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WORKSHEET FOR SEWAGE DISPOSAL WORK
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DateM- Q/
Inspector- f� Building Permit No.
Owner1::p V®'V!4 !V &_ 3 Fee
Property Address..14f� MtLtu'yC L AVX xx- . Kind of
Plumbing Contractor -Outside Sewage Disposal- `MW4'r-% s!- '101--) /-t ]4 -
Septic Tanks
Material tyt'rs`�'�"z ` �� g�' Capacities 3-1000
Proper Outlet & inlet? �� Baffle Plates?�i
Drain Field:
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Total length of lines. • �7- Number of lines
Type of soil F2 1 e, o-� Percolation Test
Width of trench Type of filter material &tL)
Amount of filter material below line
�i, e -n AJ U
Depth from top of the to finished grade 3 kL f
Check Vents -/' Check Caulking—
Check
aulking Check Grade in Horizontal Waste Pipes Clean Outs
Tonage or Yards of Filter Material�6164400QTotal Sq. Footage of Drain Field
Sand go, -\(" 1 d iI
Rock 1 r7 � � '�{�
f f
Overall Size of Mound System Size of Mound System Rock Filter Material_
Draw detailed diagram to scale with measurements below.
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KEW Cove- l(
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