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� O.w''"'y CITY UF EVERETT <br /> ��7) � Q City Hatl PI-bNE: ALpine ;-%1C1 <br /> ���61� Everett� v�ashin�ton <br /> IDISPECTION DEPAfiTtJ�ENT LOT APPrf1VAL SHEET__ <br /> NAiuiE �S[:.lJ_S6T �Lji�OE.�S /y�`. ADDRESS /7.Z -/d�7��i�I1E•'y.E ��llrU�f.�'`' <br /> ADDfiESS OF FR�FOSED BUI LUI NGL�.3 � //fi°Tffr!? �U�.,� <br /> LEGAL DESCRIPTION: LOT� BLOCK�` ._ ADDITION S V�� ��i'�=c' � <br /> FfE S <br /> TYPE UF USE �Si�-•C�F_ fW. GF BF.DA"?OfaS 3 SI ZE GF l_UT h�7�j� <br /> SOURCE OF DRINKING �JATER: f-UBLIC SUP�LY � PRIVATE '�lEl_L <br /> A. SURFACE DRAINAGE <br /> '% ; ," r <br /> 1, Is disposal field site well drainedY ___ <br /> 2, Any water coursz �stream� draina�e di 'tch� etc.) tnrou��h si{e� /� (� <br /> jV <br /> B. TOFOGRAFHY <br /> 4i <br /> 1. Any heavy slopes in field area?_._ �_ ° <br /> 2. ''��ill present topsoil in field area be removed or �raded�before field tiles are <br /> installed? ' )�1-'I% <br /> 3. '��ill any fill material be used in the di�poaal field site? �/ � If yes� how <br /> much /� n _ <br /> C. SOIL WNCITIOA�S <br /> 1. Has a hole at least 4 feet deep een dug in the di;posal field area to dete!'mine <br /> the type of soil present? '� � <br /> 2, After hole is dug record the s �1 conditions at .`,a Pollowing depths: <br /> (Record as sand� gravel� clay� packed sand� loan� �tc.) � � <br /> 12 inches C'��c�:.�!�_ . . � , 30 incF;es !' ,• . � �_ <br /> 18 inches _y��, ��-' .� 36 inches �" ��� <br /> 24 i nches /� �-��:�=?-)Z� 48 i nches � � <br /> , Ary ground water encountered before reaching a depth of � e ' �' •�L�� <br /> If so� at what depth? <br /> D. P�ATER T�ST <br /> + simple water test will show how well this soil will drain or ����olate water. <br /> -o perform this test: <br /> 1. Lip a h�ole at least 36 inches d?ep. Use a shovel or po;t hole di��erg size <br /> cf hole makes no difPerence - or�ly depth. <br /> 2, Fill hole with water, Now let all :�ater rur� out o9 hole. This soaks the <br /> �round and wi?1 E;ive a more accurate reading. <br /> 3. �gain pour water in hole to a hei�hi oP 12 inches from the bottom. Let <br /> water run cut until there is ju=t ( inches froc� bottom left in hole. <br /> 4. Note how many minutes it takes for ihis last 6 inche� to seep away. ��• »u- 7` <br /> 5. Divide this tine by 6 to obtain the rate per inch. �� .� <br /> 6. Date water test was performe.d. �� ^'_F.C's ! b <br /> I hereby sertify the above information to be correci and the abov te't were per- <br /> Formed by me as prescribed. f� C��" � <br /> Signed_,,[�� �"�' <br /> Fddressl2�, -�Fl dvf'.�'E .B�'�.t U�ai= <br /> �lE: A sept�c tank permit is issued on t.he basis of the above information. ! f <br /> �_ �ere are any changzs or alterations in thc above sta'ted soil ccnditions� it may <br /> �,;sult :^ the installation b�ino rrj��cted at ihe time of ins�,ection. <br /> G!.—�'r —77�/ <br />