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Septic As-Built Card
Town of Yarmouth Subsurface Sewage Disposal System As-Built Information Street Address: ZS Sc„�oLr Lo.K� (QA_ Map:(4S Parcel: S1 Owner Name: L.Q.Qrcfl - Ar-c\c.1 - Pr-% s00 Permit#: Bo6dc - 4L95 Date Installed: 1URC 1TIZZ< New: Repair: ✓ Installer Name: 2 4 Q E xc xU ti ov Installer Phone:P-503 T7 O(c5 Installation of(list all components,both newly installed and existing to remain in use): NEL) tsoo 90_J 1-ho 5-T- Ex 5-1:1 v,9 O jBo,c Lco c\;-ck Leach Capacity(gpd): Ground Water Depth(inches):' Health Inspection by: cc ( As-built Diagram (Print Clearly in Black/Blue Ink and Use Straight Edge) �r ori-) A ID ®I I I I®I -© U , HEALTH DEPT. A B C D E F G 1 ►Z'G " - ZZ ' 2 I2G " IS ' 3 Z 'z , 4 -z-z L Z� 5 6