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Sep~ ~nk: Mi~lmu~ liquid ~0~cily with ~l~lHbution b~_ <br /> <br /> h <br /> <br /> W.ter supp y: Pub ic syntem ~~lndivlduol well ~ ~ Community; system ...... <br /> Septl~ onk: Distance fr~ wetl~ ~ ~ ' ., ,.feel. Material,~"~ /~_C' ~ ~ '~j ~No. <br /> <br /> Oiameter~, ft. Liquid depfh ,,ft. <br /> Tile disposel field: Distribution b~x? Yes~ No ~ Other ,, ...__ ....... ~ <br /> <br /> Length of each line~ , ~ .,~ <br /> <br /> Dislonce between lines. ' .,, ~ ~ -fl, Lot llne; Front ~ /Side ~ Rear ~ <br /> Foundotle~__ ~ ft, <br />Type o~ filter moterioh Gravel: ~,~ Other,, Depth beneath lile ~ <br />Depth of filter materiel over tile ~ ......... inches. Depth at tile bel~ original grou~d surface_ <br /> <br /> Sketch of instollollon. , <br /> <br /> Note: In,cote Northerly direction, <br /> InSpection will not be made until completed form is returned to th.e,,,l;~u~, Dept_ <br /> ............. .._,, . <br /> . ~ ~,~.,. ¢ <br />DAT~ ............ S[gnolure of tns~lle~ ,, ;, ~,~-,~ '[ <br /> <br /> ~FOR HEALTH OE~. USE) <br /> <br />Syste~ apparently will ~ will not ~ function ~otJsfoctartly, and ~s therefore approved ~ Disapproved ~ <br /> <br /> .. <br /> <br />Copies: [1) Odg. HD Files (~ITAR~) ~. <br /> <br /> <br />