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CITY CF EVERLT' <br />'CytvblialI PHONE: ALpinr /-il.11 <br />Everettq ''NashinCton <br />/► INSPECTION DEFANTidENT L01 APFRUVAL SHEET <br />NAME-ki& ADDF,ES5 7,-es T. rb' <br />AJDRcSSOF PFUFOSED BUILLIIv�. <br />W 6? <br />LEGAL DESCRIPTION: LOT „_ BLOCK ADDITION /iAI 1- u S cl✓ / 4 <br />TYPE OF USE )'ES, N0. GF BEDROOMS 2" SIZE OF LOT 47- Y <br />J,IURCE OF DRINKING dATER: PUBLIC SUPPLY V� PRIVATE cIELL <br />1. Is disposal field site well drainedY a a <br />2. Any water course (stream, drainage ditch, etc.) through site?, & 0 <br />B. TOPOGRAPHY <br />1. Any Leavy slopes in field area? A/4' <br />2. dill present topsoil in field area be removed or graded before field tiles are <br />installed? A/ D _ <br />3. dill any fill material be used in the disposal field site?_d/ ` If yes, how <br />much <br />C. AIL INDITIONS <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? y E S <br />2. After hole is dug record the soil conditions at the following depths: <br />(Record as sand, gravel, clays acked sand, loam, etc.) <br />12 inchesSRA•L LOAM M f�C[K`S 30 inches SAA/I•r L em4,1 JR0C-l": <br />18 inches 36 inches " <br />24 inches 48 inches PAek2,i 5 A R a' <br />:. Any ground water encountered before reaching a depth of 4 feet'i A/ n _ <br />If soy at what depth? <br />D. HATER TE5T <br />A simple water test will show how well this soil will drain or percolate water. <br />To perform this testa <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 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 to seep away.-? 0 <br />5. Divide this time by 6 to obtain the rate rer inch. 5 <br />6. Date water test was performed. -/ - & Y <br />I hereby certify the above information to be correct and the above tests were per- <br />formed by me as prescribed. / <br />Signed Y aE 4A4A7e_'-L- <br />Address Zc5-9jI fZ_AMA& • <br />ME: A septic tank permit is issued on the basis of the above an ormation. 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 />