HomeMy WebLinkAboutSeptic As-Built Card .. IZOA.(2 Lel. - -1-6 �A-n1 -- l aLET
Town of Yarmouth oiJ1
Subsurface Sewage Disposal System As-Built Information t`
Street Address: (S7 t4J14.JDw Aiki) 4 --1 Map: L Parcel: 1‘.3
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Owner Name: �J�'.o-(7- £ jO�N064D,4t'IS0CJPermit#: /f—d-357'Oif-DC--6„ow
Date Installed: 10 - ii - 3C) t Q New: Repair: )(
£ c&Installer Name:�Ap (Q}t pS •?1 - �O Installer Phone:417-2E11
Installation of(list all components,both newly installed and existing to remain in use):
C HAN)&& 64A-4 i.1 (;t t E u Se &4 '( c_ T4)K
cp - x_ IN L&=T `I'
Leach Capacity(gpd): //. Ground Water Depth (inches): l Health Inspection by: 7{ -
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As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge-Label Risers and Zabel Filter)
A
130
3
1 I
__-
OCT 16 2019
HEALTH DEPT
A B C D E F G F
1 ace,' lar
2 301 i 5
3 -33 ' 12'
4
5
6