HomeMy WebLinkAboutHOLLY HILL BLK 1 LT 12
) /'~'X MUNICIPALITY OF ANCHORAGE
t · DEPAF,. ,~IENT OF HEALTH & ENVIRONMENTAL Ph,~TECTION
ENVIRONMENTAL ENGINEERING DIVISION
· 825 L Street - Anch°~age, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME IPHONE
. _ . ~ UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION I
/_~ /~ ,~1o~ , ~]~,, ~])~ ~.
~LOCATION / / / NO. OF BEDROOMS
Well ~bsorpt~n area Dwellin PERMIT NO.
DISTANCE TO: /~0 ' /~' ~'
~ Z Manufacturer ~ ~ ~ Material.~ j No. ~mpartments
Liq. c~t~lons IF HOME,DE: Inside len~.~. Wide, ~. Liquid depth
~[ o,S~A.C~O: //~ ~' /~,
_~ ~ Z No. Of lines ~ Length of~,each line Total~lle~gth of lines mrenc~d~. ~ inches Distance~t~en lines
~ ~ Top of tile to finish grade ~ Material beneath tile Total effective absorption area
~ ~ Length W~dth Depth ~ ~ PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ :lass Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER .
.~.E ~AT~RiA.S
SOIL TEST RATING ~
INSTALLER
REMARKS
~ OF A~ ". ~z' O,.,~:
~. ~ ~v
PERMIT NO.
PILINIc:IF,-i.R..EIT~" OF' 'RNCH~R'RGE ~ i~
DEPRRTMENT r' 'HERLTH RND ENVIRONMENTRL'--~OTECTION
825 'L' STREET, 8NCHORRGE, RK. 9950t
264-4720
O~--SITE Si~liR iiRbl IT
828895 )
RPPLICRNT
LOCRTION
LEGRL
GRIL GREEN
L12 Bi HOLLY HILLS
?125 OL OLD SENRRD 99502 ~49-6561
LOT SIZE 999999 SQURRE FEET
TYPE OF SOIL 8BSORPTION SYSTEM IS: TRENCH
MR×IMUM NUMBER OF BEDROOMS
SOIL RRTING (SQ FT?BR)= 85
THE REQUIRED SIZE OF THE SOIL 8BSORPTION SYSTEM IS:
DFPTH:~ :~: ~,, ,[4 LEr4GTH= 22 GRRVEL B, EPTH= 6
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE E×CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GR8VEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
SEPT I C TR~K S I ZE= iOk~O ~]RLLFJY~S
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE WELL WILL SERVE.
T~,3 (2) I [~SPECTI~3F~S ARE RE~LII
BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL RND 8NY ON-SITE SEWRGE DISPOSRL SYSTEM IS
· 00 FEET FOR R PRIVBTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
PE~'M I T EY;P I RES DEF:Ef~IBER ~l., 19E:2
I CERTIFY THRT
l: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF 8NCHORRGE.
2: I WILL INSTRLL THE SYSTEM IN 8CCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
V4. 0
ENGINEERS, INC.
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
5
7
7125 OLD SEWARD HWy. /'""'~ ...... ~'~ so, cs 'LOG
_10
WAS GROUI~ID WATER S
1 1 ENCOUNTERED? ~ · OL
; P
12 E
IF YES, AT WHAT
DEPTH?
SOILS LOG - PERCOLATION TEST
13
PERCOLATION
TEST
DATE PER FORMED:~~i~__
Depth to Net
Water Drop
(minutes/inch)
~.,,,..,,.,g/~ '",....2 ,:,.",-,.,,
·
ANCHORAGE, ALASKA 99503
~49 - 6561