|
V1 ktft\ a 'R,v 1 Ilt It Dig ,IVNi l ( i it.P, I\T)I111DUAL.ON-SI`II;SI WA(,I ,=,' ' ; k1 f i if/i)
<br /> i � „ ,, 5i55Sil ; =a..,
<br /> +1T EJi alit ilT39a (to be completed by sy�ster: Ii ,l,r
<br /> I 593-C88-51d1 _p� �y((��
<br /> httt u �'1
<br /> r
<br /> marioo.or.nedf•\� 3acltrtdngla;,,,,,im,
<br /> AS-BUILT PLAN OF CONSTRUC"TED SYSTEM:
<br /> Sole: I"
<br /> t TIP.," 3e O'4'9',
<br /> I i
<br /> -x.. 7"--'
<br /> .„ :-.1";"
<br /> r I
<br /> °nod ,
<br /> 1 Aft
<br /> 11)
<br /> liv1 1 A
<br /> t C� t 1
<br /> ``-Ltd. "4" p `r'i
<br /> NI i
<br /> _cc:1cl , ,., , .....„,_ '' '7(7..77,... , 4 .4' _ -.....—_---.. 1 ,
<br /> t d, c r 1 si
<br /> Ii
<br /> ,t t t ails and Eta : „ ry to locate all can mutts the system:n thc ta:ucei
<br /> }
<br /> --�
<br /> ' tiF?$i._ -__lrfitsl
<br /> JNs 1 ',_I lys'CFAI IFIC I ION•
<br /> I It RI IIS i:R,TIFY TI IATTHE ON-SITE SEWAGE SYSTEM h*:.
<br /> L ns 3tcm De .: STAI I I r, ,f Tltf:AIIOVE ADDRESS WAS CONSTRUCTED IN ACCt`£R-
<br /> 3, 0 , n-..,r, DA.,t i .,< 1€Irt:REQUIREMENTS OPTIIE PERMIT AND Ti4ERULES
<br /> I mod_ 01 1 ill 6` •'" '`1tE!NTALQUALrTY COMMMISSlO!'.
<br /> -,.usrt aominarirr4:;u '
<br /> - , t..,-through I I I ha*,',:1,.0.o. ;;z septic tank and certify it to hen.ttcrtighr
<br /> r frlucnt�e�,cn 9 I spe it The system was instated hy:
<br /> Si_e.?.1 c,. '-/ I I Property Owner(pertnitteel
<br /> X(Licensed Sewage Disposal Service
<br /> DRAIN l'IELII I rock 1.1,mq .., t i ' !Imo__at_..J 't
<br /> Ei�ck.ir.; aside-rpspe I' 11C �, Ott' I�Li�Li�:cttte\utn5er: 3 j`
<br /> P' total de ' I It '.:; ,,;,,� I II' .,i2c { r('� q(/}}-rt�
<br /> _ DI CIEQ Crjt:I7 .3..., ,�. 1 Y i3 A..1
<br /> Driietie:a .taterial IAA'.„:_..,. :Err tart r F I Y _
<br /> v rotat air inooeld f a `}t;{rt t. I 3 Depth Ntuomaro 4 \lasimmn, •
<br /> S attain Or,i i t,_ Sid _.t-._, __ -it--Z:c
<br /> Effluent i ,p: c • d
<br /> Pump;
<br /> r utI• ._._._. t ..:,.•I7,rC}zte_ .-,..._.�__. Cnrt:,�attvnat,c�. ._ its.a!�..__S.M1tG,.tit ;e...�...L� Lt�i.!
<br /> �� (ptea>e print)
<br /> l I I t ,ri:',1,..',.:1
<br /> 1tt h Jr,adtfitiin r sheet for cantportt r N..n.1 1,i..1[Criak ant Iistrd abuse Date 6/. 4',
<br /> tH For NI arose('ounts°Use t}ntt 1 ...',;a sepste system has been in',pa-end ha:station C'ewite "I'he infarmatt'rt lain hem det':nnihed is he a.cur.tic
<br /> and the sfctem is; i' Approved proved with corrections:see inspection report t I Denied 2'
<br /> Stzned: ok + ttfc: 11t„-rCY O'
<br /> MC'
<br /> I1. '-;I re '1ILI:412;514;I1'1i l,.t,Iinn.Saps':'S-tP.As-t3uiii_413V`i:r's.n_'ttt'd'k tH�r Skrr.crna .:<,:i. P_��UiF.f;xi >- E'le�t,,.r;.:.
<br />
|