HomeMy WebLinkAboutMiscellaneous - 1423 SALEM STREET 4/30/2018 (43) • Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 1423 Salem Street
Property Address
Courtney Scruggs —
Owner Owner's Name
information is
required for North Andover MA 01845 May 1, 2017
every page. City[Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope j®>
® Surface water 1,���'� � A
® Check cellar Dry
® Shallow wells B�l�
2.5'to 4'
Estimated depth to high ground water: feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
09/19/02
If checked, date of design plan reviewed: Date
Observed site(abutting property/observation erty/observation hole within 150 feet of SAS)
. ® ( 9P P
® Checked with local Board of Health -explain:
Permit proposed and asbuilt on file.
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation.
Test hole# 1 showed ESHGW at 47". Test hole#2 showed ESHGW at 47". Test hole#3 showed
ESHGW at 31". Test hold#4 showed ESHGW at 30" and Test hole#5 showed ESHGW at 48". The
basement is 5' below grade of SAS
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
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