HomeMy WebLinkAboutPREUSS #3 BLK 10 LT 3
, ~.J' MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telex)hone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAI UNG AD~R ESS
LEGAL DESCRIPTIQN
LOCATION NO. OF BEDROOMS~
DISTANCE TO: .
Liq capacity in gallons Inside length Width Liquid depth
~ ~ DISTANCE TO: Well ~ ~ / DweHin~ PERMITNO.
O ~ < Manufacturer Material Liquid capacity in gallons
~~ ~ NO. of lines I Lengthsso, each line Total ,en~of ,~ne, Trench w,~o inches Distance between lines ~
~ ~ ~ Top of tile to finish grade , Material beneath tile Total ef~t~so~ion area
~ ~ ~ inchas
Length Width Depth PERMIT NO. '
~ ~ Tgpe of crib Crib diameter Crib depth Total effectNo absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class ~th Driller Distance to lot line PERMIT NO,
~ DISTANCE TO~ Building foundation S~wer line Septic tank ~ Absorption
OTHER
PIPE MATERIALS ~ ~J~ a
SOIL TEST
INSTALLER ~
R~MARKS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
DATE PERFORMED:
SLOPE
10
11
12
13
14
15
16-
17-
18-
19-
20-
~obert A, .~a'~err
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
PERCOLATION RATE '--/A (minutes/inch)
TEST RUN BETWEEN FT AND -- FT
CERTIFI
72-008 (6/79)
=.R ANCHORAGE AREA
Department of Environmental QuaJity
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER ~ ~/~(~
INSIDE WIDTH
MATERIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY /~)00 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS I DIAMETER ~.,gt OR WIDTH 17',
LINING MATERIAL ~'~C~;~ CRIB SIZE: DIAMETER
BUILDING FOUNDATION__ NEAREST LOT LINE '~/~
ADDITIONAL ABSORPTION
LENGTH/7( DEPTH /7.-'
DEPTH ~.~I DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) g0~'~
SQ. FT.
TYPE CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION_ LOT LINE SEWER LINE
CESSPOOL
., OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES:
INSTALLED BY:
REMARKS
LOT SLOPE:
REMARKS:
Form No. EQ-031
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK __ SYSTEM
DIAGRAM oF SYSTEM
A P P R O V~/~G/.~A~.A .~. &
uep~ -.'len~ or ,~nvl ron~nenta I [~ua I i ty
~ , ' 3330 "C" Street x~,,j,'
. , '~,mchorage, Alaska 99503%
Perfon~ed for '~ ~%~¢¢ Date perfo~ed
?his ~J~ reports: Soils log ~ ~ation test
Depth
Feet
1-
I1-
13-
Was ground water encountered? D~ If yes. at what depth? .......
Reading ' Date ] Gross Time Net Time Depth to H201 Net Dr(
P
'Percolation rate minute. .
Proposed installation: Seepage Pit ......... Drain Field
Depth of Inlet . Depth to bottom of oit or trench '
Performed By: //6-~--.-.~~ .Certified By: Date:
~ ~':/ M-~V DRILLING, Inc.
P. O, ,Box 4-]224 * 13]0C International Airport Road
(907) 274-461 ]
ANCHORAGE, ALASKA 99509
DRILLING LOG
Well Owner Ted 1,1oGre
Use of Well Dom
Location (address of: Township, Range, Section, if known; or distance main road
Size of casing
Depth of Hole ~9~ feet Cased to 591 feet
Static water level 5~)O ft.
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at 10 gallons per of drawdown from static level.
(below) land surface. Finish of well (check one)
None
open end ( X );
(minute) for 1 hours with 100~
Date of completion 29 00% 74
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
Surface Organics
0 TO 2
2 TO 12
12 TO 100
iOOTo 12~
125TO 126
12~ TO_ 270
270 TO 27,~
272 TO 285
285 TO 508
508 TO 515
515TO 559
}_59 TO
564 TO 570
570 TO 590
590 595
Silty Gravel
Cobble Gravel:
siltv~ tillaceous, undifferentiated
Hardpan Till: cobbly
Boulder
Hardpan Till~ cobbly
Bou~der
SandF Gravel
Hardpan Till: gnevelly
__ $an~v Grmv_el
Gravelly HardpanL_ tillaceous
Doulder
Gravelly Hardpall
Bonlders
,
,"ayne E. ,'.'estb~
Harman: tSllaceml~
l:edium h'ater Gravel: good ssturation