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■ <br />CITY UF �VERETi <br />City Hall PF�G�E: A�F:in,. �l-il-'1 <br />' =��!�d.��a^i: Everett. ';�ashin�ton <br />INSPECTION DEP�1RTfatENT LOT APFr(1VAL SHFET <br />i�A��,E//�r,va/rd f�/u�zr/r<2 <br />ADllnES� 9�� � � '¢v� <br />I AilDRESS UF FFUFO:iED BUILUIf4Gi'S�o�9 <br />y r� �vt, F��_ L_ r" P�- <br />�EGAL DESCRIf'TION: LOT BLOCK ADDITION <br />TYFE UF USE �'L.�S � P:O. GF BEDFGUP�iS /� SIZE OF :.UT �.,� �=�'� <br />�uURCE UF llRINKIiVG ,JATER: FUBLIC SUPFLY ��,�i____--- <br />FRIVATE :1ELL <br />A. SURFAC� DRAIPIP.GE <br />1. Is disposal fielc site �se11 drained: <br />2, Any v+ater cours� �s''.rearn� drain�pe ditch� etc.) throuph site <br />B, TGrOGRAPH'r <br />_ / <br />1. Any heavy slopes in Pic-� area���� . <br />2, 'ilill present,top� �1 :', field area be remove� or praded be•Pore field tiles are <br />insialled?_ �� ' <br />3, ,Jill any fi�l/l material be used in the disposal Pizld site� � If yes, how• <br />much �/d'7a ' <br />�, �p�� �f�iDITIONS <br />1, Has a I:ola at least 4 Peet deep be ! dug �n the disposal field area to tieterm�ne <br />the iype of soil present? �'� J ---- <br />2, Hfter hole is dug record the oil conditions at the f'ollowing deptl�s: <br />(Record as sand� pravel� clay� pacl<ed sand� loam, �t�.� <br />30 inrhF�s �' --- <br />12 inches -�i������1 36 inches �--= <br />18 inches �� - 48 inches _�--_ <br />24 incnes ` -- <br />�, Any pround water encountere� before reachin� a depth of 3�e�{�' �1��`'� <br />If so� �t what depth? 1��_ �•—� <br />D. A?FR ?EST <br />A simple water test wiil show how well this soil v+ill drain or percolate e:atr_-r. <br />To periorm this test: ��� � <br />1. Di� a r�ole at least 36 inches deep. Use a shovel or posi holc di �r• size <br />of hole makes no difference - oniy depth. <br />2, Fill hole with v+ater. Now let al: water run out oS hule. This soaks the <br />�round and wili give a more accurate readinp. <br />3, Again pour water in hole to a heinht of 12 inches from the bottom. Let <br />water run out until thcre is just 6 incnes from bottom left in holc. <br />q, �!ote horr many minutes it iakes for this las: 6 inches t�seep a�+'�}' —�.�-- <br />5, Divide th�s time oy 6 to obtain the rate per nch. <br />�, Date water test vras performed.�-`F G3 <br />I hereby certify the above infurmation to be correci andlthe above tests wore {='�- <br />l"�'��.e �i h/�� <br />formed by me as prescribed. Si�nedt - <br />Address <br />KOIE: a septic tank permii is issued on ihe basis of the above inPormation• �` <br />there are any chanc�e'� or alterations in the above stated soil conditions� it may <br />r�:suli in tF�., ins{allaticn bein� rejected at the time of inspection. <br />, , — <br />