HomeMy WebLinkAboutMiscellaneous - 316 JOHNSON STREET 4/30/2018 (2) 316 JOHNSON STREET
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MAP # LOT #
PARCEL # STREET _• Q �lr _
CONSTRUCT I.ON__..APPROVAL
HAS PLAN REVIEW FEE BEEN PAID? h--3
YE5 NO
PLAN APPROVAL: DATE 7Z2Z APP. BY.-
DESIGNER:
Y._DESIGNER: I062C�P9C&- CNG. PLAN DATE:_
CONDITIONS
WATER SUPPLY: TOWN WELL
WELL PERMIT DRILLER._..._._._._.____...__._...___..........
_. __._._.._.... ....._.... .
WELL TESTS: CHEMICAL DATE APPROVED
ROVED..___.___.__
BACTERIA I DATE (IPPRUVED
BACTERIA II DATE APPROVED_.__._,.___.__
COMMENTS:
FORM U APPROVAL: APPROVAL TO ISSUE',____ YE) NO
DATE ISSUED BY
CONDITIONS:
FINAL APPROVAL: .
ALL PERMITS PAID YES NO
WELL CONSTRUCTION APPROVAL YES NO
SEPTIC SYSTEM CONSTRUCTION APPROVAL YES NO
OTHER YES NO
ANY VARIANCE NEEDED NO
FINAL BOARD OF HEALTH APPROVAL: DATE:.�I ��� ...DY: .AA . _
:a SEPT �QaLQZEM-JN51841,.8�UQN
ISTHE INSTALLER LICENSED? YES NO
TYPE. OF. CONSTRUCTION: z NEW REPAIR/
..NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW YES NO
CONDITIONS OF APPROVAL j YES NO
` s (FROM FORM U)
1• .� elf 't'( t ; i `''. •+ �, .. ... xi' } - '.. _
r "ISSUANCE OF `DWC ,PERMIT _ V ` YES NO
-1•
?' DWC" PERMIT' N0. INSTALLER: .' �JC��/
BEGIN INSPECTION YES 0:
,+ EXCAVATION .INSPECTION: : NEEDED:
! � 3 •fir_ ..`. . T • ./ ; (f •` \. \\ •' -
+PASSED y. . .� `. B '
4
-'..CONSTRUCTION INSPECTIONS NEEDED:
- t AS BUILT PLAN SATISFACTORY: YES: -
'1 �/ J.�
APPROVAL. TO BACKFILL. DATE BY
FINAL.GRADING APPROVAL: DATE ZlIZ41 J� BYE
DATE: g z7�3 BY_�Q
':• ` .FINAL CONSTRUCTION APPROVAL: •
Insurance Adjustment Service, Inc.
139 Billerica Road, Unit A-1
Chelmsford, MA 01824
(978) 256-3334
Fax (978) 256-3354
UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 3B
Date: June 26, 2008
TO: Board of Health/Building Inspector
RE: Insured: Eugene&Judith Reilly
Property Address: 316 Johnson St REC9}
No Andover MA 01845
JUN 3 o 2�0
Date of Loss: 5/30/2008 T®wN o�NORrN;°���'
HEA. , �,f w
Policy Number: 0006684293
Type of Loss: Automobile struch Insured's wood fence and rock wall.
File or Claim Number: 49162
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed$1,0100.00 or cause Mass. Gen. Laws, Chapter �A3 Section 6 to be applicable.
-
If any notice under Mass. Gen. Laws, Ch. 139, Sec. 38 is appropriate,please direct it to the attention of the
writer and include a reference to the captioned insured, locations,policy number, date of loss and claim or file
number.
Thank you for your cooperation.
Very Truly yours,
I
Tim Martino
Adjuster
Ext. 135
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AS BUILT PLAN
OF
SUBSURFACE DISPOSAL SYSTEM
LOCATED IN
H ORTH- AMDOVER) MASS .
AS PREPARED FOR_
�JARRENJ �, OGDEU ITL
DATE SEPT; 21, 19Q3
SCALE: 1 '`=20 -
-.. 6! =<�T"
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS.'
66 PARK STREET 0 ANDOVER, MASSACHUSETTS 01810 IN TEL. (6,*) 475-3555, 373.5721
Commonwealth of Massachusetts
NO ��� {��ldo IJ6y , Massachusetts
Y .
System Pumping Record
System Owner System Location
ne, I l� 31 j An5 Jv, S4-
Nv (�� , A,)d o ve(,
Date of Pumping: Quai City Pumped: l SO b gallons
Cesspool: No I.v Yes L..) Septic Tank: No Yes ltd
System Pumped by: tSereedert License#
Contents transferrred to : Greater Lawrence Sanitary District
Date: _ Inspector-
o,
3 ���9
JU//NSDN JT
AS-BUILT CHECK LIST
and
.FINAL INSPECTION
Proposed Elevations As-Built Elevation
House
ate/ 03
Tank IN
9,0
Tank OUT a ` - 76
D-box IN
D-box OUT
Trench Inverts
Line 1 „��C�-a�1 - "D•b� -8 7
Line 2
a49, 7
Line 3 G,,36 '49- y�
Line 4
Bottom of Exc.
Stone OK? y D-box checked? Pipes cemented?
pD�o� "Ole .
"D 6130
PLAN REVIEW CHECKLIST
ADDRESS ENGINEER
GENERAL
3 COPIES STAMP_ LOCUS NORTH ARROW SCALE
CONTOURS �� PROFILE t''� SECTION BENCHMARK 4---- SOIL &
PERC INFO__LZ ELEVATIONS t---" WETS. DISCLAIMER WELLS &
WETLANDS {/ f WATERSHED. DRIVEWAY (Eley) WATER LINE
FDN DRAIN ,/ SCH4 0 C/ TESTS CURRENT?
SEPTIC TANK
MIN 1500G. . 17 INVERT DROP c-' GARB. GRINDER (+200% EDF)
25' TO CELLAR otK MANHOLE TO GRADE ELEV GW OC
D-BOX
SIZE # LINES FIRST 2' LEVEL STATEMENT
INLET - OUTLET a� _ - 17 (2" OR . 17 FT) TEE REQ'D?/l/O
LEACHING
RESERVE AREA L,-" 4' FROM PRIMARY?DL 100' TO WETLANDS 2% SLOPE
100' TO WELLS •-� 35' TO FND & INTRCPTR DRAINS V�4' TO S.H.GWe�
325' TO SURFACE H2O SUPP -4-� 4' PERM. SOIL BELOW FACILITY_,c-�
MIN 12" COVER FILL?,/ (25' if above natural elev• e-i—oli-
below)
BREAKOUT MET?
TRENCHES
MIN 660 gpd� SLOPE (min . 005 or 611/1001 ) </ >3' COVER? - VENTV/2
SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) Ll IS RESERVE BETWEEN
TRENCHES?``W IN FILL?22 MUST BE 10' MIN. 4" PEA STONE?
BOT X LDNG7J + SIDE 40�¢ X LDNGZO = TOT f
(L x W x #) (G/ft 2) (DxLx2x#)
-D 157-19/UG 65- ?'G ";L-Tc/SND s 1Y2&e7:5 /9G G T.
7-6
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Town of North Andover, Massachusetts Form No.2
NORTH BOARD OF HEALTH
19
�:�•� ooc04 111-4
p
t i
• s
=--� DESIGN APPROVAL FOR
SAGMUSE��
SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant Test No.
Site Location
Reference Plans and Specs.
ENGINEER DESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
CHAIRMAN,BOARD OF HEALTH
Fee Site System Permit No.
i0 To/.vA;e 4)S
Town of North Andover, Massachusetts Form No.3
t NORTIy
BOARD OF HEALTH
• Q 4AlD I�1�Q
3? �a q,, .. •e OLU�' 19 �v
9
DISPOSAL WORKS CONSTRUCTION PERMIT
SSACHUSES
Applicant pq/ /OL-4:5-
NAME / ADDRESS c TELEPHONE
Site Location f�/V Sdi(l J7
: Permission is hereby granted to Construct ( ) or Repair HTY-1n Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. G d
-� CHAIRMAN,BOARD OF HEALTH
Fee �G D.W.C. No.
A&HILL `��
r' �a�iri�im»r�7 PACKAGE .L7
QUESTIONS?CALL 800-238-5355 TOLL FREE. - TRACKING NUMBER
q RECIPIENT'S COPY
;F� our Name)Please Print Your Phone Number(Very Important) To(Recipient's ame)Please int Recipients Phone Number(Very Important)
�e "i�.... cL1 ))69-5333 �t �a Sat(- � so$� R7--6Y
- -
Copany Department/Floor No. Company Department/Floor No.
Street Addre Exact Street Address(We CannokDeliver to P.O.Boor 0.Zip Codes.
IOv iso N1�% n ~ ree
C �� 0 C_T_ State ZI0g4.J uiredCV r V - tat j/oel ired t t 5
Lam! V`#� I «( S 7
YOUR L LL/ FERENC INFORM ION(o o al)(�aracters will appear on invoice.) IF HOLD FOR PICK-UP,Pntrt FEDIXAddress Here
rj Street
mss, Address
AYME 1❑Bip r 2❑Big Recipient's FedEx Acer Nr% r �' rd Party FedEx Acct.No.w ,otI I Bill Credit Card t ity State ZIP Required
I - - ! LJ
5 cash/
Check
SERVICES DEL IVER YAND SPECIAL HANDLING nlcxxsrs WEr YoUR DECLARED Emp.No. Date Federal Express Use
(Check only one box) (Check services required) ( only Is.dpml
Rb+IIYOYErn.ght Stendsrd Owrnght ❑ Cash Received
IoaYMrcedaaess rtwrrwgry I 'w�oyrcarauwmssartrrnaai. HOLD 1 WEEKDAY I ❑ Return Shipment
Ab SKumrtleFreMl FOR (Fill in ❑
11 OTHER 51 OTHER PICK-UP Box H) or i - - - - ❑ Third Party ❑Chg.To Dei. ❑ Chg.To Hold Declared Value Charge
❑AGING ❑PACKAGING ;❑SATURDAY Street Address
t FEDEX LETTER`66,❑FEDEX LETTER* KOAY Other 1
DELIVER or
12❑FEDEX PAK' 52❑FEDEX PAK' 3❑SATURDAY(Ext d.,Je) f City State Zip
(Not avallable to all locations) i
Other 2
13❑FEDEX BOX 53[:]FEDEX BOX 4❑DANGEROUS GOODS(�charge) T�tal j Total Total
J t11 Received By:
14❑FEDEX TUBE 54❑FEDEX TUBE 5❑/ Tot s r
Eoor.,Two Day GoverrvrlentOw^rnght 6❑DRY ICE DIM SHIPMENT(Chargeableweight) X
Ilkh"sysanmdrsinessdory (R.*wroraaeadmdusarsoM9 Dangerous Goods shipper-Declaration notregairetl DateRme Received FedEx Employee Number
GOV'T' REVISIO DATE 692
30[:]ECONOMY 46❑LETTER p y y ultae __ x kg.m El lbs. PART#1372(5 GBFE
41❑PACKAGE T F-1 OTHER SPECIAL SERVICE FORMAT#13s
Fm9ht Serviceg❑SATURDAY PICK-UP X I-..X- 1 3 6
&paclaDts owr I501as.) (Extra charge) I Received At
70OVERNIGHT 80 TWO-DAY t C1 Regular Stop 3O Dr Boz ®1991-92 FEDFX
❑FREIGHT' ❑FREIGHT— ❑ -- -�-: — — _ PRINreolN
Mcdr.a a fla�edl 12 M HOLIDAY DELIVERY OI offered) _ a p s. Release
TEfI{'3 AG19 COEDITIODS
;OLTIPLE PACKAGE SERVICE
DEFIBIT/OBS jewelry,furs precious metals.negotiable nstruments.and other
On this Airbill we our and us refer to Federal Express items listed in our current Service Gude
Corporation.its employees and agents You and your refer to the It you send more than one package on this Airbdl.you may fill in
sender,;Is employees and agents the total declared value for all packages,not to exceed the$+00
AGREEf.1EDT TO TERG;S $500 or$25.000 per package fr"t dr::crbed above (Ex-unole 5
packages can have a total decarea va,ue of ,,o to $'25.0,.0.1
By g-ving us your package to deliver.you agree to all the terms if more than one packages En Aped l..o�to c it our ao,klry
on this Airbill and m our current Service Gude.which is available for loss or damage will a im,tud to me coral vara or the
on request If there is a cont.'ct between the current Service Guide package(s)lost or damaged knot to Lxcucd the ieaser of the total
and this Aubill, the Service Guide will control. No one is declared value or the per package limits described above) You
authorized to alter or modify the terms of our Agreement. have the responsibility of proving the ICtual lose or damage.
RESPOf:31DILITY FOR PACGAGICG AZD CMIPLETIl1G AIRBILL F/LIf.'G A CLAKI
`lou are responsible for adequate) packaging your goods and ALL CLAIMS MUST BE MADE BY YOU IN WRITING You must
g notify us of your claim within strict time im•ts.See current Sery cu
for properly fill ng out the Airbill Omission of the number of Guide.
packages and weight per package from this Airbdl wi'I result in a We'll consider your claim filed if you call and nobly our
billing based on our best estimate of the number of packages Customer Service Department at 800-238.5355 and notify is ,n
received from you and an estimated"default'weight per package, writing as soon as possible,
as determined and periodically ad,usted by is Within 90 days after you notify us of your claim you must send
AIR TRAIISPORTATION TAX MCLUDED us all relevant information about it.We arc not obligated to act on
IJP ♦I/1111 L1��r� any claim until you have paid all transportation cnarges,and you
1 Y 0U A Our basic rate includes a federal lax required by Internal may not deduct the amount of your claim from thou charges
MAK
�� MAP
+J Revenue Code Section 4271 on the air transportation portion of If the recipient accepts our package without noting an damage
M Y ; { APS this sen cu. P r • Y 9 9 Y 9
i _ APPLY
LLMITATIOgS D11OUR LIABILITY on the de'ivery record, we will assume that the pack,ge was
m.
S�=tlil ll EN I, AP LY .U.1 youvmusered in good coxtent pin able, m ke i process your shipping�,('— a � r.DL1AB/LIT/ESI:OTASSUMED oil must, to the extent possible, make ?he ong.nal sh, in
_ Our liability for loss or damage to your package is limited to your cartons and packing available for inspecron.
�'' ;z-f i p f=�f' IV actual dams cs or$100,whichever is less.unless oil a for and
( 11'17 :!.0 Ev��il: ltlC declare a higher aulhor,zed value We do notprovide cargo
R/GIITTOY:SPECT
i�ab,ity insurance but you may pay an addri charge for each We may at our option of god,n p-or your packages prior to
141 S COPY 11 y'R t. additional$100 of dec aced value. It you declare a higher value or after you give them to us to dei,ver
and pay the additional charge, our liaouny will be the lesser of ,TD C.O.D.SERVICES
your declared value or the actual value of your package
m any event we will not be liable for any damages,whether NO C.O D.SERVICES ON THIS AIRBILL.If C 0 D Service is
direct incidental special or consequential in excess of the required, please use a Federal Expross C.O D. ti rbdi for this
declared value of a shipment,whether or not Federal Express had purpose.
knowledge that such damages might be incurred including,but not RESP&ISIBILITYFORPAYL:ECT
limited to,loss of income or profits.
We won't be'iable for your acts or omissions,including but not Even if you give us different payment instruction.; you will
limited to improperor insufficient packing, securing, marking or always be primarily responsible for ad duiivery costs, us well as
addressing,or for the acts or omissions of the recipient or anyone any cost we may incur m,eaher returning your package to you or
else with an Interest in the package Also,we won't be liable,if warehousing it pending disposition
you or the rec plant violates any of the terms of our agreement RIGHT OFREJECTIOG'
We won't be liable for loss of or damage to shipments of
prohibited items. We reserve.the right to reject a shipment at any Fme. when
We won't be iabie for loss,damage or delay caused by events such shipment would be'kely to cause damage or delay to other
we cannot control,Including but not limited to acts of God,perils shipments, equipment or personnel, or if the transportation of
of the au,weather conditions,acts of public enemies,war,strikes, which is prohibited by law or is in violation of any rules contained
civil commotions. or acts or omissions of public authorities in this Airbill or our current Service Guide.
(including customs and quarantine officials) with actual or
apparent authority. 1.1017EY--DAMT GUARZ77TEE
DECLARED VALUE LIMITS In the event ofuntimely delivery,Federal Express w.,:at your
request and with some limitations. refund or credit all
The highest declared value we a:ow for FedEx Letter and FedEx transportation charges. See current Service Guidr, for further
Pak sh�pments is$500 For other shipments,the highest declared information.
value we allow is$25,000 unless your package contains items of
`extraordinary value."in which case the highest declared value we part H 137204n37205
allow is $500 Items of 'extraordinary value," include artwork,
Rev 6,92
l I I'' I IG'O�/rV' �/�✓ ,i
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TOWN OF
SYSTEM PUMP NG RECO _..
. DECEIVED
V
DATE: 2` -
SEP - 3 2004
IMN OF NORTH ANDOVER
MEEALTH DEPARTVENT
SYSTEM OWNER& ADDRESS S STEM LOCATION
i (example:left front of house)
WsovL
DATE OF PUMPING: !d QUANTITY PUMPED : GO D GALLONS
JCESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER(EXPLAIN)
SYSTEM PUMPED BY: Bateson Enterprises, Inc.
COMMENTS:
CONTENTS TRANSFERRED TO: G.L.S.D Lowell Waste
L6ON 1
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Town of North Andover, Massachusetts Form No. 1
NORTH A BOARD OF HEALTH
3�0 ^t�ED "6 6 -L
19
o
nD iFF ='C? m0
APPLICATION FOR SITE TESTING/INSPECTION
7�QDRA TED
SSACHUS�
Applicant —
NAME —ADDREDS TELEPHONE
Site Location , ( QA:j/l 1_A
Engineer)(2L- YVL. &-'k' /Y�a
NAME ADD SS TELEPHONE
Test/Inspection Date and Time
CHAIRMAN,BOARD OF HEALTH
Fee_ �,_ Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
Town of North Andover, Massachusetts Form No. 1
NORTH BOARD OF HEALTH
��O��S`Ep /6 gAOL i
Y 19
* 0 mx
APPLICATION FOR SITE TESTING/INSPECTION
SACHUsy
Applicant `-_. - '
NAME ADDRESS TELEPHONE
Site Location
Engineer
NAME ADDRESS TELEPHONE
Test/Inspection Date and Time
j CHAIRMAN,BOARD OF HEALTH
Fee r Test No.
S.S. Permit No. D.W.C. No. C.C. Date Plbg. Permit No.
MERRIMACK ENGINEERING SERVICES, INC.
PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS
bb PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL.(508)475-3555, 373-5721 FAX(508)475-1448
February 2 , 1943
Town of North Andover
Board of Health
Town Hall - Main Street
North Andover , MA 01845
Attention: Ms . Sandy Starr
RE: Test P its/Percolation Tests
316 Johnson Street - North Andover , Massachusetts
Dear Ms . Starr:
Please find enclosed herewith a check payable to the Town of
North Andover in the amount of $150. 00 for test pits and
percolation tests at the subject location.
Please schedule same at your earliest convenience . Please
contact me or Les Godin of my firm should you have questions or
comments regarding the above or the enclosure .
Very tru1 ours ,
MERRIMA E GINE G SERVICES
Stephen S p k R. L . S.
Presid
SES/cd
Enclosure
'ZOA 1:4*-u JI
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MRS. ROLAND HARRIS
316 JOHNSON STREET
NORTH ANDOVER, MASSACHUSETTS
�C'4 o?
00 &4t "ve
1
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01� a .� � 404a
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�NIfI� YT.f^✓LG A
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V.,00000&
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Pm. o� Or�+ ✓�b�M1V.,Iv,ie ��l Mnsg1!G�t V
November 11, 1955
Mr. Roland ':a.rig
(- 3�* Johnson Strut
North Andover, ias3acrusetts
Dear ,1r. Harris:
The State Ds,:,•artnaent of -.b�_;c Fealth has recently conpl eted
a sanitai- s'-,I-;c7 of the z at.ershod of Lar-c Cochichewtck, the
source ^f watcr sup7ly for the tok-a ,nf 'forth Andover. This
re^ort states that t'lere t: -sts on your prcmis�x " .vidanea of
past overflow of a cesspool Tess t'-4n 250 feu: from brook,
tributary to Take Cochichewick, a violation of Fale 2." copy
of the "ales And PaEulations adoat•:d by the Stata Department
of Public iealth in 1912 for the purpose of prevcnti.ng the pbl tkm
of the waters of Lake Coehiehevici is enclosed.
You are hereby notified to r"edy the cond'_ticn named, and
within tan days of the service of this notice, plans for
construction must be submitted to this department for
approval
If at the expiration of time allowed, the plans have not
been submitted and no cause aforesaid J� shown, such
further action as the lav requires will'be taken.
Yours very truly, +
3OL D OF HEALTH
B y`
Mary F. Sh.ridims rgent
OCT 2 5 2001
TOWN OF NORTH ANDOVER
SYSTEM PUMPING RECORD
DATE: -O
SYSTEM OWNER &ADDRESS SYSTEM LOCATION
(example: left front of house)
Vdis
DATE OF PUMPING: ro-((-yl QUANTITY PUMPED [ GALLONS
CESSPOOL: NO YES SE TIC TANK: NO YES 'V
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION FULL TO COVER
HEAVY GREASE BAFFLES IN PLACE
ROOTS LEACHFIELD RUNBACK
EXCESSIVE SOLIDS FLOODED
SOLIDS CARRYOVER OTHER(EXPLAIN)
SYSTEM PUMPED BY:
COMMENTS:
CONTENTS TRANSFERRED TO:
j Board of Public Works
316
r P. 0'. Box 37
North Andover, Mass. 01845 /
Please forward us as much of the follow;ng information that is possible;
1. Type of system -,-5EPT-t c �6 NK--
72, occ.�,�a►n�s ►'v1 -'fie.
2. Age robabl� 6U3 1� to wlnevX }I,e 1 oue t was bkAd
3. Location by �o�and. N-ur�►s (awv►e`)
31 � Toy-Nso�� Si►�c—E�
4 - Maintenance re r4 d date of st ng out
1977
5. Documentation of repairs and reconstruction
..I�che `fkq�I ��Q�� dove s;rtce_ m�V�n j� ►� 1 S 7[1a►�(�. �v,�� �� I,
6. Site conditions eta k5 a hu r She- WQI� ktWee%\4t( j4NK
1,16wevec-, e- (u4 be-lovJ 41e WG(( i s u►`��- �� av< W(Er
7. Builder of systemp-{-kilUw,ry
8. Engineer who approved% knowv\/-
— Site
— System
9 . Instal,lat on Procedure J�C,�kl wvx,
0. Prohlems
WARRF,NI G. C,CD'-r-N, 3R.
BOX IN (.� 'A', - CVER
MAl-ACI-,U "1+1;, ..1645
U.S.A.
31 'T'OvrNsotit 5TRIEI-r
5 MS H t�-)T79
SEPTIC SYSTEM INSPECTION FORM
ADDRESSI
DATE INSPECTED
---- ROPERLY FUNCTIONING? Y N --�
WEATHER CONDITIONS
COMMENTS :
a
WArTER 4LA)_i Y T'Es tt), -' hes-OL- sS
DYE TEST PERFORMED? Y N
DATE?
SKETCH: