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HEET FILE CITY OF EDMONDS
LOT APPROVAL STREET,,*")0'/ tk. U-),
NAME ADDRESS
ADDRESS OF �PROPOSED BUILDING
PTION: LOO CK� ADDITIONJd r �V,
LEGAL DESCRI 'W S
TYPE OF USE 2E�"N6,76F BEDROOMS iZE OF LOT 0 0
SOURCE OF DRINKING WATER: Public Supply Private Well
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a. SURFACE DRAINAGE
i.0 1. Is disposal field site well drat
2. Any water course (stremnldrain g:d it -etc.) through site?
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b. TOPOGRAP
1. Any heavy slopes in'field--,a'rea?..'
. im n
2.. Will present topso4- field area'b6 removed or graded before field tiles -
are installed? 6W
3. Will any f ill mate ial b uVd in the disposal field, site?
If yea., how much?
SOIL CONDITIONS
1. Has -a hole at least 4 feet deep be d the disposal field area to deter-
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mine the type of*soil present?
2. After hole is dug record the soil Afonditions at the following depths. (Re-
cord.as sand., gravel.,,play,, packed sand,, loam., et
12 inches ff*_;� 30 inches Aw
19 inches- .36 inches,
24 inches 1.8 inches
3. Any ground water encountered before reaching34dTe4pth'/Zof Z4- iaeete?__�
If so at what depth?
d. WATER TEST
A simple water test will show how well this soil will drain or percolate water.
To perform this test:
1. Dig hole at least 36 inches de . -ep. Use a shovel or post hole digger —
size of hole makes no difference_'�-_only depth.
2. Fill hole with water.. Now let all'water run out of hole. This soaks
the ground and'will,givq a more ac I curate reading.
3. Again pour water inhol-.6".�to a height of 12 inches from the bottom.
Let water run out until -there is just 6 inches from bottom left -in hole, N,
4. Note how many minutes it takes for this last 6 inches to seep away..
Record this time below, I r\,t.
Number of minutes for last 6 inches to seep aw,, N)
5. Divide this time by 6 to obtain the rate per ii ch
6. Date water test was performed -
I hereby certify the above information to be
performed by me as prescribed.
NOTE:
there
result
Signed C' -194
Address-2-101.
A septic tank permit is issued on the
ct and the above tests were
are any changes or alterations in the above stated
in the installation being rejected at the time of
above inf6rma..�on. If
soil.conditions it may D
inspection. D
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