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<br /> £NOHOMISH HEACfH DISTRICT
<br /> 3011 Rookefel'_ec .�vunuc+
<br /> $5.00 fee for permi[ Everett� Washington Phone ALpine 9-2061
<br /> IAT APPROVAL SHE&T
<br /> x,�r� ;� e �
<br /> r�c�i:/ Il. �.� '� r• ADDRESS c..�`: %J;:/�/..:�i�
<br /> ADDRESS OF PROPOSED BUILDING `�7Z'`� 6'o�r�i,�sr .�Fy�y
<br /> �-, /
<br /> LEGAL DfiSCRI£TION: LOT - �� BIACK —' ADDITION � �'� F : �Y_5' I��/c!i r i�c' -J:';. :;
<br /> r �
<br /> TYPE OF USE ��'��!;.' N0, OF BEDROOMS �' SIZE OE LOT /�' f' h /9P S
<br /> SOURCE OF DBINKINC WATER: PUBLIC SUPPLY i� PRIVATE WELL '
<br /> A. SORFACE DRAINAGE
<br /> 1. Is dieposal field site well drainedY f•.;
<br /> 2. 'Any vater course (s,tCeetq, drainage ditch� etc.) :hrough siteZ iy�,
<br /> B. TOPOCRAPHY
<br /> 1. My heavy slopes in field areaY f✓+
<br /> 2. Will present [opsoil in field area be removed or graded before field tiles
<br /> are installed? �'✓C�
<br /> 3. Will any fill material be used in the disposal field site?�.'. If yes� hw much_
<br /> C. SOIL CONDITIONS
<br /> :,.: .
<br /> 1. Has a hole at least 4 feet deep been dug it�nthe disposal fie:d area to deter-
<br /> mine the type of soil present? y:
<br /> 2. Af[er hole is dug record the soil conditions at the folloWing depths.
<br /> (Record as sand, gravel, caly, packed sand, loam, ecc,)
<br /> 12 inches ho+ous,r,�; �t, ,,n,..r' 30 inches sa,,,y;� j�i�,;{;.%
<br /> 18 inches sw:rlv " 36 inches �• ��
<br /> 24 inches_ •..<ic ;;i.,,.�., ,./ 48 inches • ��
<br /> 4. Any ground water encountered before reaching a depth of 4 feet2 i-'�
<br /> If so� at what depth? -
<br /> D, WATER TEST
<br /> A simple water test will show how well this soil will drain or percolate water,
<br /> To perform this test:
<br /> 1, Dig a hole at least 36 inches deep. Use a shovel or post hole digger -
<br /> size of hole makes no difference - onl� depth.
<br /> 2. Fill hole with wuRer. Now let all water run our of hole, This soaks the
<br /> ground and will give a more accurate reading,
<br /> 3. Again pour water in hole to a height of 12 inches from tlie bottom, Let
<br /> water run out until there is Just 6 inches Erom bottem left in hole,
<br /> 4. Note how many minutes it takes for this last 6 inches to seep away, ' :� .,�, ;,_ .
<br /> 5. Divide this time by 6 to obtain [he rate per inch. >iii;i. f� , /:, ,�,� /
<br /> 6. Date water tect was performed, ,i�:; ' [ --�'`--
<br /> I hereby certify the ahove inEormation to be correct aad the above tests were per-
<br /> formed by me as preccribed,
<br /> / �,:
<br /> Signed 1-. �:�/ G_ 'r',
<br /> Address -/Yi ; �!,` < _ . ,-.. ' . - , i, .. . � T/. r,.
<br /> NOTE; A septic tank permit is issued on the basis of the ab ve information. If
<br /> there are any changes or alteration in the above stated soil conditions it may
<br /> reeult in the installation being rejected at the [ime of inepection,
<br /> _.� .
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