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��.�.- ��..._ :'1t« � .a�= <br /> CIiY CF �'dti,Ll� � �����' <br /> Ci 'ty hail PFt��E: A�ptn,_ J-'�1 '1 <br /> ve ett. '��ashin�ton <br /> p I(J�FcCTIGIJ �FP,\fiT;JFiJT LOT AFFFOl',1L SHFET <br /> ivn�,.E��.��� /-�N�I cYS� N ADDFESS 7 I � � Ccfa�h�1 Tz.�����u'-\ <br /> / c-� <br /> i1i)DI}�SS UF PNJF05CD BUI�.UtP�G � � O � �1��=1' � � c� 9 � (`f �: <br /> �LGAL DESCRIPTION: LOT BI.00K A�DITIUfd <br /> TYPE �F USE �0. CF BEUFLUP.iS �_ SIZE OF LOT SIU X I J Z <br /> :y.�l,'R�E UF llRI�VKIiVG �IATER: FUBLIC SUPFLY f`'`."�.�'� �� <br /> �, ���,T..,� � Pril VATE ,iELL <br /> A. SIIRFAC� DriAIN0.GE <br /> 1. Is disposal field site �.:�='.1 drainedY �L _. �— <br /> 2. ��ny water coursa �siri,=.r,� dr=impe ditch� eic.) throu�;l�, _ite':��.5.� _-- <br /> 3. TO�OGRA�H'( <br /> , ) ri , <br /> 1. Any he+�vy slonc:, In f ield �.�'ea`I 'li._ <br /> 2. .Jill present =opsoil in field are � be removed or ora ed oeP�iald tiles ire <br /> y � i <br /> instal led?�71L_ <br /> 3. Jill any Pill mater �al be used in the dispoaal Pield site?�._ If y�=, I;ur; <br /> much <br /> C. ;i(!IL CUNDITIJPIS <br /> 1 , Has a hole at lea�:,t 4 feet dcep be�n du� in ihe disposal Piald ar�:n i�� J��i� rminr <br /> the type of soil present? P-� <br /> ;. After hole is du�; record th�oil conditions at thc follo�vinq de.ptLs: <br /> (Record as sand pravel ; clay� paeked sand� loam� etc. � <br /> 12 inches �„_ 'D inchzs �� <br /> 18 inches �1. nL�— .i6 inches _• 7 _ <br /> 24 inches S �n��/ ti8 inches ' � <br /> �, ni�y �round waier encountT ered be`ore razchinp a depth of 4 Peot'?��.____ <br /> I f so� at v+h�t dcpth? �<< <br /> D. �::.4TFR TEST <br /> A ;inple �vater test �:�ill sho�v ho�.v �vell this soil will drain or percolate water. <br /> To perform ihis test: <br /> ] , Di� a hole at least 3b inches dcep. Use a shovel or posl hole dipgar sizc <br /> of hole makes no difference - only depth. <br /> :?, Fill hole with �.�a{ar, idow let all water run out of hole. Thi� soaks lf,c <br /> pround and v,ill pive a more accurate readinn. <br /> 3, A�ain pour water in hol� '.o a hei�ht of 12 inchos from tF�e Lotiom. Let <br /> water run out until there is just 6 incnes from hottom left in h�le. <br /> , Note how many minutes it takes for this las: 6 inches to seep away.�_ <br /> 5, Uivide ihis time by 6 to obtain the ra %eer inch. �i <br /> �. Ua1c water test was performea.� r3 <br /> I hereby certify the anove information to be correci and the above tests were per- <br /> formed hy me as prescribed. �) /� , <br /> Si�ned � � ��,y l� i�l�'��� <br /> Adciress�//� .,___�L�.rCi._�. <br /> �;Olt: %1 septic tank permii is issued on the basis of the above inPurmatiun. IF <br /> ihere are any chanpes or alterations in ihe above staied soil conditionc� i{ �m y <br /> r.•;�.�lt in the installation beinn rej�ctod ❑{ the time of in_^.p�,c;ion. <br />