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HomeMy WebLinkAboutSeptic As-Built Card �r Ak,t.) se.- L}nt a39 siv�- ,eoC& a G' ©F SACiz Nousg' .A S1 - 6 _/ / LiN /SANOti i0 ( AD! A, �� �a=a� � aq • a o Ex l 5�,No &z=so' j ANC RECEIVED MAR 2 d 2024 HEALTH DEPT. • :r • Commonwealth of Massachusetts }'' * , Title 5 Official Inspection Form F #+ , Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r „ .�; , 239 Blue Rock Road,Yarmouth,MA Property Address Janes Gleason 239 Blue Rock Road Owner Owner's Name informationedfo South Yarmouth_. MA 02664 3/9/2020 required for every ice. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.Check one of the boxes below: ►�4 hand-sketch in the area below 0 drawing attached separately t .. v ) 4-' ic)E-0- . •i poi .1. ...._ •. _ .. . 0 .4...c. a, ! a � ` z eDisrotioce.T.t., • '1:3,3 S"' ; 8, - tq- 4-13 Y r ; �� � 43 ft J f ) 83 ` 3, /-q 1.35-r1 1Y " rf teinsp.doc•rev 7128/2018 Title b Official Inspection Form:Subsurface Sewage MporaI Egoism•Page 7e of 18 ��— � � � � � �`MM M I ro �- � �, � � _ � .. � t .. ►� � M � � � � � r � aw ��y � �� a _Q w � � . A < �.�♦ .� 0� � .. C� �.. � � �� � � �n a W , � � � 7�-� � M M !ri .a.� - O � �.J M �, ( d W ,� � d M M H H > M � 3 cn c.� w I Q � � I, � �, z � '� a a i � � � � � �� EW.,, • S � fz-+ � �' � �'�� � � � Z � � �� Q Y d � c� � ` �. z z Q ,I� A U •• � � t*, ..� �'i q � ` "� � � � ¢ s�� � .a o � ii N O o . ' ►-H+ � z ,�, . �-'�i � � w �d.. a o w ; '� �'r1 i � w a a H � o j • ,z w cn w ¢ ¢ � cn a a H c� • O cn W H Z CL' C7 � Q�i Ll± H „•�• ' :. � H z 3 H tH/� t�i� H 3 r:• O :: I � O 3 tz] Q � Z ¢ � p" '� `' ..� O tn C.� �-.� ►-+ 3 q � ':•. Ey