HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: yy 118 flew_ a3 t e6T r ,jt/
ylotok Map: 9 Parcel: !0 Q' 1104. I
Owner Name: /' CKK Cori\S5 Permit#: FO1106'022'//q2
Date Installed: /o//J/p2G R New: Repair: /
Installer Name: 'Raerit. 13 C CO. 2 'C Installer Phone: 50$-(47 '08 7�
Installation of(list all components, both newly installed and existing to remain in use):
1ileu1 65C - 1ra/for\ a CoJfpa4-ote I+ Sepffc, -T AK, /tkl ) cl6b Gallon OJAI. CA2m br.r,-(30*) H-C7C)
/l}e v N-a D DO 9. r/16 1 y I.eac.A P115 Wilized/ "r-/o /euJ Pearl .
Leach Capacity(gpd): 3da Ground Water Depth (inches): /V/A Health Inspection by: -75C &bC P
I certify that this system h e ' tailed in accordance 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 Filter)
p-CioX -f- �#-S metal API
Gov +v 9flt . P4"e4+
---I mini 1704-
4`IS offcce
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C1
JAN 0 4 2023
HEALTH DEPT.
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A B C D E F G
1 13,5a
2 al ' as'
3 4V34 33'2u
4 181` Ib 1 7" 27'5'' 31.1 Si.
5 441511 1.13'
6