35-041 (4) THE COMMONWEALTH OF MASSACHUSETTS �✓ -,�
BOARD OF HEALTH
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THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( )
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has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described i.. the
application for Disposal Works Construction Permit No..--
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THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A GUARANTE T THE
SYSTEM WILL FUNCTION SATISFACTORY. --'''�
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