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HomeMy WebLinkAbout0063 OCEAN AVENUE - Health a . ; ti � -� a e . _, . . � � . _ . . . . �, , . o . . r :y _ . o TOWN OF BARN/ST�ABLE LOCATION SEWAGE# VILLAG (/I SS SSOR'S MAP&PARCEL �(� A 'INSTALLERS N &PHONE NO. � 7_pp � SEPTIC TANK CAPACITY LEACHING FACILITY:(ty e)` LC-6 CIA ssize). /a .9 NO.OF BEDR OMS OWNER 26kJ2Cf1nq PERMIT DATE O" 2 COMPLIANCE DATE: z `" Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) ,Feet Edge of Wetland and Leaching Facility(If any wetlands exist �y within 300 feet of leaching facility) 0 Feet FURNISHED BY dot R CA B� k �e --- ? V ` C4 Z,J a