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CITY OF Q
WORKSHEET FOR SEWAGE DISPOSAL WORK
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Inspector__ —_ �A� i t i` + C �1 Building Permit No.
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Kind of Building 'S F D
SETS Installer_ license# L (a ` �
Septic Tanks
Material CLM ek 111 '�'��^-� Number of Tanks 3
Size f:"ll`JMO moi' 000 . / goo
drain Field:
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Total length of lines _ ` �9 _ _ _ Number of lines
Type of soil' Ctti Percolation Test V 6 1 4Ceti�-3-
Width of trench Type of filter material` G-" _ 6 r [c_
Size of Rork Bed Size of Absorption Area
Draw detailed diagram with measurements indicating distances to septic tank risers from a
permanent structure.
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