HomeMy WebLinkAboutALPINE WOODS BLK 4 LT 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Address ~ SEPTIC TANK ABSORPTION FIELD WELL
Phone(s, I Permit No. [ No of Be:~..oms WELL ~2~0! ,,~ ~c"~ o!
Townsmp. Range, Section AS-BUILT DIAGRAM (Show Iocabon of well, septic system, properly hnes, foundation,
TANKS U
Capacity m gallons [. ~ :~i d I
Matebal No. of Compa~ments ~ ~. ;, O ~
~TRENCH BED ~ W. DRAIN ~ OTHER ~ ,~'~{' ~'-
Depth to p~pe bottom from Total depth from original grade
Fdl added above original gra~e Gravel ~epth beneath p,pe
Gravel length Gravel width
Tmal absorption area Oi~tan~e between Jmes ~
Number BI lines Sod rating Pipe material
Installer ~' i~ Date Installed U
WELLS
g PRIVATE ~ OTHER (Identilvl ~ ~.~
Installer Date Installed: ~ t'-- /7
V
Scale: ENGINEER'S
Inspections Pedormed by:
I ~ t ~ tc~ ce~ily that this inspe~ion was pedormefl according to all
72-013 (3/85)
Municipality o! Anchorage
DEPARTMENT OF H~A.~ ~ HUMAN S~¢M;;:
825"E" Streel Anchorage Alaska 995'02-0~/
SOILS LOG -- PERCOLATION TE~T~- ~ /
PErFOrMED FO~:
' SLOPE SITE PLAN
I
'~m...~ ~"~r Net Depth to Net
Reading Date Time Time Water Drop
s
L
IF YES, AT WHAT O ~.
DEPTH? P ~ ~
13 ~oniloring? 0zig: , ~
14
15
16
17
18
19
2O
PERCOLATION RATE ~ (minutes/tach) PERC HOLE DIAMETER
-/ . ./,,'
V '
72~ (R~. 4/85t
.SEWER SYSTEM 'LOCATION PLAN.
~:,~ S~CT ION / TOWN SHIP/R ANGE
~~~ ''.' ~ 5o"/- ~ .ccu..c~ o~ ~oc
PROPERTY CORNERS~ WELLS, AND SEPTIC
~ ' DRAWN BY~ SYSTEMS INDICATED IS NOT EXACT.
......... DETERMINED BY USE OF CLOTH TAPE AND
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-~.~ / .. ~ ~M- ~ :~ F:. .. ~ : .~¢ .:~: +. :~: ~: PREPARED FOR,
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