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2. Indicate whether the following facilities are present. <br /> Floor drain yes no >e Number of drains _ <br /> Food waste grinder yes no )t <br /> Dishwasher 'yes no X <br /> Automatic clothes washer yes no x Number of clothes washers <br /> 3. Septic tank capacity 90c) 1!j! 45 -L.0 {30 = SoO�• <br /> Holding tank capacity <br /> Septic or holding tank manufacturer �Kn„) i�vL+cRsr <br /> 4. SEEPAGE TRENCHES : total square feet _�7 width of trenches <br /> length of trenches 35' depth —6D" (eve -a-4e-d—. <br /> number of trenches <br /> SEEPAGE BEDS : total square feet q width 1IA <br /> length. of bed n A depth I& <br /> SEEPAGE PITS: total square feet rV A outside diameter n!A <br /> depth below inlet rn/A <br /> T <br /> total depth from top to bottom of pit r a <br /> ignature of e son completing form: FOR DEPARTMENTAL USE ONLY <br /> M & K <br /> & MAVATION <br /> Address NCR 59, Box 478d <br /> er,11V1-54801 <br /> zip (715)635-7482 <br /> Telephone Number <br /> Date 11 130 �L <br />