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v - IN - - I • ► - RVICES, ' - . •• •-• . , •• 0 <br /> CITY OF O/rr'} Ci <br /> WORKSHEET FOR SEWAGE DISPOSAL WORK <br /> Date <br /> Inspector Wt.! i - i hbs Building Permit No. <br /> Owner l2')rri ✓'S"L�" Fee <br /> Property Address 9100 w e g f��q R-a, Vii' ind of Building 5 O <br /> Plumbing Contractor-Outside Sewage Disposal5 5 <br /> y <br /> Septic Tanks <br /> Material (Q1/tCNe-4'e 'DA....,-,- Capacities `,—1 U <br /> Proper Outlet & Inlet? Baffle Plates? 'f <br /> Drain Field: <br /> Total length of lines 3Z.) Number of lines 3 <br /> /�l " Percolation Test `3 5 0 I SC/1,Type of soil <br /> »>> <br /> c <br /> Width of trench Type of filter material <br /> Amount of filter material below line <br /> Depth from top of tile to finished grade <br /> .. Check Vents t...------- Check Caulking '� <br /> Check Grade in Horizontal Waste Pipes t`_,./ Clean Outs <br /> Tonage or Yards of Filter Material Total Sq. Footage of Drain Field 363 <br /> Sand 2O v v,7S• S,4,4c�') Rock /0 '/ 3 8 <br /> Overall Size of Mound System ]-)(1 /' Size of Mound System Rock Filter Material I /Z-1 <br /> Draw detailed diagram bto scale with measurements below. , . <br /> W <br /> / Ai <br /> ---ix, <br /> >a <br /> . \ <br /> Y,•11e✓ <br /> lkI <br /> CO <br /> .3' <br /> 7! I— 5 2- <br /> 2_:" z <br /> 3 . V3 , <br /> 0 .---------7------ <br /> 2 $ b <br />