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crrY or oaotvo oete <br /> , ADDRESS � Connected to <br /> CODE SEPTIC SYSTEM INVENTORY CARD Municipal Sewer <br /> Address ����� �i�ACk;F'77S � C=iiU' /`L� Property I.D. IJ II7•-`-� 3� (�n/� WELL DATA <br /> .�Standard trench �p.� � � �,N,.T�� I I <br /> O Mound <br /> System type ❑ Other Legal Description r`�'�rM`���Mr, pF �t����, f�.;-, p � <br /> I � <br /> L <br /> Permit No. % ���'� Date of permit /�-��� ` ��� Installer �t/LL�U,/3�1 � � <br /> a, <br /> � �M� No. Bedrooms Garbage ,� �„ <br /> �Building type �E .\lI> -7VC � or GPD �- }3;� Laundry�_Dishwasher Disposal q � = I <br /> � o p <br /> a <br /> � SEPTIC TANKS: Material C�c.,r��c• . �i-��cf.•; Capacity 1) �C�C7 t 2) �`O '� ° Q c <br /> �'Cll"'IF'-{`l� It 1 3�/Sv y�/S z: � �, � <br /> Proper outlet and inlet �K Baffles (uLLiLJ/LL{ �fa`/ Liquid depth to RO level y -�" � ` <br /> °' O <br /> / � <br /> �Height of tank bottom above water table _/tit�A/� Distance to nearest building ��--U N � <br /> � <br /> � � <br /> O <br /> ! DRAINFIELD: Total length of lines �9C� Number of lines �' Trench width �_ <br /> 1 <br /> N <br /> Y <br /> Total treatment area(sq.ft.) ��n Height of drainfield above water table 2� ± � � <br /> u <br /> Type of filter material Soil type GC'?+�.y ,C/ail/� n <br /> _ �, �. <br /> d <br /> --. � S �1 /�;c. E t - <br /> Distance from nearest bldg. --�� Tile size�perc rate min/in ° � a ,c <br /> d � <br /> o v <br /> Depth of fill over drainfield �"� Depth of rock over tile under tile � a « � <br /> � N <br /> E c � <br /> .1 <br /> p a U � <br /> -rt�1 �_ - �' `1�;;. r����i lf � , � <br /> . Dr��,u�l��t�s /'P-��f��y /-2 ��F Gu�� 7�t.�. <br /> #= � " �v�ar�£s s�n�rva-�-i-y <br /> >;'-� — i�v �/�;�, ,l������-� ��' nc� � <br /> _ .. ..._.....__ ._ . _ . . __.... ....._.......--n...rMr�►'AI�'AM�'P�WM�yW���, <br /> LOCATION <br /> INSPECTION RECORD PUMPOUT RECORD SKETCH <br /> D�TE COMPLIANCE DATE GALLONS <br /> (o"c�S-�l �/(J Sc�•1`=r�Cl/UC.: � //-/=7� /5-c�C� <br /> (L�"��i�J ���,.)'.l�C'�"Z''7� � �j�f�Y�G_ <br /> ! <br /> ! � r�•- aLdU,�{�t�F�� ..1 Y'`-!a �IoLC� <br /> I�,GiA�ri�i��fv��i� sc�•rrr�zf' AiS�N4f'C�� <br /> �- ,; - ' , � _� <br /> , t, i ���-, Gl�� � i . / V� �7�� -^.. <br /> � i <br /> z-� � 'P� .�_ <br /> �=�-,� '� ' � '� --�_ <br /> ����� r � � <br /> n ,� <br /> Include: 1) Well location <br /> 2) Distance from house <br /> septic tanks,dist.bo. <br /> and drainfield <br /> C - CONFORMING S -SUBSTANDARD N - NONCONFORMING 3) North arrow and roa� <br />