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Milied"M <br />d1r;d 1, <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />Date — 2'-5— ) C) <br />I <br />Inspector •b 6 Buildi,) Permit No. 710 10- <br />Owner0 K!A :5Cve y!, .4 (Ke., Jkv, V `Fee <br />I.- <br />Property Address Z.�%o )< S+ , Kind of Building <br />Plumbing Contractor -Outside Sewage Disposal— <br />I <br />Septic Tanks VVkC_V__1*_4,t_ CTD-V- Capacities <br />Material L_ 1*1. <br />Proper Outlet & Inlet? <br />3 -13oo <br />Baffle Plates? <br />Drain Field: A I <br />Total length of lines (42( Number of lines .3 <br />Type of soil _-i-z�> ila.-t-k— Percolation Test :?=-.js4-2j 0 k <br />Width of trench Type of filter material <br />Amount of filter material below line 12- 1 # X,4 A_r > <br />Depth from top of tile to finished grade 7S /'t—Z <br />Check Vents - 4 Check Caulking <br />Check Grade in Horizontal Waste Pipes Clean Outs <br />Tonage or Ylars of Filter Material u4 Total Sq. Footage of Drain Field <br />Sand fs Rock <br />Overall Size of Mound System ASize of Mound System Rock Filter Material <br />Draw detailed diagram to scale with measurements below. <br />C <br />Y FP <br />0; VirT,4x; <br />W <br />2- <br />3 <br />ell- <br />13 <br />3 <br />Vk- <br />