PERMITTED SEPTIC SYSTEM INSTALLERS Commonwealth of Massachusetts
r o City of Salem
Board of Health Kimberley Driscoll
120 Washington Street,4th Floor Mayor
SALEM,M�t 01970
SEPTIC INSTALLER PERMIT
DATE.PRINTED: 04/19/2012
ESTABLISHMENT NAME: Wind River Environmental, LLC
File Number:BHF-2002-000007 - 577 MainStreet Suite 110
Hudson MA 01749
LOCATED AT:
SALEM, MA 01970
PermifType Permit No. Permitlssued Permi:Expires Fee Restrictions/Notes
SEPTIC INSTALLER eHP-2012-0434 Apr 19,2012 Dec 31',2012 $10.00
Total Feesi: $10.00
PERMIT EXPIRES IDecember 31,2012
Board of Health
Page 1
s CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
KIMBERLEY DRISCOLL TEL. (978)741-1800
MAYOR FAx(978) 745-0343
lxamdin o salem.com
LARRY RAMDIN,RS/REHS,CHO,CP-FS
HEALTH AGENT
APPLICATION FOR DISPOSAL SYSTEM INSTALLERS PERMIT Fee: $10.00
In accordance with the provisions of 310.CMR 15.00 and the Salem Board of Health regulations an application for a
Disposal Works Installers permit in hereby submitted:
Name of Applicant::_ GQ� CO
(Print name of Applicant)
Address: b e-jAcm .AV e, MA
Print Address of applicant
Telephone: i—ms- �Sg- 7316 E-Mail• JGQ11cAW(tf)gjf )tlMCY)�Qj .00VYl
Business Name:
Address if Different from applicant: MG I Y1 S � H U U 50Y1 iAA
I certify under penalties of Perjury, that I to the best of my knowledge and belief have filed all state tax returns and
have paid all state taxes required by law
Signature:
For official Use only
Amount Received: Received by:
Approved By : Permit# :
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2-99 THE COMMONWEALTH OF MASSACHUSETTS
;a Cit Salem
.This is to Certify that el MichaCo111ns
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IS HEREBY GRANTkED A,LICENSE
Foi' _- Title. 5 Installer Permit
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CITY OF SALEM HEALTH DEPARTMENT
t 5 Nine North Street f\,r//
-� Salem,Massachusetts 01970
Examination for Installer's Permit
S 1. Before beginning an installation of a septic system you must: (Circle as many answers that would
apply)
Speak with the Health Agent about your planned starting date, and arrange for
predicted inspections.
B. Call and leave a message that you are starting right away and begin the work without
making actual contact with the Health Agent
C. Start the work and then contact the Health Agent.
D. Check the availability of double washed stone.
Check the predicted weather forecasts.
Be sure you have a plan signed by the Board of Health.
Have a copy of the Work Construction Permit in your possesion.
Notify the Engineer that you wilt be requiring elevations to be shot for an As Built.
I heck the availabilty of all supplies:
II
2 2. As you begin the job, you notice that something noted on the plan is not correct, or you have a
q question. You would:
Contact the Engineer and Health Agent immediately.
You put in the calls to the Engineer and Health Agent, but can not reach them, so you
ji begin the job and wait for them to call you back.
i Q You stop the work until you can speak with the Engineer and Health Agent.
j{ D.You call DEP for an answer.
2 3. You begin the work and find that the water table is higher than what is noted on the plan. ,
A. You decide to pump the water and continue on.
&You call the Health`Agent and the Engineer.
I! C. You continue on with the job, your not the Engineer, you just install.
I
14.You.notice that on the plan it stated that the Engineer must stake out the field and this has not been
completed. You'would :
Contact the Engineerb'eforestarting the work.
'B Decide to stake it out,yo,urself.
C. Let the builder stake it out.
D.-just take a guess and start the work.
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r CITY OF SALEM HEALTH DEPARTMENT Y. x
Nine North Street
Salem,Massachusetts 01970
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5. Title V Regulations call for the system to be:
A. 1 00' from the pond, river, wetland, drainage ditch or other watercourse.
B. 50' from the pond, river, wetland, drainage ditch or other watercourse.
C Minimum septic tank for new construction of 1,500 gallons.
Minimum septic tank for new construction of 2,000 gallons.
ff)lnspected
a minimum of two times throughout the installation.
Constructed with either SDR 35 or Schedule 40 PVC.
Sealed at the inlet and outlet of the tank with hydraulic cement.
H. Sealed at the inlet and outlet of the tank with any type of cement.
(V Resting on a minimum of 6" of double washed stone
Resting on a minimum of 12" of washed stone.
4 6. In Salem, an.subsurface sewage disposal system that has not been used for (0 5
years is considered abandoned.
7. When installing the system, you notice a well on the property or the neighbors property, and it is not
noted on the plans, you must :
X: Contact-the Engineer
0. Contact the Engineer and Health Agent
C. Mark it off and continue on with the work.
�l Discontinue the work until contact with the Agent and Engineer is completed.
O S. Beds and fields can have how many distribution lines?
Minimum number of distribution lines is 2.
One
C. Three
�- 9.The maximum length of the beds or fields can be
A. 50feet
100 feet
C.35.feet
2-10. The slope of the distribution lines, in beds and fields must be
&.005
6
B. .050
C. .0005
D. .500 /�
CITY OF SALEM HEALTH DEPARTMENT \
Nine North Street
F Salem,Massachusetts 01970
r'1
11. The maximum distance between lines in beds and fields is
A. 3 feet
B. 5 feet
P 6 feet
D. 9 feet
'y 12. The seperation distance between the lines and the edge of the bed should be a maximum of
A. 2 feet
B. 10 feet
U4 feet
D. 6 feet
!y 13. The seperation distance between the lines and adjacent beds/fields is
A. 5 feet
10 feet
C. 2 feet
214. The maximum len of�renches should be 200 feet
True False
')-15. The width of the trench should be a maximum of 4 feet and a minimum of 2 feet.
Tru_ False
<16.The effected leaching area shall be calculated using the bottom area and maximum of two feet (per
side) of side wall are r each TRENCH.
True -t als
,17.In Title V the design rate for a residential dwelling shall be at least
A:,150 gallons per day
gallons per bedroom
11 allons per day
f
),18. Installing a system in frozen ground is allowable in Salem ?
A. True alse
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CITY OF-SALEM HEALTH DEPARTMENT
Nine North Street,
R.
— Salem,Massachusetts 01970
19. When installing a system in the winter months, frozen ground can be placed over the system ?
A. TrueFalse
1 220. When receiving stone, it is necessary to examine the stone to be sure it is double washed, rather
s than just accepting the fact that the driver and company told you it was double washed.
True False
2
21. If the inlet to the septic tank is 95.65 what would the outlet be ?
22. If the inlet to the D box is 92.90 what would the outlet be ?. 9 2 , 9 0
2 23. If ground water was estimated at 86.5,what would the minimum bottom of the bed elevation be?
9 O• �
2- 24. If the plan shows top and subsoil at 3�"p and you began to remove it and find it is really 52" in some
areas, what do you do? e, o, e uJ-{� c a��, yu. ��2 a
Z 25. A septic leaching-area must be.L feet from the border of the next property.
a 26. Aseptic tank must be jO feet from the foundation.
)-27. A septic tank must be 25 feet from foundation drain.
28. A septic leaching area must be ZO feet from the foundation.
229. Gas baffles should be placed in the outlet tee of the septic tank.
rue False
,?2 30. The baffles of the septic tank must be-added inmost tanks, how much room do they require
betweeen the top of the baffle and the cover, to operate properly?
02' BA' C. 6' D. 1011
E. It,depends on the tank
F. It depends on the baffle
G. It doffs r1 t atter.
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CITY.OF:SALEM.HEALTH DEPARTMENT
° Nine North Street
Salam,Massachusett9 01970
f�
f Z 31. Septic tanks are. required to be
V.Poured in place concrete
Precast reinforced concrete
Fiberglass
Polyethylene
(� Other materials as approved in writing by DEP
F. Metal
Z 32. Vents are required on systems that are either whole or part under driveways, parking or turning
areas or other areas ofimperviousamateriaL The following is necessary to achieve`proper venting:
,OThe pipe should be raised to the atmosphere using the same diameter pipe as the
distribution system. ;
s B. It should be designed to prevent entrance of animals by placing a fence around it.
rv" C�The vent pipe should be located beyond the limit of the impervious area subject to
vehicular tra[ ic.
33. When constructing infill, the toe of the slope shall be a minimum of 5"'ifeet from any adjacent
property line, or swale or other drainage system directing runoff away from the adjacent property shall
t ' be installed. Ad'ustmentsto the above side slopes may be,allowed rf a suitable r C k
'
&1 1 7 7is installed to mitigate potential sewage breakout: u
Z 34. The sand used for fill must bepre approved by the:Health Agent.
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False
35. Explain the procedure.you useto shoot"your elevations to check the constructionof your work after
installation. Starting with shooting the benchmark
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