HomeMy WebLinkAboutPRATOR BLK 4 LT 2017
-' · MUNICIPALITY OF ANCHORAGE "~. ,S
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
NAIV ~.HON E ~.1_ EW
' DISTANCE TO: I'Well ~ /~ Abs°rpti°n ap/~ Dwelling ~/~
~ ~ Manufacturer Material N~ of compartments
~ Liq. capacity in gallons Inside length Width Liquid depth
.- IF HOME.DE: --
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ~ Manufacturer Material Liquid capacity in gallons
= ~ ~ Well Foundatio~ ¢ Nearest ,otlinT~ ,
~ DISTANCE TO: l/¢ / . PERMIT "O.
~ grade¢~ Material beneath til~ ~/ inches
-- No. of lines/ Length of 7~nr Total ,en~yi~s Trenoh~ Distance
~ ~ ~ Top of tile tb finish
~ inches Total effecti [/~¢tionv~Bs~rp
Length I WiCth Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
¢ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO,
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
SOIL TEST RATING
72-01 (Rev. 3/78~
DEPFIRTMENT 'x... HEBL. TH F~N[:, EN',,,' I RONMENTRL ~. ~$:.'OTECT I ON
825 "L'" 5;"FREET,
ED~'-~ .... .'E?; Z TEE
PERMIT NO. ( 79E1474 )
RRY F. JONES
RRBBIT CREEK RD
L2 B4 PRR'rOR S~'D
RPPL. ICRNT
LOCRTION
LEGRL.
LOT SIZE 87J.2(~ SQURRE FEET
TYPE OF SOIL RBSORB]"ION SYSTEM IS: TRENCH
MRXIMUM NUMBER OF BEDROOMS
SOIL RRTING (SQ FT,-."BR)= 2~20
THE: REQUIRE[..' SIZE OF THE SOIL RBSORPTION SYSTEM IS:
THE LENGTH DIMENSION IS THE LENGTH (IN FEET.'.', OF THE TRENCH OR [)RRIF,!F'IEL. D.
THE DEPTH OF R TRENCH OR PIT IS THE [:,I':.]TRNCE BETWEEN THE SURFRC:E OF ]"HE
GROUND RND THE BOTTOM OF THE E,'-.,',CR'¢RTION (IN FEET).
THERE IS NO SET HIDTH FOR TRENC:NES.
THE GRF¢,,,'EL [.',EPTH IS THE MINIMUM DEPTH OF' GRRVEL BETWEEN THE OUTFRLL PIPE
RN[:' THE BOTTOM OF ]'HE EXC:FP/RTION ,'IN FEET). ~,
F'ERMZT FIPPLICRNT HRS THE RESPONSIBILIT'¢ TO INFORM THIS DEPFIRTMEN"r DURING THE;
INSTRLLRTION INSPECTIONS OF RNY WELLS FIDJRCENT TO THIS PROF'ERTY RN[:' THE
NUMBER OF RESIDENCES THRT THE WELL WILL. SERYE.
BRCKFILLING OF RNY SY.STEH WITHOUT FINRL INSPECTION RND RPF"ROVRL BY THIS
[:,EPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R HELL AND RNY ON-SITE SEWRGE: DISPOSRL SYSTEM IS
±00 FEET FOR R PRIYRTE WELL; OR
t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON '['HE TYPE OF PUBLIC WEL. L
OTHER REQUIREHENTS MFW RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGF.:RMS RRE
R',,,'RILRBLE TO INSURE PF.".OF'ER INS'FRLL.RTION.
I CERTIFY THRT
±: I RM FAMILIFtR HITH THE REQUIREMENTS FOR ON-SITE SEWERS RN[:' WELLS FIS SET
FORTH 8"r' ]"HE MI..INICIPRLIT"¢ OF RNCHORFtGE.
2; I WILL INSTFiLL THE SYSTEM IN FICCORDFtNCE kIITH THE CODES.
Z'.':: I UN[:'EF.:STRN[:' TPIF4T THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODEl_E[:' TO INCLLI[:'E MORE THFiN 5 BE[."R. OOMS.
............................
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-6§0, Anchorage, Alaska 99502 276-2221'
SOILS LOG- PERCOLATION TEST
PERCOLATION
· T EST
PERFORMED FOR:
LEGALOESCR'FT'O : £ 8 q
I ~.1~ L.
2
3
4 15'/z ~ '/'
5
6
7
9
DATE PERFORMED: ~'[~ 77
LOPE
SITE PLAN
10
11
12
13
14
15
16
17
18
19-
20-
COMMENTS 7'fL ~"/'~/ (',~ Y/''~'} U t 6
WAS GROUND WATER
ENCOUNTERED?
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
/ [7-i4 //:~ o~ Z'~~'
PERCOLATION RATE ~. ~ (minutes/inch)
TEST RUN BETWEEN -~ . FT AND ~ , FT
rd .M,4~'6A
PERFORMED BY:
72-008 (7/76)
GA/~ Y
DATE: