HomeMy WebLinkAboutInstallation Certification - 8.26.2019 - As-Built Plan / Installation Certificate Form - 50 SAW MILL ROAD 9/13/2019 ��10,0 f
VV 2�Q�P
r08itt REALM DIPAR MINT
loMtRi*nity 3 Etnuemit bttekrp��Fnt
TOWN OF NORTH ANDOVER
SEPTIC DISPOSAL SYSTEM—INSTALLATION CERTIFICATION
The undersigned hereby certify that the Sewage Disposal System N constructed;( }repaired;
By: \I .G N^E' 1� K� I le t
(Print Name)
Located at: ___ 50 Saw Mill Road
(Installation Address)
Was installed in conformance with the North Andover Board of Health approved plan,originally dated
9/11/2018 and last revised on 11/17/2018 ,with a design flow of
440 _ `gallons per day. The materials used were in conformance witli those specified on the
approved plan;the system was installed in accordance with the provisions of 310.CMR 15.000,Title 5 and local
regulations,and the final grading agrees substantially with the approved plan.All work is ac ately represented on
the As-built which has been submitted to the Board of Health.
• j
Bottom of Red Inspection Date:_ June 26, 2019 _
Fngineer epr alive(Sign re)
John D. Sullivan III, PE
And--Print Name
Final Construction Inspection Date: Aug. 5, 2019 _
Fnginee rpet t rve(Signature)
John D. Sullivan III, PE ,✓
And—Print Name
Installer _ (Signature) Date:
ea I` �� LL L'-
And—Print Name
Engineer: (Signature) Date:—_Aug 8. 2019
D_-Sullivan III- P-F __
And--Print Name
120 Maln Street,North Andover,Monothusetts 91943
Phone 978.688.9340 Fux 978.68849342 'Nub hitpt//www,nnrsbundavermn.gov