HomeMy WebLinkAboutELDON BLK 1 LT 9
i~~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
,. ENVIRONIV]ENTAL ENGINEERING DIVISION
, ~-~ L~/~// 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE
MAIUNGADDRES~~ ,~ ~ ~ ~7
LEGAL DESCRIPTION
: Well ~ Absorption area Dwelling PERMIT NO~
DISTANCE TO: [ O~ ' '~ ~
~ ~ Manufacturer
' ~Y~¢ IF HOMEMADE: ,nsideiength ~ Width Liquidde~th
B~ DISTANt- Well Dwelling PERMIT NO.
~_HO < ~rer ~ Mate~, .............
~ Well ~ Foundation Nearest lot lin~_ , PERMIT
Trench w~th ~ ~t~nes
~ ' Z No. o~n~ Length of .~in~ Total length of ,ic~¢ Distance
-~. <finches Total effective~r~area
h~ Top of tile to finish grade ~ f Material beneath tile ~ ~s
Length Width Depth PERMIT NO.
~ ~ / ~ ~ Total effect ve absorption ar~.--~
~ ~ /DISTANCE TO: Well Building foundation ~ ~
} ~ ~ JJ~ Depth Driller Distance to lot line PERMIT NO.
DEP~RTMENT' ~HEALTH AND EN',/IRONMENTAL 'OTEOTION
825 ~L' STREET, ANCHORAGE, AK.
264-4?20
O~--S I TE SEI4ER
[,.I E l::::: L AFJD PEAr,1 I
P~RMIT' NO. ( 8oo17i >
APPLICANT REGINALD YAPLE P.O. BOX ~-~987 272~6606
LOCATION BILL & DIVISION ST.
LEGAL :~~7~:~i:-.EE:~O.~S~B~: LOT S I ZE i1~50 SQURR~
TYPE OF SOIL 8BSORF'TION SYSTEM IS: TRENCH
MRXZMUM NUMBER OF BEDROOMS : ~ SOIL RRTZNG (5~ FT/BR>= i25
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C~EPTH= 12 LEt4GTI I= 24 GRAVEL DEPTH=
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 AND THE BOTTOM OF THE EXCAVATION <IN FEET>.
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET>.
REL-~LI I RED SEPT I C TFiNK $ I ---'E: I 000 GFILLOI"-,IS
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 HILL SERVE.
TH[, < 2 ) INSPECT I ObIS ARE REQLI I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINRL 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 R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVRTE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEWER LINE IS 75 FEET.
HELL LOGS ARE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTRLLRTION.
PEArl I T EXF' I RES DECEr'IBER $,1,,.. J. 980
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UN~ERSTRND/-~HRT THE ON-SITE SEWER SYSTE~ MAY REQUIRE ENLARGEMENT IF THE J
.O & E ENG.AEERING & DEVELOt ,vlENT CO.
Russell Oyster
694-2774
Performed for:
Legal Description:
Depth (feet)
0
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Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
SOIL LOG
Name: //~, ~''~'~'' ('~~'~°z- ~'-
Mailing Address:
Earl Ellis
688-2280
Soil Characteristics
PLOT PLAN
PERC. TEST
15~
16 :,~.~,,~ o~= ~
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
No If yes, what depth
Drain Field /
Comments:
Performed by:~-~.
Date: JOPE: /.
MESSAGE
REPLY
Redi~rm® 4S 471
SIGNED
SEND PARTS I AND 3 WITH CARBON iNTACT .
PART :3 WILL BE RETURNED WITH REPLY.
~u v 'oN :Huaaod
,,,-)
"4
RECEIPT Date,.~u~L ~ 19__~_~ ¢734
ACCOUNT CASH
BA~NCE ~
~ Redi{