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_ <br /> S PE S . -1720 <br /> CITY OF � �'�� <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> � <br /> �1 7 <br /> Date <br /> Inspector ���/�� �` ���"� Building Permit No. <br /> Owner �'�-� ���a Fee <br /> Property Address ��Yb �"� ��`` C°`"�� Kind of Building f�'� <br /> Plumbing Contractor-Outside Sewage Disposal Lz�'/��S '�a��s <br /> Septic Tanks ����_ <br /> ���� D���.`�� I,�oU i�� � vX�sf��y �--i� <br /> Material CIL( Capacities, <br /> Proper Outlet & inlet? `� Baffle Plates? � <br /> Drain Field: <br /> �Uw/ - lb ��(�L` ����. d� � <br /> Total length of lines Number of lines � <br /> Type of soil �1�-�-� Percolation Test �z'��7 � �S�'Z•� <br /> Width of trench Type of filter material <br /> (��o ���r-. V L <br /> Amount of filter material below line /,J+�'' /J�p!✓ <br /> �—'� ` <br /> Depth from top of tile to finished grade � ��Z <br /> Check Vents �-- Check Caulking � <br /> Check Grade in Horizontal Waste Pipes �J Clean Outs `'� <br /> Tonage or Yards of Filter Material��l-"'Lf Total Sq. Footage of Drain Field � �� <br /> � i � <br /> Sand � � �� Rock o1 – ld �3� <br /> 0 ! �� >r <br /> Overall Size of Mound System�� Size of Mound System Rock Filter Material Z✓ <br /> Draw detailed diagram to scale with measurements below. <br /> ��I�k cs��f U.f <br /> .��;�y�s� �, � <br /> �3.�; s <br /> � � ��� � <br /> � <br /> � <br /> �3�� ��Q, � � P ►� � <br /> � <br /> ^ �� � .�% y y' )�-k- <br /> � � � 2 <br /> �� I(.e.v <br /> lv t ca 1 <br /> �� ""� <br /> ,�, I C� (�rw� <br /> 5�s� <br /> �ti�r� <br /> �t• <br />