HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage�e Disposal System As-Built Information
Street Address: 2 2� <<q v( tk b2 Map: Parcel:
Owner Name: I o kai co Permit#: AK,' 23 2\2b
Date Installed: 7—Z b'2 New: Repair:
Installer Name: .C-C(Pe (�-� S c` 5 PC 1 U1 Installer Phone: 5b$ ZQU Z 0
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Installation of(list all components,both newly installed and existing to remain in use):
�e ice ox , a6tdon Syssl/►
Leach Capacity
p ty(gpd): 350 Ground�, ater Depth(inches): Health Inspection by:
I certify that this? ee,,��*• ed in accordance with the provisions of 310 CMR 15.00 and all local
regulations. t %"
Installer Signature
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
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