7 Certificate of Compliance 2017 Commonwealth of Massachusetts
rCity/Town of
Certificate of Compliance
.' Fee. Form 3
DEP has provided this form for use by local Boards of Health. Other forms may be used. but the
information must be substantially the same as that provided here. Before using this form, check with
the local Board of Health to determine the form they use.
This is to Certify that the following work on an On-Site Sewage Disposal System
Important:When
filling out forms ❑ Construction of a new system
on the computer, ET Repair or replacement of an existing system
use only the tab 0 Repair or replacement of an existing system component
key to move your
cursor•do not
use the return Has been done in/accordance with Title 5 and the Disposal System Co tructio Permit(DSCP)
key – ;2t//7-/6 -7./'7 l
/ 7.
Jw , DSCP Number DSCP Cate
Ez.c1L.__ _IreCO.h.n^el
armFacility Owner ► r^V-�' \
X qok-i.)
Street Address or Lot Nn ,( // {�
Le•e 5 (4•03 "Z'' VI .
city/Town — State Zip Code
Designer Information:
Ala E Weiss, RS Cold Sp ing Environmental Consultants. Inc.
Na Namegl10any
46 S n re Date
I r at.
1_Gc__ l',7c(iuJ
Name o pryny
1 S c I w 1�,
Signature Date
Use of this system is conditioned on compliance with the provisions set forth below:
It is recommendedthat you pump tank every two years.
AppAitiwa
The issuance of this certificate shall not be construed as a guarantee that the system will unction as
desigkilr./.4/30hei
/44.
7 /I
ApprovinAuthor y f i // giV)
g
Signature � Date
NORTHAMPTON BOARD OF HEALTH
t5form3 doc•06/03 Certificate of Compliance•Page 1 of 1
212 MAIN STREET
NORTHAMPTON, MA 01060
NORTHAMPTON BOARD OF HEALTH
212 MAIN STREET
NORTHAMPTON, MA 01060
LES
P PERC HOLE LOCATION, NUMBER
TP-1TEST HOLE LOCATION, NUMBER
ESTIMATED WATER UNE
-E- ELECTRIC MARES /
,...---6� EXISTING CONTOUR / I
--8Q- PROPOSED CONTOUR J /
',41_, WELL LOCATION31k-
/
// / $1 \9
/ / / 3 \ \
/ / \' \ \ XISTING LEACH
/ , /� \ \ \TRENCHES
i J! \ \ \
/ / , \
v
/ / 1'5 --',�\ \
__ :1 • it ,t EW LEACH FIELD:
\ , 14 W X45'L
1 l^ 11..t.714:2.'i' 1`
1 '7 4I6 �;t i' \1
i yT / _ 1
i - I I II 4 i,I 1 ; 'B.PORTI
• Y i 1, i\ , 14 JI I I y "
1
L____-_, UMP&REPLACE WITH
I :PA=1 J,,. NEW 1500 GAL.SEPTIC TANK
Z SILL €
100 I
•
AS BUILT
0.0NG 08.10.2017 1
\140--' M:15,L:22.01
SCALE: 1"=30' 1
NOTE-0 HOMEOWNER AND CONTRACTOR: f 3.18 AC+/-
CONNECTIONS FROM HEATING SYSTEM,AIRCONDITIONERS, (/
SUMP PUMPS,WATER WELL FILTRATION UNITS AND HEAT PUMPS
\
ARE NOT ALLOWED,SANITARY WATER CONNECTIONS ONLY PERMITTED. /
\ NOT AN ACTUAL SURVEY!!
LINES DRAWN FOR SEPTIC I
sisoo \ / LOCATION PUROPSES ONLY' I
/ SCALE
1
IN FEET
GRAVITY SLOPE SEPTIC SYSTEM OPERATION Ay, 0' 30' 60' 90'
MAINTENANCE NOTES FOR HOMEOWNER. m
.--1.)HAVE TANK PUMPED EVERY 2 YEARS.PUMP& 14t IBER CHECKED ANNUALLY. \ '
2.)AiTIN.T IN AREA OVER SEPTIC SYSTE!,S-GRASSY
OR SIMILAR 'ROUND-GAVER.----- \ I
3.)DO NOT PLANT ANY TREES OR DEEP ROOTING
SHRUBS WITHIN 10 FEET OF SYSTEM. \
4.)USE ONLY LIQUID DETERGENTS&LOW FLOW WASHERS,
5.)WIPE ALL OIL AND GREASE FROM COOKWARE AND DISPOSE IN TRASH
NOT SEPTIC. \
6)All Toilets and Faucets must be confirmed to not be leaking,because one leaking .
APPfiViraurz