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(::',, i aP 0 (uo (.. q. 0..,,,,,„,,,„,i,„„„,..,,,,,,,,,,,,,... &.-)L51:- <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> ``,, , CC Date F1/00/00 <br /> Inspector w' EL 6-)aJ Building Permit No. <br /> Owner S( c2iJa" e..✓o04 (72('r.'(O vel S Fee <br /> Property Address -7-i3-1,-, Et)e- 4.-I+" Kind of Building S. 47::. 0* <br /> Plumbing Contractor-Outside Sewage Disposal r") iv d,6<-5- AvS <br /> Septic Tanks <br /> Material an_.;e_iee id— Capacities <br /> Proper Outlet & Inlet? Baffle Plates? <br /> Drain Field: <br /> Total length of lines CO / Number of lines <br /> U <br /> Type of soil Percolation Test <br /> Width of trench Type of filter material <br /> Amount of filter material below line <br /> Depth from top of tile to finished grade <br /> ( t te <br /> —1-- <br /> Check Vents Check Caulking <br /> Check Grade in Horizontal Waste Pipes Clean Outs <br /> Tonage or Yards of Filter Material Total Sq. Footage of Drain Field <br /> Sand , ` - Rock <br /> Overall Size of Mound System 41-‘1( k or ` Size of Mound System Rock Filter Material l0 G' V <br /> Draw detailed diagram to scale with measurements below. j <br /> -'- dl <br /> A (01 i <br /> IALA a <br /> 1 ,0 <br /> 16( .' t <br /> 6(0 1 <br /> It <br /> (. - 1.0. 1 <br /> c\ 1 <br /> \4 _, toqi <br /> I wo 40 <br /> (--0')c Z <br /> 6.9 <br /> Pc W-- <br /> 1--------------------.2 •Q <br /> 4-0) <br /> 1 1 lo• r <br />