HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
pSubsurface Sewage Disposal System As-Built Information
Street Address:
5 Map: I � Parcel: S S
Owner Name: 20. 1i,(� �Il ) fD Permit#: ( 0 cr 0
Date Installed: ? I i 2 1 3 t New: Repair:
Installer Name: a . O (LAnn C-) 104..d Installer Phone: - 9 45
Installation of(list all components,both newly installed and existing to remain in use):
A - (-'r1,•
00
Leach Capacity(gpd):as 0 Ground Water Depth(inches): N /P Health Inspection by: ( ) rj ra f
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I certify that this system h s been instd i�j a_ccor-dant with the provisions of 310 CMR 15.00 and all local
regulations. '( \ ,Lt° a lei�
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I aller Signature
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
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c� -�� - I AUG 2 2021
J, HEALTH DEPT.
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G [1YEEI AUG ? 4 1021
PUG ( 4 2021 `., HEALTH DEPT.
HEALTH DEPT. ��
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`• TOF ASSUMED 29.46 �'�
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IN \& 12, OUTLET TEES , V.�.
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ILTER MUST
BE CLEANED',O/ ` fir\/ 1
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AS-B UILT SEWAGE REPAIR PLAN ENGINEER: STEPHEN HAAS
LOC A TION:
8 SKIPPER LN., YARMOUTH PORT, MA
MAP 115 PARCEL 53 >' .02;
PREPARED FOR: --I' `" : a\1'
ROSEMARIE DIC ENSO •
SCALE: 34
1" = 20' DATE: 8/19/21 \ gyp• - ,ti,.
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JOB NUMBER: REVISION:
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J. O'LOUGHLIN INC. ttl
714 MAIN STREET, YARMOUTH PORT, MA 02675
(508) 362-4942 jolinc@verizon.net