Septic As-Built Card Town of Yarmouth
(( Subsurface Sewage Disposal System As-Built Information
Street Address: 10 Y V 1 Mhl<pv Map:50 Parcel: 0`3
Owner Name: 1 QU( 01(0414G1A F5 k 6t" Permit#: ily 420
Date Installed: 31 lei(zo2y New: k/ Repair:
Installer Name: `\;tit t, VU( Installer Phone: 603 V71 5'??.77
Installation of(list all components,both newly installed and existing to remain in use):
IV cv) 1145'0 qatm vOt -1-etet -tb 4/2o dls+r(bvhan bbx nr,,,A1 L.CcQ
e,InAtit►btl.S a gccq&k cam "
Leach Capacity(gpd): 390 Ground Water Depth(inches): /36" Health Inspection by:
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
• aAC WELL 1146
t i A
5 i +
CIES O • O O
,40
r ❑
' 3
Vear
MAR 2 5 ZO%4
HEALTH DEPT.
A B C D E F G
1 1cr g
2 2/.3 50.5
3 33, 1 35.4
4 3442 3Z,8
5 L/( . ,s
6