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CITY UF tVERFTI <br />City Hall i'I-UR[: ay:�n, '�-il )1 <br />�verett. '�ras!iinston <br />I NSPECT I ON �[F,�RT:iEN i LOT APFrl)4'AL SH�ET <br />. <br />dAmiE ��7a`r `S�'���` ADDFESS <br />;,�; .� �'f� il41�K'ac1 /�v�'• — <br />AilDRcSS UF FF�Ji-OS[D .ILUIIVG � <br />�.5-� � ,. ,. p�,� �.� S �,�� PlPf <br />LEGAL DESCRIPTION: LOT�/�2EBLOCK�i_ ADDITIUiV /► � <br />TYFE UF USE Sft�� �^ �l�gl'. GF f3EDPC01�fS "—' SI ZE OF LUT ��'� X�— <br />SOURCE OF llRINKIiVG �JATER: f-UBLIC SUPFLY X +•RIVi1TE :;ELL "— _ <br />A. SLRr A.C� D�i.41 NA.Gt <br />1 Is disposal field site v+ell drainedY � ` �.e <br />2. �ny water coursz �stream, drairrn�e ditch� etc.) throuPh siie? <br />8, TUFOGRAFH'r <br />1. Any heavy slopes in f'ield area? �Yu - <br />2, 'ili11 preseni topsoil in Pield area be removed or �rad�d before field tiles are <br />installcd: /V� Vs If es how <br />3. .Jill any fill material be used in the dispo,sal Pield site'? Y� <br />yn ;{%// <br />much .<//dttiii Fid/�1 �%'�C:S�IL�CONDITIOP!S <br />1. Nas a hol� at least 4 feet de�e� been dug in the disposal field area to determine <br />the ty�e of soil prese�t? It+=' <br />I_, ��Fter hole is dug record the soil conditions at the follo�ving depths: <br />�Record as sand� gravel� clay� packed sand� loam� etc.) �y!`� <br />12 inches �r�k ��s'���•�' 30 inches _ <br />18 inches �r� d��%iL� 36 inches _ �°"� <br />24 inches <br />Qs srs 48 inches s�e� <br />�, Hny ground water encountered be`ore reachin� a depth of 4 fect'? Q - <br />If so� at v+hat depth? <br />D. !lATFR TEST <br />A simple water test :vill show how well this soil will drain or percolate �vater. <br />To perfcrm this test: <br />1. Dip a hole at leasi 36 inches deep. Use a shovel or post hole diggerg size <br />of hole makes no difference - only depth. <br />2. Fill hole with water. Now let all water run out of hole. This soaks the <br />�round and will give a more accur�te readin�. <br />3, A�ain pour aater in hole to a heighi of 12 inches from the botiom. Let <br />water run out until there is ust 6 inches £rom bottom left in hole. , <br />4, Note how many minutes it takes for this last 6 inchesytoj�eep away. ZO.n�i��fc:� <br />5. Divide ihis time ty 6 to obtain the ra2e pe�� ch.____— <br />6. Uat� water test was performed.�� ��9 - <br />I hereby certify the ahove information to be correct and the abuve te�ts �vere per- <br />�' xu... � � C�IC� <br />formed by me as pr �¢r;��ied?�` . 5i ned_s..,�-'`{`�� L" <br />��udt_tc�ed G,P.� � ��%�J /�!�!li9i:i4c� i �'. lii�%IF���n. <br />� ��� Addres=- <br />;�OTE: A septi ank p��iq�t is � sued on tl�e basis of the above in£ormai�on• �P <br />there are any •-nve z�lter�y�t�ons in the above stated soil condiiions� it may <br />result in the tal���i bci rejected ai the time of inspection. <br />.� y .. 1� <br />o� <br />