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r <br />CI'fY CF'�VEf1ii <br />C11Y ��ell i��'1�1r��_: /{i_�:In� �i-ll �� <br />Evere{t. ��ashin�ton <br />INSFECTION DEPARTialENT LOT AFfi-UVAL SHF.ET <br />/� n� / _> , <br />�vn.�E_,n�-�1't�at_11 /Jl�'�,R l,',. � ,��llFEss_ - � <br />AilDRcSS OF rFCiUS[D BUILUIPIG � � .� � �j^'--'' .� , ' ,. •' ? a - <br />� <br />LEGAL DESCRI Fj ION: LOT_�_ BLUC( � ADDI TI(1N �-�<.. �' C�c Jn, ,, C� �_�t.. <br />C� L�j�_ . !o : n �'� <br />�1'FE GF USEr�.�.o�-.r'�... KC ;iF E3EDfY`Uiv1S SIZE OF �UT���n %� ���, y-3 <br />;uUHi;E UF llRl'JKING �IATER: FUBLIC SUPFLY _�_^ rNIVATE .+'ELL _ <br />A. 3URFACc URAINAGE <br />1, Is disposal field site well drainedY 1-' <br />2, Any water course �stream� drain�ge ditch� ei ) through site?_� �j. �-�_. <br />�� <br />B, TOrOGR.4�HY <br />I, Any heavy slopes in field area? �.�+-� <br />2. .�ill present topsoil in field area be removed or �raded before field iiles ara <br />installed'? <br />3. Ji ll any fill materialJbe used in the disposal Pield site?_� If yes� how <br />much __�" <br />C. �IL IX�NDITIOt�S <br />l. Nas a hole at least 4 feet deep baen dup in the dispo,al field area to determine <br />the type of soil present? <br />?. �\fter hole is du� record the soil ^ndiiions at the following depths: <br />(Record as sand� r,vel� clay� packed sand� loam� etc.) ., <br />1? inches 30 ir.ches C ti-�-�' �'�« - <br />18 inches <,Lrc"� ' a' 36 inches -��-� �'�� <br />24 inches � C' 48 inches � �� �'��, <br />�, tiny ground wate encountered efore reachinp a depth f 4 ieet' ���'__ <br />If so� at what depth' '�— <br />D. tlA7fR TEST <br />A simple water test will show how well this soil will drain or percolate water. <br />Tu pPrform this test: <br />1. Di� a hole ai least 36 inches deep. Use a shovel or post ho'.e dip�ar� size <br />of hole makes no difPerence - only depth. <br />2, Fill hole �.vith water. IJow let all water run out of hole. This su-:ks the <br />�round and will �ive a more accurate readinP. <br />3. �gain pour water in hole to a heigM of 12 inches Prom the bottom. Let <br />water run oui until there is jus: 6 inches from bottom lePt in hole. <br />4, Note how many minutes it takes for this last 6 incl,es to seep away. �^<<.-«�'� <br />5. llivide ihis time by 6 to obtain the rate per inch. <br />6. Date water test was performed. -`� -�� °�_ L�— <br />I hereby certify the above inforru-�tion to be cor�ect and the above tests were per- <br />£ormed by me as prascribed. � <br />� i�ned J?-f- �-,� u v <br />Address_/ �i �/ /)•t�.�L !`. *i•� <br />f:OTE: �� se��lic iant; permit is issued un the ba�i� oP the b ve inPormatinn. If <br />there are any ch;inges or alterations in the ahove sta{ed soil condiiions� it m.�y <br />result �n ihe installation beinp rejected at ihe iime of inspection. <br />