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HomeMy WebLinkAboutSeptic As-Built Card I 4 Commonwealth of Massachusetts * . v-- Title 5 Official Inspection Form -- __l _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 331 Union Street, South Yarmouth M -61 P-90 Property Address Anthony Penny Owner Owner's Name information is 331 Union Street, South Yarmouth _ MA 02664 March 11, 2020 required for every City/Town — State Zip Code Date of Inspection page. D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference f landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below 0 drawing attached separately i f)'16(114- �NlA p o 0 1 .5; x... 5 aµt �— 5. i _-- _ –I _ � — - — �- - - - — 1. \..... i lei • © ® 0 .. 110.41,40i,, , , , . . . . . ... . ... ,•..,... .- . . . . . ... , . , . . . . .. , a a = 3 is' : isIll 5 -- SII ' any' , ' `l l i '1 i 9 tt Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 t5insp.doc•rev.7126/2018 7 (7`