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.� " _ - _-p... <br /> � • � <br /> � <br /> I <br /> i;ITY CF cVtfiEl'� <br /> City Hall P�,pi!L. �1��;:n,. �-�1J1 <br /> [verett; '�7ashin�ton <br /> INSPECTION DEP,�RTi�IENT LOT APFrOVAL SHEET <br /> iVAm�E_ 1/\I ' ' ' � /^ ' <br /> '�. --" W �% !� K. ADDRES3 � I �C� Y � & i'�' � K-/G- <br /> Ai1DHctiS UF F'fi�J�=pSED BUILUIfJG__ � O ' (�(� G � � �� {� � <br /> LEGAL DESCRIPTION: LOT�, BLOCK ADDITIUN _ �c' -�/�-r�,s-�y.,,.J d/�,,,� <br /> iYFE UF USE �_ �p, OF BEDFpOMS � ' ' <br /> —�_ sizE oF �ur _qo x � i8 , z � <br /> �URCE OF DRINKING �JATER: FUBLIC SUPFLY � <br /> PRI VATE cJELL <br /> A. �URrA.C� D�iAINP.GE <br /> 1. Is disposal Pield site well drainedY � <br /> 2• Any water course (stream� drainzge oitch� et .) throu�h site? � <br /> B. TO_ �GRq?FIY <br /> 1. Anv heavy slopes in field area? yl�p <br /> 2. ':liil present io soil in field area be removed or �raded before field tiles are <br /> in:.talled?� <br /> 3. ��ill any fill material be used in the disposal field site? '' <br /> much � If yes� how <br /> i <br /> C. �JIL (��iDITIOP.S '•• <br /> 1. Nas a hole at least 4 feet deep been dug in the disposal fi�ld area to determine <br /> the type of soil present? (,�.t2 <br /> 1. ��fter h�le is dug record the so[i conditions at the following depths: <br /> ��ecord as sand��gravel � clay� p�ok�d sand� loam� etc,) <br /> 12 inches -YVL�'y< < —f"„�* �.p,,.� <br /> 18 inches 3� inches � <br /> 24 inches __ 3G inches ✓ <br /> � 48 inches _� � <br /> >. Any �round water enco�ntered before reachin� a depth of 4 �{? <br /> � P so� at wha{ depth? <br /> D• 41ATFR 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, Di� a hole at least 36 inches deep. Use a shovel or post hole di���r� size <br /> of hole makes no difference - only dep{h. <br /> 2. Fill hole with water, Now let all wa{er run out of hole. This soaks the <br /> �round and will �ive a more acc��rate readinv. <br /> 3. A�ain pour wa{er in hole to a iiei�l�t of 12 inches from the bottom. L={ <br /> water run oui until there is just 6 incnes fram bot{om lePt in hole. <br /> 4. Note huw many minutes it takes fur this last 6 inches to seep �r,yay,�� <br /> 5. Divide this time by 6 to obtain e r te er� inch.�'� <br /> 6. Date water {est wac performed.—��-,t% � <br /> I hereby cer{ify the above information to be correct and the above tests v�ere per- <br /> formed by me a� pre�cribed. _ <br /> Sisned i r ��e.t, . ,.� <br /> 10TE: A septic tank permii is issued on the basissof the above information. , If <br /> there are any changes or alterations in the above stated �oil conditions� it may <br /> result in the installation being rejected at the time of :nspection. <br /> —c _. <br />