HomeMy WebLinkAboutSeptic As-Built Card U C9V11 n (1DY Varrnoulurs
Subsurface Sewage Disposal System As-Built Information
Street Address: t'4 C'TG-" lj t2_. LI, . Map: II3 Parcel: 30
Owner Name: rQl YZrf" di e_or—e, ,15fzoZA Permit#: Z 3- 05A
Date installed: 51 10 - Z _ New:_ Repair:
Installer Name: 0p'i 3. tJw2 CO . Installer Phon ,, ?9g) /774877
Installation of(list all components, both newly installed and existing to remain in use):
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,EY/.5ri b!� . /000 90J. TA-t t K �GJ e /I o /000 l Pedt,,919 cHfiM(ez
Ow )). _-74- ( 0 _sw.„
b/( Ii/G-i,�•16-Zi '--
Leach Capacity(gpd): 1410 Ground Water Depth(inches): !DZ Health Inspection 1 •
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
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p11.. JUN 12 2023
1• i' - HEALTH DEPT.
11111 41 3
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11111 � C 7- I
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3 379 41q5 - — -
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