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f- <br /> j CITY OF FVERETI <br /> City Hall PM)NE: ALpinc 1-'ll _'1 <br /> Everett, Aashington <br /> INSPECTION DEPARTXNT LOT APPROVAL SHEET <br /> NAME I �� 13e u Alal ADDRESS _ <br /> r <br /> -' ADDRESS OF PFOFOSED BUILDING -E /.'� <br /> LEGAL DESCRIPTION: LOT_ BLOCK ADDITION <br /> TYPE OF USE L. 5 NO. OF BEDFOOMS .3. SIZE OF LUT Zs � <br /> SOURCE OF DRINKING .LATER: FUBLIC SUPFLY PRIVATE DELL <br /> A. SURFACE DRAINAGE <br /> 1. ! s disposal field site well drained? 5 <br /> 2. Any water course (streams drainage ditch, a c.) through site? .db <br /> B. TOFOGRAPP Y <br /> 1. Any heavy slopes in field area?,_ AD <br /> 2. gill present tops oII in field area be removed or graded before field tiles are <br /> installed? <br /> 3. .fill any fill ma erial be used in the disposal field site? If yes, how <br /> much <br /> C. 40IL OUNDITIONS <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? e s <br /> L. After hole is dug record the saril conditions at the following depths: <br /> (Record as sand, ravel, clay, packed sand, loam, etc.) <br /> 12 inches 63 30 inches if <br /> 18 inches S„ 4y:rue/ 36 inches / <br /> 24 inches 48 inches <br /> s. Any ground water encountered before reaching a depth o 4 feet? <br /> If so, at what depth? <br /> D. 17ATER TEST <br /> i 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 /> 4' 2. Fill hole with water. Now let all water run out of hole. This soaks 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 takes for this last 6 inches 10 seep away. <br /> 5. Divide this time by 6 to obtain the rate per inch. 3 <br /> 8. 6. Date water test was performed. 9-/-L Z:5 <br /> ( I hereby certify the above information to be correct andtheabove tests were per- <br /> formed by me as prescribed. <br /> z S i gndd r!^O <br /> Add ress?tom "(,9Z4- deW <br /> ME: 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 /> r <br />