HomeMy WebLinkAboutDEBORA BLK C LT 51
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\ 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
NAMELs
A
7 l^
PH NE
��y�GJ�
(]NEW
PGRADE
MAILING ADDRESS 9a � � CA(( �-
LEGAL DESCRIPTION
LOCATION G �--+•
NO. OF BEDROOMS
oDISTANCE
TO:
Well 1
Well
'f'
Abs orppon area
DwellingR
Dwelling d
C
sT O.
PE.7
-7.3
:1e
EZ
WF
Manufacturere,e/
Mate Q
No. ofc mp tments
Ligq t vallons
`J(JL/
IF HOMEMADE:
Inside length
Width
Liquid depth
d Y
Jt�2
DISTANCE TO:
Well
Dwelling
PERMIT NO.
_?
Manufacturer
Material
Liquid capacity in gallons
O
1
DISTANCE TO:
Well ,�-..
Foundation q/ /1
L Tom'
Nearyst �nt-ke
/U
PEH f N
37�
r Z
F-? W
No. of lines
Length of each lin
Total leng o ines.sf..
Tran h •idtl},7.
inches
Distance t �n 1' s„
I7
.I..
0
Ton of ble finish grade
Mat9r I reneath Y e
2 �Z�1-rf Ct.Q/�inches
Total of tective absorption area
W
Length
Width
Depth
PERMIT NO.
a s•
o.
Wd
Type of crib
Crib diameter
Crib depth
Total effective absorption area
t"
DISTANCETO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
7.7I,N
PIPE MATERIALS
I/G
SOILTESTRATING
INSTALLER
REMARKS
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DATELEGAL
APPHOVED��
72.013(Rev.3/78) r
MU" I C I rFIL- I TY OF n",=H(DF2FiGE
DEPARTMENT Q"1 HEALTH AND ENVIRONMENTAL e-OTECTION
• = 825 'L STREET, ANCHORAGE, AK. 99-11
264-4720
Ot�l-S~ I TE E}EW ER PERM I T
PERMIT NO. C 800373 )
APPLICANT MARTIN HANNA SR EX 9030 CHUGIAK 694-2420
LOCATION ER
LEGAL I"LT.S'BLK.0 DEBORA`SYDl LOT SIZE 17500 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FT/BR)= 184
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
F?EPTH= 1.2 FLENOTH= 443 OMn EL_ E>EF}TH= ?
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
I�EG!U I RED SEPT I G TF3tJFC '-'=; I ZE= 1.000 GFlL-L C-'Nn3
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.
--- TWO C 2 ] I FJSF='ECT I OtJS FIRE REQU I REE> ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND
TO A COMMUNITY SEWER. LINE IS 75 FEET.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERMIT EXP I RES= E?ECEMGER �1
I CERTIFY THAT
1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWERS
FORTH BY THE/FUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERS ND TAT THE ON-SITE SEWER, SYSTEM MAY REQUIRE
RESIDENCE If`REM DOLED Tf-nINQLUDE MORE THAN 3 BEDROOMS.
SIGNED:
15"00
AND WELLS AS SET
ENLARGEMENT IF THE
ISSUED ------- V4. 0
❑ SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
Pouch 6650, Anchorage,Vaska 99502 2762221
SOILS LOG - PERCOLATION TEST
7
PERFORMED FOl/j r/ / / /// DATE PERFORMED: om
O: I
(t
,LEGAL DESCRIPTION:- '-/ 6o rCL S /P I I
7619 5 o / L
51Lry S in
PekoL11Vc,J
100
Wr[,c,
gr6sr l'
COMME
PERFORMED
72 003 (7176)
Reading
Date
WASGROUNDWATER��
L
ENCOUNTERED?
Net
Drop
D
2;2ts
P
�y
E
IF YES, AT WHAT
t'
DEPTH?
elt� "')
it,
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
2;2ts
—
�y
—
2
t'
z • $
elt� "')
it,
z ,
3/
zS
10
IF
PERCOLATION RATE 15�(minutes inch)
DATE: