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Reco ual Sewage Disposal System <br /> o P,e Completed bY inst,aller <br /> <br /> ~4~1 number= Living unlt~ ... / ~ 9ede<,C.m$~{~ths ~-~ ~{H}me~t= Ye~ [] No <br /> Voter suppiy~ Public system ~' Individual well ~Communl{~y system <br /> epilc tank: Distance from well ~'~4~ feet, Moforlol~No. of CQmparfments <br /> u{al ~iquld copoclty..~./.~.~ O .... ga. n~lde length ./-~v, <~ ,~"~ jI- icl inside w <br /> Diameter ff. Ltqutd depth fi. <br /> lie disposal field, Distribution bce<? Yot ~, No ~ ~fhe~ <br /> <br />qidth of trench .......... ~ ** ~. Well ~ ~ <br />~istance be~een lines ~' ff. L~ fine= Front ~ Sld~ Rear ~ fi_ <br /> <br /> ~ filter mater~l: Grovel: ~ ~ Other .Depth ben,th tile ~ <br /> eptfl of filter mater~} over tile ~ Inche~. Depth ~ fl~ bel~ or,teal gr~d surf~e <br /> <br />Note, {ndi~fe No,hotly d~[on. <br /> Jn~peclioB will not ~ mode un~l c~m~let~ fgrm I~ returned fo the Heohh. Depf- <br /> <br /> apparently will ~ wlJ{ not [] <br />~emark$ <br /> <br /> (FOR HEAL'I'I.I D{~PT. <br /> <br />function latl$foctorliy, and is therefore approved ~'-' Di~approvnd <br /> <br /> <br />