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r -�M�TRO WEST INSPECTION SERVICES, INC. • 763-479-1720 <br /> � J ���� <br /> ci�r oF �- <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> Date �� � � /� <br /> Le;�t �, �'-� t�J-r� fi , / � <br /> Inspector � ` �rU Building Permit No. `���`T � � ��� <br /> Owner �L y��1-C?���'''��S Fee <br /> Property Address ��-'' 1� �"'���'� Kind of Building 5 r 1,J <br /> Plumbing Contractor-Outside Sewage Disposal � �"� �'� � S✓`�S <br /> Septic Tanks <br /> Material ����-'r"�-'��•�{"�r�l Capacities � ��( J � � <br /> cI' <br /> Proper Outlet & ►nlet? �`� Baffle Plates? <br /> Drain Field: � <br /> Total length of lines ��1 Number of lines � <br /> Type of soil I�IC.�-�'�, Percolation Test �� �' �� t�V�., <br /> Width of trench ✓ J Type of ' er material � ��L- <br /> (o �r � <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 Filter Material � ` Total Sq. Footage of Drain Field �� ��' <br /> Sand �� � 1� Rock �U J�� � <br /> , �. <br /> Overall Size of Mound System_ _ �L /` �w7 Size of Mound System Rock Filter Material r /Z <br /> Draw detailed diagram to scale with measurements below. <br /> � �,� �� <br /> � <br /> �° �5� C = `f3 � r <br /> �� � � <br /> � � �� <br /> � 3 _ � 31 <br /> v� � � `� � � , <br /> � � � � �' , <br /> � z � � 3 Z = sw <br /> `�'��� <br /> � �� � <br /> �,����N i � I � ��� <br /> � �, � �wt . <br /> �c�` ���- <br />