HomeMy WebLinkAboutSEP1975-00027•
RLS E1VED' ON-SITE SEWAGE DISPOSAL `SURVEY OF
JUL
2 3'80 �-
Street Or
JEFF COUO", Division Block Lot Landmark
'HEAl-TFi Lion, Lot Size '7 141 A
II. System Owner
Address
XTelephone Number
Permit (?) (Previous Owner)
Date Issued
Lot Size
/46 )(/00
III. Installer
Average Number of
People Served_
Date Ins"talled
Number of Bedrooms
C
Time In -Service (years)
+(Clothes Washer
YES
NO
XSeptic Tank Pumped
�,.-
YES NO HOW
)(Dishwasher
OFTEN
YES
NO
x # of Months/Years Residence Occupied?
(Garbage Disposal
�-
YES
NO
IV. Type of cover over drainfield. (i.e(grass, landscaping, etc.)
jC V. Repairs (when, what, who) Cause/of Failure
VI. Comments (Over for Sketch) 5ee s U f
VII Action Taken
•
RLS E1VED' ON-SITE SEWAGE DISPOSAL `SURVEY OF
JUL
2 3'80 �-
Street Or
JEFF COUO", Division Block Lot Landmark
'HEAl-TFi Lion, Lot Size '7 141 A
II. System Owner
Address
XTelephone Number
Permit (?) (Previous Owner)
Date Issued
Lot Size
/46 )(/00
III. Installer
Average Number of
People Served_
Date Ins"talled
Number of Bedrooms
C
Time In -Service (years)
+(Clothes Washer
YES
NO
XSeptic Tank Pumped
�,.-
YES NO HOW
)(Dishwasher
OFTEN
YES
NO
x # of Months/Years Residence Occupied?
(Garbage Disposal
�-
YES
NO
IV. Type of cover over drainfield. (i.e(grass, landscaping, etc.)
jC V. Repairs (when, what, who) Cause/of Failure
VI. Comments (Over for Sketch) 5ee s U f
VII Action Taken