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HomeMy WebLinkAboutV Inspection Report 2026 Apr 10/A:s.A Commonwealth of Massach usetts Title 5 Official lnspection Form aDsubsurface sewage Disposar system rlr, - Not for votuntary n.."rrr"n,, APR 2 7 ZAZ6 248 Camp St. Foxwoods ll Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma.02673 4-10-26City/Town State Zip Code Date of lnspection lnspection results must be submitted on this form. lnspection forms may not be altered in anyway. Please see completeness checklist at the end of the form. A. lnspector lnformationlmportant: \y'Uhen filling out forms on the computer, use only the tab MichaelSears key to move your Name of lnspector Jim The lnspector Mancursor - do not use the return key.Company Name P O Box 784 Company Address West Yarmouth Ma.02673City/Town 508-364-4398 State st14430 Zip Code I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Tifle S(310 cMR 15.000); I have personally inspected ihe sewage disposat system at the property addresslisted above; the information reported below is true, accuEte and complete as of the time of myinspection; and the inspection was performed based on my training and experience in the proper functionand maintenance of on-site sewage disposal systems. After conduiting this inspection I have determinedthat the system: Telephone Number License Number B. Certification 1. [] Passes OF2. n Conditionatty passes MICHAEL 1. 3. n Needs Further Evaruation by the LocarApproving Authority SEARS *:. No. SI144304. n ralls * €5,N 4-10-26 lnspector's Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Boardof Health or DEP) within 30 days of compteting this inspection. lf the system has a design 1ow of10'000 gpd or greater, the inspector and the system owner shall submit the report to the appropriateregional office of the DEP. The original form should be sent to the system owner and copies sent tothe buyer, if applicable, and the approving authority. Please no.te: This report only describes conditions at the time of inspection and under theconditions of use at that time. This inspection does not address'how irr" "v"i", wit! performin the future under the same or different conditions of use. tsinsp.doc. ey. 7 l26t2ojg Title 5 Official lnspection Formt Subsurfa6 Sewage Disposat System . page 1 of 18 Ht T F 5fr' Gommonweatth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldq V Property Address Foxwoods Condominium Homeowners Association Owner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26 City/Town State Zip Code Date of lnspection G. lnspection Summary lnspection Summary: Complete 1, Z, 3, or 5 and all of 4 and 6. 1) System Passes: ffi t have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evatuated areindicated below. Comments: System meets minimum Massachusetts DEP standards, this lnspection is not a guarantee of futureworking conditions. 2l System Conditionally passes: f] One or more system components as described in the "Conditional Pass" section need to bereplaced or repaired. The system, upon completion of the replacement or repair, as approved bythe Board of Health, will pass. Check the box for "yes", "no" or "not determined" (Y, N, ND) for the following statements. lf "not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structuralyunsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will passinspection if the existing tank is replaced with a complying septic tank as approved by the Board ofHealth. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate ofcompliance indicating that the tank is less than 20 years old is available. nV trru nf.fO(Exptainbetow): tsinsp.doc . ev. 7 1261201 I Tille 5 Official lnspection Fomr Subsurface Sewage Disposal System . page 2 of 18 ?4.s,}.Gommonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system rorm - Not for voluntary Assessments 248 Camp St. Foxwoods il Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma. 02673 4-10-26City/Town State Zip Code Date of lnspection C. lnspection Summary (cont.) 2l System Conditionatty passes (cont.): E pump Chamber pumps/alarms not operational. System will pass with Board of Health approval ifpumpsialarms are repaired. ! observation of sewage backup or break out or high static water level in the distribution box dueto broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System willpass inspection if (with approvat of Board of Health): n broken pipe(s) are reptaced f] v tr ru E ruo (Exptain berow): n obstruction is removed E V fl f.f E ruO (Exptain betow): n distribution box is teveted or replaced n y tr f.f n UO (Exptain betow): n fne system required pumping more than 4 times a year due to broken or obstructed pipe(s). Thesystem will pass inspection if (with approval of the Board of Health): n broken pipe(s) are reptaced tr v n ru E ruo (Exptain betow): n obstruction is removed tr v n rrr E uo (Explain betow): 3) Further Evatuation is Required by the Board of Health: E conditions exist which require further evaluation by the Board of Health in order to determine ifthe system is failing to protect public health, safety or the environment. a' System wil! pass unless Board of Health determines in accordance with 310 cMR15'303(1Xb) that the system is not functioning in a manner which will protect pubtic heatth,safety and the environment: tsinsp.doc' rev 712612A18 Title 5 Official lnspection Form: Subsurface Sowage Disposal System , page 3 of 18 5$. Commonwealth of Massachusetts Title 5 Official lnspection Form Subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods lt Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma.02673 4-10-26 Cityffown State Zip Code Date of lnspection C. Inspection Summary (cont.) tr Cesspool or privy is within 50 feet of a surface water n Cesspool or privy is within 50 feet of a bordering vegetated weiland or a salt marsh b. System willfail unless the Board of Health (and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public heafth,safety and environment: I fne system has a septic tank and soilabsorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply.n fne system has a septic tank and SAS and the SAS is within a Zone 't of a public watersupply. fl ffre system has a septic tank and SAS and the SAS is within 50 feet of a private watersupply well. f] fne system has a septic tank and SAS and the SAS is less than 100 feet but S0 feet ormore from a private water supply well**. Method used to determine distance: c. Other: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecalcoliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate niirogen is equalto or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis mustbe attached to this form. 4l System Failure Griteria Applicabte to Alt Systems: You must indicate "yes" or "No,, to each of the foltowing for all inspections: Yes tr tr No x Backup of sewage into facility or system component due to overloaded orclogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface watersdue to an overloaded or clogged SAS or cesspool Title 5 Official lnspection Formr Subsurfacs Sewage Disposal System . page 4 of 18 tsinsp.doc. ev. 7 126t2018 5$. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposa! system Form - Not for voluntary Assessments 248Camp St. Foxwoodsll Blds V Property Address Foxwoods Condominium Homeowners AssociationOwner information is requlred for every page. Owner's Name West Yarmouth Ma, State 02673 4-10-26 City/Town Zip Code Date of lnspection C. lnspection Summary (cont.) 4l System Failure Griteria Applicable to Alt Systems: (cont.) Static liquid level in the distribution box above outlet invert due to an overloadedor clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is lessthan lz day flow Required pumping more than 4 times in the last year Nor due to clogged or Any portion of the sAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply ortributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public water supplywell. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feetfrom a private water supply well with no acceptable water quality analysis. frhissystem passes if the well water anatysis, performed at a DEp cerilfiealaboratory, for fecal coliform bacteria indicates absent and the presenceof ammonia nitrogen and nitrate nitrogen is equat to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the anitysisand chain of custody must be attached to this form.l The_ system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. The system fails. I have determined that one or more of the above failure criteria exist as described in 310 cMR 15.303, therefore the system fails. Thesystem owner should contact the Board of Health to determine what will benecessary to correct the failure. Yes Nonx trxnx trx trx trx trx trx tr 5) large Systems: To be considered a large system the system must serve a facility with adesign flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either "yes" or "no" to each of the following, in addition to thequestions in Section C.4. Yes No tr the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (lnterim Wellhead protection Area - IWPA) or a mapped Zone ll of a public wat,er supply well Tifle 5 officiar rnspection Form: subsurface sewage Disposar system . page 5 0f 18 tr n tsinsp.doc . rcv. 7 t26l211 I tr n x 5$. Commonwealth of Massachusetts Title 5 Officia! lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 St. Foxwoods ll Address Foxwoods Condominium Homeowners AssociationOwner information is reguired for every page. Owner's Name West Yarmouth Ma.02673 4-10-26 City/Town State Zip Code Date of lnspection C. lnspection Summary (cont.) lf you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section C.4 above ihe large system has failed. Theowner or operator of any large system considered a significant threat under Section C.5 or failedunder Section C.4 shall upgrade the system in accordance with 310 CMR 15.304. The system ownershould contact the appropriate regional office of the Department. You must indicate "yes" or "no" for each of the following tor altinspections:b. Yes ! tr x n x x x x x No x X D x tr n n tr n Pumping information was provided by the owner, occupant, or Board of Health were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recenily or as part ofthis inspection? were as built plans of the system obtained and examined? (lf they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were allsystem components, excluding the SAS, located on site? were the septic tank manholes uncovered, opened, and the interior of the tankinspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? was the facility owner (and occupants if different from owner) provided withinformation on the proper maintenance of subsurface sewage disposal systems? The size and location of the soil Absorption system (sAS) on the site hasbeen determined based on: Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to part C is at issueapproximation of distance is unacceptabte) [310 CMR 15.302(5)] x x x tr tr tsinsp.doc' rcv. 7 t26t20,tg Title 5 Official lnspsction Form: Subsurface Sewage Disposal System . page 6 of 16 n 5$' Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma. 02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation 1. Residentia! Flow Conditions: Number of bedrooms (design):Number of bedrooms (actual):10 10 DESIGN flow based on 310 cMR 15.203 (for exampte: 110 gpd x # of bedrooms) Description: 1 100 Number of current residents. Does residence have a garbage grinder? Does residence have a water treatment unit? lf yes, discharges to Seasonal use? Water meter readings, if available (last 2 years usage (gpd)): Detail: NA EyesX No !YesI No ls laundry on a separate sewage system? (lnclude laundry system inspectioninformation in this report.) Laundry system inspected? nYesI No EYesX No nyesX No NA Sump pump? Last date of occupancy: !yesX No Present Date tsinsp.doc' rcv. 7 126120,18 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 7 of 1g ,i*5.\Commonwealth of Massachusetts Title 5 Official Inspection Form subsurface sewage Disposa! system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods il V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma. 02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 2. Gommercial/lndustrial FlowConditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Basis of design flow (seats/persons/sq.ft., etc.): Gallons per day (gpd) Grease trap present? Water treatment unit present? lf yes, discharges to: lndustrial waste holding tank present? Non-sanitary waste discharged to the Tifle 5 system? Water meter readings, if available: Last date of occupancy/use: Other (describe below): ! yes fl No fl ves f1 No EYes! No !yes! No Date 3. Pumping Records: Source of information. Was system pumped as part of the inspection? lf yes, volume pumped: How was quantity pumped determined? Reason for pumping: NA EvesI No gallons tsjnsp.doc. tev. 7 l26l20ja Tit16 5 Official lnspection Form: Subsurface Sewage Disposal System . page g of 1g 5s. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposat system Form - Not for Voluntary Assessments 248 Ca St. Foxwoods ll Property ress Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26City/Town State Zip Code Date of lnspection 4 D. System lnformation (cont.) Type of System: X Septic tank, distribution box, soil absorption system tr Single cesspool n Overflow cesspool n Privy n Shared system (yes or no) (if yes, attach previous inspection records, if any) tr lnnovative/Alternative technology. Attach a copy of the current operation andmaintenance contract (to be obtained from system owner) and a copy of latestinspection of the l/A system by system operator under contract tr Tight tank. Attach a copy of the DEp approval. tr Other (describe): Approximate age of all components, date installed (if known) and source of information: NA Were sewage odors detected when arriving at the site? 5. Building Sewer (locate on site plan): Depth below grade: Material of construction: n cast iron X +O pVC E other (exptain) Distance from private water supply well or suction line: EvesX No 22" feet comments (on condition of joints, venting, evidence of reakage, etc.): tsinsp.doc . rcv. 7 1261201 I Tjtle 5 Official lnspection Fom: SubsurFace Sewage Disposal System . page 9 of 18 feet 5$' Commonweatth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for voluntary Assessments 248 Camp St. Foxwoods ll Bldg V Property Address Foxwoods Condominium Homeowne rs AssociationOwner information is required for every page Owner's Name West Yarmouth Ma. 02673 4-10-26 City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 6. Septic Tank (locate on site plan): Depth below grade: Material of construction: X concrete E metal 2000 gal tank 12" ! fiberglass n potyethytene fl other (exptain) feet lf tank is metal, list age ls age confirmed by a certificate of compliance? (attach a copy of certificate) tr yes n No Dimensions: Sludge depth: Distance from top of sludge to bottom of ouflet tee or baffle Scum thickness Distance from top of scum to top of ouflet tee or baffle Distance from bottom of scum to bottom of ouflet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to ouflet invert, evidence of leakage, etc.):2000 gal tank with in and out tees in place, both coverslteet aigraoe years 2000 I 29" 0 8" 18" Sludge judge, tape tsinsp.doc . rev. 7 1261201 I Tille 5 Official lnspstion Form: Subsurface Sewage Disposal System . page 10 of 16 A.Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface sewage Disposal system Form - Not for voluntary Assessments 248 CampSt. Foxwoods il BtdsV Property Address Foxwoods Condominium Homeowners AssociationOwner informatlon is required for every page. Owner's Name West Yarmouth Ma.02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 7. Grease Trap (locate on site plan): Depth below grade: Material of construction: n concrete f]metat fl fiberglass f] potyethytene f] other (exptain): feet Dimensions: Scum thickness Distance from top of scum to top of ouflet tee or baffle Distance from bottom of scum to bottom of ouflet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to ouflet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: E concrete E metal I fiberglass E potyethytene n other (exptain) Dimensions: Capacity: Design Flow: gallons gallons per day t5insp.doc. rcv. 7 126t2018 Title 5 Official lnspection Fom: Subsurface Sewage Disposal System . page .l .l of l8 /d\.Commonwealth of Massach usetts Title 5 Official lnspection Form subsurface sewage Disposat system rorm - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Blds V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma.02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 8. Tight or Holding Tank (cont.) Alarm present: Alarm level: Date of last pumping ! Yes fl ruo Alarm in working order:n Yes ! t'lo Date Comments (condition of alarm and float switches, etc.) * Attach copy of current pumping contract (required). ls copy attached? 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above ouflet invert 0 fl Yes n r'lo Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, anyevidence of leakage into or out of box, etc.): D Box is 16x16 with 2 ouflet lines, cover is 12" below grade tsinsp doc . rcv.7t2612018 Titls 5 otflcial lnspection Form: Subsurface Sewags Disposat System . page 12 of 1B /c\Gommonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system rorm - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Blds V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma.02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 10. Pump Chamber (locate on site plan): Pumps in working order: Alarms in working order: E yes E yes f] No. f] No. Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.) * lf pumps or alarms are not in working order, system is a conditional pass. 11. soil Absorption system (sAS) (locate on site plan, excavation not required) lf SAS not located, explain why: Type. ! n n n leaching pits leaching chambers leaching galleries leaching trenches leaching fields overflow cesspool in novative/alternative system Type/name of tech nology: number: number: number: number, length: number, dimensions number: 11 tsinsp.doc. rev. 7t26l2O1B Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 13 of 1g 5$. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for voluntary Assessments 248 St. Foxwoods ll Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma 02673 4-10-26 City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 11. Soi! Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition ofvegetation, etc.): SAS is 11 Flow Diffusers, flows are wet with no sign of failure at time of inspection Covers at grade 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration Depth - top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction lndication of groundwater inflow E yes E tto Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): tsinsp.doc. rev 7126t2018 Title 5 Official lnspection Form: Subsurface Sewage Disposal System . paga.14 of1g ,aF\.Commonweatth of Massachusetts Title 5 Official lnspection Form Subsurface sewage Disposat system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth 4-10-26 City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 13. Privy (locate on site ptan): Materials of construction : Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): Ma 02673 tsinsp.doc . ev. 7 t261201 I Title 5 Offlcial lnspection Form: Subsurface Sewage Disposal System. page 1S of 18 /A Commonwealth of Massach usetts Title 5 Officiaf lnspection Form subsurface sewage Disposal system rtorm - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page Owner's Name West Yarmouth Ma. 02673 4-10-26City/Town 5t-ate Zip Code Date of lnspection D. System lnformation (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent referencelandmarks or benchmarks. Locate alt wetts within 100 fdet. Locate where public water supply entersthe building. Check one of the boxes below: xn hand-sketch in the area below drawing attached separately F C RQrtL l0 o rrr tSlnsp.doc. rev. 7l26tZ01E Title 5 Official lnspection Form: Subsurface Sewage Disposal System , page .16 of 1B t ,,4"Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods il Bldg V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page Owner's Name West Yarmouth Ma.02673 4-10-26City/Town State Zip Code Date of lnspection D. System lnformation (cont.) 15. Site Exam: X Check Stope X Surface water X Check cellar X Shallow weils Estimated depth to high ground water:11', feet Please indicate all methods used to determine the high ground water elevation: n Obtained from system design plans on record lf checked, date of design plan reviewed:Date X Observed site (abutting property/observation hole within 1S0 feet of SAS) ! Checked with local Board of Health - explain: checked with local excavators, installers - (attach documentation) Accessed USGS database - explain: n n You must describe how you established the high ground water elevation No ground water per last report Before filing this lnspection Report, please see Report completeness Ghecklist on next page. tsinsp.doc . rev. 7 t26l2O1B Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 17 of.lg $. Commonwealth of Massachusetts Title 5 Official lnspection Form subsurface sewage Disposal system Form - Not for Voluntary Assessments 248 Camp St. Foxwoods ll Blds V Property Address Foxwoods Condominium Homeowners AssociationOwner information is required for every page. Owner's Name West Yarmouth Ma. 02673 4-10-26City/Town State Zip Code Date of lnspection E. Report Gompleteness Checklist Complete all applicable sections of this form inclusive of: X n lnspector lnformation: Complete allfields in this section. X A. Certification: Signed & Dated and 1, 2, 3, or 4 checked X C. lnspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checktist) compteted X O System lnformation: For 8: TighVHolding Tank - pumping contract attached For 14: sketch of sewage Disposal system drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included tsinsp.doc' rcv. 7 126t20't I Title 5 Official lnspection Form: Subsurface Sewage Disposal System . page 1B of 18