HomeMy WebLinkAboutSeptic As-Built Card (2) Town of Yarmouth
Subsurfacece Sewage Disposal System As-Built Information
Street Address: 7 ilaLii'Q Map: Parcel:
Owner Name: etKe f/47 M" Permit#: Vrt 04 "Zq_941
Date Installed: 7— /. p2 y New: Repair: 4
Installer Name: L NPX,I C2 4'i 477.1 tL C Installer Phone:o'Ja51 737/
Installation of(list all components, both newly installed and existing to remain in use):
/ Oa y4L 7:4 /e ,D,g-3 0?- 6-?D,.c1I /7/-Zd e//'v uIEtec
Leach Capacity(gpd): 330 Ground Water Depth(inches): Alfr Health Inspection by:
I certify that this system h en in e i rd e with the provisions of 310 CMR 15.00 and all local
regulations.
Installer Signature
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and/abeLFilter)
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