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CITY OF EVERETI CC^ <br />City Hall PHONE: ALpin� 9-11J1 ca✓Wo <br />Everett, '3ashington �---� <br />INSPECTION DEPARTIdENT LOT APPROVAL SH T <br />IAivF � ADDRESS Z _. <br />{' ADDRESS F PfOFOSED BOIL IjNG � y rf�t C'LGtQ� ���stl� <br />d� EC�AL ES' ldi=f (9N/� LOi �i3LQCIC % ADDITION < &!, <br />ai y� <br />YPE OF USE A 13 NO. OF BEDROOMS SIZE OF LOT x — <br />SOURCE OF DRINKING DATER: PUBLIC SUPPLY PRIVATE BELL_ <br />A. SURFACE DRAINAGE <br />1. Is disposal field site well drained? J <br />2. Any water course (stream, drainage ditch,Cc.) through site? <br />B. TOPOGRAPHY <br />1. Any heu%,y slopes in field area? ' <br />2. :Jill present to oil in field areage removed or graded before field tiles are <br />installed?_� <br />3. .Jill any W l material be used in the disposal field site?A" If yes, how <br />much <br />C. SOIL CONDITIONS / <br />f / <br />1. Has a hole at least 4 feet dee been du in the d•s sa fi ld ark de rmtnel <br />the type of soil present? J 'brajj <br />2. After hole is dug ecord th soil. conditions at the following depths: J'Z <br />(Record as sand avel clay, packed sand, loamy et <br />12 inches (4th i�i - 30 inches --`j <br />18 inche 36 inches <br />24 inche. - 48 inches <br />7. Any ground water a countered before reaching a depth of 4 feet?__ <br />If soy at what depth?— <br />� D. WATER TEST <br />A simple water test will show how well this soil will drain or p,nrcolate water. <br />To perform this test: <br />j xl. Dig a hole at least 36 inches deep. Use a shovel or post hole digger; 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 will P.ive a more accurate reading. <br />3. Again pour water 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 />X4. Note how many minutes it takes for this last 6 inches seep away: ryjj1_ <br />X5. Divide this time by 6 to obtain the rate per inch _ <br />�6. Date water test was performed. (gel`• '��+"- �{� <br />I hereby certify the above information to be correct and the above tests were per- <br />formed by me as prescribed. <br />Signed <br />Address_ ! 44 r <br />MUTE: A septic tank permit is issued on the basis of th above of rNA ion Tf <br />there are any changes or alterations in the above stated soil conditions, it <br />result in the installation being rejected at <br />the time of inspection. <br />