HomeMy WebLinkAboutSeptic As-Built Card Zc* IC —frtarX . 3
Town of Yarmouth 66-21)t2f30 NS
-�7 �/ Subsurface Sewage Disposal System As-Built Information
Street Address: T r �O�+SL�4), ACJ 3 1f Map: C Parcel: 1
Owner Name: 1J r O C (y C�,c k Permit#: 19_ico/!/DC—I5-3Q0/
Date Installed: ,5/ i New: Repair: \/
Installer Name: C S e ( t11LcA. 1- Installer Phone: 5-0f 3?8-a((
Installation of(list all components,both newly installed/ and existing to remain in use):
I/600 i�cQ C4- p frtl ./-E109().. -/--- 0--36 ,k I 9- 0-r? rrro or rri'
eill/ �-� 1 .3)-ix
Leach Capacity(gpd): 3310 Ground Water Depth(inches): 4 Health Inspection by: _
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As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
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JUN 072019
HEALTH DEPT.
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