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CITY OF EVERETI <br />City Hall PHONE: ALpine 1-11J1 <br />Everett, 'Washington <br />INSPECTICN DDFPARTTMENTT LOT APFFOVAL SHEET <br />GGyr9w ADDRESS fE <br />NAME _ 7 — <br />ADDRESS OF PROFOSED BUILDING <br />LEGAL DESCRIPTION: LOT25f:E BLOCKADDITION S rn°�✓ <br />TYPE OF USE NO. OF BEDFOOMS —, SIZE OF LOT � � x y .3 <br />SOURCE OF DRINKING DATER: PUBLIC SUPPLY K PRIVATE r!ELL___ <br />A. SURFACE DRAINAGE <br />1. Is disposal field site well drained? <br />2. Any water course (stream, drainage ditch, e'(c.) through site? — <br />B. TOPOGRAPHY <br />1. Any heavy slopes in field area?� — <br />2. dill present topsoil in field area be removed or graded before field tiles < <br />installed? 4�0 o i/'L� I f yes, hi <br />3. .Jill any fill material be used in the disposal field site. <br />much <br />— C. SOIL CONDITIONS <br />1. <br />2. <br />S. <br />Has a hole at least 4 feet deep been dug in the disposal field area to dete <br />the type of soil present? _� <br />After hole is dug record the s it conditions at the following depths: <br />(Record as sand, gravel, clay, packed sand, loam, etc.) <br />12 inches � 36 inches ��'�„" <br />18 inches 36 inches- <br />24 inches 48 inches 4M^' <br />Any ground water encountered before reaching a depth o 4 <br />If so, at what depth? <br />D. UATER TEST <br />A simple water test will show how well this soil will drain or percolate water. <br />To perform this test: <br />1. Dig a hole at least 36 inches deep. Use a shovel or post hole digger; 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 />ground and will give a more accurate reading. <br />3. Again pour water in hole to a height of 12 inches from the bottom. Let <br />water run out until there is just 6 inches from bottom left in hole. - <br />4. Note how many minutes it takes for this last 6 inches to seep away. <br />5. Divide this time by 6 to obtain th rate per inch. O/ <br />6< Date wat-r test was performed. i �a C <br />I hereby certify the above information to be correct and the above t is were per- <br />formed by me as prescribed. �y „✓ <br />Signed_ <br />Address <br />NOTE: A septic tank permit is issued on the basis of the above information. If <br />there are any changes or alterations in the above stated soil conditions, it may <br />result in the installation being rejected at the time of inspection. <br />