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�: p , � <br /> � �o �I %�/� `�/����-- �.� <br /> _`�� � 7 ��TY �r ��E�.�,, �Y/,� j� � <br /> City Hall Pf-0�E: HLcin� '�-l�l,Jl <br /> Everett. '�Jashin�ton <br /> I hSPECT;GN DEPARr!;,1EP!T LJT APF,(,VAL SHEET <br /> '� �l <br /> idA�v�E� '> i� � _ ADDfiESS OC '� � ;t � ���v.t., � �c, <br /> r G � <br /> AilDRtSSQF PF,OrOSED BL'ILUING�� a Z�� '-dJ-2� <br /> �G�a4�G.'r�t. .��. <�.. e2 +.G. j'� � � r , l: t� C <br /> �EGAL DESC41 PTION: LUl'� BLOCK � ADDI TI(iiJ �5�� Y +/�`�"""" ''""� y � <br /> iYFE UF USE ��_ n:p, GF BEDF�Ofu1S 3 SI ZE OF �OT ��'�X �2�' <br /> yJLFCE OF llRINKIUu JATER: f-UBLIC SUPFLY � PRIVATE .'ELL <br /> A. �URFACc DRAINAGE <br /> 1, Is disposal field site well drainedY � _ <br /> 2. Any water c�ursz (stream� drainzge ditch� etc.) thro�rh site?_ _ __ <br /> B. TOFOGRAPHY <br /> 1. Any heavy slopes in field area? O <br /> 2. ,7i11 present top oil in field area be removed ��r �raded before f�eld tiles are <br /> installed?�i <br /> 3. .lill any fill maf .rial be used in the disposal field site? c� If yes� how <br /> much , <br /> C. S01� �11NDITIONS <br /> l. Has a hole a: �eaet. 4 fect d e been du� in the disposal fieid area to determine <br /> the type of so.l urasent? '-� <br /> %. A1'ter hole is dip record the soil conditions at the followinQ depths: <br /> (Record as sand� �ravel) clay� packed sa�id� loam� etc.) <br /> 1� inches __ �nr�G Lt'�l-�n 30 inchas <br /> 1? inches �,�o � � 36 inches ��j�.._ <br /> 2 9 i nches ���..� ? . �.-,,,..r 48 i nches l���./r..- <br /> >. Any �round water encount�red before reachin� a depih of � fee{?/Y�ni�. �-.�.-_,r.�;',.4 <br /> I f so� at. what depth? �T�-�,�,;� �ww <br /> D. flATER TEST <br /> A simple water test v�ill show how well this soil will drain or percolate water. <br /> To perform this test: <br /> 1. Dig a hole at least 3G inches deep. Use a shovel or post hole dig�er� 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 /> ground and �vill give a rrore accurate rradin�. <br /> 3. A�ain pour water in hole to a heiqht of 12 �nches from the bottom. �et <br /> water run out until there is just 6 inches from bottom lePt in hole. � <br /> 4. No{e how many minutes ii takes for this last 6 inches to seep away.�r:. �u;sL. <br /> 5. Divide this time by 6 to obtain he r e �e: inch. �S'�u-,..� <br /> 6. �3te water test was performed._;���— <br /> ( I�ereby certify the above information to be correct and the above tests were per- <br /> formed by me as prescribed. / <br /> 5i�ned ,r/�—_�.17 _ �'�!1�-t/ <br /> Address���/C"e.rt F:,r,,v nv� <br /> 1'OTE: A septic tank permii is issued on the basis of the above information. If <br /> there ar� any cl�anPes or alterations in the a6ove stated soil conditions� it may <br /> result in '.he installation being rejected at the time of i�spection. <br /> —� <br />