HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
IC
Subsurface Sewage Disposal SystAs-Built Information
Street Address: q 1 C NU( Hi Mi4j!�.� Sr1, Map:\C1 c�I Parcel: \--)3\
Owner Name: )4(..LCNsOJJ Ml mcfG8-,H6 iK C o. Permit#: (?XNI,C- - c.ti
Date Installed: 8/— 3 —2-U 7-2-- New: Repair:
SInstInstaller Name: '2 't-'.- Co.A, J Ip4y Installer Phone: ---17C". Zg ZS...—
Installation
allation of(list all components,both newly installed and existing to remain in use):
/— /1-20 2.5- 2.coi tto' 6,ur sir: 1- H-2o 5'Iio/ p—E32hc
' - g'-2C; ? oyL.-)d/�S sf>< 1Z, 3-3 `A '2-1 ��''22,, C
Leach Capacity(gpd): —21W
(0 Ground Water Depth(inches):12( " Health Inspection by: .5 C.,
I certify that this system een in d in accordance with the provisions of 310 CMR 15.00 and all local
regulations.
Installer Signature
—4 IAs-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
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