HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth LaGok Only
Subsurface Sewage Disposal System As-Built Information
Street Address: 5Soxirst c. 00-1lc
9 c1 Rck- Map:L)S] Parcel: 4
Owner Name: R onoAc ovr co 1 S
9 Permit#: 19- 2 33
Date Installed: C A 14, 19 New: Repair: Ir.
Installer Name: *4 G3 Exec :AjOf\ Installer Phone: 9`)`)- 0653
Installation of(list all components, both newly installed and existing to remain in use):
I rOO 1 ST - L-1 20 Box - .� )4 ZO SCX� .� L,e Sk ft Ler-04-1
[Ex�sM a.3,5 * ( 12.83'
Leach Capacity(gpd): ego Ground 1Nater Depth(inches): 1.32- Health Inspection by: POW 1 o/ss/I y
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge)
fl
1.////d
0 I t3 C
OCT 162019
HEALTH DEPT.
A B C D E F
1 13'6" _ 11 `
2 z& " Zy '
3 23's " 39
4 Tyr S" 142 's"
5
6