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CITY UF �VEFiEI"1 <br />City Hall PF�1�E: A�E,i�� �-71J1 <br />Everett. '��ashin�ton <br />INSPFCTION DEPART(a1ENT LOT APFP,�V�L SHEET <br />fVAiviE_ ��i�// � f l�f �.-nP 5 ADDFESS���,' .SCiu�h �i �o c r,�u a� <br />AJDR�SS UF Ffi0i-09LD BUILUING�:O .�i� ('/PS f /a„� <br />lt)rliC�h sc� � <br />LEGAL DESCRI PTION: LOT1U BLOCK ADDI TION oF f„ i j B S�'c ii �� 3�,'- �`)' � r <br />N;w R,A� <br />TYFE �F USE,s�;u/�/'Nfi f�:0. GF BEDFQOf�iS 3 SIZE OF LUT �C�/I�/�Iv P�iia, <br />9JURCE OF I1R1NKIiVG �JATER: FUBLIC SUPFLY v1�' S_ _ . FRIVATE clE�L <br />�-- <br />A. �URrA.C� DiiAINP.Gc <br />1, Is disposal field site �rell drained° a�: � <br />2. �1ny water course �stream� drainage ditch� etc.) through site? �1 C <br />B. �O�GRAFHY <br />1. Any heavy slopes in field area? ��('S <br />2 �lill present topsoil in field ar�a be removed or �raded before iield tiles are <br />instal led? !� �� <br />3. ��ill any fill material be used in the disposal iield site'? c�_ If yes� how <br />much <br />C. �IL CUNDITIJh!S <br />1. Has a hole at least 4 feet deep been dup in the disposal field area to determine <br />the type of soil present? < <br />2, After hole is duP record t soil conditions at .he following depths: <br />(�ew+J as sand� pravel�,clay� packed sand� loam� et .1 <br />12 inches K�� Sor l 30 inches �n�:in /nr, � <br />18 inches h�n�n /D��w� 36 inches _ �� <br />24 inches �� 48 inches Grr /J��h <br />s. Any ground water encountered be`ore reaching a depth of Q feet?�� _ <br />If so, at v�hat depth? <br />D. 4lATFR TEST <br />A simple �+•ater test v:ill sliow how well this soil will drain or percolate water. <br />To perform this test: <br />1. Dip a hole at least 3b inches deep. Use a shovel �r post hole dip�ar� size <br />of hole makes no diPference - orly depth. <br />2, Fill hole with water. Now let 4i1 w�ter run out of hole. This soaks the <br />�round and will �ive a more accurate reading. <br />3. APain pour water in hole to a height of 12 inches from the bottom. Let <br />water run out until there is just 6 i�ches from bottom left in hole�— <br />4. Note how many minutes it takes for this las: 6 inches to seep away. � <br />5. Divide this time by 6 to obtain the rate per inch. 'S r++�•ivlE <br />G. Date water test was performed.�/f / 7 U <br />I hereby certify tha above information to be �orrec't and the above tests tvere per- <br />formed by me as prescrihed. �/J ���/ <br />Si�ned F�/ri.. q . �� <br />"�i°���"• Address T � <br />-�°"v;`„ KOTE: A septic tank permii is issued on the ba�is of the above information. If <br />,��, <br />` there are any changes or alterations in the above stated soil ecnditions� it may <br />result in the installation bein� rejected at the time of inspection. <br />,. <br />_l`,- �_S` � � . . <br />