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j � , <br /> . . � . _ <br /> CITY UF �VEf;EII <br /> Ciiy Hall PhOhE: A�pi�; �-il�i <br /> [vereit� '��asf�ington <br /> IPiSPFCTICN DEP,1RT61FNT LOT APFnC1VAL SHEET <br /> I (' /� /�' i' <br /> iJ;b�.t � .?( •J�C I e+ l-C�✓r S�� C D ADDRESSf�<� /'I� C{'J i.[1 S�: ��d�f�(: <br /> / <br /> AJDRcSS OF FFUFOSED BUILUING <br /> LEGAL DESCRIPTION: LOT BLOCK ADPITIU� ��� / ��� �'��J� _ <br /> TYPE �F US�j- ��II/�)eflCi'�r�i� �c�DR.�MS SI ZE OF :UT �SC'. -, NI07 / I<�� <br /> l� 2l-a � '� �l nYC�i <br /> SUURCE OF URINKIiV dATER: FUBLIC SUPFLY �U � II G PRIVATE �lELL <br /> g; SURFAC� DRAIN4GE <br /> 1. I ., disposal field site well d,-ainedY G/e s � , <br /> Q, Any water course �stream� drain�pe ditch� etc.) t rouph siie?_ �—_ <br /> !_. TOFOf:RAPH'f <br /> 1. Any heavy slopes in f'ield area?_�O__ <br /> [. lJill present topso� tn field area be removed or �raded bePore field iiles are <br /> inctalled? �D <br /> 3. ��ill any fill material be used in the disposal field site?� If yes� how <br /> m�ch <br /> C. yJIL CIJNDITIOPdS <br /> 1. Has a hole at least 4 Peei deep be �} du in the disposal field area to determine <br /> tl�e type of soil present� _ �1�•� <br /> �. i�fter hole is dug record the soil conditions ai the followin� depths: <br /> (Record as sand grav=l . cla�� ���, saqd� loam� e :. ) /I / �. � <br /> 12 inches �=�� �'nd 30 inches �:.'_�G� 9��?G/1'Cd <br /> c.'/7 <br /> 18 inches �� � �- 36 inchrs _ __ �� ` <br /> 24 inche, _�/ Ii � 46 inches "— `-+ � ` <br /> �. Any ground waier encountered before reachinp a depth of 4 Peet'j�YQ_ <br /> If so� ai wh�t depth'? <br /> A. IlATFR TEST <br /> A simple water iest will show how well ihis soil will drain or percolate water. <br /> To perform this tes1: <br /> 1. Di� a hole at leasi 36 inches deep. Use :� shovel or post hole digper� size <br /> of hole makes no difference - only depth. <br /> 2. Fill hole with water. Now let all water run out of hole. This soaks the <br /> pround and will �ive a more accurate rea•iing. <br /> 3. ���ain pour water in hole to a hei�ht of 12 inches from the botiom. Let <br /> �.vater run ouf until there is just 6 inches from bottom left in hole. <br /> 4. Note how many minutes it takes for this last 6 inches {o seep away.��" <br /> 5. Divide this time by 6 to obiain the rate per 'nch. ���i' <br /> G. Date water test was performed. / �" � - <br /> I hereby ceriiPy the above information to be con�ec and t e abov e s were per- <br /> forrned by me as prescribed. � �r� <br /> Signed � <br /> Arldress , � � '��`G� �'`�y���' ��'r1 <br /> �101E: A septic tank permii is issued on the basis of ihe abuve information. � f � <br /> there are any chan�es or al;erations in the above stated soii conditions� it may <br /> result in the installation beine rejected ai U�e time of inspection. <br />