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i. <br />Y <br />�N,.�`�n I�� ciTY �� tvEF�t� <br />i1�, �� ��'� Clty Hall PHOP;'t: �3Lpinc "-7101 <br />,�ti� Il� Evereit� Washingten <br />�t IfVSPECTION DEPAf3TIv�ENT LOi APPfd:1V��L SH't�? <br />� <br />iVA�u;E��c� �..c; ./l�ipi;i>r.- IiL�C ADDRESS!'7-! ./.,� 7/�Ci`" il% .ii<i'i/ /lc�/ �''� <br />AllURESS OF �F�FQSED BUILUIIVG ����' �' ���-�" �' �' <br />i ii�� � � i�i- ,; � <br />LEGAL DESCRIPTION: LOT � 3LOCK�_ �DDITIUN�� ' <br />TYPE UF USE�S7,G' ��4./' !//�/NO. OF BEDR�UIJ�S ? SIZE OF LUT <<�' X•` `-' �' <br />�JURCE OF DRINKIiVG JATER: rUBLIC SUPFLY <br />� � rRl VATE ��'ELL <br />A SURFACE DRAINAGE <br />1. �s disposal fiEld site well drair.edY _.—',�'•y � 11 � �� <br />2, Any water course lstream� dr�inage ditch� etc.�1 through site• <br />B TOFOGRA?HY <br />1. Any heavy slopes in field area?_ V E' S ---�- <br />z, i�ill preseni topsoil in 1'ield area bo remo�/ed or �raded before field tiles are <br />installed? -'l'1 �" <br />3. '�lill any fill material be used in the disposal ficld site'?.s!:S_ If yes� I�oW <br />much � <br />� S01 L O�iNll I T I ONS <br />1. Has a hole at least 4 Peet doep been dug ii� thc disposel field area to determine <br />the type of soil present� �" 3 <br />� After hole i^ dug record the so�il conditions ai the following depths: <br />�(flecord as sand� �ravel� clay� packed sand� loam� etc.) <br />12 inches �271 30 inches � - 7� - � / r _^ /� <br />18 inches,;;=�����/,� 36 inches _ v� �i_t�umer <br />24 inches 48 inches � � <br />, Any ground water encou�iered before reachin� a depth cf feet� 2L-- -- <br />If so� at what depth? i;�pTFR TEST <br />, simple water test will show hov well this soil will drain or percolate watcr. <br />, perform this tesi: <br />1, Lig a hole at leasi 36 inches deep. Use a shovel or po,1 hole di��er� size <br />of hole makes no diPference - only depth. 7his soaks the <br />2, Fill hole W�{��'+3t'��� Now let all water run out oP h��•^_. <br />ground and will give a more accurate rr•�ding. <br />3, A�,ain pour water i� hole to a height of ]2 inches from the bottom. �e�(/ <br />water run oui until thcre is just 6 inchcs from bottom left in hole. � <br />4, fJote hew many mi�utes it takes for ihis last 6 inches to seep aWay• <br />5, Divide this time by 6 to obtain ihe rate per inch..�.--- <br />6. Date water tesl was performed..'% %/ t; �' � <br />I heroby certify ihe above information to be correct and ihe above te'is were per- <br />,rmed b me as prescribed. ' <br />Y 5i�ned �� ��titi' - 'C- !'�/ <br />.� <br />Address, � ,. � .=� �j �r�,[ : � ��, 1, , �/ v:' <br />^iE: �� sepiic tank permii is issued un the basis of ihe a6ove inPormation. If <br />�ere a'c 'iny ch;in,�as �r alierations in thc above siated soil conditions� i� �1y'` <br />:suli .�� the installation bein� reje�ted ai the time of ir,�,ection. <br />