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May 05 2015 03:14PM HP FaxRusty Olson 7634988290 page 7 <br /> �� ��—c� Yvl-1 <br /> Ci! 1 I OF • . �___ � <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> Date � � � + r r� � <br /> lnspector f/���!/� /�Jb�y 8uiiding Permit No. <br /> Owner �2� �,J 4: 11i�-Y'kvt <br /> Fee <br /> Property Address ��� � ►A� �-a�E .Kind af Building � �+� <br /> j 1 • C -� <br /> Plumbing Contractor•Outside Sewage DisposalT'�„U�L-S ��1�h5 �?C� <br /> �J — <br /> Septic Tanks <br /> Material�C}Z''►tv'�� �1-/�rwrh� Capac+ties � �4�t'�.% <br /> Proper Outlet & Inlet?--V� Baffle Plates> � <br /> Drafn Field: <br /> � / � <br /> Total length of I�nes �g Number of lines� <br /> Type of soil � Percolation Test �� • ?Y'-S't� ►� <br /> Width of trench �ype of filter material {' +^C ��"` C� <br /> Amount of filter material below line � � ��� <br /> Depth from top of tile to finished grade <br /> Check Vents •� Check Caulking "� <br /> Check Grade in Horizontal Waste Pipes �� Clean Outs �� <br /> Tonage or Yards of Fiiter Material � V � +4�5 Total Sq. Footage of Drain Field <br /> Sand �'r"7-� � �� Rock l� �X `� 1 � . <br /> �j ,� <br /> Overall 5ize of Mound System_�r ��f Z Size ot Mound System Rock Filter Material ��_ <br /> Draw detailed diagram to saale with measurements below. <br /> � � _ 3�� ;�!' <br /> 2= .�Z � v.r � ��' <br /> � � .S-�, � � 5 <br /> �� � �'� � ��'�`" �2���w,qY <br /> Z � 7 7 ` !� <br /> 3 r �,� . <br /> ,�ti �,�/-�c�� w�c� /G,� � <br /> v � ' j h Z.� •��h�- c _.�rf.t;'f' <br /> � ��- .3 s �' �� � I C�:.��� .�� �v--� <br /> 7��t �w � Ca � �.YLYti'1 <br />