HomeMy WebLinkAboutSAND LAKE #2 BLK 7 LT 124
Olt -132 �2S
MUNICIPALITY OF ANCHORAGE
® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAMEp
E+�. �— v 41) �.S I A
�
PHONE 3
— �Q J
EW
❑ UPGRADE
MAILIN ADDRESS
r/d Ule-
LEGAL DESCRIPTION
LOCATION ' /
NO. OF BEDROOMS J
Uy
DISTANCE TO:
Well _D r
y
Absorption area
Dwelling / t
PERMIT NY,
U
F -Z
wF
Manufacturer /• n
Materials
No. of cc partments
y
Liq. capacity in gallonsInside
IF HOMEMADE:
length
Width
Liquid depth
y
DISTANCE TO:
We
Dwelling
PERMIT NO.
Oz F
Manufacturer
Material
Liquid capacity in gallons
❑
W =
DISTANCE TO:
Well '"
Foundation �l� 7
J
Nearest lot line
7
PERMIT NO.
J w z
Z w
�—CC
No. of lines
Length of eacc ine
Total length g Z7
J
Trench width
inches
Distance between lines
I...
❑
Top of tile to finish gradeMs-taterial
beneath tile
�� ��
inches
Total effective absorption area
Q A 0
W
C7
Length
Wid
Depth
PERMIT NO.
Q F
as
Lu
Type of crib
ib eter
Crib depth
Total effective absorption
area
LU
W
DISTANCE TO:
Well
Building foundation
Nearest lot line
_j
Class �
Nl �
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
r
Lo
f
.
PIPE MATERIALS
SOI L TEST RATI NG
INSTALLER
D W A/C_Ile
REMARKS
iJ lvEL�Lai
r
A
!%6
APPROVED DATE LEGAL
O It,// - P7
79413 (Rev. 3/78)
P19PHRTMENT ' � HEALTH AND ENVIRONMENTAL 7'8TECTI0W
, ^ 825 STREET, ANCHORAGE., HK.
° 264-4720
^ t-4 FE L_ L_ ��� CA P-4 I '-F F= �FEE ��� �F-:.' 1-4 1�
PERMYT NO. ( 810159 )
APPLICANT ��RLINESTHD
LOCATION WILCOX
LEGAL L12 B7 SAND LAKE #2
^ /
TYPE OF SOIL. ABSORPTION SYSTEM
MHXIMUM NUMBER OF BEDROOMS =: Z
2810 RUNESTHD CIRCLE
LOT SIZE
IS: TRENCH
|
,2/� �J��
' '
6750 SQUHRE FEET x
|
,SOIL RF
u/
THE REQUIRED SIZE OF THE --SOIL ABSORPTIOTEM IS
:JL.:JL EF P-4 0 -IF�� �- 0 Fe F::# %,rR E-- L_ EA F-- N�t, q U-1�
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) 81: THE TRENCH OR DRHINFIELD.
THE DEPTH OF H TRENCH OR PIT IS TH' DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCHYHTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH QF GRAVEL. BETWEEN THE OUTFALL. PIPE
AND THE BOTTOM OF THE EXCHVHTION (IN FEET).
���U I F--"lE7C6 �"ESEEF=`T I 8::�: �I 72EF-=
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT' THE WELL WILL SERVE.
-I- t1_1 cl < :a, > T P-4 _�_- 9=11 F=' C�'T 'r Cl P--I:� �R-C E-:--- �F-7 C. --g U 1 r-? F_-��
BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND
TO H COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND M[/ST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
rR I FREE E-ff EE 9::� FEE r-1 �- EZ F-." 22.1 J..
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
SIGNED: N.S.�D~_.~.~___.....�_
APPLICANT �
ISSUED BY �~ �HTE___ ..��� V4.0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
❑ PERCOLATION
TEST
Pouch 6650, Anchorage, Alaska 99502 276-2221
SOILS LOG- PERCOLATION TEST
PERFORMED FOR: '.►.l{-r\���Yl C.� 1 a.��/ DATE PERFORMED: Z-7 76
LEGAL DESCRIPTION:
DEPTH
2
3
4
8cza.r.N �i�-ry s'ANAy
6ce_ormLn!i
J "
5
7
8
9-
10
12
13-
14-
15-
16-
17
314151617
18-
19-
20-
COMMENTS
81920COMMENTS C
SLOPE
Re."^1Tapt
WAS GROUND WATER
�,f2A�wL C�ENCOUNTERED?
w+, 'M IF YES, AT WHAT
DEPTH?
I Z�.S�f/ISDa�
SITE PLAN J
Reading
Date
_
Gross
Time
Net
Time
Depth to
Water
Net
Drop
—
I
i
�
I
Reading
Date
_
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN FT AND
(minutes/inch)
— FT
PERFORMED BY: `sem! l �1�'� CERTIFIED BY DATE:
72-008 (7/7.6) -