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7�' <br />�///`T _ t.cc-- <br />CITY UF tVEREIi <br />City Hall PI-�CINE: ri�;,i�,. ._;1 �t <br />Everett� 7Jashin�ton <br />Iid:iFECTIGDi DEF'ARTiaiEiuT LOl APPFUVAL SHEET <br />�.A�v,f= ��r � �� �,i S '1�.� rc: ADDRESS�� �'c�� �- G'l4.v /�r,- ��SI�— <br />�llDRtSS Gf �FUrOSED BUILUII'JG % / j �'� � t <br />�EGAL DESCRI PTIUN: LUT� BLOCK ADDI TIUN L»9 rr.c �;� 7�P r>'�� ���- <br />I VP[ UF USE I C� f�. GF BEDFCU(J�S 3 SI ZE OF �UT %,7 J� I a I_ <br />;(�UHCE OF URtNKIiVG �IATER: i=UBLIC SUPFLY � '� 'rRIVATE :JELL __ <br />.4. SURFACE DRAINAGE <br />1. Is dispesal field site well drained': _`� <br />2, Any water course �strcam� drainage ditch� tc.) tnrough site? �lc, <br />B. TOFOGRA?HY <br />i <br />l, Any heavy slopes in field area`�_ ��' <br />2, :lill present topsoil in field area be removed or graded before field tiles are <br />installed? %��� <br />3. ,iill any £ill material be used in the disposal Pield site'?� If yes, how <br />mucl� l�i� �bi�c4io � <br />C SOIL C(iv�ITiONS <br />i. iias a hole at least 4 feet deep been dug in the disposal field area to determine <br />the type of soil present� � C� <br />.��fier hole is dug record the sotl conditions at the following depths: <br />(Necord as sand, gravel clay� packed sand� loam� etc.) � <br />f&'4t i nches � �- �� 30 i nches � 1' ��, S n ���y_ °'i"j L <br />18 i nch=6 ���o •��,t�_•� �• �•,'Z 36 i nches `v w o.+ d Q.'r.� � iI <br />24 inches �� �_.^_� �� 44 inches � Su 112 <br />„ Hny ground water e�countered before reachinp a depth of 4 ieet� _ <br />If se� at what depth? <br />D. FlATER TEST <br />4 simple v+ater test will show how well this soil will drain or percolate water. <br />To perform #his test: <br />1. Dip a hole at least 36 inches deep. Use a shovel or post hole di�ger� 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 />�round and will �ive a rtare accurate readin�. <br />3, A�ain pour waier in hole to a hei�ht of 12 inches from the bottom. Let <br />water run out until there is just 6 inches from bottom left in hole. �.'�I Y` <br />4, �lote how many minutes it takes for this last 6 inches to seep away. <br />5. Divide this ttme by 6 ta obtain t�he rate per inch. <br />6. Date water test was performed. h-�`� '�%� <br />I hereby certify the above information to be correel-a d the al�ove tests �tiere Pv- <br />formed by me as prc.scribed. J <br />�igned �-C .��"2' <br />Address /�' 30 � i,-�-z�.,.,.-2'.., -!%L�� <br />�;C.`TE: A septic tank permit is �ssued on the basis of the above informaiion. If <br />?��ere are any chan�es or alteraiions in the above stated soil co�ditions� ii may <br />r:suli ir Ih�- insiallalion being rejected .=.i the iime of inspection� <br />