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CITY OF EVERETI <br />City Hall PHONE: Arpin )-11J1 <br />I Everett, 1117ashington <br />INSPECTION DEPARTMENT LOT APFnOVAL SHEET <br />NAME/2�, 4 . ADDRESS G%C/qL <br />The North 192.13 feet of the South 576.33 feet of the East <br />216.00 feet of Government Lot 2, Section 18, Township 28 N., <br />i Range 5 E., W.M. EXCEPT the east 150 feet of the North 132.13 <br />thereof, and EXCEPT County Road. <br />TYPE OF USE NO. OF BEDFOOMS SIZE OF _UT _6E %`. <br />SOURCE OF DRINKING DATER: PUBLIC SUPFLY ` PRIVATE BELL <br />A. SURFACE DRAINAGE <br />1. Is disposal field site well drained: y P-r- S <br />2. Any water course (stream, drainage ditch) etc.) through site?_ NO <br />B. TOPOGRAPHY <br />1. Any heavy slopes in field area? 1V _ <br />2. .dill present topsoil in field area be removed or graded before field tiles are <br />! installed?_4/,-Y�) <br />3. Jill any fill material be used in the disposal field site?-,&O If yes, how <br />much <br />C. SOIL CONDITIONS <br />1. Has a hole at least 4 feet deep been dug in lh;e disposal field area to determine <br />the type of soil present? e <br />2. lifter hole is dug record th soir. conditions F the following depths: <br />(Record as sand, gravel, clay, packed sand, loam, etc.) <br />12 inches 30 inches�� <br />i 18 inches 36 inches ./+ +� <br />24 inches 48 inches 21 124� <br />_ <br />i. Any ground water encountered before reaching a depth of 4 feet? -4/0 <br />If so, at what depth? <br />D. WATFR 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 inche- deep. Use a shovel or post hole- digger; size <br />of hole makes no difference - only depth. <br />�i 2. Fill hole with water. Now let all :eater 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 fr-)m bottom left in hole. 4. Note how many minutes it takes for this last 6 inches to seep away./S - 2712� <br />5. Divide this time by 6 to ob•;ain the rate per inch.'• ' z Y.L.? <br />6. Date water test was performed.- <br />Z /- <br />I hereby certify the above information to be correct and the above tests were per- <br />formed by me as prescribed. <br />S i gned-"�*�y'T <br />Addresses?/�/O 7_ _ <br />ROTE: 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 />