HomeMy WebLinkAboutSeptic As-Built Card D-Box *-LeAck4 Coal
Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: 'S (0ci\cj-eVArC.A.4- cp c/1 I^3
Vd�. Map: I Parcel: 62--Cj
Owner Name: ( CA. k S Permit#: I 1
1 ®Oitir"iq
213 q7
Date Installed: ' I ,el New: Repair:
Installer Name: (tcs.e GtVII/ V"\evccLClr/l-I Installer Phone: Cob' ??'67, fio
exot
Installation of(list all components,both newly installed and existing to remain in use):
6 005 T. Ce>‹('54-14,5'
D'63 )o , - S-0 J C ub-ers.
2c 'x/3/(t >_ i `� i(/ 7`iSe12-C
Capacity ma
p y(gpd):-353 Ground Water Depth(inche ): /}� "
Leach Ca Health Inspection by: 1":112-
0
J12-
0 6,4 2//9
As-built Diagram
(Print Clearly in Black/Blue Ink and Use Straight Edge—Label Risers and Zabel Filter)
LI, s4
ptdr{r
Osi
t Dec%
l
3 0
L__________Lsv RECEIVED
JUN i'4 2019
HEALTH DEPT.
A BCD
1 4Q3). S E F G
2 s�
.5.s -
3 LIT) fl
4 53.5 lila
5
6