HomeMy WebLinkAboutMiscellaneous - 120 LACONIA CIRCLE 4/30/2018 (11) M
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
'5 120 Laconia Circle
Property Address
Karen Crawford
Owner Owner's Name
information is North Andover MA 01845 August 2 2013
required for every g ,
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
0"
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D-box approximately 6' below grade. Unidentified cast or ductile iron pipe, 10" dia. over d-box
approx. 12" below grade (contractors be advised this could be a pressurized pipe). D-box camera
inspected, liquid level with outlets. D-box must be replaced to bring access within 9"of finish grade
per North Andover Regulations.
Pump Cha r(locate on site plan):
Pumps in working orde . ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, c ition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption p System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
SAS location confirmed based on d-box location and record certified foundation plan
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