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Home My WebLink About0004 VANDUZER ROAD UNIT UNIT 2 - Health � I/6ndu2er Bern stR-b12. 3�a - oar ooe -- VANhvZ T WN BARD LE LOCATION SEWAGE # COA/ i2'D -602 VILLAGE W yl ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. TANK CAPACITY Two 6 cww - LEACHING FACILITY: (type) 1V©/U E (size) NO.OF BEDROOMS BUILDER-OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 r- c O O _y Ep