HomeMy WebLinkAboutSeptic As-Built Card 4 ' l
Commonwealth of Massachusetts
'''. si Title 5 Official Inspection Form
o1414,„ , Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
`^ = 85 North Main Street
Property Address
Zachary Hunter
Owner Owner's Name
information is
SOt armouth Ma 02664 .___...._ 3/6/2020
required for every ein State Zip Code Date of Inspection 1
ice•
D. System Information (cont.)
14. Sketch Of Sewage Disposal System:
Provide a view 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. Check one of the boxes below:
g hand-sketch in the area below
0 drawing attached separately
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