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_ - ^:p <br /> � <br /> I <br /> CITY OF EVERETT <br /> City Hall PHONE: ALpine 9-7101 <br /> Ev�=.rett� ��ashinoton <br /> IPISFECTICN DEPARTfdENT LOT APFPfJVAL SHEET <br /> NAi�E,�:���7�; _ /f'C a�L„z�,•!r o �� ADllnESS .Qo� ' J rY D x -' c �+ ��"° ��'�''� <br /> ✓ - �� �, Q�// <br /> • ADDRESS UF FfiOrOSED BUILUING �DvZ � L!/.�ni� /"e/�ti'-- �il,� <br /> LEGAL DEaCRI PTION: LOT� BLOCK ADDI'fIUN �v�' r n r e�.-n, �' �•� /�- <br /> • i <br /> TYFE UF USE _ f�. OF BEDRCOfu�S 3 SI ZE OF �OT /6 � �( /�O <br /> SOURCE OF URINKI�VG dATER: FUBLIC SUPFLY . � FRII�ATE c1ELL <br /> � j A. SURFACc '1RAINAGE ����s_ ������ <br /> 1. Is disposal Pield site vrell drained° �'!r'�P <br /> 2. Any water course (stream� drainage ditch� etc.) through site? �%':' <br /> B. TOFOGRAPHY <br /> 1. Any heavy slopes in field area? <br /> 2. 17i11 present topsoil in field area be removed or graded before field tiles are <br /> installed? �XC's <br /> 3. '�Jill any fill material be used in the disposal field site?Na If yes� how <br /> much <br /> C. 9DIL WNDITIONS <br /> 1. Has a hole at least 4 feet deep been dug in the disposal field area to determine <br /> the type of soil present? _ � %�r�S <br /> 2. i�Qter hole is dup record the soil coriditions at fhe following depths: <br /> (Record as sand� gravel� clay� packed sand� loam� etc. ) <br /> 12 inches �� s'oi� 30 inches <br /> lE inches 36 inches <br /> 24 inches 48 inches �✓ ����c�✓ U �:frr:' <br /> ?. �ny ground water encountered before reaching a depth of 4 feet • Na <br /> If so� at .vhat depth? <br /> D. l�lATER TEST <br /> � simple water test ti:�ill show hoa well this soil will drain or percolate water. <br /> ?o perform this test: <br /> '. Li� a hole at least 36 inches deep. Use a shovel or post holc digger� size <br /> of hole makes no difference - onl� depth. <br /> z, fill hole with water. Now let all water run out of hole. This soaks the <br /> �round and will Qive a more acc��rate readinp. <br /> 3. A�ain pour water in hole to a hei�ht 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 it takes for this last 6 inches to see away. ,r'0 ;,�r�n v� E� <br /> 5. Divide this time oy 6 to obtain �he -ate per inch. 3�»��'�� �r .�p� /���.� <br /> 6. Date wat�r test �vas performed. /i0i•r� /S' /�� P ' <br /> I hereby certify the above information to be correct and the above tests �vere per- <br /> �ormed by me as prescribed. �, � �;! •� <br /> . �igned_ � .7'-� J :! �/�� <br /> Address��U T�:: .rr,�. �(.'li; I_-i'���G� /�J ,?J'//, <br /> �TF: A septic tank permii i: issued on the basis of the above information. If <br /> t'�ere are any ch�inges or altcrations in thc above stated aoil ccndiiiens� it may <br /> r�sult i�� the insiallation betn� rejecicd at ih� time of ins;�e.ction. <br /> —t: - <br />