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��'G.-C1 e�L� <br /> CITY _ ( - <br /> � <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK �b ._��,_Q�, <br /> /,i�°/�'� �� � �f Date- - <br /> W <br /> Inspecto Building Pe;mit No._�_ <br /> Owner �l�'� � —'��-- �C7 .S�v,B�.S <br /> Property Address_ —Kind f Building � �� ��� �� �l/ <br /> Plumbing Contractor-Outside Sewage Disposal ' <br /> Septic Tanks <br /> ��G i-�� � w�� ''f aU <br /> Material Capacities <br /> Proper Outlet & Inlet? � Baffle Plates? �— <br /> Drain Field: � Z r. f(�, ��(�z � <br /> Total length of lines ��� �� Number of lines <br /> Type of soil , ` �=� Percolation Test � ST�'1 <br /> Width of trench Type of filter material �� � �Y�� �' <br /> Amount of filter material below line �V j� �� <br /> 1 � �� � <br /> Depth from top of tile to finished grade �1 Z- <br /> Check Vents `'"' C� Caulking '�' <br /> Check Grade in Horizontal Waste Pipes "�� Clean Outs � <br /> Tonage or Y�rds of Fil�r Material �' Total Sq. Footage of Drain Field � r o <br /> Sand � �s3 _ Rock �' �� �x 3z <br /> r , 3l �,�i <br /> Overall Size of Mound System S�oX53 Size of Mound System Rock Filter Material_� <br /> Draw detailed diagram to scale with measurements below. <br /> � l 3� � w <br /> L <br /> • Z,, �Z � ,_;-��. � --�i !� <br /> � r,r,Z,,� ' L' <br /> 4,� � � y� <br /> a � � � � ' �s � <br /> i ,,�.� �P�'Y �� Z, �g`' r��f<�. <br /> �► I� , �� z ��,,��3, ,�, a1�,� � - �6 <br /> C ��r�� '�'�� ,./ Z e t 1 t� <br /> � << � �P 3 ��o g4�1�s �� <br /> ,, � �.. �.� � j 'l�z ,v��'s <br /> �tp N�' �' � t� <br /> ,�(} o h c.�k-�C-'� <br /> �l � Z '�3 a r p.�' <br /> 1�r�� ��j� o i�) GQ1ti`�✓ <br /> v <br />