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HomeMy WebLinkAboutFAIL - Title V Inspection Report - 962 TURNPIKE STREET 9/19/2026 Town of Nod Andover Commonwealth of Massachusetts I Inspec ion Totle 5 Off'iocia OCT 2 2026 Form I� Subsurface Sewage Disposal System Formof for Voluntary Assessments TURNPIKEHealth Department 962 STREET Property Address PAUL FIONTE Owner am information is, NORTHANDOVER MA 01845 SEPTEMBER 19, 2026 form.page. ity/'Town Inspection results must be submitted on this Please It s edit at the end of the form. Important:When A. Inspector Information filling out forms n the computer, o s team use only the tad ..� _. key to move your Name of Inspector cursor-do not Bates on Enterprises..... Inc. use e return do'"',m"' ""y__"key illy Andovertot Company Address MA 01810 it o n State Zip Code 75 6 l 1 .�._.lephone Number er License Number B. Certification l certify, tl t� I am a DEP approved system inspector in full compflance with Section 15,.340 of Tl*tle 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property belowlisted above; the information reported s to and complete s of the time inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of ors-site sewage disposal systems. After conducting this inspection l have determined that the system. , 1. [] Passes . E] Conditionally Passes Needs Further Evaluation by the Local proving Authority 4. Fails M _.... Signature Date The system inspector shall submit a copy of this inspection report to the r vin Authority oar of Health or Ewithin 30 days of completing this inspection. If the system has a design flow of 1 O,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 e sent to the system owner and copies seat t the buyer, it applicable, and the approving authority. Please note: This rdescr*lbes condiltions at the time of inspection and under the conditions of use at that time.This Inspection doesrwill perform conditions in the future under the same or dWerent t5i a p, .rev.7/2612018 Title5 Official inspection Form,Subsurface Sewage Disposal System.Page I of 1 Commonwealth of Massachusetts *%ect* T"t1e 5 Ot't'"icial Ins*p ion Form Subsurface Sewage Disposal System Parma Not for Voluntary Assessments 962, TURNPIKESTREET Property Address PAUL FIONTE OwnerOwner's e....�..... .�..M......_......... ,,_ .�....w..._........_....u.....�.m..�.__..�..,_v.�..,....... information is ICIORTH Al lDOVER A 1 5 SEPTEMBER 19, � 26 ` _.,,. ._.___.._._.__ .. ._ ,__.,_._ n___.__.._....._._.__.. .. ._ _ re Ired for agar page. City/Town....__�_.w._�... � .... State Zip Code�� _ ate� Inspection . .�... ....�. _,,..,.. _._Mu..µ_...._..._....,_.. C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 C R 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. C tints: 2 System Conditionally Passes* one or more system components p nents 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, ill pass. Check the box for"yes, "no" or `not determined" „ N, 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 net) is structurally unsound, exhibits substantial infiltration or extiltrati n or *ark 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. metal septic tank will pass inspection if it is structurally sound, net leaking and if e certificate of Compliance indicating that the tank is less than 20 years old is available. El Y 0 N E ND Explain below): t5in p.d .rev.7/26/2018 Title 5 Official InspectionForm:Subsurface Sewage Disposal posal System-liege 2 of 18 (j Commonwealth of Massachusetts T"Itle 5 Off'c'al Inspect"ion For rA Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 962 TURNPIKE STREET Property Address PAUL FIONTE Owner owner's Name information is NORTH DOVE M 01845 SE.: `I EM E" g, 2026 required for every _a___.__�__ ___��. w_. ..___. ..________ _�_�. ..____._w...M.._.... page. City/Town State Zip Code Cate of inspection C. Inspection Summary (cont.) 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 El Y El N El N (Explain below): obstruction is removed F.] Y [] N 0 ND (Explain below): distribution hex is leveled or replaced 0 Y 7 NEI NEB (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): [:1 broken pipe(s) are replaced 7 Y 0 N F� ND (Explain below)- 0 obstruction is removed E] Y El N F NCB (Explain below): 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 ante with 310 Cl 11 15.303 1 (h)that the system is not functioning in a manner which will protect public health, safety and the environment: t8insp.doc•rev.7/26/2018 Title 5 official Inspection Form-Subsurface Sewage Disposal System*Page 3 of 1 Commonwealth of Massachusetts For V ion T*tle 5 Otticial Insw%ect" �r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 62 TURNPIKE Property Address P u L F'IONTC Owner Owner's Name information i � �� ---- page. 5 S� No P�'�i�l�� required for very __.._� �''_____ 1 __...._ ..m.... �.._____ .m,,___�_..____m_�._�__.. ___. q `, " " _._.�____w._.__� _ ___ . City/Town___ __. �._. State Zip Code Cate of Inspection C. Inspection Summary (coat.) System Failure Criteria Applicable to All Systems. (cont.) . Yes No z El Static liquid level in the distribution box above outlet invert duce to an overloaded or clogged SAS or cesspool El z Liquid depth in cesspool is less than " below invert or available volume is less than 1/2 day flow 11 z Required pumping more than 4 times in the last year NOT due to clogged or obstructed p ip s). Number of times pumped: 11 z 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. 0 z 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 foot 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 coliforrn bacteria indicates absent and the presence of'ammonia nitrogen and nitrate nitrogen is equal to or leas than 5 ppm, provided that no Other failure criteria are triggered. rA copy of the analysis and chain of custody neat be attached to this form.] 0 z The system is a cesspool serving a facility with a design flow of 2000 gpd-- 1 g 000 gpd. z E The system few I have determined that one or more of the above failure cr iteria exist as described in 310 cG1 R 15.303, therefore the system fair. The system owner should contact the Board of health to determine what will be necessary to correct the failure. 5Large Systems: To be considered a lame 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`eyes" or"no" to each of the following, in addition to the questions in Section c.4. Yes No El El 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- IWP ) or a mapped Zone 11 of a public water supply well pp t n p.do •rev,71 /2018 Title;5 Official Inspection Form:Subsurface Sewage Disposal System "age 1 o?i Oft uomm ►nwea th of Massachusetts Tatle 5 Off'i'cimal Inspect*10n Fors _.- 1 Subsurface sewage Disposal System Form Not for Voluntary Assessments 962 TURNPIKE STREET Property Address A L FlOITTE Owner owner's Name information is NORTH A DOVE MA 01845, SEP TE �..._F 1 g, o2 required for every City/Town �....___n..._..____.__� _�.,_._,..� � "tat � Zip cc� e.. .�,.__ T_C� a Date f � Inspection D. System Information (cont. . Septic Tank (locate on site plan): 3 Depth below grade: feet__.. .._.... __ Material of construction: concrete El metal E] fiberglass El polyethylene other(explain) If tank is metal, list ages years Is age confirmed by a certificate of compliance? (attach a copy of certificate) `des No ' X ' 4' Dimensions.: - 11 Sludge depth: 3611 Distance from top of sludge to bottom of outlet too or baffle _ �... ___ if Scum thickness Distance from top of scum to top of outlet toe or baffle 12ti Distance from bottom of scum to bottom of outlet tee or baffle determined? �' .C.11: C�E.JCS How were dimensions dote TAPE MEASURE Comments on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leafage, etc.): RECOMMEND PUMPING OLDER SYSTEMS YEARLY CONCRETE E INLET AND OUTLET BAFFLES of TANK IN FAIR CONDITION LIQUID LEVLS Goo NO EVIDENCE OF LEAKAGE AGE t5insp,doc»rev.7/ /016 Title 5 Official Inspection Farm;Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts 14 "tie 5 u'ff"ici'al Ins-p- n For it _. Subsurface Sewage Disposal System Form Not for Voluntary Assessments "�� wA G 962 p 4 F TURNPIKE STREET Property Address Owner Owner's Name information is NORTH A,I DOVE A� 01845 SEPTE�MBE 1 , 202 required for every __.....p City/Town/Town State Zip code Date f In_ pace. Inspection D,, System Information (cont. 7. Grease Trap (locate on site plan): Depth below grade., f I ___ . .._­M_.___..___._..___...___...... ...an_ .. __.___ eet Materiel of construction: 0 concrete El metal fiberglass El polyethylene E] other(explain): Scum thickness Distance from top of scum to top of outlet tee or baffle _ .._.________________ _ W.__.. .v__ w._ _._________ 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: 0 concrete El metal fiberglass polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.d rc•rev.7/'26/2018 Title 5 Official Inspection Form.-Subsurface Sewage Disposal System•Page 11 of 1 <� kk uomm nwealth of Massachusetts ion For �y}"gyp '..':�m�."""".m'.M m."""».,'�.` ._,".�.,���.':...`"'y•[/"�+ TI'tle Offoicial � Inspecto' pie ............... ..r.....N�..._ I, r I> Subsurface Sewage Disposal System Form of for Voluntary Assessments 962 TURNPIKE STREET Property Address IAA L F I C TE ..__.._____ . ------ OwnerOwner's ..__._ __ _..w.__..___..___�_.._.. _..._ __..._..... ____.. .. information is _ _�_... _ _ _ _ ._ ___.. ._..._. TE E 1 , 2 CA B required i rod for every !�! A C I �f� 11�lA 01845 �� ._. e page. City/Town State ZipCode Cate of Inspection D. System Information (cont. . Tight or Holding Tarok(cent.) Alarm present: 0 Yes No Alarm level, M.... __ _ _ Alarm in warping order: 0 Yes [I No Date of last pumping: Date_� Comments (condition of alarm and float switches, etc.). Attach copy of current pumping contract(required). Is copy attached? El Yes E] No 9. Distribution Box(if present roust be opened) (locate on site plan): 11 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. - C X IS NOT LEVEL DISTRIBUTION IS NOT EQUAL NO EVIDENCE OF SOLIDS CARRYOVER EVIDENCE OF LEAKAGE D-BOX FLOODED t rinsp.doc•rear.712612018 "title 8 Official Inspection Farm:Subsurface Sewage Disposal System•Page 12 of 1 Commonwealth of Massachusetts mitle 5 Otticial Insvp%ect"ion For p f��0 Subsurface Sewage Disposal System For • Not for Voluntary Assessments 962 TURNPIKE STREET r Address operty PAIL f=IOITE OwnerOwner's._. information is NORTH ANDOVE MA 01845 SEPTA MBE 1 g, 202 required for every _.._ page C ity/Town State Zip Code Date of Inspection D. System Information (cont. 10. Pump Chamber(locate on site plan): Pumps in working order: El `des 0 No* Alarms in working order: 0 Yes 0 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 looted, explain why: Type: leeching pits number: leeching chambers number: leaching galleries number: leaching trenches numberr, length: 2' 50' LONG__ -- El leeching fields number, dimensions: overflow cesspool number: innovative/alternative system Type/name of technology: t in p.doc w rev. /26/2013 Title 5 official inspection Form:Subsurface Sewage Disposal System•Pace 13 of 18 Commonwealth of Massachusetts T'Itle 5 Off"icial Inspection Form Subsurface Se age Disposal System Form - of for Voluntary Assessments 92 TURNPIKE STREET ---------- Property Address PAUL FIT'E OwnerOwner's Name.._. _... ._.....a.._.. ...,......mw. ..w_..._._.__, _ ._ _..__...___ µ_.._.�_._.... _..... ......... .. ... __....._._w_ w_.m__.. __. ___. .�... _..._..................._...W_.._.µ.. __.. information is NORTH ANDOVER01845 SE TE ER 19, 2 26 required for every _am _.... _. _.. ..__...._...._�.._,.... ... ___,.. w..._ __.�._a._._�.. M ......._.....__.......... _.._.�_ ... m.._ _.......w.ww..... _......_...._._... _....._.,._.w_..__. page. City/Town State Zip Code Date of Inspection D. System Information (coat.) 11 S %l Absorption System (SAS) (cont.) Comments (note condition of soil, algae of hydraulic failure, level of p nd ng, damp soil, condition of vegetation, etc.): SOIL AND VEGETATION OK SIGN OF HYDRAULIC FAILURE NO EVIDENCE OF PONDING 12. Cesspools (cesspool must he pumped as part of inspection) (locate on site plan): Number and configuration .�. .�,........�...._.�..,._..__. .._ �._,.._�m._._..�.... ...__...._._..�. Depth —top of liquid to inlet invert __.._...._w. __------------ Depth of solids layer Depth f scum layer .....w..�w Dimensions of cesspool Materials of construction Indication of groundwater inflow D Yes 0 N Comments (note condition of soil, signs of hydraulic failure, level of p ndin , condition of vegetation, etc. t ins .d -rev,7/26/2018 Title Official inspection Fora:SUbsurface Sewage Disposai System.Page 14 of 1 Commonwealth of`Massachusetts .x r ionFor�nn Flo 5Official Inspect" tia Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' • ``4 962 TURNPIKE STREET Property Address PAU L FIONTE Owner Owner's Name information is NORTH ANDOVER MA 01845 SEPTEMBER 19, 2026 required for eery 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. Locale where public water supply enters the building, Check one of the boxes below; Z hand-sketch in the area below ❑ drawing attached separately VV5 . a � 55 RON • �D t5insp.doc•rev.7/26/2018 Title 5 Offlclal inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts ion Toltle Off'i*cial u Subsurface Sewage Disposal System Form Not for Voluntary Assessments :: w _962 TURNPIKE, STREET _...... � _. .... _ ___..._....._.._.�..w_�._._.._. ..... .w...._�.._.._._.___..��__._��_w._.________._.�__..__.... _. ....._..._......... _..._w._.w Property Address PAUL FI _...a......._ M.___..._. ....._. .._ ....__........_... ... . ...._.w. . _----- Owner Owner's is Marne information as NORTHANDOVER MA 5 SE E BER 9" 2 26 required for every .. _. page City/Town State Zip Code Gate of Inspection D. System Information (coat.) 15. SI* a Exam: Check Slope Surface water Z Check cellar [I Shallow wells Estimatede h to high rid water: feet..... . ............��.._.�...._._.... .�...�.��._. ._.._.�_� .�._.___�_�__�-�__.__.�..__._.___._..m.�...� Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record It checked, date of design plan reviewed Date..._ .. _........... _ ._.wm__.. _...v_..____- Observed site abutting property/observation hole within 150 feet of SAS) Checked l ed with local Board of Health -explain: O PLANS ON FILE El Checked with local excavators, installers (attach documentation) El Accessed USES database - explain: You must describe hove you established the high ground water elevation:: TEST PIT DATA WATER TABLE 2" BELOW LEACH LINES Before filling this Inspection Report, please see Report Completeness C eck Est on next page. t5in . oc•rear. 12 /201 'itle 5 Official InspectionForm:Subsurface Sewage Disposal csel System-Page 1 'cf 1 �2*111 � m weal of Massachusetts a T t I e 5 ion utticiai ins,pecto Form d Form - Not for Voluntary ntar Assessments Subsurface Sewage Dilssal System A , 962 TURNPIKE STREET - ...____ _....v_..___...__ ..µ........_..._.. .w............._.. _._....._._.....__._._ .. _ ....w._..- __...____w._..........._.. .........._......_._._........_ __..._._....._.w... _. ..�._a...__ _......_.........w_ .___._.... _ Property Address FAA L FI TE Owner Owner's Name required for every page. City/Town State Zip code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclus va , inspector information: Complete all fields In this section.. B. Certification: Signed & bated and 1, 21 3, or 4 checked C. Inspection Summ lry- 1, 2, 3, or 5 completed as appropriate 4 'allure Criteria) and (Checklist)list completed D, System Information: For : Tight/Molding 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 t In . c•rear.7/2612018 "title 5 Official Inspection Earn:Subsurface Sewage Disposal sal System•Page 18 of 1