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CITY �'F tVEkETI <br /> Ciiy Hall PI-,O�E: A�p�n� 'J-71J1 <br /> Everett. Ylashin�ton <br /> INSPECTION DEP,�RT�riENT LOT APFi-,�VAL SHEET <br /> �vn�,�E �.�=.5� �t�= ��o l_ ("J ADDFESS � / 5�'3Rbs'j /Nul(��7� W�� s/ <br /> AilDRtSS UF FF�Jf-OSED BUILUIIVu �/ �� ��f' /ti� ���� n C� I� C C�_ <br /> LEGAL DESCRI PTIUN: LUT� BLOCK�_ ADDI TIUiJ Fl%�� � lJ �l� S' <br /> TYFE UF USE A'0. GF BEDfl�01+iS ._� SI ZE OF :.UT ,�i.2.;;� � �S�C <br /> �URCE UF llRINKIUG �IATER: FUBLIC SUPFLY �_ FRIVNTE �lEIL <br /> A. oURFACE Dr�AINAGE <br /> 1. Is disposal field site well drair.ed� _ Y � 'S <br /> 2, Any water coursa �stream� drainage ditch� etc. throuph site?_ CS <br /> B. TO�GRAFHY <br /> 1. Any heavy slop�s in field area? /v �=� __ <br /> 2. 'ilill present topsoil in field area be removed or �raded ::efore field tiles sre <br /> insta] led? i1/ �^ <br /> 3. �lill any fill material be usad in the disposal fiald site?_ t� If yes� how <br /> much <br /> C. �I I_ OUNDI TIONS <br /> !. Nas a hole at least 4 feet deep been dug in the disposal field area to deter�iine <br /> the type of soil present:' � S <br /> 2. i�fter hole is dug record the so 1 conditions at the followin� depths: <br /> (Record as sand� gravel � clay� packed sand� loam� etc.) <br /> 12 inches L.e /a- tii_ 30 inches � �' � ��I <br /> 18 inches � O A F'1 36 inches 5 A ti' b <br /> 24 inches l_e .t /�� • 48 inches i A- ti'�7 <br /> s, Any �round water encountered bafore reachinp a d�:pth of 4 fec-t? �� __ <br /> I f so� at v+hai depth'? <br /> D. F;ATFR TEST <br /> A simple water test �aill show L•o�v well this soil will drain or p�rcolate water. <br /> To perform this test: <br /> 1. Dig a hole at leasi 36 inches deep. Use a shovel or pos'. H�le dig�ar� size <br /> of hole makes no difference - only depth. <br /> 2, Fill hole with �.vater, Now let all water run out of hole. ihis soaks the <br /> �round and will give a more accurate readinP. <br /> 3. Again pour �.vater in hole to a height of 12 inches from the bottom. Let <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 las: 6 inches to seep away.� <br /> 5. Divide this time by 6 to obtain the rate per inch. x' � � 4 <br /> 6. Date water test tvas performed._/ � <br /> I hereby certify the above information to be correci and the above tests �•+er per- <br /> forred by me as prescribed. /, <br /> 5i�ned -�' QX : r' e��� <br /> Address '��5� 3�sj'�L�nT.'�tc c ����Sti <br /> �OTE: A septic tank permii is issued on the basis of the above informatiun. If <br /> there are any chanpes or alterations in the above stated soil ccnditions� it may <br /> result in the installation bein� rejected at the time of inspection. <br /> -��:i- - <br />