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cir�r oF � ''°'" c� �j 1 .��� <br /> • WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> f � <br /> G �� Date �� � � ��7 <br /> Inspector �'` �'� � Building Permit No. <br /> Owner 1 r � `��`4'h�''°'1 �'" �i✓ Fee <br /> Property Address � � L��-e-- ���e K of Building S�`� <br /> Plumbing Contractor-Outside Sewage Disposal yGs�J °�`�'S � <br /> Septic Tanks �X�����"$ <br /> Material ��— Capacities ���� ����''��h <br /> Proper Outlet & Inlet?, � Baffle Plates? � <br /> ZS � �RC S <br /> Drain Field: z' � <br /> Total length of lines �J�X� ' � Number of lines `� <br /> Type of soil (�.? ��"k— Percolation Test �v� �`s��" <br /> Width of trench Type of filter material �'� / �6`�t— <br /> �� � <br /> Amount of filter material below line ( L SA <br /> i <br /> Depth from top of tile to finished grade � ��L <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 ��,x �� _ Rock <br /> /0 f <br /> Overall Size of Mound System ��1` F1� Size of Mound System Rock Filter Material 3 "�� <br /> Draw detailed diagram to scale with measurements below. <br /> . �, , , ,s-° ,�.1 <br /> Z ' �g�: t�-F � <br /> 3 - L! s <br /> ,,,� . ..__ <br /> . �� y,�'' .,.__�------ <br /> � � ,,►y` �r"" �v eQ. I� �'.e- <br /> ,: y�- � w <br /> :;, � <br /> ► <br /> .,, 3 i <br /> P' p� �-�S'�� '� ,,�-�1 <br /> �� <br /> I ✓ <br /> P�� � w` 1 - t3 -� <br /> (��vl� <br /> �"�� <br />