HomeMy WebLinkAboutMiscellaneous - 115 SHERWOOD DRIVE 4/30/2018 (7) Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
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115 Sherwood Drive
Owner North Andover, MA 01845
information is George E. Canellakis
required for 4/26/2011
every page. State Zip Code Date of Inspection
D. System Information
Description:
U77441 .ta x
r moles .,-5-
Number of current residents:
Does residence have a garbage grinder? �j(!�T � �1 'D� Yes ❑ No
Is laundry on a separate sewage system?[if yes separate inspection required] Yes No
Laundry system inspected? ❑ Yes No
Seasonal use? ❑ Yes No
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
Sump pump? ❑ Yes �Z No
Last date of occupancy: Cy� 'yT
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present?
❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17