HomeMy WebLinkAboutTitle V Inspection Report - 75 LOST POND LANE 2/22/2002 COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 70 Lost Pond Road_
North Andover
Owner's Name:_Tom Murphy_
Owner's Address: 70 Lost Pond Road_
—North Andover,Ma.01845
Date of Inspection: 2/22/2002
Name of Inspector:—Neil J.Bateson-
Company Name:—Bateson Enterprises Inc._
Mailing Address: 111 Argilla Road
Andover,Ma.Win-
Telephone Number:_(978)475-4786_
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DE P
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Fail
Inspector's Signature- ",Date: 2/22/2002
The system inspector shall submik a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DER The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving
authority.
Notes and Comments:After inlet tee was install in septic tank by Peter Breen,the septic system now Passes
Title 5 Inpection.
****This report only describes conditions at the time of inspection and under the condit Ons Meat:qAyg
time.This inspection does not address how the system will perform in the future under the sa e or di efeli
conditions of use.