HomeMy WebLinkAboutTitle V Inspection Report - 951 FOREST STREET 6/5/2017 Commonwealth of Massachusetts
MTitle 5 Official Inspection ° 1
Subsurface Sewage Disposal System Form Not for Voluntary Assessment
951 Forest Street __.-...-.-- '' "
Property Address -— ----- ,
Kevin Patterson
Owner
._...-._-..._.—
Owner's Name
information is
required for every North Andover Ma 01845 5-10-17
page. City/Town State Zip Code Date of Inspection
B. Certification (corn.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below,
Comments: K
Distribution box was replaced
B) 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):
I
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t5ins.doc-rev.6116 Title 5 official inspection Form:Subsurface Sewage Disposal System•Page 2 of 17