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fl� <br /> , '�tivw-1 =H-- % �'-� <br /> ' GI iY ( F �Vti-,E1�1 ..� <br /> City Hall PF�JRE: A�p�rn_ ��-ilJl ����� J <br /> �vere{{. ';lashir�ton <br /> I��!:;FECTICN DEPdRTfJiFNT L07 APf-�(�b'AL SHFET <br /> 7 <br /> r!;�;:r Z�. 6��� 5 E r;DllnES� 7��3 -C i.J r-r R� � l�iC <br /> i��DR�SS UF FFurOSED BUILUIf1G '77/5 .T��niiPc=2 <br /> � 7c SyCc�i.Fn/cRLS% <br /> �EC�AL DESCRIPTION: LGT� BLOCK ADDITIUiV /;/�UrT�� Tc (��FiL� ir, u 'na 'f <br /> , n :� <br /> IYFE �F USc DNi (C0. GF �EDFCOi.SS 3 SIZE OF LOT r.�9� >, <br /> /5�' <br /> uLRCE OF URIiJKIidG JATER: FUBLIC SUPFLY �%� PR11h�i�E ,'ELL <br /> A. �URr PC� DiiAf NP.Gt <br /> 1. is disposal Pield site .ve:l drair.ed� yc5 W��es�n,� <<'T <br /> �. %1ny �vater coursa (stre,.m, ciraina�,e ditch� etc.) throu�h site� o <br /> B. TOrOGRAPH'f <br /> 1 . :ln� heavy slopc; in ficld area�_ /1�e <br /> ?_. :Jill present topsoil in field area be removed or praded before field tiles are <br /> ins`.alled?__L�1v ���� <br /> 3. .lill �ny fill m.�terial he used in the disposal Pi�ld sit�?_ 'lt v If yes� hor: <br /> much <br /> C. �IL CUNDITIOP!S <br /> 1. II,�s a holc at l�asi 4 Peet d ep been dup in the disposal fi�td ar�_,� io de{rrmine <br /> th� type of soil present� - <br /> %. nfte; hole is duP record t e soil conditions at the Pollowing depths: <br /> l� ecord as sand� �ravel � clay� packed sand� loam� etc. ) <br /> 12 irhes _LoA�i 30 inches SA /✓!' <br /> 18 inches _ _Sani�V �ei+M 36 inches �7Aei4a'o Sid�i_n <br /> ?ti inches .SiiN�� 48 inches f•;liw'.S� � S�vr��� <br /> �. r;ny t�round water encountered before reachin� a depth of 4 feet? _ <br /> If so� at what depih? <br /> D. ':!ATER TEST <br /> A sirn?le water test �:ill show hcw w�ll this soil will drain or percolrite �rater. <br /> To i:crform this test: <br /> 1 . Di� a hole at least 36 inches deep. Use a shovel or post hole dip�ar size <br /> of hole makes no difference - only depth. <br /> ;�, Fill hole with tivater. Now let all water run out of hole. This soaks the <br /> �round and will �ive a more accurate readinP. <br /> 3. A�,ain pour water in hole to a hei�hi of 12 inches from the botiom. Let <br /> �vater run out until there is just 6 inches `rom bottom left in h�le. <br /> �. Note how many minutes it takes for ihis las; 6 inches to seep �way..�� <br /> �, llivide this time by 6 to obtain the rate per inch. +l <br /> G. Date water test vras performed. SG�T � /9 n.r <br /> I hereby certify the above information to be correci and�f� above tests �vere per- <br /> formed by me as prescribed. j/� �� <br /> 5i�,���d r it, <br /> Address yi. � ' <br /> �JIIE: A septic tank permii is issued on the 6asis of the above informution. If <br /> there are any channes or alter�ticns in the aLovc staiod soil ccnditions� � i m2y <br /> r��sul{ in thn; in;t::llation b�.in,� r�,j�r��-�i nl the time of insF���c:ion. <br /> A#� <br />