301 Certificate of Compliance 2001 FORM 3A - CERTIFICATE OF COMPLIANCE
COMMONWEALTH OF MASSACHUSETTS
Board of Health, Nor/ os-v+rrfen
CERTIFICATE OF COMPLIANCE
Jesctiption of Work: ❑ Individual Component(s)
he undersigned hereby certify that the Sewage Disposal System;
Constructed G'1 Repaired ( ), Upgraded O, Abandoned ( )
c: 3of s + Raad
y: Co+{' v■ Tree_ Service-
X w« �.
MA.
L Complete System
ttas been installed.:in accordance with the provisions of 310 CMR 15.00..(Title 5) and the
pproved design plans/as-built plans relating to application No
aced 7- 30 -OS Approved Design flow 6O5 (gpd)
Installer beferfa
Designer
Inspector
The issuance of this permit shall not be construed as a guarantee that the system will
function as designed.
C6MPONCNT
Seenc Tgsnc
CeP Tt0.AcctSS
DIST.FROM A
13'
btsi.ftcM 8
25'
4AL.E,CY TASK 2-
Access GeveP-
45'
OEP APPROVtD IOW sI