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HomeMy WebLinkAboutSeptic As-Built Card { Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 2 Halyard Road, Yarmouth Port M - 135 P-59 Property Address Lucia Wier do Bruce Marcel _ Owner Owner's Name information is required for every 36 Burgess Point Road, Wareham MA 02571 March 24, 2020 page. City/Town State Zip Code Date of Inspection 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: ►/ hand-sketch in the area below 0 drawing attached separately i � I F t 4 O © A 0 al' $l - sU ' ce 3 ` 34 ' 3 = 35 ` y � y5 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 t5insp.doc•rev.7/26/2018