/16/2019 -38,% 12/7/20118 874 a Actual 14 1/22/2019 -81%