HomeMy WebLinkAboutupdated pg 7 - Title V Inspection Report - 46 LIBERTY STREET 11/26/2019 Commonwealth of Massachusetts RECE1VEp
�n ,g Title 5 Official Inspection Form 6 20
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b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
` 46 Liberty Street SOWN OF NOEp R��
Property Address
Harit& Heather Vora
Owner -- --- — —
Owner's Name
information is required for every North Andover MA 01845 8-26-2019
_.
page. City/Town 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): 600
Description:
Number of current residents: 0 —— -
Does residence have a garbage grinder? ® Yes ❑ No
Does residence have a water treatment unit? ® Yes ❑ No
If yes, discharges to: Has filter&descaler, no discharge
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonaluse? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d On well water
9 ( Y 9 (gP ))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: Vacant Aug.19,
2019
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18