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i_ <br /> . , �IiY CF �V�ittl�� <br /> Ci{y hiall P'-,�I`:'L: A��;in, �-l1J1 <br /> Lverett, '�l�shin�ton <br /> I idSPECTION DEP,IRTI�iENT LOT APF7�GA� SFIFET - <br /> N�1�eE_ !�D� � �_L� C I � <br /> ��NSI � _ :;DDF S:i /�. ,��� I.3El/t� �Y �1<�cA Cc� <br /> ��+�DR�SS OF FF,UFOSED BUILLING 1Hi�-�1 � �` �� � �� � � <br /> �-O—F�tr'S,U� <br /> ��GALDESCRIF'TIUN: LOT BLOCK M°FTft9o•rFwcs� �y3eso`r <br /> ADDITI(1iV �:u�H �esry SEc. i7:- 2F 9 6.,L. <br /> 1 YF[ �F USE Lv n M �;0. CF �EDF�UI�iS •3 SI ZE OF �OT �B )( / �f.3. c^� '3 <br /> i.�Ui�CE OF URINIlI�VG �JATEf�: i=UBLIC SUPFLY ES _ , riIVhTE ,;E�L � <br /> A• �l!RFAC� DRAI iJ�GE <br /> 1. Is disposal field site v:ell drainedY �/E`> SLnYc ;� p'!lt_V� o�- Lel <br /> �• %�ny water course �strearn� draina�,e dit � etc. ) throuph site:'_ /.�-, <br /> , <br /> B. TOrOGRtirH'( <br /> 1. ��ny h.eavy slopes in field area? �V D <br /> 2• .lill present topsoil in field arEa be rerrovec,' or arad:d 'oePure fi.:ld tiles :ire <br /> installed?_ M U <br /> F� � 3. ,Jill any fill material be used in the disposal ii��lc sitc? C� If yes� how <br /> � much <br /> C• �IL (�f'DITIOP!S <br /> 1, Has a hole at least 4 feet deep been dup in the cisposal fi�ld area to deiermine <br /> the type of scil present? L`S <br /> >. Hfter hole is dup record the soil conditions at {he follovain� depths: <br /> (Record a� sar�d� �r:���el � clay� packed sand loam etc. ) <br /> 12 ir.,;hes LoR M1 �0 inches C I. A �/ <br /> 1P i nches L c ij M ---�� <br /> 36 inches _�� <br /> 24 inches LC.AM � S'AWn q8 inches <br /> ;, any �round water encoun�—{�-_rP�before reachin� a depth ef �l ��{'� � (y __ <br /> If so� a{ what depth`?__ - <br /> �7ATFR TEST <br /> �� simple water test v.�ill sho�v how well this soil will drain or perco]ate eraier. <br /> �o perform this test: <br /> 1. Dig a hole at least 36 inches deep. Use a shovel or pos{ holc di��erg size <br /> of hole makes no difference - only depth. <br /> 2. Fill hole with e�ater, Now let all water run out of ho;e. Thi� soaks the <br /> �round a�d will �ive a more accuratE readinp. <br /> 3. A�ain pour water in hole to a hei�ht of 12 inches from the bottom. LF.{ <br /> water run out until there is just 6 inches from bottom ieft in nole. <br /> 4. Note how many minutes it takes for this last 6 inches tu seep away,�_�'���V� <br /> 5. Divide this time �- 5 to obtain the ate er inch. �„(_-�- M!N <br /> 6. Date water tr st �+ , performed. /� / S ' <br /> � hereby certify the above information to be correct and the above tests �:ere p�r- <br /> formed by me as prescribed. � <br /> 5 i�ned ��� '! � �. C_�-x/� <br /> Address = u' = R� �.:.'<1 , <br /> �COTE: A septic tank per �ii is issued on the basis of the above informat�on. If <br /> there are any chanpes or alterations in the above stated soil ccnditions� it may <br /> re,��]{ in the ins}allation bi,inp re�ec{ed at the time of inspection. <br /> I <br />.__ _ <br /> - ��. �_ _ - -- <br />