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Inspector <br />CITY OF INDEPENDENCE-* <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />< <br />Date — 2 2"/e <br />Building Permit No. 7_0c>`! " e) C_" <br />Owner r.C} W -c t-,�3 % (– 6CJd 1-11"141 Fee <br />Property Address -110 of Kind of Building <br />Plumbing Contractor -Outside Sewage Disposal i' A `1 �a d"`;�`� <br />Septic Tanks 9 <br />Material �'- n'�� <br />(OAVWQ� Capacities 1 <br />Proper Outlet & Inlet? `' Baffle Plates? <br />Drain Field: 1 <br />Total length of lines; Number of lines <br />Type of soil 15 ��� Percolation Test " �s <br />Width of trench Type of filter material <br />Amount of filter material below lined <br />Depth from top of tile to finished grade <br />Check Vents v� Check Caulking <br />Check Grade in Horizontal Waste Pipes Clean Outs <br />Tonage or Yards of Filter Material 'g 5 `9 5 Total Sq. Footage of Drain Field <br />Sand 2- X i Rock <br />�r <br />