33 Appleby Road (002) CITY OF SALEM, N/L-1SSACHUSEITS
ti 'BOARD oi�.Hi,'A];]'H,
98 WASH ING I ONS'IRk'E"t',31zi)Fj,OOR PublicHeakh
Prevett,Piomutd.Protect.
Tr_:i_ (978)741-1800
KRMBERLEY DRISCOLL health;i_rsalemxom
LARRY RAIMD IN,RS'/REHS,CHO,Cl'-PS
M AYOR 111,"ALTI-1 A(ANT
Application for Disposal System Installers Permit
Fee: $10.00
(check or money order payableto City of Salem-NO CASH)
In accordance with the provisions of 3 1 O.CMR 15.00 and the Salem Board of Health regulations,an application for a
Disposal Works Installers permit is hereby submitted:
Name of Applicant:
7?'
(print name of applicant)
Address: 11&c7 e--- 11L_64 40/0-kY2
(print address of applicant)
'AP 6,b
Telephone: Email 0VC4LZ_C'0
Business Name:—
Business Address(if different from applicant):
I certify under penalties of perjury that,to the best of my knowledge and belief, I have filed all state tax returns and
have paid all stat-4,xes re
Signature: Date:
;T I
For Official Use Only
Amount Received: $ Received By: V-k
Approved By: Permit
;F F 901 4 I-P— PIS!P
1685
71he Commonwealth of Massachusetts
Town of Boxford
Board of Health
Number 18- 2 Fee $100.00
This is to Certify that the Board of Health has this day granted a Disposal Works Installer's
Permit to:
Jonathan Granz
Deng business at: Preventative Septic Services
240 Asbury Street
South Hamilton, MA 0 982
TO CONSTRUCT,ALTER,INSTALL ALL or REPAIR
Individual Sewage Disposal Systems
This permit Is issued in conformity with.the State Environmental Code Title'V,
Regulation 2.2,and expires December 31,2018,Mess sooner revoked.
Permit No. 18-32
Issued: March 01,201E
-4w
Kend l L.Longo
Director of Public Hea
Town of Boxford
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THE COMMONWEALTH OF MASSACHUSETTS> xrY
HAMILTON BOARD OF HEALTH
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Permit M IP27-18 FEE: $150.00
TOWN OF HAMILTON
SEPTIC INSTALLER PERMIT
Jonathan Granz
DBA Preventative Septic Services
240 Asbury Street
S. Hamilton, MA 01982
IS HEREBY GRANTED A"DISPOSAL WORKS INSTALLERS PERMIT' TO CONSTRUCT,
ALTER, INSTALL OR REPAIR
Distribution Boxes and Pipes for Septic Systems only
This permit is granted in conformity with the State Code Title V, Regulation 2.2, and expires
December 31, 2018 unless sooner suspended or revoked.
DATE: �
Leslie Whelan, Health Agent
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�?t3 �'ikShtlf*C7Tf)4 511t1ili.'!',3 ]1,�?� t PublIcHealth
'J HL.(978)741-19N) Pf"aai.Premere.Pro"M
health@salcim.com
KI-MBERLEY DRISCOLL LARRY R:1MUIN,R.Othl lS,010.Ci'-K;
MAYOR ark..lraliAcTIM
Name: TO&6TA&LI Phone#: OM- W 41-Qoa
Address: B C& f E I"- gee 0?7V- f4, ci(,MAM HA C 0ez Aag
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Examination for License for Septic Work in Salem.
ZI. As you begin the job,you notice that sometIh:ing noted on the plan is not correct, or you
have a question. You.would: (picktwO)
0 Contact the engineer and health agent immediately.
b. You put in the calls to the engineer and health agent, but cannot reach them, so you
begin the job and Nvait for them to call you back.
You stop the work until you can speak.with engineer and health agent.
d. You call the DEP for an answer.
V ' r t
. The slope of the distribution lanes in the beds and fields must be: (f�etg�rfaa )
.00.E
b. .050
c. .0005
d. .50
3. Septic tanks may not be constructed of the following materials:
a. Poured-in-place concrete
b. Precast reinforced concrete
c. Fiberglass
Metal
e. Polyethylene
.� Other materials as approved in writing by the DEP.
4M a septic tank the inlet pipe elevation shall. be no less than 2 inches or more than 3 inches
above the invert elevation of the outlet pi0e.
b�e
. false
i
15. When a sewer system becomes available, `y person owning a tight tank shall connect to
the sewer within 30 days and the tight tank shall be properly abandoned.
true
b. false
6. A system is not considered failing if the static liquid level of the distribution box is above
the level of the outlet invert.
a. true
. false.
7. The top of all system components shall be installed no less than 48 inches below the finished
grade.
a. truer
. fais e
Z8. The minimum distance required between a leaching facility and a private well is:
a. 25 ft.
b. 50 ft.
c. 75 ft.
. 100 ft
9. A minimum of how much crushed stone is required beneath a septic tank?
a. Inches
b. 4 inches
inc�e
d. 8 inches
10. When garbage grinders are installed the leaching area must be increased by:
a. 10% b. 15% c. 25%
/11. Alarms provided in the pump systems can be, connected to the same circuit used for pump(s).
a. true
�
o washed stone or replacement sand may contribute to the
/12. Excess amount of fines n r p y ,
premature failure of a septic system.
a
b. false
I
/13. Outlet pipes from the D-box are not require to be level the first two feet.
a. trifle
. false
it
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i
Z14When a system has been pumped the local Board of Health is required to receive a copy
of the pumping record.
tru Ll
2. false
115. If a septic system or cesspool requires pumping more than 4 times a year the system is
considered failing.
tru'
b. false
/16. Regarding setback distances, pick the one in6orirect distance.
a. from property line to septic tank is 10 feet
b. from bordering vegetative wetland to soil absorption system is 50 feet
from cellar wall to septic tank is 50 feet
d. from.a surface water supply(reservoir)t6 the septic tanks of SAS is 400 feet.
i
17. The building sewer shall be sufficient to serve the connected fixtures. In no case
shall the building sewer be less than four inches in diameter.
true
/b. false
18. Beds and fields can have how many distribution lines?
minimum number of distribution lines is two
b. one
19. (6 pts.)
A plan provides a benchmark of 89.92 and u get a rod reading on the benchmark of
1.2 feet above the benchmark. Using the height of the level, what would your rod
reading have to be if the plan shows the bedi bottom elevation to be 84.20? 95.'40
20. (4 pts.)
When constructing in fill, the floe of the slope shall be a minimum of 5 c feet
from any adjacent property line or Swale or other drainage system directing
runoff away from the adjacent property;shall be installed. Adjustments to the above
side slopes may be allowed if a suitable xmPxAvroos aom e► . is installed to
mitigate potential sewage breakout.
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Bf?AliE7 OF T11�,�3.7`[f
TEL.('M)741-I WN)1=:X. )7AS 745-03d3 �rrt� t�
Iramdinr)salexri.com
KIMBERLEY DRISC OLL
MAYOR L1llIZ1 R1�t3?T?�.T3�,fT:I-rw,r"TI��.ra-1
Questionnaire for contractor repairing a distribution box
On title V subsurface disposal systems:
The following information and questions are far conttactors asking to do distribution box repairs on
Title V subsurface disposal systems:
The State Environmental Code Title V: Minimum Requirements for the Subsurface Disposal of
Sanitary Sewage, 310 CMR 15.232 "Distribution Boxes", state the following:
(Please f ffin the blankspaces with the correct answer.
1) For all gravity flow distribution systems, a water tight distribution box designed to equal
distribution of septic tank effluent to the distribution lines of the soil absorption system shall
be provided between the septic tank and the soil absorption system.
t 2) The minimum inside dimension of the distribution box, regardless of material, shall be
inches.
[' The minimum wall thickness for reinforced ccrcrete shall be A" - inches.
/3) 'Ibe distribution box shall conform to the following design specifications:
a) Wien the soil absorption system into be dosed or the slope of the inlet pipe exceeds
0.08_ F�per Fo# , an inlet tee, baffle or splash plate extending to
Q g inch(es) above the outlet invert elevation shall be provided to dissipate the
velocity of the effluent.
b) The invert elevation of all. outlets snail be equal to each other and located at least
" inches below the invert elevation of the inlet. The distribution lines leading
from the distribution box shall all have the same invert elevation as determined by
flooding the distribution box to the height of the distribution line invert after all lines
have been scaled in place. If all inverts are not the same elevation, they shall be
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ii
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adjusted by filling with durable and nod'deformable material permanently fastened to
the line or reconstruction the lines until 411 inverts are the same elevation.
i
V/c Outlet distribution lines shall be level fb'r a minimum of the first �, feet of their
length. There shall be at least one outlet for each effluent distribution line.
d) Every distribution box shall have watertight cover or in the case of systems with a
design flow greater then 2,000 gpd,watertight manhole with cover.
/- e) livery distribution box shall have a minimum sump of � inches as measured
below the outlet invert elevation.
��/4) 31.0 CNfR 15.221, general construction requirlments for at system components states...
distribution boxes shall be constructed or set level and true to grade on a level stable base
which has been mechanically compacted.- If the component is placed in fill, proper
compaction is required to ensure stability-and rt'o prevent settling; native ground with a
inch stone base if otherwise ad1, quate.
The top of all system components including the septic tank, distribution box or dosing
chamber and soil absorption system shall ibe installed no more than 3 6" inches below
finish grade, Where site restrictions prevent compliance with this provision, a variance may
be sought.
Name: (pri 'go Date: `? 4
is
Name: (signature) az�� I
tz
f ,
Score: out of 10
Notes: