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'yp . <br /> � • • . C I N OF [VERETT <br /> Ci �y :'al! <br /> Everett� �+aehington <br /> FHONE: ALpine 9-llUl <br /> INSFECT!�! DEPARTNENT <br /> l0T A.ppRUVAL SHE T <br /> n � �U � � <br /> NAM.t ri/ �, r'. ,, ,'.7,edGt'/nni ADDRESS 7,��//- �_s7 C--;I.F,v;+/ <br /> ADDRESS OF PRCPOSED RUILDING <br /> LEGAL �ESCRIPTION: LOT BLACk ADDITION <br /> T�E � �� N0. OF 8[DROc�uS � SIZE OF' LOT <br /> SOURCE OF DRIMKItJG ,.ATER: PUP,LIC SUFF�Y V FRIVATE ��Ell <br /> n. URFAC DRAINAGE <br /> 1 . Is disposal field site well drained: ES <br /> 2. Any water course (stream� drainage dit h� etc.) through site? <br /> 8. Tt7PpGRAFHY <br /> i . Any heavy slopes in field area'r 5 <br /> �• �:ill present to soil in field area e removed or �raded before field tiles arP <br /> insialled: �-�'fn�i' <br /> -i• �. ill any fill rt�tertal be u�ed in the disposal field site? n If yes� how rtuch <br /> C. SOIL CONDITIOiJS <br /> 1 . Has a hole at least 4 feet deep been dup in the disposal field area to determin� <br /> the type of soil present`i <br /> 't'. A£{er hole is dug record thF- soil conditions at the followinp depths. <br /> �Record as sand� pravel � oa��y packed sand� loam�_etc.) <br /> lc inches �oArr 30 inches��+ei'�.•. "`,=��.� <br /> lE inches,�..,�-�.--; 3b inches • • �� - <br /> 24 inches__Ji9C;;,ri� ��,,�:� qK inches �� <br /> . Any ground water encountered before reachinQ a depth of 4 feet? <br /> If so� at what depth? <br /> D. WATER TEST <br /> �. simple wa{er test v,ill shov; how well {his soi] will drain or percolate water. <br /> To perform this test: <br /> 1 • Dig a hole et leasi 3G inches deep. Use a shovel or post hole dig�er: size <br /> of hole rtakes no difference - only depth. <br /> �. Fill hole with water, t•iow lei all �rater run out of hole. This soaks the <br /> ground and wi11 �iv� a rrbre accur�te readin�. <br /> 3. Apain pour water in hole io a height of 12 inches from the bottom. L�t <br /> water run out until there is just 6 inches from bottom left in hole. <br /> 4. Note how many minutes ii takes for this l�st 6 inches to seep away. <br /> �. Divide this time by G to obtain th? raie �_er inch. <br /> 6. Date v:ater iest was perforn�ed. <br /> I hereby certify the above inforrr�tion to be correct and the above tests were per- <br /> forrr�ed by me as prescribed. <br /> Si�ned_ rc...�_ , . �. � r��,/, ,��;. <br /> Address r , 7- ` � �r /„/, ..y �'.., ,-c,• �i.. <br /> PiCTE: P septic tank permit is issued on the basis of ihe above �nformation. If <br /> 'here r.re any changes or alterations in ihe e_bove stated soii conditions� i { ma,y <br /> �'Fs�1t in the installation beinp refected at the time of inspection. <br /> —c -� <br />