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;i <br />CITY OF EVERETI <br />City Hall PHONE. ALPIne J-i1J1 <br />Everett, 14ashington <br />I - ECT10_N-P' ;BENT SOT APFFUVAL SHEET <br />J r <br />IVAiwEt ADDRESS V;,2 <br />ADDRtSS OF PPoJFC;ED BUILDING <br />1 LEGAL DESCRIPTION: LOT `� BLOCK ADDITION <br />TYPE OF USES` W. OF BEDFOOMS SIZE OF.. LUT -!2X //l <br />SOURCE OF DRINKING DATER: PUBLIC SUPFLY C 1 PRIVATE BELL 7z1 <br />SURFACE-94INAGE <br />1. Is disposal field site well drained?/.' <br />2. Any water course (stream, drainage ditch etc.) through site?_ --125 e <br />B. TOPOGRAPHY <br />1. Any F :lopes in field area?_ <br />2. dill t typsoil in field area be removed cr graded before field tiles are <br />inst, <br />3. Jill air iil Lmaterial be used in the disposal field site? 2 - If yes, how <br />much C <br />C. SOIL CUNDITIONS <br />1. Has a hole at least 4 feet d�_been Twin thn 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, clayq packed sand loamy etc.) <br />12 inches 36 inches <br />18 inches 36 inches <br />!� 24 inches 48 inches <br />1. Any ground water encounter d before reaching a depth of 4 feet?_ <br />If soy at what depth? <br />D. WATER TF_ST <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 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 eonks the <br />ground and will vivo a more accurate readin@. <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.�e* <br />5. Divide this time by 6 to obtaip-the rat` e inch. �z <br />6. Date water test was performed. <br />I herebyy certify the above informatio o be correct and the �bove tests were per- <br />formed by me as prescribed. / n <br />Signed /�/i/i l �..X <br />Address, T— " <br />NUTE: A septic tank permit is issued on the bar.g;of the above infor tion. I <br />there are any changes or alterations in the abov� stated soil conditions, it may <br />result in the installation being rejected at the tame of inspection. <br />