HomeMy WebLinkAboutMiscellaneous - 66 COLONIAL AVENUE 4/30/2018 (11) Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Y
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
66 Colonial Avenue
Property Address
Jeremy Segal
Owner Owners Name
information is
required for every North Andover MA 01845 5/28/2013
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 4
feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 6/6/1996
Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Health -explain:
Design plan
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
As per test pit data on design plan.
Before filing this Inspection Report,please see Report Completeness Checklist on next page.
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