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AilDR�SS U <br />�,,-��/�z, <br />�-- <br />LLI <br />i;ITY bF �VtF;EI'. <br />City Fiali PI-u(�'E: A�.,:i%,.. i-�1 1 <br />�vere+t. '.lashin�ton <br />T LOT APfF(iti'?,L SHEcI" <br />l _ i^,DllnESS .�7 %�2- ��(9r.�;��2,�/ wr <br />�=GAL DESCRIFTIOiV� LOT � <br />TYFE �F USECEL��r�RO. <br />Y <br />GF BEDF�01��5 �_ SI ZE OF �OT %�!.� 3�.?. ,.� _ <br />SuURCE OF llRINK�iVG ��ATER: FUBLIC SUPFLY !/ <br />A. �URFAC� Dr�AINP,G"e <br />FRIVHTE <br />1. Is disposal field site e,ell drained: 't/'t''�� <br />2. Any vrater coursz (strcvm� draina�e ditch; etc.) thr�i t� site`•' ���ri- <br />8. TOfOGRAFHY <br />1. Any he�vy slopcs in field ar=a? /�ii� <br />2. ':lill present tepsoil in field area be removed or �raded before field tiles are <br />instailed`? /14�+� <br />3. �Jill any fill material be used in the disposal fi�ld site'��ulf yes� how <br />much <br />C. S(?IL CUI��DITIOP!S <br />/ kl, <br />1. Has a hole at le:�st 4 feet deep been du� in the disposal field ar a io determine <br />tiie type of scil przsent. / <br />� <br />?_. �ifter hole is duP record th soil conditions ai :he follo�rin� depths: ��` y <br />��ccord as sand� �ravel clay� pe.cked sand� loam� etc.) �" ,�1� ° <br />12 inches �.�, 3C inches �'- a.•-.��_ ny4 'r^Y` <br />18 inches �__G_ 36 inches _ ,-t�� � �'� �" f` <br />��.�.a-� <br />24 inches �� 48 inches / .� � � � <br />s. riny �round water encoup _red be`ore reachinn a depth of 4 feei'•'��7-' __ <br />If so� at whai depth? <br />D. �:;ATER TEST <br />A simple water test �:ill show hotv well this soil_ will drain or percolate c�ater. <br />To perform this test: <br />1. Di� a hole at least 36 inches deep. Use a shovel or post holc dipger� size <br />of hole makes no difference - only depth. <br />2, Fill hole with water. Now let a11 water run out of hole. ?his soaks the <br />5round and will pive a mcre accuratc reading. <br />3. A�rain pour v:aier in hole to a height of 12 inches frcm the botiom. �et <br />water run out until there is ju=t 6 incnes from bottom leFt in hole. ' <br />7. Note how many mirn�tes it takes for this las: 6 inches/ �to,, seep away.__'� <br />5, Divide this time by 6 to cbtain e rate per inch.�y1 <br />6. Date water test was performecr.�� �. /, 9�� <br />I hereby certify tha above information to d"ie cor� rect and �he above tests �vere��er- <br />formed by me as prescrihe�. s � 2��� // <br />Si�ned ,� 'Lr��.' �'�u —� ��•-L�/- .�- <br />Address � ? �..'sc- '__�<�eSQ-t��/ U��a. <br />P;�JIE: A septic tank permii is i�sued on the basis of th'e above informatiun. If <br />there are any chan�es or alteraticns in the above stated soil conditions� it may <br />r.,suli in the installatior bein� rejected at the time of inspection. <br />� /� � � � <br />C L cvL � ;�v/�� lc%y /�iYr � ! ' �� r ?r" , <br />�, ,; ;, . , : � � . �' -��_� �- � ,� , � :T <br />�' : � �'ij c �-� �' � , o E ;-� .� r � :1 . � � :, ,, i. •'�- C c � � l � ..- y� ���? ,'L,.w <br />. t , <br />