HomeMy WebLinkAboutCHANDELLE ACRES LT 6000
. 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
NAME IPHONEI ;:w
MAILING ADDRESS
L~GAL DESO~IPTION
LOOATION NO. OF BEDrOOmS
DISTANCE TO: I~o~I Ab~°~"i°~:r~a D~"Hiy~, PERMIT NO~ OO~
~ Z Manufacturer J Material No. of compartments
kiq. capaciW in ~all6ns Inside length ~idth liquid depth
~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
~ -- ~ Manufacturer Material Liquid capacity in gallons
Q ~ Foundation t Nearest lot line ~ PERMIT NO,
~ ~ DISTANCE TO:
Lengt~of each line , Total le~ines v Trench widt~ j Distance between lines
~ ~ ~ No. of lines ~ ~, .~. ~. $ ~ /~~- i~s
~ Top of tile ,o finish grad,..__ ~'~ ,' ' Material beneath tile /' -~=ahas Total effect~e~o~tion area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ . Well Building foundation Nearest lot line
~ DISTANCE TO:
C~~~ ~ Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
I
DISTANCE TO:
OTHER
PIPE M~TERIALS ,
SOl L TEST RAT~G
REMARKS
-
APPROVED DATE LEGAL
72-013 (Rev, 3/78)
'3F:':,.JNE', F~N[:' THE E:O'T'Ti:i?i :)~:' T'F.~E E?:(::F¢¢F:F?':[01'4 ~' ~H FEET
THE F~F'~::~'-::; E'E':'"r~4 :::.E: 'T'HE hi!NZNLL" E:,E?TH OF:' GF:F:F.'Ei .... E:ETWE::E:N THF: O...TF:.::iLL.
~,.i:., ~4E' E,:~TT'E¢',! C,::' THE: ELNE:~VFf"F]JCfi'.,~ ~': .EN F'EE:J'T'.,.
~SOI LS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
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2
3
4
5
6
7
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9
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
~PERCO LATION
TEST
10
11
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13
14
15
16
17
18
19
20
Gross Net Depth to Net
Reading Date Time Time Water Drop
_/./~ ,d 7/-2 /.).~,F (.,Y .~.n,~
· -- ,. 4'¢,¢ '/b .~.,0~
WAS GROUND WATER S
ENCOUNTERED? ~ OL
/
P.
IF YES, AT WHAT ~, ~' E
DEPTH?
72-008 (6/79)