HomeMy WebLinkAboutSeptic As-Built Card I own or Yarmoutn
Subsurface Sewage Disposal System As-Built Information
Street Address: 36 Ck;c.R cLtcc LiJ Map: w7-1 Parcel: l Z
Owner Name: Soto\\at"\ Si 1Qo-- Permit#: 2 I 1 h1 c4
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Date Installed: ncxrcL. 2.2T22 New: Repair:
Installer Name: 1 .B EXev.0crl;or. Installer Phone: WM - 0653
Installation of(list all components, both newly installed and existing to remain in use):
/500 t-r'io S7 • t-12o _943ox - 2 ).4Z0,coo 90,) cf c_
4-e iy
Leach Capacity(gpd):3 L/c( Ground Water Depth(inches): Health Inspection by: I I4 `:'
Hcv. 3—‘13 -zZ
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge)
H of
RECEIVED
MAR 2 2 2022
•
HEALTH DEPT.
A M a
RCAR
3 j- _edkrz. oom
•
A B C D E F G
1 41 - Zy '
2 La, ' al
3 40 IS A' 58
4 41 ' 63 '
5
6