HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: 95 PO/)J ST- Map: (06 Parcel 36
Owner Name: PI-fit 11 -f- fM aq etre-4 ST4hac1S_ Permit#: 131 Q TQ- 2.. 60 4/1 S'
Date Installed: —.)l)✓1<. —7 , ZZ-2-_- _ New: ? Repair: —1
Installer Name: -gPeA K-111p•A e , Installer Phone: 5.02- ?j,2-Ss&s"-
Installation of(list all components,both newly installed and existing to remain in use):
1560 cisy, -9,6x s -s .
Leach Capacity Q
p ty(gpd): Ground Water Depth(inches): Health Inspection by:_ ' 1 '
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 Zabel Filter)
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449
449
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1 Z
A B C D E F G 1
1 I. _5Z I
2 L3 27
3 4414'
4 5s ' '4
5
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