691 Certificate of Compliance 2000 IM : THE REAL ESTATE CONNECTION FAX NO.
413 582 1293 Mar. 27 2990 04:27PM P2
DESIGNER'S CERTLFICATE OP COMPLIANCE
THE UNDERSIGNED DESIGNER ON I J U Ey 19
'.NSPECTEDA TITLE 5 SEPTIC SYSTEM INSTALLATION AT: BOARD DFHEALTH
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ASSESSOR'S it 4p /3 PA,LCut- Z& IOB # 98 - 01)
ADDRESS G9/e5rs nprv.i Rn - /VOtrx Ainpm...MASSACHUSETTS,
AND CERTIFIES THAT. BASED UPON FIELD OBSERVATIONS AND SUPPORTING
INFORMATION PROVIDED BY THE INSTALLER THE DISPOSAL WORKS AS
CONSTRUCTED GENERALLY SATISFIES THE INTENT OF THE FOLLOWING
DESIGN PLAN ENTITLED: /; 72
(PL DATE)
(PLAN TITLE)
WITH THE FOLLOWING EXCEPTIONS To .S f Co in r- e rt n 51 IA' S P>L-c e)c
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DESIGNS' .r j FosOts- D TE 1/9»
I AM A CURRENTLY LICENSED INSTALLER IN THE TOWN AND HAVE INSTALLED
THE ABOVE REFERENCED SEPTIC SYSTEM STRICTLY IN ACCORDANCE WITH THE
ABOVE REFERENCED PLAN. ANY EXCEPTIONS ARE NOTED ABOVE. A
DIMENSIONED AS-BUILT PLAN IS ATTACHED SHOWING TWO DIMENSIONS FROM
PERMANENT PAINTS TO EACH OF THE FOLLOWING. SEPTIC TANK 1NVV'.RT-IN AND
INVERT OUT; ALL ANGLE POINTS IN ALL PIPING; D-BOX;BEGINNING AND END OF
FAWN H LEACHING PIPE; CENTER COVER OF LEACH CHAMBER.
/ J'
.HEATS'/
DISPOSAL WORKS CONSTRUCTION PERMIT #
APPROVED FOR CONSTRUCTION ON