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' ) ' ' 9-1720 <br /> CITY OF d Vcn 0 <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> i <br /> //,, Date ' j <br /> Inspector1th / '/re 6,bh Building Permit No. <br /> Owner sc'i!T Y're1- //4 7A/1"/' Fee <br /> Property Address5� o Id Ci-).c t 1 13ay `"`kind of Building 57'✓ <br /> Plumbing Contractor-Outside Sewage Disposal 4cl LS +Scn"S <br /> Septic Tanks ,l <br /> Material '6✓Y1C-ke� ( IYt. ) <br /> Capacities 3— 1300 <br /> Proper Outlet & Inlet? ✓ Baffle Plates?_ ✓ <br /> Drain Field: <br /> Total length of lines 1! Number of lines 3 <br /> Type of soil U-ck Percolation Test 2us47 01 S c.*"-•- <br /> Width of trench Type of filt r material 6 IS h""- <br /> Amount of filter material below line ,moi' Ste' 9 ked- <br /> Depth from from top of tile to finished grade //2.- f <br /> Check Vents ✓ /Check Caulking <br /> Check Grade in Horizontal Waste Pipes ✓ Clean Outs '--"'"----/ <br /> Tonage or Yards of Filter Material /80 yds- 54-j Total Sq. Footage of Drain Field 6 s.'i <br /> Sand SC/ X 3 8 , Rock /Q ! l` �� , <br /> � , II <br /> Overall Size of Mound System OS- X ,..2 Size of Mound System Rock Filter Material I 2-- <br /> Draw <br /> Draw detailed diagram to scale with measurements below. <br /> _3 tr (1'.- f <br /> 3N IS3 ti <br /> -MOONS 2-o etti e- I <br /> la\ 6 <br /> P P <br /> Lo 14 (4irv.. 59SA-04— ril'Ueiokit <br /> 11, Fi`/ -e✓ /r. z `=-� 5i <br /> 1t-14K t 4( 0 kms <br /> w' ‘1)(' air <br /> 1.--- 21 cW <br /> 3 - 35-n S -44 /U <br /> P / ` !b, E <br /> Z ti <br /> 3 - 36 r — ` _ <br />