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l T.• — . <br />� S .. r„ . _ . . <br />J� �. � � <br />y✓� �� ..y � �. . <br />r:� s;�, �; <br />����`kK,a'ik€s �i S=°��� _..,�.` 7 '%„ � <br />CITY OF EVEFETT <br />City Hall <br />Everett� iaashington <br />INSFECTIOPI DEPART��EPJT <br />1' _�1 ..� % . • � / <br />FHONE: ALpine 9-'7101 <br />LOT A.PPRGVAL SHEET <br />�D 7 / <br />NAN.E_�,G�wu.l r•�/��ur ADDRESS /P�73 I�c°V /2 G� ,(�i,ti,3�� l,crv�, <br />ADDRESS OF PRC{�GSED BUILDING�,C���/2( 4 �„�`..,,���.vrL.} <br />LEGAL DESCRIPTION: lOT BLOCK ADDITI <br />T`!PE OF USE N0. OF BEDRO�NS SIZE OF L <br />SWRCE CF DRIP!KitdG „ATER: PUELIC SUFFLY % PRIVATE v+ELL <br />P. SURFACE DRAINAGE <br />I. Is disposal field site well drair:edi \!e S <br />2. Any water course (stream� draina�� �itch� etc.) through site? f��N e <br />B, TGPOGRAPHY <br />s <br />Any heavy slopes in field area: N'�nfN F <br />::ill present topsoil in field zrea be rertaved or graded be�re field tiles are <br />insia]]ed? �% nfC <br />.:ill any fill material be used in the disposal field site? u0 If yes� how much <br />N,h c <br />C. SOIL CONDITIOtJS <br />Has a hole at least 4 feet deep been dug in the disposal iield area to determine <br />the type of soi] present? V eS <br />After hole is dug record t� soil con�itions at the £ollowing depths. <br />(Record as sand� gravel� e�e� packed sand� loam� etc.) <br />12 inches �.� a v�n 30 inches *�' <br />18 inches i n a t�. 36 inches 5......,� <br />24 inches 1 0� rn 48 inches <br />Any �round water encountrred before reaching a depth f 4 feet?_;,..rn.e _ <br />If so� at what depth? .-n wu <br />D. �iVATER TEST <br />A simple water test nill show how well this soi] will drain or percolate water. <br />To perform this test: <br />1. Dig a hole a.t leasi 36 inches deep. Use a shovel or post hole diggergsize <br />of hole makes no difference - only depth, <br />2. Fill hole with water, f�low let all water run out of hole. This soaks the <br />ground and will give a more accurate reading. <br />:3. APain pour water in hole to a height of 12 inches from the bottom. Let <br />water run ouf u�til there is just 6 inches from bottom left in hole. <br />4. Note hovi many minutes it takes for this last 6 inches to se�p away..3 a, <br />5. Divide this time by 6 to obtain the raie per inch. � <br />6. Date v:ater tesi was perfornred. /� 27— /9L•2 _ <br />I hereby certify the above information to be correct and the above tests v+ere per- <br />formed by me as prescribed. ��� <br />S i gned � . i /jt"��t <br />Address�tL_�G � __�dP'`' <br />p�CTE: A septic tank permit is issued on the bas�s of the above inforiration. If <br />!here are any chan�es or alterations in the �bove stated soil conditions� it may <br />��es�lt in the installation beinp reject�d at the tim� of inspection. <br />p� • �J. n <br />ot`�, � �� %�-����.lr � 3 3 z <br />�a..,•) <br />