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CITY OF Immi <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />Inspector Building Permit No <br />Owner <br />Proper <br />Plumb <br />Fee <br />Kind of Building 8 FD <br />Septic Tanks y� <br />Material C A-v,W kyx Capacities `-"moo <br />� <br />Proper Outlet & Inlet? ✓ Baffle Plates? I_/ <br />Drain Field: r <br />Total length of lines- '3 0 Number of lines 3 <br />Type of soil �^-�- Percolation Test -s <br />Width of trench Type of filter material ��•^e-� <br />!r <br />Amount of filter material below line_����7 <br />Depth from top of tile to finished grade ,> (�2-- <br />Check Vents <br />Check Caulking <br />Check Grade in Horizontal Waste Pipes Clean Outs <br />Tonage or Yards of Filter Material S Total Sq. Footage of Drain Field �U <br />Sand �_y / X, 70 - Rock_C 2 <br />Overall Size of Mound System C111— Size of Mound System Rock Filter Material 3%T <br />Draw detailed diagram to scale with measurements below. <br />(00U?D <br />r c:;) .A- ( ? <br />