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Septic As-Built Card
LOT NO. : 3( ADDRESS : (.‘ Z( r+f wr Ayr— OWNERS, NAME : 0-/ A- ..L¢t we.g SEWAGE FERMI:: NO. : NEW: X. REPAIR: JUN 2 3 1998 DATE ISSUED: DATE INSTALLED: � -,3-'61+ HEALTH DFPT. INSTALLERS NAME : nZ i-(yt_ 5,.i C[Nf s INSTALLATION OF: WATER TABLE FINAL INSPECTION BY: . DRAWING OF INSTALLATION ON REVERSE SIDE: r' r • • 16, )