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tA <br />12 12 05:28p Brad <br />MMIRMIMIUMM <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />Date— S- l d /0 <br />inspector ] I' Building Permit No. <br />Owner <br />Property Address_9 2. <br />Kind of Buildin <br />SSTS Insfmller _ Q.'"`'` License <br />Septic Tanks <br />Material Y +� Number of Tanks <br />Sita <br />Drain Field: 1 <br />Total length of lines Number of Ernes <br />Type of sail clr� Percolation Test ^ (t j .5 ±21 <br />Width of trench Type of tuber mateftl <br />Size of Rock Bed1 0 lC ' S•iza of Absorption Area. <br />Craw detailed diagram with measumments indicating distances to s c tank risers from a <br />permanent structure - <br />6k -41) k 41)k <br />W <br />p.4 <br />j <br />