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- MA?40N COUNTY. HEALTH DEPT.-Sanitation Specifications Num er <br />Do <br />....... <br />permit Issued To~ ~illia~ll A. W~z'd 5~-7!92 .Property Address__ ._~P~ E'~ ...... Aura,. ,,~.1 <br />Septic tank:: Min,murn hquJd capacity wiff~ distribution box 7.~ Gals <br />Subsurface DJsp~osal F.~e]d required - / ~5'~_ Lin ft ~."~ (~3// Width of trench ~1.~) ~-~ sg ft <br /> <br /> Record Of Individual Sewage Disposal System <br />To Be Completed by~lnst.~,ller <br /> <br />Total humbert Living units ,/' -- _8adrooms?-/?-4zl='r?Buths I~a~ement Yes [] No ~---- <br /> <br /> Water supply~ Public system <br /> Septic tank Distance fromm.well <br /> Tolal liquid capacity ~. ~ ~' <br /> Diameter <br />Tile disposal field:: Oistribution~tox? <br />Length o[ each line 7 <br />Total length of all hnes_~(~4f'_~' ~.~ <br />Width of trench <br />~otal square foalage <br />Dislonce between lines ..... <br /> <br />T>,pe of filter malarial Gravel:: _ ,:C'~ <br />Depth of filter' mat,~rial o~er tile <br /> <br /> ,Individual well ~ <br />/ "~'~ feet, Material <br /> ga[ Inside length <br /> ft, Liquid depth <br /> Yes ~J~,~,.No k~ Other <br /> <br />Community sys}em <br /> No of comportments / <br /> ft ms,de width ft <br /> ,,ft <br /> <br />_ft Distance from:: <br />ft Well / .x' --~ _it <br />_ft Nearest <br /> ft Lot line:: Front ~J Side E] <br /> Foundation ft <br /> _Depth beneath tile <br /> <br />__ Other <br /> inches Depth of tile below original ground surface <br /> <br />Rear [] f~ <br /> <br /> inches <br /> <br />~ketch of installation <br /> <br />Note: Indicate Northerly direction <br /> Inspection will not be made until compJeted form is returned to the Health, Dept <br /> <br />DATE .... .~ <br /> <br />System opparr~nlly will ~'""~ill not [] <br /> <br />Copies: (1) Orlg,, HD Files <br /> <br /> {FO~ HEALTH DEPT USE) <br /> <br />function satisfactorily: end is therefore approved []~"~'~isopp*o~ed [] <br /> <br /> <br />