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TO: NORTH ANDOVER, MASS 19 701
BOARD OF HEALTH
FROM: DESIGN ENGINEER Re: Soil Absorption Sewage
System Inspection
This is to certify that I have inspected the construction of the said disposal system at
--tlo7— B &,Y D North Andover, Mass.
SITE LOCATION
The grades and construction are as specified in my plans and specifications dated
19—
PrY�'4 4, e'c�zc
Engoeer/Reg. S,106tarian
NORTH B.N MTM. BOARD OF HEALTH
YX�
_ IN8TN-UAI7ON CHICK LIST
APPROVID DISAPPROVED EXCAVA ON OK
Date:
"?S
Reason:, -.1 �Z <
1 As Built bmitted
eck: Lot location, dimensions of system, location in regard to
percolation tests, depth of system, water table
3.
5.
'stance to Wetland Areas,
Water Line Location
No PV ipe
Drs, Streeo� use, Drainage Easement and Wells.
Septi ank - Tees, Cement -Pipe to Tank -Joints on both side of Tank.
6.- Distr'tion Box - No cracks in box or cover, all lines flow erually from box.
7. Leach Fields Dime ions, Stone ^ pths, Cappe nds, Clean do e -trashed stone
8. Leach Pits - Dimensions, Depth of Stone, Splash pact tees, Cement -pipe to tank -
joints on both sides of tank, Clean double-imshed stone
9. No Gare Disposals
10. Final Gr g ('(;barricading of sub -surface system;
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