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OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 66 Colonial Avenue
North Andover
Owner: Valentine
Date of Inspection: _10/31/2002_
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.
40'
A to Tank = 2715"
A to D -Boa = 24111"
B to Tank = 32'5"
B to D -Boa = 44'6"