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UIiY CF �VLREI�i <br /> City Hall PFpN[: A��:in� ��-il '1 <br /> �vereii, '�7ashin�ton <br /> IP!SP�CTICN DEPIRT�JiENT LOT ApFF7)VAL SHEET <br /> �dAia.E _� �� ��ILV�� ADDFESS �/S �t�i�t�.i.r ,� <br /> AJDR�SS Of FFd)�ryED QUI UING <br /> ; .,� ��/ <br /> d -�, i � <br /> LEGAL DESCRIPTIUN: LUT d�38LOCK _ ADllITIUN �c.tr�f� � •L(-'�-���� <br /> IYFE (�F USc _ _ f�, uF �EUFI:)Of�iS �_ SI ZE OF �UT � +� ' ��" <br /> :iUl1RCE Uf llRINKIiVG �JATER: F�BL�C SUPFLY i�IC'.J i-riIVATE �:ELL , �_t_ <br /> ��/, - . . <br /> A. �URrACt biiAINAGE <br /> 1. Is disposal fi�ld site vrell drained: �-�.l <br /> 2, Any �.vatcr c�urse �stresn� draina�e ditch� eiw.) ihrouph si{e"? /J�P-(� <br /> B. TOFOGRAFH'f <br /> 1. Any hea�.y slooes in fie;d ar�a� .��J <br /> ?_. :lill presen{ topsoil in field area be removed or �radc�d before field iiles are <br /> installec2 G_2,/1 <br /> 3. �Jil! any fill material be used in the disposal fi�ld sit�.? .� If yts, ho�; <br /> much /1'1 in� ( <br /> C. �IL �NUITIOP!S <br /> 1. Has a hole at least 4 feet deep been dug in ihe disposal firld rrca to determine <br /> the type of soil present? i(;- C-J <br /> T, ii£ter hole is d�P record the soil condi, ions at .he follow�r,� depils: <br /> (fiecord as sand. �ravel� clay� packed sand� loam� e{c. ) <br /> 12 inches � ��rit,� . /-irncr,r j 30 inches ��'[ la`,�f 5;;.:� � _ , . , , , �� <br /> 18 i nches ` /���h -�- �,.: ; 36 i nches _ I '!J r '�r , <br /> 24 inches ���1i��t� 48 inches � �ti . �; r�L-f; �4s -i:" ^ <br /> ;�� -� <br /> s. Hny �round wai�R encouniered before reachin� a depth of 4 feet? _�',, <br /> If so� at what depth?__/F��/it= <br /> D, �lATfk TEST <br /> � A siwple water test +:ill e5or� how well this soil will drain ur percolate v+ster. <br /> To perform ifiis tesi: <br /> 1. Dip a hole ai leasi 3G inches deep. Use a shovel or post hole dip�er� size <br /> oi' hole makea no difference - only depth. <br /> 2, fill hole with water. (Vow lei all water run �ut of hole. This soak> the <br /> �round and will giv.e a rnore accurate readinp. <br /> 3. Apain pour wa+er in hole {o a height of 12 inches from tl�e boitom. Le{ <br /> water run out u�til there is jusi 6 inches From bottom left in hole. <br /> 4. IV�te how many minutes it fakes for this lasi 6 inches io seep away.1�ij <br /> 5, llividc ihi5 time by u to obtain the r'ate �er inch. 2 0 -. �---• <br /> 6. ll,te watet' test was performad. '� ��� � �;' <br /> I hereby certify th� above information io be correct and t�e ab ve ,�ls were per- <br /> formed by me is prescribed. ,�/� e � <br /> �i�ned_,L,� � r , �-Z <br /> Address S ' c <br /> P:OTE: :�. sept�c tank permii is issued on the basis of the above inFormation. If �'' , , ._ <br /> � <br /> thcre ;ire any chnnva, or �lteraiicns in thc af;ove sta{ed soil ccndiiions� ii may ' � � <br /> n.sult in the inslallation bcin� r� jccied ;ii ihn {i�ie of inspcc:ion. �` <br />