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CITY OF EVERETT <br />City Hall <br />Everett� i+ashington <br />INSFECTIOPJ DEFARTNEPJT <br />LOT APPRGVAL SHEET <br />' • �,_ � 1 a� .. o. � � �• <br />ADDRESS OF PRCi'QSED '' .LDI <br />FHONE: ALpine 9-'1101 <br />LEGAL `JESCRIPiION: LOT_i�BLOCK�ADDITION�,,,_.._.....�- �lc�.r-�iL <br />TYPE OF USE ���NO. OF BEDROCt� S S I ZE OF LOT �j'c X!-s� z <br />SCYJRCE Qf DRIMKRJG �.ATER: PUELIC SUFFLY PRIVATE ��ELL <br />A, SURFACE DRAIPIAGE <br />1. Is disposal field site well drained% �- <br />2. Any water course (stream� drainage ditch� etc.) through site? � <br />B. T(�CGRAFHY <br />I. Any heavy slopes in field area'r � % <br />�. ;+ill present topsoil in field area be 'ertaved or graded before field tiles are <br />installed?_ <br />.S. '�:ill any fill mat�r�l be used in the disposal field site?�,�If yes� how much <br />� � /�. <br />=g� <br />i. Has a h <br />the tYF <br />2. Af ter h <br />� Record <br />12 <br />lE <br />24 <br />� C. SOIL CUNDITIONS ' <br />le at leasi�C feet deep been dug in the disposal field area to determin� <br />of soil present? �,✓ <br />le is dug record thl:� soil conditions at the followin� depths. <br />as sand� pravel� `� Y� packed sand� loam� etc.) <br />inches ✓ 30 inches�� <br />inches }��.,�,� n�( 36 inches i� <br />inches_ 4R inches <br />Any ground water en oinir.red before reachin� a depth of 4 feet? <br />If so� at what depth? 3 <br />D. 44ATER TEST <br />A simple viater test nill show how weil this soil will drain or percolate water. <br />To perform this test: <br />l. Dig a hole at least 36 inches deep. Use e shovel or post hole diggeresize <br />of hole makes no difference - only depth. <br />2. Fill hole with water, !Jow let all w�ter run out of hol�. This soaks the <br />�,round and wil] give a more accurate readin�. <br />;i. Apain pour water in hole tc a hei�ht of 12 inches from the bottom. Let <br />water run out until there is just 6 inches from bottom left i� hole. <br />4. Note how many minutes it takes for this last 6 inches to seep away. .2 % <br />5. Divide th;s time by G to obtain the rate per inch. <br />6. Daie v;ater test was perforn�ed. �Q c�,�1 _� � i 9C. z_ <br />I he�eLy ceriify the above information to be correct and the above tests were per- <br />formed by me as prescribed. <br />Signed � .,,. � .l�,LtN/ <br />Address��_.. � 2,_ _��� <br />PiCTE: A septic tank permit is issued on ihe basis o£ the above infor�r tion. If <br />'here are any changes or alterations in ihe �bove stated soil conditions� it may <br />res�lt in the installation beinp rejecled at the time of inspection. <br />