35-269 (5) THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
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THIS IS k/ .�C RIT'll, Th t the Indivj4ual Sewage Disposal System constructed
or Repaired
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Installer
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has been installed in Eacco5ce with the provisions of '11= 5 of The State Sanitary Code as de'scribed in the
application for Disposal Works Construction Permit No...C2 ..............• dated__.___. ................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANT� THAT THE
SYSTEM WILL UNCTION SATISFACTORY. 7
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....... .............. Inspector...... . ....... .................
DATE.... .. ............... .......*......