Loading...
HomeMy WebLinkAboutInstallation Certification - As-Built Plan / Installation Certificate Form - 288 STILES STREET 12/7/2020 PUBLIC HEALTH PiJP4 tTMW* (ommunuy-k.Ecic o' c fleYeiapment` TC}WNf 4k`fl'�IDRT 'AN -ER ;!�gPTIC DISPOSAL CC,RTMC—ATIOZ4 T ie urtcl i d1dreb c.. ._ P Y cexti£y!That the Sewag bpQSaf:Syteir�( } ostructed,:;( ) epatred, g JamesBoraczek. (Pruit Naiine) .Lo at;:28B Stiles.Street, . (Installation Address): Was itistalIed in,cvnfbrmance w tli'tl#e NoiM AhdOVe BoaW dfrHealtI..approved'ptan arigi pally.dated; 4une;28 20"19 and last revised on jOY-2,2026 -;i�r#1 a.design flow-6f 30 galIons per day. The materials.used line in conforinance_with:tHose-specified oil"the r approved plan;,the syste&:vias.Wtalled iu accordance With the grovisions:of310',CIMH IS:QQD,Title 5,agd local regulations;-aiid.thefiinal grading agrees substantially with the approved plan.All woik is.:accuidtely rep&tented bfi the As built,which bas-been submitted f6 the.Board of Health.: 7 Bottom of e:Bed,Inspectiou'Dat �. Engineer presentative. Signature) BenjdMIh C. Osgood,Jr_, And--print Name '146At(instruction Ins _ecijon,Date..91221202t}' Rrigineer Regresertfafiv agnature) Benjamirl-C..Osgood,.Jr ; Arid--',1?riit 11ame. ;Installer: Engineer: (S9gitetu Xe}° Date: And.-PfidNaine - 20 Main--'Sire tE for h Andovdr Mqs achvsOft 01845 Phdnd #A.688 0540 Fdit 97.88 6.88.914k ' Web ht#p jjwrVw hoi liuitdoverma gov_