HomeMy WebLinkAboutSeptic As-Built Card •
• Commonwealth of Massachusetts
fl Title 5 Official Inspection Form
c -= Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
19 Bradford Road,West Yarmouth, MA
Property Address
Voskanian Shaunt 73 Williston Road
Owner Owner's Name
information is Auburndale MA 02466 3/12/2020
required for every
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
I
1w
t
R vhR
2e10 0i
• • • - •
lam.. mom
temo mow
'. _ 0.14
SWSt ether
Al 8 3/' $/ =/6.S,
pZ z 211° 52 = 2 2.5.,
3 3/' 8 3 s 330.5-
y,39.S. gy=233'
tSinsp.doc•rev.7/28/2018 Title 5'Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18