HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: 3 `tL LU mbe'j (Lc.k Tr,i I Map: 7Y Parcel: 2-13
Owner Name: Edc,ci l De ou.. Ct Permit#:6 H DC`23-2158
Date Installed: 97A3 New: Repair: V
Installer Name: ci ,w i cue, ( o n`,-trk_A;o n Installer Phone:S Fr-77?-03S..3
Installation of(list all components, both newly installed and existing to remain in use):
Ex iL 4i /kJ /iro Go., ( fiQ (c to bc. Revsec-(1 tilleJ -Iwo 930 G4
'1 l0 Lec-(c.,,,D G!-ktrn6Cs.s ay-0 One 3-3 H--d0.
Leach Capacity(gpd): 3 5-3 Ground Water Depth (inches):, r, Health Inspection by:
/Encc;Q.1{'e t.-&'
I certify that this tem ha s bee installed in accordance with the provisions of 310 CMR 15.00 and all local
regulations
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Installer Signature
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
Il
13
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V
0‘ *
- 10 l
5c? �No Q ®
A B C D E F G
1 10- a s'
2 L 's' a-'5"
3 µ6 - :34` 6`,
4 Mgr " 37'er
5 ,fa; 7" 9-3' 6„
6