35-021 (5) THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............CITY...................OF...........NORTHAMPTON
..................................................................
(gatifiratr of (gampliana (11f4or Repaired
THIS Ir"OEPTI Y,,.,, hat the Individual Sewage Disposal System constructed
1 t.11er
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by---------------- -----------
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at................ .......
of Z11 e ,i n
has been installed in accordance with the provisions of 5 e State S, itary ode V de e in the
application for Disposal Works Construction Permit No------- 36-7 .......... dated. ------- ........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST_RUED AS A GUA ANTEE THAT THE
SYSTEM WILL �ON SATISFAgTORY.....F K40 — inspector..........DATE.................. .....I......I........................ ..•...............•.... ..... .......... ..•....••......•...•......