HomeMy WebLinkAboutSeptic As-Built Card 5 9 Le) . Yilamot)-N RP vo c IA
Property Address Map section parcel lot
TYPennionainfl Permit number
(Residential/Commode') Rifibltke i 5COM)C. • ZO • CM
ele l'•elan
Number of bedrooms
(residential)or square
footage(commerdal) ,k INA b bm Date of installation Seedober a 3 / .Z '
o Special dr :
Capacity required and Mm .G.P.D.required: 4(4/ cunstancts
Alternative Tedinologyl
provided(G.P.D.) .4/6 3 e(s)etc.?Please
GPD.provide& • sPecitY NA
LTAR(application rate) Installer Name PO4"kikt44>615 tifiG.
Leaching twiny component
description and dbnensions. C - -Nal A
Designers Name Alba
Water serviaefrAtirmwa.
(Town or well) 1-blillel Installer Signature° utfaill:Ma
- f
Depth to Groundwater 1-/O to ci...irle, t C) *Instances signature above indicates the system was installed ., .- as
proposed in permit phut and is the installas certificadan as required 1, . V OAR
State Zone m (yeano) Wi, '2.0 Ve... :Ca 1542
The septic system location must be placed on the reverse side. Use two permanent lanchnsits(such as house cornea)to locate system components.
These landmirks should be identifi" ed with lanes and the system cowman should be identified wing number& At a minimum.two septic tank
covers.the&box.all four comers al the leading facility and its inspection parts must bengal!measured from the chosen hedonics.
FALMOUTH,MA
RECEIVED
HEALTH DEPT.
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4( a = A 4.3'6'� *16-`�-' 41= Q Sq 416 -3;'6'
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AUG I 2022
u\e- HE_LTH DEPT