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Washington
County SanitarA""�istrict
County, Md.
�►
SANITARY SEWER LATERALCONSTRUCTION RECORD
Project:
SD6-1-S Fountainhead
Street (or
location) : '.� /'c�-0 s���4'�'
1 r*
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MH 3/6 to MH 3/
Contractor:
Corson and.Gruman Company
3 ��✓
ate
Wye
on
Sta.
Mainline
Wye
Size St'
or Drop
L RALS
Excay. Lgth.
Laying Lgth. Sjz'e
-C X y''i- I O ro
Notes: yap sc ,<•zr,a �S.Q
Z' 6 u Inspector
Depth of Cleanout" @ Flow Line
Cleanout From
Layed @ _
Basement Service
9, a , t -//
9
00�1
Amounts pertaining to work completed this period, reviewed and approved.
By �'ls'
nspector rson & roman uperi en—dent—
(Form WCSC - 4)
1
Washington County Sanitary District
SEWER SERVICE LOCATION
Subdistrict No. SD -6
Contract: SD6-1S
Property Address: Pennsylvania
- -
1�3 7
Place an 'X' in the sketch below to indicate where the property owner
wants the service connection (lateral) to enter the property. Place a
wooden stake in the ground at that location.
-Coni, E1�k Ca�'�9
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1876 ti -a8
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It � � D - ► �.l�us�
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The undersigned agree that the Sanitary District may excavate for
the lateral a total of ten (10)'feet inside the property line at the
location indicated above, said ten (10) feet to include five (5) feet of
lateral installation beyond the cleanout, plus an additional five (5) feet
of excavation beyond the terminus of the lateral to facilitate, and make
less expensive, the owner's connection to the lateral and to prevent
damage to the lateral installed by the District in those areas where
rock is encountered.
Date:-
dwn r
Owner
Attest:
Wash. Co. Sanitar5Di trict
(Form WCSC-56)
(110878)