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��� CI1Y G� cVERE'fT <br /> � ,�� City Hall F'F[�A'E: :�rine 9-71J1 <br /> � 1�' `� "cverelt, iashin�ton <br /> � � IUSP�'CTICR DEP.;H7,EP.7 l0T APFFDVAL SFEET <br /> � NA»t_ • � : )' L . �(" l.�,r ( �REaS I � �! I�/�„r<�l. n r•.� <br /> wn�ss oF =wz�z a;iu,iras � `� 3 � � �/���, " - ��1 <br /> . �� :.�.�. s � -- <br /> �EGAI. DES(�il PTION_ LOT�SM3Lp�__� ADDI TIUN Sa� �.:r. + : '� : � ' <br /> TYPE (.F USE _^k[•�: t�D. GF BEDfDOL: �'� 51 ZE OF �UT 7� y ( 7 V <br /> 5ui1F'x.'E OF DRINCIVG .1ATER: �BLIC 5U'1Y ✓ 'rriIVATE �E�L <br /> A. �;(iFAf,� DRAIYA(� <br /> 1. Is disposal field site v:ell drair.ed� � F '-> _ <br /> 2. My �;er course �stream� drainage ditch� etc.) througA site� /b i� <br /> s. roroc�a�;r <br /> ,.� . ., , <br /> 1. My heavy s lopEs i n P i e 1 d area? �� .�t-s'��- `'x"T-'-'� L )� �"'� � � C'' <br /> 2. 7i11 present psoil in field area be reno or oraded '�efore field tiles are <br /> installed? �e,,r-, <br /> 3. �ill any fill �aterial be used i�� tAe disposal field site?� �f yes� how <br /> �r, ��..:{.k /' w,ru-..L'L�-� <br /> C. �1l Q�W!T WNS <br /> !. ►;as a hole at least 4 feet decp been dug in the disposal field area to determine <br /> the type of soil p�esent? <br /> 2. Af{er hole is dug record the w 1 oadiiions at li+e fnlloving Aepths: <br /> (Fieco�d as sand� qrave! clay� padced s�nd� loa�� etc i , <br /> Iz �nches �� 30 �ncfies jw�.,� �a�-.n f �c'`� <br /> lE incfies �T 1..� .._sl 36 incl� •I <br /> -- 24 c� •• •. as �� N.: r,�.� <br /> ?. My qround reter enoov�tered 6e�aro reachin3 a depth of 4 feet? r�✓.� <br /> �f so} at �fiat depth?_ <br /> f�. •�ATEF TEST <br /> + sirple �eter test ��11 s!w� ho� ��Il this soil .:11 drain or peroolate water. <br /> �o perfor� tAis !est: <br /> 1. Li� a hole at least 36 inc!ies deep. l'se a �hovel or post hole digger� sixe <br /> of hole nakes ro difference - only depth. <br /> 2. Fill hole �ith aat�r. ?b� lei all 4ter run out af hoh,. -T�;is snaks the <br /> So�nd anc �ill qive a mo�e acour;ie r�ding. <br /> 3. Again pour �ter in hole to a height ef 12 incfms fro� the 6otta+. Let <br /> �ater run o�t until tMre i� ju�t 6 irrhes froo botta� left in hole.32 <br /> 4. Note ho� nenr oin,ites it takes f�r this las: 6 ind�es� aray. <br /> �. Divide tnis tiae q 6 10 obtai^ t �at r ir.ch.� '� <br /> 6. Date �ate� test �as pxfcrtC. �f� f <br /> � hereby certify .Aa above infor�tion te mrrec; ard•the above tasts Rre per- <br /> -or�d by oe a5 p�esctl'ed. , �� <br /> �i "�' <br /> Addre � <br /> ^TE: .i y�tic tank �r�ii is issu�c � t�e `zsis of the aboK infar�ati IF <br /> : �era a-� �ny dw�es ar alteratio� in tf� z�ve stated soil ccwdiliona� it � <br /> r_wlt i� t1+e installation beir� rejeete� at the tise of in�r_etiaw. <br />