HomeMy WebLinkAboutMiscellaneous - 1423 SALEM STREET 4/30/2018 (44) Fk
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Commonwealth of Massachusetts
' u W Title 5 Official Inspection Form
" Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
1423Salem Street _
Property Address
Courtney Scruggs
Owner Owner's Name
information is North Andover MA 01845 May 1, 2017
required for
every page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
i
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17