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CITY OF EVERETT <br />City Hall <br />Everett, aashington <br />INSPECTION DEPARTNENT PHONE: ALpine 9-7101 <br />7 LOT <br />APPROVAL SHEET <br />NAIVE� 'tom" _ ADDRESS 3 / 8 - L a SCLV 1 l71 ey <br />ADDRESS OF PROPOSED BUILDING Z . 9 r. 7 <br />t - _ <br />LEGAL DESCRIPTION: LOT2 BLOCM ADDITION <br />TYPE OF USE �N0. OF BEDRO%S .9 SIZE OF LOT /3A- P3 <br />SOURCE OF DRINKING r.ATER: PUBLIC SUPPLY v PRIVATE hELL <br />A. SURFACE DRAINAGE <br />I. Is disposal field site well drained? <br />2. Any water course (stream, drainage ditch, etc.) through site?A e <br />B. TOPOGRAPHY <br />1. Any heavy slopes in field areal :7" o <br />2. rill present topsoil in field area be removed or graded before field tiles are <br />installed?_ _ -,_- <br />f. s.ill any fill material be used in the disposal field site? v If yes, how mu,h <br />C. SOIL CONDITIONS <br />1. Has a hole at least 4 feet deep been dug in the disposal field area to determine <br />the type of soil present? <br />2. After hole is dug record the soil conditions at the following depths. <br />(Record as sand, gravel, W, packed sand, loam, etc.) <br />12 inches 30 inches <br />IP inches 36 inches <br />24 inches 48 inches <br />Any ground water encountered before reaching i depth of 4 feet? ., e <br />If so, at what depth? <br />D. WATER TEST <br />A simple water test will show how well this soil will drain or percolate water. <br />To perform this test: <br />I. Dig a hole at least 36 inches deep. Use a shovel or post hole digger: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 />ground and will give a more accurate readino. <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 from bottom left in hole. <br />4. Note how many minutes it takes for this last 6 inches to seep away <br />ti. Divide this time by 6 to obtain the rate per inch._ / h.� <br />6. Date water test was perforned. ni -,i 'a <br />I herebyy certify the above information to be correct and the above tests were per- <br />formed by me as prescribed. <br />Signed_L_ <br />Address�/ fr__[ <br />NOTE: 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 />�"7 <br />