HomeMy WebLinkAbout- Title V Inspection Report - 90 LOST POND LANE 1/7/2019 q
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
90 Lost Pond
Property Address
Julgit Kalkat
Owner Owner's 7Name
information is
required for every North Andover ------- MA 01845 -------
page. CityfTown State Zip Code Date of Inspection
D. System Information
1, Residential Flow Conditions:
Number of bedrooms (design): 4 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 660
Description:
RECEIVED
............
TOVOIOF�ORTHM�,MER
11EAU
Number of current residents: 5
Does residence have a garbage grinder? ❑ Yes No
Does residence have a water treatment unit? ❑ Yes No
If yes, discharges to:
Is laundry on a separate sewage system? (Include laundry system inspection
information in this report.) Yes No
Laundry system inspected? El Yes n No
Seasonal use? D Yes E No
Water meter readings, if available (last 2 years usage (gpd)): Yes
Detail:
-----------
..........
Sump pump? El Yes E No
Last date of occupancy: Current
Date
t5insp.doe rev,7/2612018 Title 5 Officiat Inspection Form:Subsurface Sewage Disposal System-Page 7 of 16