HomeMy WebLinkAboutSeptic As-Built Card - Bldg 15 Town of Yarmouth
Subsurface Sewage Disposal System As-Built Information
Street Address: L 0o Bwx. Island Z2 l E,u tthrl is Map: 41 Parcel: qi
Owner Name: KDr5epond Coy p. Permit#I: ,' 2-2- ' 0k52
Date Installed: 1212 7 122 New: Repair: "
Installer Name: QApert' 8 Our Co Irv, Installer Phone:50p- 02 6E30
Installation of(list all components,both newly installed and existing to remain in use):
C2) 1500-gal Micro Fax i- -t-zuw , Q.q iitacttl , b box 02) goo - 9a 1.
tairLirg c.a ,Gtrr
Leach Capacity(gpd): 1545%5Ground Water Depth(inches): I2Z, Health Inspection by:
I certify that this system has been in talled in accordance with t e provisions of 310 CMR 15.00 and all local
regulations. I'. (3 . (Y\.
Installer Signature
As-built Diagram MAC!
AC!
1 (Print Clearly in Black/Blue Ink and Use Straight Edge-Label Risers and Zabel Filter) 4
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