HomeMy WebLinkAboutSeptic As-Built Card Commonwealth of Massachusetts
'=-0=, Title 5 Official Inspection Form
is=p Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
;.V � 35 Debs Hill Road, Yarmouth Port M - 108 P -66 - C39B
Property Address
Joan Bailey c/o Alice Boyd
Owner Owner's Name
information is
required for every 6 Turner Road, Scituate MA 02066 May 7, 2024
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
❑ drawing attached separately
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t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 16 of 18