HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information (��(
Street Address: �1 1"n 3 0 1a —I off- Map: 1 Parcel: 14
Owner Name: KC!21 N S Permit#: 2.-- C (Li
Date Installed: 5— 19 - 2 v 2-7— New: Repair:
Installer Name: CRICe, CacA S p 1-t c Installer Phone: 1
Installation of(list all components, both newly installed and existing to remain in use):
�- IS(o S►4-I I- 3 -Noi-z 4-20 17- eo,i; Sb 504 4-2o Pay we((s
25-(1, 13t X 2
Leach Capacity(gpd): 3 y 8:1 Ground Water Depth(inches):N 1 V} Health Inspection by:
13 8''
I certify that this system has been installed 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 Zabe Filter)
(Zae- pc H
U_
•
. <_ 3
SPE
OCT 21 2022
HEALTH DEPT.
A B C D E F G
1
2 LI
3 a' 6''
4 5� �� s e-
S
6