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M� PECTI ERVICE�, . • " -479-1720 <br /> CITY OF ���J�� <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> Date `� �S ��� <br /> � /�.i, �j <br /> Inspector f �'t v�'"�� Building Permit No. <br /> Owner �"-�- T�'���` � Fee <br /> Property Address� _`� � � �r"�^ ��` Kind f Building_���� <br /> Plumbing Contractor-Outside Sewage Disposal `� <br /> Septic Tanks <br /> Material �25��� '��`��v�. Capacities � � � �� <br /> Proper Outlet & Iniet? .,�1 Baffle Plates? � <br /> Drain Field: w� <br /> P �Total length of lines 3� Number of lines <br /> Type of soil ��Z�� Percolation Test � � `S�{�' <br /> Width of trench Type of filter material �st.c� F`r�✓r�c. <br /> Amount of filter material below line j� ,/f� <br /> Depth from top of tile to finished grade � �i� <br /> .✓ <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 Rock _�f�� .3� <br /> �� / ( l <br /> Overall Size of Mound System �'L���� Size of Mound System Rock Filter Material Z- <br /> Draw detailed diagram to scale with measurements below. <br /> �/ - <br /> � � r � <br /> ,� 2 . � �� <br /> , � � � �� 5 � � <br /> � � a � � <br /> .�--L� � <br /> 3 � , � , � <br /> 2 �, <br /> 3� � <br /> �� �'�� � <br /> � � <br /> ,� Z <br /> iM `� ��p � <br /> , � y� 3 <br /> ,�N �o <br /> ������ <br />