HomeMy WebLinkAbout0416 OLD OYSTER ROAD - Health F
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SENT BY: BORTOLOTTI CONST; 5084289399; APR-3-06 13:04; PAGE 1/2
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BOWPOLOTTI CONSTRUCTION,INC
P.O.BOX 704,MARSTONS MILLS,MA,02648
508-771-9399 S08-428-8926 508-428-9399/ X
SEWAGE DISPOSAL SYSTEM EVALUATION
loiffing,Lddrc�ss.
pecte By: Date:
perly Add s: Ma &L tuer uye
N TE: satisfactory evaluation does not guarantee that the system vill coy tinue to function.
A Sketch of the property and sewage disposal components must a comp ny this form.
RESIDENTIAI. COMME1 CIAL USE
Lf t Size.• Lot Size:
. of B drooms: Q Type of Business: ,.
C`rl}age 'rindet':_AZWater Softener: Sq.Ft.of Bldg:
Ober W iter Use(Applisnices) Mp/pf Employees
Water Use Activi :
ar Ro nd: k/(J Seasonal:vd-la- -
esterSource: Water Source:
Se t c System Installed(Date): Title Yes ) No
Corn onent No. Size Length Type Ftto Ft. a Conditions
Well Wotl tnd
Bu Ming. wer
Sel tic Tax k
Effluent Pipe
014. Box
f)i,. _ Pipe
LC ch Pit
Vo
ssors
ch
tuber
viden . of Ground Stain Yes( ) No ( nknown ( )
viden of l3reakout/Overlafid Yes( ) No I nknown ( )
viden of Overflow to Surface Yes( ) No I nknown ( )
viden of Lush Growth around Pit/CesspoolYes( ) No (6 ) Inknown ( )
. andin Liquid in Pit 1/2 or More Full Yes( ) No tnknown ( )
viden of Excessive Pumping Required Yes ) No {� ) nknown
Co imen.. ke
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SENT BY: SORTOLOTTI CONST; 5084289399; APR-3-06 13:05; PAGE 2/2
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