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r/ �'�-f � i �/VI'-"�� <br />��� n. <br />�: <br />� � j � � 7 <br />�� -��'k'�'L::�i��i.. <br />�- / <br />�c/ry_S�� i;ITY OF �VERETi <br />� Ciiy Hall P'r.�P:��: �, -+'� '� <br />��Ere{t. ��ashin�ton <br />,IPI�PECTICN DEP,aRT��iENT LOT kPF=fJ�AL Sh�I;:ET �(��_. ,, <br />ir`�.�� ( `�a � . �, ,�J /���?�— nDllFiES`i ") %�/'� � I�1fu i ��-'. Y-�l <br />- vY�E <br />NilDRtSS OF FFUF05EL BUILUIPJG �-�1��� �� - <br />�tGAL DESCR�+TION: LOT_ BLUCK ADDITI��V <br />� �� SIZE OF LOT X 2 X-3�� / <br />I YFE UF USE�fi+e tt I<0. GF f3EDFGUfviS �_ <br />i <br />�URi;E UF URI i4Kl iVG �IATER: i-UBLI C SUPFLY ���' rRl VATE .:ELL __ <br />A, SURFACE D JP.GE <br />1. Is Jis osal field site well drained'� Q���'� "'1 <br />2, ilny v:ater coursa �stream� draina�e ditcF.�� eic.) throuph site? �' �� <br />B. TOFOGRAFH'f <br />1. �ny he�vy slopes in field area��'"��_ <br />2:lill present toosoil in field area be removed or �raded before field tiles �r� <br />installed': "' <br />3. �lill any fill material be used in the disposal fiold sitn'•' �/�'�__ �f� y�=�� ho�v <br />much <br />C. �OIL CU�iDITIOi�S <br />!, Nas a hole at least 4 f�e��-deep been dug in th� c��pos,�l fiold arc�::�. to ,!�i�rr�ine <br />the type of soil present`•' `' <-'^-' <br />% After :�ole is du� record the �Soil conditions at the Pollowin� deptVs: <br />((.��cord as sand� �ravel� clay� packed sand� loam� etc.) - <br />30 inches ��' �� <br />l2 inches � •�-`=��C� "i '«, _ i <br />18 inches �_ �- '— 36 inches , � <br />24 inches �-.r' •x 48 inches �,��� � �l�`�'/ <br />„,,,,� 5round ::ater encou�tered before reachin� a deptH of 4 fect'� -�''-'� ---- <br />IP ;o� at what dcpth? <br />D. !7ATFR TEST <br />i� nimple v+ater test will show how v+ell this so�l will drain or percolate water. <br />To perform this test: <br />1. Dip a hole at leasi 36 inches deep. �1se a shovel or pos+ 'nole diggerg size <br />oP hole makes no dif£erence - only depth. This soaks th�� <br />?, Fill hole with water. Now let all water run out of hole. <br />�round and will �ive a more accurate readinp. <br />3, A�ain pour water in hole to a hei�ht of 12 inches from the bottom. Let <br />�.vater run out until there is jus't � inchvs irom botlum leit in holc, <br />Note how many minutes it takes for this last 6 inches to seep a�v�Y• ''k`'=- <br />'i, Divide this timc by 6 to obtain 1 he rate �er inch. n�ni <br />i,, llate water test was performed..L' ";L`/ •��� �� <br />I 1,.-:reb certif the above information to be corr�ct and,the above tesls '•.�re per- <br />t�.rmed by me asYprescribed. '���'" �� �/� <br />Si�ned�f �c,� ' ur ��-;��i <br />Address� %� -• c�s _ r .�f,-.-I f' <br />r;�E; A septic t,�n4: pormii i; issued on the basis oP the above ihformaiion. <br />�i��i� ,,r�• ai�y chr+n��es ��r zltcrniions in 'the �hovu stated soil r_ondition�� �t °'�Y <br />r,;�.ul' ir the in,tall:�;�on b�inn r����ctr�1 ii thc tim=;,f inspection. <br />