HomeMy WebLinkAboutMiscellaneous - 136 STONECLEAVE ROAD 4/30/2018 (2) L 136 STONECLEAVE ROAD Pad `
T 2101104.8-0125-0000.0 i
t NORTH aN`MTM. BOARD OF HF.,ALTH
I 5T.4LLATION CIT33K LIST _
APPROVID DISAPPROVED E CCAVATION OK
Date: Date:
Reason:.
s Built Submitted
Check: Lot location, dimensions. of system, location in regard to
percolation tests, depth of system, crater table
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2. Distance to Wetland Areas, Drams, Street & House, Drainage Easement an Wells.
3. Water LineL ation
4. No VC Pipe
5: Septic T - Tees, Cement-Pipe to Tank-Joints on both side of Tank.
6. Distribution Box - No kks box or cover. Cl�l line3'' flotir eruallsy from box.
7. Leach 'elds - Dimensions, Stone Depths, Capped ends, Clean double-gashed stone
1
8. Leach Pits - Dimensions, Depth of Stone, Splash pad4 tees, Cement-pipe to tank-
joints on both sides of tank_, Clean double-imshed stone
9. No
�rxg
e Disposals +
10. Final ading ;barricading of sub-surface system
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TOWN OF NORTH ANDCWSP,,
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(j/ �� SYSTFM PUMPING RECOKL
,SYSTEM OWN4R& ADDRESS SYSTEM LOCATION
,36 5*,,,L,e&,,6 Az� 0, rlll'f(L /faL)
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DATE OF Pt1MpjNQ; 6 _QUANTITY PUMFE
5opuc Tank: NU. y�
NA rVKE ON SBAvtCE: Kou'fiNe. _
RECEIVE[
UbSbA V A'nom:
OOOD CONDITION PULL 'rU (`ovbR JUN 0 3 2005
I,wvy 011LIWE _ BAPP ES IN PLACE.
Rom LIACMUD WNBACK TOWN OF NORTH ANDOVER
OXCIS381Y6 SOLJOS _. FLOODED HEALTH DEPARTMENT
-SOLID CARRYQYER OTHER EXPLAIN -
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VUMMENTS.
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