HomeMy WebLinkAboutMiscellaneous - 66 COLONIAL AVENUE 4/30/2018 (13) Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
66 Colonial Avenue
Property Address
Jeremy Segal
Owner Owner's Name
information is
required for every North Andover MA 01845 5/28/2013
page. Citylrown 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
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17