HomeMy WebLinkAboutPass - Title V Inspection Report - 55 TURTLE LANE 10/5/2026 Commonwealth of Massachusett°gys
ilcia ioln a 1� Inspect' Form
Totle 5, Offm
Jr.
y..................
Not for ry A
I Subsurface Sewage Disposal System Form Volunta ssessments
55 Turtle 11ane
Property Address
_—KrIstIft- V_eeney
Owner Owner's Name W Mn is north And�over M�A 0 184 5
required for every .......
page. City/Town State Zip Code Date of Inspection
Inspection results, must be submitted on this,form. Inspection forms may not be afteredi in any
way., Please see completeness checklist at the end of the form.
Important.:When A. Inspector Information
filling out forms
on,the c omputer, Steven Blackburn
use only the tab mm. ....................................... ......... -------
key to move your Name of Inspector
cursor-do not Sm Bled kburn
use the return .....-----
key. Company Name
31 mckinney d!r
Company Address,
Hud�son 03,0151
............... ...... ..........City/Tolwn State Zip Code
..........fit;J-,500,4______
Tellephione Number License Number
Bi. Certification
I certify that.- I am a DEP approved system Inspector in full compliance with Section, 15.314101 of Title 51
(310 CAR 15.0010); II have pers,on�ally 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 t,rain in�g and experience in the proper function
andl maintenance of on-site sewage disposal systems.After conductingi this iinspection 11, have determined
that the system.
1. basses
2. El C,oinditioinallyPasses
3. E Needs Further Evaluation by the Local Approving Authority
4. Fails
"000
101/51/26
..............................
Inspectors Signatu rly Date
The syste�m inspector shall submit a copy of this inspection report,to the Approving Authority,(Board
i
of Health or DE,P)wilthin 30 days, of completing this inspection. If the system has a desig�n fliow of
10,000 gpid or greater, the in�spe!ctoir and the system owner shall subm�it the report to the approlpr�iat,e
regional office olf'the D,EPI. The ori'g�inall form should be sent to the,system owner and copies sent to
4
the buyer I if applicable„ and the appr vingl authority.
P lease notes: This report ri�lly dIescribes,conditions at the time of inspection and under the
conditions of use at that time.Thpis inspection does, not address how the system will perform
in the future under the same or different conditions of'use,.
t5insp.doc-rev.,5/19/2026 Title 5 0,fficiai Inspection Form:Subsurface Sewag�e Disposal Systern-Page 1 of 18
.s
Commonwealth of Massachusetts
Title 5 O Form
Q Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
• 55 Turtle lane
Property Address Kristin Sweeney
Owner Owner's Name
information is
required for every North Andover ma 01845 � .
page. Cit crown State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 5.
1) System Passes:
[3 I have not found any information which indicates that any of the failure criteria described
in 310 C M R 15.303 or in 310 C M R 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.5/19/2026 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System.Page 2 of 18
w Commonwealth of Massachusetts,
rA rp� � �i c iInspectnion �
ii Subsurface dace Sewage Disposal System, Form Not for Voluntary ry Assessments
55 Turtle lane
Property Address
Kristin
.,..., , ,... .,...,.... .......... .......
Owner Owner's Name
information is NorthArai l r '�
5
required for ever
page., CitylTown State Zip Code Date of Inisp ction
C., Inspection SuImrmary (cont.)
211) System Conditionally Passes cone.
Pump Chl r h r pumps/alarms not operationall. System will pass with Board of Health rova,l i
pumps/alarms are repaired.
El Observation of s,ewage backup or break oluit or,hi ih static,water level in the distribution box dine
o broken or obstructed plipe(s) r due to r ken, salad or uneven distribution box. System w illl
ass, inspection if i h ,pupprol gal of Board of Health):
0 broken ipe(s)are r aced, EliI x slain below)-.,
El obstruction is removed Y x it in el
Ej distribution box is leveled r replaced) Y i slainbelow):
The system required purnpingmore than 4 times a year due to broken or obstructed I i s . The
system will pass inspection i (with approval of the Board of Health):
broken i are rlacd Y [ �
] N ND (Expilain 11
obstruction is removed Y El N (Explain, below):
):
3), Further Evaluation is Re,quiired by the Board of Health:
Co
u udi i� ns exist which r ire furtherevaluation by the Board HIea,l '� in order ermine if
the system, is failing to protect pubilic health, safety or the environment.
a. System will Puss unless Board of Health determines in accordance with 31
151.31013(11)1(b)thuat the system is not fuuructionling in amanner w is I will protect public health,
safety,and the environment.,
t5ins .d .rev.5/19/2026, gait.e 5 Of cial Inspection For-Subsurface S wage Disposal System.Page 3 Of 18
�w Commonwealth of Massachusetts
Tintle 5 QAmhfficial Inspecti"on For
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
55 Turtle lane
'"„w..�,..wi" M..........,w.....................,........... ..,,,..m...�........................
......
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..............,..,...,............�.,.,..,..,.,.....«,......,..,,.....:,...,,..,..,..,,.,...�.,.�, ....,.,...,_....
Property Address
Kristin Sweeney
Owner --------
vr,rrter .. ........_.. .........u..._..w....._..._._._
information is
mat North Andover /5/26
requiredfor even __H__._.-.__.... _.... _w................. _.....W__._ __.._....__w._w .. _......._.. _....M.M�. _.... .._..._.. _.. ._.._..�_.....�...
page. City own State Zap Code Date of Inspecti n
C. Inspection Summary (cont.)
Cesspool or privy is within 50 feet of a surface eater
Cesspool or priory is within 50 feet of a bordering vegetated wetland or a salt marsh
b. System will tail 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:,
E: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.
El The system has a Septic teak and SAS and the SAS is within a Zane 1 of a public water
supply.
El The System has a septic teak and SAS and the SAS is within 50 feet of a private water
supply well.
El 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 it the well water analysis, performed at a DEP certified laboratory, for fecal
coli orris bacteria indicates absent and the presence of,ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 pp , provided that no other failure criteria are triggered. A copy of the analysis rust
be attached to this form.
c. Oth r.-
4 System Failure criteria Applicable to All Systems
.-
You must indicate "Yes" or"No"o" to each of the following for allinspections,.,
Yes No
El El aul up of bew ge into faulity or by8tem c;o p rent due to overloaded or
clogged SAS or cesspool
1:1 El Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
tt~In p.doc.rev.5/19/ i Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 4 of 1
Commonwealth of Massachusetts,
.................
�cia P
TIT"Lle 5 O,tA"t""iml 0 1� Insi-iiiiiiiiii-ec'ion Form�
10 Subsurface,Sewage Disposal Syste�m Form Not for'Voluntary Assessments,
515 T'urtle Lan�e
Property Address
Kristin Slwee!n�ey
Owner Owner'.s�N�am.e ...........
information is North Andover Ma 10/5/261
required for every ........ 011845 ........ .........................
pagie�. City/Town State Zip Code Date of Inspection
C., Inspection Summary (con�t.)
is
4,)l System Failure Criteria Applicable to All Systems: (cont.)
Yes No
Static liquid level in the distribution box above outlet invert due to,an olverloaded
or clogged S,AS or cessplool
Liquid depth in cesspool is less,than 6"" below invert oir available volume is, less
E] IN than 1/2day flow
El 12 Required plumping moire thian 4 times in the I ast year NOT due!to clolgiged or
obistructed pipe(s)., Number of times pumped.
El [2 Any portion of the SAS, cesspolol�l or privy is below hiigh ground water elevation.
El 15� Any portion of cesspool or privy is,within 1010 feet of a, surface water supply or
tributaryto a surface water s,uppily.
Any portion of a cesspool or privy is within a Zone I of a plubilic water su�ppily
well.
El 50 Any port,ion of a ces,splooll or,privy is with�in 510 feet of a private water supply wel�l.,
E] 1� Any portion of a cesspool or privy is less than�, Il 00 feet but greater than 50,feet
from a private water su�piply well w�ith no acceptable water quality analysis. [This
system p�as,ses 'if the well water analysis, performed at a, DE,P certified
laboratory, for fecal' colliform, bacteria 'Indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than ,5 ppm�,i
p "ded that no other failure criteria are triggered. A copy of the analysi
rovi I is
and chain of custody must be attached to thlis,form.]
E] The system is a cessplooll serving a faci�lity with a designi flow of 2000 gpd-
10,00:0 gpd.
The system faI*Is. I have determined that one or more of the above failure
criteria exist as described in 31'0 CIVIR 15.31013, th�eref'ore the system fails. Th�e
system owner,should contact the Bloa�rd of Health to determine what will be
necessary to,correct the fai'lure.
5) Large Systems: To be considered a large systern the system must,serve,a facHifty with a
design flow of 11101,000 gpd to, 15,:000 gpd.,
For large systems,, you must indicate either"yes,"or"no"' to,each;of the following, in add�i�tion to the
questions in Section C.4.
Yes No
1:1 E] the systern is withini,400 feet of a surface drinking water supply
El D thile system is within 200 feet of a tributaryto a surface drinking water supip�ly
the system is located in a nitrogen sensitive area (Interim W'ellhead Protection
1:1 E] i
Area —IWPA)or a mapped Zone I I of a public water suippily wel�l
t5insp.doc-rev.5/19/20261 Title 5 Official Inspection Form-subsurface Sewage Disposal System-Page 5 of 18,
r
a commonwealth of Massachusetts
ttici"al Inswftect'
_. . aTitle
5 0"' ion Form
� ww
. Subsurface Sewage Disposal System Form Not for Voluntary Assessments
55 Turtle lane
� � �.._... _..,..�...�.»....._.........�m..�..�............w_w.w.�._.a.._..W._.a...._w,._.u.�.......,,......�......._....... ........._w..w_._.�..��.�._,....w_. .......�..._n_.mww._......m._.._.................��.. ... .._.....u,,....._._..�._____u_.. .__..._.w_._..... .._...w._...._�_..._w__..... .__...._._._._.W. _..w__.�........�.._.� _.......�.,......._...�
Property Address
Kristin stln Sweeney
_......_ .o.._. .._....._. _.M___.._.._..__.. ._ .....
Owner Owner .�_......_.__..____............ _._. .�..w�.�_.�._...,._._...�.�.._____.___.�......�.............�.w�__ w_�__....._w.o w�...._..�... .___....._____-__............�..__w...�....�w_......_._. ._._..�.._.�.......�..�..
er°s Name
information Is earth Andover01845
required for eve ..W ._.. _.... _� __.__......_ ..... 5/26
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 s significant
threat, or answered styes"to any question in Section CA above the large system has failed. The
owner or operator of any large system considered e significant threat under Section C.5 or failed
under Section CA shall upgrade the system in accordance with 313 CMR 15.304. The system owner
should contact the appropriate regional office of the Department.
6. You must nd'Icate `yes" or "no" for each of the following g for all lrrsp►ectl ns:
Yes No
N 1:1 Pumping information was provided by the owner„ occupant, or Board of Health
El [R Were any of the system components pumped out in the previous two weeps?
Has the system received normal flows in the previous two weep period?
Have large volumes of rater 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 asN/A)
Was the facility or dwelling inspected for signs of sewage back u
EN El Was the site inspected for signs of break out'
N 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?
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 care
Existing information. For crumple, 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 CR 15.302(5)]
t5lnsrp.d -rev,5/1 /026 Title 5 Oifficial Inspection Form.-subsurface Sewage Disposal System•Page 6 of 1
Commonwealth of Massachusetts
rA Title 5 Official Inspection Form
1>.
Subsurface Sewage Disposal Systm Form Not for Voluntary Assessments
55 Turtle Lane
Property Address
Kristin Sweeney
Owner Oner I s Name
i
w
nformation is
North Andover 10/5/26
required for every ....... 01845
pag�e. City/Town State Zip,Code Date of Inspection
D. S,ystemi, Information
1. Residential Flow Conditions::
Number of bedrooms (design).- Number of bedrooms (actual): 4
440
D ES I G N flow based on 310 Cl l 15.203 or exam pie 11:0 g pd x#of bed room s):
Description-.
4xl 1 0=440
Number of current residen:,ts,:
Doles, residence have a garbage grinder? E] Yes [2 No
Does residence have a water treatment unit? Ej Yes N No,
If yes, discharges to: .......... ...............
Is, laundry on a separate sewage system? (Include laundry system inspection El Yes, N o
information in this rep rt.)
Laundry system inspected? Yes No
Seasonal se El Yes Ej No,
atta � .-d
Water meter re�ad'ings,, if available (last 2 years usage (g1pd)): he
Detail:
Sump pump? Yes N o
Last date of occupancy- Current
Date
t5insp.doc-rev,5/19/2026 Title 5 Cora Inspection Form Subsurface Sewage Disposal System-gage 7 of 18
L;ommonwealth of Massachusetts
To
�
p� o t5 le Official Inspection
u _ a Subsurface Sewage Disposal System Form Not for Voluntary Assessments
55 Turtle Lane
_...._.._.,.M_.w_-_-------------
Property Address
lr s i we ..........._._,...,......_ .__._..._.
Owner Owner's Name
information i� A 5 26
� art rud��e�r
required u red for ale .-------w..�.____mm_ ..
...�.._._ _.........,__.._ .....�
page. City/Town State Zip Code Cute of Inspection
D. System Information (cont.)
2. Commercial/Industrial Flow Conditions:
Type of Establishment- ._w_.__.......,_....... .........
Design flaw(based our 310 C R 5.2 3)` Gallons
erry guy (gad)�_.w... ._.w._..�___ �w�_.....,......_w.._.
Basis of design flow (seats/persons/s .ft., etc.,).-
Grease trap present? El Yes Ej No
Water treatment unit present? El Yes N
Ifyes, discharges t _..�. _m._,. ..,....,�...�.w.._..µ...._......,w_w,_..... ..__�.M.M. .���..............._._..__�.�__._w _._w�__�,��.._._�___��_. ....__�_.��... ._.�. ..��...,n._..,._........,...._.,�...,......,., ., .._..
Industrial waste holding tank present? El Yes N
Non-sanitary waste discharged to the Title 5 system? El Yes E:] N o
Water meter readings, if available.-
Last date of occupancy/use- Date __...... ,..� _.._._..,. _�. ...µ...µ......,.,,.._,,.,.,._..�...._._�..... __
Other(describe below).-
3. Pumping Records,:
Source of information:
Was system pumped as part of theinspection? El Yes N o
Ifyes, volume um ed: _ a_.,_._..... µ,,.,., _.._.._._ _.._.............._._....... _�.�.._......,....._.._..�.._...._..,,_ __ _.._,.....�..,.
gallons
How was quantity pumped determined?
Reasonfor u m i ng: _..........,_ ........__w.www__ .._w._....._._.w.,.,.., ..._w._. _ ._ .....µ.... .,., __w_.._w._._ __ ........,_„mm_..,.
t5in p.doc.rev.all /026 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 8 of 18
loft
t;ommonwealth of Massachusetts
---lip Toltle 5 Offici ns a 0ion For
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
55 Turtle lane
Property Address
Kristin Sweeney
Owner Owner's Name
information is required for every North Andover ma
.......
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
E Septic tank, distribution box, soil absorption system
F Single cesspool
1:1 Overflow cesspool
E] 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
El Tight tank. Attach a copy of the DEP approval.
Other(describe):
Approximate age of all components, date installed (if known)and source of information".
2003
Were sewage odors detected when arriving at the site.? El Yes ER to
5. Building Sewer(locate on site plan):
Depth below grade:
feet
Material of construction:
E] cast iron ER40 PVC EJ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
t5insp.doc-rev.5/19/2026 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18
. Commonwealth of Massachusetts
k,p 1tticiaInspect"ion For
10 Subsurface Sewage Disposal System Form Not for voluntary Assessments
55 Turtle lane
Property Address
Kristin `weene
Owner owner's Name
information is
req u i red for every
page. City/Town State Zip Cede Date of Inspection
D. System Information (cont.)
6. Septic Tan (locate on site plan):
Depth below grade. _
feet
Material of construction-
[2
concrete El metal El fiberglass [:1 polyethylene other(explain)
If tank is metal, list age:
years
Is age confirmed by a certificate of compliance? (attach a copy of certificate) F� 'Yes n No
11x5x5
Dimensions.
1.51 feet
Mudge depth.
2.5 feet
Distance from top of Mudge to bottom of outlet tee or baffle - -- -- -------� -- - �- -- - -
Scum thickness
Distance from top of scum to top of outlet tee or bade - -
Distance from bottom of scum to bottom of outlet tee or bade1 nil
How were dimensions determined? sludg_pjud tape me sure
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Lot of trash in tank recommended to owner to pump
t5insp.doc.rev.5/19/2026 Title 5 Official Inspection Farm:Subsurface;Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
T I I
1 Insps ion Form
s1 Subsurface Sewage Disposal System Form! Not for Voluntary Assessments
55,Turtle la rile
.............
Property Address
--Kristin Sweeney ............
Owner Owner's Name
information is Noirth Andover Ma
required for ever y _4 _4 5........... 10/5/26
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
7'. Grease Trap (locate on site plail
Depth below grade.- feet
Material of construction:
El! concrete E] m eta,l fiberglass El polyethylene El other(explain):
Dimensions.-
Scum, thickness
Distance from top of scum to,to of outlet tee or baffle
Diis,tance from bottom of scum to blotto,m of outlet tee or baffle ...........
Date of last pumpling: Da.te
Comments on pu�mpling recommendations, inlet and outlet tee or baffle conditions, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
8. Tight or Holding Tank (tank must be plumped at time of'inspectionr ), (locate on site plan):
Depth below grade:
M' terial of construction
El concrete E] metal El fiberglass, El polyethylene other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons pier day
t5insp.doic-rev.5/191/2026 Title 5 Offidal Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18
r
Commonwealth of Massachusetts
'tie 5 u't"t'i"c'ial Inspect"ion For
rA T1
10 Subsurface Sewage Disposal System Farm Not for Voluntary Assessments
55 Turtle lane
Property Address
Kristin Sweeney
OwnerOwner's Name _ .�.�.____�... .____._.__M.m_. .. ....�_.. ..�..__._. __ ...w .._ .. _.�.. .. _.._. .
information is forth Andover ma 10/512
required for every ____ _ .�_ _. _____ ________._... _ _ -0-1-84 _. _
page. City/Town State Zip Cede [date of Inspection
D. System Information (cont.)
. Tight or Molding Tank(cont.)
Alarm present. El Yes F1 No
Alarm level _ ____.m____.__ _.__... _.. ._ Alarm in working order: El Yes F] No
Date of last pumping: Crate
Comments (condition of alarm and float switches, etc.)*
*Attach copy of current pumping contract(required). is copy attached? El Yes l to
g. Distribution Box(if present must be opened) (locate on site plan):
below outlet T
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.):
equalizers in D box due to force main
t5insp.dcc.rev,5/19/2026 Title 5 Official InspectJonForm:Subsurface Sewage Disposal System.Page 12 of 18
Commonwealth of Massachusetts
-j-icm I Inspecto u'"E""m ion For
Totle 5 0* 1 ia
1' Subsurface Sewage Disposal System Form Not for Voluntary Assessments
55 Turtle Lane
Property Address
—Kristin Sweeney
Owner Owner's Name
information is North Andover
required for every Ma -------
page. City/Town State Zip Code Datpe_Yll'n"s-pection
Di. System Information (cont.)
10. Pump Chamber(locate on site plan):
Pumps in working order: ER Yes El No*
Alarms, in working order: No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
pump chamber was buried and has tree on the corner of it
Pump Chamber in good condition and all floats and alarms work
If pumps or alarms are not in working order, system is a conditional pass.
11. Soil Absorptilon System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why.-
Type:
El leaching pits number:
[] leaching chambers number:
leaching galleries number-
f wry.---
leaching trenches number, length: -- _--__ _
leaching fields number, dimensions:
ED overflow cesspool number:
El innovative/alternative system
Type/name of technology:
t5insp.doc-rev.5/19/2026 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18
uommonwealth of Massachusetts
u ici"al Inspect"
T"tle 5 'ff" ion Form
a0 Subsurface Sewage Disposal System Form -Not for Voluntary Aswear ents
� ........ ... 55 Turtle leas
Property Address
Kristin Sweeney ... __
__-__��n_._.M.�._..�._.w ......_�._�.,�.... ...... w...�..... w. �...ww_.. _..__ .._.._......._w.........�_...,._.�......�....�..�._.....w___..._._.....� _�_____w_.w_�.._._.._�........�..�......... ..._........m___..._..�..�_�.��._�..�.__....._
Owner Owner's Name
information is North Andover
requiredfor every __........k._._..w__ .____w _. __u..m.a_ ............. _._.. _w ......___._.....w.._.........._......_...w._...w__..w.._...�..�...�. _._........
page. City/Town.._...........��.�..._�.�....�..mm....�._..._ State Zip Code Date of Inspection
D. System Information (coat.)
11. Soil Absorption System (SAS) coat.
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.)*
no signs offailur
no p ndir g
o vegetation over,growth
2. Cesspools (cesspool must he pumped as part of inspection) (locate on site plan)-
Number and configuration ��..�..�_......._.._....._._........__-�w.__-.._� _�_ _. __.w. ��...
Depth —top of liquid to inlet invert ..._
Depthof solids lyer .. .._w.__. ._. w_ __-_ ____mm__.....M.....�_w�w............._........�..
Depth of scum layer,
Dimensions of cesspool �� .__.. _ _.� .... ...�.�.�...�...........�..._.
Materials of construction __�__- _ _.__�.ww._.._ _._.._...M.._........_.. � �...._...�.w......
Indication of groundwater inflow El Yes El N
Comments (note condition of soil, signs of hydraulic failure, legal of pond ing, condition of vegetation,
etc.):
twin p.d -rev.51/19/2026 Title Oi i i l InspectJon Farm:Subsurface Sewage Disposal System•Page 14 of 1
AMA
.. ..
qr, 1711!� Tl*tle 5 u'ffi'cial Inspecti"onFor
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
�4
55 turtle large
.�- ._ ..�.._._.._..._..._ _.�......_.�.._�___��_....._....�.n.�...____M._w_..._____._.�.__-M. __.�_�_..___.a_�.__�._..__Mw_._.mv_µ_.nw�..wmmr......�.....� W.µ�.µ..w.w.ww.....w_w._......._� ._.._ _._.. ___. ..__ww..._ ... ._._...__ ....��...._.�..........w_....�...
Property,address
_.. t*stin—Sweeney....._.....__...wm. _ __ _.m_..a.__ _.. ..._. o...µ._o.o.... _ww_._ _ _w w._w_._......._..__.._.._...... . __....._........mn_....w.......
.� _..
Owner �ner°s Nears
information is Ma
required for every .......8
page. city/Town State Zip Code Cate of Inspection
D. System Information (coat.)
13. Priory(locate an siteplan):
Materials of construction: _a_......__..._.._. .__..... ..____ _W_. _..._.......
.....� _._ �.........__._.... _ �_ ._w.w__.....
Dimensions
Depthof s o�l i d s mm........... ......_w_........_._- ---------- ..__.w-.1.1 . -_......----._....----.._-......._._µ.....-....-.. .ww.-_. ..._....--_ .._ w._...._. __.........._M..._.._.
Comments (rote condition f sail, signs of hydraulics failure, level of ponding, condition vegetation,
etc.
t�i s .do -rear.5/19/2026 Title 5 official InspectionForm:Subsurface Sewage Disposal System•Page 15 of 1
t;ommon weal th of Massachusetts
T'tle 5 OT'T'I'c"ial Inspect'
X _f,
ion Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
55 Turtle lane
Property Address
Kristin Sweeney
Owner Owner's Name
information is North Andover
required for every —ma _10/5/26
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
14. Sketch Of Sewage Disposal System-
0
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.-
El hand-sketch in the area below
[54 drawing attached separately
t5insp.doc-rev.5/1912026 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18
w Commonwealth f Massachusetts
111
_w... °. _._....- T'ItleOff'icial For
In Subsurface Sewage Disposal System Form Not for Voluntary Assessments
M_
l
55 Turtle Lane
Property Address
Kristin Sweeney
Owner's...�.. .......w_....__w.. .a...._��---_-____._..___...
Owner Naas
information is North Andover ma
required for every --------------- ........ _5�_ .....wo6__..._. _..... _ ___.__. .m..........
page. Cite own State Zip code Date of Inspection
D. System Information (con�t.)
15. Site Exam:
Check Slope
Surface grater
EN Check cellar
Shallow wells
3011 11
Estimated depth to high r u rid grater; ...e�.......... _.w.__ _.._.. w- �._._.__..w.............w.__....__
fe
Please Indicate all methods used to determine the high ground water elevation:
Obtained from system design plans on record
0
If checked date of design In r�ri� re ,� 3..,_. W..._...ww__µ..__..._.__�__
Date
El Observed site (abutting pro e rty/obs,ervation hole within 150 feet of SAS)
Checked with local Board of Health explain:
El checked with local excavators, installers - (attach documentation)
Accessed USES,database --explain.-
mass mapper
You must describe hoer you established the high ground water elevation:
mound system
basement has sump pump
SOIL LOGS SHOW REDOX @3011
Before filing this Inspection Report, please see Report Completeness Checklist list on next page.
t in p.doc.rev.5/19/2026 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Fags 17 of 1
Commonwealth of Massachusetts
_ Ti ici'alForm
� l
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 55 Turtle lane
R,t 1V Y
Property Address
Kristin Sweeney
Owner Owner's Name
information is North Andover 01845
required for every j n/.r, 96 r
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
Complete all applicable sections of this form inclusive of:
E� 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
El 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.5/1912026 Title 5 Ofridal inspection Form:Subsurface Sewage Disposal System•Page 18 of 18