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Inspector <br />01201tO C <br />CITY OF (7637 <br />e✓ <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />Building Permit No. <br />Date Z 2,5- %S <br />Owner 1UCVt� c Fee <br />Property Address 'L/3 SO u+.iia eA->1'1_ Kind of Building 5 i 2 <br />i <br />Plumbing Contractor -Outside Sewage Disposal— Z M <br />Septic Tanks <br />Material -Capacities 2— ZSZ' //300 <br />Proper Outlet & Inlet? 4 Baffle Plates?— <br />Drain <br />lates? <br />Drain Field: / 1 <br />Total length of lines �Q / Number of lines <br />Type of soil Percolation Test <br />Width of trench Type of filter material <br />Amount of filter material below line Y /� <br />Depth from top of tile to finished grade <br />Check Vents <br />Check Caulking�� <br />Check Grade in Horizontal Waste Pipes —Cl ean Outs <br />Tonage or Yards of Filter Material Total .Sq. Footage of Drain Field td o <br />Sand Rock lJ )c:5d S L — S <br />Overall Size of Mound Svstem <br />Size of Mound Svstem Rock Filter Material <br />