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CITY UF EVERETT <br /> City Hall PFq1E: ALpine 9-l101 <br /> Everett� �'Jashington <br /> IMSPECTIGN DEP;1RT4iENT LOT APFrtJVaL SHEET <br /> f�A�viE°_�u'�S,c=T /.�cl��D��S //�C- ADDFESS i 7-Z -�oj.: �/'i`UF .�F" ,dL-L�'//��= <br /> A�DRESS OF FfiOFOSED BUILUING ��'G°� �` /f`E�/J/h_=R ce�AY <br /> LtGAL DESCRIFTIO�: LOT� BLOCK_� ADDITIUN S L y U/;-,�J C/Pf S % <br /> J�.��r_' ,rEs <br /> TYFE GF USE _� P�O. GF BEDF�Of�S 3 SIZE OF LOT 7S' X i3 -� <br /> SOURCE OF DRINKING �lATER: 'FUBLIC SUFPLY F/l "rRIVATE t;ELL <br /> A. SURFACE DRAINAGE <br /> 1. Is disposal field site well drainedY C/ ��s <br /> 2, Any water coursz �stream� draina�e ditch� eic.) throu�h si e' , v 0 <br /> 6. TOFO;RArHY <br /> 1. Any heavy slopes in field area� S <br /> 2. Clill present topsoil in field area be re oved or �raded before field tiles are <br /> installed? /1�(' <br /> 3. '.lill any fi11 m t rial be used iri the disposal field site? �S If yes� how <br /> much G <br /> C. SOIL (Y�NDITIONS <br /> 1. hias a hola at least 4 feet deep been dug in the �isposal fiel,', area to deterinine <br /> th� type of soil present? > <br /> 2. Afier hole is dug record the il conditions at the ('ollowing depths: <br /> ��«•cord as sand� grav,l clay� packed sand� loam� etc. ) <br /> 12 inches -'��v��t?�� 30 inches ��._� f <br /> 18 inches 7�/ � 36 incheCn — �• <br /> 24 i nches � � � 48 inches � -,i�n/_/'/a� � <br /> . �ny ground water encountered beforr- reachiny a ticpth of 4 fect'? �L C�__ <br /> If so� at what depth? <br /> D. 47�9TFR TEST <br /> 1 ;imple water test vrill show how well this soil will drain or percolate �vater. <br /> o periorm this test: � <br /> :. L�ip a hole at least 36 inches deep. Use a shovel or post hole di��er� size <br /> .f�hole makes no difference - only depth. <br /> 2, Fill hole with water. Now 1et all water run out oP hole. This soaks the <br /> �round and will �ive a rore accurate reading. <br /> 3. A�ain pour water in hole to a hei�hi of 12 inches from the battom. Let <br /> water run out until there is just 6 inches from bot'tom left in hole. <br /> 4. Note how mzny minutes it takes fbr this las: 6 inclis� _to,,.�s ep�aw�ay.�-l- _ <br /> �. Divide this time by 6 to obtain the rate per inch.�3 <br /> 6. Date water test was performed. 3 fi_-L3 c ,y� <br /> � hereby certify tha aoove information to be correct and the above tests were per-- <br /> "ormed by me as prescribed. !� � � <br /> Signed %'' � l��.i�_, <br /> ,iddressL7�z —/G ��*'�G�G ,�:5 ,a�=:��u,..c- <br /> �TE: �1 septic tank permii is :ssued on the basi; of the above informatiun. IF <br /> c'�era a�u nny changes or alterations in thc above stated soil conditions� it may <br /> r :sult :�� the installation beinE rejected ai the time of ins,,ection. �G��J��� <br />