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CITY OF <br />WORKSHEET FOR SEWAGE DISPOSAL WORK <br />�Ctdj <br />Date^�� . <br />t) 1 �1 QCs kr v� Ce Building Permit No. 2001 `— 00-3S I <br />Fee <br />Property Address' / i °q+� e� ' Kind of Building <br />Plumbing Contractor -Outside Sewage Disposal C -.04. -s <br />Septic Tanks ��(D4kVVj;k)}Material C�' e-wl-„�� Capacities_ — 1 �d <br />Proper Outlet & Inlet? Baffle Plates? <br />Drain Field: <br />Total length of lines Number of lines <br />Type of soil Percolation Test +' <br />Width of trench Type of filter material��`�� <br />Amount of filter material below line <br />Depth from top of the to finished grade <br />lL <br />Check Vents °' Check Caulking <br />Check Grade in Horizontal Waste Pipes t”' Clean Outs <br />Tonage or Yards of Filter Material IftV 6A-5- Total Sq. Footage of Drain Field <br />t i <br />Sand -tlx -- Rock % r }� ► t <br />r i f i <br />Overall Size of Mound System f Size of Mound System Rock Filter Material <br />Draw detailed diagram to scale with measurements below. <br />12 <br />PJ � <br />