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czT1 or 1� .r�c�rT <br />c�ty �«.�.i <br />?verett� YIa.=liingion `'HOnE: kLpinr 9-7101 <br />Ib'Sl ECTI01'. �FARTi 1ENT <br />i.OT kPPRGiU1L 'c,Fi4.;T <br />P�l�I'IE_� a L�.�.�_e.u�Y+�— ._ 9ll!'Rr:SS <br />i�DDk��S Or YROPOSrD BU�LDIP?G ��/ _2/ _ _C" %��S�f <br />I�GAL D�SCRIFTIOiQ: LOT _S B;4CIi�ADDIT301:�I,1�?' . r_L��� � <br />7--r--,- <br />TYPE OP US���aS. h'G. ^P L�LDROOiiS_�__ _SIZL C�i� LOT /06 iC ��� <br />SOURC� OF DRIi KIi i l:�firLR: YUBLIC : uYPLY L_ PRIV�^E ' LLL <br />Ae uURi�kC� DHAII:l.G� <br />c <br />1. Is disposal field site ia=11 drained? �� _, <br />2. Any iaater course (etream� drainage ditch� tc. ) chrough site?__7� n <br />B. TOi'OGi?AI�iIY <br />1. Any neavy slopes in field area7 i� �; <br />7., l�lill present topsoil in field area be removed or Nraded before :ield tilcs are <br />installed? � C <br />3. u1i71 an,y fill raaterial be used in tl�e di.sposal field site?1j�If yes, how mucL <br />C. SO]'L CC'n'DITIOi;S <br />l, Ha: a hole at le.�st 4 feei deeu been du; in the di,,osnl £ield area to determine <br />the type oi ^,oil nresent" <br />2, Afi:Fr hole i.s dug record the ;oil cor.diticns at the folloi�ring deptiis. <br />(Record as sand� gravel� clay� packed sand� loa`n� etc.) <br />12 inches_ 30 inches. <br />18 inches 90 incLes c:—� <br />2Q inches 48 inches <br />3, An}� ground �.=ater encountered beFore i•eciching a de; th o� !, feet?___ <br />If so, at :ahai depth: <br />D. !iAT�?� TEST <br />i. simn'e lrater tes: trill shota i�ota �rell this suil �ri':-] drain or percolate �a�:tex•, <br />io �,eriorm tiii� tesi: <br />1. Dig •a hcle at lea,t 36 inches de�p. U,e .: si�ovel or ncst holz digger; <br />size of hole 'a�alce� no difierence - or,ly depth, <br />2, F`ill hole rrith iaater. I`oir let all t;ater run ou+. o{' itole. Tl,:s soaks the <br />�ro•and and crill give a nore a:,curatc read:ng, <br />3. :+[�ain pour tiater in hole to a height of 12 ir,chc:s iro:a tne> bot�oi:�, Let <br />iaater run out until there is ,jus't � incLes fro�a bcti;oui 1�ft in holc. <br />!,, h?ete hor; oiany miimtes it tzyes for thie �a�t 6 irches to ceGp airay. � in <br />5. Divide tL•is time U,y b to ohtain t?� a{e ei• inch. '�)��1, _ <br />6a Date �aater test was rericrr..ed, L�, ' �`.y� __ <br />i <br />I uereUy r.ertiS,� tlie above ii;fo�:,;atior '.o ��e Co:'Y'Bri __ a t�1B a oV +^:�iere per- <br />forr�ed U}� r.ie as ;:�rescril:ed. � <br />Si�ncd .� � <br />i;ddre::s 1 (,�a�1 � ' aL,>— <br />Ter <br />I�•�;rr�: .. •2Ci:{;1C t1P.1? j�6TT!lli: 13 i3^'l3q 011 'JiC 0,:51^ O� 1,f:B .iYJpJP L]�uT'(i11'•.1017. Tf <br />there nre an�� �:l�n:;�-ea r_�r elterati.nns _� i,:e �bove et.r.{'^_�i ;oil co�.c'itions, it may <br />recult i�, C:ir :ir.stal7.;�i;.in�: cir� ;�e�crt,-.;i �;t fl�, ti:tc o.' .. ,cc�_on. <br />