HomeMy WebLinkAboutSeptic As-Build Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information /�
Street Address:C\C\ 1(e(c\ (\\3� Map:()-22_ Parcel:6;
Owner Name a � \' _V)L C:'1(o� LLC_ Permit#:22—()\c'
Date Installed: 3 I ci C.G2.2-- New: Repair: 7\
Installer Name:1 esV .. a % •S l[L,xJL c'iCo InstallerPhone:��–.... -'c‘�
Installation of(list all components,both newly installed and existing to remain in use):
bpi( 1 ►c\C A cc- D( \1 c ccrACA \ C.I ,rv\ l -
Leach Capacity(gpd): 3 3' Ground Water Depth(inches): 13 Health Inspection by:D• 1Inom-e,t-e, .- C
I certify that this system has been installed in a vvtth the provisions of 310 CMR 15. and all local
regulations.
Installer Signature
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge–Label Risers and Zabel Filter)
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RECEIVED
t MAR 10 2022
HEALTH DEPT.
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