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HomeMy WebLinkAbout0085 OLD SALEM WAY - Health �Ien00 O O i��164—iJEWAGE F BARNSTABLE:LOCATIO � # 1000 m OV VILLAGE - ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. 0,4t N� L�. &5— SEPTIC TANK CAPACITY s L LEACHING FACILITY: (type) S'D 0 Or 7 y)a ))s (size) NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: 3 I t I d 0 COMPLIANCE DATE: 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 within 300 feet of leaching facility) Feet Furnished by Ic 0 a n r �"�