HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: 5Z W•1.f 1 t11 1�C Map: 3Y Parcel: 83
Owner Name: PifkkQ C 4 1<PrR C HA Permit#: 22 —Oa? 1
Date Installed: V02-- New: Nof Repair:
Installer Name: s`f e,.,3 1-crfr‘ S Installer Phone:@DR)3Go--S 1
Installation of(list all components, both newly installed and existing/ to remain in use):
tkQ-4-v 1,'00 -t_. -r1 .S� / `')c 1-s i,I ,v S f o C eagli,4
Leach Capacity(gpd): 330 Ground Water Depth (inches):_( " Health Inspection by: bed 4r0Cie.-
I certify that this system has bee ' accordance with the provisions of 310 CMR 15.00 and all local
regulations. o
Installer Signature
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge-Label Risers and Zabel Filter)
Liq
2 OJ
3 To eo,e
rt,5 (are— 0 ' RECEIVED
OCT 18 2022
HEALTH DEPT.
A B C 0 E F G
1 67' 4" Ili (p''
2 18' '711 I I'
3
4 45' �Ip'
5
6