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OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1423 Salem Street
North Andover,MA 01845
Owner's Name: Arnab&Kimberly Chakravarti
Date of Inspection: 10-29-2007
SITE EXAM
Slope
Surface water
Check cellar x
Shallow wells
Estimated depth to ground water 30"from original grade.
Please indicate(check)all methods used to determine the high ground water elevation:
x Obtained from system design plans on record-If checked,date of design plan reviewed:
x_ Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Dug hole with auger in low drop off area and reviewed design soils on 11-21-2001