HomeMy WebLinkAboutPage 15 of Inspection Report with Notes � �i-c� Cf�illC�z�ip S�
�� � CommornreaNh Of Massachusetts �y f�i�( /`t'��E`�� ��a �J�
���� Title 5 Official Inspection Form �
Subsetrfac�SwMage Disposd System Form-Not for Yolwdery Assessrne�ts
250 Blue Rodc Ftoad South Yartnouth M-101 P-173
PropeFty Atldress
Doris Schetf do E Hans&JudiGi A Lundsten{buyers)
Ox�ner Ownefs Name
intartiauon k �B��. �t G�� RI 02818 Decembef 12.2014
rsquired fir avaY ��� State ZF Code Dats oF Im�on
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D. System Information (co�t.)
Skeh:h Of Sewage Disposet System: Provida a view of the sewage dlsposal system,including ties to
at least two pertnanent reference IendmaAcs or benchmarks.Locate all weils within 100 feet Locate
where pu6lic water supply er�ters the bu�ding.Check one of the boxes bebw.
� hand�ketch in the ar�below
❑ drawing attached se�rat�y
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