35-274 THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE LTH ` ap JUL 2 8
.................OF......./'.."'�/.............. DEPT 'E
(gatifiratr of T"Ut li
TH S TO C RTIF , That the I al Sewage Disposal System constructed (�) or Repaired ( )
..•.... . . .._.._
............. ...........................
••---•........................••-----••--------.......---....--•-
bY•---•----•- --� // .. h Installer
!Y�•_ _•___•:..........T---.C------------------•-----•-----------•-------•---•-------•--------------•------------
at.............. • - . Q.O- .-- -----•--------.......
has:been installed in accordance with the provisions of L I L.. > of The State Sanitary Code s d cribed in the
e dated. ���
application for Disposal Works Construction Permit No.....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RU AS A GUAR A=HAT THE
SYSTEM W FU CTION SAT S CTORY.
G� Inspector.. ...........••--.. ... . ---
DATE............. . . ..... ..a. `.._...�.................