HomeMy WebLinkAboutSeptic As-Built Card Q,ox 4—Le-Acts oN Ly
Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: 33 RPlJtc4 L0 Map: ?0 Parcel:
Owner Name: R}`G Lcr4A k(- OtS Permit#: L"I-0475o W DC-141'3031)
Date Installed: S 67- 1 9 New: Repair: V
Installer Name: CIMS6 f ME) -Kr Installer Phone: 6O9-3i8-a-I«o
Installation of(list all components,both newly installed and existing to remain in use):
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Leach Capacity(gpd): 330 Ground Water Depth(inches):' ) " Health Inspection by: -NV-
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As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
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