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Septic As-Built Card
Town of Yarmouth Subsurface Sewage Disposal System As-Built Information Street Address: a& (3 e 1 -er . Teri Map: '3 Parcel: 2 Owner Name: C q r1''i i 'J v tori L Permit#: 6 0 if DC— 15- /61--AS t Date Installed: — g IC? New: Repair: X Installer Name: rI I IS d rO 04 Installer Phone:SO t 36 (p a.37 Installation of(list all components,both newly installed and existing to remain in use): x157?,uC- (o 60 CA . 5,71W1t A/(k) /©b o uwr® c H 04r/4 —6-3 6- X s( i-/ CAO I-1 v ! //,‘'30,e s'r °)ez_.6 Leach Capacity(gpd): ?cI Ground Water Depth(inches): P ✓/Health Inspection by: r/ As-built Diagram (Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter) � l r 2 046.0.-rec cz.-- Iry 4(4=97 S � � A B C D E F G 1 JO ' 2 ,$ 1.7 3 2.1, `f 19.5 4 3$" 3Q.5 5 37' 36.6 6 'fa.5 3a'