HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
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Subsurface Sewage Disposal System As-Built Information ,,
Street Address: 1 g C�1/ lVJ Map: 42. UP Parcel: �t
Owner Name: SAM.. ° S'-kphen 111Qdk, Permittt: 073-195
Date Installed: Z/(S ZO2t( New: Repair:
Installer Name: T .T, Dui Co. Installer Phone: Sng 47`7 %g7?
Installation of(list all components, both newly installed and existing to remain in use):
M 1 /506 ,y i fT_t See& Pik fo nea /-2O Ar/nholot beX 71.v 67, ea(' 1/-2-6
50t'
Leach Capacity(gpd): 5354 Ground Water Depth(inches):/(/ tQ Health Inspection by:
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I certify that this system has been ins ccordance 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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H EALTI- U E P T.
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A B C D E F G
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2 zo.'1 52, R
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3 Z B � 3c. ►
4 2S4. D 291
5 32'1 21'5