HomeMy WebLinkAbout- As-Built Plan / Installation Certificate Form - 185 MILL ROAD 11/6/2018 (3) I
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PUBLIC HEALTH DEPARTMENT
Coimnnniiy&Economic Devrelolament
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
I'lac undersigned hereby certify that the Sewage Disposal System()5 constructed; repaired;
(Print Marne)
I.,ocated at: 185 Mill Road
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved Plan,originally dated
....._.and last rswiscc!on « 6/6/2017 ------ __.__,with a design flow of
440 gallons per day. The materials used were in conformance with those specified on the
approved plan;the system was installed in accordance with the provisions of 310. CMIS 15.000,Title 5 and local
regulations,and the final trading agi-ces substantially with the approved plan.All work is accurately represented on
the As-built which has been submitted to the Board of Health.
Bottom of Bed Inspection Date:9/17/18&9/20/18
h ragh►ega R a esen fav Signature)
John D. Sullivan 111, PE
.And--Print Name
Filial Construction Inspection Date:9128/18
Engin r Rep se ativc(Signature)
John D. Sullivan III, PE
An(] ,Print Naane
Installs�. (Signature) Date: +� ( 1
And..Print Name
Engineer: (Signature) Late: 10/1/2018
John D. Sullivan 111, PE
And--Print Name 1
120 Main Street, North Andover, Massachusetts 01845
Phone 978.688.9540 Fax 97 . 8 a954 Web litti)c//Www.aaortlitindoveraaaaa.gov