HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address:442 West Yarmouth Road _ Map:66 Parcel:84
Owner Name: Marcia Ricketts Permit#: 23-3815
Date Installed:April 20, 2023 New: Repair:X
Installer Name: Ready Rooter Excavating Installer Phone: 508-888-6055
Installation of(list all components, both newly installed and existing to remain in use):
Installed 1500 gallon septic tank, H-20 DB-3 and 2 H-20 500 gallon leach chambers
w/ 4' of stone.
Leach Capacity(god):342 Ground Water Depth (inches):70.8" Health Inspection by: Engineer
I certify that this system has be tailed in a rdance 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 Zabel Fitter)
APR 2 1 2023
HEALTH DEPT
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A (J C
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LA—belb1/4\
--`av J'A. 1
A
1 21'4" 26'
2 16' 32'2"
3 31' 18'
4 34'6" 22'9'
5
6 1
Commonwealth of Massachusetts
►� * g Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
442 West Yarmouth Rd
Property Address
Jim McGrail
Owner Owner's Name
information is
required for every West Yarmouth MA 02673 03/18/20
Paige. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
14. Sketch Of Sewage Disposal System:
Provide a view of the sewage disposal system, including ties to at least two permanent reference
landmarks or benchmarks.*Locate all wells within 100 feet. Locate where public water supply enters
the building. Check one of the boxes below:
0 hand-sketch in the area below
® drawing attached separately
442 West Yarmouth Rd
West Yarmouth, MA 02673
Front
B
A
1000 gallon septic tank
O 1
0-box
■ 2
6' Radius Leach Pit w/ 3'
stone
w
3
Al 28.0' 81 42.0'
A2' 31.0' 82 45.0'
A3 30.0' 83 54.0'
West Yarmouth Rd