HomeMy WebLinkAboutSeptic As-Built Card Town of Yarmouth
Subsurface Sewage Disposal System
As-Built Information c� �/ \
Street Address:\G�`) �c.:A 10(AP� \)-\ ` Map: I�1 t > Parcel: D )
Owner Name: W GAY\ > ,)l Y,� p\ Permit#:Date Installed: 3 L I G 11.01-3 New: Repair: V/
Installer Name:P �G cY\ L �� ,X�1 Installer Phone:(1 1 ' J \Z"Cif"\6
Installation of(list all components,both newly installed and existing to remain in use):
t\ \t-\\e`c \500 c \\o c. - c c C \c\ c,\\p,\ \\RX D>o \e�=
\n „1\ee'_ \A-Lo 5cc\V-r‘ \mac itAN C\� m (`)
Leach Capacity(gpd): Ground Water Depth(inches): Hca"Ith Inspection by:
I certify that this system has been installed in accordance 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)
i I `,
`1(x,SL j1
4
—Cc 0 0
A B C D E F G
1 ►`�,5 -2- e`3
2 � � 5 -7,7
3 l.,("1- k3
4 ..5 2' 03
5
6
MAR CUL3
HEALTH DEPT.
MI3 LSOWC
MAR 16
HEALTH DE