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gov CERTIFICATION OF SEWAGE DISPOSAL SYSTEM BY INSTALLER This certification shall not be used in lieu of inspections required by personnel of the Department and may be duplicated on company letterhead provided it contains the information below. Health Department Reference Number Suffolk Tax Map Dist Sect s Blk s Lot s Project Name or Address Subdivision Name Lot Applicant s Name Date of System Installation Description of System Installed Septic Tank Volume gallons Shape Rectangular Cylindrical ...

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