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CITY OF EVERETT <br />City Wl <br />Everett, ephington <br />INSPECTION DEPARTVENT <br />NAN.c <br />0'r A. d( <br />ADDRESS OF PROPOSED BUILDING_ <br />FHONE. ALpine 9-7101 <br />LEGAL DESCRIPTION: LOT, g;iOCM ADDITIOV <br />TYPE OF USE /'r. 5 NO. OF BEDRCOVS\� T SIZE OF LOT <br />)OURCE OF DRINKING ..ATER- PUBLIC SUPFLY �— PRIVATE <br />A. SURFACE DRAINAGE <br />I. Is disposal field site well drainedi V SOZ9 <br />2, Any water course (stream, drainage ditorit etc.) through site?_ZP7t� <br />B. TOPOGRAPHY <br />1. Any heavy slopes in field areal <br />!•ill present to in in,fipld tea be removed or graded before field tales nro <br />installed? 'f /1 T <br />s. ..ill my fill rn<atarial be ur in the disposal field site7L�lf yes how much <br />C. SQIL CONDITIONS <br />1. Has a hole at least 4 feet deep bean dug in the disposal field area to determine <br />the type of soil present? T' <br />2. After hole is dug record thf soil conditions at the following depths. <br />(Record es sand, pravel� y packed sand, loam, .) <br />l2 inches �c 30 inches ^ le a <br />lE inches 36 inches <br />24 inches / 4r+ inches <br />Any ground water encountered before reacting a depth of 4 feet? <br />If soy at what depth? ---- <br />D. WATER TEST <br />r- <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 et 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 saaks 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 from bottom left in hole. <br />4. Note how many minutes it lakes for this last 6 inches to seep away. V 0 Al <br />5. Divide this time Ly 6 to obtain the rat r er i ch. 1 <br />6. Date water test was performed. — <br />I hereby certify the above inforrr,ation to be correct,a the above test were/per <br />formed by me as prescribed. <br />Signed- �• <br />NCTE: A septic tank permit is issued on the bast-_ of thabo h ve information. If <br />!here are any changes or alterati,ns in the rbove stated soil ronditions, it may <br />rasult n the installation heinp -ejected at the time of inspection. <br />