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." <br />, , . <br />�r-! <br />. <br />C17Y OF c"VEPET"t <br />City Nall <br />,,�, Eve�etiy i�ashin�ton <br />INSF'ECTIOM DEFARTNEMT <br />�OT APPRGVAL SHEET <br />fH01VE: RLpine 9-'l101 <br />P�NtE�f -' � ' . - . , , . . . , _ ADDRESS , „ . . _ . w _ . , . . .. .. <br />_ , � <br />ADpRESS OF PRCPUSED BUILDING :-� � �;%A �' <br />LEGAL DESCRIPTION: LOT `.' BLOCk ADDITIONf UY?' �� ;�' � <br />TYPE OF USE � " N0. OF BEDROOH S"' S I ZE OF LOT i�i,�. �.;' �.'� '''� �` " <br />SOURCE OF DRI�!KIIJG ..ATER: FUELIC SUFFLY i� PRIVATt tiEl_� <br />A, SURFACE DRAINAGE <br />i. Is disposal field site w�=.I1 drained% r��'> <br />2. Any water course (sireamy drainage ditch� etc.) through site? N� <br />1 <br />L <br />� <br />B. TOPOGRAFHY <br />Any heavy slopes in field area: N G <br />�.i]] present topsoil in field area be removed <br />inst. �led? Q�O <br />..ill any fill material Ge used in the disposal <br />or graded 6efore field tiles are <br />field site? '� If yes� how much <br />C. SGIL CONDITIOtJS <br />1. Has a hole at least d feet deep been dug in the disposal field area to determine <br />ihe type o£ soi] Nres?nt% V'[',.S <br />2. After hole is u'ug record �I�te� soil conditions ai ihe following depth,. <br />(Record as sand� ravel� ea�:�i� packed sand� loam� etc.) <br />12 inches.� i'!-' LG- .�v� 30 i�lches �''�' .'-t%'�'�i <br />]8 inches '' '' 36 inches ' " <br />24 inches �� qR inches " �� <br />�. Any ground wat�r encountcred before reaching a depih of 4 feet? <br />If so� at whai depth? — <br />D. 4rATER TEST <br />A simple water tesi nill show ��cN well this soil will drain or percolate water. <br />To perform this iest: <br />1. Dig a hole at least 36 inches deep. Use 2 shovel or po^; !�ol� diggcr size <br />of hole rrakes no difference - only depth. <br />2. Fill hote with wate�. tJow let al] waier run out of hule. This soaks `he <br />ground and will give a rtare accurate reading. <br />:i. Again pour water in hole to a hei;ht of 12 inches from the boitom. LAi <br />waier run out �ntii there is just 6 inches from bottom ]eft in hole. <br />4. Nete how many minutes it iakes for this ]ast 6 inches to seep away. %!'� <br />5. Divide this iime by G to obtain the rate per inch. <br />6. Date water test was perforn�ed. '` "? � ��:% <br />I hereLy certiFy the above inforrration to be correct and the above tests �ticrc per- <br />formed by me as prescribed. <br />Sj���� ,. <br />Address ' � <br />P�CTE: A septic tank permit is issued on 'the basi, of Ith� above inforrrHtion. If <br />there are any chan�es or alterations in the above stated soil conditions� it may <br />res�li in the installation beinp rejocted at the time of inspection. <br />.� iu,4r:'C:Xu ��°rl��.tcs���'�, <br />