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i <br /> II <br />� <br />' <br /> I, <br /> Q,u�u.x -!R �e �.�`E <br /> ' CI iY GF cVEFIETI `— <br /> City Nall P!-�O�E: A�,:in. '-i': '1 <br /> Everett. Clashir,�tcn <br /> INSPECTIGN DEP,1RT�iENT LOT ,4PFrUVAL SHEET <br /> % -y� /� C_ <br /> NAw;E ti:'S� C'E�� , �c��c'-��v� ADDFESS ,�5�?U �� � iL_,'�-'�� v '- c �` ; <br /> tiilDRtSSOFrfiOrOSEDBUILUIP!G ,' Q�' 7 �i`���L �� �'z� �`�-� �'� <br /> �J�� 6�a�-�� �� e" � - • , " _b` <br /> �LGAL DESCRI F1�IUN: LOT� BLOCY ADDI T�UN .c��'<�c' f�:i ,_iG-�. �'.�i —�7<<<� �7�� � <br /> � , _ � <br /> TYPE UF USE `- �� ,'>>�; �0. GF 6EDFC0!�1S _�_ SI ZE 0� �OT .-i� X���% <br /> :;uURCE Gf llRIiJKIiVG dATER: FUBLIC SUPFLY _ �� _ r�IV4�E JELL� __ <br /> A. SURFACE DRAtNAGE <br /> 1. � s disposal field si.e well drained° '�/� � <br /> 2. Any �+ater course �stream� drain�ge ditcf_ ��tc.) throu�h site� %� � <br /> 8. TOFOGP�AFH'! <br /> 1. Any heavy slopes in Pield area? ��' / <br /> 2. ':lill present to�soil in field area be removed or �raded before field tiles are <br />' installed? �l-u <br /> � 3. ��ill any fill material be used in the di;posal fiald site? �Z� If yes� how <br /> much <br /> C. �IL WNDITIONS <br /> I1. Has a hole at least 4 feet deep been dug in the disposal field area to determine <br /> � the type of soil present? <br /> � After hole is dug record the soil conditions at the following depths: <br /> � . <br /> �Record as sand� �ravel� clay� packed sand� loam� etc. ; <br /> 12 inches 30 inches ' - <br /> 18 inches 36 inches .��'-,i��0' .-.�'���``�= <br /> � 24 inches 46 inches <br /> ,. Any ground water encountered before reaching a depth Qf 4 feet� �u� . _ <br /> If so� at what depth? <br /> D. �UATER TEST <br /> A simple wa{er test will show how well this soil v+i:l drain or percolate water. <br /> To per£orm this test: <br /> 1. Di� a hole at least 36 inches deep. Use a shovel or post hole dipgerj 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 /> �round and will give a more accurate readinv. <br /> 3. �gain paur water in hole io a hei�ht of 12 inches from the bottom. Let <br /> water rw� out until there is just 6 inchc5 �'rom bottom left in hole. _ <br /> 4, iVote how many minutes it takes for this last G inches to seep away. .�S <br /> 5. Divide this time by 6 to obtain t ec�at��er inch. _ <br /> (�, Date water test wzs performed. <br /> I hereby certify the above information to be correct and the above test� were per- <br /> 1'ormeu by me as prescribed. a <br /> Signed �_L' <br /> Address o�~� <br /> KOTE: A septic tank permit is issued on the basis of the above int'ormation. � f <br /> there are any chanpes or alterations in the above stated soil conditions� it may <br /> resuit in the irs'allation 6einp rejected at the time of inspection. <br /> � <br /> � <br /> -�...�. .��e.�,:�._ - —l� 1 <br />